In the high stakes world of graduate school admission, getting a few additional points on an entrance exam like the GRE, LSAT, MCAT, or GMAT can make the difference between a lower tier versus a top tier law school. For instance, the median LSAT scores for Stanford Law, Harvard Law, and the University of Chicago Law School in 2017 were 171, 169, and 170, respectively. Alternately, the average LSAT score for smaller, regional schools like St. Mary’s Law School in San Antonio and the South Texas School of Law in Houston were both 150. Thus, it pays to squeeze out a few extra points on an entrance exam. And we mean it pays – literally. The average starting salary (median) of a newly minted lawyer from Harvard falls at $143,000 and a lawyer fresh out of the St. Mary’s school of law school pulls down approximately $65,500.

Because of the sense of desperation created by the desire to be admitted to the best law schools, testing companies such as the Law School Admissions Council, the organization that offers the LSAT, fiercely protect the integrity of the test to defend against cheating and fraudulent accommodations requests. This means that they keep upcoming tests under lock and key. Further, they have multiple layers of security to ensure that no student gets an unfair advantage.

Regarding fairness, academic accommodations are essentially conditions under which “disabled” students can participate in class and take tests that are designed to compensate for weaknesses associated with a given disability. Common physical disabilities are blindness or motor deficits associated with conditions such as cerebral palsy or multiple sclerosis. For instance, if someone is blind they may have test books printed in braille, and if one cannot physically write, they may be permitted the use of a scribe. Notably, there are other “disabilities” that may be less apparent to others. These include Attention-Deficit/Hyperactivity Disorder, Specific Learning Disabilities in Reading/Math/and Written Language, Auditory and Visual Processing Disorders, and emotional conditions such as Generalized Anxiety Disorder, Panic Disorder, Major Depression, and Bipolar Disorder. All these conditions can affect the ability to learn. For instance, a 2011 study titled “Cognitive Impairment in Bipolar Disorder” by Latalova, Prasko, Diveky, and Velartova, found that even bipolar patients whose mood was stabilized through medication still had deficits in concentration, cognitive processing, and memory.

For many of the above psychiatric conditions, especially ADHD, diagnoses are made in childhood and the individual has a lifelong history of assessments, medication treatment, and a “paper trail” of accommodations. In fact, when reviewing requests for accommodations, tests like the GRE, GMAT, LSAT, and MCAT, look for a historic “paper trail” documenting a person’s illness throughout their life. The reasoning goes that if someone has a long history of accommodations, they are more than likely submitting a “valid” accommodations request, as opposed to someone who is diagnosed in college, who may be “gaming the system.”

It is unfair, however, to cast a suspicious eye on students who are diagnosed in later life. The fact is, ADHD is ubiquitous among the adult population. The National Institute of Mental Health reports that 4.4% of U.S. adults have ADHD (that translates into approximately 13,000,000 people). Because many cases of adult ADHD are diagnosed later in life, these often bright and hardworking students have never had accommodations in school. This does not mean they have not suffered, however. An article in the American Journal of Psychiatry in 2006 (Am J Psychiatry. 2006 Apr, 163(4):716-723) reported that 38.3% of adults with ADHD had mood disorders and 47.1% of adults with ADHD had anxiety disorders. For students with ADHD working almost inhuman hours to “make the grade” because of reductions in cognitive efficiency, it is often the stress associated with school that leads to mood and anxiety problems. Fortunately, psychoeducational testing can identify that these students have ADHD and can in some cases help them attain accommodations. Students with adult onset cases of ADHD should not be denied accommodations simply because they were diagnosed at a later age.