supporting students with significant ongoing illness

Introduction

There are many conditions that may interfere with a student's academic functioning. Some of their symptoms, like limited mobility or impaired vision, and the types of intervention required may resemble those covered elsewhere.

The general principles apply, particularly the need to identify the disability and to discuss with the student both its manifestations and the required considerations.

Below are brief descriptions of some of the more prevalent disabilities among students, along with some recommended accommodations.  Most of the accommodations have already been outlined in the relevant sections above.

• Medical Conditions:
  • Cancer
  • Respiratory Problems
  • Seizure Disorders
  • Sickle Cell Anaemia
• Physical Conditions:
  • Closed Head Injury
  • Cerebral Palsy
  • Multiple Sclerosis
  • Muscular Dystrophy
• Other:
  • AIDS - Acquired Immune Deficiency Syndrome
  • Substance Abuse

Medical Conditions

Cancer

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.

Therapy and treatment of cancer can cause violent nausea, drowsiness and/or fatigue, affecting academic functioning or causing absences. Surgery can result in amputation, paralysis, sensory deficits, and language and

Respiratory Problems

Respiratory problems are characterised by attacks of shortness of breath and difficulty in breathing, sometimes triggered by stress, either physical or mental and exposure to air-borne pollutants. Fatigue and difficulty climbing stairs may also be major problems, depending on the severity of the attacks. Frequent absence from lectures may occur and hospitalisation may be required when prescribed medications fail to relieve the symptoms.

Seizure Disorders

Misconceptions about these disorders - that they are forms of mental illness, contagious and untreatable.  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 of the brain.

Three distinct types of seizures exist

1. Petit Mal means "little" seizure and is characterised by eye blinking or staring. It begins abruptly with sudden dimming of consciousness and may last only a few seconds. Whatever the person is doing is suspended for a moment but resumed again as soon as the seizure is over. Often, because of its briefness, the seizure may go unnoticed by the individual as well as by others.
2. Physcomotor 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 minutes to a half hour. The person may have no recollection of what happened, but may experience fatigue.
3. 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 lectures.
   
   In the event of a Grand Mal seizure, the following procedure should be followed:

• Keep calm. Although its manifestations may be intense they are generally not painful to the individual.
• Remove nearby objects that may injure the individual during the seizure
• Help lower the person to the floor and place cushioning under his/her head
• Turn the head to the side so that breathing is not obstructed
• Loosen tight clothing
• Do not force anything between the teeth
• Do not try to restrain bodily movement
• After a seizure, a lecturer should deal forthrightly with the concerns of the class in an effort to forestall whatever negative attitudes may develop toward the student

Sickle Cell Anaemia

Sickle cell anaemia reduces blood supply to vital organs and the oxygen supply to the blood cells, making adequate lecture room ventilation an important concern.

Because many vital organs are affected, the student may also suffer from eye disease, heart condition, lung problems and acute abdominal pain. At times limbs or joints may be affected. The disease is characterised by severe crisis periods, with extreme pain, which may necessitate hospitalisation and/or absence from lectures. Completing academic assignments during these periods may not be possible.

Physical conditions

Closed Head Injury

Students with brain injuries are becoming more prevalent. These students often exhibit one or more of the following symptoms: short-term memory problems, serious attention deficits, auditory dysfunction, cognitive deficits, behaviour problems, problems of judgement and serious anxiety attacks.

Cerebral Palsy

Manifestations may include involuntary muscle contractions, rigidity, spasms, poor coordination, poor balance or poor spatial relations. Visual, auditory, speech, hand-function and mobility problems might occur.

Multiple Sclerosis

Symptoms may include disturbances ranging from mild to severe: blurred vision, legal blindness, tremors, weakness or numbness in limbs, unsteady gait, paralysis, slurred speech, mood swings or attentions deficits. Because the onset of the disease usually occurs between the ages of 20 and 40, students are likely to be having difficulty adjusting to their new condition.

Periodic remissions are common and may last from a few days to several months. As a result, mood swings may vary from euphoria to depression. Striking inconsistencies in performance are not unusual.

Muscular Dystrophy

The atrophy of the muscles results in chronic problems. Walking, if possible, is slow and appears uncoordinated.  Manipulation of course materials may be difficult.

Other Conditions

AIDS - Acquired Immune Deficiency Syndrome

Manifestations of AIDS are varied, depending on the particular infections or diseases the individual develops. Extreme fatigue is a common symptom.  Because of the social stigma, fear and/or 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 the lecturer to deal openly and non-judgmentally with it and to foster an atmosphere of understanding.

Substance Abuse

Substance abuse is a condition of physiological and/or psychological dependence on any of a variety of chemicals, such as illegal drugs, some prescription drugs and alcohol.

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

Students showing symptoms of substance abuse should be referred the College Health Service.

In cases of inappropriate behaviour during lectures, discuss it with the student in a private setting.

For further information see

AHEAD - www.ahead.ie

This Irish voluntary organisation provides an excellent start for all students with disabilities on studying at Third level. It has many useful links, publications and general information.

Skill - www.skill.org.uk

The British equivalent to Ahead provides useful information that is relevant to students studying in Ireland or considering study in Britain.

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