50 (Thousand) Shades of Gray

1. 50 (Thousand) Shades of Gray Mastering the Interactive Process

2. Carolyn L. Boone, Coordinator of Access & Equity Services Tompkins Cortland Community College Randy Borst, Director of Accessibility Resources University at Buffalo Kelly Hermann, Director of the Office of College-wide Disability Services Empire State College We have no answers… only questions! 

3. Ambiguity

4. Policy • A well-written policy should cover all accommodation requests. Generally there is no need to have a separate policy to cover therapy animals, or dining accommodation requests or residence hall accommodations or … . • EXCEPT: one reason to have such policies is to remind other members of the college community of the possibility of the need for accommodation and the appropriate procedures to follow.

5. I have a policy that … • Scenario from audience participant

6. Documentation: What the Writers Say • Objective evidence of a diagnosis • OR – it may be based on patient self-report (depending on the diagnosis!) • May or may not include testing • Gives the DS provider an opportunity to think about how a student might perform in an educational setting

7. Documentation: What the Writers Say • The most useful = the rarest • Diagnosis (or description of the mental or physical impairment) • Summary of etiology, progress, and prognosis of the condition • Functional limitations • Side effects of medications (if any) • Triggering mechanisms/conditions to be avoided • Recommendations

8. Documentation: What the Writers Say • The least useful = the commonest • Prescription-pad note: “ADHD. Takes Ritalin. • Prescription-pad note: “Was seen in office for depression and anxiety • Hospital discharge along with general information given to all patients with a particular diagnosis • A stack of clinical exam notes • Section 504 Plan or IEP that names no impairment and lists only vague reasonable accommodations

9. Documentation: What the Student Says • Most helpful • Educational plans • What’s working • What’s not working and why if known • Narrative of events relative to impairment and limitations • Accommodation history if there is one • Reflections on personal/social/identity issues • Accommodation request(s) if any

10. Documentation: What the Student Says • Anecdotal evidence that fills in the gaps of knowledge from medical or educational documentation • Allows DS to ask questions based on knowledge of educational environment and review of other documentation • May confirm assumptions or raise new suspicions – don’t be afraid to ask questions!

11. Documentation: What the student says • Least helpful • What services do you provide? • My mother can tell you everything. • I have ______________ and I need help • Translate to something helpful • Our services are individualized. Did you have something specific you’d like to tell me about? • I’m sure your mother knows lots of things. What has she shared with you to tell me? • Let’s see if we can find out what would help you.

12. Documentation: Conflicting Evidence • If student report differs from existing knowledge of diagnosis or review of medical or educational documentation, DS needs to ask more questions • How old is the documentation – does it need to be updated? Have other things changed? • Professional judgment is key!

13. Assumptions • Be wary of assumptions • We never say never, but if we never hear/read again the phrase: “Is X accommodation appropriate for Y disability” … it will be too soon! • Analyze what documentation and student say about student and the individualized circumstances.

14. Documentation: Conflicting Evidence • If student report differs from existing knowledge of diagnosis or review of medical or educational documentation, DS needs to ask more questions • How old is the documentation – does it need to be updated? Have other things changed? • Professional judgment is key!

15. Clinical Settings, Internships, Labs • Be proactive … this discussion can and should happen during the initial interview • It may come up again during subsequent semesters as students change majors, or major requirements change • Students don’t know what they don’t know … and neither do you; be open to modifications • The interactive process is a 2-way street (this means YOU can initiate a discussion!)

16. Scenario: Photography Lab • Jacob Photoman, a student in the Art Program at XYZ Community College is taking ART 123 – Photography. The course syllabus indicates among other technical activities, that the student will be expected to load and unload film for processing in the darkroom. The student effectively has use of only one hand and attempts to load and unload the film have resulted in tearing the film. • He comes to you requesting that he be allowed to have someone else load and unload the film. What do you do?

17. Scenario: Office Administration Internship • Helga Intern has spina bifida and uses a wheelchair. She has some limitations in her fine motor skills as well but has met the requirements for 65 wpm with 5 or fewer errors in her typing speed as well as all other program requirements. • What does the internship advisor need to consider in placing her and what should her supervisor know before she is placed?

18. Newly Acquired Disabilities(And Long-standing Undiagnosed Disabilities) • The interactive process is much more complex • Questions may need to be more intrusive • Trial and error may be needed • Educating and or explaining may be needed

19. I have a student in a clinical who … • Audience participant question

20. Scenario: Newly Acquired Disability • Bob Builder was injured (broken back, several surgeries to fuse vertebrae and a head injury that makes his processing time slower) at his construction job and can no longer complete the tasks and duties of building houses. He decided to come to ABC University for a degree in business administration so he can start his own general contracting business. He cannot sit for long periods of time and has difficulty holding his books to read. He has come to your office only because his professor told him he should and has no idea what to do or ask for.

21. Socio-Legal ConstructHelp all understand that • “Disability” does not mean “inability” • SSN: Disability impacts performing in all occupations for which applicant is qualified • Workers’ Compensation: Disability impacts current job because of workplace injury • Identity as a PWD comes from personal response to disability • Disability culture and success make up identity • Awareness of rights and responsibilities

22. Intake at a distance? • What information do you miss by not seeing the student in person? • Initial contact is typically via email • Phone interviews: • Asking good questions • Probing for understanding • Trusting your instincts • Follow-up is key!

23. ? Wrap Up And Questions