Diabetes
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FOREWORD 1
A commitment to the principles of equality in educational opportunity
was expressed by the Vice-Chancellors from the four universities which
compiled the original booklet "Reasonable Accommodations".
We endorse this sentiment whole heartedly and agree with them
that this booklet will be a valuable resource for teaching staff
in their efforts to provide teaching assessment and techniques that
are flexible to the needs of students with disabilities.
We must look upon access in its broadest terms not just physical
access to buildings but the need to use alternative methods to provide
access to knowledge.
We must focus on ability not disability and strive to adapt the
procedure to the person not the person to the procedure.
In commending this booklet to you, we wish to thank the Department
of Employment, Education and Training for providing the funding
for this project through their Higher Education and Equity program.
Emeritus Professor L.W. Nichol, D.Sc. F.A.A.
Vice-Chancellor The Australian National University
Professor Don Aitkin F.A.S.S.A.
Vice-Chancellor University of Canberra
Foreword 2
Each of our universities is dedicated to equality of educational opportunity,
expressed in strong commitment to the creation of campus environments
free from discrimination and bias is matters affecting people with
disabilities.
We encourage members of the campus communities to work with those
with disabilities in enjoying the same facilities, programs and
services available to all.
Considerable progress has been made towards making the physical
environment accessible. We must also give attention to the learning
environment. It is important, then, to make reasonable accommodations
in the classroom, in our relationships with students with disabilities,
in our techniques for teaching, and in our methods of evaluating
their progress.
Each of us hopes therefore that this booklet will be helpful in
working towards our common goal of providing equal access for all
members of our communities. We commend it to you.
The four universities involved wish to thank the Department of
Employment, Education and Training for recognising that support
for students with disabilities is necessary and possible, and for
the stimulus to cooperation provided by the grant of funds for the
project.
Signed:
Emeritus Professor Dianne Yerbury AM
Vice-Chancellor, Macquarie University
Professor L. Michael Birt AO CBE
Vice-Chancellor and Principal
University of New South Wales
Professor D. McNicol
Vice-Chancellor and Principal
University of Sydney
Professor RD Guthrie
Vice-Chancellor
University of Technology, Sydney
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Introduction
Students with disabilities are a rapidly growing minority at all
tertiary institutions in Australia.
Although 16 per cent of the Australian population has disabilities
or impairments with long-term consequences, it is estimated that
presently no more than 2-3 per cent of the student population has
a disability. This small, but significant group is growing steadily,
as educators, students and the community become more aware of the
options available to people with disabilities.
The obligation to accommodate students with disabilities extends
beyond the moral responsibility and beyond the universities' commitment
to fulfil the promise of access.
Federal and State legislation currently provides protection against
discrimination. The Human Rights and Equal Opportunity Commission
Act (1986) has a United Nations Declaration on the Rights of Disabled
Persons (1978) scheduled to it which recognises that disabled persons
are entitled to "the right to any necessary treatment, rehabilitation,
education, training and other services to develop their skills and
capacities to the maximum".
The Commonwealth Disability Services Act (1987) has as one of
its key objectives that people with disabilities should receive
services which are tailored to their individual needs and goals.
The New South Wales State Anti-Discrimination Act (1977) covers
discrimination on the grounds of physical and intellectual disability.
It is expected that in 1992, new Federal Disability Anti- Discrimination
Legislation will be introduced, ensuring uniformity across all States
of rights for people with disabilities.
Existing anti-discrimination law in Australia and overseas uses
the concept of 'reasonable accommodation' to ensure equal treatment
in practice for people with disability in many situations.
The concept of reasonable accommodation, or adjustment covers
campus design, includng the provision of equipment and access, and
study course design. Applying the concept means that academic and
administrative staff, wherever it is necessary, possible and reasonable
to do so, take into account a student's disability and make appropriate
adjustments to the learning environment to lessen the impact of
the disability.
Accommodations should be made wherever they are reasonable and
do not cause undue or unjustifiable hardship to the university.
Within this legal framework and under their various codes of practice,
the universities are required not to discriminate against students
or prospective students on the grounds of disability and have undertaken
to work towards the provision of resources, such as access for students
with impaired mobility, and assistance to students with other disabilities.
Academic ability is the primary basis for participation in tertiary
education.
To accomplish this goal, both physical and learning access must
be provided. This means more than the removal of architectural barriers
and the provision of auxiliary services. It means that reasonable
accommodations must be made in the teaching process to ensure full
educational opportunity and effective communication. This principle
applies to all teaching strategies and methods, as well as to administrative
policies.
The means of achieving this ideal are often not merely matters
of judgement. They are matters of knowledge and understanding which
many academics may not have because of inexperience in teaching
students with disabilities.
Improved communication methods and teaching skills, resulting
from removal of barriers and heightened awareness, are certain to
benefit all university students, not just those with disabilities.
Students with disabilities are individuals with varying needs
and they have the same rights as other students to fulfil their
academic potential.
This guide is designed to provide basic information and promote
understanding of the needs of students with disabilities.
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Dispelling Disabling Myths
The first step in teaching students with disabilities seems
obvious: treat them, simply, as students.
They are motivated to attend university for the same reasons as
others and they bring with them the same range of intelligence and
academic skills.
Revising our perceptions and attitudes is the first step in accommodating
students 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
students.
Some Examples of Disabling Myths
"Science courses are not suitable for students with disabilities".
"Students with disabilities are more likely to drop out of courses
than other students".
"Students with disabilities should all study through external
courses".
"People with disabilities won't get jobs".
"Equal opportunity means everyone should be treated the same,
so students with disabilities are not entitled to support services".
"I went to an experiential seminar about working with people who
have disabilities. We picked our 'disabilities' out of a hat, and
it was no great surprise when I drew my worst fear - quadriplegia.
"While in this role for one hour, I was left facing a blank wall,
had coffee spilt on me, had an incredibly itchy face... and worse
still, my colleagues suddenly started talking to me as a 'case'
and not as me!"
"This gave me time to think about one of my students who is in
a wheelchair and I realised how thoughtless we can be. I rang him
that night and we talked about the workshop and the revelations
it had brought my way." University lecturer.
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The Language of Disability
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', 'differently abled'
and 'sufferer' are also strongly 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.
DON'T USE USE INSTEAD
the deaf people who are deaf
(or hearing impaired)
the vision impaired people with vision
impairment
the disabled people with disabilities
- If it is appropriate to refer to a person's disability, choose
the correct terminology for the specific disability.
- Appropriate terminology includes people who are blind;
vision impaired; deaf, hearing impaired; intellectually impaired;
mobility impaired.
- People with or who have: cerebral palsy; Downs syndrome;
mental illness; paraplegia; quadriplegia; epilepsy; specific learning
disability; speech impairment.
- Be careful not to imply 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.
- 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 dehumanises
the person and emphasises powerlessness.
DON'T USE USE INSTEAD
victim of AIDS or AIDS person with AIDS
sufferer
polio victim had polio
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Where to go for Help
Advisers to Students with Disabilities
The role of the adviser to students with disabilities in your university
is to offer advice and support to both students and staff.
She/he can work together with you in finding an optimum solution
to issues that affect teaching students with disabilities.
The advisers provide a communication liaison point between staff
and outside agencies, as well as the students themselves and the
community. They have extensive contacts with support services groups,
inside and outside the university. As well, they can offer advice
and help to locate and assess new technology and equipment.
Special equipment available for use by students with disabilities
is different in each of the institutions, however most are likely
to have special audio-visual equipment along with computers, braillers,
text scanners and talking book machines.
Support Services
Established services available at your institution may include:
note-taking
amanuenses
interpreting for deaf and hearing impaired students
readers' schemes
tutoring schemes
examination support
library - resource systems
loop systems for sound magnification
FM systems
parking
support groups
counselling services
typing, photocopying
ergonomically designed desks and chairs
Assistive Equipment in the ACT
The Australian National University
Contact Disability Liaison Officer 6249 5036
For Vision Impaired Students
- Braille embosser - Computer Centre of the Faculties.
Course handouts, reading tests, examination papers on disk can
be brailled. Contact No. 6249 3650
- Computer with Zoomtext software to enlarge print and Mastertouch
Gold Touch tablet with voice synthesiser. Located in Chifley Library.
- Word Processing facilities on the above.
- Scanner to be added to the above package by end of 1992.
- Vantage closed circuit TV to enlarge print.
- Microfiche magnifying lense.
- Talking calculator, 4 truck tape recorder.
- List of Voluntary Readers.
- Access to Royal Blind Society NSW & Canberra Blind Society
facilities - eg. tapes counsellors and computer equipment.
- Tactual map of part of campus.
- CDROM holdings in Library.
For Hearing Impaired Students
- FM Aids
- Tape Recorders
- Tutor/Notetakers (limited funding)
- Sign Interpreters (limited number in ACT)
Mobility Impairment
One Motorised Scooter shared with University of Canberra.
Check with Adviser regarding access to buildings.
Writing Impairment
Volunteer students as notetakers and photocopiers.
Limited funding for paid notetakers.
Voluntary typing assistance.
Desk slopes and ergonomic chairs.
Examinations
Amaneunses, extra time and a wide variety of assistance is offered.
Library Facilities
These include lockers for personal equipment, good lighting, Touchpone
200, sloped desks and ergonomic chairs, One OPAL terminal is on
a low table.
Librarians are very willing to assist with searches and getting
books from high shelves.
Separate Disability room in Chifley, Hancock and Menzies Libraries.
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Teaching Students with Disabilities: an overview
While many students with disabilities may learn in different
ways, their differences do not imply inferior capacities. There
is no need to dilute curricula or to reduce course requirements
for students with disabilities. However, particular accommodations
may be needed, as well as modifications in the way information is
presented and in methods of examination and assessment.
Inability to obtain lecture notes is the bottom line for many
students with disabilities. For a wide variety of reasons, they
may not be able to acquire material from lectures in the same way
as other students.
There are numerous practical ways in which these students can be
assisted, such as giving lecture notes and reading lists ahead of
time. This would not result in academic advantage for students with
disabilities, simply a reasonable opportunity to be as up-to-date
with course material as other students.
Determining that a student is disabled may not always be a simple
process. Some disabilities are noticeable through casual observation
- an immediately recognisable physical impairment, for example,
or the use of a cane, a wheelchair or crutches.
Some disabilities are less evident, such as hearing impairment,
vision impairment and learning disabilities. In some instances,
the consequences of medical conditions may have a disabling effect.
These include cancer, diabetes, kidney disease and epilepsy.
Finally, there are students with multiple disabilities, which
are caused by such primary conditions as muscular dystrophy, cerebral
palsy or multiple sclerosis. Depending on the nature and progression
of the illness or injury, it may be accompanied by a secondary impairment
- in mobility, vision, speech or coordination.
It is not the disability itself, but the effect the disability
has on the student which is relevant.
Some students with disabilities will identify themselves to the
university prior to enrolment so that any necessary support can
be arranged with minimum delay.
Support given to students with disabilities is an integral part
of the responsibility of academic staff.
The changes should in no way affect academic standards and students
with disabilities are expected to meet the normal assessment standards.
The learning requirements of students with disabilities should
be established as soon as possible after enrolment by the adviser
to students with disabilities in consultation with the relevant
members of academic staff to ensure, as far as practicable, that
the student is able with support to complete the requirements of
the course. The student should be involved in every level of these
discussions.
If you suspect that a student has a disability, you may wish to
discuss the question with the student, by taking them aside and
asking if they need assistance.
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Teaching Strategies
Specific suggestions for teaching students with disabilities will
be offered in the sections devoted to each disability. Here are some
general considerations to keep in mind:
Dividing the responsibilities.
To the extent manageable, students with disabilities bear the primary
responsibility, not only for identifying their disabilities, but for
making necessary adjustments to the learning environment - for reading
and taking notes, for example. However, the cooperation of academic
and administrative staff is vital for attaining effective communication
between teacher and student. In the case of examination arrangements
and use of department resources, collaboration is particularly important.
Staff-student relationships.
Dialogue between the student and the teacher is essential early in
the semester, and follow-up meetings are recommended. Staff should
not feel apprehensive about discussing the student's needs as they
relate to the course. There is no reason to avoid using terms as they
refer to the disability, such as 'blind', 'see' or 'walk'. However,
care should be taken to avoid generalising a particular limitation
to other aspects of a student's functioning.
Often, for example, people in wheelchairs are spoken to very loudly,
as if they were deaf. The student will probably have had some experience
with the kind of initial uneasiness you may bring to the relationship.
The student's own suggestions, based on experience
with the disability and with study, are invaluable in accommodating
disabilities in university learning.
Attendance and promptness
The student using a wheelchair or other equipment may be prevented
from getting to lectures on time because of obstacles or barriers.
Others may have periodic or irregular difficulties, either from their
disability or from medication. Understanding the reasons for late
or irregular attendance, and being flexible in applying attendance
rules would be helpful.
Teaching environment and methodology adjustments.
A wide range of students with disabilities would benefit from:
- receiving up-to-date book lists well prior to the beginning
of term.
- thoughtful seating arrangements.
- A variety of presentation methods such as speaking directly
toward the class, and from writing key lecture points and assignments
on the blackboard.
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 characterise some disabilities and medical
conditions. Drowsiness, fatigue or impairments of memory or speed
may result from prescribed medications. It is important to distinguish
between these conditions and apathetic behaviour.
Examinations and Assessment.
Depending on the disability, the student may require the administration
of examinations orally, the use of readers and/or writers, extensions
of time for the duration of the exams, a modification of test formats,
availability of computers or, in some cases, different areas for sitting
exams. For out-of-class assignments, the extension of deadlines may
be justified.
The objective should always be to accommodate the students'
learning differences, not to lessen academic requirements.
The same standards should be applied to students with disabilities
as to all other students in evaluation and assigning results.
Special arrangements, such as those set out below, may be necessary:
- Arrangements can be made for students to sit exams in a separate,
quiet room. Students with learning disabilities are especially
sensitive to distractions.
- Time extensions on exams and written assignments should be approved
when there are significant demands on reading and writing skills.
- Avoid overly complicated language in exam questions and clearly
separate them on the exam paper.
- Try not to test on material just presented since more time is
generally required to assimilate new knowledge.
- Aids such as dictionaries, computer spell checks, a proofreader,
or in mathematics and science, a calculator should be permitted.
In mathematics, a student with learning disability may understand
the concept, but may make errors by misaligning numbers or confusing
arithmetical facts.
- When necessary, arrangements can be made for students to use
a reader, writer, word processor, tape recorder or typewriter.
- Consider alternative exam designs. Some students with learning
disabilities may find essay formats difficult, for example multiple
choice questions in language aimed to trick are very difficult
for people with a hearing impairment and learning disability.
- Consider alternative or supplementary assignments that may serve
evaluation purposes, such as taped interviews, slide presentations,
photographic essays or hand-made models.
- Be aware that misreading of a key word is much more likely for
students with disabilities, especially a learning disability.
For example, if an answer is well-framed but seemingly not relevant
to the set question, a flexible attitude to assessment may be
necessary.
- Poor handwriting or spelling may not necessarily indicate an
immature or uninformed exam answer, instead it may be the result
of a disability.
- Exam rooms may need to be free of fluorescent lighting, which
causes visual disturbances in some students such as strobing effects
that make reading slow and difficult.
- Exam papers may sometimes need to be printed on coloured paper
to avoid visual difficulties.
- Special arrangements for exams can be worked out with the exam
section and the adviser to students with disabilities.
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Key Points
- Vary your presentation methods and teaching strategies.
- Modifications of teaching practices will benefit all students,
not just those with disabilities.
- Establish good dialogue and draw upon the student's own experience
of their disability.
- Divide the responsibilities between student, adviser and academic
staff to ensure effective communication.
- Be flexible and consider alternatives whenever possible.
- Plan early. Special equipment should not be seen as a substitute
for good teaching practice.
- Assistance given to students with disability and changes to
teaching practice will only serve to increase academic standards,
not lower them.
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Teaching Students with Learning Disabilities
Learning disabilities often occur in people of average or above
average intelligence
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.
Learning disabilities often occur in people of average or above
average intelligence and they involve one or more of the basic processes
used in understanding or using spoken or written language. Of presumed
neurological origin, they cover disorders that impair such functions
as reading (dyslexia), writing (dysgraphia) and mathematical calculation
(dyscalculia). They vary widely within each category in the patterns
they exhibit.
The condition has only recently been identified and still often
goes undiagnosed. The marked discrepancy between intellectual capacity,
achievement and output (expressing information and responding) is
what characterises a learning disability.
EFFECTS
Achievement
One key sign is that academic achievement as revealed by tests,
does not correspond to ability. The student may show consistent
success in some subjects, while doing poorly in another, despite
comparable effort.
Organising Difficulties
The person may not perceive or discriminate patterns and arrangements
in the same way as others do. They may go off at a tangent in conversation
and seem personally disorganised. Problems with sequencing and organising
may be reflected in poor study habits.
Undiagnosed Learning Disabilities
Students with undiagnosed learning disabilities may not know why
they have more trouble with certain tasks, and may have poorer social
skills.
Auditory Processing
Some students may experience difficulty integrating information
presented orally, hindering their ability to follow the sequence
and organisation of a lecture.
Reading Difficulties
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 students, comprehension and speed are improved
with the use of audio presentation methods.
Writing Difficulties
Legibility, writing speed and spelling may be severely hampered
under the pressure of time constraints of a formal exam.
Memory or Sequencing Difficulties
These may impede the student's execution of complicated directions.
Note-Taking
Some students with learning disabilities need alternative ways
to take notes because they cannot write effectively or assimilate,
remember and organise material while listening to a lecture.
Participation
It is helpful to determine the student's ability to participate
in class activities. While many students with learning disabilities
are highly articulate, some have severe difficulty in talking, responding
or reading in front of groups.
Specialised Limitations
Some students with learning difficulties may have poor coordination
or trouble judging distance or differentiating between left and
right.
Laboratory Work
The science laboratory can be especially overwhelming for students
with learning disabilities. New equipment, exact measurement and
multi-step procedures may demand precisely those skills which are
hardest for them to acquire.
Behaviour
Because of perceptual deficiencies, some students with learning
disabilities are slow to grasp social cues and respond appropriately,
they may 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 the adviser to students with disability.
Teaching Strategies
Once a student with a learning disability and the nature of the
disability are known, these strategies may help:
Before the Start of the Semester
- Make required book lists available prior to the start of term
to allow students to begin their reading early, or consult with
the adviser about having texts put on tape.
- Extra time to read material is important.
- Provide students with chapter outlines or study guides that
cue them to key points in their reading.
During the Semester
- Use a variety of teaching methods to enhance learning for students
with learning disabilities. Communicate in the student's preferred
mode/s; for example, a taped record of a discussion may be necessary,
rather than written materials.
- Ensure you keep the student's attention and make the environment
distraction-free.
- Use simple language and minimise the length and complexity of
communications.
- Stay on the topic; demonstrate; use concrete examples.
- Repeat and rephrase information.
- Read aloud material that is written on the blackboard or that
is given in handouts or transparencies.
- In laboratory situations, the labelling of equipment, tools
and materials is helpful. An individual orientation to the laboratory
and equipment can minimise student anxiety.
- Encourage students to take essay plans to Study Skills Adviser
as the orginsation of ideas is particularly difficult for these
students.
- Explore the use of oral or taped answers in exams with the addition
of points in note form.
- Multiple choice questions where a number of similar but different
statements are offered are very difficult.
- The Royal Blind Society of NSW provides services for these students
as people with a print handicap. Material can be taped through
this service.
- A guide for oral and tape assessments has also been produced
- contact the Disability Liaison Officer at your institution.
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Teaching Students with Vision Impairment
Whatever the degree of impairment, students who are vision impaired
should be expected to participate fully in lecture and tutorial activities,
such as discussions and group work. To record notes, some students
use tape recorders, laptop computers with speech or large- print output,
or computerised braillers. They may confront limitations in laboratory
classes and field trips, for example, but with planning and adaptive
equipment their difficulties can be minimised. Remember that glare
is a big problem and they will see better on some days than others.
It is important to remember, that while equipment is useful, assistance
from academic staff is vital for students with vision impairment.
Teaching Strategies
Before the start of the semester:
- Provide reading lists or course outlines in advance to allow
time for arrangements for taping or brailling of texts to be made.
Ensure reading lists are up-to-date.
- In cooperation with the adviser to students with disabilities,
assist the student in finding readers, note-takers or tutors,
as necessary, or pair the student with a sighted classmate or
laboratory assistant.
- Reserve front row seats for low-vision students. If a guide
dog is used, it will be highly disciplined and require little
space. Under State legislation ( The Dog Amendments Act, 1907),
guide dogs must not be refused entry to buildings and classrooms.
- Ensure that students with vision impairments are notified of
organisational changes in an appropriate way. It is difficult
to find lecture rooms if changed at the last minute.
During the semester
- Face the class when speaking. Speak clearly in a normal voice,
not loudly, slowly or with exaggeration.
- Identify yourself by name, in case the person does not recognise
your voice.
- Indicate verbally when you are entering or leaving the person's
presence.
- Convey orally whatever you have written on the blackboard or
shown on overheads. Use simple, clearly understood language.
- Work with the student and service providers to ensure information
is received in appropriate formats - enlarged copies of the required
size, brailled information or audiotapes - for all important or
recurrent information.
- If you are planning to use a video tell the student and discuss
alternative ways to approach information that the students may
miss.
- Be flexible with assignment deadlines and allow extra reading
time.
- Ask if assistance is required, don't assume it is, but be alert
to the person's needs.
- Doors should be kept closed or open, not partly open.
- Objects should not be moved from their usual places without
letting the person know.
- Keep corridors clear of objects.
- Open-book exams pose a major problem for students with vision
impairment. If you are planning to use this method, discuss with
the student and/or the adviser whether an alternative is required.
- Use of an amaneunsis, extra time and adaptive equipment is necessary
in exams.
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Teaching Students with Hearing Impairment
The effects of hearing loss on communication may depend on the extent,
type and timing of the impairment.
The extent may range from mild to profound, and may involve the
loss of some or many frequencies of sound. It is often possible
for people to hear certain sounds (usually of low frequency, such
as vowels) but not others. A 'mild' loss may still make it impossible
for the person to understand a lecturer's voice eight metres away,
even when a hearing aid assists at closer distances.
If a student has been deaf from birth, they may require the use
of a thesaurus, dictionary or sign language interpreter during exams.
Speech may be minimal, and there will be a resulting difficulty
in grasping language and vocabulary. Students who have lost hearing
after birth may have varying degrees of speech, depending on the
time of loss.
The more common types of hearing loss are conductive loss, resulting
from impairment to the outer or middle ear, and sensori-neural loss,
if the inner ear is affected. These two types can occur in conjunction
with each other. A hearing aid offers reduced assistance for sensori-neural
loss, because it cannot replace the lost or damaged nerve cell in
the inner ear.
Students with hearing impairment may use speech, lip reading,
sign language interpreters and hearing aids to enhance oral communication.
Hearing aids or amplification systems may include public address
systems and transmitter/receiver systems with a clip-on microphone
for the lecturer. For those who use lip-reading, only 30-40 per
cent of spoken English is comprehensible, even for those who are
highly skilled.
For people who are deaf or hearing impaired and who choose to speak,
feedback mechanisms are 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.
Indications that a student has a hearing loss may include a student's
straining to hear, use of loud or distorted speech, and consistent
failure to respond.
Teaching Strategies
- Students with hearing impairment will benefit from front-row
seating. An unobstructed line of vision is necessary for students
who use interpreters and for those who rely on lip-reading and
visual cues. If an interpreter is used, the student's view should
include the interpreter and the lecturer. Do not speak facing
the blackboard.
- Be aware that moustaches, beards, hands, books or microphones
in front of your face can add to the difficulties of lip readers.
- Keep your face within view of the student and speak in a natural
tone. Explain new concepts as you introduce them and write key
words on the board.
- When an interpreter is being used, speak directly to the student
and not to the interpreter.
- Recognise the brief amount of extra processing time that the
interpreter takes to translate a message from its original language
into another language ( whether to English or sign language, or
vice versa) because this will cause a delay in the student's receiving
information, asking questions and/or offering comments.
- If a student in your class has an interpreter, approach them
and ask for their suggestions on how you can assist. Contact the
adviser to students with disabilities for more detailed information
about working with interpreters.
- Repeat questions or remarks of other people in the room.
- Try to avoid using amplified sound.
- Use visual aids to reinforce spoken presentations when possible.
- If requested, assist the student with finding a notetaker or
contact the Disability Liaison Officer.
- 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 student in writing when
conveying important information such as assignments, scheduling,
deadlines etc.
- Ensure your face is well lit, and that lipreaders are not facing
into the light.
- Use your usual lip patterns, but speak just a little slower
than usual. Do not speak while the person is writing. Do not shout.
- Where possible, arrange seating in a circle for tutorials to
assist students who lip-read or seat the student beside you.
- Make sure you have the attention of the student before you attempt
to communicate.
- Be amenable to wearing a microphone transmitter for use with
an FM aid if asked.
- Encourage students to ask lots of questions in tutorials so
they can have some control of discussions. Place in smallest tutorial
group.
- Give student reading references for next lecture and tutorial
topics in advance.
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Teaching Students with Mobility Impairment
A wide range of conditions may limit mobility. Among the most common
permanent disorders are such musculoskeletal disabilities as partial
or total paralysis, amputation or severe injury, arthritis, muscular
dystrophy, multiple sclerosis, head injury 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, students
may have difficulty getting to or from lectures, participating in
tutorials, and managing assignments and examinations. All mobility
impairments increase the time and effort which students must expend.
Using facilities which others take for granted, such as toilets, canteens,
libraries and lecture rooms may be a major undertaking.
Access
Physical access to lecture rooms is a key concern for students with
physical disability. Those who use wheelchairs, calipers, crutches,
canes or prostheses, or who tire easily find it difficult moving about,
especially within the time constraints imposed by lecture timetables.
Occasional lateness may be unavoidable.
Absence or lateness may be caused by transportation problems,
inclement weather or lift or wheelchair breakdown. Getting from
lecture rooms may pose similar problems, especially in cases of
emergency.
The universities are working towards creating campus environments
which are accessible to wheelchair users and others with mobility
impairments.
These practical access accommodations being made include installing
ramps, handrails, lifts, correctly positioned light switches, car
parking, toilet facilities and signs using the international symbols.
These modifications to the campus environment are benefiting all
students and staff, not just those who have mobility impairment.
Teaching Strategies
- Speak directly to the student as you would to any other person
- even if speech is impaired; use the same tone of voice and volume
and the same eye contact.
- Stand or sit free of a wheelchair, as it is often considered
part of the person's body space.
- Be alert to offer assistance unobtrusively with holding doors
open, carrying objects, providing photocopies, assisting with
phone calls, ensuring clear passageways and removing library books
from high shelves.
- Allow in-class written assignments to be completed out of class
with the use of a writer, if necessary.
- Facilitate a barrier-free environment.
- Plan allocation of accessible tutorial rooms in advance.
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Teaching Students with Speech Impairment
Speech impairments range from problems with articulation or voice
strength to complete voicelessness. They include difficulties in projection,
as in chronic hoarseness and oesophageal speech; fluency problems,
as in stuttering and stammering; and the nominal aphasia that alters
the articulation of particular words or terms.
Some of these difficulties can be managed by such mechanical devices
as electronic 'speaking' machines or computerised voice synthesisers.
Others may be treated through speech therapy. All of them can
be aggravated by the anxiety associated with oral communication
in a group.
Teaching Strategies
Patience is the most effective strategy in teaching students with
speech impairments.
- Give students the opportunity - but do not compel them - to
speak in a group situation.
- Allow students the time they need to express themselves,
without interrupting them by filling in gaps in their speech.
Don't be reluctant to ask a student to repeat a statement and
don't make assumptions on what has been said.
- Address students naturally. Don't assume that they cannot hear
or comprehend. Difficulty with speech and communication does not
necessarily mean the thinking process is faulty.
- Consider course modifications, such as one-to-one presentations
or a typed presentation read by another student.
- Check whether the person uses an alternative communication system/aid
eg. Cannon Printer.
- Maintain eye contact.
- If difficulties are holding up the flow of the class after a
reasonable time, suggest student meets with you after class to
discuss the points.
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Teaching Students with Psychological/Psychiatric Impairment
Students with psychological/psychiatric disabilities present some
of the most difficult challenges to university academic staff. Like
those with other disabilities, their impairments may not be visible
and, in fact, may be latent, with little or no effect on their learning.
Unlike others, however, their emotional disturbances may manifest
themselves in negative behaviour ranging from indifference and recalcitrance
to disruptiveness. Such conduct makes it hard to remember that they
have as little control over their disabilities as do students with
physical disabilities.
One of the most common psychological impairments among students
is depression. The condition may be temporary, in response to inordinate
pressures at university, in a job, at home or in social life. It
may be manifested as a pathological sense of hopelessness or helplessness
which in its extreme may provoke threats of, 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 is also prevalent among students and may also be the transient
reaction to stress. Mild anxiety, in fact, may promote learning
and improve student's functioning. Severe anxiety, however, may
reduce concentration, distort perception and weaken the learning
process. Anxiety may manifest itself as withdrawal, constant talking,
complaining, joking or crying, fantasising, or extreme fear, sometimes
to the point of panic. Bodily symptoms might include episodes of
lightheadedness or hyperventilation.
Some students who are undergoing treatment take prescription medication
to help control disturbing feelings, ideas and behaviour. This medication
might cause side effects such as drowsiness and disorientation.
Teaching Strategies
- In dealing with psychological conditions that impair functioning
of the affected student alone, the principles outlined for all
students with disability in the Overview section generally apply.
If the behaviour begins to affect others or your course, other
measures may be necessary.
- Discuss inappropriate behaviour with the student privately,
directly and forthrightly, outlining if necessary the limits of
acceptable conduct.
- In your discussions with the student, do not attempt to diagnose
or treat the psychological disorder, but only the student's behaviour
in the course.
- If you sense the discussion would not be effective, or if the
student approaches you for help, refer the student to the adviser
to students with disability or other appropriate agency such as
the university health or counselling service.
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Teaching Students with other Disabilities and Medical Conditions
There are a number of disabilities and medical conditions that may
interfere with a student's academic work, their ability to attend
lectures, concentrate, complete assignments or complete exams. Some
of these symptoms, like limited mobility or impaired vision, and the
types of intervention required may resemble those covered elsewhere
in this guide. The same general principles apply to teaching all students
with disabilities, particularly the need to identify the disability
and to discuss with the student both its effects and the necessary
considerations. Below are brief descriptions of some of the more prevalent
disabilities among students, along with recommended teaching strategies.
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Cerebral Palsy
Cerebral palsy is caused by an injury to the motor centre of the brain,
which 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.
Those severely affected may need to use a wheelchair, while those
mildly affected may have no physical manifestations at all.
For appropriate teaching strategies, refer to sections on speech,
vision and mobility impairments.
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Multiple Sclerosis
Multiple sclerosis is a progressive disease of the central nervous
system, characterised by a decline of muscle control. Symptoms may
include disturbances ranging from mild to severe blurred vision, 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 experience difficulty in adjusting to their 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 teaching strategies, refer to sections on speech,
vision and mobility impairments.
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Muscular Dystrophy
Muscular dystrophy refers to a group of hereditary progressive disorders
that most often occur in young people, producing 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.
Refer to the section on mobility impairment for appropriate teaching
strategies.
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Closed Head Injury
Students with brain injury are becoming more common, mainly due to
the high incidence of motor vehicle accidents.
These students may exhibit communication problems, particularly
in their speech (eg distorted or slurred speech, difficulty in finding
words). Cognitive deficits include short-term memory problems, difficulty
in planning and organising thoughts and actions, poor insight and
low attention span. Personality problems are also common. These
include impulsiveness, low frustration tolerance, inappropriate
social behaviour (eg offensive language), mood swings and a general
inability to control emotions, particularly aggression and anxiety.
For teaching strategies, refer to the Overview and the sections
on learning disabilities and epilepsy.
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AIDS (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. Teaching strategies will likewise vary.
Students with AIDS may be reluctant to reveal their condition
because of social stigma, fear and misunderstanding surrounding
this illness. It is therefore exceptionally important that the confidentiality
be strictly observed. In addition, if the issue should arise in
class, it is important for academic staff to deal openly and non-
judgmentally with it and to foster an atmosphere of understanding.
For general teaching strategies, refer to the Overview section.
If cancer is involved, see the section below. For particular impairments,
see the applicable sections on 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 anaemia.
The primary treatments for cancer - radiation therapy, chemotherapy
and surgery - may induce additional effects. Therapy can cause violent
nausea, drowsiness, and fatigue, affecting academic work or causing
absences from lectures. Surgery can result in amputation, paralysis,
sensory deficits and language and memory problems.
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Respiratory Problems
Many students may have chronic breathing problems, the most common
of which are bronchial asthma and emphesyma. Respiratory problems
are characterised 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 lateness or absence from lectures may occur and hospitalisation
may be required where prescribed medications fail to relieve the
symptoms.
For appropriate teaching strategies, refer to the section on mobility
impairment and the Overview.
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Epilepsy and Other Seizure Disorders
Students with epilepsy and other seizure disorders are sometimes reluctant
to divulge their conditions because they fear being misunderstood
or stigmatised. Misconceptions about these disorders - that they are
forms of mental illness, contagious and untreatable, for example -
have arisen because their ultimate causes remain uncertain. There
is evidence that hereditary factors may be involved and that brain
injuries and tumours, occurring at any age, may give rise to seizures.
What is known is that seizures result from imbalances in the electrical
activity in the brain.
Three Distinct Types of Seizure Exist:
- Petit Mal means 'little' seizure and is characterised by eye
blinking or staring. It begins abruptly with a 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 seizure may go unnoticed
by the individual as well as by others.
- Psychomotor seizures range from mild to severe and may include
staring, mental confusion, uncoordinated and random movement,
incoherent speech and behaviour outbursts, followed by immediate
recovery. They may last from two to 30 minutes. The person may
have no recollection of what happened, but may experience fatigue.
- Grand Mal seizures may be moderate to severe and may be characterised
by generalised contractions of muscles, twitching and limb jerking.
A few minutes of such movements may be followed by unconsciousness,
sleep or extreme fatigue.
Students with seizure disorders are often under preventive medication,
which may cause drowsiness and temporary memory problems. Such medication
makes it unlikely that a seizure will occur in class.
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 may injure the student 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 the bodily movement.
If the seizure continues for more than 10 minutes, get medical help
or call an ambulance.
Make sure someone stays with the student after the seizure, who
should then be taken to a quiet place to rest.
After a seizure, academic staff should deal forthrightly with
the concerns of the class in an effort to forestall whatever negative
attitudes may develop toward the student.
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Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS), formerly known as ME (myalgic encephalomyelitis)
is believed to be caused by an abnormal response to a virus or some
other 'trigger' factor.
CFS is a chronic condition lasting months or years. People with
CFS are prone to relapse if they exceed the limits of physical or
mental exertion which their illness imposes.
Symptoms may vary in severity from day to day, and even from hour
to hour. There may be profound physical and mental exhaustion, persistent
pain in muscles and joints, headaches varying from dull to intense,
dizziness, nausea, fainting, poor concentration and memory, pallor
or flushing of face, an inability to tolerate extremes of heat,
light or sound, for example a noisy lecture room and a sensitivity
to various agents and chemicals.
As a consequence of this illness, the student may feel a great
sense of isolation and loneliness with a serious loss of self- confidence.
It is important that the student be trusted and treated sympathetically.
Difficulties should be discussed as they arise. Good communication
between the staff member and the student is essential and the student's
ability to cope will be assisted by such empathy.
The student will need to avoid prolonged standing, extremes of
heat and cold, exposure to fumes from science laboratories and gas
heating and mental or physical exertion beyond the limits imposed
by their condition.
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Manual Dexterity Disabilities
A not uncommon disability that lecturers will encounter with students
who may for example have arthritis, occupational overuse syndrome,
fractures, multiple sclerosis or cerebral palsy.
Occupational overuse syndrome, also known as Repetitive Strain
Injury, may include diseases such as tenosynivitis and carpal tunnel
syndrome. The symptoms are usually pain, swelling, stiffness of
wrist, elbow or the small joints in the hand. It also commonly causes
pain in the neck and shoulders.
It tends to occur in people as a result of doing repetitive tasks
such as typing, writing or playing musical instruments and may result
in long term stiffness, pain and limited joint movement.
Rest and a variety of treatment approaches may improve the situation
but it is vulnerable to recurrence under conditions of stress and
overuse. Writing may be difficult and slow necessitating the provision
of notetakers and alternative assessment techniques. These may include
extra time for rest breaks, a combination of notes and oral or tape
assessment (see guide to these techniques) or an amanuensis. For
some students with manual dexterity problems the use of a computer
in examinations may be necessary.
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Diabetes
Diabetes means too much sugar (or glucose) in the blood. The reason
for this is lack of insulin, a substance the body needs to use sugar.
People with diabetes are treated with insulin injections, some modifications
of their diet and exercise. To balance the injected insulin, meals
need to be evenly spaced throughout the day, with extra food given
before exercise.
It may be necessary for the student to eat in class or in examinations.
Instability of the diabetes may mean absences or delayed assignments.
Consideration is required (and flexibility)
Hypoglycaemia. Sometimes the blood sugar level will fall
below normal and the person may experience a 'hypo' or hypoglycaemic
reaction. A 'hypo' can occur if a student misses a meal entirely;
runs late for a meal; fails to eat extra carbohydrate before exercise
or takes too much insulin inadvertently.
The symptoms of hypoglycaemia vary from one person to another
and include sweating, pallor, day dreaming, slurred speech, shakiness,
crying, confusion and bad temper.
If a 'hypo' is untreated, unconsciousness can follow and urgent
medical attention should be sought. Never attempt to give an unconscious
person food or drink.
High blood sugar levels, hyperglycaemia, can result when a person
with diabetes eats too much, eats the wrong kinds of food, or does
not have enough insulin to meet body requirements, such as during
examinations or other times of stress.
The classic symptoms of hyperglycaemia are increased thirst, increased
urination, increased appetite and signs of dehydration (cracked
lips, dry skin, sunken eyes).
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Credits
The idea for and parts of the text of this publication have been used
with permission from 'Reasonable Accommodations: Teaching College
Students With Disabilities. The President's Commission On Disability
Issues', University of Maryland at College Park, USA (1990).
The concept for the University of Maryland publication was originally
produced by The Higher Education and The Handicapped Resource Centre
(HEATH) USA, The US Department of Education and The American Council
on Education.
The text of the original publication was written and adapted by
Anabel Lockhart, of Lockhart Darby Pty Ltd on behalf of Macquarie
University, The University of New South Wales, The University of
Sydney and The University of Technology, Sydney.
The University of Canberra and the Australian National University
acknowledge with gratitude permission by the University of New South
Wales to use the material from the original production of "Reasonable
Accommodations: The text has been slightly adapted for their
purposes.
The material in this publication is also based on the experience
and research of the advisers to students with disabilities at Macquarie
University, The University of New South Wales, The University of
Sydney, and The University of Technology, Sydney, as well as a staff
development kit prepared by Griffith University.
Assistance with writing this booklet has been received from the
Royal Blind Society of New South Wales; the Paraplegic and Quadriplegic
Association of New South Wales; the Deaf Society of New South Wales;
the New South Wales Mental Health Association; the New South Wales
Institute of Psychiatry; the Tenosynivitis and Overuse Injuries
Association of New South Wales; Diabetes Australia; the M.E./C.F.S.
Society of New South Wales; the Director of Equal Opportunity in
Public Employment and the New South Wales Anti-Discrimination Board.
Other references include 'A Resource Book for the Employment for
People With Physical Disability in the NSW Public Sector', and 'The
Lancet'.
NOTE:
The information in this guide is also available on audio tape.
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