The idea that schools should provide accommodations for those students who experience difficulty and disability is a relatively new one. In the past, primary, secondary, and tertiary educational institutions existed as institutions; however, as the sciences advanced and more became known about the nature of human learning disabilities, institutions of all different types and sizes began to realize that a learning disability is not necessarily associated with an intellectual disability. With this realization came the development of a number of important programs, all of which have one particular end goal: to develop an educational system in which people can thrive regardless of whether they have a learning disability or not. While this sounds like an idealistic goal—and it is—it is also a noble one, as it has allowed students with many different types of disabilities a much greater range of success in their lives.
One of the most important realizations that many tertiary institutions have come to in recent years is that disability is a diversity factor, much like race, gender, and socio-economic class (Barber, 2012; Connor, 2012; Terras & Leggio, 2015; Foster, 2014). Students of varied backgrounds are important to the development of any program, as they provide alternate views and different ideas on subjects; in a dental school, an individual with a disability must be capable of performing all the necessary physical requirements of dentistry, of course, but accommodations might be made in the classroom or in the test-taking realm to ensure that these students are not left behind as a result of their difficulties with learning (Foster, 2014; Connor, 2012; Troiano et al., 2010; Vickers, 2010; Lightner et al., 2012; Marshak et al., 2010; Cory, 2012).
Literature Review
In recent years, concerns about the accessibility of the school environment have informed the development of the educational environment in the United States, even at the tertiary level. Barber (2012) presents the results of interviews among college students in New Jersey, focusing on a number of different degree programs; the research seems to suggest that the presence of support staff, like counselors and instructors educated specifically to deal with learning difficulties, directly affects students with learning disabilities and how these students deal with the stresses of everyday school life—and similarly, it directly affects the rate at which students graduate (Barber, 2012; Cawthorne & Cole, 2010).
However, there are other issues as well: graduation is not the end of a student’s educational career, and students who are successful in their first iteration of tertiary education might still struggle in graduate programs and beyond (Barber, 2012; Barnar-Brak & Lectenberge, 2010). Barnar-Brak and Lectenberge (2010) provide valuable information to further study the effectiveness of accommodations for students with learning disabilities as well as what is expected of service providers. Interestingly, many of the studies that exist regarding the nature of accommodation in tertiary education are founded on how the students feel about their access to accommodation; a student’s access to accommodation, however, is not necessarily a guarantee of his or her success in school or the overall likelihood of that student to succeed in the long term (Barber, 2012).
There also seems to be some important differences between undergraduate students and graduate students in the scope of accommodation needed and the way that these students address the issue of accommodation. Terras and Leggio (2015) present discussion on accommodations that offered to graduate students who are pursuing online education. The study focuses on the factors that may have led to the success of the students who have all identified as being diagnosed with a learning disability. Terras and Leggio (2015) ask their students to identify their feelings and their experiences regarding the accommodations made available to them based on their overall experience with online courses; these experiences form the backbone of the recommendations made by the researchers (Terras & Leggio, 2015; Cawthorne & Cole, 2010).
The reduction of the stigma regarding student disability and accessibility has changed the way the current system works, and has increased the number of students who are interested in utilizing disability services (Newman & Madaus, 2015; Izzo et al., 2011). Newman and Madaus (2015) present a longitudinal transition study focusing on demographics, secondary school preparation, type of disability, accommodation strategies, and student success in post-secondary studies. The researchers concluded from the results that students in secondary institutions who are identified with a learning disability and who received an education that included transition planning are increasingly likely to request academic accommodations in post-secondary studies (Newman & Madaus, 2015; Howlin, Halligan & O’Toole, 2014).
Current Theories
The most prominent theories in disability research today seem to suggest that students with disabilities—especially disabilities like ADHD, dyslexia, and slow processing speed—can be provided an education just like students who are neuro-typical (Connor, 2012; Troiano et al., 2010; Vickers, 2010; Lightner et al., 2012; Marshak et al., 2010; Cory, 2012). These students may be unable to take tests or complete assignments as quickly as their peers, but the current thinking suggests that speed is not necessarily something that should be valued above all else in the educational process (Foster, 2014; Newman & Madaus, 2015; Howlin, Halligan & O’Toole, 2014). Students who struggle in the classroom are not necessarily stupid, as many would have assumed in the past; their learning structure and style is just vastly different from the typical student, and therefore, options must be provided to this student to ensure that the student has maximized his or her potential for success.
Currently, research suggests that institutions, instructors, and students must all be educated on the appropriate accommodations, how to implement them, and where to find them (Newman & Madaus, 2015; Howlin, Halligan & O’Toole, 2014). Students must be able to self-advocate, especially when they are old enough to be enrolled in dental school. However, instructors and institutions should also be vocal about the types of accommodation offered to students who do happen to have learning disabilities (Foster, 2014; Newman & Madaus, 2015; Howlin, Halligan & O’Toole, 2014). The current theory suggests that the provision of a quiet space to work and take examinations is one of the most important accommodations that the institution can provide to students, and institutions seem to provide these kinds of accommodations regularly.
Contradictions and Inconsistencies
There are, however, problems with accommodations as well, especially in graduate programs like dentistry. Students with disabilities who cannot carry out the physical requirements set by the practice of dentistry cannot enter into programs at all—this is because the health and safety of potential future patients is at risk if students cannot safely carry out all the tasks associated with dentistry (Barber, 2012; Barnar-Brak & Lectenberge, 2010). There is certainly a contradiction between the desire to be inclusive of people who are different, including those who have disabilities—physical and learning—but there are also limitations that programs must set on inclusivity for the protection of the institution, the future patients, and the potential student.
The difficulty of striking this balance cannot be overwrought; institutions that are willing to alter their programs to be more inclusive and include more people of different ability level are free to do so, but the average dental school program does not have this ability (Barber, 2012; Barnar-Brak & Lectenberge, 2010). These institutions, instead, must focus on developing the best and most effective method of addressing issues of diversity within the population of students enrolled in the program. There are basic accommodations that the Americans with Disabilities Act require—for instance, handicap accessible buildings—but for tertiary institutions, there are also interesting balances that the program itself must strike to balance the needs of the program against the potential entry of a student with a physical limitation or learning disability (Barber, 2012; Barnar-Brak & Lectenberge, 2010; Foster, 2014; Newman & Madaus, 2015; Howlin, Halligan & O’Toole, 2014).
Recommendations
The field of disability studies and the role of disability studies in the success or failure of students with disabilities at American medical schools is one that is just beginning to come to the forefront of consciousness. Young students were the first concern for disability advocates: undoubtedly, disability advocates believed, in the early 1990s, that accommodating young students was the best way to set them up for success in the long term. However, it became apparent that students need support at all levels of education, so the concern for student success began to be integrated at every level of education.
Providing accommodations quietly and without fanfare is not enough for students at any educational level. Although it should be assumed that students in graduate programs know what they need to be successful—after all, these students have been in school for over a decade by the time they reach dental school—instructors and accommodations providers should make themselves known to the student as soon as possible when the student enrolls in the program (Terras & Leggio, 2015). In fact, the research seems to suggest that there are three levels of accountability: first, the student must advocate for him or herself, because there is always the chance that the instructor and the institution—the two other levels of accountability—will fail the student. The research suggests that while instructors and institutions are doing better in their quest to better serve the student, there are still students who are not appropriately protected by current “best practice” policies in accommodations (Summers et al., 2014; Russak & Hellwing, 2015; Newman & Madaus, 2015; Foster, 2014; Gerber, 2012).
Unfortunately, there are still stigmas regarding the use of disability services in secondary and tertiary education (Lightner et al., 2012; Marshak et al., 2010; Mamiseishvili & Koch, 2010). For many students, disability services are fraught with the stigma of being “stupid” or “slow”—even though these services are meant to provide help to intelligent students who learn differently, the overall effect of shaming in earlier years cannot be denied (Troiano et al., 2010; Vickers, 2010). As such, institutions have to be very careful to ensure that they are not causing further harm to students when foisting accommodations and similar services in these students (Troiano et al., 2010; Vickers, 2010; Lightner et al., 2012; Marshak et al., 2010). Unfortunately for students with disabilities, there is no easy way to solve the problem. Even with careful investigation, the research seems to suggest that accommodations can be helpful for students with disabilities—but only if and when students choose to seek out this assistance and help from the institution (Connor, 2012; Troiano et al., 2010; Vickers, 2010; Lightner et al., 2012; Marshak et al., 2010; Cory, 2012). The problem seems to be that there are still significant barriers for students who are choosing to seek out—or, as it were, to not seek out accommodations. Research has progressed to the point where learning disabilities, especially disabilities that affect a student’s ability to learn in a classroom environment but not the student’s ability to learn overall (ADHD, dyslexia, etc.) are problems that can be worked through relatively easily (Connor, 2012; Troiano et al., 2010; Vickers, 2010; Lightner et al., 2012; Marshak et al., 2010; Cory, 2012). However, there is no doubt that there is a disconnect between dental schools and students who are enrolled: perhaps students are frightened of the stigma of needing assistance, or perhaps they are just used to operating without any help at all (Connor, 2012; Troiano et al., 2010; Vickers, 2010; Lightner et al., 2012; Marshak et al., 2010; Cory, 2012).
Discussion and Conclusion
Dental schools are, perhaps, not unique in their struggle to provide appropriate accommodation for students. Many schools struggle with the balance between facilitating an individual’s struggle for knowledge and providing too much support; dental and medical schools are particularly hard-pressed to strike this balance because there is a lot at stake for these students in the outside world. It becomes more and more important for students to be capable of operating independently—however, schools also have to take into account programs like the Americans with Disabilities Act, which requires schools to provide necessary and appropriate accommodations.
The blurring of this line has meant that schools must provide appropriate accommodations to students for fear of litigation, but the research also seems to bear out a strange reality: not all students with disabilities take these accommodations into account when developing a learning style or structure. Institutions and instructors can be more proactive in their development of these accommodations, as this will lessen the stigma that is associated with accommodations and encourage students who need to use accommodations to do so without shame. However, it seems that it will be a long time before students can actually break free of the stigma that existed for so long; disability services are still under-used by students for a wide variety of reasons.
References
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