Guide for Working with Individuals with Disabilities

Important Phone Numbers

Table of Contents

Introduction
Disabling Myths
Accommodating Individuals Who Have Disabilities: An Overview
Learning Disabilities/Attention Deficit Disorder
Visual Impairments
Physically Disabled or Hand-Function Impairments
Hearing Impairments
Psychological Impairments
Speech/Language Impairments
Other Disabilities
     AIDS and HIV Disease
     Cancer
     Cerebral Palsy
     Acquired Brain Injury
     Multiple Sclerosis
     Muscular Dystrophy
     Respiratory Problems
     Seizure Disorders
     Sickle Cell Anemia
     Substance Abuse
The Language of Disabilities

Introduction

The obligation to accommodate individuals with disabilities extends beyond the moral responsibility and beyond the university's commitment to fulfill the promise of access.

Disability Accommodations and the Law - A Brief Summary

Two important federal laws govern the issue of disability accommodations in the university setting. The Americans with Disabilities Act (ADA) prohibits discrimination on the basis of a disability by state and local governments and public accommodations. In addition, Section 504 of the Rehabilitation Act of 1973 prohibits discrimination on the basis of a disability by programs receiving federal financial assistance. These statutes apply to individuals with physical or mental impairments that substantially limit a major life activity. As a general matter, institutions are required to make reasonable accommodations  for otherwise qualified persons with disabilities, unless such accommodations would present an undue burden  for the institution.

With respect to employment, universities cannot discriminate against hiring, review, promotion, demotion, discharge, or other aspects of employment, against any applicant or employee with a disability, on the basis of that person's disability, if the person is qualified and able to perform the job's essential functions with reasonable accommodation. However, employers are not required to provide accommodations that would cause undue hardships like significant expense, difficulty, or undue disruption.

With respect to students, affected activities include:

Admissions:  Universities may not deny admissions to otherwise qualified applicants solely because of their disabilities; nor may such applicants be subjected to discrimination in the admissions or recruitment process on the basis of their disabilities. Affected areas may include application, testing, interviewing, and the decision making process.

Programs and services for enrolled students:  Academic programs, as well as athletics, counseling and placement, financial aid, health and insurance activities, and extracurricular activities are subject to the requirements of the ADA and Section 504. Universities are not however, required to make substantial modifications or fundamental alterations in program standards or requirements to accommodate students with disabilities.

Physical facilities:  Housing, transportation, and off-campus programming also are affected by the statutes.

Both the ADA and Section 504 describe a complaint procedure. Employment-related complaints generally are referred to the Equal Employment Opportunity Commission; other complaints are referred to the agency with jurisdiction (usually the Department of Education). Persons alleging discrimination by a public entity do not have to first exhaust their administrative remedies before pursuing legal remedies.

The requirements imposed by these statutes come at a time of declining resources for many institutions. Thus, administrators must try to comply with the law and provide reasonable accessibility and accommodations within budgetary restraints. Nonetheless, colleges and universities are the forefront of the integration of persons with disabilities.

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Disabling Myths

Their similarities with others are much more significant: we are dealing, first and foremost, with people.

The first step in accommodating individuals with disabilities seems obvious: treat them, simply, as people. After all, they come to Fairfield University for the same reasons that others do and they bring with them the same range of intelligence and skills. Yet these truisms are easier said than acted upon. Our best intentions often run into attitudes that dramatically distort our relations with people who have disabilities.

Poor attitudes may be natural and innocent, deriving as they do from fears, guilt, and inexperience with individuals who have disabilities. But as forms of prejudice, they can be devastating to the person with a disability. These attitudes reduce our expectations of the individual's performance. They define the person by the disability, as if it comprises the entirety of his or her being. They lead us to isolate and segregate people with disabilities, hurt their pride, deter their maximum achievement, and damage their confidence. The wrong attitudes can be more disabling than any other condition.

Stereotyping prevails no more, and no less, on campus than it does in the larger society.

At a university, however, it does not only perpetuate the prejudicial treatment encountered by people with disabilities elsewhere, but it may undermine the work or scholastic performance and reinforce the negatives they are trying to surmount at crucial junctures in their lives.

Revising our perceptions and attitudes, then, is the first step. In accommodating individuals who present themselves, learn, or perform in ways that are different from others, it is vital to remember that their similarities with others are much more significant: we are dealing first and foremost with people.

Some Disabling Myths

The Myth of the Helpless Invalid, which manifest itself in excessive deference and solicitousness.

The Myth of the Heroic Cripple, which places the person with a disability on a pedestal, making it difficult for him or her to assimilate and function.

The "Spread" Phenomenon, which generalizes from a single disability and assumes there are also intellectual, social and other physical deficits.

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Accommodating Individuals Who Have Disabilities: An Overview

There is no need to dilute the curriculum or reduce requirements for individuals with disabilities.

The individual's own suggestions, based on his or her experience with the disability within the school or work environment, are invaluable in determining reasonable accommodations.

Individuals bring a unique set of strengths and experiences to the campus, and individuals with disabilities are no exception. While many learn or work in different ways, their differences do not imply inferior capacities. There is no need to dilute curriculum or to reduce requirements for individuals with disabilities. However, special accommodations may be needed, as well as modifications in the way information is presented and in methods of testing and evaluation. Faculty and supervisors will be aided in these efforts by drawing upon the individual's own prior experiences, using available college and department resources, and collaborating with Student Support Services. In this respect, open communication is an essential part of successful accommodation.

Determining that an individual has a disability may not always be a simple process. Visible disabilities  are noticeable through casual observation - an immediately recognizable physical impairment, for example, or the use of a cane, a wheelchair or crutches. Other individuals may have a hidden disability  such as a hearing impairment, cardiac condition, learning disability, cancer, diabetes, kidney disease, or psychiatric or seizure disorder.

Additionally, there are individuals who have multiple disabilities. Multiple disabilities  can be caused by such primary conditions as muscular dystrophy, cerebral palsy, or multiple sclerosis. A person with a hearing impairment may have impaired speech ability secondary to the hearing loss. Finally, some individuals may have dual disabilities, such as impaired vision and a learning disability.

Some individuals with disabilities will identify themselves as such by contacting the Office of Academic & Disability Support Services, or their instructors or supervisors. Others, especially those with "hidden" disabilities, may not - because of their fear of disbelief either about legitimacy of their problem or the need for accommodation. Such individuals may run into trouble in their studies or work. In a panic, they may self-identify just before an examination or before an assignment is due and expect instant attention to their needs.

The faculty member or supervisors should make an announcement at the beginning of the term or at the onset of employment inviting individuals with disabilities to discuss possible needs for accommodation. For example, a syllabus might contain a statement such as, "Fairfield University is committed to making reasonable accommodations to individuals with disabilities that have been documented by the Office of Academic & Disability Support Services (Campion Trailer).  If you wish to discuss academic accommodations for this class, please contact the professor by (date)." Establishing a climate of awareness of individual differences and abilities makes a dialogue about the need for accommodations much easier to accomplish. If you suspect an individual has a disability, discuss the issue with the individual. You may find such an approach awkward, at least initially, but the end result will be extremely beneficial if the individual's circumstances are made known early.

However a disability is defined, it should be verified and discussed with the Office of Academic & Disability Support Services.

Things to Keep in Mind

Specific suggestions for interacting with individuals with disabilities will be offered in the section devoted to each disability. Here are some general considerations to keep in mind, regardless of the specific disability:

Dividing the responsibilities
To the extent manageable, individuals with disabilities bear the primary responsibility, not only for identifying their disabilities, but for making necessary adjustments to the learning or work environment, for special arrangements and the use of department resources. However, the cooperation of faculty and administrators is vital.

Faculty-Student, Employee-Supervisor relationships
Dialogue between the individual and instructor or supervisor is essential in the process and follow-up meetings are recommended. Faculty or supervisors should not feel apprehensive about discussing the individual's needs as they refer to the situation. There is no reason to avoid using terms that refer to the disability, such as "blind," "see," or "walk." However, care should be taken to avoid generalizing a particular limitation to other aspects of a person's functioning. Often, for example, people in wheel chairs are spoken to very loudly, as if they were deaf. The individual will probably have had some experience with this kind of initial uneasiness you may bring to the relationship. The person's own suggestions, based on experience with the disability and with school or work, are invaluable in accommodating disabilities.

Attendance and promptness
The individual using a wheelchair or other assistive devices may encounter obstacles or barriers in getting to class or work on time. Others may have periodic or irregular difficulties, either from their disability or from medication. Flexibility in applying attendance and promptness rules to such individuals is helpful.

Classroom and work site adjustments
A wide range of individuals with disabilities may be served in the classroom or workplace by making information available before the beginning of the term or job.

Functional Problems
In addition to the adjustments that will be discussed in detail for each category of disability, some understanding is required in working with more subtle and sometimes unexpected manifestations of disability. Chronic weakness and fatigue characterize some disabilities and medical conditions. Drowsiness, fatigue, or impairments of memory or speed may result from prescribed medications. Such difficulties and interference with the individual's ability to perform should be distinguished from the apathetic behavior it may resemble.

Advising
It is very helpful for academic advisors to be aware of students' disabilities. Awareness of disability helps advisors to better plan a student's schedule and make advising recommendations.

Note-taking
Students who cannot take notes or have difficulty taking notes adequately would be helped by allowing them to tape record lectures, or by permitting them to utilize an assigned note-taker.

Testing and evaluation
Depending on the disability, the student may require the administration of examinations orally, the use of readers and/or scribes, extensions of the time for the duration of exams, a modification of the test format or, in some cases, make-up or take-home exams. For out-of-class assignments, the extension of deadlines may be justified. The objective of such considerations should always be to accommodate the student's learning differences, not to dilute scholastic requirements. The same standards should be applied to students with disabilities as to all other students in evaluation and assigning grades.   The Office of Academic & Disability Support Services should be consulted before faculty make testing accommodations.

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Interacting With Individuals Who Have Learning Disabilities/Attention Deficit Disorder

Drawing upon the individual's own experience offers invaluable clues to the types of adaptation that work.

Learning Disability

A learning disability is any of a diverse group of conditions that cause significant difficulties in perceiving and/or processing either auditory, visual and/or spatial information. Of presumed neurological origin, the condition we call learning disability covers disorders that impair such functions as reading (dyslexia), writing (dysgraphia) and mathematical calculation (dyscalculia). Individuals with learning disabilities vary widely within each category in the patterns they exhibit.

Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder

Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder results in a persistent patter of inattention and/or hyperactivity or impulsivity which is more frequent and severe than is typically observed among individuals at a comparable level of development. People with attention deficit disorder frequently exhibit anxiety, depression, dyslexia, dysgraphia or dyscalculia.

People with learning disabilities/attention deficit disorder have average to superior intelligence as well as adequate sensory and motor systems, as evidenced by the extraordinary achievements of numerous people with learning disabilities/attention deficit disorder. But these conditions have only recently been identified and they still go often undiagnosed. That is why it is often misunderstood - by people with learning disabilities/attention deficit disorder themselves as well as others - as intellectual deficiency, which it emphatically is not.

In fact, the marked discrepancy between the intellectual capacity and achievement is what often characterizes a learning disability. In addition, certain behavioral characteristics may be noted in a person with attention deficit disorder. Documentation of the disability is required not only to establish the need for special services but to determine the kind of special services that are indicated. Individuals believed to have a learning disability/attention deficit disorder who have not been previously or reliably identified should be referred to the Office of Academic & Disability Support Services. Students should understand that faculty are not obligated to make accommodations unless the student's disability has been documented by Academic & Disability Support Services, and suggestions made for reasonable accommodations.

While a learning disability/attention deficit disorder cannot be "cured," it may be circumvented through intervention and compensatory strategies. In general a variety of compensatory modes enhances learning for individuals with learning disabilities/attention deficit disorder, as for others, by allowing them to master material that may be inaccessible in one particular form.

In working with people with learning disabilities/attention deficit disorder, it is important to identify the nature of the kind of disability in order to determine the kind of strategies that might accommodate it. Drawing upon the individual's own experience offers invaluable clues to the types of adaptations that work.

Academic & Disability Support Services

Academic & Disability Support Services provides the following services: academic advisor/advocate, (Director of Academic & Disability Support Services), CD's available from the Recordings for the Blind and Dyslexic, extended test time (time one and a half or double time), individual accommodations as appropriate (classes are not expected to be altered), note takers and readers, notification in writing of accommodations to professors, oral testing and teaching study skills.

Workplace and Teaching Strategies for Individuals Who Have Learning Disabilities

Once a student with a learning disability and the nature of the disability are known, these strategies may help:

Auditory Processing/Visual Processing

Some individuals may experience difficulty integrating information presented orally or visually, hindering their ability to follow the sequence and organization of a lecture, or follow a series of instructions. Many of the strategies listed below which aid such students' classroom performance are good teaching practices which maximize all students' performance. Others are management techniques which improve job performance for all workers.

• Provide individuals with a course syllabus or other written expectations at the start of the semester or employment period.
• Outline class presentations and write new terms and key points on the chalkboard or overheads.
• Repeat and summarize segments of each informational presentation and review its entirety.
• In dealing with abstract concepts, paraphrase them in specific terms and illustrate them with concrete examples, personal experiences, hands-on models and such visual structure as charts and graphs.

Memory

Memory or sequencing difficulties may impede the student's execution of complicated directions.

• Provide all important instructions in writing.
• Keep oral instructions concise and reinforce them with cue words.
• Repeat or re-word complicated directions.

Reading

Reading may be slow and deliberate, and comprehension may be impaired for a student with a learning disability, particularly when dealing with large quantities of material. For such a student, comprehension and speed are expedited dramatically with the addition of auditory input.

• For all assignments, identify expectations clearly in writing.
• Make required book lists available prior to the first day of class to allow students to begin their reading early or to have texts put on tape.
• Provide students with chapter outlines or handouts that highlight key points in their readings.
• Read aloud material written on the chalkboard or that it is given in handouts or transparencies.

Note-taking

Some individuals with learning disabilities need alternative ways to take notes because they cannot write effectively or assimilate, remember and organize the material while listening to the lecture.

• Allow note-takers to be utilized class.
• Permit tape recording or make your notes available for material not found in the texts or other accessible sources.
• Assist the student, if necessary, in arranging to borrow classmates' notes.

Participation

It is helpful to determine the person's ability to participate in group discussions and classroom activities. While many individuals with learning disabilities are highly articulate, some have severe difficulty in talking, responding, or recalling in front of groups.

Specialized Limitations

Some individuals with learning disabilities may have poor coordination or trouble judging distance or differentiating between left and right. Such devices as demonstrations from the person's right-left frame of reference and the use of color codes or supplementary symbols may overcome the perceptual problem.

Science Laboratory

The science laboratory can be especially overwhelming for individuals with learning disabilities. New equipment, exact measurement and multi step procedures may demand precisely those skills that are hardest for them to acquire.

• An individual orientation to the laboratory and equipment can minimize student anxiety.
• The labeling of equipment, tools, and materials is helpful.
• The student's use of cue cards or labels designating the steps of a procedure may expedite the mastering of a sequence.
• Specialized adaptive equipment may help with exact measurements.

Behavior

Because of perceptual deficiencies, some individuals with learning disabilities are slow to grasp social cues and respond appropriately, they lack social skills, or they may have difficulty sustaining focused attention. If such a problem results in classroom interruptions or other disruptions, it is advisable to discuss the matter privately with the student or with Academic & Disability Support Services.

Evaluation

A learning disability may affect the way an individual's classroom or employment performance should be evaluated. If so, a special arrangement may be necessary.

• Allow individuals to take examinations in a separate, quiet room with a proctor. Individuals with learning disabilities are especially sensitive to distractions. Testing services are available at the Office of Academic & Disability Support Services.
• Grant time extensions on exams and written assignments when there is significant demand on reading and writing skills.
• Avoid overly complicated language in examination questions, and clearly separate them in their spacing on the exam sheet. For a student with visual perception deficits, it may be wise to avoid using answer sheets, especially computer forms.
• Try not to test recently presented material since more time is generally required to assimilate new knowledge.
• Permit the use of a dictionary, computer spell checks, a proofreader, or in mathematics and science, a calculator. In mathematics, the student may understand the concept, but make errors by misaligning numbers or confusing arithmetical facts.
• When necessary, allow individuals to use a reader/scribe, word processor, tape recorder, or typewriter.
• Consider alternative test designs. Some individuals with learning disabilities may find essay formats difficult, and a student with a perceptual impairment will always have trouble with "matching" tests.
• Consider alternative or supplementary assignments that may serve evaluative purposes, such as taped interviews, slide presentations, photographic essays or hand-made models.

For more ideas on alternative methods of instruction and evaluation, you may wish to consult with the Office of Academic & Disability Support Services.

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Interacting With Individuals Who Have Visual Impairments

They may confront limitations in laboratory classes, field trips and internships, but with planning and adaptive equipment, their difficulties can be minimized.

Visual impairments vary greatly. Persons are considered legally blind when visual acuity is 20/200 or less in the better eye with the use of corrective lenses. Most persons who are legally blind have some vision. Others who have low vision may rely on residual vision with the use of adaptive equipment. Persons who are totally blind may have visual memory, its strength, depending on the age when vision was lost.

Whatever the degree of impairment, individuals who are visually impaired should be expected to participate fully in the classroom or workplace activities, such as discussions and group work. To record notes, some use such devices as laptop computers or computerized braillers. They may confront limitations in laboratory classes, fieldwork, and internships, but with planning and adaptive equipment their difficulties can be minimized.

Before or early in the semester or the employment period

• Provide copies of reading lists, syllabi or other necessary printed resources in advance to allow time for arrangements to be made such as the taping or brailling of texts.
• In cooperation with Academic & Disability Support Services, assist the student in finding readers, note-takers or tutors, as necessary, or team the student with a sighted classmate or laboratory assistant.
• Reserve front seats for low vision individuals. If a guide dog is used, it will be highly disciplined and require little space. Individuals who use laptops or braillers may require seating near electrical outlets.

During the Semester

• Face the class when speaking to maximize clarity.
• Convey in spoken words whatever you put on the chalkboard and whatever other visual cues or graphic materials you may use.
• Permit lectures and other informational meetings to be taped and/or provide copies of lecture notes, where appropriate.
• Provide large print copies of classroom materials by enlarging them on a photocopier.
• Be flexible with assignment deadlines.
• Plan field trips and such special projects as internships well in advance and alert field supervisors to whatever adaptations may be needed.
• Advise guest speakers (in advance), so they can make appropriate adjustments to their presentations.
• If a specific task is impossible for an individual to carry out, consider an alternate assignment.

Examinations and Evaluations

• Individuals should not be exempt from examinations or be expected to master less content or a lower level of scholastic skill because of a visual impairment. Alternative means of assessing their course achievement may be necessary. The individuals themselves, because of their experience in previous learning situations, and Academic & Disability Support Services may offer suggestions on testing and evaluation strategies. The most expedient devices are alternative examinations (oral, large-print, Braille, or taped), the extension of time for exams, and the use of such aids as print enlargers or tape recorders. Academic & Disability Support Services is available to assist with the administration of classroom exams.
• Other adaptations suited to specific instructional situations, such as tactile materials, may be helpful.

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Interacting With Individuals Who are Physically Disabled Or Who Have Hand-Function Impairments

A wide range of conditions may limit mobility and/or hand function. Among the most common permanent disorders are musculoskeletal disabilities such as partial or total paralysis, amputation or severe injury, arthritis, active sickle cell disease, muscular dystrophy, multiple sclerosis and cerebral palsy. Additionally, respiratory and cardiac diseases, which are debilitating, may consequently affect mobility. Any of these conditions may also impair the strength, speed, endurance, coordination and dexterity that are necessary for proper hand function. While the degree of disability varies, individuals may have difficulty getting to or from class, performing in class, and managing out-of-class assignments and tests.

Getting to and from a destination

Physical access is a major concern of individuals who are physically disabled. Those who use wheelchairs, braces crutches, canes or prostheses, or fatigue easily, find it difficult moving about, especially within the time constraints imposed by tight schedules. Occasional lateness may be unavoidable. Tardiness or absence may be caused by transportation problems, inclement weather or wheelchair breakdown.

When working with individuals with physical disabilities:

• Consider the accessibility factor early in the contact period.
• Be prepared to arrange for a change of classroom or work site if no other solution is possible.
• Familiarize yourself with the building's emergency evacuation plan and assure that it is manageable to individuals who are physically disabled.

In Class/At Work site

Some classrooms or work sites present obstacles to the full participation of individuals who are physically disabled. In seating arrangements, every effort ought to be made to integrate them into the mainstream. Relegating individuals to a doorway, a side aisle or the back of the room should be avoided. Even such apparently insurmountable barriers as fixed seating may be overcome by arranging for a chair to be unbolted and removed to make room for a wheelchair.

Laboratory stations or other workstations too high for wheelchair users to reach or transfer to, or with insufficient under-counter knee clearance may be modified or they may be replaced by portable stations. Otherwise the assistance of an aide may be needed.

• Individuals with hand-function limitations may have similar difficulties in the laboratory or the work site, as well as in doing assignments and in taking written tests.
• Permit the use of a scribe or tape recorder.
• Team the individual with a laboratory partner or assistant.
• Allow some written assignments to be completed at home with the use of a scribe if necessary.
• Academic & Disability Support Services can administer oral or taped tests, or provide space and supervision for extended testing time requiring the use of scribes.

Out of class/Off-site assignments

For individuals who are physically disabled or who have hand function impairments, the use of the library for reading or research assignments may present obstacles. Arrangements for assistance with library personnel may have to be made for access to card catalogs, bookshelves, and microfiche and other equipment, or for manipulating the pages of publications. Because the completion of required work may thus be delayed, the extension of deadlines may be appropriate.

Off-campus/off-work site assignments and field trips may poise similar problems of access to resources. Individuals should consider such expedients as advance notice to people who rely on special transportation, the extension of deadlines and alternative assignments

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Interacting With Individuals Who Have Hearing Impairments

Indications that a person has a hearing loss may include a person who appears to strain to hear, use of loud or distorted speech, and consistent failure to respond.

Individuals who are deaf or hard of hearing may use a wide range of services depending on the language or communication system they may use.

Culturally deaf people are members of a distinct linguistic and cultural minority. The members of this group us American Sign Language as their first language. Therefore, members of this cultural group are bilingual and English is their second language. As with any cultural group, deaf people have their own values, social norms, and traditions. Because of this, be sensitive and attentive to cross-cultural information in the mainstreamed classroom setting. Culturally Deaf persons may use American Sign Language interpreters in the classroom setting.

Hard of Hearing refers to those individuals who may use speech, lip reading and hearing aids to enhance oral communications. Hearing aids or amplification systems may include public address systems and transmitter/receiver systems with a clip-on microphone for the instructor or speaker. For those who use lip reading, only 30-40% of spoken English is understandable, even for those who are highly skilled.

For people who are deaf or hard of hearing who choose to speak, the ability to self-monitor accuracy of speech articulation is usually quite limited; therefore, vocal control, volume, and articulation may be affected. These secondary effects are physical and should not be viewed as mental or intellectual weaknesses.

There are a variety of services available to individuals who are hard of hearing. Individuals should contact Academic & Disability Support Services to coordinate services.

Things to Keep in Mind

• Individuals who are deaf or hard of hearing will benefit from front row seating. An unobstructed line of vision is necessary for individuals who use interpreters and for those who rely on lip reading and visual cues. If an interpreter is used, the person's view should include the interpreter and professor.
• Avoid speaking in low-light conditions, such as in a darkened lecture hall while showing slides or movies. If you must do this, have lighting for the speaker's face or translator.
• Keep your face within view of the person and speak in a natural tone.
• When using an interpreter, speak directly to the deaf person and not the interpreter.
• Recognize the processing time that the interpreter takes to translate a message from it's original language into another language (whether English to American Sign Language or vice versa) because this will cause delay in the person's receiving information, asking questions and/or offering comments.
• Repeat questions and remarks of other people in the room.
• Use visual aids and the chalkboard to reinforce spoken presentations when possible.
• If requested, assist the person with identifying a note-taker.
• When possible, provide the student with class outlines, lecture notes, lists of new technical terms and printed transcripts of audio and audio-visual materials.
• Do not hesitate to communicate with the person in writing when conveying important information such as assignments, scheduling, deadlines, etc. E-mail can be a useful tool to facilitate communication between individuals with hearing impairments and their instructors or supervisors.
• Some individuals have poorer hearing ability in one ear than in the other. This is more important in small groups than in a larger setting. Consider preferential seating in small groups.
• Hearing aids amplify background sound as much as they amplify speech. Avoid carrying on conversations in noisy settings. Background whispering may greatly interfere with the ability to hear a classroom lecture.

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Interacting With individuals Who Have Psychological Impairments

Individuals with psychological/psychiatric disabilities present some of the most difficult challenges to college faculty and staff. Like those with other disabilities, their impairments may be hidden and, in fact, latent, with little or no effect on their learning. Unlike others, however, their emotional disturbances may manifest themselves in negative behavior ranging from indifference and recalcitrance and disruptiveness. Such conduct makes it hard to remember that they have as little control over their disabilities as do individuals with physical disabilities.

Depression

Among the most common psychological impairments is depression. The condition may be temporary, in response to inordinate pressures at school, on the job, at home, or it may manifest as a pathological sense of hopelessness, which may provoke in it's extreme, threats or attempts at suicide. It may appear as apathy, disinterest, inattention, impaired concentration, irritability, or as fatigue or other physical symptoms resulting from changes in eating, sleeping, or other living patterns.

Anxiety

Anxiety is prevalent among individuals who have psychological impairments and may be the transient reaction to stress. Mild anxiety, in fact, may promote learning and improve performance. Severe anxiety, however, may reduce concentration, distort perception, and weaken the learning process. Anxiety may manifest itself as withdrawal, constant talking, complaining, joking, crying, fantasizing, or extreme fear, sometimes to the point of panic. Physical symptoms might include episodes of light-headedness or hyperventilation.

Students and employees on a college campus are susceptible to the same myriad of psychological/psychiatric disorders found in any school or work setting, some of which express themselves in inappropriate classroom or workplace behavior or inadequate performance of required tasks. Some individuals who are undergoing psychological/psychiatric treatment take prescription medication to help control disturbing feelings, ideas, and behavior. This medication may cause undesirable side effects such as drowsiness and disorientation.

In dealing with psychological conditions that impair the functioning of the affected individual alone, the principles outlined for all individuals who have disabilities in the Overview section generally apply. If the behavior begins to affect others, your course of instruction or office procedures, other measures may be necessary.

Suggestions

• Discuss inappropriate behavior with the individual privately, directly, and forthrightly, delineating if necessary the limits of acceptable conduct.
• In your discussion with the individual, do not attempt to diagnose or treat the psychological disorder but only the individual's behavior in the course of the workplace.
• If you sense that discussion would not be effective, or if the individual approaches you for therapeutic help, refer the individual to Counseling Services, the Health Center or Academic & Disability Support Services.
• If abusive or threatening behavior occurs, refer the matter to the Dean of Students office or campus safety.

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Interacting With Individuals Who Have Speech/Language Impairments

Patience is the most effective strategy when communicating with individuals who have speech impairments.

Speech impairments range from problems with articulation to fluency or vocal strength. They include difficulties in vocal projection, as in chronic hoarseness or esophageal speech following laryngectomy. Other speakers may demonstrate fluency problems, as in stuttering ("stammering"). Articulation or speech sound errors may be acquired as a result of neurological disease or stroke, or may accompany developmental disabilities such as cerebral palsy, cleft palate or significant hearing impairment.

Individuals who cannot utilize the vocal channel to communicate effectively may be aided by the use of augmentative and assistive communication devices, such as communication boards, or speech synthesizers. These devices typically convey information at a rate slower than that of vocal interaction, and the listener should accommodate this slower pace of interaction.

Individuals with less severe articulation disorders may have slower and less intelligible speech.

Stuttering (or stammering) is a neurologically based disorder of speech production. A person who stutters may take longer to convey a spoken message. As with many other speech conditions, stuttering symptoms are aggravated by the anxiety inherent in oral communication in a group. Stuttering is widely perceived to be the result of shyness and anxiety, another disabling myth. In fact, anxiety is often the result of the speaker's negative past experiences with listener reactions to the stuttering. Some individuals who stutter or have other oral communication impairments do not have concerns about classroom or workplace presentations; others do. Some therapies to reduce stuttering may result in slower rate or reduced prosody (intonation) which can affect grading on some types of oral presentations. For these individuals, other assignment or grading options should be made available.

Communication Strategies

• Give individuals the opportunity-but do not compel them to speak.
• Give individuals the time they require to express themselves, without unsolicited aid in filling in gaps in their speech. Don't be reluctant to ask the person to repeat a statement. But don't finish sentences for them.
• Address individuals naturally. Don't assume the "spread phenomenon" - that they cannot hear or comprehend.
• For individuals who have severe verbal impairment, consider course or job modifications, such as one-to-one presentations and assignments compatible with the use of a computer with a voice synthesizer

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Interacting With Individuals Who Have Other Disabilities

There are many other conditions that may interfere with an individual's academic or job functioning. Some of their symptoms, like limited mobility or impaired vision and the types of intervention required may resemble those covered elsewhere in this manual. The general principles set forth in the Overview apply, particularly the need to identify the disability and to discuss with the individual both its manifestations and the required considerations. Below are brief descriptions of some of the more prevalent disabilities among individuals, along with recommended accommodations.

AIDS (Acquired Immune Deficiency Syndrome) and HIV Disease

Acquired Immune Deficiency Syndrome (AIDS) is caused by a virus that destroys the body's immune system. This condition leaves the person vulnerable to infections and cancers that can be avoided when the immune system is working normally. The virus is transmitted primarily through sexual contact or needle sharing with intravenous drug users. It is not transmitted through casual contact.

Manifestations of AIDS are varied; depending on the particular infections or diseases the individual develops. Extreme fatigue is a common symptom. Adaptations will likewise vary.

Individuals who have AIDS may be afraid to reveal their condition because of social stigma, fear and/or misunderstanding surrounding the illness. It is therefore exceptionally important that confidentiality be strictly observed. In addition, if the issue should arise in class, it is important for faculty to deal openly and non-judgmentally with it and to foster an atmosphere of understanding.

For general considerations, please refer to the Overview section. If cancer is involved, see the section below. For particular impairments, please see the applicable section on specific disabilities.

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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 or anemia.

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

For general considerations, please refer to the Overview section. For particular impairments, please see the applicable section on specific disabilities.

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Cerebral Palsy (CP)

Cerebral Palsy (CP) is caused by an injury to the motor center of the brain, which may have occurred before, during, or shortly after birth. Manifestations may include involuntary muscle contraction, rigidity, spasms, poor coordination, poor balance, or poor spatial relations. Visual, auditory, hand-function, and mobility problems may co-exist.

For appropriate accommodations refer to the sections on speech, visual,physical disabilities and hand-function impairments.

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Acquired Brain Injury

Individuals who have brain injuries are becoming increasingly more prevalent. These individuals often exhibit one or more of the following symptoms: short-term memory problems, serious attention deficits, auditory dysfunction, cognitive deficits, behavior problems, problems of judgement, and serious anxiety attacks.

For general considerations, please refer to the Overview section and the sections on learning disabilities and/or seizure disorders.

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Multiple Sclerosis (MS)

Multiple Sclerosis (MS) 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: blurred vision, legal blindness, tremors, weakness, or numbness in limbs, unsteady gait, paralysis, slurred speech, mood swings, or attention deficits. Because onset of the disease usually occurs between the ages of 20 and 40, individuals are likely to be having difficulty adjusting to the condition.

The course of Multiple Sclerosis is highly unpredictable, periodic remissions are common and may last 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.

For appropriate accommodations, refer to the section(s) on speech,visual impairment,physical disabilities and hand-function impairments.

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Muscular Dystrophy (MD)

Muscular Dystrophy (MD) refers to a group of 40 hereditary, progressive disorders that most often occur with young people, producing degeneration of voluntary muscles of the trunk and lower extremities. The atrophy of the muscles result in chronic weakness and fatigue and may cause respiratory or cardiac problems. Walking (if possible) is slow and appears uncoordinated. Manipulation of materials may be difficult.

Refer to the section on physical disabilities and hand-function impairments for appropriate accommodations.

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Respiratory Problems

Many individuals have chronic breathing problems. The most common of these are bronchial asthma and emphysema. Respiratory problems are characterized by attacks of shortness of breath and difficulty in breathing, sometimes triggered by stress, either physical or mental. Fatigue and difficulty climbing stairs may also be major problems, depending on the severity of the attacks. Frequent absence may occur and hospitalization may be required when prescribed medications fail to relieve the symptoms.

For appropriate accommodations, refer to the section of physical disabilities and Overview.

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Seizure Disorders

Individuals with epilepsy and other seizure disorders are sometimes reluctant to divulge their conditions because they fear being misunderstood or stigmatized. Misconceptions about these disorders-that they are forms of mental illness, contagious, and untreatable, for example-have arisen because their ultimate cause remain uncertain. There is evidence that hereditary factors may be involved and that brain injuries and tumors, occurring at any age, may give rise to seizures. What is known is that seizures result from imbalances in the electrical activity of the brain.

Three Distinct types of Seizures exist:

Petit Mal means "little" seizure and is characterized by eye blinking or staring. It begins abruptly with a sudden dimming of consciousness and may last only a few seconds. Whatever the person is doing is suspended for a moment but resumed again as soon as the seizure is over. Often because of its briefness, the seizures may go unnoticed by the individual as well as others.

Psychomotor seizures range from mild to severe and may include staring, mental confusion, uncoordinated and random movement, incoherent speech and behavior outbursts, followed by immediate recovery. They may last from two minutes to a half- hour. The person may have no recollection of what happened but may experience fatigue.

Grand Mal seizures may be moderate to severe and may be characterized by generalized contractions of muscles, twitching and limb jerking. Unconsciousness, sleep or extreme fatigue may follow a few minutes of such movements.

Individuals who have seizure disorders are often under preventative medication, which may cause drowsiness and temporary memory problems. Such medication makes it unlikely a seizure will occur in class or on the job.

In the event of a Grand Mal Seizure, follow this procedure:

• Keep calm. Although its manifestations may be intense, they are generally not painful to the individual.
• Remove nearby objects that might injure the person during the seizure.
• Help lower the person to the floor and place cushioning under his/her head.
• Turn the head to the side so that breathing is not obstructed.
• Loosen tight clothing.
• Do not force anything between the teeth.
• Do not try to restrain bodily movement

After a seizure, faculty or office managers should deal forthrightly with the concerns of others in an effort to forestall whatever negative attitudes may develop toward the individual.

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Sickle Cell Anemia

Sickle Cell Anemia is a hereditary disease that reduces the blood supply to vital organs and the oxygen supply to the blood cells, making adequate ventilation an important concern. Because many vital organs are affected, the individual may also have an eye disease, heart condition, lung problems, and acute abdominal pain. At times limbs or joints may be affected. The disease is characterized by severe crisis periods, with extreme pain, which may necessitate hospitalization, resulting in absence. Completing academic or administrative tasks during these periods may not be possible.

For appropriate accommodations, refer to section(s) on visual and hand-function impairments, as well as the Overview..

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Substance Abuse

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

These individuals may experience psychological problems, such as depression, anxiety, or very low self-esteem. They may exhibit poor behavioral control, and if they are using medication as part of their treatment, they may experience undesirable side effects.

Refer individuals exhibiting symptoms of substance abuse to Jeanne DiMuzio, Director of Health Education, x2369.

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The Language of Disabilities

People with disabilities prefer that you focus on their individuality, not their disability, unless, of course, it is the topic about which you are writing or speaking. The term "handicapped" is falling into disuse and should be avoided. The terms "able-bodied," "physically challenged" and "differently able" are also discouraged. The following are some recommendations:

Never use the article "the" with an adjective to describe people with disabilities. The preferred usage, "people with disabilities," stresses the essential humanity of individuals and avoids objectification. Alternatively, the term "disabled people" is acceptable, but note that this term still defines people as disabled first, and people second.

NOT the deaf
BUT people who are deaf (or hearing impaired)

NOT the visually impaired
BUT people who are visually impaired

NOT the disabled
BUT people with disabilities

If it is appropriate to refer to a person's disability, choose the correct terminology for the specific disability.

Partial list of appropriate terminology:
People who are blind; visually impaired; deaf; hard of hearing; mentally retarded; non disabled; physically disabled.

People who have or people with: cerebral palsy; Down syndrome; mental illness; paraplegia; quadriplegia; partial hearing loss; seizure disorder; specific learning disability; speech impairment.

Be careful not to imply either that people with disabilities are to be pitied, feared, or ignored, or that they are somehow more heroic, courageous, patient or "special" than others. Never use the term "normal" in contrast.

NOT Trina held her own while swimming with normal children.
BUT Trina qualified for her "Swimmer" certificate last week.

A person in a wheelchair is a "wheelchair user" or "uses a wheelchair". Avoid terms that define the disability as a limitation; such as "confined to a wheelchair," or "wheelchair-bound." A wheelchair liberates; it doesn't confine.

Never use the terms "victim" or "sufferer" to refer to a person who has or has had a disease or disability. This term dehumanizes the person and emphasizes powerlessness.

NOT victim of AIDS or AIDS sufferer
BUT person with AIDS (PWA)

NOT polio victim
BUT had polio

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From Campus Guidelines for Using Inclusive Language and Illustrations in University Publications, University of Maryland at College Park