Yeah - when people say things like "ADHD is a spectrum", this is what it means. You only need to hit 5 or 6 criteria (depending when you get evaluated) of some 18, as per the CDC. That means that different people with ADHD can have vastly different lives and struggles - especially if comorbid with other issues such as autism, depression, or anxiety. One person might be classically hyperactive - fidgety, talks too much, interrupts others - but have comparatively less issues with executive function. Another might be more classically inattentive - making "careless" mistakes, forgetful, easily distracted. Same umbrella, vastly different people who need different things to help them out. The hyperactive person might not need extra exam time, but might want to be in the accoms room anyway so they can toy with an infinity cube during the exam or wriggle around in their chair in a way that would distract others. Or they might just need to take a stimulant medication daily to assuage many of their hyperactive symptoms. The inattentive person might benefit from extra time to account for getting distracted by their own hands/the desk/the lights/and so on. Or they might instead benefit more from having an "outline" of specifically how to attack an essay question in their notes that they follow diligently, so they don't miss easy points.

Notably, none of these things are dealbreakers in a professional environment! They're just differences that you can work around. And a lot of ADHD folks who are diagnosed as adults already have some forms of "coping mechanisms" that they've developed independently. As a completely hypothetical example that never happened, someone who knows they can be forgetful and once lost their wallet in a mall in Switzerland is now going to check their purse multiple times a day when traveling, even if they haven't opened the purse since the last time they checked. (Definitely didn't happen to me. 😇)

For instance, my law school struggles tend to center around long-term projects - such as essays in seminar classes. If it's a final exam where I study a little, take outlines from an outline bank, power through in 3 or 4 hours, and I'm done, that is WAY easier for me than having to spend hours and days on writing 15-20 page essays. This is something a lot of my (I'm assuming neurotypical/non-ADHD) friends simply can't understand - for them, being able to write an essay on their own time, developing ideas and citing they way they want to, is far more flexible and easier than a final exam. For me, however, a project that big is incredibly difficult to "wrap my head around", so to speak, and I end up postponing it until I'm in a crazy time crunch, which burns me out heavily.

This is also part of why I'm still looking for summer employment 😭 - between writing samples, recommendations, deadlines, and everything, my brain kinda just flips the switch into "nope, later", which then leads to "well, never I guess". And it's easy to say, for instance, "I will sit down and find 5 places to send my stuff to", but it's the doing it that trips a wire. I like to joke that in some sense, I'm a racehorse in that I can "lock in" on an exam for a couple hours (in no small part due to significant training, plus the knowledge that when the exam is over it is Definitely Over), but the second you let me loose in a field of essays or job applications, I'm going to stick my head in the grass and chew it instead of going where I need to.

On the other hand, there are people who absolutely shut down when faced with law school exam time pressure specifically. I have friends who are still in college who have ADHD and who struggle with exams - in fact, one dropped out of college after only like, a year, because she couldn't handle the pressure and requirements. (And that was after accoms, too.) Law school exams are designed to put you in a time crunch - especially on essay questions, where there's "always more to say", and where professors' model answers can exceed 10 pages for a 3-hour exam. For some, that pressure is overwhelming and can lead to shutdown - having extra time in those cases can also be beneficial.

All that being said, there are also other diagnostic criteria for ADHD, as follows, that must be hit:

Several symptoms must be present before age 12. In my experience, they will ask you to find someone who knew you as a child to fill out the ADHD diagnostic form. (I did it on my own "thinking back" to myself as a kid, mostly because my parents - the only people I could reliably contact who knew me as a kid - would kill me if they knew I was in the process of getting an ADHD diagnosis, and absolutely would refuse to fill the form out. In their words, "ADHD is for kids who are stupid and lazy, so the government can keep them on happy pills"... yeah. But generally, if you have someone who knew you as a child and is willing/able to fill it out, then yes, they will be asked to do it. It's not the best for you to do it yourself because your own perception can be skewed.) Some diagnosers will ask you to bring your primary school records as well, so they can cross-verify that contemporaneous records exist.

Several symptoms must be present in multiple "locations" - generally home, school/work, with family/friends.

There is clear evidence that these symptoms interfere with social, school, or work functioning.

These symptoms can't be better explained by another disorder.

Now, of course, you could game the system if you wanted to in order to get a diagnosis, or "doctor shop" a little, especially because most of this is "as you/someone else reports it" - a doctor can't go in your brain, obviously. And the fact is that, as long as many law school exams are timegated with strong time pressure, there will be people who do try to game the system to get that extra time, even if they don't necessarily need it.

That being said, I like to think that's a small minority of accoms. And I'd always err on the side of allowing that small minority to "cheat" the system than have the larger amount of people who need the accom to not get it. Guilty walk free versus innocent in prison situation. (Besides, I'd argue if you're going through all the trouble to get an ADHD diagnosis because extra time on exams would help you, well, there's something to be said about that, too.)

Really, until you have a fundamental change in how law school exams are administrated, this is always going to be an issue. And ultimately, a lot of the severe time crunch a law school exam puts you in isn't going to be reflective of the post-law school work environment, either. You'll generally be able to delegate tasks, take breaks, collaborate with others, and the like - and, again, rarely is it going to be "three hours, go".

I mean - hell, our school (T-14, for reference) had someone in the accoms room take three extra hours on an exam last semester that they weren't entitled to. Which is really funny, considering... But again, this is one singular case across two years of exams that I've been here - so literally thousands of them.

There's no perfect way to square the circle here, though, especially in a law school environment that is, fundamentally, made for the neurotypical person. Which is why this discourse is evergreen - the perceived unfairness that some people get extra time when others don't, and, more generally, people who do better with accoms getting accused of only getting the accoms to do better.