Support and Inclusion of students with disabilities at higher
education institutions in Montenegro
Support and Inclusion of students with
disabilities at
Higher Education
Institutions in Montenegro
WP 3
Definition of support services
for students with disabilities at HEIs
DEV 3.1
Analysis of needs and identification of support services (report)
Final Report
Prepared by:
Agnieszka Bysko (UW) a.bysko@uw.edu.pl,
Anna Szymańska (UW) anna.szymanska@uw.edu.pl,
Paweł Wdówik(UW) pawel.wdowik@uw.edu.pl,
Donata Kończyk (UW) donata.konczyk@uw.edu.pl,
Natasa Mauko (DSIS),
Ioannis Agaliotis (UOM) iagal@uom.gr,
Konstantinos Papadopoulos (UOM) kpapado@uom.gr,
Maria Platsidou (UOM) platsidou@uom.edu.gr,
Lefkothea Kartasidou (UOM) lefka@uom.edu.gr
Date 07.09.2012
This project has been funded with support from the European Commission. This publication
reflects the views only of the author, and the Commission cannot be held responsible for any use
which may be made of the information contained therein.
Tempus Project 516758-TEMPUS-1-2011-1-GR-TEMPUS-JPGR
Support and Inclusion of students with disabilities at higher
education institutions in Montenegro
CONTENTS
1.
Introduction ....................................................................................................................... 3
2.
Higher education students with physical disability or / and orthopedic impairment ....... 4
3.
Higher education students with visual impairment / disability ........................................ 7
4.
Higher education students with hearing impairments .................................................... 11
5.
Higher education students with psychological and psychiatric disorders ....................... 14
6.
Higher education students with specific learning disability ............................................ 17
7.
Higher education students with long-term health conditions ........................................ 19
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1. Introduction
The main goal of this report is to characterize the main disabilities occurring at
European higher education institutions. Besides giving the basic knowledge
concerning each disability, it describes the academic and non-academic
consequences of each disability. Understanding the needs resulting from disabilities
is crucial to building up the system of support within the higher education institution,
that is why this report is meant to be the first step before the next one which will be
the manual specifically describing and recommending the academic services.
These two parts together e.g. report (dev. 3.1) and manual (dev. 3.2) – will finally
create the comprehensive document allowing to understand the specific aspects and
consequences of each disability, and also to create the appropriate services relevant
to successful and independent university studies.
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2. Higher education students with physical disability or / and
orthopedic impairment
The term “mobility impairments” refers to a broad range of disabilities that may have
very different causes. Some students are born with mobility impairments/ physical
disability/ orthopedic impairment, while other can be caused by illness, injury or
accident. It may be any condition that affects the ability to move, from lack of
coordination in a particular group of muscle fibers to complete paralysis. Some
students may also experience non-visible disabilities like epilepsy, respiratory
disorders etc.
It is necessary to remember how many daily activities are dependent on proper
functioning of groups of muscles, those smaller and bigger, located all over the body.
Some health condition result in striated muscle (skeletal, cardiac muscles)
impairment, some of them affect smooth muscle tissues that determine functioning
of vital internal organs and structures such as blood and lymphatic vessels, urinary
bladder, uterus, gastrointestinal tract, respiratory tract, muscles that control
accommodations and movements of the iris. All of these structures can be affected
in case of motor disability. “Classic” mobility problems are quite often accompanied
by those less apparent difficulties that result from smooth muscle control deficits.
2.1 Commonly met non-academic consequences of mobility impairments:

social perception of mobility impairment as a prototype of “unhappiness” and
“life disaster”,

being perceived as if disability, which is in most cases apparent, was a core
personality element and the most influential determinant of behavior, needs
and life choices of a person with disability,

consequences in social interactions, eg. being forced to get help, having one’s
personal space violated, not being asked what kind of need is really required
and accepted in a particular situation,

meeting architectural barriers,

muscle spasticity or low muscle tone; difficulties with the tasks that require
precise movements and/or physical strength (reaching objects, holding,
grasping, manipulating them, pointing),

difficulties with eye-movements eg. with intentional directing eyes toward
objects, with maintaining eye-contact during conversations,
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
intensive tiredness; much more energy require to complete daily tasks, to
move, to change position, to keep balance, to make movements precise
enough,

difficulties in changing one’s position, broader range of possible positions that
enable completing everyday tasks; difficulties with staying in an unchanged
sitting position for a longer time,

thermo-regulatory problems caused by bad circulation,

respiratory problems,

gastroenterological problems,

coexistence of speech problems (frequently met),

coexistence of epilepsy,

balance problems,

dependency on others in some areas of everyday activities (some students
are able to take care of themselves on their own, others need a little support
of another person while some need full support of another person),

inability to carry heavy and bulky things,

suffering from pain and sometimes sleep disturbances caused by experiencing
it,

inability to attend some of inaccessible public places,

inability to control some range of movements what might be perceived as
eccentric behavior,

great amount of time has to be spent on rehabilitation,

possible post-injured psychological symptoms,

limited chance for utilization of many commonly used daily stress relievers limited access to sport and recreation facilities,

being more predisposed to develop other somatic conditions based on
specific body functioning eg. limited movements.
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2.2 Commonly met academic consequences of mobility impairments:

limited chances for an independent exploration of the environment and, in
case
of possible poor hand-eye coordination, more difficulties in processing details
of objects that are held,

lack of manual precision – difficulties with manipulating objects, poor
handwriting and/or lower typing and keyboard skills,

necessity to use additional breaks during classes because of greater effort
taken to complete tasks and/or because of the results of coexistent somatic
(eg. urinary or gastric) problems,

in case of speech problems - problems to pass oral exams without any
communication support,

stronger dependency on transport facilities, sometimes additional absences
caused eg. by bad weather conditions,

inaccessibility of lecture halls, desks, laboratory facilities, accessories, tools they are often designed in a way that violates the principle of low physical
effort required,

sometimes inaccessible of standard paper instructional materials and books
because of inability to turn pages manually and/or directing gaze,

inaccessibility of many fieldworks, eg. geological or archeological ones.
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3. Higher education students with visual impairment / disability
Visual impairment refers to different conditions, from partial-sightedness,
overlapping the situations of people with a severe near- or far-sightedness and those
with a selective gaps in peripheral field of vision, to legally acknowledged blindness.
To determine what does a visual disability mean in each particular students' situation
it is necessary to take under account three factors: visual acuity, a range of field of
vision and every other somatic functional condition that influences the abilities to
receive and process visual stimuli properly. For example a student with standard
visual acuity and normal field of vision can be functionally recognized as severely
visually disabled because of the lack of proper eye-movements that are necessary
condition for visual recognition of an object. This multidimensionality and complexity
of every individual student's situation result sometimes in misunderstanding in
academic interactions. Good illustration of how it may happen can be the situation of
a student who is suspected for abusing an academic support system because of his
very nice handwriting and the use of standard 12-point font – features that cannot be
easily associated with visual impairments. In fact he has serious problems with fluent
fast reading because of severely narrowed field of vision which however do not
excludes reading printed materials. Partially sighted student is sometimes viewed by
faculty member and classmates as “faking it”. Faculty and staff members may have
difficulty believing that partially sighted students need access to printed material
because most of these students do not use white canes for travel and are able to get
around like everyone else. Also, depending on the nature of the vision loss, these
students may not be able to read other people’s visual cues and spatial descriptions,
so they sometimes appear disengaged from social interactions or disoriented.
By the time legally or totally blind students reach tertiary education (unless they are
newly blind), they have probably mastered techniques for dealing with certain kinds
of visual materials. Most blind students use a combination of methods, including
readers, audio books, recorded lectures and, sometimes, Braille materials.
Orientation in strategies used so far by a student is crucial to determine proper
accommodations. Partially sighted and low vision students meet the challenge of
gaining access to printed information in much the same way as blind students except
for using Braille. They use texts in audio format, readers, raised line drawings, talking
terminals, enlarging software and other tools. In addition, they use large print
materials, magnifying devices (among those devices that enable magnifying the
content from the board placed in a distance, based on camera) or lenses.
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3.1 Non-academic obstacles:

similarly as in case of motor disability social perception of visual impairment
set some additional barriers; a person may be perceived as if disability, which
is in most cases apparent, was his or her core personality element and the
most influential determinant of behavior, needs and life choices,

consequences in social interactions, eg. being often forced to get help, being
directed without a request or permission, having one’s personal space
violated, not being asked what kind of need is really required and accepted in
a particular situation; being treated in overprotective way or being avoided
because of people’s sense of incompetence in a contact with a blind person;
difficulties in turn-taking during conversation because it requires following
visual signals; limited abilities to acknowledge the discrepancy between
verbal and non-verbal communicates eg. to receive from a person listening
the signals of being inattentive or frustrated, limited opportunities to initiate
interactions (there is no chance to notice someone who is in a distance and to
focus his/her attention or to see familiar faces in crowd at the party),

common circadian rhythm deregulation because of a lack of stimulation of
light sensitive cell of retina; a person may have an adverse pattern of activity
– may feel drowsy during a day and be able to work more effectively at night;
sometimes
a necessity to utilize personal strategies of staying awakened and attentive,

difficulty to imagine especially huge or far distant objects (eg. complex curved
front of a building) that are impossible or very difficult to be experienced via
other senses, being dependent on simplified raised-line drawings provision or
someone else’s description of those objects; difficulties to understand some
spatial relations,

visual concepts and characteristics conceptualized in a different way in
compared to people with no visual disabilities (those concepts are developed
through an analogy to sensations other than those visual; a person may used
visual notions properly in a context of communication while still having
troubles to fully understand some meanings),

spatial orientation difficulties, assistance need to get to know new
environment and new routes (the need of a spatial orientation and mobility
training),
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
few terminals and commonly used city systems equipped in speech-synthesis
facilities esp. guidance systems with voice-output,

difficulties with following administrative procedure still partly based on
printed application forms and necessity of handwritten signature,

serious barriers in access to works of art,

difficulties in daily living activities, esp. in a new and changing environment
like
a dormitory room with no stable arrangement of objects and accessories,

obstacles to freely develop one’s one image (to match colors, to choose one’s
own fashion style),

psychological problems (eg. weaker sense of self-efficacy) esp. in a situation
of vision loss; being a part of a culture that is highly visual (there are tons of
visual messages received every day ) makes the adaptation process more
difficult.
3.2 Academic obstacles:

longer time to read irrespectively of a method used (with Braille technic
being the longest – it takes longer time to find a clues in the text because of
linear searching method),

inability to read printed materials or to use them in their standard form;
serious barriers are set by a low quality copied instructional materials often
provided for students,

inability to utilize visual cues given in a standard way during classes and
assessments; being unable to locate objects on the base of instructions such
as “As we can see here…”, “Please look there…”, “Those statistics printed in
red…”, “Classes canceled today” (a paper note fixed to the door of a lecture
hall),

inability to acquire new knowledge that is provided fully in a graphic form
with no additional textual description, eg. graphs, diagrams, models,

barriers in using notes made on a classic blackboard,

obstacles to interpret commonly
audiodescription of visual content,
used
video
materials
with
no
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
difficulties in interpreting non-verbal cues during sharing information eg. to
take turns fluently during a group discussion,

inaccessible web-pages (eg. flash web-pages, important web-content and
tools defined by visual elements, unclear content structure that makes
navigation extremely difficult),

longer time to reach all the texts required in an accessible format, longer time
of preparation to exam period.
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4. Higher education students with hearing impairments
Members of an administration and academic staff who work with students with
hearing disabilities should be prepared to answer extreme diversity of difficulties,
strengths and attitudes toward a student's own way of communication. Among
students from this group are:

hard-of-hearing students using mainly auditory channel of receiving
information and oral way of communication and strongly dependent on their
remained abilities to hear with a wide range of oral language competencies,
from very proficient language user to very poor one,

hard of hearing student mainly dependent on lip-reading with a wide possible
range of language competencies (as above mentioned),

deaf students strongly dependent on lip-reading, quite often with
comprehension skills and communication fluency affected,

deaf students who are users of natural sign languages and often do not
consider themselves as students with disabilities but representatives of
particular culture based on separate language. This culture has its own
manifestations eg. visually coded poetry. It is based not only on the specific
language but also on stronger sensitivity to visual and tactual information of
people who cultivate it. Quite often they acquire sign language in home
environment and their oral languages' knowledge is developed a bit later on
the basis of visual-spatial language system – the natural mean of early
communication of the group members. They might be professional, selfconfident communicators (with different level of speech competencies). They
use lip-reading as an assistive tool of communication. Support of signlanguage interpreter is crucial for them to participate in classes actively. the
lack of signs for professional terminology may be a problem of SL user during
his/her studies,

students during the rehabilitation period after receiving cochlear implant who
are able to perceive new sounds but have to learn what the particular
streams of sounds mean; they experience the problem of being neither a
member of deaf community nor those who acquire their knowledge of oral
language in a natural way,

students with difficult level of efficiency of alternative, compensatory
communication strategies – either deaf or hard-of-hearing.
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4.1 Examples of commonly met non-academic consequences of students'
hearing impairment:

sense of loneliness, a sense of being odd caused by daily communication
barriers, sometimes lack of fully efficient communication strategies also with
the hearing family members (eg. to describe less practical, more existential
issues),

lack of support, hearing disability is perceived as less negatively influential on
development and everyday functioning in a majority context than for example
visual disabilities what in most cases is far from being true,

identity problems – consequences experienced mostly by deaf student who
do not know sign language and whose education was based basically on oral
techniques with the main goal to learn them speak fluently; some of them do
not perceive themselves as confident speakers as well as do not know any
alternative means of communication – they feel neither a part of deaf
community nor the part of the community of hearing majority,

being strongly relied on other’s knowledge of strategies that support
communication with people with hearing disabilities (keeping eye-contact,
speaking not too fast with no excessive changes compared to everyday
articulation, eliminate background noises, using repetition and paraphrasing
to clearly set the context of what is meant, keeping face and mouth steadily
visible, using visual aids to illustrate the content of the conversation),

safety and organizational issues – necessity of greater vigilance – many public
and on-campus systems, customs and procedures are based on oral/sound
information delivery (eg. public transport, administration staff being
unresponsive to the need of using supportive means of communication;
custom of calling someone if the case is urgent),

being perceived as a person with disability while perceiving oneself as a deaf
minority member.
4.2 Possible academic problem areas connected with hearing disabilities:

speech fluency,

following oral instructions and lectures,

taking notes during lectures,

completing other simultaneous tasks if one of those requires following-oral
instruction (dependency on being face-to-face with the speaker),
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
following the discussions that are not well moderated (people talk at the
same time, no clear turn taking, tables set in a way that makes it difficult to
see each other during the discussion),

longer time to complete written assignments – it is necessary to look up a
new dictionary and to control the style of the text; it is important to
remember that users of sign languages are much more accustomed to nonlinear, visual-spatial and simultaneous structure of phrases, very different
from the one oral language users know,

access to few audio or audiovisual materials provided with captions or the
text enclosed.
What is useful in order to understand the position of students with hearing
disabilities is comparing their situation to the one of students who are foreigners.
Those positions are very similar because most students with hearing difficulties also
did not follow the standard pattern of acquisition of oral language that is used by
local majority. They could be less proficient in understanding the particular concepts
rooted in language of hearing majority and their way of perceiving the world. Their
naturally acquired tools of communication are visual and spatial cues that is why deaf
and hard-of-hearing students can take great benefits from using a lot of visual
materials to illustrate the content.
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5.
Higher education students with psychological and psychiatric
disorders
To provide academic accommodations that would fit best it is especially useful to
switch from the diagnostic discourse towards thinking about functional outcomes of
a particular psychological/psychiatric problems. What makes this approach
particularly useful is the fact that every individual student's condition is a stream of
different symptoms from different diagnostic areas changing in time rather than a
static figure suggested by descriptions in diagnostic manuals. For example a student
who suffers from schizophrenia may need no support on the basis of psychotic
symptoms such as hearing voices or being overwhelmed by fear and disoriented,
features typically associated with this diagnosis, because of the good results of
treatment and the absence of such symptoms. Instead of it he or she may take great
advantage from the support designed for students with symptoms of depression
while being in the phase of adapting to the new diagnosis and social environment's
reactions to it. A student with no psychiatric diagnosis but with serious transition
problems or after a traumatic experience could need some support originally
designed for students that suffer from psychotic problems. A main problem of a
student with Asperger Syndrome can be the frequency of experiencing very intense
anxiety episodes as a response to very unstable physical and social environment,
followed by depressive reactions, what makes his or her situation very similar to the
situation of a student with anxiety-depressive disorder. The core element of many
conditions is complexity and liability of symptoms and their quick changes in time.
That is why all of accommodations should be provided on the basis of regular
medical functional assessment and regular educational counseling. This kind of
assessment let us drift off the labeling tendency and makes us more responsive to
current changes is students' needs.
5.1 Examples of commonly met non-academic consequences of students'
psychological/ psychiatric problems:

sleep pattern disturbances,

change in appetite, weight and/or one's typical level of caring for one's own
image,

extensive tiredness,

agitation,

fear, from less intensive and persistent to very intensive episodes of it,
causing dramatic 'fight or flight' reactions,
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
inability to undertake daily responsibilities and roles because of energy,
motivation and/or cognitive functions negative changes; among those last:
difficulties with focusing attention, comprehension difficulties caused by
problems with integration of information, overwhelming self-centered or
anxiety provoking thoughts, eg. those about perceived diminished intellectual
efficiency, troubles with information retrieval, thinking concentrated on ritual,
repetitive pattern of activities (aimed at interfering with anxiety-provoking
thoughts) which grasp great deal of one's cognitive resources, problems with
decision-making,

change in the individual typical level of socializing eg. social withdrawal or
intensive socializing sometimes accompanied by extensive substance use and
risk-taking,

avoidance of situations that involve interactions and cooperation,

difficulties with perceiving and integrating social cues to properly interpret
people's intentions,

oversensitivity or diminished sensitivity to some stimuli,

anhedonia and the loss of interest in activities that were once considered
pleasurable,

being more susceptible to somatic problems, injuries and accidents,
sometimes higher vigilance to sensations coming from inside of the body and
the tendency to perceive them as dangerous (as well as some external
signals),

eccentric speech pattern eg, over-talkativeness or use of unusual word
associations,

lower threshold for reacting to daily hassles with intense tension, anxiety,
anger, irritation, lack of sense of safety and disorganized behavior,

preoccupation with details of a traumatic event that triggered
psychological/psychiatric problems, re-experiencing the event in the
nightmares and during daydreaming,

lack of sense of belonging to the nearest social environment, felling of being
odd,

experiencing depersonalization and/or derealization – well known
environment and one's own identity starts not being perceived as something
known and safe,
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
repeated feeling of guilt, embarrassment, being humiliated , sense of selfworthlessness,

altered one's body-image,

fatigue, trembling, muscle tension, headaches, nausea etc. as a results of
condition itself or treatment,

diminished immune function and poor illness recovery.
5.2 Possible academic consequences of mental health difficulties:

missing classes,

fear of public speaking,

fear of authority figures,

troubles with keeping standard deadlines,

vulnerability to negative effects of improperly delivered feedback (eg. too
global, very judgmental),

difficulties with common requirements of work in cooperation with peers,

sensitivity to distraction during completing tasks,

longer time to manage emotions triggered by exams, resulting in longer time
to complete tests,

stronger dependency on regular feedback on academic progress; difficulties in
self-motivating and avoidance of facing academic challenges on time
(motivation to avoid facing the task for as long as it is possible to prolong the
phase before the evaluation to protect self-esteem); problems with setting
priorities,

stronger dependency on the level of predictability of academic environment,
esp. information on schedules and requirements given, because of the
unpredictability of changes in health state that interfere with planning and
completing the tasks.
What is often an additional challenge that can influence students' psychological wellbeing is an influence of past traumatic experience, other socio-cultural background,
belonging to a minority or the status of a first generation student. All of this factors
can make it even more difficult to adapt during the transition to university.
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6. Higher education students with specific learning disability
SLD means a condition of neurological origin, adversely affecting the capability of an
individual to process specific kinds of information (mainly symbolic). One or more
processes involved in processing information, including written or spoken language,
are affected. Among those affected aspects of information processing may be:
auditory perception, detection and manipulation of sounds units such as phonemes,
syllables, words, detecting correspondence or discrepancy between the sign and the
sound (consequently between stream of sounds and the hole meaning), processing
time intervals within stream of stimuli, put information units in order, discriminating
between competing sounds, memorizing sequences of information, comparing new
information with those previously stored in long-term memory, retrieving already
stored information, constructing answers and solving problems under time pressure,
prioritizing incoming information and structuring them, comprehension difficulties
based on the efficiency of the above mentioned processes. All of those processes are
tools to perform higher lever mental tasks. The condition manifests itself fully in
cases of severe incompatibility between the individual’s learning preferences and the
way instruction is organized and implemented.
Specific learning difficulties mean significant difficulties in coping with the demands
of one or more of the traditional academic domains (Reading, Writing, and
Mathematics) often accompanied by problems in social skills and strategy learning,
and occasionally by shortcomings in attention focusing, fine motor coordination, and
organizational skills.
6.1 Examples of commonly met non-academic consequences of specific
learning difficulties:

difficulties with time management and organizing the process of completing
tasks,

high dependence on the quality of feedback given – it should not be too
global and imprecise, strengths should be emphasized,

obstacles to fully utilize personal strengths in everyday activities – many of
everyday situations are designed in a way that is based on standard abilities in
reading, writing or number processing,

difficulties with getting a proper diagnosis of learning difficulties as an adult,
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
psychological difficulties, diminished sense of self-efficacy based on repeated
failure to keep standard educational expectations.
6.2 Examples of commonly met academic consequences of specific learning
difficulties:

being more susceptible to distraction, difficulties with focusing attention,
prioritizing information, differentiate signals (information to be remembered)
from the background,

lack of fluency in determining the right link between the sign (symbolic
representation) and that what the sign represents,

difficulties with working under time pressure and under working memory
overload eg. when the material or a lecture is not well-organized and it is to
be processed in a very short time and esp. in the presence of source of
distraction,

difficulties with extraction of most important information and with taking
notes,

troubles with structuring the content eg. with writing assignments,

comprehension problems,

barriers in reading aloud,

dealing with the demands of daily academic life (eg. keeping deadlines,
following rules, using the library, finding classrooms, formulate one's own
schedule to complete long-term task and formulating appropriate questions
to clarify misconceptions),

spontaneously developing learning strategies and using them in the
appropriate conditions.
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7. Higher education students with long-term health conditions
Long-term health conditions commonly met in the academic environment among
students who apply for accommodations (based on UW experiences):

neurological problems eg. SM, epilepsy, conditions caused by injuries,
pharmacologically induced neurological symptoms,

immunological, rheumatologic and endocrinological diseases eg.
hypothyroidism strongly connected with probability of experiencing low
mood episodes,

respiratory problems,

allergies eg. food allergies,

skin diseases,

gastrological problems,

urinary system problems,

stress-related functional somatic symptoms.
7.1 Examples of commonly met non-academic consequences of students'
long-term health conditions:

tiredness,

pain,

sleep disturbances,

thermo-regulatory difficulties,

distorted sense of self-efficacy and personal control in different areas
(physiological processes, aim-oriented activities, choice of career, maintaining
relationships, perceiving one's own physical and social attractiveness),

negative body-image concerns,

time and the way of completing tasks determined by dynamics of changing
symptoms,

hospitalization periods - interruption in normal way of functioning,

physiological and sensory disruption,
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Support and Inclusion of students with disabilities at higher
education institutions in Montenegro

difficulties with communicating needs of support while meeting one's own
need of privacy and confidentiality - consequences of invisibility of health
problems and their dynamically changing outcomes.
7.2 Possible academic consequences of health condition:

time and way of completing tasks determined by dynamics of changing
symptoms - remission time and exam period often do not overlap,

missing classes,

inability to keep up with standard deadlines and standard schedule of exam
period,

inability to proceed with long tasks without additional breaks,

inability to attend classes because of immune deficiency eg. after treatment,

problems with working in teams and being interdependent in completing the
tasks because of having difficulties with meeting standard deadlines,

the necessity of using leave permissions and changing group of mates,

problems in concentration resulting in difficulties in note taking,

conflict between time of classes and time of medical appointments.
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