A traditional classroom with limited access

As university faculty and administrators across the country are closing schools, scrambling to flip course work to on-line or virtual programing  due to COVID-19, many are also finalizing decisions on acceptances for the 2020 fall incoming classes.  Hopefully, they give priority to attracting and retaining students with disabilities as part of diversity initiatives.

However, although this year is the 30th anniversary of the signing of the Americans With Disabilities Act and March is recognized as Disability Awareness month, accessibility concerns of this group of students often go unnoticed with university diversity initiatives.

The concept of Universal Design for Learning can offer solutions for virtual learning as well as for the approximately three and a half million students who identify as having a disability. This number translates to roughly 20% of the student body in college each year. 

Universal Design innovative teaching approaches borrow design concepts from architecture that focus on changing and improving access and opportunities for use of many environments for all people.

Some examples include curb-cuts with truncated domes and sensors that open doors automatically. Universal Design for Learning is the creation of curriculum and services automatically built into the educational process that not only supports increasing access but may minimize the need for accommodations.

Universities such as Boston CollegeColorado State University and the California State University System are institutions with UDL initiatives working to create institution-wide proactive designs to their courses with built-in UDL features.

Despite these efforts, most of academia continues to exclude students with disabilities by failing to incorporate easy access across learning experiences. This community includes students with mobility impairment, or who are blind, or students with non-apparent disability, such as ADHD or fibromyalgia.

Clear examples of exclusion occur when a student using a wheelchair has to ask for assistance to enter and exit the washroom because of an inaccessible door. For students with non-apparent disability lack of access is less noticeable but real and as prohibitive to creating an environment for learning.

Simple shifts in teaching approaches make a major difference in learning successes for our students with disability. By using UDL guidelines as our standard practice we avoid triggering a student with PTSD, allow students who otherwise might feel labeled as different by peers to feel instead a part of the classroom community, and remove the perceived burden of many students that they are asking for too much when requesting an accommodation.

One student’s recent feedback of a course using UDL said this was their “first safe learning experience of college.”

As assistant professors in occupational therapy at two major universities, we are committed to incorporating universal design throughout our courses and in classroom policies and practices. We set expectations for access at the beginning of class to create a space where students can share, challenge themselves safely, and develop an appreciation of differing perspectives.

We do this by stating our commitment to inclusion up-front in our course syllabus by offering alternative means for students to process course content plus options for assessing what they’ve learned through UDL.

While almost 20% of undergraduate students reported having a disability in 2016, a more recent study found that only 3% of medical students were registered with their on-campus disability services center.

A 2019 study shows that college students with disabilities, especially those in allied health and medicine, may choose not to request formal accommodations due to fears of being stigmatized.

In addition to stigma associated with disability, the additional work involved in securing disability accommodations and inadequacy of accommodations to meet students’ disability-related needs might also be contributing to the disproportionately small number of allied health students identifying with disability and seeking support during their allied health professional education.

The U.S. Department of Health and Human Services recommends addressing the demographic makeup of providers in the healthcare workforce as a strategy to reduce health disparities.

2015 report from the Congressional Black Caucus Health Braintrust shows treatment by racial and ethnic minority providers with common lived experiences or culture can be a powerful tool in improving the community’s health. 

And the American Medical Association calls for more attention to intersectionality (including disability) in order to improve equity in medical education and reduce healthcare disparities for patients. 

To be sure, there are many ways schools can, and do, support students with disabilities. These range from legally mandated reasonable accommodations such as note-takers, extended time on tests, and accessing resources.

What these supports have in common is that they are only available or offered to students with disabilities upon request. The conversation on disability access is typically about accommodating a particular student who is already enrolled at the institution, rather than purposefully recruiting students with disabilities. 

Most practices to expand diversity, equity, and inclusion in allied health programs are not enough.

We recommend institutions committing conscious efforts for improving recruitment and retention of a diverse student community closely examine current practices and allocate necessary resources to assure access of students with disabilities in all phases of recruitment as well as throughout the curriculum.

By not attracting and mentoring a diverse range of students to become and remain part of academic programs and healthcare workforce, universities and ultimately the communities lose.

Universal design approaches need to also be present beyond the classroom and woven throughout the program’s policies and procedures to create a welcoming environment for all learners and achieving the vision of more diverse allied health programs and universities. 

For example, recruitment and retention efforts can include improving website and campus accessibility, revising technical standards such as requirements for matriculation, promotion, and graduation from the degree program.

Universal Design in Learning can serve to attract potential students by ensuring accessible websites that are well organized and easy to navigate in various formats. This can mean being accessible to screen readers for students with low vision as well as being accessible for viewing from a mobile device for students trying to access the website on the bus traveling from one job to the next. 

Although attention to the climate and curriculum of specific educational programs is important, allied healthcare students do more than just go to class, study for exams, and engage within the bubble of their particular department.

The U.S. Bureau of Labor Statistics reports that full-time college students spend only 15% of their average weekday engaging in educational activities. So creating a welcoming and accessible campus environment is paramount to ensuring a positive student experience. It needs to be part of conversations about student recruitment and retention. 

Fall enrollment, number of full-time students, and number of part-time students in post-secondary degree-granting institutions all fell between 4 and 8% from 2010 to 2017.

In higher education seeing declines in student enrollment,attracting, welcoming, and mentoring a wide range of students may be vital to the health of the university and academic setting.  

Colleges and universities need all students to be successful. Allied health professions in particular need effective practitioners to maintain the health of society. The future depends on it.

Laura VanPuymbrouck, PhD, OTR/L, is an Assistant Professor in the College of Health Sciences at Rush University in the Department of Occupational Therapy. She is a Public Voices Fellow through The OpEd Project.

Contributing Author

Jenna Heffron, PhD, OTR/L is an Assistant Professor in the School of Health Sciences and Human Performance at Ithaca College in the Department of Occupational Therapy.