At our institution, I think we have improved drastically in our understanding of and provisions for "reasonable accommodations". The challenge has not been so much the what to provide, as the how quickly it can be provided so as not to interfere with the student's access to the same materials and resources. We offer an accelerated model, so struggle a bit in having the ability to provide a student enrolled in a particular class, for example, with all the handouts in the appropriate formats at the same time as other students receiving them in the standard format so that they can maintain the same rate of progress. Is there additional interpretations that the student being provided accommodations must maintain the same rate of progress as other students? Additionally, we are struggling somewhat in determining what is reasonable for LD/ADHD students that "need more time" for assignments, test, etc. How do we determine, based on their functional levels, what is appropriate without having an expert in that disability on our staff?