General Considerations and Instructional Strategies

Below are guidelines and helpful hints for teaching students who have various kinds of disabilities. When in doubt either ask the student with the disability or contact the Office of Services for Students with Disabilities for more information at (816) 235-5696 or by e-mail at disability@umkc.edu.

Table of Contents

1. Assisting Students with Disabilities in an Emergency
2. Vision Impairments
3. Hearing Impairments
4. Mobility Impairments
5. Chronic Illnesses
6. Psychiatric Disabilities
7. Learning Disabilities
8. Attention Deficit/Hyperactivity Disorder
9. Traumatic Brain Injury (TBI)

From the Federal Emergency Management Agency Website:

People with disabilities who are self-sufficient under normal circumstances may have to rely on the help of others in a disaster.

PROVIDE ASSISTANCE

• People with disabilities often need more time than others to make necessary preparations in an emergency.
• The needs of older people often are similar to those of persons with disabilities.
• Because disaster warnings are often given by audible means such as sirens and radio announcements, people who are deaf or hard of hearing may not receive early disaster warnings and emergency instructions. Be their source of emergency information as it comes over the radio or television.
• Some people who are blind or visually-impaired, especially older people, may be extremely reluctant to leave familiar surroundings when the request for evacuation comes from a stranger.
• A guide dog could become confused or disoriented in a disaster. People who are blind or partially sighted may have to depend on others to lead them, as well as their dog, to safety during a disaster.
• In most states, guide dogs will be allowed to stay in emergency shelters with owners. Check with your local emergency management officials for more information.
• People with impaired mobility are often concerned about being dropped when being lifted or carried. Find out the proper way to transfer or move someone in a wheelchair and what exit routs from buildings are best.
• Some people with mental retardation may be unable to understand the emergency and could become disoriented or confused about the proper way to react.
• Many respiratory illnesses can be aggravated by stress. In an emergency, oxygen and respiratory equipment may not be readily available.
• People with epilepsy, Parkinson's disease and other conditions often have very individualized medication regime's that cannot be interrupted without serious consequences. Some may be unable to communicate this information in an emergency.
• Be ready to offer assistance if disaster strikes. Prepare an emergency plan.
• Work with students, staff and faculty who are disabled to prepare an emergency response plan.

Be able to assist if an evacuation order is issued. Provide physical assistance in leaving the building.

As many as two million Americans are considered legally blind. Around 25 percent of that number, about 50 million, are totally blind (i.e., have only light perception, or no vision at all). The remaining 75 percent have either visual acuity equal to 20/200 or less, or a visual field limited to 20 degrees or less. In practical terms, a student who is legally blind may be able to move about without the aide of a cane or guide dog but need assistance when reading. Many diseases and disabilities can significantly diminish the visual processing necessary to function in an academic setting. Some students who are not legally blind may also qualify for accommodations. Such conditions as documented eye strain, pain, severely fluctuating vision, or an inability to track print for a substantial length of time may require accommodation.

General Considerations:

• Most students with very low vision or who are totally blind use a cane or a dog guide. The use of such mobility aids may vary in accordance with individual preference and circumstance. For example, a student may have good "day vision" and only require the use of such travel aids when it is growing dark.
• Before assisting any student who is visually impaired ask them if they would like some help and then wait for a response before acting.
• Words and phrases that refer to sight, such as "I’ll see you later" are commonly used expressions and usually go unnoticed unless a speaker is particularly self-conscious. Students with vision loss can still "see" what is meant by such expressions.
• When talking with or greeting a student with a vision impairment, speak in a normal voice. Most people with vision impairments do not also have hearing impairments; if they do they will let you know. Do not speak to the student through a third party or companion, and use the student's name when directing the conversation to him or her.
• When joining a group or conversation identify yourself to the student.
• When giving directions, say "left" or "right", "step up" or "step down." Convert directions to the vision-impaired student's perspective. When guiding a student (into a room, for example) offer your arm and let him or her take it rather than pulling the person's sleeve.
• If a student uses a dog guide, it should never be petted or distracted while in harness. To distract a working dog guide undermines the training and/or the performance of the animal, thereby placing the student in danger.
• Common accommodations for students with vision impairments include alternative print formats, magnification devices, raised lettering, tactile cues, adaptive computer equipment, the use of scribes and readers for exams, print scanners, taped lectures, lab or library assistants, and time extensions for assignments and exams.

Instructional Strategies

• Include a disability access statement in the course syllabus such as: "To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact the Office of Services for Students with Disabilities (OSSD) as soon as possible. To contact OSSD call (816) 235-5696.
• It would be helpful to have copies of the syllabus and reading assignments ready no less than six weeks prior to the beginning of classes so documents are available for timely translation into alternative formats.
• Provide vision-impaired students with materials in alternative formats at the same time the materials are given to the rest of the class. The accommodation letter will specify what format is appropriate.
• Repeat aloud what is written on the board or presented on overheads and in handouts. Pace the presentation of material. If referring to a textbook or handout, allow time for students to find the information. Allow students to tape lectures.
• When appropriate, ask for a sighted volunteer to team up with a vision-impaired student for in-class assignments.
• Keep a front row seat open for a student with low vision. A corner seat would be especially convenient for a student with a guide dog.
• Assist the student with finding an effective peer notetaker from the class.
• Make field trip arrangements early and ensure that accommodations will be in place on the given day (e.g., transportation, site accessibility).
• Be flexible with deadlines if assignments are held up by the document conversion process.
• Students who are blind may have difficulty moving about campus and are often dependent upon others for transportation. Be flexible in applying promptness rules to students who are blind.
• When in doubt about how to assist the student, ask him or her as privately as possible without drawing attention to the student or the disability.
• Allow the student the anonymity afforded other students (i.e., avoid pointing out the student or the alternative arrangements to the rest of the class).

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-conducting paths of the outer and middle ear. The degree of loss can be decreased through the use of a hearing aid or by surgery. People with conductive loss might 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.

Given the close relationship between oral language and hearing, students with hearing loss might also have speech impairments. One's age at the time of the loss determines whether one is prelingually deaf (hearing loss before oral language acquisition) or adventitiously or postlingually deaf (hearing loss after oral language acquisition). Those born deaf or who become deaf as very young children might have more limited speech development. In addition, students with learning disabilities which affect auditory processing may exhibit behavior resembling a hearing impairment.

General Considerations:

• The inability to hear or process language quickly does not affect an individual's native intelligence or the physical ability to produce sounds.
• Some students who are deaf are skilled lip readers, but many are not. Many speech sounds have identical mouth movements which can make lip-reading particularly difficult. For example "p," "b," and "m" look exactly alike on the lips, and many sounds (vowels, for instance) are produced without using clearly differentiated lip movements.
• Only about one third of all English words can be lip-read. Many of those words that can be lip-read are identical to other words. Students who lip-read pick up contextual clues to fill out their understanding of what is being said.
• Make sure you have the visual attention of a student who is deaf before speaking directly to him/her. A light touch on the shoulder, a wave, or other visual signal may be helpful.
• Look directly at a person with a hearing loss during a conversation, even when an interpreter is present. Speak clearly, without shouting. If you have problems being understood, rephrase your thoughts. 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, gum chewing, pencil biting, and similar obstructions of the lips can also interfere with the effectiveness of communication.
• Common accommodations for students who are deaf or hard of hearing include sign language or oral interpreters, assistive listening devices, Telecommunications Devices for the Deaf (TDDs), volume control telephones, peer notetakers, captioned videos, and time extensions for assignments and exams.
• For many students who are deaf English is a second language. Their first language is often American Sign Language (ASL) which has its own syntax and grammar. This creates some difficulty in writing papers and essay examinations. Students who are having difficulty with English grammar and syntax will need to utilize the services of the Writing Lab. For in-class essay exams you should allow some flexibility when grading for grammar or syntax.

Modes of Communication

Not all students with hearing impairments are fluent users of all of the communication modes used across the deaf community, just as users of spoken language are not fluent in all oral languages. For example, not all students who are deaf can read lips. Many use sign language-but there are several types of sign language systems. American Sign Language (ASL) is a natural, visual language having its own syntax and grammatical structure. Signed Exact English (SEE) is a manual system which utilizes English syntax and grammar. Fingerspelling is the use of the manual alphabet to form words. Pidgin Sign English (PSE) combines aspects of ASL and English and is used in educational situations often combined with speech. Nearly every spoken language has its own unique accompanying sign language.

In addition to sign language and lip-reading, students who are deaf also use oral language interpreters. These are professionals who assist persons who are deaf or hard of hearing with understanding oral communication. Sign language interpreters use highly developed language and Fingerspelling skills; oral interpreters silently form words on their lips for speech reading. Interpreters also use voice, when requested. Interpreters will attempt to interpret all information in a given situation, including instructors' comments, class discussion, and pertinent environmental sounds.

Instructional Strategies

• Include a disability access statement in the course syllabus such as: "To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact the Office of Services for Students with Disabilities (OSSD) as soon as possible. To contact OSSD call (816) 235-5696.
• Circular seating arrangements offer students who are deaf or hard of hearing the best advantage for seeing all class participants.
• When using an FM wireless assistive listening device (ALD) for group discussion it would be helpful to pass the microphone around the class members who are speaking.
• When desks are arranged in rows, keep front seats open for students who are deaf or hard of hearing and their interpreters.
• Repeat the comments and questions of other students, especially those from the back rows. Acknowledge who has made the comment so students who are deaf or hard of hearing can focus on the speaker.
• When appropriate, ask for a hearing volunteer to team up with a student who is deaf or hard of hearing for in-class assignments. Assist the student in finding effective peer notetakers from the class.
• If possible, provide transcripts of audio information.
• Most videos produced in recent years are closed-captioned for the hearing impaired. Be sure to arrange for a video monitor that is capable of displaying the closed-captioning. Familiarize yourself with the controls for turning on the captions. Older videos may lack captioning. These videos may need to be captioned or a script needs to be prepared in advance to allow the hearing impaired student access to the material.
• Allow several moments extra for oral responses in class discussions.
• In small group discussions, allow for participation by students with hearing impairments.
• Face the class while speaking; if an interpreter is present, make sure the student can see both you and the interpreter.
• If there is a break in the class, get the attention of the student who is deaf or hard of hearing before resuming class.
• People who are deaf or hard of hearing often use vision as a primary means of receiving information. Captioned videos, overheads, diagrams, and other visual aids are useful instructional tools for students with hearing impairments.
• Be flexible: allow a student who is deaf to work with audiovisual material independently and for a longer period of time.
• When in doubt about how to assist the student who is deaf or hard of hearing, ask him or her as privately as possible without drawing attention to the student or the disability.
• Allow the student who is deaf or hard of hearing the same anonymity as other students (i.e., avoid pointing out the student or the alternative arrangements to the rest of the class).

Mobility impairments range in severity from limitations of stamina to paralysis. Some mobility impairments are caused by conditions present at birth while others are the result of illness or physical injury. Injuries to the spinal cord cause different types of mobility impairments, depending on the areas of the spine affected. Quadriplegia refers to the loss of function to arms, legs, and trunk. Students with quadriplegia have limited or no use of their arms and hands and often use motorized wheelchairs. Paraplegia refers to the loss of function to the lower extremities and the lower trunk. Students with paraplegia typically use a manual wheelchair and have full movement of arms and hands.

General Considerations:

• Many students with mobility impairments lead lives similar to those without impairments. Dependency and helplessness are not characteristics of physical disability.
• A physical disability is often separate from matters of cognition and general health; it does not imply that a student has other health problems or difficulty with intellectual functioning.
• People adjust to disabilities in a myriad of ways. Character traits (e.g. courageous or manipulative) should not be assumed on the basis of disability.
• When talking with a wheelchair user, attempt to converse at eye level as opposed to standing and looking down. If a student has a communication impairment as well as a mobility impairment, take time to understand the person. Repeat what you understand, and when you don't understand, say so.
• A student with a physical disability may or may not want assistance in a particular situation. Ask before giving assistance, and wait for a response. Listen to any instruction the student may give. By virtue of experience, the student likely knows the safest and most efficient way to accomplish the task at hand.
• Be considerate of the extra time it might take a student with a disability to speak or act.
• Allow the student to set the pace of walking or talking. A wheelchair should be viewed as a personal-assistance device rather than something to which one is "confined." It is also a part of a student's personal space; do not lean on or touch the chair.
• Mobility impairments vary over a wide range, from temporary (e.g., a broken arm) to permanent (e.g., a form of paralysis or muscle degeneration). Other impairments, such as respiratory conditions, may affect coordination and endurance. These can also affect a student's ability to participate/perform in class.
• Physical access to a class is the first barrier a student with a mobility impairment may face, but it is not the only accessibility concern. An unshoveled sidewalk, lack of reliable transportation, or mechanical problems with a wheelchair can easily cause a student to be late or absent.
• Common accommodations for students with mobility impairments include peer notetakers, accessible classroom/location/furniture, alternative ways of completing assignments, lab or library assistants, assistive computer technology, and time extensions for assignments and exams.

Instructional Strategies

• Include a disability access statement in the course syllabus such as: "To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact the Office of Services for Students with Disabilities (OSSD) as soon as possible. To contact OSSD call (816) 235-5696.
• If possible, try not to seat wheelchair users in the back row. Move a desk or rearrange seating at a table so the student is part of the regular classroom seating.
• Height of tables should permit wheelchair access. Tables can be easily raised using blocks of wood under the legs.
• Make field trip arrangements early and ensure that accommodations will be in place on the given day (e.g., transportation, site accessibility).
• Make sure accommodations are in place for in-class written work (e.g., allowing the student to use a scribe, to use assistive computer technology, or to complete the assignment outside of class).
• Be flexible with deadlines. Assignments that require library work or access to sites off-campus will consume more time for a student with a mobility impairment. Students with chronic and medicated pain may need extended time or additional explanations of material covered in class or pending assignments.
• Students using wheelchairs or other utility devices may encounter obstacles to getting to class on time. Others may have periodic or irregular difficulties, either from their disability or from medication. Faculty can help by being flexible in applying attendance and promptness rules to such students.
• When in doubt about how to assist the student, ask him or her as privately as possible without drawing attention to the student or the disability.
• Allow the student the anonymity afforded other students (i.e., avoid pointing out the student or the alternative arrangements to the rest of the class).

Chronic illnesses 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 chronic illnesses, varying significantly in their effects and symptoms. Types of chronic illnesses may include cancer, chemical dependency, diabetes mellitus, epilepsy/seizure disorder, HIV, lupus erythematosis, multiple sclerosis and renal disease.

General Considerations:

• Students affected by disabling chronic illnesses differ from those with other disabilities because these types of disabilities are often unstable. This causes a person’s condition to vary; therefore, the need for and type of reasonable accommodation may change.
• Some common accommodations for students with disabling chronic illnesses may include peer notetakers, reduced course load, relocation of a meeting or class, and time extensions for assignments and exams.

Instructional Strategies

Disabling chronic illnesses often require instructional strategies similar to those listed for other disabling conditions. The use of such strategies will depend on how the disability is manifested. Faculty members who would like more information about instructional strategies for students with chronic illnesses should contact OSSD.

Students with psychiatric disabilities experience significant emotional difficulty that may or may not have required treatment in a hospital. With appropriate treatment, often combining medications, psychotherapy, and support, the majority of psychiatric disorders are cured or controlled. The National Institute of Mental Health estimates that one in five people in the United States has some form of psychiatric disorder. However, only one in five persons with a diagnosable psychiatric disorder ever seeks treatment due to the strong stigmatization involved. It is important to note that not all psychiatric disorders identified in the DSM-IV are "disabilities" as defined by the ADA and Section 504. Some common psychiatric disabilities are depression, bipolar disorder (manic depression), anxiety disorders, and schizophrenia.

Some Considerations:

• Trauma is not the sole cause of psychiatric disabilities; genetics may play a role.
• Psychiatric disabilities affect people of any age, gender, income group, and intellectual level.
• Most people with psychiatric disabilities do not exhibit disruptive behavior.
• Eighty to ninety percent of people with depression experience relief from symptoms through medication, therapy, or a combination of the two. Depression is a variable condition that may fluctuate during a person's lifetime.
• Common accommodations for students with psychiatric disabilities are alternate methods to complete assignments, time extensions for assignments and exams, taped lectures, provision of advance copies of syllabi, and consultations for study skills and strategies.

Instructional Strategies

• Include a disability access statement in the course syllabus such as: "To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact the Office of Services for Students with Disabilities (OSSD) as soon as possible. To contact OSSD call (816) 235-5696.
• Spend extra time with the student, when necessary, and assist the student in planning assignment sub-phases and in time management by scheduling follow up at specified intervals.
• Be flexible with deadlines. A written agreement specifying the accommodative extension is helpful in most cases.
• Allow the student to tape record lectures.
• Assist the student in finding effective peer notetakers from the class.
• Clearly define course requirements, the dates of exams, and when assignments are due. Provide advance notice of changes.
• When in doubt about how to assist the student, ask him or her as privately as possible without drawing attention to the student or the disability.

Learning disabilities are neurologically-based conditions that interfere with the acquisition, storage, organization, and use of skills and knowledge. They are identified by deficits in academic functioning and in processing memory, auditory, visual, and linguistic information. The diagnosis of a learning disability in an adult requires documentation of at least average intellectual functioning along with a deficit in one or more of the following areas:

• auditory channel processing
• visual channel processing
• information processing speed
• abstract and general reasoning
• memory (long-term, short-term, visual, auditory)
• spoken and written language skills
• reading, decoding and comprehension skills
• mathematical calculation skills and word problems
• visual spatial skills
• fine and gross motor skills
• executive functioning (planning and time management)

Four Criteria for a Diagnosis of a Specific Learning Disability

1. Prior and Exclusionary Condition. A specific learning disability is a presumed central nervous system dysfunction which does not result from a sensory disability such as visual, auditory, or tactile loss or impairment. Learning disabilities may exist as secondary disabilities to an unrelated primary disability such as a spinal cord injury, closed head injury, brain damage from substance abuse, cerebral palsy, multiple sclerosis, etc. The presence of the learning disability must be established prior to the onset of learning problems resulting from depression or alcohol/drug abuse, or the consequences of economic disadvantage.

2. Cognitive Potential. The range of intellectual function is an IQ of 85 and above on either the Verbal, Performance or Full Scale IQ score.

3. Potential vs. Performance Discrepancies. Two types of discrepancies are used in these evaluations: aptitude-achievement and intra-achievement. An aptitude-achievement discrepancy reflects disparity between certain intellectual capabilities of an individual and his or her actual academic performance. An intra-achievement discrepancy is present within individuals who have specific achievement deficits, such as inadequate reading comprehension or spelling skills.

4. Chronicity. The problems should have existed throughout the developmental stages of learning.

Some Considerations:

• A learning disability is not a disorder that a student outgrows. It is a permanent disorder affecting how students with normal or above-average intelligence process incoming information, outgoing information, and/or categorization of information in memory.
• Learning disabilities are often inconsistently manifested in a limited number of specific academic areas, such as math or foreign languages. There might have been problems in grade school, none in high school, and problems again in college. Instructional design and presentation, workload, test or evaluation format often determine the manifestations.
• Learning disabilities should not be equated with retardation or emotional disorders, although learning disabilities can coexist with other conditions.
• Common accommodations for students with learning disabilities include alternative print formats, taped lectures, peer notetakers, alternative plans to complete assignments, time extensions for assignments and exams, and consultations regarding study skills and strategies.

Instructional Strategies

• Include a disability access statement in the course syllabus such as: "To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact the Office of Services for Students with Disabilities (OSSD) as soon as possible. To contact OSSD call (816) 235-5696.
• Keep instructions as brief and uncomplicated as possible. Repeat exactly without paraphrasing.
• Assist the student in finding effective peer notetakers from the class.
• Allow the student to tape record lectures. Clearly define course requirements, the dates of exams, and when assignments are due. Provide advance notice of any changes.
• Present lecture information in a visual format (e.g. chalkboard, overheads, PowerPoint slides, handouts, etc.).
• Use more than one way to demonstrate or explain information.
• Have copies of the syllabus ready no less than six weeks prior to the beginning of the semester so textbooks can be transcribed to tape in a timely manner.
• When teaching, state objectives, review previous lessons and 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 (e.g., substituting oral for written work).
• Provide assistance with proofreading written work.
• Stress organization and ideas rather than mechanics when grading in-class writing assignments.
• Allow the use of spell-check and grammar assistive devices when appropriate to the course.
• When in doubt about how to assist the student, ask him or her as privately as possible without drawing attention to the student or the disability.

Current opinion is that these conditions are caused by insufficient activity of the neurotransmitter which maintains synaptic connections and which focuses and sustains attention. For example, norepinephrine is associated with focused attention and maintenance of mental arousal, and a deficiency causes attention to wander involuntarily. Similarly, acetylcholine is associated with voluntary and involuntary motor activity, and a deficiency of that chemical causes involuntary muscular movement.

When these chemicals are insufficient, voluntary effort to pay attention and to suppress activity is not possible. Increased effort to organize is unproductive. Stimulants may be used medically to increase the synaptic connections. For nonprescriptive assistance, informally, individuals may turn to caffeine and other stimulants.

The academic manifestations of ADHD include distractibility in class and while doing homework, impulsive and unplanned reactions to environmental stimuli, inability to maintain regular schedules of any type, and the habit of procrastination until urgency helps to focus attention. When a singular work assignment is being procrastinated, the technique often has moderate success. When work assignments are long and complex, last minute efforts cannot be compressed into the available remaining time. Because of the inability to correctly perceive the passage of time, the following behaviors are frequently manifested: poor nutrition, insufficient rest and sleep, as well as the development of communicable infections. The student may experience a reasonable uncertainty about due dates being met, causing anxiety about performance quality to occur. The individual often becomes discouraged and expresses emotional detachment. ADHD may serve to undermine mental health, especially after individuals with these disabilities have made exhaustive efforts over a period of time to produce quality work without success.

Instructional Strategies:

• Include a disability access statement in the course syllabus such as: "To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact the Office of Services for Students with Disabilities (OSSD) as soon as possible. To contact OSSD call (816) 235-5696.
• Keep instructions as brief and uncomplicated as possible. Repeat exactly without paraphrasing.
• Assist the student in finding effective peer notetakers from the class.
• Allow the student to tape record lectures.
• Clearly define course requirements, the dates of exams, and when assignments are due. Provide advance notice of any changes.
• Present lecture information in a visual format (e.g. chalkboard, overheads, PowerPoint slides, handouts, etc.).
• Use more than one way to demonstrate or explain information.
• Have copies of the syllabus ready no less than six weeks prior to the beginning of the semester so textbooks can be transcribed to tape in a timely manner.
• When teaching, state objectives, review previous lessons and 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 (e.g., substituting oral for written work).
• Refer the student to the Writing Lab for help in proofreading written work. Stress organization and ideas rather than mechanics when grading in-class writing assignments.
• Allow the use of spell-check and grammar-assistive devices when appropriate to the course.
• When in doubt about how to assist the student, ask him or her as privately as possible without drawing attention to the student or the disability.

Though not always visible and sometimes seemingly minor, TBI is complex. It can cause physical, cognitive, social, and vocational changes that affect an individual permanently. Depending on the extent and location of the injury, symptoms caused by a brain injury vary widely. Some common results are seizures, loss of balance and coordination, difficulty with speech, limited concentration, memory loss, fatigue and loss of organizational and reasoning skills. Typical manifestations are a limited ability to assess situational details, make plans and follow through. Class attendance may be irregular.

General Considerations:

• A neuropsychological test battery is generally an accurate assessment of cognitive recovery after TBI. Conversely, a traditional intelligence test is not an accurate assessment of cognitive recovery following TBI. Students with brain injuries might perform well on brief, structured, one and two step tasks but have significant deficits in learning, memory, and executive functions. Often long term memory of information learned before the trauma remains intact.
• Recovery from TBI can be inconsistent, and a "plateau" is not evidence that functional improvement has ended.
• TBI can substantially alter self-perception. The person may recall abilities and personal management skills prior to the injury but be experientially unaware that these abilities and skills are no longer the same.
• When current performance fails to meet pre-disability performance expectations, depression often ensues.
• Common accommodations for students with TBI may include time extensions on assignments and exams, taped lectures, instructions presented in more than one way, alternative plans to complete assignments, peer notetakers, course substitutions, priority registration, consultations regarding study skills and strategies, and alternative print formats.

Instructional Strategies:

• Include a disability access statement in the course syllabus such as: "To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact the Office of Services for Students with Disabilities (OSSD) as soon as possible. To contact OSSD call (816) 235-5696.
• Keep instructions as brief and uncomplicated as possible. Repeat exactly without paraphrasing.
• Assist the student in finding effective peer notetakers from the class.
• Allow the student to tape record lectures.
• Clearly define course requirements, the dates of exams, and when assignments are due. Provide advance notice of any changes.
• Present lecture information in a visual format (e.g. chalkboard, overheads, PowerPoint slides, handouts, etc.).
• Use more than one way to demonstrate or explain information.
• Have copies of the syllabus ready no less than six weeks prior to the beginning of the semester so textbooks can be transcribed to tape in a timely manner.
• When teaching, state objectives, review previous lessons and summarize periodically.
• Allow time for clarification of directions and essential information.
• Provide study guides or review sheets for exams.
• Provide alternative ways for students to perform tasks (e.g., substituting oral for written work).
• Provide assistance with proofreading written work. Stress organization and ideas rather than mechanics when grading in-class writing assignments.
• Allow the use of spell-check and grammar-assistive devices when appropriate to the course.
• When in doubt about how to assist the student, ask him or her as privately as possible without drawing attention to the student or the disability.

These guidelines were adapted from guidelines used by the Division of Rehabilitation Education Services at the University of Illinois at Urbana-Champaign. Many thanks to Brad Hedrick for permission to use the guidelines.