A 17-year-old high school senior with a history of attention deficit hyperactivity disorder presents to the office. He shares that he was recently accepted to college but is worried about keeping up with the coursework. How do you advise him?
The transition from high school to college can be daunting, especially for individuals with disabilities that impair academic performance. One in five postsecondary students has a disability, defined as a condition that substantially limits one or more major life activities. Psychiatric disabilities include, but are not limited to, depression, anxiety, attention deficit hyperactivity disorder, autism spectrum disorder, obsessive compulsive disorder, and learning differences. Compared with students without disabilities, college students with disabilities are more likely to drop out of school, take longer time to complete their degrees, and experience poorer academic outcomes overall. Academic accommodations have been linked to positive outcomes including higher GPAs and shorter time to graduation.
Although federally funded colleges and universities in the United States are legally required to provide reasonable modifications for students with disabilities under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, most postsecondary students with disabilities, especially males and non-white students, do not request accommodations. Barriers to requesting accommodations are numerous and may include a lack of awareness of available supports, concerns about stigma, and discomfort with self-advocacy. While K-12 schools are mandated to identify and evaluate students with disabilities, postsecondary schools are not. As a result, students who are accustomed to schools intervening on their behalf may not realize that obtaining support in college typically requires self-initiation.
Primary care providers can play an important role in advocating for their patients by equipping them with the knowledge and support needed to access accommodations in the college setting. Below are several ways to support college-bound patients with disabilities.
Educate patients about available accommodations. Colleges and universities offer a variety of academic modifications to help students with disabilities succeed. Common ones include extended time on exams, note-taking assistance, support with study skills, alternative exam formats, and access to adaptive technology. The specific accommodations granted to each student will depend on the nature of their disability. Discuss with patients and their families which supports were helpful in high school and whether similar accommodations may be beneficial in college.
Normalize requesting accommodations for disabilities. Patients may hesitate to request accommodations because of concerns about stigma. Listen to and validate their feelings while also emphasizing that disabilities affect approximately 19% of college students and that requesting support may help them achieve their academic goals. It can also be helpful to remind patients that federal laws protect students from disability-based discrimination.
Encourage early registration with the college’s disability services office. Once a patient decides to request accommodations, the first step is to register for the college’s disability services office. Contact information is typically easy to find through a quick online search. Recommend that patients register as soon as they receive an acceptance letter, as the accommodation process can take time. Encourage them to review their school’s specific requirements, as processes vary by institution. For example, at the University of San Diego, students are required to (1) schedule an intake appointment, (2) submit student forms, (3) submit forms from medical professionals, and (4) work with a disability specialist to determine reasonable accommodations.
Assist patients in gathering documentation. If a patient has or previously had a 504 Plan or an Individualized Education Plan (IEP) in high school, encourage them to maintain copies of these documents to share with the disability services office, as these may help support proof of disability. In many cases, students must also provide forms or letters from medical professionals, such as pediatricians or psychiatrists, to verify their condition.
Encourage patients to build a support team. If patients are comfortable, caregivers can help support them during the transition process. Patients can also ask high school staff to coordinate with college personnel to facilitate a smooth transition. Once in college, patients should plan to communicate proactively with their professors to ensure that their accommodations are implemented. For example, students can email professors their accommodation letters prior to the start of each semester. Providing patients with practical strategies like these can help them develop self-advocacy skills that will benefit them in college and beyond.
For the abovementioned high school senior, consider providing these tips to maximize his chance at academic success in college. This can help him build the confidence and skills needed to navigate this important life transition.