Disability Definitions & Instructional Tips

A Learning Disability is a disorder in one or more of the central nervous system processes involved in perceiving, understanding and/or using concepts through spoken/written language or nonverbal means. This disorder manifests itself with processing, memory, communication, reading, writing, spelling, and maturity. While learning disabilities may affect any of these areas, deficiencies are usually limited to only one or two areas.

The student with a learning disability may exhibit problems in one or more of the following areas:

Reading

Students may:

• Have a slow reading rate and/or experience difficulty in modifying the reading rate in accordance with the difficulty of the material.
• Struggle with comprehension and retention of written material.
• Have difficulty distinguishing between sounds.
• Have difficulty identifying important/relevant points or themes.
• Encounter difficulty mastering phonics.
• Confuse similar words, and have difficulty integrating new vocabulary.
• Encounter poor tracking skills resulting in skipped words, phrases or lines, or losing place on the page.

Organization

Students may:

• Have difficulty managing time effectively.
• Have a tendency to work slowly, rush through work carelessly or impulsively, start before listening to or reading instructions.
• Experience an inability to identify key points in a lecture or chapter.
• Have a short attention span.

Written Language

Students may:

• Have difficulty with sentence structure resulting in incomplete sentences, inappropriate use of grammar and missing inflectional endings.
• Make frequent spelling errors.
• Transpose letters, making words and sentences jumbled or unclear.
• Omit or substitute sounds, especially in unfamiliar vocabulary.
• Have difficulty copying correctly from written information.
• Exhibit poor penmanship or poorly formed letters.
• Capitalize incorrectly.
• Have difficulty with spacing in paper preparation.
• Have overly large handwriting.

Oral Language

Students may:

• Encounter an inability to concentrate on and comprehend oral language.
• Have difficulty expressing ideas orally and/or sequencing events properly.
• Exhibit difficulty in managing more than one task at a time.
• Experience difficulty retaining a list of information.
• Possess an inability to distinguish between sounds or a combination of sounds.

Mathematics

Students may:

• Have difficulty mastering basic facts that underlie other operations; can hinder math computation and comprehension if unaddressed.
• Experience problems with number reversals.
• Confuse operational signals.
• Have difficulty recalling the sequence of operational processes.
• Experience difficulty understanding and retaining abstract concepts.
• Exhibit poor comprehension of word problems and limited understanding of ratio, proportions, or relative size.
• Encounter reasoning deficits and an inability to eliminate irrelevant data in applied problems.

Despite learning problems, students with learning disabilities still have a number of talents and gifts. With support, motivation, and appropriate accommodations, many can successfully complete a college degree.

Educational Implications: It is important to note that the effects of a learning disability on academic performance typically result from deficits in long-term retrieval, short-term memory, processing speed, auditory, visual, and/or other cognitive deficits.

Instructional Considerations

Suggestions for instructional support for Reading:

• Announce readings well in advance to allow students plenty of time to complete them and to be able to break the reading into smaller chunks at a time.
• Provide PowerPoint slides before the lecture so that students can preview them ahead of time.
• Possibly provide a study guide for the text offering reflection questions or guidelines which will direct student's attention to the learning objectives for a reading.
• SDS may provide text in electronic format with a screen reader such as Kurzweil to facilitate reading.

Suggestions for instructional support for Writing:

• Give as much notice as possible for written assignments.
• Allow students to submit an assignment before the due date to receive direction and feedback before resubmitting for the final grade.
• Allow rewrites.
• Consider structuring long-term course projects with several small components due throughout the semester before the due date for the final project.
• SDS may provide access to voice recognition software such as Dragon Dictate Naturally Speaking.

Suggestions for instructional support for Test Preparation and Test Taking:

• Encourage students to visit you for support and guidance and to request their accommodations as needed.
• Consider including a section in your syllabus on "How to Do Well in this Course" that presents your personal guidance and suggestions on how students should study and how they should prepare for your exams.
• Possibly provide study guide, study questions or a review session to aid mastery and preparation for exams.
• Provide additional study resources or practice problems beyond what might be assigned.
• If possible, offer multiple ways to assess learning beyond one or two large exams per semester. Consider projects, presentations, short quizzes.
• Encourage students to come to your office to review the questions they missed after an exam. Help students identify how they can study more effectively for the next exam.

Suggestions for instructional support for Math:

• Encourage the use of the math lab study tables and support a request for a one-on-one tutor if needed.
• Encourage students to visit you for support or guidance and to request their accommodations as needed.
• Provide additional study resources or practice problems during the semester beyond what might be assigned.
• Consider providing practice problems for review session to aid mastery and preparation for tests.
• If possible, offer multiple ways to assess learning beyond one or two large exams per semester. Consider projects, presentations, short quizzes.
• Encourage students to come to your office to review the questions they missed after an exam. Help students identify how they can study more effectively for the next exam.

Additional suggestions for instructional support for students with learning disabilities:

• Use Blackboard or Moodle to post all course materials.
• Consider providing assignments in both oral and written format.
• When possible, include audio/visual aids in each lecture. Use board, overhead projector, PowerPoint slides and handouts to highlight key concepts when lecturing and to provide visual support.
• Contact Student Disability Services with any questions or concerns.

 

Other Instructional Information

Post Secondary Students with Learning Disabilities

 

Attention Deficit Hyperactivity Disorder is a neurobehavioral condition that affects a person's behavior and learning process. Symptoms may include: hyperactivity, impulsivity, distractibility, disorganization, sleep disorders, and mood changes. Symptoms of ADHD may also cause a high level of frustration, therefore can lead to negative thinking, low self-esteem, irritability, and depression. For some people, ADHD co-occurs with a specific learning disability as well.

Students with ADHD may have difficulties completing in-class assignments. During quizzes/exams, students with ADHD often need extended time in an environment with limited distractions. In addition to these academic accommodations, students with ADHD may also need notetakers and recording devices for lectures.

Functional Limitations

Students with ADHD may exhibit some of the following characteristics:

• Have difficulty organizing, planning and managing time effectively.
• Have a tendency to work slowly, rush through work carelessly or impulsively, start before listening to or reading instructions.
• Experience an inability to identify key points in a lecture or chapter.
• Have a short attention span.
• Lose things necessary for tasks or activities.
• Can be forgetful in daily activities.
• Avoid, dislike or be reluctant to engage in tasks that require sustained mental effort.
• Fidget with hands or feet or squirm in their seat.
• Often talk excessively, blurts out answers before questions have been completed, interrupts or intrudes on others, has difficulty waiting their turn.
• Have difficult time relaxing.

Instructional Considerations

General Considerations:

• Encourage students, at the beginning of each semester, to discuss accommodations outlined in their accommodations letter.
• Provide a detailed course syllabus.
• Announce reading assignments well in advance.
• Begin lectures and/or discussion with a written and oral overview of topics to be covered.
• Use board, overhead projector, or handouts to highlight key concepts when lecturing.
• Make statements that emphasize important points, main ideas, and key concepts when lecturing.
• Provide all assignments in oral and written format and be available for further clarification.
• Provide a study guide for the text and encourage study groups, peer tutoring, and study labs.
• Prepare study questions for review sessions to aid in student's mastery of the material for exams.
• Assist with accommodations recommended by the Student Disability Services Office such as note takers, recording of lectures/demonstrations, readers for tests, extended time on tests, as well as other alternative test arrangements.
• Allow students to sit where there are fewer distractions.

Autism / Asperger's Disorder is a neurological disorder that affects one's ability to understand and respond to other's thoughts and feelings.  Impacts may manifest in cognitive, behavioral and social characteristics.  In general, individuals on the spectrum may have a large disparity between their technical skills and abilities and their social competence.  Asperger's Disorder is the high end of the autism spectrum, often referred to as High Functioning Autism.

Functional Limitations

Students with Autism / Asperger's Disorder may exhibit some of the following characteristics:

• Poor eye contact
• Difficulty understanding facial expressions and non-verbal communication; misreads social cues
• Inappropriate social interaction, may have problems working in small groups
• Unusually strong narrow interests
• Above average to superior intellect
• Lacks voice intonation
• Impulsive
• Make lack comprehension of humor
• Very literal and concrete thinking patterns; may resist unexpected change in routine
• Prone to sensory overload
• May attempt to monopolize conversation; may interrupt lectures and questions; may abruptly change type of conversation
• Become tangential in answering questions
• Exhibit distracting behavior in long classes
• Engage in self-stimulating behavior suck as rocking, tapping, playing with "stress toys"
• Correct instructor or be argumentative
• Difficulty in talking when stressed; may have problems requesting help; may have difficulty regaining composure once agitated

Instructional Considerations

General Considerations:

• Allow students to sit near the instructor and away from classroom distractions.
• Provide clear, detailed information (oral and written) about the structure of the course, course requirements, assignment due dates, and the dates of the exams.
• As much as possible, follow the schedule of activities and assignments listed on the course syllabus.
• Be consistent in approach and keep variations to a minimum. If a change (in timetable, room, lecturer) is needed, give clear, specific information as far ahead as possible. Supplement oral with written instructions.
• Use clear, unambiguous language (spoken and written). Avoid or explain metaphors idioms, sarcasm, irony, etc. Avoid using absolute words such as "always" and "never" unless that is exactly what you mean. Do not take misbehavior personally.
• Give explicit instructions providing feedback about what is required and what is inappropriate and why.
• Since concentration can be a problem, consider developing a system to nonverbally remind the student to pay attention or guide him/her back on task. Visual cues work better than visual ones.
• Provide visual support for instructional materials such as charts, power point slides, outlines, tables.
• In group work, make clear exactly what is required of students. Provide written instructions and expectations.
• Provide instant, constructive feedback about behavior when there is a problem. Be firm and direct. If possible, ask the student to verbalize the error as well as a plan for the next time something similar happens.
• Use clear directives and establish rules if a student invades your spaces or imposes on your time or if the student's classroom comments or conversational volume becomes inappropriate.
• Contact Student Disability Services to arrange for a meeting between the professor, SDS and the student to discuss any issues that may occur.
• As much as is possible, prepare student for any scheduled changes in routine, as well as, environmental changes.
• Be aware that "visual clutter" and auditory noises (such as the hum of fluorescent lighting) can be very distracting and "overloading" to a student with autism.
• If a high-functioning student with autism uses repetitive verbal arguments and/or repetitive verbal questions, it is helpful to interrupt what can become a continuing, repetitive litany. Continually responding in a logical manner or arguing back seldom stops this behavior. The subject of the argument or question is not always the subject which has upset the student. More often the individual is communicating a feeling of loss of control or uncertainty about someone or something in the environment.
• Request the student write down the questions or argumentative statement, then write down your reply. This usually begins to calm them down and stops the repetitive activity. If that doesn't work, write down the repetitive question or argument and ask the student to write down a logical reply (perhaps one they think you would make). This distracts from the escalating verbal aspect of the situation and may give the student a more socially acceptable way of expressing frustration or anxiety. Another alternative is role-playing the repetitive argument or question with you taking the student's part and having the student answer you as they think you might.
• Assume nothing when assessing skills. For example, the individual with autism may be a "math whiz" in Algebra, but not able to make simple change at a cash register. Or, they may have an incredible memory about books they have read, speeches they have heard or sports statistics, but still may not be able to remember to bring a pencil to class. Uneven skills development is a hallmark of autism.

 

Other Instructional Information

My Semester with an Asperger's Syndrome Student

Understanding Students on the Spectrum

Living with Aspergers - Butler Students Perspective

Being Green, Life with Asperger's Syndrome

 

Hearing impairment refers to a reduction in sensitivity to sound that may be accompanied by some loss of the ability to interpret auditory stimuli correctly, even when amplified. In the United States, more persons have a hearing impairment than any other chronic physical disability. In general, persons born deaf tend to present the greater challenge to education because, in addition to being unable to hear, they often have very limited verbal communications skills. Nevertheless, educationally, persons who are deaf continue to succeed at every level. Hearing impairments make achievement more difficult to obtain, but most students rise to the occasion and achieve great success.

Functional Limitations

Students with a hearing impairment may exhibit some of the following characteristics:

• Impaired language development affecting comprehension of written materials, test questions, speaking, and writing.
• Misinterpretation of assignments.
• Difficulty participating in group discussions or other small-group activities.
• Difficulty in grasping abstract concepts.
• Inability to participate independently in a class without the assistance of an interpreter.
• For hearing aid users: reduced comprehension due to environmental noise.
• Dependence on visual cues.
• Inaccurate assessment of strengths and weaknesses based on standardized test scores.
• Social isolation and a sense of vulnerability due to communication barriers.
• Reluctance to ask for assistance or to have something repeated.

Instructional Considerations

General Considerations:

• Provide a detailed syllabus and lecture outline.
• Use good quality visual media to provide supplemental instruction of material.
• Supply a list of technical terminology and unfamiliar words or terms.
• Utilize overhead projectors as a substitute for board work (this allows you to face the class while you are writing).
• Write a key word or phrase about the topic being discussed on the board or overhead (this is especially important when the topic changes frequently).
• Post notice of class cancellations, assignments, etc., on board, overhead or in writing to ensure understanding.

Communication Techniques:

• Confer with student to determine the rate and volume of voice communication that will facilitate comprehension.
• Convey your message through facial expression, gestures, and other "body language."
• Pacing or writing on the board while speaking or speaking with your back to the person who has a hearing impairment restricts the student's ability to pick up context clues through lip reading or facial expressions.
• Excessive facial hair or anything that blocks the area around your mouth may also interfere with the student's ability to lip read.
• Rephrase a thought rather than repeat the same words if the student does not understand.
• Check for comprehension by asking for an explanation or illustration in such a way that does not single out the student with a hearing impairment from the rest of the class.
• Repeat or rephrase questions and comments brought up by other class members so that a student with a hearing impairment does not miss valuable portions of class discussion.
• Consider learning a basic sign language to enhance your ability to communicate with students with hearing impairments.

Environmental Considerations:

• Allow the student to sit in the front row or other optimum location
• Avoid standing with your back to a window or other sources of lights as the glare makes it difficult to read lips and other facial expressions.
• Maintain enough light during films to enable the student to see the interpreter.
• Look into obtaining films that are close-captioned.
• Provide better lighting for the student who is visually dependent and cannot add reliable auditory cues to the available visual information.
• Avoid placing a person who already has a substantial hearing loss in a noisy environment; such an environment assaults their vibratory sense (these persons should use ear protection to prevent further hearing loss).
• Be aware that room acoustics and environmental noise need to be considered for a student using a hearing aid.
• Uncarpeted floors, bare plaster walls, ceiling, heating, and cooling fans create noise and echoes that lower the effectiveness of the hearing aid.
• Inform the person with a hearing impairment by touch or signal to evacuate the building in case of an emergency.

Interpreter Tips:

• Direct questions and conversation to the student, not the interpreter.
• Provide the interpreter a list of technical terms and unfamiliar vocabulary to facilitate ease of interpretation.
• Do not expect interpreters to assume other duties; they are in the classroom for the student's benefit.

Hearing Aid Tips:

• Hearing aids amplify sound in a noisy environment; a student may need to turn off the aid to prevent discomfort.
• Instructors need to indicate when the aid should be reactivated.

Visual impairment is the loss of visual function of such magnitude that special aids and use of other senses are necessary to achieve performance ordinarily directed by visual cues. Students have a wide range of impairments, from mild impairment to complete absence of sight. It should not be assumed that a student cannot participate in educational activities simply because the student is visually impaired. Orientation, mobility, and rehabilitation specialists employed by the state Division of Blind Services can often determine special aids and/or accommodations that facilitate integration into the classroom setting. The Student Disability Services Office can also aid in explaining and providing accommodations.

Functional Limitations:

Students with a visual impairment may exhibit some of the following characteristics:

• Inability to utilize visuals such as films, graphs, demonstrations, and written materials.
• Difficulty in taking traditional paper and pencil exams.
• Need for a longer period of time to complete assignments.
• Difficulty in focusing on small-group discussion when there is more than one group functioning due to noise.
• Need for a variety of low-vision aids to integrate the classroom.
• Feelings of social inadequacy and isolation due to societal barriers.
• Reduced personal independence.
• Difficulty initiating career choices due to employer misconceptions.

Instructional Considerations

General Considerations:

• Provide syllabus electronically. 
• Provide large print visuals when appropriate; disability office will assist.
• Provide textbooks in advance so that electronic text can be created.
• Provide supplements to films such as sound tapes and oral summaries for preview and review.
• Permit visually impaired students to record lectures for review and reinforcement. Place recorder in close proximity to eliminate background noise and ensure quality.
• Photocopies of class handouts or course packets should be of good quality and should not be reduced below original size so that the materials may be easily transferred into alternative format.

Environmental Considerations:

• Allow partially sighted student to sit near the front of the room or in other optimum locations.
• Be sensitive to possible environmental hazards to visually impaired students such as misplaced furniture in walkways or barriers hanging from the wall or ceiling.
• Be aware of emergency routes and provide assistance to students when appropriate.

It is difficult to determine a simple, meaningful definition for seizure disorder due to the wide variability of symptoms associated with the disorder. A seizure may be defined as an episode of abnormal motor, sensory, autonomic, or psychic activity (or a combination of these) as a consequence of sudden excessive electrical discharge from cerebral neurons. ( Lippincott Manual of Practical Nursing, 4 ^th Edition ). Such seizures may consist of only a brief suspension of activity (petit mal), or a full-blown generalized motor seizure (grand mal). Other than the occasional seizure, persons with this disorder generally look and function as everyone else in society but may experience some memory dysfunction. The educational potential for persons who have seizure disorders is considered to be good and is not diminished if seizures are well controlled (unless serious memory deficits exist).

Functional Limitations

Educational Implications:

Students with a seizure disorder may possibly exhibit problems in one or more of the following areas. However, it is important to keep in mind that clinical presentation does vary between individuals.

• Brief lapses of consciousness or "staring spells" causing disruptions in the learning process.
• Side effects from anticonvulsant medication resulting in slowed reactions, clumsiness and poor hand coordination, eye focusing difficulty, and flatness of affect.
• Increased absences (if grand mal seizures are not well controlled medically).
• Memory deficits due to complex partial seizures or temporal lobe epilepsy.
• Clouded thinking caused by chronic seizure disorders and the effects of medication.
• Social isolation due to the general public's fear and misunderstanding of seizures.
• Avoidance of social situations because of fear and embarrassment should a seizure occur.
• Negative employer attitudes and rejection in job seeking due to misunderstanding of the disorder and fear that company liability and insurance rates will increase.

Instructional Considerations

General Considerations:

• Learn what to do when a grand mal seizure occurs.
• Allow for absences related to recovery from grand mal seizures.
• Recognize effects of medication on performance and allow extra time for exams and completion of class activities.
• Help student in assessment of career opportunities in their chosen career field.

Seizure Aid

• Refer to student specific information provided by SDS.
• Remove objects that may injure the student.
• Do not attempt to stop the seizure nor interfere with the student's movements; let the seizure run its course.
• Never try to place any object in the mouth. Turn the head or body to the side to prevent the tongue from slipping to the back of the throat and interfering with breathing.
• Assure a student who has experienced a seizure that all is well and that you understand.
• If possible, give the student privacy if bladder incontinence occurs after a grand mal seizure.
• Allow the student who has experienced a grand mal seizure to rest and check his/her condition frequently (the student will usually be disoriented and extremely tired).
• Do not give food or drink to the student unless seizure activity has passed.
• Check with Student Disability Services Office to find out who should be notified in case of emergencies.

A motor impairment is partial or total loss of the function of a body part. Such impairment may be the result of spinal cord injury, amputation, or musculoskeletal back disorders. Impairment of this nature may result in involuntary movements, total or partial paralysis, and reduced levels of functioning in tasks that require general trunk mobility. Motor impairments range from very visible injuries, like that of the spinal cord and amputation, to less obvious conditions such as a chronic back disorder. Because of the variety of circumstances, the educational expectations for students with motor impairment will differ greatly in relation to their particular type of disability. Educational planning for the student includes investigating and exploring the interests, aptitudes, and physical limitations of the student to determine the appropriate educational goal.

Functional Limitations:

Students with a motor impairment may exhibit some of the following characteristics:

• Difficulty moving from one location to another.
• Impaired writing and/or speaking due to the physical disability.
• Inability to sit, stand, or walk for prolonged periods of time.
• Difficulty participating in classes involving physical activity.
• May need special assistance in laboratory situations.
• Difficulty taking traditional paper and pencil exams.
• May require additional time to move from class to class.

Instructional Considerations

General Considerations:

• Do not assume that students with motor impairments cannot participate in an activity; always consult with the student regarding limitations.
• Give assistance only if the student asks for it; do not assume that assistance is required.
• Incorporate a means by which the student can participate in group activities. This may include: adaptive equipment, pairing the student with another classmate, or pairing the student with an assistant.
• Check emergency exits and routes so assistance may be provided as necessary.
• If necessary, utilize the expertise of a rehabilitation engineering program to adapt equipment, furnishings, tools, etc.

Wheelchair User

• Check for accessibility in and out of the classroom. Student Disability Services will assist with appropriate classroom furniture such as wheelchair-height workstations, aisle widths, etc., to accommodate the student's needs.
• Do not hang onto or lean on a wheelchair; it is often considered to be part of the person's "body-space".
• Push the wheelchair only if asked or if you have offered and it has been accepted.

Hand-Function Limitations

• Assist with a note taker.
• Allow the use of recorders for lectures and discussions.

Chronic Back Problems

• Allow students to alternate activities in sitting, standing, and walking.
• Be aware of emotional discomfort that often accompanies chronic pain.

One in every ten persons in the United States has some form of psychological disorder with varying degrees of severity. Because of the frequency of psychological problems in the general population, it can be assumed that instructors will most likely encounter students with these disabilities in the regular classroom. Psychological disturbances are grouped into a number of categories including psychoses, neuroses, mood shifts, organic brain syndromes, substance abuse, and personality disorders.

Functional Limitations

Instructional Considerations

General Considerations:

• Encourage students at the beginning of each term to discuss with you any modifications that will help to facilitate their learning.

Educational Considerations:  Every case is different, but there are some commonalities in the academic considerations of students with psychological disabilities:

• A student with an emotional disorder may be receiving ongoing treatment; therapeutic medications that affect performance and speed may play a factor in student accomplishments.
• Student behaviors which vary from expected norms may be an indication that the student is experiencing a recurrence of symptoms and is in need of intervention.
• Although students can assume full responsibility for their thoughts, feelings, and actions, empathy from the instructor is appreciated.
• Medications help with some symptoms of psychological disability, but medication side-effects can contribute to a student's academic problems.  The side-effects from psychiatric medications may include drowsiness, fatigue, dry mouth and thirst, blurred vision, hand tremors, slowed response time, and difficulty initiating interpersonal contact.
• The ability to function effectively may vary from day to day.
• It may be helpful to review instructional considerations about learning disabilities and Attention Deficit/Hyperactivity Disorder; a number of these suggestions will also be appropriate for students with psychological disabilities.

There are many conditions that may interfere with a student's academic functioning. Some symptoms, such as limited mobility or impaired vision, as well as the types of intervention required may resemble those covered elsewhere on this website. Below are brief descriptions of some of the more prevalent disabilities among students.

AIDS (Acquired Immune Deficiency Syndrome)

Acquired Immune Deficiency Syndrome ( AIDS ) is caused by a virus that destroys the body's immune system. This condition leaves the individual vulnerable to infections and cancers that a healthy immune system would normally destroy. The virus is primarily transmitted through sexual contact or the sharing of needles by intravenous drug users. It is not transmitted through casual contact. Because of the variety of infections and other diseases to which the person with AIDS becomes susceptible, symptoms of the disease and specific accommodations will vary for each individual. Fatigue is common. Allowances for absences due to illness or treatment may be necessary.

It is important to note that students with Acquired Immune Deficiency Syndrome can in no way infect another individual through casual contact. In fact, individuals who are not infected are more of a threat to infected individuals than persons with AIDS are to uninfected individuals. Students with AIDS are highly susceptible to all sorts of viruses and infections. Faculty and students should keep these factors in mind when interacting with students with AIDS .

Students with AIDS may be afraid to reveal their condition because of the social stigma, fear, and/or misunderstanding surrounding the condition. Confidentiality should, therefore, be strictly observed. In addition, if the issue should arise in class, the faculty member should address it openly and in a non-judgmental manner. Faculty should attempt to foster an atmosphere of understanding to the student in all situations.

Cancer

Because cancer can occur in almost any organ system of the body, the symptoms and particular disabling effects will vary greatly from one person to another. Some people experience visual problems, lack of balance and coordination, joint pains, backaches, headaches, abdominal pains, drowsiness, lethargy, difficulty in breathing and swallowing, weakness, bleeding and/or anemia.

The primary treatments for cancer - radiation therapy, chemotherapy, and surgery - may create additional symptoms. Therapy can cause violent nausea, drowsiness, and/or fatigue, affecting academic functioning or causing absences. Surgery can result in amputation, paralysis, sensory deficits, and language and memory problems.

Cerebral Palsy

Cerebral palsy is caused by an injury to the motor center of the brain. Such injury may have occurred before, during, or shortly after birth. Manifestations may include involuntary muscle contractions, rigidity, spasms, poor coordination, poor balance or poor spatial relations. Visual, auditory, speech, hand-function, and mobility problems may occur. Specific accommodations are covered in the sections on visual, hearing, motor, and speech impairments.

Closed Head Injury

Enrollment of students with brain injuries is steadily increasing. These students often exhibit one or more of the following symptoms: short-term memory problems, serious attention deficits, behavior problems, problems in judgment, and serious anxiety attacks.

Diabetes

Diabetes occurs when the pancreas produces very little or no insulin, or when the body does not respond appropriately to insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy.  The process of turning food into energy is crucial because the body depends on  energy for every action, including pumping blood, walking, thinking, and studying.  Reasonable accommodations are required by most students with diabetes and might include: the chance to have a snack or drink in class whenever needed, a small amount of extended time on an exam if the blood sugar should destabilize, or the opportunity to leave class in order to test blood levels or administer insulin as needed.

Multiple Sclerosis

Multiple Sclerosis is a progressive disease of the central nervous system, characterized by a decline of muscle control. Symptoms may include disturbances ranging from mild to severe. These include: blurred vision, legal blindness, tremors, weakness or numbness in limbs, unsteady gait, paralysis, slurred speech, mood swings, or attention deficits. Because the onset of the disease usually occurs between the ages of 20 and 40, students are likely to be having difficulty adjusting to their condition.

The course of multiple sclerosis is highly unpredictable. Periodic remissions are common and may last anywhere from a few days to several months, as the disease continues to progress. As a result, mood swings may vary from euphoria to depression. Striking inconsistencies in performance are not unusual.

Muscular Dystrophy

Muscular Dystrophy refers to a group of hereditary, progressive disorders that most often occur with young people, producing the degeneration of voluntary muscles of the trunk and lower extremities. The atrophy of the muscles results in chronic weakness and fatigue and may cause respiratory or cardiac problems. Walking, if possible, is slow and appears uncoordinated. Manipulation of materials in class may be difficult.

Respiratory Problems

Many students have chronic breathing problems, the most common of which are bronchial asthma and emphysema. Respiratory problems are characterized by attacks of shortness of breath and difficulty in breathing. Symptoms are sometimes triggered by physical or mental stress. Fatigue and difficulty climbing stairs may also be significant problems, depending on the severity of the attacks. Frequent absence from class may occur. Hospitalization may be required when prescribed medications fail to relieve symptoms.

Rheumatoid Arthritis

This section's guidelines may also pertain to other musculoskeletal disorders, connective tissue disorders, and chronic degenerative diseases. Rheumatoid Arthritis is a chronic degenerative disease affecting the joints and surrounding muscle tissue. Symptoms of the disease include pain, swelling, and limited mobility. Because the etiology of this disease is unknown, it is difficult to control. Flares (sudden exacerbation of disease activity) can result in debilitating swelling and pain, occurring frequently without warning. The treatment for rheumatoid arthritis is usually aggressive drug therapy (sometimes requiring hospitalization) which may result in side effects, making the student ill. Orthopedic interventions involving hospitalization and surgery may also be necessary.

Regular class attendance may be impossible for the student with rheumatoid arthritis due to flares and medication side effects. It may be necessary for students to complete assignments when their disease is less active. Students may find that their disease is less active at a particular time of the day. Students often suffer from weaker immune systems that may result in frequent illnesses.

It is usually not physically obvious that an individual has rheumatoid arthritis. Because of this, the student may be reluctant to identify himself or herself. It is also possible for a person with rheumatoid arthritis to be mobile in the afternoon hours but unable to attend morning classes due to pain.

Due to pain, swelling, and limited range of motion, extra time may be required to complete exams. It may also be necessary for the student to require assistance in writing. Exams may need to be administered in an area where the student is permitted to stand intermittently or move about. Finally, because of unexpected flares and medication side effects, it is possible that students will have difficulty taking exams at the originally scheduled time and may need to reschedule.

Sickle Cell Anemia

Sickle Cell Anemia is a hereditary disease that reduces the blood supply to vital organs and the oxygen supply to blood cells. This makes adequate classroom ventilation an important concern.

Because many of the vital organs are affected, the student may also experience eye disease, heart and/or lung problems, and acute abdominal pain. At times, limbs or joints may be affected by the illness. The disease is characterized by severe crisis periods, with extreme pain that may make hospitalization necessary and would subsequently result in absence from class. Contemplating academic assignments during these periods may not be possible.

Speech Impairment

Speech impairments range from problems with articulation and voice strength to complete voicelessness. Impairments include difficulties in projection (as in chronic hoarseness and esophageal speech), fluency problems (as in stuttering and stammering), and the nominal aphasia that alters the articulation of particular words or terms.

• Give students the opportunity to speak in class, but don't force it if they are uncomfortable.
• Permit students the time they require to express themselves.
• Don't offer unsolicited aid to fill in gaps in their speech. Don't be reluctant to ask the student to repeat a statement.
• Address students naturally. Don't assume the "spread phenomenon" (that they cannot hear or comprehend your statements and discussion).

Substance Abuse

Substance abuse is a condition of physiological and/or psychological dependence on any of a variety of chemicals, such as illegal drugs, some prescription drugs, and alcohol. Individuals who are recovering from drug and alcohol abuse or who are in treatment programs to assist in their recovery are covered by federal anti-discrimination legislation and are eligible for college services for students with disabilities.

These students may experience psychological problems including depression and anxiety. They may exhibit poor behavioral control, and, if medication is a part of their treatment experience undesirable side effects.