Cerebral palsy is caused by an injury to the motor centre of the brain, which may have occurred before, during or shortly after birth. Manifestations may include involuntary muscle contractions, rigidity, spasms, poor coordination, poor balance or poor spatial relations. Visual, auditory, speech, hand-function and mobility problems may occur.
Those severely affected may need to use a wheelchair, while those mildly affected may have no physical manifestations at all.
Multiple sclerosis is a progressive disease of the central nervous system, characterised by a decline of muscle control. Symptoms may include disturbances ranging from mild to severe blurred vision, blindness, tremors, weakness or numbness in limbs, unsteady gait, paralysis, slurred speech, mood swings or attention deficits. Because the onset of the disease usually occurs between the ages of 20 and 40, students are likely to experience difficulty in adjusting to their condition.
The course of multiple sclerosis is highly unpredictable. Periodic remissions are common and may last from a few days to several months, as the disease continues to progress. As a result, mood swings may vary from euphoria to depression. Striking inconsistencies in performance are not unusual.
Muscular dystrophy refers to a group of hereditary progressive disorders that most often occur in young people, producing degeneration of voluntary muscles of the trunk and lower extremities. The atrophy of the muscles results in chronic weakness and fatigue and may cause respiratory or cardiac problems. Walking, if possible, is slow and appears uncoordinated. Manipulation of materials in class may be difficult.
AIDS (Acquired Immune Deficiency Syndrome)
AIDS is caused by a virus that destroys the body's immune system. This condition leaves the person vulnerable to infections and cancers that can be avoided when the immune system is working normally. The virus is transmitted primarily through sexual contact or needle sharing with intravenous drug users. It is not transmitted through casual contact.
Manifestations of AIDS are varied, depending on the particular infections or diseases the individual develops. Extreme fatigue is a common symptom. Teaching strategies will likewise vary.
Students with AIDS may be reluctant to reveal their condition because of social stigma, fear and misunderstanding surrounding this illness. It is therefore exceptionally important that the confidentiality be strictly observed. In addition, if the issue should arise in class, it is important for academic staff to deal openly and non- judgmentally with it and to foster an atmosphere of understanding.
Because cancer can occur in almost any organ system of the body, the symptoms and particular disabling effects will vary greatly from one person to another. Some people experience visual problems, lack of balance and coordination, joint pains, backaches, headaches, abdominal pains, drowsiness, lethargy, difficulty in breathing and swallowing, weakness, bleeding or anaemia.
The primary treatments for cancer - radiation therapy, chemotherapy and surgery - may induce additional effects. Therapy can cause violent nausea, drowsiness, and fatigue, affecting academic work or causing absences from lectures. Surgery can result in amputation, paralysis, sensory deficits and language and memory problems.
Many students may have chronic breathing problems, the most common of which are bronchial asthma and emphysema. Respiratory problems are characterised by attacks of shortness of breath and difficulty in breathing, sometimes triggered by stress, either physical or mental. Fatigue and difficulty climbing stairs may also be major problems, depending on the severity of the attacks.
Frequent lateness or absence from lectures may occur and hospitalisation may be required where prescribed medications fail to relieve the symptoms.
Epilepsy and Other Seizure Disorders
Students with epilepsy and other seizure disorders are sometimes reluctant to divulge their conditions because they fear being misunderstood or stigmatised. Misconceptions about these disorders - that they are forms of mental illness, contagious and untreatable, for example - have arisen because their ultimate causes remain uncertain. There is evidence that hereditary factors may be involved and that brain injuries and tumours, occurring at any age, may give rise to seizures. What is known is that seizures result from imbalances in the electrical activity in the brain.
Students with seizure disorders are often under preventive medication, which may cause drowsiness and temporary memory problems. Such medication makes it unlikely that a seizure will occur in class.
In the event that the student experiences a seizure, follow this procedure:
- Keep calm. Although its manifestations may be intense they are generally not painful to the individual.
- Remove nearby objects that may injure the student during the seizure.
- Help lower the person to the floor and place cushioning under his/her head.
- Turn the head to the side so that breathing is not obstructed.
- Loosen tight clothing.
- Do not force anything between the teeth.
- Do not try to restrain the bodily movement.
If the seizure continues for more than 10 minutes, get medical help or call an ambulance.
Make sure someone stays with the student after the seizure, who should then be taken to a quiet place to rest.
After a seizure, academic staff should deal forthrightly with the concerns of the class in an effort to forestall whatever negative attitudes may develop toward the student.
Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS), formerly known as ME (myalgic encephalomyelitis) is believed to be caused by an abnormal response to a virus or some other 'trigger' factor.
CFS is a chronic condition lasting months or years. People with CFS are prone to relapse if they exceed the limits of physical or mental exertion which their illness imposes.
Symptoms may vary in severity from day to day, and even from hour to hour. There may be profound physical and mental exhaustion, persistent pain in muscles and joints, headaches varying from dull to intense, dizziness, nausea, fainting, poor concentration and memory, pallor or flushing of face, an inability to tolerate extremes of heat, light or sound, for example a noisy lecture room and a sensitivity to various agents and chemicals.
As a consequence of this illness, the student may feel a great sense of isolation and loneliness with a serious loss of self- confidence.
It is important that the student be trusted and treated sympathetically. Difficulties should be discussed as they arise. Good communication between the staff member and the student is essential and the student's ability to cope will be assisted by such empathy.
The student will need to avoid prolonged standing, extremes of heat and cold, exposure to fumes from science laboratories and gas heating and mental or physical exertion beyond the limits imposed by their condition.
Manual Dexterity Disabilities
A not uncommon disability that lecturers will encounter with students who may for example have arthritis, occupational overuse syndrome, fractures, multiple sclerosis or cerebral palsy.
Occupational overuse syndrome, also known as Repetitive Strain Injury, may include diseases such as tenosynivitis and carpal tunnel syndrome. The symptoms are usually pain, swelling, stiffness of wrist, elbow or the small joints in the hand. It also commonly causes pain in the neck and shoulders.
It tends to occur in people as a result of doing repetitive tasks such as typing, writing or playing musical instruments and may result in long term stiffness, pain and limited joint movement.
Rest and a variety of treatment approaches may improve the situation but it is vulnerable to recurrence under conditions of stress and overuse. Writing may be difficult and slow necessitating the provision of notetakers and alternative assessment techniques. These may include extra time for rest breaks, a combination of notes and oral or tape assessment (see guide to these techniques) or an amanuensis. For some students with manual dexterity problems the use of a computer in examinations may be necessary.
Diabetes means too much sugar (or glucose) in the blood. The reason for this is lack of insulin, a substance the body needs to use sugar. People with diabetes are treated with insulin injections, some modifications of their diet and exercise. To balance the injected insulin, meals need to be evenly spaced throughout the day, with extra food given before exercise.
It may be necessary for the student to eat in class or in examinations. Instability of the diabetes may mean absences or delayed assignments. Consideration is required (and flexibility)
Hypoglycaemia. Sometimes the blood sugar level will fall below normal and the person may experience a 'hypo' or hypoglycaemic reaction. A 'hypo' can occur if a student misses a meal entirely; runs late for a meal; fails to eat extra carbohydrate before exercise or takes too much insulin inadvertently.
The symptoms of hypoglycaemia vary from one person to another and include sweating, pallor, day dreaming, slurred speech, shakiness, crying, confusion and bad temper. If a 'hypo' is untreated, unconsciousness can follow and urgent medical attention should be sought. Never attempt to give an unconscious person food or drink.
High blood sugar levels, hyperglycaemia, can result when a person with diabetes eats too much, eats the wrong kinds of food, or does not have enough insulin to meet body requirements, such as during examinations or other times of stress. The classic symptoms of hyperglycaemia are increased thirst, increased urination, increased appetite and signs of dehydration (cracked lips, dry skin, sunken eyes).
Colour blindness is typically a genetic condition, and it is much more common in men than in women. There are many different types and degrees of colour blindness - more correctly called colour deficiencies. Approximately one in 12 men has at least some colour perception problems. Less common, acquired deficiencies stem from injury, disease, or the aging process. Although not called "colour blindness," when people age, their corneas typically turn yellowish, severely hampering their ability to see violet and blue colours. It is extremely rare to be totally colour blind (monochromasy - complete absence of any colour sensation).
Adapted from Reasonable Accommodations published by the ANU (no longer available on-line - April 2010)