Neurocognitive

Acquired neurocognitive impairments are those caused by injury (e.g., traumatic brain injury/concussion, penetrating head wound, blast injury) or disease process (e.g., stroke, bacterial meningitis).

For Test Takers

All requests for accommodations for ABIM examinations based on neurocognitive impairments should include the following pieces of documentation:

1. A completed accommodations request form (pdf).
2. A signed Verification and Release Form.
3. A personal statement containing the following. (You can use the request form above to complete your personal statement.)
   • Your name and contact information
   • Title of the exam for which you are requesting an accommodation
   • Description of the specific accommodation you are requesting
   • Description of any alternative accommodations.
   • Description of the nature of your impairment, including:
   • When it was first identified or diagnosed
   • When it was last evaluated and/or treated 
   • The name of the professional who evaluated and/or treated the condition
   • How your impairment is accommodated in your daily life
   • A list and, where applicable, documentation of past accommodations you have received for standardized testing or in academic settings. If you have received no previous accommodations, then you should provide an explanation for why no accommodations have been received in the past and why accommodations are necessary now.
4. A professional report confirming the presence, nature and extent of your impairment and the need for specific accommodation. Professional reports should be by a qualified and licensed/certified professional with specific and appropriate expertise evaluating adults with the impairment that you have. See the “For Evaluators” section below for details of what the professional report should contain.
5. A comprehensive neuropsychological evaluation conducted by an appropriately qualified professional. The evaluation should include assessments of intelligence, memory and brain-sensitive neuropsychological functional limitations caused by your condition. Testing should be sufficiently recent to describe your current limitations and the limitations that can reasonably be expected to be present at the time you take the exam for which you have applied. If you are still in a process of recovery and have not yet plateaued, then the evaluation should be sufficiently recent to reasonably be assumed to describe your anticipated limitations as of the time of your ABIM examination. See the “For Evaluators” section below for details of what thecomprehensive neuropsychological evaluation should contain.

Note: Past failure of ABIM examinations does not, in and of itself, constitute objective evidence of a functional limitation due to a disability.

For Evaluators

Your professional report shoud include:

• Your name, address and phone number 
• Your area of specialty/expertise
• Description of the specific functional limitations caused by the test taker's impairment that require accommodation
• Description of the accommodations recommended by you
• Description of the history of treatment and/or rehabilitation efforts that the test taker has received for their impairment
• Documentation addressing whether the test taker’s impairment substantially limits one or more major life activities within the meaning of the ADA
• Objective evidence of functional limitations:
  • A list of all standardized test instruments and assessment procedures used to diagnose and evaluate the functional impact of the test taker's impairment
  • Date(s) of assessments and/or treatment contacts upon which the evaluator’s report and opinions are based

Your comprehensive neuropsychological evaluation should include:

• A diagnostic interview addressing the test taker's premorbid level of functioning both in academic and professional settings, as well as premorbid functioning in the context of standardized evaluations such as the SAT, MCAT and prior board examinations.
• A comprehensive and complete assessment of aptitude. The recommended evaluation procedure is the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) because abbreviated measures such as the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II) do not provide a complete picture of the test taker's relative strengths and weaknesses in order to assess functional impairment.
• A complete, integrated neuropsychological battery, such as the Halstead-Reitan Neuropsychological Battery or a flexible battery that addresses motor skills, sensory functions, perceptual motor functions and cognitive processes such as executive mental functions, attention and concentration, and abstract reasoning skills.
• Memory assessments utilizing an age-normed, standardized instrument assessing both verbal and nonverbal memory such as the Wechsler Memory Scale-Fourth Edition (WMS-IV).
• A quantitative assessment of emotional stats, with symptom measures such as the Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), and where appropriate, a psychometric assessment of personality and emotional functioning such as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) or Personality Assessment Inventory.
• Explicit, cognitive symptom validity measures, including raw scores for the symptom validity test(s) used.
• Test scores, in the form of standard scores and percentiles. All scores should be based on appropriate age norms, except in the case of a test for which no age norms are available. For tests that only have grade-based norms, scores should be provided for first year college norms, as well as the norms based on the test taker's current grade.
• A specific diagnosis based on standard, accepted diagnostic nomenclature and supported by the history and objective test data.