Connecting the Introductory Course to the Lives of Peers with Disabilities

Hunter W. Greer and Ashton D. Trice
James Madison University

 
            The chapter on abnormal psychology in introductory textbooks is most often a quick tour through DSM-V by way of diagnostic criteria, lifetime instances, and general symptomology. Myers (2014), for example, lists diagnostic criteria for both major depressive disorder and persistent depressive disorder; mentions a number famous people who have had depression, and contrasts the biological and social-cognitive perspective. There is a short paragraph about the stressors of college and mood disorders in general. Schizophrenia and personality disorders are given similar coverage. ADHD and autism spectrum disorders are discussed only in boxes (autism in the developmental chapter); traumatic brain injury is not covered in the text.  

            Normally, there is scant attention, if any, to the ways in which various conditions affect everyday life, particularly how mental health issues and/or disability may affect college students. This is unfortunate for three reasons. First, by not exploring how mental health issues affect coping with the environment students best understand, because they are coping with it themselves, we may be missing an opportunity to provide meaningful learning. Second, for non-majors, the introductory course may be their only examination of the etiology, expression, and treatment of psychological disorders. Students may be less able to recognize or support those with mental health issues as friends, parents, and voters if their learning is confined to psychiatric diagnostic criteria. Finally, by not discussing how mental health issues and disability impact college performance, we fail to help students behave more tolerantly and helpfully toward affected peers.

            All of this matters at least in part because students with disabilities or mental health issues have low success rates in college. They often feel marginalized on campus and are likely to earn low grades and be twice as likely as their nondisabled peers to drop out (Sparks & Lovell, 2009). The most consistent finding in the research on why this is so, is that few disclose their disability to friends and teachers or seek classroom accommodations (Kurth & Mellard, 2006; Quinlan, Bates, & Angell, 2012) or they wait to seek assistance only after several distressing semesters (Lightner, Kipps-Vaughan, Schulte, & Trice, 2012). Among the prominent reasons that students give for not seeking assistance are that they worry that their professors will think them intellectually inferior and their peers will view accommodations as “cheating” (Hartman- Hall & Haaga, 2002; May & Stone, 2010).

            Research has found that faculty do hold somewhat negative views and have limited knowledge of how to help (Lombardi, Murray, & Gerdes, 2011), but it has also been found that modest interventions can make substantial impacts on both the willingness of faculty to assist students with disabilities and the quality of that assistance (e.g., Milligan, 2010; Murray, Lombardi, & Wren, 2011). Surprisingly, we know very little about peer attitudes. There are no published studies on the views of accommodation by American college students.

            We have conducted three studies at our university to 1) describe how nondisabled peers view students with disabilities and the appropriateness of accommodations for them; 2) elucidate the underlying (mis)understandings students have about mental health issues and disability, and 3) suggest a way of supplementing introductory course material that will help explain the challenges of mental health issues in the context of college. By changing the understanding of disability and mental health challenges, we hope to change the attitudes toward students with mental health issues and thereby enhance the climate for them.

A Survey of Attitudes

            In our first study we surveyed the opinions of 245 students about individuals with the “psychological” disabilities of depression, learning disabilities, ADHD, TBI, and autism spectrum disorders. The questionnaire focused on obtaining ratings of the acceptability of granting individuals with each of these disabilities 10 specific accommodations.  These ratings were on a 7-point scale, so scores of 4.00 or better were generally positive, while those below 4.00 were negative. The administration of the survey was done on-line using Qualtrics, and students enrolled in 100-level psychology courses participated for course credit.      

            We found little support for accommodations to persons with ADHD or depression. The mean ratings for the 10 accommodations were 3.44 (SD = 0.86) for depression and 3.62 (SD = 0.91) for ADHD. Traumatic brain injury (M = 4.87, SD = 1.10) and autism spectrum disorder (M = 4.91, SD = 1.03), however, received positive endorsements. The ratings for granting accommodations for learning disabilities were close to neutral (M = 4.32, SD = 1.02).  

            Across the five disabilities, there was little support for preferential registration (M = 3.37, SD = 1.27), waiving penalties for late papers (M = 3.25, SD = 1.07), or waiving graduation requirements (M = 2.74, SD = 1.31). Ratings for substitute activities for papers (M= 3.88, SD = 1.22), unlimited time on tests (M = 3.92, SD = 1.06), and waivers from dormitory residence requirements (M = 4.12, SD = 0.93) were rated neutrally, while note-takers (M = 4.62, SD = 1.00), oral tests (M = 4.63, SD = 1.26), quiet testing (M = 5.90, SD = 1.07), and 25% extra time on tests (M = 5.29, SD = 1.28) received positive views.

Understanding the Results: Focus Groups

            In the second study, we conducted four focus groups, also drawn from the same introductory classes, to ask about the findings of the first study. All of the focus groups were conducted during the exam period, so all students had completed the course. We structured the focus groups around the following questions:

1. Why were the ratings of giving accommodations low for students with depression, ADHD, and LD?
2. Why were the ratings relatively high for TBI and Autism Spectrum Disorder?
3. Why were the accommodations of waiving graduation requirements and penalties for late papers, and early registration rated so low?
4. Why were quiet testing, oral tests, and note-takers rated so positively?
5. Why were the accommodations of substitute activities for papers, unlimited time on tests, and waivers of the dormitory policy rated neutrally by other students?

The reservations about granting accommodations to peers experiencing major depression were attributed to the idea that depression is “easy to fake” and that “everybody gets depressed.” The first of these beliefs is part of the widely researched phenomenon in both the educational and organizational literatures that people are more likely to assist when someone has a noticeable disability, such as an orthopedic or sensory disability, than one that cannot immediately be seen (Neely & Hunter, 2014). Both of these issues indicate how little students know about how disabilities or mental health issues are diagnosed, even after completing an introductory psychology course. Likewise, the belief that “everyone gets a little ADHD from time to time” and that ADHD was not only easy to fake, but was frequently faked, was expressed in all focus groups. Other students indicated that they believed that stimulant medication cured ADHD and therefore no further accommodations were necessary: “It’s just like having glasses for a vision problem: once you have them, you don’t need anything else.” The participants in the focus groups had little to illuminate why accommodations for learning disabilities received only neutral endorsements.

            When asked about the relatively high endorsement of accommodations for students with autism spectrum disorder and traumatic brain injury, two themes emerged. The first was references to media representations of the disorder (“It would be like asking Sheldon to survive having a roommate without the roommate agreement” or “Everyone’s seen things about concussions in the NFL”); the second was the expectation that these disorders would be visible (“If you’re around someone on the spectrum, you get it really quickly.” There appeared to be confusion in several students between traumatic brain injury and post-traumatic stress disorder.

            As for accommodations themselves, there was nearly unanimous belief that all testing should be in quiet rooms for all students, with or without disabilities, and two of the focus groups turned into lengthy discussions of why faculty members tolerated distracting activities during tests. There was also nearly universal acceptance of oral tests, 25% extra time, and note takers. “If I miss a class, I get someone’s notes. That’s not a problem. If I have a broken arm, I take my tests orally. It doesn’t alter the playing field. If right before I turn an exam in, I change my mind about what I want to say in an essay, most professors would give you a little extra time. Some people need these things nearly all the time. Some of us only once in a great while.”

            Many of the less favored accommodations were seen through the lens of the social contract: different universities, programs, and majors had different graduation requirements. “Students know what they are getting into, therefore it isn’t fair for them to try to get out of (graduation) requirements.” The same went for course requirements, such as penalties for late papers, unlimited time on tests, and substituting activities for papers. “A paper is a paper,” one student said. “Sometimes that doesn’t matter, but if it’s an English course it sure does. As they say, you can’t dance about architecture.” Dormitory modifications were seen as impairments to developing “school spirit” and “not making them (students with disabilities) live in a dorm would be to deprive them of an important aspect of U life. Wouldn’t that be discrimination?”  Preferential registration received the least support in the focus groups. Here the most common theme was students’ worry that they would not be able to complete degree requirements because a person with a disability had gotten a seat in the class they needed, a highly unlikely event, given that most seniors need advanced courses in their majors to complete degrees.

Intervention

            We were surprised at the negative tenor of the survey results. Indeed, with such negative attitudes, students’ worries about peers’ reactions to getting accommodations are well founded. And while the focus groups disclosed that many of the negative attitudes were due to misunderstanding of the process (“You shouldn’t get an advantage in a class just because you broke up with your boyfriend”) or of the nature of disabilities (“Why don’t they just take their meds?”), these attitudes are there unless the misunderstandings are addressed.

            But whose job is it to address them? Certainly, some of the responsibility falls to K-12 school systems. They have been giving accommodations to peers for 13 years prior to coming to college, largely without explaining any aspect of the process to classmates. Perhaps some of the responsibility at the university-level belongs to Orientation or the Office of Disability Services. While we would not suggest that psychology departments should take this on alone, a small amount of attention may produce substantial benefits. Psychologists have expertise in many facets of the accommodation process: We grasp the nature of disabilities; we understand effective instruction; we know about developing competence and expertise. We also understand the effects that marginalization and stigmatization and how disabilities and mental health issues affect learners well beyond the classroom: how they manage time, stress, and conflict. Even if we are not responsible for explaining the process, adding our perspective should help student developed deep and nuanced responses to the needs of their peers,

            In the third study we looked at whether a brief (1200 word), on-line, reading about the impact depression can have on college students can change attitudes. In this study we asked participants for both ratings of “how fair do you think it would be” to grant each of the same 10 accommodations as in the previous study, and we also asked for ratings of whether the student thought the intervention would be “helpful.”

            The reading addressed many of the issues that had arisen in the focus groups. For example, we emphasized that in order to receive accommodations for depression, there has to be a formal diagnosis by a psychiatrist, which includes a statement of the probable educational impact on the specific student in specific contexts, and that the condition has to exist over an extended period of time. We developed examples that included the classroom impact; out-of-class academic impact; as well as the effects on social interactions and relationships. We included visual illustrations and reinforced the material from the textbook (diagnostic criteria and incidence).  

            Those who read the materials about depression rated the accommodations for depression as significantly fairer (M = 4.58, SD = 0.88) than those who read an unrelated reading (M = 3.54, SD = 1.00). And while the composite of the 10 accommodations rated for helpfulness did not achieve significance, the ratings of waivers of penalties for late papers and unlimited time on tests, both frequent accommodations for depression, were rated significantly higher among those who completed the depression-related reading.

            We also looked at a similar reading about TBI, but that did not bring about significant changes, largely because endorsements were very high in both the control and readings conditions.

            These findings suggest, as usual, that additional investigations in the area are warranted as well as that on-line ancillary readings might be a profitable avenue of pursuit to develop students’ understanding of mental illness/disability and to increase social justice on campuses. As research, these studies are highly limited in that they look at only one institution, and many of the attitudes toward individuals with disabilities and accommodations are local: for example, large state institutions often do have problems with class availability which may affect views on  preferential registration that would not exist at small, private colleges. There are other accommodations that may be of more pressing concern in other places; for example, some institutions have begun to experiment with allowing students with TBI to receive financial aid while not being full-time enrolled. The processes we followed to develop the intervention (a survey to determine areas of concern; focus groups to get perspective on the problems; and a brief intervention targeting what was learned from the survey and focus groups) might have more generalizability.
  
References

• Hartman-Hall, H. M., & Haaga, D. A. (2002). College students’ willingness to seek help   for their learning disability. Learning Disability Quarterly, 25, 263-274.         
• Kurth, N., & Mellard, D. (2006). Students’ perceptions of the accommodation process in post secondary education. The Journal of Postsecondary Education and Disability, 19, 71-84.
• Lightner, K. L., Kipps-Vaughan, D., Schulte, T., & Trice, A. D. (2012). Reasons university students with a learning disability wait to seek disability services. Journal of Postsecondary Education and Disability, 25, 145-159.
• Lombardi, A. R., Murray, C., & Gerdes, H. (2011). College faculty and inclusive   instruction: Self-reported attitudes and actions pertaining to universal design. Journal of Diversity in Higher Education, 4, 250-261.
• May, A. L., & Stone, C. A. (2010) Stereotypes of individuals with learning disabilities: Views of college students with and without learning disabilities. Journal of Learning Disabilities, 43, 483-499.
• Milligan, N. V. (2010). Effects of training about academic accommodations on perceptions and intentions of health science faculty. Journal of Allied Health, 39, 54-62
• Murray, C., Lombardi, A., & Wren, C. T. (2011). The effects of disability focused training on the attitudes and perceptions of university staff. Remedial and Special Education, 32, 290-300.
• Myers, D. G. (2014). Exploring psychology (9^th ed.). New York: Worth.
• Neely, B. H., & Hunter, S. T. (2014). In a discussion on invisible disabilities, let us not lose sight of employees on the autism spectrum. Industrial and Organizational Psychology: Perspectives on Science and Practice, 7, 274-277.
• Quinlan, M. M., Bates, B. R., & Angell, M. E. (2012). ‘What can I do to help?’: Postsecondary students with learning disabilities’ perceptions of instructors’ classroom accommodations. Journal of Research in Special Educational Needs, 12, 224-233.
• Sparks, R. L., & Lovell, B. J. (2009). College students with learning disabilities diagnoses: Who are they and how do they perform? Journal of Learning Disabilities, 42, 494-510.

Authors’ note: Address correspondence to Dr. Ashton Trice at tricead@jmu.edu 

Hunter Greer is a third year graduate student in the Clinical Mental Health Counseling program at James Madison University, completing an internship at the counseling center at Bridgewater College.
 
Ashton Trice is a Professor in the Graduate Psychology Department at James Madison University where he teaches developmental and educational psychology courses in the school psychology program. He received his doctorate in Educational Psychology from West Virginia University. His primary interests are career development among adolescents with disabilities and media influences on mood and cognition.