Faculty Handbook
Accommodating Students

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• Introduction
  
  
• Teaching and Accommodating Students with Disabilities
  
  
• Important Considerations When Teaching Students With Disabilities
  
  
• Determining Reasonable Accommodations
  
  
• Obtaining Academic Accommodations
  
  
• Types of Disabilities and Instructional Strategies:
  
  • Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder
  • Learning Disabilities
  • Physical Disabilities
  • Visual Impairments
  • Traumatic Brain Injuries
  • Hearing Impairments
  • Psychiatric Disabilities
  • Speech and Language Disabilities
  • Medical Systemic Disabilities
    • Cancer
    • Chemical Dependency
    • Diabetes
    • Epilepsy/Seizure
    • Chronic Fatigue Syndrome
    • Human Immunodeficiency Virus (HIV+)
    • Lyme's Disease
    • Lupus
    • Multiple Chemical Sensitivity (MCS)
    • Multiple Sclerosis (MS)
      
      
• The Language of Disabilities
  
  
• Rights and Responsibilities
  
  
• Disability Related Law
  
  
• Frequently Asked Questions
  • What is a disability?
  • What is meant by "is regarded as having such an impairment" in the definition of disability?
  • Isn’t "disability - handicap" the same thing?
  • What is a reasonable accommodation?
  • How does a student become eligible to receive accommodations?
  • Who determines the accommodation?
  • The determination of reasonable accommodations considers the following
  • Won't providing accommodations on exams give an unfair advantage to a student with a disability?
  • What do I do when a student discloses a disability?
  • What if a student doesn't tell me about a disability until late in the semester?
  • Can I review the student’s documentation of disability?
  • What if I suspect a student has a disability?
  • What if the student with the disability is failing?
  • What if a student with a disability is often absent?
  • What is a notetaker?
  • How can I assist a student with getting notes?
  • Who is responsible for requesting an interpreter?
  • What can I expect if there is an interpreter in my classroom?
  • What should I do if my class needs to evacuate the building due to an emergency?
  • What if a student has a seizure in my classroom?

  Faculty Guide to Campus Resources

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The purpose of this handbook is to provide East Tennessee State University (ETSU) faculty with practical information and suggestions in working with students with disabilities. Students with disabilities are a rapidly growing minority at ETSU as in American Higher Education.

The obligation to accommodate these students extends beyond the moral responsibility and our university’s commitment to academic access. There is also a legal imperative, which is embodied in section 504 of the Rehabilitation Act of 1973, which states, in part:

"No otherwise qualified handicapped individual...shall solely, by reason of his handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination, under any program or activity receiving Federal financial assistance."

In 1990 the Americans with Disabilities Act was passed focusing new attention on issues relating to individuals with disabilities. To comply with this mandate, colleges and universities that receive federal assistance must ensure that the same educational programs and services are offered to students with disabilities. Academic ability must be the sole basis for participation in postsecondary education.

To accomplish this goal, both physical and programmatic 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 instructional process to ensure full educational opportunity. This principle applies to all teaching strategies and modes, as well as to institutional and department policies.

The means of achieving this ideal are often not merely matters of judgement. They are matters of knowledge and sensitivities that most of us simply do not have because of inexperience in interaction with students with disabilities. This handbook is designed to fill such gaps in order to heighten awareness and provide basic information for the benefit of faculty, staff, and students.

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Every student brings unique strengths and experiences to higher education, and students with disabilities are no exception. While many learn in different ways, their differences do not imply inferior capacities. There is no need to dilute curriculum or to reduce course requirements for students with disabilities. However, special accommodations may be needed in the way information is presented and in methods of testing and evaluation. Providing accommodations ensures equal opportunities for success in mastery of course material; it does not mean compromising the content, quality or level of instruction. All students are required to meet a standard of competency in course work; students with disabilities are no exception.

Many teaching strategies that assist students with disabilities are also known to benefit students without disabilities. Instruction provided in an array of approaches will reach more students than instruction using one method. The following suggestions are meant to assist instructors in meeting the growing diversity of student needs in the classroom, particularly those with disabilities.

During Registration:

• Make class syllabus and a list of required texts available by request to students; this allows time for students to obtain material in alternative formats and to begin reading assignments.
• Be available to discuss class content.
• If available and appropriate, select a textbook with an accompanying study guide for optional student use

Early in the semester:

• Place a statement in your syllabus and make an announcement at the first meeting of the class such as: "Any student who may need an accommodation based on a disability, please make an appointment to see me during my office hours. A Faculty Accommodation Form from Disability Services authorizing your accommodations is preferred." This approach preserves students’ privacy and also indicates your willingness to provide accommodations as needed.
• Because some students with disabilities need additional time to process and complete assignments, convey expectations at the beginning of the course (i.e. grading, material to be covered, due dates) in written and oral format.
• Announce reading assignments well in advance for students using taped materials or other alternative formats. To record an entire book takes an average of six weeks; but the material can be produced in installments when the sequence of the materials to be used is known.

General Strategies for Teaching and Presentation:

• Begin class with a review of the previous lecture and an overview of topics to be covered that day; give questions the students should be able to answer by the end of the lecture. At the conclusion of the lecture, summarize key points
• Highlight major concepts and terminology both orally and visually
• Emphasize main ideas and concepts during lecture and highlight them on the blackboard, overhead or computer display
• Speak directly to students
• Diminish or eliminate auditory and visual distractions
• Present new or technical vocabulary on the blackboard, overhead or computer display or use a handout
• Use visual aids such as diagrams, charts, and graphs
• Give assignments both orally and in written form; be available for clarification.
• Provide time lines for long-range assignments
• Use sequential steps for long-range assignments; for example, for a lengthy paper:

1. Select a topic
2. Write an outline
3. Submit a rough draft
4. Make necessary corrections with approval
5. Turn in final draft

• Provide the opportunity to review feed back on drafts of papers so that there is adequate time for clarification, rewrites, and refinements
• Provide study questions and review sessions to aid in mastering material and preparing for exams
• Give sample test questions; explain what constitutes a good answer and why
• Facilitate the formation of study groups of students who wish to participate
• Encourage students to seek assistance during your office hours and to use campus support services

Points to Remember

• When in doubt about how to assist, ask the student directly in private and check the Faculty Accommodation Form provided by Disability Services. If there are still additional questions, contact Disability Services.
• Confidentiality of all student information is essential. At no time should the class be informed that a student has a disability, unless the student chooses to do so themselves.
• The student code of conduct regarding disruptive behavior applies to all students. If there is question about behavioral conduct, or if you require assistance or guidance concerning a student with a disability, contact Disability Services.

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Students using wheelchairs or other utility devices may encounter obstacles in getting to class on time. Others may have periodic or irregular difficulties either from their disability or from medication.

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 a disability. Chronic weakness and fatigue characterize some disabilities and medical conditions. Drowsiness, fatigue, or impairments of memory and/or speed may result from prescribed medications. It is important to distinguish such difficulties and interferences with the student’s ability to perform from the apathetic behavior it may resemble.

Students with disabilities bear the primary responsibility for identifying their disabilities and making necessary adjustments to the learning environment; for example, reading and taking notes. For testing arrangements and the use of departmental resources, the cooperation of the faculty member is vital.

Dialogue between the student and the instructor is essential early in the term, and follow up meetings are recommended. Faculty should not feel apprehensive about discussing the student’s needs as they relate to the course. 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 the student’s functioning. Often, for example, people in wheelchairs are spoken to very loudly, as if they were deaf. The student probably will have had some experience with this kind of initial uneasiness you may bring to the relationship. The student’s own suggestions, based on experience with the disability and with academic work, are invaluable in accommodating the disability in college.

Depending on the disability, the student may require the administration of exams orally, the use of a reader or scribe, extension of time for duration of exams, or modification of test formats. The objective of such considerations should always be to accommodate the student’s learning differences, not to weaken scholastic requirements. The same standard for evaluation and grading should be applied to all students, regardless of disability.

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A reasonable accommodation is a modification or adjustment to a course, program, service, job, activity, or facility that enables a qualified student with disabilities to have an equal opportunity. An equal opportunity means an opportunity to attain the same level of performance or to enjoy equal benefits and privileges as are available to a similarly-situated student without a disability. The University is obligated to make a reasonable accommodation only to the known limitations of an otherwise qualified student with disabilities. To determine reasonable accommodation, Disability Services may seek information from appropriate University personnel regarding essential standards for courses, programs, services, jobs, activities, and facilities. Final determination of reasonable accommodation is made by Disability Services. Reasonable accommodations are determined by examining:

1.	The barriers resulting from the interaction between the documented disability and the campus environment;
2.	The possible accommodation that might remove the barriers;
3.	Whether or not the person has access to the course, program, service, job, activity, or facility without accommodations; and
4.	Whether or not essential elements of the course, program, service, job, activity, or facility are compromised by the accommodations.

Accommodations make it possible for a student with a disability to learn the material presented and for the instructor to fairly evaluate the student’s understanding of the material without the impact of the disability.

A student should receive approval before receiving accommodations. The student is responsible for providing the Disability Services office with current documentation from a qualified professional regarding the nature of the disability. After discussion with the student, Disability Services staff determine appropriate accommodations based on the nature of the disability described in the documentation and its impact on the educational activity. Students have the option to utilize a Faculty Accommodation Form specifying authorized accommodations. The student is responsible for requesting these forms each semester, delivering them to the instructor, and talking with them about arrangements for academic accommodations. The process of requesting and receiving accommodations is interactive; all people involved, the student, the instructor, and Disability Services Staff, have a responsibility to make sure the process works.

Examples of reasonable accommodations which students with disabilities may require include:

• Sign language interpreters
• Use of scribes, readers, and/or notetakers
• Use of a tape recorder for lectures
• Taped textbooks or class materials
• Alternate format of notes, required readings, handouts or exams (i.e. enlarged, brailled)
• Quiet distraction - free environment for taking exams
• Captioned film or video material
• Computer aided notetaker
• Use of computer for writing assignments or exams
• Preferential classroom/furniture location
• Assistive listening devices
• Adaptive computer technology
• Exam modifications

If testing accommodations are necessary, students are responsible for discussing the arrangements with their instructors.

The need for notetakers will be documented in the Faculty Accommodation Form. Students who cannot take notes or who have difficulty taking adequate notes, can be accommodated in a number of ways, including: taping lectures, using an in-class volunteer notetaker, and/or providing an outline of lecture materials. The student may ask the instructor for assistance in finding a classmate who would volunteer to provide a copy of lecture notes.

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Obtaining Academic Accommodations

1. Students with disabilities who require accommodations must seek assistance from Disability Services in a timely manner, usually prior to the start of classes or as soon as a disability becomes known.
2. Students with disabilities must provide documentation of their disability and how it limits their participation in courses, programs, services, jobs, activities, and facilities of the University.
3. Disability Services will file official documentation of the disability, including information about the manifestations of the disability.
4. Disability Services will ensure that disability related documents are kept confidential and shared with University personnel on a limited, need-to-know basis only.
5. Disability Services and the student with disabilities will discuss the interaction between the disability and the academic environment and determine the reasonable accommodation.
6. Disability Services will outline the process for the provision of reasonable accommodation with the following questions to be answered: what accommodation will be provided; why will they be provided; when will they be provided; who is responsible for providing them; and how will they be provided.
7. Disability Services will prepare individualized Faculty Accommodation Forms certifying that the student has a disability and stating the determined reasonable accommodations. The form details the provision of the recommended accommodations, when the accommodations will be provided and how they will be provided. The form also invites faculty to contact Disability Services if there are concerns or questions about the accommodations. Instructors will be expected to assist in the provision of accommodations when reasonable and necessary. Instructors are not expected to compromise essential elements of the course or evaluation standards.
8. The student with disabilities will be responsible for delivering the Faculty Accommodation Forms to faculty.
9. Students with disabilities will be responsible for contacting Disability Services if reasonable accommodations are not implemented in an effective or timely manner. Disability Services will work with University personnel and the student with disabilities to resolve disagreements regarding recommended accommodations.
10. Students with disabilities who believe they have been discriminated against on the basis of their disability may file a grievance with the Office of Affirmative Action.

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The following pages address some of the categories of disabilities and include a definition, characteristics, considerations, instructional strategies, and accommodations to assist the student.

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ADD and ADHD are neurological conditions affecting both learning and behavior. They result from chronic disturbances in the areas of the brain that regulate attention, impulse control, and the executive functions which control cognitive tasks, motor activity and social interactions. Hyperactivity may or may not be present. Students often have difficulty concentrating on and completing tasks, frequently shifting from one uncompleted activity to another. In social situations, inattention may be apparent by frequent shifts in conversation, poor listening comprehension, and not following the details of instructions.

Characteristics (may include):

• Inability to stay on task

• Easily distracted

• Poor time management skills

• Difficulty in being prepared for class, keeping appointments, and getting to class on time

• Reading comprehension difficulties

• Difficulty with math problems requiring changes in action, operation and order

• Inability to listen selectively during lectures, resulting in problems with note taking

• Lack of organization with work, especially written work

• Difficulty following directions, listening and concentrating

• Blurting out answers

Considerations and Instructional Strategies:

Since these students often also have learning disabilities, effective accommodations may include those also used with learning disabilities. Effective instructional strategies include providing opportunities for students to learn using visual, auditory and hands-on approaches.

The following strategies are suggested to enhance the accessibility of course instruction, materials, and activities. They are general strategies designed to support individualized reasonable accommodations.

• Include a disability access statement on syllabus (see "General Strategies for Optimizing Learning")
• Keep instructions brief and uncomplicated as possible
• Allow the student to tape record lectures
• Assist the student in finding an effective notetaker if necessary
• Clearly define course requirements, dates of exams, and when assignments are due; provide advance notice of any changes
• Provide handouts and visual aids
• Use more than one way to demonstrate or explain information
• Break information into small steps when teaching many new tasks in one lesson (state objectives, review previous lesson, summarize periodically)
• Allow time for clarification of directions and essential information
• Provide study guides or review sheets for exams
• Provide alternative ways for the students to do tasks, such as dictations or oral presentations
• Stress organization and ideas rather than mechanics when grading in-class writing assignments
• Allow the use of spell-check and grammar-assistive devices
• When in doubt about how to assist the student, ask him or her
• Allow the student the same anonymity as other students (i.e. avoid pointing out the student or the alternative arrangements to the rest of the class)

Accommodations (may include):

• Copies of classmate’s and/or instructor’s notes or overheads
• Extended time for exams
• Exams in a quiet, distraction-free environment
• Spell checker, reader or scribe during exams
• Use of blank card or paper to assist in reading
• Tape recorders
• Taped texts and classroom materials
• Extended time for in-class assignments to correct spelling, punctuation, grammar
• Instructions or demonstrations provided in more than one way
• Syllabus provided before the start of the semester

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Learning Disabilities

A learning disability (LD) is any of a diverse group of conditions that cause significant difficulties in perceiving or processing auditory, visual, and/or spatial information. Learning disabilities are neurologically based and may interfere with the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical skills. They affect the manner in which individuals with average or above average intellectual abilities process and/or express information. A learning disability may be characterized by a marked discrepancy between intellectual potential and academic achievement resulting from difficulties with processing information. The effects may change depending upon the learning demands and environments and may manifest in a single academic area or impact performance across a variety of subject areas and disciplines. Students vary widely in the patterns of strengths and weaknesses they exhibit.

Documentation of the learning disability is required not only to establish the need for special services but to determine the kind of special services that are indicated. Students who are believed to have a learning disability that has not been previously identified, should be referred to Disability Services for consultation.

In working with a student with a learning disability, it is important to identify the nature of the learning disability to determine the kinds of strategies that might accommodate it. Drawing upon a student’s own experience offers invaluable clues to the types of accommodations that work.

Difficulties may be seen in one or more of the following areas:

• Oral and/or written expression
• Reading comprehension and basic reading skills
• Problem solving
• Ability to listen selectively during lectures, resulting in problems with note taking
• Mathematical calculation and reasoning
• Interpreting social clues
• Time management
• Organization of tasks, such as in written work and/or essay questions
• Following directions and concentrating

Using a variety of instructional modes will enhance learning for students with a learning disability by allowing students to master material in one form when it may be inaccessible in another form. A multisensory approach to teaching will increase the ability of students with different functioning learning channels-auditory, visual and/or haptic (hands-on), to benefit from instruction.

Auditory Processing: Some students may experience difficulty integrating information presented orally hindering their ability to follow the sequence and organization of a lecture. To minimize this potential problem:

• Provide students with a course syllabus at the start of the semester
• Outline class presentations and write new key terms and key parts on the chalkboard or overhead
• Repeat and summarize segments of each presentation or lecture and review its entirety
• Paraphrase abstract concepts using specific terms and illustrate them with clear examples, personal experiences, hands-on models and such visual structures as charts and graphs

Reading 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:

• Make required book lists available prior to the first day of class to allow students to begin their reading early or have texts put on tape
• Provide students with chapter outlines or study guides that cue them to key points in their readings
• Read aloud material that is written on the board or that is given in handouts or transparencies

Memory may impede the student’s execution of complicated directions. Therefore:

• Keep oral instructions concise and reinforce them with brief cue words
• Repeat or re-word complicated directions

Notetaking: Some students with Learning Disabilities need alternative ways to take notes because they cannot write effectively or assimilate, remember, and organize the material while listening to a lecture

• Allow notetakers to accompany a student to class
• Permit tape recording or make your notes available for material not found in texts or other accessible sources
• Assist the student if necessary in arranging to borrow classmate’s notes

Participation: It is helpful to determine the student’s ability to participate in classroom activities. While many students with Learning Disabilities are highly articulate, some have severe difficulty in talking, responding or reading in front of groups.

Specialized Limitations: Some students with LD may have poor motor coordination or trouble judging distance or differentiating between right and left.

Laboratories can be especially overwhelming for students with Learning Disabilities. New equipment, exact measurements, 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 tools, equipment, and materials may be helpful
• The student’s use of cue cards or labels designating the steps of a procedure may expedite the mastering of a sequence

Behavior: Because of perceptual difference, some students with Learning Disabilities are slow to grasp social cues and respond appropriately. They may lack social skills, or have difficulty sustaining focused attention. If such problems result in classroom interruptions or other disruptions, it is advisable to discuss the matter privately with the student or the Disability Services Director.

• Tape recorders and/or laptop computers
• Copies of classmates and/or instructor’s notes or overheads
• Extended time for exams
• Exams in a quiet, distraction-free environment
• Frequent breaks allowed during exam; exam given by page or by section
• Calculator, Spell checker, reader, and/or scribe during exams
• Alternative form of exam, such as an oral test or an essay instead of multiple choice format
• Use of blank card or paper to assist in reading
• Taped texts or classroom materials
• Extended time for in class assignments to correct spelling, punctuation, and /or grammar
• Concise oral instructions
• Instructions or demonstrations presented in more than one way
• Syllabus provided before the start of the semester

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A variety of physical disabilities result from congenital conditions, accidents, or progressive neuromuscular diseases and may limit mobility and/or energy. These disabilities may include such muscoskeletal disabilities such as partial or total paralysis, amputation or severe injury, arthritis, spinal cord injury (paraplegia or quadriplegia), spina bifida, cerebral palsy, active sickle cell disease, muscular dystrophy, multiple sclerosis, polio/post polio, and stroke. Additionally, respiratory and cardiac diseases which are debilitating, may affect mobility. Any of these disabilities may also impair the strength, speed, endurance, coordination, or dexterity necessary for university life. While the degree of disabilities varies, it is important to recognize that for many reasons, some students may have difficulty getting to and from class, performing in class, taking notes, and managing out-of-class assignments and tests.

Physical access to classrooms is a major concern of students who have physical disabilities. Those who use wheelchairs, braces, crutches, canes or prostheses, or who fatigue easily, find difficulty in moving about, especially in the time constraints imposed by class schedules and accessible transportation. Tardiness or absences may be caused by transportation problems, inclement weather, or elevator or wheelchair breakdowns. For all these reasons, occasional tardiness by students with disabilities may be unavoidable.

Considerations and Instructional Strategies

• When speaking with a person who uses a wheelchair, try to converse at eye level; sit down if a chair is available
• Make sure the classroom layout is accessible and free from obstructions
• If a course is taught in a laboratory setting, try to provide an accessible work station or team the student up with a laboratory partner or assistant
• If a student also has a communication disorder, take time to understand the person. Repeat what you understand and when you don’t understand say so.
• Ask before giving assistance, and wait for a response. Listen to any instructions the student may give; the student knows the most efficient way to accomplish the task at hand.
• Let the student set the pace when walking or talking
• A wheelchair, braces or crutches are part of a person’s personal space; do not lean on, touch, or push the wheelchair, unless asked
• When field trips are part of the course requirement, make sure accessible transportation is available
• Ask the student if he or she will need assistance during an emergency evacuation, and assist in making a plan if necessary

• Accessible location for the classroom and place for faculty to meet with student
• Adaptive seating in classrooms
• Notetakers, tape recorders, laptop computers or copies of instructor and/or classmate’s notes
• Adaptive computer equipment/software
• Test accommodations: extended time, separate location, scribes, access to adapted computers
• Adjustable lab or computer tables
• Advance planning for field trips to ensure accessibility

In the event you are unable to provide the necessary accommodations, Disability Services can assist you in determining or arranging accommodations.

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Visual impairments vary greatly. Most people considered legally blind have some vision. A person with 20/200 or lower visual acuity with correction has legal blindness. A visual impairment exists when corrected vision is no better than 20/70. The term blindness can be reserved for those with total loss of sight, and visually impaired can refer to people with various gradations of vision.

The following terms are used to describe students with visible impairments:

• Totally Blind individuals learn via Braille or other nonvisual media
• Legally Blind indicates an individual has less than 20/200 vision in the more functional eye or a very limited field of vision (20 degrees at its widest point)
• Low Vision refers to a severe vision loss in distance and near vision. Individuals may use a combination of vision and other senses to learn, and they may require adaptations in lighting or the print size, and in some cases, Braille

Most students with visible impairments can use a combination of adaptations for class participation and learning needs including readers, Braille, cassette tapes, and adaptive computer equipment.

Considerations and Instructional Strategies

• If needed, identify yourself at the beginning of a conversation and notify the student when you are exiting the room
• Nonverbal cues depend on good visual acuity. Verbally acknowledging key points in the conversation facilitates the communication process.
• A student may use a guide dog or white cane for mobility assistance. A guide dog is a working animal and should not be petted.
• When giving directions, be clear: say "left" or "right", "step up", or "step down". Let the student know where obstacles are; for example, "the chair is to your left" or "the stairs start in about three steps".
• When guiding or walking with a student, verbally offer your elbow instead of grabbing his/hers.
• Allow the student to determine the most ideal seating location so they can see, or hear, or if appropriate, touch as much of the presented material as possible
• Discuss special needs for field trips or other out-of-class activities well in advance.
• Familiarize the student with the layout of the classroom or laboratory, noting the closest exits, and locating emergency equipment.
• Ask the person if they will need assistance during an emergency evacuation and assist in making a plan if necessary.

• Provide syllabi in advance to allow arrangements for taping or brailling texts
• Work with Disability Services and the student to find volunteer note takers or team the student up with a sighted classmate

Accommodations (may include):

• Reading aloud materials from overheads, blackboards, or handouts
• Verbal description of class activity, such as when a show of hands is requested, stating how many hands were raised
• Permit lectures to be taped or provide copies of lecture notes, where appropriate
• Advance notice of class schedule and/or room changes
• Alternative test formats such as taped, large print or Braille, use of readers, scribes, tape recorded responses, extended time, adapted computer or closed circuit TV
• Class assignments available in electronic format, such as computer disk, to allow access by adaptive computer equipment
• Students should not be exempted from exams and/or be expected to master less content because of their visual impairment

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Though not always visible and sometimes seemingly minor, brain injury is complex. It can cause physical, social, cognitive, and vocational changes that affect an individual for a short period of time or permanently. Depending on the extent and location of the injury, symptoms caused by a brain injury vary widely. Some common results or symptoms are seizures, loss of balance or coordination, difficulty with speech, limited concentration or attention deficits, memory loss, behavior problems, anxiety attacks, problems of judgement and loss of organization and reasoning skills.

Traumatic brain injury typically results from accidents, however, brain injury may also be caused by insufficient oxygen, stroke, poisoning or infection.

Brain injury can cause physical, cognitive, behavioral, and/or personality changes.

• Recovery from a brain injury can be inconsistent. A person may take one step forward, two back, do nothing for a while and then unexpectedly make a series of gains. A "plateau" is not evidence that functional improvement has ended.
• Effective teaching strategies include providing opportunities for a student to learn using visual, auditory and hands-on approaches.

Accommodations (may include):

• Tape recorders
• Copies of classmate’s notes or overheads
• Extended time for exams
• Exams in a quiet distraction-free environment
• Breaks during exams, or exams given by a page or section
• Use of blank card or paper to assist in reading
• Taped texts and classroom materials
• Use of handouts and visual cards
• Extended time for in-class assignments to correct spelling, punctuation, and/or grammar
• Word processor with spell check and/or voice output to provide auditory feedback
• Concise oral instructions
• Syllabus provided before the start of the semester

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Hearing impaired is a broad term that refers to varying degrees of hearing loss from partial to total deafness. The age of onset plays a crucial role in the development of language; persons with a prelingual hearing loss often have weaker oral communication skills than those whose loss occurred after speech development.

The causes and degrees of hearing loss vary across the deaf and hard of hearing community, as do methods of communication and attitudes toward deafness. In general, there are three types of hearing loss:

Conductive loss affects the sound-conductivity paths of the outer and middle ear. The degree of loss can be decreased through the use of a hearing aid. People with conductive loss may speak softly, hear better in noisy surroundings than people with normal hearing, and might experience ringing in their ears.

Sensorineural loss affects the inner ear and the auditory nerve and can range from mild to profound. People with sensorineural loss might speak loudly, experience greater high-frequency loss, have difficulty distinguishing consonant sounds, and not hear well in noisy environments.

Mixed loss results from both a conductive and sensorineural loss.

Those who have a hearing impairment may use a variety of communication methods including lipreading, amplification, cued speech, signed English and/or American Sign Language (ASL). Not all individuals who are hearing impaired are fluent users of all the communication modes used across the deaf community, just as users of spoken languages are not fluent in all oral languages. For example, not all deaf students lip read and many use sign language of which there are several types of systems. American Sign Language (ASL) is a natural, visual language having its own syntax and grammatical structure. Pidgin Sign English (PSE) combines aspects of ASL and English and is used in educational situations often combined with speech.

In addition to sign language and lipreading, deaf students also use sign and oral language interpreters. These are professionals who assist deaf or hard of hearing persons with understanding communications not received orally. Interpreters also assist hearing persons with understanding messages communicated by deaf or hard of hearing individuals. Sign language interpreters use highly developed language and finger spelling skills; oral interpreters silently form words on their lips for speech reading. Interpreters will interpret all information in a given situation, including instructors comments, class discussions, and environmental sounds.

Students who communicate with speech and lipreading, as opposed to communicating manually with sign language are referred to as "oral". Some students with hearing loss may have enough residual hearing to benefit from personal FM transmitter amplification units of which the professor will wear a transmitter and a student can properly adjust the amplification on the receiving unit they wear.

Considerations and Instructional Strategies:

• Even skilled lip readers can only distinguish 30 to 40% of spoken English under the best conditions. Many speech sounds have identical mouth movements which can make lipreading difficult. For example, "p", "b", and "m" look exactly alike on the lips and many sounds (vowels, for example) are produced without using clearly differentiated lip movements.
• Make sure you have the individual’s attention before speaking. A light touch on the shoulder, wave, or other visual signal will help.
• Look directly at the person during a conversation even when an interpreter is present. Speak clearly without shouting. If you have problems being understood, rephrase your thought. Writing is also a good way to clarify.
• Make sure that your face is clearly visible. Keep your hands away from your face and mouth while speaking. Sitting with your back to a window or light, gum chewing, cigarette smoking, pencil biting and similar obstructions of the lips can also interfere with the effectiveness of communication.
• Recognize the processing time the interpreter takes to translate a message from its original language into another language. The student may need more time to receive information, ask questions, and/or offer comments.
• Individuals who have hearing impairments often also have difficulties with speech, reading, and writing skills given the close relationship between language development and learning.

Accommodations (may include):

• Seating which allows a clear view of the speaker, the interpreter and blackboard or overhead
• Written supplement to oral instructions, assignments, and directions
• Providing handouts in advance so that the student can watch the interpreter rather than read or copy new material at the same time
• Use visual aids whenever possible including captioned versions of videos and films
• Repeat questions or comments from other students
• Assist the student in providing a notetaker for class lectures
• Test accommodations may include: extended time, separate place, access to word processor, or use of interpreter for directions
• Provide unfamiliar vocabulary in written form, on the blackboard, or in a handout
• Use of electronic mail for discussions with the instructor
• When evaluating written material from students who are hearing impaired, advise tutoring if grammar or syntax problems exist
• Allow the student the same anonymity as other students (i.e. Avoid pointing at the student or discussing the alternative arrangements with the rest of the class).

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Students with psychiatric disabilities represent a growing population on our campuses. These disabilities may be hidden with little or no apparent effect on a student’s learning. Psychiatric disabilities refer to a wide range of behavioral and/or psychological problems characterized by anxiety, mood swings, depression, and/or compromised assessment of reality. These behaviors persist over time; they are not in response to a particular event. Although many individuals with psychiatric disabilities are stabilized using medications and/or psychotherapy, their behavior and affect may still cycle. The National Institute of Mental Health estimates that 1 in 5 people in the U.S. have some form of psychiatric disability, but only 1 in 5 persons with a diagnosable psychiatric disorder ever seeks treatment due to the strong stigmatization involved. Below are brief descriptions of some common psychiatric disabilities.

Depression is a major 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 most activities, thoughts of suicide, insomnia, and feelings of worthlessness or guilt. 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.

Bipolar Disorder (manic depressive disorder) causes a person to experience periods of mania and depression. In the manic phase, a person might experience increased initiative and a decreased need to sleep.

Anxiety Disorders can disrupt a person’s ability to concentrate and cause hyper-ventilation, a racing heart, chest pains, panic and extreme fear. Severe anxiety may reduce concentration, distort perception and weaken the learning process. Anxiety may manifest itself as withdrawal, complaining of extreme fear.

Schizophrenia can cause a person to experience a distortion of reality and in some instances delusions and hallucinations.

Considerations and Instructional Strategies

• Psychiatric disabilities affect people of any age, gender, income group, and intellectual level.
• Students with psychiatric disabilities may not be comfortable disclosing the specifics of their disability.
• If a student does disclose, be willing to discuss how the disability affects him or her academically and what accommodations would be helpful.
• Drowsiness, fatigue, memory loss, and decreased response time may result from prescription medications.

Accommodations may include:

• Quiet, distraction free testing area
• Extended time for exams
• Notetakers or tape recorders in class
• Extensions, incompletes or late withdrawals in the event of prolonged illness
• Modifications of seating arrangements (near the door or at the back of the classroom)
• Beverages allowed in class due to medications which may cause extreme thirst

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Speech and language disabilities may result from hearing loss, cerebral palsy, learning disabilities, and/or physical disabilities. There may be a range of difficulties in articulation or voice strength to complete absence of voice. Included are difficulties in projection, fluency, problems such as stuttering and stammering, and in articulating particular words or terms.

Considerations and Instructional Strategies

• Give students opportunity, but do not compel speaking in class. Ask students for a cue they can use if they wish to speak.
• Permit students time to speak without unsolicited aid in filling in the gaps in their speech.
• Do not be reluctant to ask students to repeat a statement.
• Address students naturally. Do not assume that they cannot hear or comprehend.
• Patience is the most effective strategy in teaching students with speech and language disabilities

Accommodations (may include):

• Modifications of assignments such as one-to-one presentation or use of a computer with voice synthesizer
• Alternative assignments for oral class reports

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Systemic disabilities are conditions affecting one or more of the body’s systems. These include the respiratory, immunological, neurological, and circulatory systems. There are many kinds of systemic impairments, varying significantly in their effects and symptoms. Below are brief descriptions of some of the more common types:

Cancer is a malignant growth that can affect any part of the body. Treatment can be time-consuming, painful, and sometimes result in permanent disability. 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.

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Chemical Dependency is considered a disability when it is documented that a person has received treatment for drug or alcohol addiction and is not currently using. Chemical dependency can cause permanent cognitive impairments and carries with it a great deal of stigma. These students may experience psychological problems such as depression, anxiety or very low self-esteem. Individuals may exhibit poor behavioral control, and if they are using medication as part of their treatment, they may experience undesirable side effects.

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Diabetes causes a person to lose the ability to regulate blood sugar. People with diabetes often need to follow a strict diet and may require insulin injections. During a diabetic reaction, a person may experience confusion, sudden personality changes, or loss of consciousness. In extreme cases, diabetes can also cause vision loss, cardiovascular disease, kidney failure or necessitate the amputation of limbs.

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Epilepsy/Seizure Disorder causes a person to experience a loss of consciousness. Episodes, or seizures, vary from short absences or "petit mal" seizure to less common "grand mal". Seizures are frequently controlled by medications and are most often not emergency situations. Students with epilepsy and other seizure disorders are sometimes reluctant to divulge their conditions because of fear of being misunderstood or stigmatized. Each student’s seizures may be different and it is best to talk to them individually as to how to react to them and respond to their seizure.

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Chronic Fatigue Syndrome is an autoimmune disorder which causes extreme fatigue, loss of appetite, and depression. Physical or emotional stress may adversely affect a person with this disability.

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Human Immunodeficiency Virus (HIV+) and AIDS inhibits one’s ability to fight off illness, infections, and cancers. Manifestations of AIDS are varied, depending on the particular infections or diseases the individual develops. Students who are HIV+ or have AIDS may be afraid to reveal their condition because of the social stigma, fear, and misunderstanding surrounding the illness. It is exceptionally important that confidentiality be strictly observed.

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Lime's Disease is a multi systemic condition which can cause paralysis, fatigue, fever, sleeping problems, memory dysfunction, cognitive difficulties and depression.

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Lupus can cause inflammatory lesions, neurological problems, extreme fatigue, persistent flue-like symptoms, impaired cognitive ability, connective tissue dysfunction, and mobility impairments. Lupus most often effects young women.

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Multiple Chemical Sensitivity (MCS) often results from prolonged exposure to chemicals. A person with MCS becomes increasingly sensitive to chemicals found in everyday environments. Reactions can be caused by cleaning products, pesticides, petroleum products, tobacco smoke, perfumes and scented personal products. Though reactions vary, nausea, rashes, light-headedness, and respiratory distress are common to MCS.

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Multiple Sclerosis (MS) is a progressive neurological condition with a variety of symptoms, such as loss of strength, numbness, vision impairments, tremors, paralysis and depression. The intensity of MS symptoms can vary greatly; one day a person might be extremely fatigued and the next day feel strong. Extreme temperatures can also adversely affect a person with MS. Because the onset of the disease usually occurs between the ages of 20 and 40, students are likely to be having difficulty adjusting to their disability.

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Considerations and Instructional Strategies

• The condition of a student with a systemic disability may fluctuate or deteriorate over time, causing the need for and type of accommodation to vary
• Fatigue may be a significant factor in the student’s ability to complete required tasks within regular time limits.
• A student may need to leave the classroom early or unexpectedly and should not be held accountable for missed instruction.

Accommodations (may include):

• Extended time for exams
• Recorded course material
• Use of scribes or readers
• Extensions, incompletes, or late withdrawals in the event of an exacerbation of the disability

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People with disabilities prefer you focus on their individuality not their disability. The term "handicap" is falling into disuse and should be avoided as well as the terms "able bodied", "physically challenged", and "differently abled".

The following are some recommendations: Never use the article "the" with an adjective to describe people with disabilities. This 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. For examples:

• Not "the deaf," but "people who are deaf or hard of hearing;"
• Not "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. For example:

• People who are blind are visually impaired;
• People who are deaf are hearing impaired;
• People who are developmentally disabled; non-disabled; physically disabled.
• People with or have cerebral palsy, down syndrome, mental illness, paraplegia, quadaplegia, partial hearing loss, seizure disorder, or specific learning disabilities

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

Never use the terms "victim" or "sufferer" for someone who has or has had a disease or disability. This term dishumanizes a person and emphasizes powerlessness.

A person is not a victim of AIDS or AIDS sufferer, but a person with AIDS or not a polio victim, but a person who had polio.

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".

People with disabilities are not conditions or diseases, they are individual human beings. First and far most, they are people. Only secondary do they have one or more disabling conditions. Hence they prefer to be referred to as people with disabilities.

A Disability (is a condition caused by a accident, trauma, genetics, or disease) which may limit a person’s mobility, hearing, vision , speech or mental function. Some people with disabilities have one or more disabilities.

A handicap is a physical or attitudinal constraint that is imposed upon a person regardless of whether that person has a disability. Example:

Some people with disabilities use wheelchairs. Stairs, narrow doorways, and curbs are handicaps imposed upon people with disabilities who use wheelchairs.

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Students with Disabilities at ETSU have the right to:

• Equal access to courses, programs, services, jobs, activities, and facilities offered by the university.
• Equal opportunity to work, learn, and receive accommodations, academic adjustments, and/or auxiliary aids and services.
• Confidentiality of information regarding their disability as applicable laws allow.
• Information available in accessible formats.

Students with disabilities at ETSU have the responsibility to:

• Meet qualifications and maintain essential institutional standards for the programs, courses, services, jobs, activities, and facilities.
• Identify to Disability Services as having a disability in order to receive accommodations, and to seek information, counsel, and assistance as necessary.
• Provide documentation to Disability Services from a qualified professional about how their disability limits participation in courses, programs, services, jobs, activities, and facilities.
• Follow published procedures for obtaining reasonable accommodations, academic adjustments, and/or auxiliary aids and services.
• Follow the published ETSU student code of conduct.

ETSU has the right to:

• Identify and establish essential functions, abilities, skills, and standards for courses, programs, services, jobs, activities, and to evaluate faculty, staff, and students on this basis only.
• Request and receive through Disability Services current documentation from a qualified professional that supports a student’s request for accommodations, academic adjustments, and/ or auxiliary aids and services.
• Deny a request for accommodation, academic adjustments, and or auxiliary aids and services if the documentation does not demonstrate that the request is warranted or if the individual fails to provide appropriate documentation.
• Select among effective accommodations, academic adjustments, and /or auxiliary aids and services.
• Refuse to provide an accommodation adjustment and/or auxiliary aids and service that imposes a fundamental alteration of a program or undo hardship on the university.

ETSU has the responsibility to:

• Accommodate the known limitations of a student with a disability.
• Provide information to faculty, staff, students, and guest with disabilities in accessible formats upon request.
• Ensure that courses, programs, services, jobs, activities, and facilities when viewed in their entirety are available and usable in the most integrated, and appropriate settings.
• Evaluate faculty, staff, students, and applicants on their abilities, not their disabilities.
• Provide or arrange accommodations, academic adjustments, and/or auxiliary aids and services for faculty, staff, students, and guests with disabilities in courses, programs, services, jobs, activities, and facilities.
• Maintain appropriate confidentiality of records and communication except where permitted or required by law.
• Maintain academic standards by providing accommodations without comprising the content, quality, or level of instruction.

A professor at ETSU has the right to:

• Determine course content and general methods of teaching.
• Make decisions on how best to adapt their teaching and assessment methods to accommodate all students.
• Ensure that the standards in their course are not lowered or comprised.
• Fail any student if he or she does not demonstrate mastery of essential course requirement.
• Determine through consultation with Disability Services, the most appropriate way to adapt their course to the needs of a particular student.
• Question a specific accommodation request if it is either inappropriate for their course or if the nature of the request would alter the essential requirements of the course.

A professor at ETSU should know:

• What specific disabilities are, and are not
• That students who are registered with Disabilities Services have provided adequate and appropriate documentation of their disability from a qualified professional and the accommodation requests are based on this documentation.
• That trained professionals at Disability Services are available to assist them should they wish advisory information about how to adapt their course or accommodate student needs.
• That they can discuss alternative ways to assist students with disabilities especially if they feel the requested accommodations are inappropriate or unbelievable.
• That some students with disabilities have academic or behavior problems unrelated to their disability, therefore professors are not obligated to treat such problems any differently than they would for a student without a disability.

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The Americans with Disabilities Act (ADA):

The Americans with Disabilities Act was signed into law on July 26, 1990. The purpose of the act is to:

• Provide clear and comprehensive national mandates to end discrimination against individuals with disabilities, provide enforceable standards addressing discrimination against individuals with disabilities.
• Ensure the Federal Government plays an essential role in enforcing these standards on behalf of individuals with disabilities.

The term Disability is defined as "a physical or mental impairment that substantially limits one or more of a person’s major life activities, has a record of such an impairment, or is regarded as having such an impairment." The same definition is used in Section 504 of the Rehabilitation Act.

The Americans with Disabilities Act gives people with disabilities civil right protection like that provided to individuals on the basis of race, sex, national origin, and religion. It guarantees equal opportunities for individuals with disabilities in employment, public accommodations, transportation, local and state services, and telecommunications.

Section 504 of the Rehabilitation Act of 1973 states that "No other wise qualified individual with a disability in the U.S. ... shall solely by reason of ... disability be denied the benefits of, or excluded from the participation in, or be subjected to discrimination in any program or activity receiving Federal Finance assistance"

A person with a disability includes "any person who 1) one has a physical or mental impairment which substantially limits one or more major life activities including walking, seeing, hearing, speaking, breathing, learning, working, caring for one self, and performing manual tasks, 2) has a record of such impairment, or 3) is regarded as having such an impairment."

A qualified person with a disability is defined as one "who meets the academic and technical standards required to admission or participation in the educational program or activity."

Under the provisions of Section 504 of the Rehabilitation Act of 1973, the college may not discriminate in the recruitment, admission, or the educational process or treatment of students. Students who have self identified, provided documentation of disability, and requested reasonable accommodation are entitled to receive approved, appropriate academic accommodations, or auxiliary aids that enable them to participate in, and benefit in all educational programs and activities.

Under these laws the University may not :

• Limit the number of students with disabilities admitted
• Make preadmission inquiries whether or not an applicant has a disability
• Use admission test or criteria that inadequately measures the academic level of students with visual, hearing or other disabilities, because provisions were not made for them
• Exclude a student with a disability from any course of study solely on the basis of their disability
• Counsel students with disabilities toward a more restricted career than students without disabilities, unless such counsel is based on strict licensing or certification requirements in the profession
• Measure student achievement using modes that adversely discriminate against students with disabilities
• Institute prohibitable rules that may adversely affect the performance of students with disabilities

Modifications and Accommodations for Students with Disabilities include:

• Architectural barrier removal,
• Services such as readers for students with visual impairments or learning disabilities, qualified interpreters and notetakers for students who are deaf or hard of hearing.
• Modifications of courses in major fields of study, or degree requirements on a case by case basis
• Testing accommodations
• Alternative formats and methods for students to demonstrate course mastery
• Adaptive computer technology

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