Students with Disabilities in Veterinary Education
Joseph Taboada and Stephanie Johnson
School of Veterinary Medicine, Louisiana State University, USA
Working with students with disabilities is an important part of the management of a veterinary curriculum. Disabilities are common among professional students. A survey by Sack et al. (2008) found that 2.3% of medical students request accommodation for disabilities. This probably underestimates the true number of professional students with disabilities, as less than half of students with disabilities state that they report their disabilities when asked anonymously (Lund, Andrews, and Holt, 2014; Majumder et al., 2010). It is generally agreed that 6–8% of first-year college students self-identify as having a disability. Over 90% of these will identify as having a learning disability or a cognitive disorder such as attention deficit disorder (ADD; Henderson, 2001). This percentage probably also underestimates the number of students with disabilities, as many students are not identified until they get into college. High-achieving students are often not identified until they get into professional school, since they have been able to self-accommodate and be successful in undergraduate curricula. High-achieving students with learning disabilities, anxiety disorders, and ADD and attention deficit/hyperactivity disorders (ADHD) often report academically hitting a wall in the first year or two of professional school. All this makes it important for a veterinary school to have resources available to help students recognize the need for assessment for disabilities.
There are legal, ethical, and educational factors that must be taken into consideration when dealing with students with disabilities within the curriculum. The Americans with Disabilities Act (1990) stipulates that postsecondary institutions are responsible for providing necessary accommodations when a student discloses a disability. While the onus is on the student to self-identify the disability, the onus is on the school to develop a plan of reasonable accommodation for the student. Ethically, by not making accommodations available or creating a culture in which students are afraid to self-identify, the school has reduced the likelihood of success of a subset of its students, thus having potential impacts on the entire program. Educationally, there are curricular considerations in developing accommodations for students with disabilities, but there are also educational considerations for students in the program who have not identified as having a disability. Having disabled students in the curriculum is like many other areas of diversity, where having the diversity within the population of students has a net positive effect on how all of the students will address that subset of society (McKee et al., 2013). Developing an understanding and skill set in dealing with diversity is an important aspect of a professional education where the practitioners will be working with the public as patients and clients. Learning how an individual with a disability can accomplish a task in a way that might be different than how the nondisabled student was able to accomplish the same task opens one to recognizing that there are often ways of doing things that are different, but just as effective, rather than fostering an attitude of assuming that something cannot be done. This helps students and faculty recognize bias that they probably do not realize they have, but that can have a significant impact on a part of their eventual clientele.
When the United States Congress passed the Rehabilitation Act of 1973, it included Section 504, which forbade discrimination against persons with disabilities by programs and activities receiving federal financial assistance. This had an impact on virtually every institution of higher education, except the US military academies and a few small religious schools. It is important to note that this was a civil rights statute and created a protected class relative to prohibiting discrimination. This was the first civil rights statute designed to prevent discrimination against persons with disabilities and was patterned after the Civil Rights Act of 1964.
Section 504 of the Rehabilitation Act states that “no qualified handicapped person shall, on the basis of handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity which receives Federal financial assistance.” This legislation made it illegal for most postsecondary institutions to discriminate against an individual with a disability in admissions or while they are participating in the educational program.
On July 26, 1990, President George H.W. Bush signed into law the Americans with Disabilities Act (ADA) of 1990. This law gives civil rights protection to individuals with disabilities, similar to that provided to individuals on the basis of race, sex, national origin, and religion. The ADA guarantees equal opportunity for individuals with disabilities in the areas of employment, state and local government services, public transportation, privately operated transportation available to the public, places of public accommodation, services operated by private entities, and telephone services offered to the general public. Many commentators regard the ADA as the most sweeping piece of civil rights legislation since the Civil Rights Act of 1964. The ADA also protects qualified persons with disabilities from discrimination in many areas of postsecondary education, including admissions, academic activities, and research. Further, the ADA applies to all postsecondary educational programs, even if such programs do not receive federal financial assistance. The regulations provide a list of conditions that should easily be concluded to be disabilities: deafness, blindness, an intellectual disability (formerly termed mental retardation), partially or completely missing limbs or mobility impairments requiring the use of a wheelchair, autism, cancer, cerebral palsy, diabetes, epilepsy, human immunodeficiency virus (HIV) infection, multiple sclerosis, muscular dystrophy, major depressive disorder, bipolar disorder, post-traumatic stress disorder, obsessive compulsive disorder, and schizophrenia. In education, learning disabilities make up the majority of disabilities that must be accommodated.
Under the ADA, postsecondary institutions must make “reasonable accommodations” so as to provide students with disabilities equal opportunity to participate in educational activities. Reasonable accommodations are considered modifications or adjustments to the environment, the means by which educational outcomes are achieved, or the way in which things are usually done that enable students with disabilities to have an equal opportunity to participate in an academic program, unless to do so would “fundamentally alter” the nature of the program or result in an “undue burden.” It is important to note that courts have upheld that providing accommodations does not compromise the essential elements of a course or curriculum; nor does it weaken the academic standards or integrity of a course. Accommodations simply provide an alternative way to accomplish the course requirements by eliminating or reducing disability-related barriers. They provide a level playing field, not an unfair advantage. It is also important to note that the cost of the accommodations has not been judged to be an “undue burden” for universities (APA, 2016).
In 2008, the ADA Amendments Act of 2008 (ADAAA) was passed, and directed that regulations be interpreted using the language that a covered disability is one in which a physical or mental impairment “substantially limits” one or more major life activities, a history of having such an impairment, or being regarded as having such an impairment. The amendment broadened the definition of disability and added to the ADA examples of “major life activities,” including, but not limited to, “caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.”
Universities and postsecondary institutions that accept federal aid are required to have someone identified as a point person who is responsible for making sure that students with disabilities are not being discriminated against. In most cases, universities have set up offices of disabilities services to deal with these issues and to make sure that the university is not in violation of federal law. These offices will have the expertise to determine which students have a disability that requires accommodation, and will have the expertise to determine what is considered a reasonable accommodation. The typical disabilities with which disabilities offices routinely work include attention deficit/hyperactivity disorders (ADHD), learning disabilities (LD), psychological disabilities (e.g., depression, anxiety, bipolar disorder, eating disorders, etc.), autism spectrum disorders (ASD), medical and chronic disabilities, mobility disabilities, being blind and visually impaired, being deaf and hard of hearing, traumatic brain injuries (TBI), intellectual disabilities, and temporary disabilities. Physical disabilities are less common than disabilities that may go unseen (Wu, Tsang, and Wainapel, 1996).
Most veterinary schools will not have the expertise to manage students with this broad spectrum of disabilities effectively, and should work very closely with the disabilities services office to facilitate student access to appropriate accommodations. It is important for the dean’s office to identify an individual or office within the veterinary school program to work closely with the disabilities services office, and to serve as a resource within the veterinary program for veterinary students needing facilitation in working with the disabilities services office. This individual can also be helpful in educating the disabilities services office about the veterinary curriculum, which is often quite different from other more typical programs within higher education. This function usually falls within the associate dean for academic or student affairs’ offices. Best practice is for veterinary schools to have a social worker or psychologist on staff with experience and training in recognizing and working with students with disabilities, especially learning and psychological disabilities. This resource can be critical to the success of veterinary students with disabilities in university settings, where disabilities services offices often have office hours limited to times that may not be as accessible to veterinary students, who have longer class and clinical schedules compared to the typical university student.
Students are not required to report disabilities, but they are only eligible for accommodations if they do report them to the university-designated official. Once the disabilities services office determines an appropriate accommodation, the student is required to share that decision with the instructor of the course in which they are requesting the accommodation. They are not required to report the fact that they have a disability to any other official of the veterinary school, such as the student affairs office, which can complicate facilitation of the process of accommodation. We encourage students to self-identify disabilities to our office of student affairs early and to register with the office of disabilities services so that we can facilitate the process, and they have the option of using an accommodation at the point they feel they need it, without waiting for what can be a protracted process of verifying the disability and determining what an appropriate accommodation should be.
The School/College of Veterinary Medicine
The most appropriate point of contact for advocacy related to students with disabilities within the veterinary educational environment is the dean of students’ office. While ultimately the disabilities services office has the final authority on disability-related issues, the associate dean for student and/or academic affairs and/or their designee should be responsible for working with students and faculty and the campus resources to facilitate the process relative to determining what would be appropriate and reasonable accommodations for a student in the veterinary curriculum with a documented disability. The veterinary professional program should identify the essential functions, abilities, skills, and knowledge of the curriculum and evaluate students on this basis. Students with disabilities should meet the same standards and expectations as their peers. The only difference would be the use of an accommodation in meeting those standards.
Students should be made aware, prior to beginning the professional program, of the process of registering with the office of disabilities services. This can be done when welcome or information packets are sent out following admission and enrollment, but should at least be done within four to six weeks of the start of school, to allow ample time for the student to gather the supporting documentation they will need to supply to the disabilities services office. The resources available to students on campus should be defined along with the necessary steps that the student must take in order to complete registration of the disability. If the student has not been previously diagnosed with a disability, the dean of students’ office should be able to provide a list of resources to the student for counseling/testing purposes. Once registered, the student must be aware of the notice of accommodation process within the university where the school of veterinary medicine is located. In most school environments, the student only has to identify their request for accommodations to the coordinator/instructor of record of the course for which they are requesting accommodations. If the student needs any assistance with the request for, and/or the specific accommodations, the associate dean would facilitate this.
The dean of students’ office is also responsible for making sure that the School of Veterinary Medicine faculty are aware of the ADA and the school’s policies and processes relative to disability accommodations. Most importantly, the faculty should be aware of their role in maintaining confidentiality when they assist a student with their request for accommodation. The student cannot be identified to their fellow students or faculty not involved in the course.
The Veterinary Student
First and foremost, students with or without a registered disability are expected to meet academic standards established by the School of Veterinary Medicine and required of all students enrolled in the program. It is the student’s responsibility to obtain and complete the required paperwork in order to register with the disabilities services office. If the student needs to be evaluated for a suspected disability, it is the student’s responsibility to make the appointment with the evaluator, as well as arrange for payment for the evaluation. It is also the responsibility of the student to submit the appropriate forms for completion to their treating physician relative to the disability that is being registered. Once the completed paperwork is submitted to the disabilities services office, it is the student’s job to follow up with the office to make sure that their file is complete.