All students face anxiety as they enter college. For students with disabilities, this transition also entails becoming familiar with and working within an entirely new system for accessing support and communicating disability-based needs.

Our child with a disability is preparing for entry into college – are they prepared to assist him/her?

BY H. BARRY WALDMAN, DDS, MPH, PHD AND STEVEN P. PERLMAN, DDS, MSCD, DHL (HON)

"An estimated 11 percent of (college) undergraduates and 5 percent of graduate students have disabilities, and they are entering higher education in greater numbers, with a wider variety of disabilities, ethnicities, and socio-economic backgrounds"1 Equal access to higher education for people with disabilities has been a federal mandate for over 40 years, and colleges and universities provide accommodations and services for students with disabilities in a variety of ways. "Data on student success and outcomes are not conclusive, however, and available research reports persistence and graduation rates that are not on par with non-disabled peers."2 

"Many campus communities do not address disability as part of diversity and campus climate efforts. Even after addressing physical and structural barriers, the campus environment may be inhospitable for students, faculty, and staff with disabilities due (to discrimination in favor of ablebodied people) as well as curricular, programmatic, and policy barriers. These barriers may be especially challenging for students with disabilities who identify as members of other marginalized groups, including students of color, LGBTQ students, and students who grew up in poverty."3 - National Center for College Students with Disabilities (NCCSD)* 

* NCCSD is the only federally-funded national center in the U.S. for college and graduate students with any type of disability, chronic health condition, or mental or emotional illness. It functions through the Office of Postsecondary Education at the U.S. Department of Education.

Ideally all students should feel comfortable living and socializing on campus, while pursuing coursework, extracurricular activities, career preparation, and research opportunities on campus. "However, students with various backgrounds, ethnicities, and identities experience campus climates in highly individualized ways, and harassment and discrimination experienced based on actual or perceived identities adversely affects their educational outcomes."3

If college students do not feel welcome and comfortable in the popular living, social, and study established places on campus, some students may prefer to find spaces on campus that they consider "safe" (i.e., where they are less likely to experience harassment and discrimination because of their disabilities or backgrounds). Students of color with disabilities may seek out faculty, mentors, and staff who can understand all facets of their identities and experiences, including how disability and health experiences may be affected by their cultures and communities. On the other hand, students with disabilities may not want to be labeled as disabled or network with other students who have disabilities. 4 

COMMON BARRIERS IDENTIFIED BY STUDENTS

"…While the field of postsecondary [school] disability is increasingly embracing a model that recognizes disability as an aspect of student diversity, not all campuses or community members have recognized this. As one student described, 'I would say it [the disability] is one that we kind of like nudge under the table, and it doesn't necessarily get talked about because I think people with disabilities are considered lesser for some reason, a little bit.' Another student observes, '…it's tough, like, disability is the best word we have right now, but it has connotations outside of it, and I think a lot of times, when people think of disability, they think of, like, oh, what's wrong with me or it's medicalized.'" 5

STUDENT IN A WHEELCHAIR

THE NEXT LEVEL: Colleges are not obligated to provide specialized instruction or tutoring. They do have to abide by federal civil rights laws and the Americans with Disabilities Act (ADA), and provide accommodations to students who are eligible under the ADA. Some may also provide support services like tutoring or coaching for a fee.

All students face anxiety as they enter college. For students with disabilities, this transition also entails becoming familiar with and working within an entirely new system for accessing support and communicating disability-based needs. Under the Americans with Disability Act (ADA) college students with disabilities are required to disclose and request accommodations typically by reaching out to the campus-based disability resource office. Some students must take on the role of being their own self-advocate, in many cases for the first time and often with little or no training. However:

"Campus assurances of confidentiality don't necessarily ameliorate the concern around 'the stigma'. One student noted, '…I don't really feel comfortable talking to someone I don't know [about my disability] even though they say it's confidential. Who knows if it's confidential?' Another student expressed concern about disclosure through student records at the school. 'Students are so afraid to request [accommodations] for disabilities because they think they are going to mark[ed] …and when [you] ask for a job…nobody is going to hire you. I don't know if that's true.'" 5

SUGGESTIONS AND DIFFICULTIES

Work with the disability resource office: They may not be aware of available services, difficulty navigating academic office procedures, inadequate accommodations, and lacking support for self-advocacy and disclosure skill development.

Classroom and instructional environment: Instructors may be uninformed about campus procedures, unresponsiveness to students, or challenge student requests for accommodations (see following section on What Parents Can Do). Campus access and supports: Physical barriers, as well as gaps in services and programs across campus. Campus climate: Possible negative interactions with peers, experiences of stigma related to the disability, and the added work of addressing physical, curricular, and attitudinal barriers across campus.5

"Self-advocacy and disability disclosure are an essential part of life as a college student with a disability, but this ongoing role is challenging for some students. As one student shares, 'I think that's ours. It's a burden. It's something that I find difficult, but just like with being upfront with the teacher beforehand, I have to be a little more outgoing than I normally would be.' Or another student experiences it this way, 'I really feel like there's this burden to disclose all the time and…to almost try to comfort everyone else when I need an accommodation… I feel like there's this burden of making everyone else feel comfortable about my disability on campus.'"5

THERE IS THAT REALITY

"Individuals with disabilities who attain higher levels of education are more likely to experience positive employment outcomes. Nevertheless, employment outcomes for individuals with disabilities are not commensurate with those of individuals without disabilities who have comparable educational attainment."6

Although college students with disabilities benefit from the same types of career development activities as their peers without disabilities, many institutions are not doing enough to develop students' knowledge of disability-related employment policies, disclosure, and workplace accommodations, which may be critical in improving students' career trajectories.

THE PERSPECTIVE FROM STUDENTS WITH A DISABILITY: WHAT WOULD BE A GOOD COLLEGE CAMPUS?

"When I think about what a good campus would look like for college students with disabilities, it is a campus that embraces and works with a presumption of [student] competence.

THE PARENT'S PERSPECTIVE

Some of the things parents need to know: While many students with disabilities are capable of graduating from high school, there is a wide array [by state] in the proportion of these teenagers actually graduating. Ranging from: 29% in Nevada to 81.91% in Arkansas. 7

Even with supportive high-school preparation, students may still lack the confidence or emotional maturity to leave home for college. They may also be burned out. In that case, a gap year – a year between high school and college – may prove beneficial.

"Have they had so much remediation [in high school] that they really haven't experienced life yet? If so, it may be a good idea for them to get a part-time job or explore their passions in art or music or drama that they didn't have time for because of educational therapy, speech therapy, or other remediation… Although community colleges will never win the 'prestige bat tle,' they are another low-stress, low-cost way to begin the college experience, spend time maturing, and plug academic holes. Many four-year schools also have agreements with community colleges that ensure classes are transferrable. And SAT or ACT scores often are not required for students transferring from community colleges." 8

About a third of students with disabilities who enroll in a fouryear college or university graduate within eight years. The outcomes for those who enroll in two-year schools aren't much better; 41 percent graduate, according to federal data. These outcomes aren't because students with disabilities can't handle the coursework. The vast majority of special education students can grasp rigorous academic content. It is estimated that up to 90 percent should be able to graduate from high school meeting the same standards as general education students, ready to succeed in college and careers. But high schools often neglect to teach these students the soft skills that will help them in higher education – like how to study, manage their time and self-advocate. These skills can make the difference between getting a degree or not at a time when America expects a large number of jobs requiring postsecondary education to go unfilled.9

The reality is that your child is transitioning into the world of adults. Yes, difficult for him/her and you. But these changes are necessary if your young adult child is to learn to live, work and succeed in the world beyond the protective environment that you and other parents have provided during the childhood years.

WHAT PARENTS CAN DO : UNDERSTANDING THERE ARE DIFFERENCES BETWEEN HIGH SCHOOL AND COLLEGE

If your child had an Individualized Educational Plan (IEP) or 504 Plan (developed to ensure that a child who has a disability has access to the same education their classmates are getting) in high school, you probably played a role in their learning process. You had access to the people who were providing supports and services, and you were able to monitor how well those supports were being implemented. College is a different story — starting with the fact that there are no IEPs or special education in college. Still, almost all colleges have a disability services office for students with learning and attention issues.

1. Colleges don't have the same legal requirements as high schools. They are not obligated to provide the same level of supports and services that a student might have received in high school. For instance, they don't have to provide specialized instruction or tutoring. They do have to abide by federal civil rights laws and the Americans with Disabilities Act (ADA). Colleges provide accommodations to students who are eligible under the ADA. Some may also provide support services like tutoring or coaching for a fee.

2. Your child must register as a student with disabilities to get accommodations to attend. This happens with the disability services office, not the admissions office.

3. The requirements for documentation in college are changing.

4. There may not be "case managers" in college. Your child may have a dedicated contact person at the disability services office.

5. Different schools offer different levels of support. All colleges that receive federal funds must ensure equal access to students with disabilities. That means they have to provide reasonable accommodations. Having extra time for taking exams is an example of an accommodation. Other typical accommodations available in college may include:

6. You're no longer automatically in the loop. When your child was in high school, parents were legally entitled to be part of the process. It's the exact opposite when your child is in college. The law protects your child's privacy. If you want to talk to the disability services officer or anyone else involved with your child's accommodations, you'll need permission from both your child and the school.

7. Colleges are not required to provide evaluations for learning and attention issues. After high school, your child will have to go for a private evaluation if he/she wants updated test results, or if he/she suspects they may have an undiagnosed learning or attention issue. 10

ABOUT THE AUTHORS: H. Barry Waldman, DDS, MPH, PhD is a SUNY Distinguished Teaching Professor, Department of General Dentistry, Stony Brook University, NY. E-mail: h.waldman@stonybrook.edu Steven P. Perlman, DDS, MScD, DHL (Hon) is the Global Clinical Director and founder, Special Olympics, Special Smiles and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine.

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