Accommodating Students with Psychiatric Disabilities
After this presentation faculty and administrators will be able to
- list types of psychiatric disabilities and how they affect learning,
- discuss functional limitations resulting from psychiatric disabilities, and
- list typical accommodations for students who have a psychiatric disability.
Approximately 45 minutes.
The disabled student services coordinator or other staff member who has experience with individuals with psychiatric disabilities; a student with a psychiatric disability could deliver some of the presentation or participate in discussions.
- Select the presenter(s).
- Develop presentation outline and activities using the "Sample Script" provided in this section and the ideas listed in the Presentation Tips section of this notebook.
- Create presentation slides from provided templates.
- Add the contact information for campus resources to the "Resources" slide and to printed publications as appropriate.
- Photocopy the handout template Academic Accommodations for Students with Psychiatric Disabilities. Create alternative formats as necessary.
- Photocopy the presentation evaluation instrument to distribute at the end of the session (see pages 189-191 for examples) or create your own.
- Add a link on your department's website to The Faculty Room at http://www.washington.edu/doit/Faculty/.
Equipment and Tools
- Video projector, computer and presentation slides; Internet connection (optional)
- handout (Academic Accommodations for Students with Psychiatric Disabilities)
- presentation evaluation instrument (pages 189-191)
- Distribute handout.
- Begin presentation.
- Discuss possible accommodation strategies.
- Discuss department or campus issues.
- Note campus resources.
- Distribute and collect completed evaluation instruments.
For further preparation resources for this presentation, consult
- The Faculty Room at http://www.washington.edu/doit/Faculty/Strategies/Disability/Psych/
- Universal Design in Higher Education: From Principles to Practice published by Harvard Education Press, 2008.
Today we will be discussing how to accommodate students with psychiatric disabilities for full inclusion in your courses.
The objectives of today's presentation are to
- list types of psychiatric disabilities postsecondary students may have.
- describe how mental health issues impact learning.
- discuss typical accommodations for students who have psychiatric disabilities.
What is a Psychiatric Disability?
A person with a psychiatric disability has a diagnosable mental illness causing severe disturbances in thinking, feeling, relating, or functional behaviors that results in a substantially diminished capacity to cope with the demands of daily life (http://www2.bu.edu/cpr/reasaccom/whatis-psych.html).
In 2006, the U.S. Department of Education reported that 11.3% of students with disabilities enrolled in postsecondary institutions report having a mental illness or depression. A mental illness may result in a psychiatric disability.
A psychiatric disability is an invisible disability; it is typically not apparent to others. However, students with psychiatric disabilities may experience symptoms that interfere with their educational goals, which may include, yet are not limited to:
- heightened anxieties, fears, suspicions, or blaming others;
- marked personality change over time;
- confused or disorganized thinking;
- strange or grandiose ideas;
- difficulty concentrating, making decisions, or remembering things;
- extreme highs and lows in mood;
- denial of obvious problems or a strong resistance to offers of help; and
- thinking or talking about suicide.
These diagnoses are defined by the American Psychiatric Association.
This is a mood disorder that can begin at any age. Major depression may be characterized by a depressed mood most of each day, a lack of pleasure in previously enjoyed activities, thoughts of suicide, insomnia, and consistent feelings of worthlessness or guilt.
Bipolar Affective Disorder (BAD, formerly Manic Depressive Disorder)
BAD is a mood disorder with revolving periods of mania and depression. In the manic phase, a person might experience inflated self-esteem, high work and creative productivity, and a decreased need to sleep. In the depressed phase, the person experiences the symptoms of depression.
Borderline Personality Disorder (BPD)
BPD is a personality disorder that includes both mood disorder and thought disorder symptoms. This diagnosis has both biological and environmental determinants. Individuals diagnosed with BPD may have experienced childhood abuse and family dysfunction. They may experience mood fluctuations, insecurities and mistrust, distortion of perceptions, dissociations, difficulty with interpersonal relationships, and limited coping skills.
This is a thought disorder that can cause a person to experience delusions, hallucinations, and paranoia. Schizophrenic individuals typically demonstrate concrete thought processing and appreciate structure and routines.
These are mood disorders in which the individual responds to thoughts, situations, environments, or people with fear and anxiety. Anxiety symptoms can disrupt a person's ability to concentrate and focus on tasks at hand. Symptoms may be in response to real or imagined fears. Specific anxiety disorders include generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, social and specific phobias, and post-traumatic stress disorder.
The following functional limitations related to psychiatric disabilities may affect academic performance and may require accommodations (Center for Psychiatric Rehabilitation, 1997):
- Difficulty with medication side effects: Side effects of psychiatric medications that may affect academic performance include drowsiness, fatigue, dry mouth, thirst, blurred vision, hand tremors, slowed response time, and difficulty initiating interpersonal contact.
- Screening out environmental stimuli: An inability to block out sounds, sights, or odors that interfere with focusing on tasks. Limited ability to tolerate noise and crowds.
- Sustaining concentration: Restlessness, shortened attention span, distraction, and difficulty understanding or remembering verbal directions.
- Maintaining stamina: Difficulty sustaining enough energy to attend a whole day of classes on campus; combating drowsiness due to medications.
- Handling time pressures and multiple tasks: Difficulty managing assignments, prioritizing tasks, and meeting deadlines. Inability to multi-task.
- Interacting with others: Difficulty getting along, fitting in, contributing to group work, and reading social cues.
- Fear of authority figures: Difficulty approaching instructors or teaching assistants.
- Responding to negative feedback: Difficulty understanding and correctly interpreting criticism or poor grades. May not be able to separate person from task (personalization or defensiveness due to low self-esteem).
- Responding to change: Difficulty coping with unexpected changes in coursework, such as changes in the assignments, due dates, or instructors. Limited ability to tolerate interruptions.
- Severe test anxiety: Anxiety to the extent that the individual is rendered emotionally and physically unable to take the exam.
Students with a history of psychiatric disabilities can be intelligent, sensitive, creative, and interesting. You can employ strategies that will promote their success in your class. For example:
- Address a variety of learning styles (e.g., auditory, visual, kinesthetic, experiential, or combination of styles).
- Incorporate experiential learning activities.
- Be prepared to set behavioral expectations for all students in your class.
- Embrace diversity to include people with psychiatric disabilities.
Some students with psychiatric disabilities may require accommodations to allow them equal access to classes, programs, and coursework. An accommodation is the removal of a barrier to full participation and learning. The emphasis is on access, not on outcome. This is done by providing the student with a disability equal access to the content and activities of a course, but not ensuring success.
Each student with a disability is encouraged to register with their campus office that supports students with disabilities in order to receive accommodations. Personnel from this office typically send instructors a letter documenting specific accommodations required for the student with the disability. It is the responsibility of the instructor to provide the accommodations. It is the student's responsibility to fulfill the academic requirements of the course. The best solutions result when the instructor, student, and disability support service professional work cooperatively. Meeting as a group may facilitate problem-solving alternatives. Respecting the privacy of the student by not discussing his or her disability or accommodations with others outside of this meeting is essential. Review accommodations periodically with the student to assess effectiveness and adjust to changing needs.
Typical classroom, exam, and assignment accommodations that may be recommended by the disabled student service professional for a student with a psychiatric disability include the following:
- preferential seating, especially near the door, to allow the student to leave class for breaks;
- prearranged or frequent breaks;
- beverages permitted in class;
- audio or video recorder use;
- assigned classmate as a volunteer assistant;
- notetaker or photocopies of another's notes;
- early availability of syllabus and text books;
- availability of course materials (lectures, handouts) in alternative formats; and
- private feedback on academic performance.
Typical accommodations for students with psychiatric disabilities taking exams include the following:
- exams in alternative format (e.g., multiple choice, essay, oral, presentation, role-play, or portfolio);
- use of adaptive computer software (e.g. optical character recognition, allowing scanned text to be read aloud by the computer's sound card; or speech recognition for converting the spoken word to printed word on the computer screen);
- extended time for test taking;
- exams individually proctored, including in the hospital;
- exam in a separate, quiet, and non?distracting room; and
- increased frequency of exams.
Typical assignment accommodations for students with disabilities include the following:
- substitute assignments in specific circumstances;
- advance notice of assignments;
- permission to submit assignments handwritten rather than typed (if possible);
- written assignments in lieu of oral presentations, or vice versa;
- assignments completed in dramatic formats (e.g. demonstration, role-play, and sculpture);
- assignment assistance during hospitalization; and
- extended time to complete assignments.
Not all requested accommodations are reasonable. An accommodation is not reasonable if it would:
- pose a direct threat to the health or safety of others;
- result in substantial change in an essential element of the curriculum;
- require a substantial alteration in the manner in which educational opportunities are provided; or
- pose an undue financial or administrative burden to the institution.
On most campuses, a student with a disability must register with the disabled student services office to receive accommodations. Personnel from this office typically send instructors a letter documenting specific accommodations required for the student. It is often helpful to schedule a three-way meeting with the student, instructor, and disability counselor. Review accommodations periodically with the student to assess effectiveness. Respect the privacy of the student by not discussing his or her disability or accommodations with others. It is important that the instructor provides the accommodations required; it is the student's responsibility to fulfill the academic requirements of the course.
Here are some resources that might be useful to you as you work to maximize effective communication with all students in your classes. [Elaborate.]
For comprehensive information on accommodations, a wide range of case studies, frequently asked questions, and general resources, visit The Faculty Room at http://www.washington.edu/doit/Faculty/. This resource was developed at the University of Washington as part of a nationwide project to provide resources to faculty and administrators so that they can make their courses and programs accessible to all students. You can link to this resource from ____. [Arrange to provide a link from your campus' disabled student services website before the presentation.] Consider linking to this website from your department's faculty website.
Thank you for your time today and for your interest in finding ways to ensure that all of the students in our programs have equal opportunities to learn, explore interests, and express ideas.