The guide to assisting students with disabilities. Equal access in health sciences and professional education

Endeavouring to draft a guide to address the tangible and detailed processes involved in granting accommodations to students with disabilities in higher education may seem a task fraught with challenges and pitfalls in a contemporary landscape that is in constant turmoil and transformation. Most campuses indeed are tentatively shifting from a retrofitting approach to more proactive and inclusive pedagogical models such as the universal design for learning. What may have previously appeared as established practices are also now being challenged regularly in court, as society globally questions its views and perceptions of disability. It is nevertheless a task that Meeks and Jains undertake with enthusiasm, scrutiny and nuance as they seek to provide an overview that is both up to date and reflective of the field as a whole.

The editors tackle this bravely, and with a desire to be accurate, legally up to date and explicitly pragmatic. The intention is therefore at once twofold, as is nicely illustrated by the juxtaposition of the foreword and introduction given respectively by Scott Lisner and Alice Wong: on the one hand, Meeks and Jains aim to provide a definitive legal opus on accommodations in the area of health sciences in higher education; simultaneously, they seek to examine the complex and often frustrating experience students may face in a sector that too readily still embraces ableism.

It is important to note from the start that, in order to achieve the degree of thoroughness it targets, The Guide to Assisting Students with Disabilities narrows down its focus explicitly from the start to health sciences and professional education. Practitioners from other fields may therefore not find in this manual the solutions to the specific concerns they may have. This said, it can be argued that Meeks and Jains’ work achieves a degree of transferability to other contexts of higher education and may be relevant to many in other fields. For lack of more targeted resources of this calibre in other areas of higher education, it may be destined to become a manual of reference for many.

Focusing on the area of health sciences specifically is challenging in itself. Indeed, trying to take pen to paper and produce a solution-focused guide to accommodations in higher education is an even more daunting endeavour in the area of health sciences, because issues such as laboratory use, professional accreditations, board examinations, and so forth, complicate the landscape no end. It also becomes tricky to examine power, confidentiality and ethics in a field that often purports to be both ‘teacher’ and ‘healer’ and relates to its students with disabilities with ambivalence. This is a topic the text explicitly acknowledges and addresses with circumspection.

The volume is edited by Meeks and Jains but includes contributions by a good dozen other authors, the editors at times co-authoring certain pieces. The editors’ presence is tangible right through in terms of calibre, direction and intentions, but it transpires even more explicitly at the end of the volume in a section that recaps the content with hands-on, concise and jargon-free recommendations for academics and service providers, in the forms of ‘dos and don’ts’.

Some chapters are so detail focused as to be slightly limited in scope, but a few others stand out through the originality of their content. Chapter 4, which discusses laboratories and clinical settings, represents a valuable resource for higher education professionals in a field where resources on this topic are scarce. The same can be said of Chapter 5 which discusses licensing boards and examinations, an unchartered territory in the literature. Chapter 7 also stands out for its innovative focus on professionalism and the delicate etiquette of communication around the issue of accommodation, a dimension still rarely examined by service providers who can remain over-focused on legislative imperatives and liability. Critical pedagogy has yet to find its place in disability service provision and this chapter goes some ways to indicate its rich relevance.

One overall issue with the volume is that it will appear too US-centric to many readers. This is a shortcoming that is difficult to avoid for authors who wish to offer hands-on technical solutions to specific legal questions. Jurisdiction and context become central. The advice given is American with Disabilities Act (ADA) based and will not be immediately relevant to readers overseas, or even in Canada.

It is perhaps regrettable too that reform, advocacy for change and innovation do not have more of a presence in the volume. There is little talk, for example, of the universal design for learning and, while the social model of disability is discussed early on (15), there are few explorations of its relevance and contemporary usefulness later on in the volume. Change is occurring daily and many health science faculties, field coordinators and even licensing boards are examining how to shift their approaches towards social model practices, while continuing to guarantee the right to accommodations afforded by the legislation. It would have made this volume truly exceptional had the authors ventured into this terrain and offered examples and illustrations of innovative practices that currently, at times, go beyond the mere legal requirements and target systemic change in perceptions. The field and the employment market are changing and adapting rapidly, and as a result so do our learning and training institutions; it may therefore appear contradictory to attempt to crystallize best practices when the notion of accessibility, or core professional competencies – for health professionals particularly – is constantly evolving and being challenged by public scrutiny.

Even in the United States where the process of determining accommodations can be overly legal, complex and rigid, there has been change in the last decade and a move towards practices that embody social model intentions, rather than on diagnosis. Association of Higher Education and Disability (AHEAD’s) updated guidelines on documentation have come some way in re-centring this process on dialogue and rendering it less mechanical (AHEAD 2012). It is perhaps a pity that this now well-respected protocol which has been adopted by many universities in North America is not reflected in this volume.

Similarly, any attempt to present definitive legal solutions to the complex process of offering accommodation in the area of health sciences in higher education perhaps runs the danger of presenting this institutional reflection as a well-oiled machine, something it is arguably not. One perilous oversight of this perspective is to ignore the socio-economic implications of the diagnostic approach. Many students are still prevented from accessing accommodations they are entitled to simply because they lack fast and cost-effective access to caregivers and health specialists. This is an issue that has never been more relevant than in these days of much-debated health insurance reform in the United States. The accommodation process in higher education, for many, is inherently linked to wealth and raises, from a sociological perspective, dire stakes in terms of social justice. It would be encouraging to see these issues of social justice discussed more frequently, explicitly and in more depth.

Meeks and Jains’ guide will no doubt establish itself as a work of reference which is sure to be used widely by service providers in the health sciences sector in the United States, particularly by young professionals entering the field who may not have had times to accumulate know-how in the process of determining accommodations. This is, after all, a growing issue in a profession widely still dominated by baby boomers who gained their ‘hands on’ experience at the very emergence of the rights legislation; the gap in expertise has never been felt so sharply as now that a generation of practitioners heads for retirement en masse. There is an urgent need for manuals of this type which will enable the fast and efficient on-boarding of new professionals. This volume provides solid answers to frequently occurring questions. The sociologists or Disability Studies scholars amongst us may, on the other hand, find that the perspective it offers is slightly simplistic and, for the sake of exhaustiveness, avoids important issues related to change and social justice.

Frederic Fovet
Faculty of Education, University of Prince Edward Island, Charlottetown, Canada
[email protected]
© 2017 Frederic Fovet
https://doi.org/10.1080/09687599.2017.1401330