Testing
Accommodations
Handbook
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NBCOT Testing Accommodations
Handbook
NBCOT® certification programs are accredited by the National Commission for Certifying Agencies (NCCA) under their
Standards for the Accreditation of Certification Programs.
NBCOT has also been awarded accreditation by the International Accreditation Service (IAS) for demonstrating
compliance with ISO/IEC Standard 17024:2012, Conformity Assessment – General Requirements for Bodies Operating
Certification of Persons.
NBCOT does not discriminate against any individual because of race, ethnicity, gender, age, creed, disability, religion, marital
status, sexual orientation, or national origin. NBCOT reserves the right to amend the procedures outlined in this handbook. All
documentation submitted to NBCOT, for any reason, becomes the property of the organization. This includes but is not limited to:
certification eligibility, initial certification, certification renewal, reinstatement, disciplinary action, international regulatory aairs
or other NBCOT matters. For the most up-to-date information/announcements concerning NBCOT certification, please visit www.
nbcot.org or contact us via phone at: 301-990-7979.
AOTCB/NBCOT Exams ID 62 rev121523
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any
means (electronic, mechanical, photocopying, recording, or otherwise) without prior written permission of the copyright owners.
©2023 National Board for Certification in Occupational Therapy, Inc.
‘NBCOT
®
’ is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.
‘OTR
®
’ is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.
‘COTA
®
’ is a service and trademark of the National Board for Certification in Occupational Therapy, Inc.
All marks are registered in the United States of America.
All general correspondence, including requests for information concerning NBCOT Testing Accommodations (TAs), should be
directed to:
National Board for Certification in Occupational Therapy, Inc.
One Bank Street, Suite 300
Gaithersburg, MD 20878
Email: acc[email protected]g
Website: https://www.nbcot.org
ACCREDITED
NCCA BY ICE
CERTIFICATION PROGRAM
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Table of Contents
Overview .... 4
Standard Exam Administration .... 4
Who Can Request Testing Accommodations for the OTR® or
COTA® Examination? .... 5
How to Request Testing Accommodations for
NBCOT Exams .... 6
NBCOT’s Testing Accommodations Review Process .... 7
ACCEPTING YOUR TESTING ACCOMMODATIONS
APPROVAL NOTICE .... 7
REQUESTING TESTING ACCOMMODATIONS AFTER RECEIVING AN
ATT LETTER .... 8
WITHDRAWING A TESTING ACCOMMODATIONS REQUEST .... 8
SCHEDULING AN NBCOT EXAM APPOINTMENT WITH TESTING
ACCOMMODATIONS .... 8
REAPPLYING WITH PREVIOUSLY APPROVED TESTING
ACCOMMODATIONS .... 9
Required Documentation for Testing Accommodations
Requests .... 9
EXAMPLES OF DOCUMENTATION TO SUBMIT FOR REVIEW .... 10
EXAMPLES OF UNACCEPTABLE FORMS OF DOCUMENTATION .... 10
Testing Accommodations Request Form .... Appendix A
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Overview
In compliance with the Americans with Disabilities Act (ADA), NBCOT® provides reasonable and appropriate
testing accommodations (TAs) for exam candidates with disabilities who are otherwise eligible to take the
OTR® or COTA® certification examination.
Testing accommodations are changes to the regular testing environment, and auxiliary aids and
services that allow individuals with disabilities to demonstrate their true aptitude or achievement level
on standardized exams or high-stakes tests. Reasonable testing accommodations do not compromise
the validity of the examination, jeopardize examination integrity and security, fundamentally alter the
measurement of the skills and knowledge the examination is intended to test, or impose an undue burden
on NBCOT. Accommodations cannot be made to the actual content of the examination.
Some personal items such as medical devices and medication do not require a formal request for testing
accommodations. Please refer to the list below for standard items that do not require a request for testing
accommodations.
Pearson VUE – Comfort Aid List
For questions regarding testing accommodations, please contact ac[email protected]g.
Standard Exam Administration
A standard NBCOT certification examination is a four-hour, computer-based exam taken in-person at a
Pearson Professional Center. Pearson VUE is NBCOT’s exclusive test administration partner. The test center’s
standard testing environment provides a quiet, limited/reduced distraction test space with continual
monitoring throughout the exam.
During the exam, candidates will be able to highlight text in the passage area that they feel is important
to refer back to as they progress through the exam. A strike out feature is also available to help candidates
visually eliminate possible options from consideration. Candidates have the option to modify the color
scheme by changing the background and text colors of the exam at any time. Candidates can also adjust the
screen brightness and change the size of the content by zooming in or out on the screen. For details on these
features, as well as additional functionality of the exam in the computer-based testing environment, view
the online exam tutorial(s).
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Who Can Request Testing Accommodations
for the OTR® or COTA® Examination?
Candidates with a documented disability as defined by the ADA may request testing accommodations. An
individual with a disability is defined by the ADA as “a person who has a physical or mental impairment
that substantially limits one or more major life activities (such as seeing, hearing, learning, reading,
concentrating, or thinking) or a major bodily function (such as the neurological, endocrine, or digestive
system)” when compared to most people in the general population. A diagnosed disability does not
automatically necessitate testing accommodations.
The decision as to whether testing accommodations are recommended for a NBCOT exam candidate
is determined by the candidate’s qualified healthcare professional. A qualified healthcare professional
is licensed and/or certified to assess, diagnose, and treat the applicant’s relevant disability. If testing
accommodations are recommended, candidates must make the request in their exam application and
include supporting documentation from their qualified healthcare professional.
Under the ADA (revised 2008), test anxiety is not considered a disability under federal law. Candidates
requesting testing accommodations related to anxiety must be diagnosed with an anxiety disorder that is
more generalized and must include examples of how the anxiety creates a disability in other areas of their
life, beyond testing.
Non-specific diagnoses such as individual learning styles, general learning dierences, academic challenges,
computer phobias, slow reading, test diiculty or test anxiety (see above paragraph) in and of themselves
do not constitute a disability or impairment and are not covered under the ADA.
English as a second language is not covered under the ADA.
Accommodations may be approved for candidates with documented qualifying temporary medical
conditions not otherwise covered by the ADA. Candidates with temporary and transitory conditions should
contact NBCOT at accommodations@nbcot.org as soon as possible. The decision as to whether a medical
condition not covered by the ADA is a “qualifying medical condition” for purposes of a NBCOT testing
accommodations approval is at the sole discretion of NBCOT.
Pregnancy, in and of itself, is not considered a disability under ADA. However, accommodations may be
approved for candidates with documented qualifying temporary medical conditions such as pregnancy with
medical complications or impairment.
Nursing candidates: NBCOT supports candidates who require a break to express or pump breast milk
during their exam. Candidates must make a testing accommodations request in their NBCOT application
and be approved for testing accommodations to express or pump during their exam appointment. This
ensures Pearson VUE can coordinate private space in the test center for this accommodation. Approval of
this accommodation may require candidates to schedule their exam at a dierent test center than their
preferred location.
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How to Request Testing Accommodations for
NBCOT Exams
1. Read the Certication Exam Handbook available at nbcot.org.
The Certification Exam Handbook provides information on a standard NBCOT exam administration.
2. Review our list of personal items that do not require a testing accommodations request.
▷ Pearson VUE – Comfort Aid List
3. Gather all required supporting documentation.
Supporting documentation from a qualified healthcare professional must be submitted with
each reasonable and appropriate testing accommodations request as outlined in “Required
Documentation for Testing Accommodations Requests” on page 9. Candidates are encouraged to
gather all documentation prior to applying for the exam.
4. Open a NBCOT Certication Examination application.
Go to www.nbcot.org.
▷ If applying for the first time, create a MyNBCOT account as outlined in the Application Process
section of the Certification Exam Handbook.
▷ If you have an existing MyNBCOT account, log in using your unique email address and password,
then follow steps to apply or reapply.
5. Request Testing Accommodations in your exam application.
▷ Select “Yes” when asked if testing accommodations are required.
▷ Answer all presented questions.
▷ If you were granted testing accommodations during previous educational and testing experiences
(e.g., college/graduate school, GRE), click “yes” and add a reference for previously granted
TAs to include: year(s) of accommodation, Name of Institution/Organization, and Type of
Accommodation(s).
6. Upload required supporting documentation.
To protect the confidentiality of testing accommodation requests and all supporting documentation,
candidates must upload all required documentation to the Testing Accommodations section of their
exam application.
▷ First time testing accommodations requests: Candidates requesting testing accommodations for
the first time, whether a new applicant or reapplying, must upload all required documentation as
outlined on pages 9-10 before continuing with the exam application.
▷ Previously approved candidates who wish to request new testing accommodations for their next
exam attempt should refer to “Reapplying With Previously Approved Testing Accommodations” on
page 8.
▷ Do not email NBCOT personal medical documentation. If a document will not upload, please
contact accommodations@nbcot.org.
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7. Read and conrm the Declaration and Authorization statements.
8. Monitor the email account listed in your MyNBCOT prole.
Testing accommodations requests are reviewed aer an exam application is submitted and in the
order they are received. NBCOT emails candidates when additional documentation is requested
and/or a Testing Accommodations Approval Notice is ready for review in the candidate’s exam
application. We recommmend checking your email, including your spam/junk folder, regularly for
the emails from NBCOT.
NBCOT’s Testing Accommodations Review
Process
Approval of testing accommodations requests are based on the candidate’s request, the diagnosis of
their disability or temporary medical condition or impairment and supporting documentation from their
qualified healthcare professional(s).
Candidates must submit documentation to support each testing accommodation request. Please refer to
pages 9-10 for details about the required documentation.
NBCOT may request additional documentation at any time from the candidate and/or their qualified
healthcare professional(s) to support the requested testing accommodations. NBCOT cannot communicate
with a third party (e.g., parent, spouse, program director) unless the candidate is also present and provides
verbal permission.
An initial review is completed within 10 business days from the exam application submission date, though
reviews may take longer during busy times. Requests are reviewed in the order they are received and only
aer an exam application is submitted. Candidates are notified by email if additional documentation is
needed and when their Testing Accommodations Approval Notice is available in their exam application for
review.
ACCEPTING YOUR TESTING ACCOMMODATIONS APPROVAL NOTICE
Upon approval of a candidate’s testing accommodations request, the candidate will receive an email
advising them to log into their MyNBCOT student dashboard to read and review their Approval Notice.
• The Approval Notice is available in the Testing Accommodations section of the exam application.
• The candidate is expected to read the Approval Notice in full to include the IMPORTANT
INSTRUCTIONS section, which details unique information and instructions regarding approved
testing accommodations.
• If the candidate understands and agrees to the approved TA and instructions provided, click “I
accept.”
• If the candidate does not agree with the approved TA, they reserve the right to request an
additional review within seven days of receiving the Approval Notice by contacting NBCOT at
acc[email protected]. The decision resulting from an additional review is considered final.
Aer a candidate accepts their Approval Notice and all other exam application documentation is approved
(e.g., academic verification documentation, background check), they will receive an Authorization to Test
(ATT) with Testing Accommodations letter via email and in their MyNBCOT student dashboard. This letter
authorizes the candidate to schedule an exam appointment with NBCOT’s test administration partner.
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REQUESTING TESTING ACCOMMODATIONS AFTER RECEIVING AN
ATT LETTER
If a candidate receives their ATT letter and needs to request testing accommodations due to an unforeseen
medical diagnosis/complication or temporary impairment, they should email accommodations@nbcot.org
as soon as possible to discuss next steps.
WITHDRAWING A TESTING ACCOMMODATIONS REQUEST
Candidates can withdraw a testing accommodations request at any time before receiving their ATT
letter. Log in to your MyNBCOT student dashboard. Click View My Exam Application, expand the Testing
Accommodations section, then click the Withdraw TA button.
SCHEDULING A NBCOT EXAM APPOINTMENT WITH TESTING
ACCOMMODATIONS
To schedule a NBCOT exam appointment with testing accommodations, a candidate MUST have received an
Authorization to Test (ATT) with Testing Accommodations letter.
It is imperative that candidates with testing accommodations read and follow the scheduling instructions
outlined in their ATT letter and Testing Accommodations Approval Notice. Both the ATT letter and Testing
Accommodations Approval Notice are available in the candidate’s MyNBCOT account.
Some testing accommodations require special coordination with Pearson VUE. Candidates will receive
scheduling instructions in their NBCOT Testing Accommodations Approval Notice if their appointment
requires additional coordination with Pearson VUE aer receipt of their ATT letter.
What to Expect Scheduling with Pearson VUE
• Candidates with testing accommodations should begin the scheduling process by clicking the Access
Pearson VUE button located on their MyNBCOT student dashboard.
• Pearson VUE will display your approved testing accommodation(s) on your Pearson VUE dashboard.
Please review the listed testing accommodation(s). Contact NBCOT at accommodations@nbcot.
org if there are any questions or discrepancies from your NBCOT Testing Accommodations Approval
Notice.
• If your testing accommodations require you to schedule by phone, you will be notified on the Pearson
VUE dashboard, and the phone number will be provided.
REAPPLYING WITH PREVIOUSLY APPROVED TESTING
ACCOMMODATIONS
Candidates reapplying for the exam with previously approved testing accommodations will be presented
with their pre-approved TAs in the Testing Accommodations section of the exam application.
When presented with the question “Do you require testing accommodations?” pre-approved candidates
click the Yes response to review their pre-approved TAs. Candidates may select some or all of their
previously approved testing accommodations. If you are requesting ONLY pre-approved testing
accommodations, do not click the Request New Testing Accommodations button. Click the Continue button
to advance through the exam application.
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Previously approved candidates requesting new/additional testing accommodations complete the following
steps:
• Select the desired pre-approved testing accommodations from the list.
• Click the Request New Testing Accommodations button in the Testing Accommodations section of the
exam application.
• Update questions #1-4 to include the new testing accommodations request. Do not delete any
previous requests in Question 1.
• Upload all required supporting documentation as outlined on pages 9-10.
Required Documentation for Testing
Accommodations Requests
Supporting documentation must include all the items listed below.
Candidates do not need to be retested for their stated diagnosis.
1. Name and credentials of the qualified healthcare professional(s) that qualify them to assess,
diagnose, and treat the relevant disability.
• Include license and/or certification number.
2. Contact information of each qualified healthcare professional providing documentation.
• Include address, phone number and email address.
3. Specific and professionally recognized disability diagnosis.
• Include candidate’s diagnosis, DSM/diagnosis code, and diagnosis date.
• Include results of testing/assessments leading to diagnosis, dated within the past seven years*.
4. Description of how the candidate’s disability aects one or more major life activities as compared to
most people in the general population.
5. Explanation of how the candidate’s disability impairs their ability to test under NBCOT’s standard
testing conditions, as outlined in the “Exam Day: Questions & Answers” section of the Certification
Exam Handbook.
6. Document testing accommodations approved for prior standardized testing.
• If no prior accommodations exist, the qualified healthcare professional should include an
explanation as to why no accommodations were given in the past and are needed now.
7. Specific recommendations for reasonable testing accommodations.
• If extra time is intended for stop the clock breaks rather than additional exam time, this should
be specifically stated.
• If an exam time extension is recommended, please be as specific as possible (e.g., one additional
hour, time and a half), avoiding non-specific recommendations like “extra, additional, more,
extended.”
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8. Detailed explanation of why each accommodation is necessary to minimize the impact of the
disability while taking a NBCOT exam.
Examples of documentation to submit for review:
• NBCOT Testing Accommodations Request Form with qualified healthcare professional cover letter
and/or oice stamp or digital signature (Recommended, see appendix A);
• Letter from qualified healthcare professional including all required documentation elements, dated
within the past seven years*;
• A report (e.g., psychological or neuropsychological evaluation) prepared by a qualified healthcare
professional, dated within the past seven years*;
• Documentation of testing accommodations for a similar high-stakes exam such as GRE, LSAT, or
MCAT;
• Documentation of testing accommodations due to disability in an IEP, Section 504 Plan, or
documented accommodations from a private school.
*Some documentation dated outside of seven years may be considered based on diagnosis.
Examples of Unacceptable Forms of Documentation
• Handwritten letters
• Handwritten patient records or notes from patient charts
• Diagnosis on prescription pads
• Self-evaluations found online or in print
• Correspondence from educational institutions or testing agencies not directly addressed to NBCOT
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Appendix A
Testing Accommodations
Request Form
Dear Healthcare Professional:
The exam candidate identified below is requesting testing accommodations to take a National Board
for Certification in Occupational Therapy, Inc. (NBCOT®) Certification Examination and is submitting
documentation prepared by you in connection with their request.
NBCOT requires supporting documentation from qualified healthcare professional(s) licensed and/or
certified to assess, diagnose, and treat the applicant’s relevant disability.
Exam Candidate Information
Candidate Name: Birth Date (MM/DD/YYYY):
Healthcare Professional Contact Information
(To be completed by the healthcare professional.)
Name: Title/Occupation:
Address:
City: State/Country: Postal Code:
Phone: Email:
Licensure/Certi cation Information
(To be completed by the healthcare professional.)
License/Certification Number: State/Country: Expiration Date:
Disability Diagnosis
(To be completed by the healthcare professional.)
Disability Diagnosis
DSM/Diagnostic
Code
Diagnosis Date
ID 71 rev121423
For a fillable PDF Request Form, click here.
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Appendix A
Disability Impact
(To be completed by the healthcare professional.)
Prior Testing Accommodations
(To be completed by the healthcare professional.)
Describe how the candidate’s disability
a ects one or more major life activities
(outside of testing) as compared to
most people in the general population.
Explain how the candidate’s disability
impairment impacts their ability to
test under NBCOT’s standard testing
conditions, as outlined in the “Exam
Day: Questions and Answers” section of
the Certification Exam Handbook.
(Standard exam is 4-hour computer-based
exam taken in a reduced-distraction testing
center.)
Document what testing
accommodations have been approved
for prior standardized testing (e.g., SAT,
GRE, college exams).
If no prior accommodations exist,
the qualified healthcare professional
should include an explanation as to
why no accommodations were given in
the past and are needed now.
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Appendix A
Testing Accommodations Recommendation(s)
(To be completed by the healthcare professional.)
Please document specific recommendations for reasonable testing accommodations based on applicant’s
disability diagnosis along with an explanation of why each accommodation is necessary to minimize the
impact of disability while taking an NBCOT® exam.
• If an exam time extension is recommended, please be specific (e.g., one additional hour, time and a
half), avoiding non-specific recommendations like “extra, additional, more, extended”.
• If extra time is intended for stop the clock breaks rather than additional exam time, this should be
specifically stated.
Speci c recommendation(s) for reasonable
testing accommodations
Explanation why this accommodation is
necessary to minimize impact of disability
while taking an NBCOT® exam
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Appendix A
Declaration
(To be completed by the healthcare professional.)
I hereby certify that the above information is true and is given pursuant to the authorization to release
information by the above-named candidate. I attest I have specific training and experience in the
assessment, diagnosis, and treatment of the disability identified above. I hereby certify I personally
completed this form and provided specific recommendations for reasonable testing accommodations for
the NBCOT exam. I may be asked by NBCOT to verify the above information at any time.
IMPORTANT — This document is considered void without the healthcare professional’s signature.
This document must include one of the following: digital signature with timestamp, a cover letter on
practice letterhead to accompany this form, or off icial off ice stamp below.
Signature of Healthcare Professional:
Printed Name of Healthcare Professional:
Date:
Off ice Stamp
