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In their systematic review, Lovett and Nelson
report a worrisome lack of evidence for most school accommodations (eg, additional exam time) for students with attention-deficit/hyperactivity disorder (ADHD). With the exception of reading examination questions aloud to younger children (primary grades), most of the scant evidence of benefit suggests that any benefit of accommodation is not specific to ADHD but would apply to any student. Furthermore, students and support staff "often express ambivalence and dissatisfaction" with accommodations. Finally, it appears that accommodations are being substituted for the more expensive evidence-based therapeutic interventions. This would be like seating a student with myopia 2 feet from the blackboard instead of fitting refractive lenses or providing a wheelchair instead of corrective surgery and physical therapy. Thus, Lovett and Nelson's
findings challenge the wisdom of routine clinical recommendations for accommodations. Such recommendations may even be a disservice, especially if they take precedence over evidence-based interventions. This inconvenient finding has several ramifications and poses some problems in light of the widespread recommendations for and use of school accommodations for ADHD.

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