The increase in complex students - meeting their needs through accurate justification

- with particular reference to CFS/ME, ASD and Dyspraxia

Lizzie SherwoodTeam Leader

Exeter Access Centre

AIM : supporting complex students

through …

• Assessor best practice

• Accurate justification

• Matching technology accurately to students’ needs

PROCESS FRUSTRATIONS

ACKNOWLEDGING LIMITATIONS

OF THE SYSTEMand attempting to find ways of

• altering

• conveying

• reducing

Improved Communication

Graham Tranter – roving ambassador for SFE

• How the DSA Teams are structured

• Problems with electronic file attachments

• 42,000 applications supported this year • 30% increase on last year• 18-22,000 invoices per month

E-mail:Graham_Tranter@slc.co.uk

Which DSA TEAM does what ?

Team 1 – Eligibility

Team 2 – Entitlement

Team 3 – Response

– Assessors key contact – the recent Pilot was aiming for a

72 turn-a-round for queries – DSA Officers to phone the assessor direct

rather than create a succession of e-mails

Team 4 – Invoices

Team 5 – Student Claims

I wear many hats too !

• Study Needs Assessor for the DSA

• Keeping up to date with changes• SFE’s working practice• Access Regulations• Accessible technologies

• Team Leader for the Exeter Access Centre

• Monitoring the increase in queries• Follow-up with SFE • Supporting my team of assessors

• Specialist Teacher Diagnostic Assessor• Maintaining PATOSS accreditation

• Specialist Tutor• supporting students

• Fitness to Study meetings• supporting staff

• finding work-place solutions• supporting colleagues

• including team development

• Harassment Adviser Network

Leads to a continuous

awareness of needs

The process

Accurate and often EXTENTIVE

JUSTIFICATIONis essential

Assessor ‘best practice’

andkeeping up to date

with innovation

Matching technology accurately to the student’s needs

Describing the impact of disabilities

accurately- especially with

Co-morbidity

FIVE YEARS AGO

• 80% Dyslexia• 10% Other SpLD mixtures• 1% Autistic Spectrum• 9% Physical and complex mixtures

My current range of assessments

• 30% Dyslexia• 25% Other SpLD mixtures

– Mostly Dyslexia with Dyspraxic difficulties

• 10% Autistic Spectrum– Most often with ADHD or Dyspraxia

• 35% Physical and complex mixtures – 10% of these are Dyslexia and CFS/ME

Super-Specific SpLDsWorking Memory problems

Susan Gathercole and Tracy Packiam Alloway http://www.york.ac.uk/res/wml/SG.htm

NOT YET recognised for DSA

Needs to be described as

Specific Learning Difficulties with pronounced

Working Memory Deficit

C0-MORBIDITY

We understand the conditions individually

BUT• Do we consider the ‘overlap’ enough?

• How do we gain this experience / knowledge?

• How do we best explain this to DSA officers?

Creating a Venn Diagramoften adds to clarity

An unusual Co-morbidity

Dyslexia • Auditory short-term

memory• Slower speed of processing• Organisational difficulties• Slower reading ability• Slow writing speed• Need for extended

deadlines• 25% extra time in exams• Need for study support for

planning

Severe Haemophilia A• Needs to be aware of

vulnerability (particularly damage to legs)

• Sight weaknesses / eye strain / vulnerability

• Prone to spontaneous bleeding into his joints

• Time for Factor VIII infusions three times a week

• Coping with pain

Additional impact

• Time management• Heightened anxiety• Increased fatigue• Often unable to leave room• Less interaction with fellow students• Lower-self-esteem• Occasional bouts of depression

Do I need to prioritise one disability more than another to provide the best support?

SOMETIMES

However, it is essential that all the needs are fully covered in the NAR justifications for technologies – especially new technologies

Especially in negotiating the ‘tablet’ jungle!!

First attempt ...In conjunction with her iMAC, xxxx should have an iPad2 for when she has to remain

in bed due to fatigue. This will ensure that she can still read books in ‘pdf’ format, access her e-mails and lecture notes on-line. She will be able to synchronise time management tools such as Calendars and use the TextHelp App that is an add-on to her copy of TextHelp on her desktop computer. It will prevent her from being as far behind in her coursework and reduce her anxiety, thus aiding her concentration.

• As her typing skills are good she should have an iPad2 with a small fold-a-way keyboard to enable her to make notes and transfer these quickly to the compatible computer in her accommodation. This will save her time and energy as she will not need to type up hand-written notes or carry files, paper or books.

• Without an iPad2 and portable keyboard this student would be advised to have note-taker support. The cost of note-taker support for 10 hours of lectures a week for a minimum of 24 weeks would be £6,000 an academic year.

• Not only is the iPad2 more cost effective in this one situation, it also allows the student independence and has significantly more academic uses – as a diary and organizer, as an alternative to carrying books and paper, as a means of researching and essay writing on campus and as a means of studying when they need to rest in bed in their accommodation.

Take TWO !!As an assessor who evaluates the needs of many students with the combination of

Dyslexia and Chronic Fatigue /ME as a disability, I am concerned at the seeming lack of understanding regarding students with a SpLD and a serious physical disability. However, I appreciate that unless one is supporting students with co-morbidity (two or more disabilities) on a daily basis it is not always easy to understand just how disabling

Dyslexia complicated by Chronic Fatigue /ME might be.

Firstly, with Dyslexia alone, everyday tasks and study take significantlylonger to complete. With CFS/ME as well, the time available to workeffectively is limited by overwhelming fatigue. As I have suggested in thepast, it is not just a case of having a cup of tea and resuming work in 20minutes - it is essential that work it carefully organised around plannedrest periods to ensure maximum productivity. To over-ride this strategy andtry and work the same hours as other students would cause a build-up oftiredness that might prevent xxxx from working for two or three days.

there's more ... NOTETAKING

Part of affecting a strategy for xxxx is linked to note-taking. A digital recorder may be a proven strategy for many students but not all. To record lectures and listen again to full lectures and then type notes is a time-consuming and energy sapping strategy. xxxx does not have time or energy to spare - she also has the advantage of excellent typing skills. So it would be most effective for her to type notes in lectures. An iPad is the ideal tool - it is very light-weight, it has a long batterylife. xxxx has not got the stamina to return to her accommodation during the day if she has gaps between her lectures - she needs to work in a quiet place on campus - not always with access to an electrical socket. Then, when she does get home she can sleep and work again when recovered. The cost of an iPad is not a lot more than a good digital recorder bundle and Audio-notetaker as an editing tool. Furthermore, when the cost of training on how to use the recorder with audio-notetaker is added in, the combined cost is substantially more than an iPad.

and yet more ...Over a period of time ‘note-taking’ tools have progresses. First of all it was a small

tape recorder, then 'Dictaphones' with mini tapes, then mini-disc players with fiddly mini-discs to label - along-side these were PDAs for students who wanted to link notes to their computer; then came the digital recorder. The art of taking notes in lectures is evolving - we cannot ignore excellent technology that enables the more disabled students, especially if it is also cost-effective.

Digital recording is just one strategy and if it is not an appropriate strategy the student will soon abandon the equipment which is a total waste of funds. A full assessment should be tailored to the needs of the individual student. xxxx does not need to carry around a laptop – in fact she would be exhausted carrying around any laptop. She needs a very light-weight portable device that can give her note-taking support and internet access

Even a lightweight laptop (barring a MACbook Air) is more than twice the weight of an iPad. xxxx would also need to carry a bulky battery charger as no full laptop has the capacity to run for more than a few hours. xxxx could carry an iPad and the portable keyboard in a typical handbag. When she gets back home she can immediately connect her iPad and up-load her notes to her main computer while she sleeps or eats.

and finally !xxxx's fatigue gives her severe headaches and she needs a large screen for processing

her work. If she had a lightweight laptop - with standard ergonomic connectivity she would also need an external monitor to minimize eye strain, especially when reading pdf documents and when using Texthelp to proofread documents. This would add to the cost of her laptop equipment. xxxx's English course demands accurate proofreading - unlike a student on, for example, a politics course - one of the learning outcomes of all modules is accurate proofreading skills and well structured writing. For someone with Dyslexia and CFS this is a very time-consuming process; hence they need the most efficient and familiar integrated system to facilitate their studies.

I would suggest that even with this support xxxx's productivity levels will not be equal to her peers because her speed of processing is reduced by her Dyslexia and her need to take rest breaks - when a student has multiple disabilities their problems are compounded and the impact of a severe headache from looking at a small screen could prevent xxxx from working for a whole day. She does not have the physical resources to shrug-off a headache, it just becomes another hurdle - so prevention is better than cure.

An increasingly common combination

Dyslexia

CFS/ME

More vulnerable

An increasingly common combination

Dyslexia • Auditory short-term memory• Slower speed of processing• Organisational difficulties• Word reading efficiency• Word decoding efficiency• Slow writing speed• Slow oral reading speed• Poor phonological processing• Poor spelling • Need for study support

CFS / ME• Vulnerable to infection• Increased fatigue when

reading – headaches/migraine

• Compromised intellectual ability

• Reduced performance skills• Poor concentration• CONSTANT need for

extended deadlines (embarrassing)

Significantly more vulnerable• Heightened anxiety• Stresses over changes to schedule • Tendency to OCD• Often unable to leave room• Embarrassed that she has to refuse parties • Lower-self-esteem – doubts her place at University

• Doubts her ability (which is high-average)

• Occasional bouts of depression

Chuckie - a particularly needful combination

ASD /Aspergers

Dyspraxia

Life in the

overlap

A particularly needful combination- exceptional verbal abilities

ASD / Aspergers• His exceptional verbal abilities put

pressure on him to over-achieve• Dislikes being interrupted –

tendency to create a one-way dialogue

• Misjudges social cues• Need for advance warning of

changes to time-table• Finds touching difficult - has to

travel 1st Class on train• Need for study support for time

management and planning

Dyspraxia• Poor non-verbal reasoning• Poor directionality – sometimes

has sudden terror attacks if he has to go somewhere where he might get lost – even on campus

• Other poor spatial/motor skills• Poor sequencing of ideas• Poor spelling• Slow handwriting • Checks and rechecks all work

which is time consuming• 25% extra time in exams

Life in the overlapdescribed as ... “bright enough to attempt to change”

• Heightened anxiety• ASD specialist mentoring to remain calm -

becomes emotional under stress• Anger/Frustration management - may need to

leave the room without giving a reason• Dresses for emotional safety

(i.e. Always immaculate - wears a dark suit/shirt/tie – a barrier, reducing interaction with fellow students)

• Occasional bouts of depression• Increased fatigue to a state of exhaustion

Tommy A trio of demanding disabilities

High Functioning

Autism

SpLDPartial Sight (Blind in right eye)

Demanding Disabilities- has no desire to socialise / interact with the main student body

• Pre-entry orientation support – 6 planned visits (2 blocks of 3 visits during July/August) with an aim to improve confidence

• High anxiety about being attacked (cannot see people approaching on his right side) – has a buddy / note-taker with him most of the ‘working’ day

• ASD specialist mentoring with study skills – needs to be delivered by the same person as he cannot cope with too many support people (this person also take notes if note-taker is sick)

• Super-sensor – hypersensitive to being touched so cannot travel on public transport alone – has a taxi to University; cannot listen to the sound of his own voice – has to have all digitally recorded ideas transcribed

• Few emotional responses – finds it hard to work in groups - often dismissive of his support worker – no ‘chatting’ – walks ahead etc

• Occasional depression / self-harming• Very high levels of fatigue leading to feelings

of despair – emotional outbursts at home (he lives with his mother who is retired – she occasionally requests advice)

AngelicaPanics at imperfections

ASD / Aspergers• Good verbal abilities mask high

levels of social anxiety – often talks too much

• Always talks about actual facts – her course – her volunteering interests – never herself

• Misjudges social cues – very trusting of others

• Need for advance warning of changes to time-table

• Her comments are often too honest for the girls she lives with

SpLD• Needs study support for time

management and planning work• Limits her writing to what she

can spell – hence her work reads as if it is written by a much younger person

• Becomes sleepy after reading for 20 mins – needs to improve her reading strategies

• Has to complete work in advance of deadlines so she can proofread thoroughly

• Problems with statistics – always worried about dealing with numbers in general but will ask for help from tutors

The perfectionist• Worries herself to a state of emotional exhaustion • ASD specialist mentoring to help her focus – has experienced a

very emotional transition to University• Easily frustrated by her perceived short-falls – needed study

support to endorse her own ‘good practise’ and suggest new planning methods – help her Mathematical confidence

• Getting the right balance between academic work and her organised social commitment – does not socialise as such but believes in ‘social involvement’, so can get overloaded by valid committee work and volunteering

• When over-tired she becomes increasingly anxious about elements of her course – such as practical lab tests that go wrong or not understanding statistics perfectly

• Life skills – the length of time it takes her to use the washing machine, go shopping and cook meals often take a higher drain on her time and emotional energy than her academic work

Assessor best practice – personal level Sharing specialist

knowledge

Good communication with SFE/DSA team

Inviting suppliers to give personal training

Understanding your own learning style

• with Colleagues• with SFE

• Making the most of the Response Team

• 4-6 training sessions• Product knowledge• Improving products• On going CPD

• On-line test

VARK How do I learn best?

http://www.vark-learn.com/english/page.asp?p=questionnaire

VISUAL AURAL

READ/WRITEKINESTHETIC

Do you prefer a teacher or a presenter who uses:• question and answer, talk, group discussion, or guest speakers• demonstrations, models or practical sessions• handouts, books, or readings• diagrams, charts or graphs

• You are not sure whether a word should be spelled `dependent' or `dependant'. You would:

• find it in a dictionary• write both words on paper and choose one• think about how each word sounds and choose one• see the words in your mind and choose by the way they look

Some sample questions ...

MY RESULTSMy scores were:

• Visual: 9 • Aural: 6 • Read/Write: 6 • Kinesthetic: 8

Multimodal

Assessor best practice – with students

Explain – this is not a TEST !

Listen carefully to HOW the student explains an issue

Carefully explain the process of what happens once the interview is over

• Students relax and tell you more

• Can often pick up another concern, even another disability

• Process help-sheet

DSA Application Process

RECEIVE A LETTER FROM SFEThis will tell you what support SFE has agreed to, from the report. SFE will indicate their

preferred quotation. If you need help with ordering equipment, contact the DRC.

STUDY NEEDS ASSESSMENTThis is a discussion with an assessor with knowledge of your disability and the support

needed for your course. The assessor will write a report and send a copy to you.

RECEIVE A LETTER FROM SFE/ BOOK ASSESSMENTIf eligible for DSA – book a Study Needs Assessment with the assessment centre

named in the SFE letter or your nearest centre. They will need copies of all the evidence sent to SFE and may send you a pre-assessment questionnaire.

RECEIVE ASSESSMENT REPORTMake sure you send back, signed, any forms you receive with your report.

If you don’t, SFE may not receive a copy of your report and support will be delayed.

APPLY FOR DSADownload the DSA forms online or obtain paperwork from Student Finance England (SFE).

Send form to SFE with medical evidence and /or a copy of an Educational Psychologist’s report.

RECEIVE RECOMMENDED EQUIPMENT AND SUPPORT Contact the DRC Disability Adviser –

to help ensure DSA recommendations are put into place.

TOP TIPS

• Learning from students - they know a lot about their own difficulties, which is particularly useful if it is something unusual

• Observe the student’s body language – it can give you clues to what might be appropriate support– This is also why I think all students should be interviewed

face-to-face

• More pro-active students often have brilliant solutions that are not expensive and are not on equipment lists

Potential challenges

• Finding out about the facilities available at a specific University during vacations

• Considering what are ‘reasonable’ adjustments

• Convincing the ‘independent thinking’ student that they need more support than they consider essential

Process frustrations

• E-mailing SFE and just getting a computer generated reply

• Indicating a ‘preferred quote’ with well-reasoned evidence to support the choice and having it ignored by SFE

• Not always knowing which quote has been chosen

BIGGEST FRUSTRATIONHaving e-mail replies returned to the bottom of ‘the pile’ rather than being dealt with immediately by the person who contacted you with a query!

Final thoughts on DSA recommendations !

Assessors are sometimes understandably reluctant to suggest new solutions but should persevere.

- Particularly with regard to human support

- New technologies

- Travel alternatives

Conclusions

• Every disabled student deserves a well-reasoned objective assessment

• Theoretically It is the professional (impartial) balance achieved between the assessor and SFE that makes this a fair but arguably too lengthy system

Recommended Reading

That’s the Way I Think – David Grant – Routledge Dyslexia, dyspraxia and ADHD explained - ISBN 978-0-415-56464-9

The Passionate Mind – Wendy Lawson – JKP How People with Autism Learn - ISBN 978-1-84905-121-7

Aspergirls – Rudy Simone - JKP Empowering Females with Asperger Syndrome - ISBN 978-1-84905-826-1

Contact InformationLIZZIE SHERWOOD

Disability Advicee.m.e.sherwood@exeter.ac.uk

Specialist Teacher Diagnostic Assessmentslizziesherwood@yahoo.co.uk