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Candidates with disabilities are entitled under the Human Rights legislation of each Province or Territory to reasonable testing arrangements that provide for fair and valid assessment. Organizations administering tests are accountable for responding to requests for testing accommodations while ensuring the integrity of the examination. In order for an assessment to be valid, the examination must accurately test the knowledge, skills, or whatever it is intended to measure, rather than the candidate's disability. In other words, testing accommodations should be made to ensure the accurate measurement of a candidate on the dimensions of interest, not the functional limitations caused by the candidate's disability. The accommodations provided should not place candidates with disabilities at an advantage or disadvantage in comparison to other candidates.


The National Dental Hygiene Certification Board (NDHCB) supports reasonable and appropriate modifications to the NDHCB examination procedures and/or materials in order to accommodate candidates with disabilities.


The purpose of this document is to provide details on various possible examination procedures and/or materials, as appropriate, offered to ensure fair and valid assessment of candidates with disabilities. It is designed for use by candidates with various disabilities who would like to request special accommodations for the Exam.


Before using the guidelines to determine what modification(s) could be made to testing conditions, it is essential that individuals involved in such requests be familiar with the:


  • registration/licensure/certification requirements;

  • examination eligibility criteria and the procedures for the administration of the examination.


Guiding principles


A. The examination is one of the measures on which a candidate's eligibility for registration/licensure/certification is based. It is used to assess the candidate's overall knowledge of theory and practice and is meant to supplement the other information a regulatory authority collects about a candidate.


B. The determination of whether a testing accommodation is appropriate will be based on:


  1. whether the disability disadvantages the candidate in the standard test taking task;

  2. whether the test-taking task that is being accommodated by the modification is critical to performance in the work-place;

  3. the extent to which the same or a similar accommodation is likely to be needed or made available in the work-place;

  4. whether the accommodation alters the skills and abilities that are measured, and at the level at which they are assessed; and

  5. whether the accommodations provided give the candidate with a disability an unfair advantage over other candidates or alter the nature or level of the qualification or knowledge being assessed.


C. The NDHCB will modify the examination procedures and/or the examination material, as appropriate, to meet the needs of disabled candidates, while protecting the integrity of the examination.

D. The NDHCB will make these modifications on a case-by-case basis on the basis of complete information.


E. Candidates with disabilities are informed in advance that they can request appropriate testing accommodations.

F. All applicants will be provided with an equal opportunity to complete the examination.


Definition of Disability


In the context of this policy, a disability is any health-based restriction or lack of ability (resulting from a medical impairment) to perform the required examination in the manner or within the range considered normal for a human being.  A disability includes any degree of physical disability, a condition of mental impairment, and/or a learning disability.​


Note:   Lack of language proficiency in either English or French is not grounds for review of examination results or for any form of special accommodations.


Categories of disabilities and common testing accommodations


The following classification has been made according to testing accommodations for candidates with various types of disabilities. This classification is not exhaustive nor does it provide the decisions that should be made regarding the appropriate accommodations for specific individuals.


The classification is designed to provide direction regarding typical accommodations. It should be noted that the same accommodation may be used by individuals with different disabilities, and individuals with the same disability may use different accommodations. The great variety of disabilities makes it close to impossible to generalize rules for testing accommodations. Each request for accommodations will be reviewed on a case-by-case basis. Decisions regarding appropriate accommodations will be based on the nature of the disability and its impact on the candidate's ability to perform the tasks involved in taking an examination.


Candidates with Visual Disabilities

As for all request for testing accommodations, each request for accommodations due to visual disabilities will be dealt with on an individual basis. Reasonable accommodations may include:

  • Recorded version of test material;

  • Recorder (individual who fills in answers);

  • Larger text exam;

  • Special lighting;

  • Additional time;

  • Separate testing room; and/or

  • The candidate’s own adaptive technologies.


Candidates with a Hearing Impairment

These candidates usually have to receive information through printed material or oral/sign language. Reasonable accommodations may include:

  • Written instructions;

  • Special seating to allow candidate to view person giving oral instructions; and/or

  • The candidate’s own adaptive technologies​.


Candidates with Motor Disabilities

These candidates have reduced mobility. Reasonable accommodations may include:

  • Recorder (individual who fills in answers);

  • Additional time;

  • Separate testing room; and/or

  • The candidate’s own adaptive technologies​.


Candidates with Learning Disabilities

These candidates have difficulties in processing information from on screen or printed material. Reasonable accommodations may include:

  • Audio recorded material;

  • Additional time;

  • Separate testing room; and/or

  • The candidate’s own adaptive technologies​.


Candidates with Limited Physical Tolerance

These candidates have limited physical tolerance due to physical, psychological, or cognitive disabilities. Reasonable accommodations may include:

  • Special timing with frequent breaks;

  • Additional time;

  • Separate room; and/or

  • The candidate’s own adaptive technologies​.


Testing Accommodations


Writing Centre

When selecting writing centres, NDHCB ensures that the sites are accessible (e.g., ramps, railings, etc.) in order to meet the needs of candidates with limited mobility. If some writing centres are not accessible, an alternate site which is accessible should be provided upon request.


Separate Room

Because of their disability, some candidates may require a testing environment that minimizes distractions resulting from noise, movement, or both. Conversely, other candidates compensate for their disability to process information by talking aloud and will require a separate room so that they do not disturb other candidates taking the examination. A separate room should normally be provided when using a recorder.


Additional Time

Extending the time to take a non-speeded test is frequently used to accommodate a variety of disability-related conditions and is often provided in combination with other accommodations. It should normally be provided when accommodations include an audio version, or a recorder.


The standard extension is time-and-one-half (e.g., 2 hours is extended to 3 hours). However, decisions regarding the provision of additional time will be reviewed on a case-by-case basis.




The use of an individual (selected by the NDHCB) to fill in the answers may be appropriate for candidates who have difficulty writing independently. The role of the recorder is strictly limited to writing/clicking what is dictated by the candidate.


For the examination, the recorder will be asked to complete the information portion of the online exam and to select the candidate's answers to each question. The candidate will be requested to sign a CANDIDATE DECLARATION FORM which waives the recorder and the NDHCB for unintentional errors in recording the candidate's answers and other information provided. Steps can however be taken to minimize potential errors (e.g., have recorder read response after recording it). Specific instructions for recorders are provided in the “Forms” section of this document. Since the candidate will most likely be taking the examination in a separate room, the person invigilating the examination could also act as the recorder. The recorder will also have to sign a SECURITY DECLARATION FORM.


Audio version of Exam


The NDHCB will provide to candidates whose disability precludes independent reading of the test material with an electronically recorded audio version of the exam (usually using a Kurzweil machine or online software).  The provision of a human reader service will only be available in exceptional circumstances and the role of this individual (selected by the NDHCB) will simply be to read, not to interpret, what is presented.


Modification of Test Material


For some candidates it may be appropriate to modify the test presentation in order to accommodate them. The modifications will be made to the format/presentation of the examination material and not to the content of the examination. Each request will be reviewed on a case-by-case basis, keeping in mind the type of accommodation being requested and the functional limitations of the candidate arising from the candidate’s disability.


Informing candidates


Candidates are informed through the NDHCB website and on the application form of the process, procedures and deadlines for requesting accommodations to write the certification examination so that appropriate arrangements can be provided.


Thus, if accommodations are not requested at the time of the Examination application, NDHCB cannot guarantee that the special accommodations will be available.


Documentation of disability


In order to protect the integrity of the testing process and avoid unnecessary preparation for testing accommodations, the NDHCB requires advance notification of accommodation for disability-related needs and documentation to substantiate the request for accommodations.


The purpose of the documentation is to substantiate the request for accommodations and to provide information as to what is required. Requests for documentation are limited to establishing the need and type of accommodation. Appropriate documentation of the need for accommodation by an appropriate specialist is required.


The purpose of this documentation is not to cast doubt on the validity of the person’s needs or to get confirmation of a diagnosis, but to have an adequate description of the nature and extent of functional limitations to determine appropriate accommodations. 


Each candidate seeking accommodation must provide documents containing the following information:

  • An attestation by a qualified health professional that the candidate has been diagnosed with a disability.  For greater clarity, the NDHCB does not require disclosure of the precise diagnosis, but only confirmation that the candidate has been diagnosed with a disability;

  • An attestation by a qualified health professional that the diagnosis and functional limitations are based on a systematic and differential assessment method;

  • A clear description of the nature and extent of the functional limitations that are specific to the candidate and resulting from the disability.  The NDHCB, in appropriate circumstances, may request that this information come from a qualified health professional;

  • Where appropriate, a description of the variability of the candidate’s functional limitations;

  • Where appropriate, any side effect of medications that are specific to the candidate;

  • Where the functional limitations are not recent, documentation of having previously received the same or similar accommodations in a testing situation.  This information is necessary because there is likely to be a history of accommodation in an academic setting. Persons involved in providing the accommodations, such as educators from the special education department, can provide the necessary documentation.


In cases where the NDHCB legitimately needs more information about the candidate’s disability to make the accommodation, the candidate must provide the nature of his or her disability.


The candidate is required to bear the cost of providing the requested documentation.


Information related to the candidate's disability is highly confidential and will not be disclosed to third parties.


Cost of Testing Accommodations


Testing accommodations are provided at no cost to the candidate with a disability. The NDHCB will be responsible for all reasonable costs associated with providing accommodations to candidates.


Guidelines for Requesting Testing Accommodations


Guidelines for the Candidate


  1. The candidate must submit a "Special Accommodations Application Form" to the NDHCB by the deadline indicated on the application form.

  2. The candidate is also required to get his/her treating health professional to submit a Special Accommodations Documentation Form to the NDHCB by the deadline indicated on the application form. Candidates are encouraged to submit this form at the same time as their Special Accommodations Application Form.

  3. The candidate is also required to submit, with the request for testing accommodations, supporting documentation setting out the accommodations the candidate has received during past educational settings.

  4. The candidate may be required to submit additional documentation with the request for testing accommodations and to bear the cost of providing the required documentation.

  5. The candidate will be asked to complete a "Candidate Declaration Form" if a recorder is required by the candidate.


Commitment by the NDHCB


  1. Review all written requests for testing accommodation that are received.

  2. See that the required forms are completed and that the supporting documentation, if necessary, is submitted by the candidate.

  3. Determine if it can support the request for testing accommodations.

  4. Maintain a record of all accommodations that have been provided.

  5. Inform the candidate in writing that it supports the request or not. If the request is approved the NDHCB will submit to the candidate the specifics of the accommodations that are approved. In the event the NDHCB does not approve the request for testing accommodations, the decision and rationale will be documented and a copy sent to the candidate.


The NDHCB will arrange for the provision of the approved accommodations and is responsible for all reasonable costs associated with the provision of these testing accommodations.




  • Ontario Human Rights Commission. (2016). Policy on ableism and discrimination based on disability.  Toronto: Author.

  • American Psychological Association. (2014). Standards for educational and psychological testing. Washington:  Author.

  • Education Testing Services. (2017-2018). Bulletin Supplement for Test Takers with Disabilities or Health-Related Needs.  Princeton: Author.  at https://www.ets.org/s/disabilities/pdf/bulletin_supplement_test_takers_with_disabilities_health_needs.pdf 

  • King, W.L., & Jarrow, J.E. (1991). Testing accommodations for persons with disabilities:  A guide for licensure, certification, and credentialing. Washington:  Association on Handicapped Student Service Programs in Postsecondary Education.

  • National Council of State Boards of Nursing Inc. (1989). Providing for the needs of handicapped candidates. Issues 1989. 10(5). Chicago:  Author.

  • Public Service Commission. (2007). Guide for Assessing Persons with Disabilities. Ottawa:  Author.

  • Weatherby, F., & Moran, M. (1989, July-August). Admission criteria for handicapped students. Nursing Outlook, 179-181.