Addressing and Enhancing Diversity in Academic Programs: Faculty, Students and Clients with Disabilities Katherine D. Seelman, Ph.D. School of Health and Rehabilitation, University of Pittsburgh The Council of Academic Programs in Communication Sciences and Disorders 2002 Conference, April 25 Palm Springs, CA

Two Windows on Disability  Rehabilitation Sciences lack knowledge that is subjective and social, sufficient to explain the experience of the disabled person.  Disability Studies lacks knowledge that is objective, sufficient to support a scientific base for medical treatment.

Two Windows on Disability: Professional and Patient/Client Two Windows on Disability: Professional and Patient/Client  Health professionals can develop a view of disability that is at substantial variance from its reality for many disabled people.  Disabled people can develop a view of health care that is at substantial variance to its value for them.

Different Roles: Health Care Professionals  The role of health care professionals is associated with knowledge that is objective, scientific.  Health care professionals make decisions important to disabled people, including decisions about life and death and for long term care interventions such as assistive technology, including hearing aids, assistive listening devices and augmentative communication.

Different Roles: Patient/Client  The role of the patient/client is associated with subjectivity, emotion and personal experience and is related to Disability Studies.  Experientially-based knowledge is often under valued..

Example: M.D. and Disabled Patient:  to examine his nervous system…felt a sense of horror come over me. You can’t feel anything here on your shoulder? You can’t move your legs.”

M.D. as a Disabled Patient  “I next met this man in a spinal cord unit in 1985 as I was pushed to the computer next to him in occupational therapy. A few months earlier, I had severed my cervical spinal cord playing rugby and I was a quadriplegic—slightly more impaired than was my former patient.”

M.D. as a Disabled Person  “Now, 15 years after becoming disabled, I find myself completely at home with the concept of…being me.”  “Now I know that my assessment of the potential quality of life of severely disabled people was clearly flawed.”

Studies of Quality of Life  Neurologists were significantly more likely to believe that physical impairment was an important determinant of quality of life than were disabled people.  92 per cent of people with quadriplegia reported being glad to be alive while only 18 per cent of emergency service personnel believed they would be glad to be alive.

 Disabilities do not have the same social consequences as illnesses. Social Consequences of Illness and Disability: Are They Different?

Social Consequences of Disability and Illness  People with illnesses are usually cured.  People with disabilities frequently live with disabilities for life.

Social Consequences of Disability and Illness: Are They Different?  People who are ill are patients who try to get well.  People who are ill may be temporarily relieved of their family and work roles.  People with long- term disability are often not ill.  People with disabilities cannot be permanent patients who forfeit their family and work roles.

Social Consequences of Disability and Illness: Are They Different?  People who are ill rarely have to radically change their lifestyles, i.e., where they live, their friends, their job.  People who have acquired disabilities may find they need support to learn how to live a new life.

Implications for Attitudes, Research, Training and Practice  Identify holistic paradigms and models that inform attitudes, research, education and training and practice.  Incorporate into training and practice, disabled people and Disability Studies.  Identify and incorporate into research, problems that are important to disabled people.

Paradigms and Models  Biophysical model  Social model  Integrative model

Integrative Model: Important Reports and Studies  World Health Organization: ICF  Institute of Medicine: Enabling America  National Institute on Disability and Rehabilitation Research: Long Range Plan  Centers for Disease Control: Healthy People 2010

Training for Whom?  Medical students, practitioners  Allied health care students and practitioners, including nurses, pharmacists, physical therapists, occupational therapists, audiologists, speech pathologists and rehabilitation engineers  Disabled people

Training Initiatives  Incorporation of Rehabilitation Science and Disability Studies into curricula development:  Primary Care  Clinical Prevention  Long Term Care and Rehabilitation  Emergency Services

Training  At the level of the individual faculty member, student or client/patient  At the Health Care System level  At the Public Policy Level

Integrative Framework for Research, Teaching and Learning about Disability in Medicine and the Health Sciences  Knowledge based in Rehabilitation Science and Disability Studies, especially Development of Integrative paradigm and models, especially the ICF  Development of curricula, internships and practicum

Scenario: A Hard of Hearing Student in an Audiology AU. D.Program  Enter a student with bilateral moderate- severe hearing loss  Completed very successfully undergraduate degree using an FM system  Must engage in new communications situations, involving group projects and presentations

Scenario: A Hard of Hearing Student in an Audiology Masters Program (continued)  Participates in clinical practicum that requires:  monitoring the sounds generated by an audiometer  Troubleshooting hearing aids via a listening stethoscope, recording speech responses of young children during language testing….

Questions that Arise for the Faculty (continued)  Must the student “self-identify” herself as a disabled individual to the clinical sites to which she is assigned?  Which “hat” does a faculty member wear when the student experiences a communications failure in class? In clinical practicum? Instructor? Audiologist? Advocate?

Questions that Arise for the Faculty (continued)  If an FM system breaks down in class, is it the instructor’s (audiologist) role to fix it?  In clinic, if the instructor notices that the student is unable to accurately hear children’s responses to test stimuli, does she/he recommend or prescribe an accommodation?

Questions that Arise for the Faculty (continued)  Who is responsible for the provision of accommodations at outplacement clinical practicum sites?  Example: A student needs to have the audiometer monitor output patched in directly to her hearing aids in order to score audiometric tests accurately.

Questions that Arise for the Faculty (continued)  What constitutes ‘reasonable accommodations’ so that a student may satisfy requirements for clinical contact hours and face to face contact?

Questions that Arise for the Faculty (continued)  Can the profession provide alternative career paths for students who, with reasonable accommodations, cannot hear a hearing aid signal, score audiometric tests…  Example: A non clinical track such as hearing aid marketing