Use of Simulated Discussions of Postsecondary Accommodations to Inform Self-Advocacy Instruction

Abstract

Researchers increasingly recognize the importance of high school students with disabilities being prepared to advocate for postsecondary academic accommodations. The purpose of this study was to inform how self-advocacy instruction can reflect the authentic context in which postsecondary students with learning disabilities (LD) and with attention deficit-hyperactivity disorder (ADHD) advocate for accommodations. Postsecondary undergraduate students with LD and with ADHD engaged in a video-recorded simulated meeting to discuss accommodations with a standardized (actor-portrayed) professor. A qualitative analysis of the meetings and postsimulation interviews was conducted. Findings demonstrate how students with LD and students with ADHD discuss accommodations with a professor, including their tendency to be hesitant to assert their preferences and needs for accommodations. Data from postsimulation interviews also suggest that participating in and reflecting upon the simulated interview facilitated students to assess their self-advocacy and identify changes they would make in future conversations about accommodations. Implications for research and practice in self-advocacy instruction are discussed.

Keywords

self-advocacy accommodations postsecondary education learning disabilities attention deficit-hyperactivity disorder

Introduction

Legal protections and increased access to a general education curriculum in high school have contributed to increased enrollment in postsecondary education for students with disabilities in the United States (Rojewski et al., 2015). Along with mental health-related disabilities, the most prevalent disability categories in postsecondary education are students with learning disabilities (LD) and students with attention deficit hyperactivity disorder (ADHD): 2%–4% and 4%–8%, respectively. Further, approximately 60% of postsecondary students who have ADHD also report having another diagnosis, such as LD or a mental health disorder (Evans et al., 2017).

Postsecondary education presents a challenging environment for many students, including an increased expectation of independence and academic skills. Students with LD and students with ADHD, especially, experience difficulties and negative outcomes relative to their nondisabled peers in postsecondary education. Specifically, students with LD report more difficulty completing assignments (McGregor et al., 2016) and are less likely to graduate than students without LD (Newman et al., 2019). Students with ADHD also have lower rates of graduation (Hechtman et al., 2016), as well as lower grade point averages than postsecondary students without ADHD (DuPaul et al., 2021). For students with ADHD, decreased academic performance and graduation rates may be attributed to difficulties with executive functioning and elevated rates of depressive symptoms, both of which are common among this group of postsecondary students (DuPaul et al., 2021).

Fortunately, there are ways to support students in achieving more positive outcomes. One such major factor is access to disability-related accommodations. Accommodations include adjustments to tasks, processes, or the environment that are intended to provide students with disabilities equal opportunities to participate in academic programs (Keenan et al., 2019). Students with LD who receive accommodations report increased contact with faculty and less difficulty completing course assignments (McGregor et al., 2016). Further, students with LD, including those with a comorbid ADHD diagnosis who use disability-related accommodations, are more likely to persist and graduate at 2- and 4-year postsecondary institutions (Newman et al., 2019). With regard to accommodations used by students with LD and with ADHD, Kim and Lee (2016) found that the use of accommodations was correlated with higher GPA, with testing accommodations having the most impact. Moreover, earlier access to and longer use of accommodations are associated with increased cumulative GPA and earlier graduation (Blasey et al., 2022).

However, many students with disabilities do not access disability-related accommodations. McGregor and colleagues (2016) found that only 33% percent of students who reported having LD were receiving accommodations once enrolled in postsecondary education. Newman and colleagues (2019) noted that students with LD, including those with a comorbid ADHD diagnosis, are more likely to use supports that are available to all students (e.g., tutoring) than using disability-related accommodations.

Explanations for why postsecondary students do not access accommodations include increased responsibility in the process of requesting accommodations compared to high school. That is, to receive services, students must register with their college or university and provide documentation of a disability that demonstrates a substantial limitation that affects their learning (Keenan et al., 2019). Postsecondary students are also commonly expected to communicate with professors about how given accommodations apply to a particular course.

Disclosing eligibility for accommodations to individual professors is a significant deterrent to students utilizing accommodations in courses. For example, in interviews with postsecondary students with disabilities, Lyman and colleagues (2016) found that negative interactions with professors, the desire not to be treated differently than others, and fear of becoming a burden, contributed to students’ reluctance to disclose their disability to professors. Similarly, postsecondary students with LD in Denhart's (2008) study expressed reluctance to request accommodations because of a fear of how they would be perceived by professors.

The need for students to disclose their disabilities and communicate with postsecondary staff and faculty about accommodations underscores the importance of self-advocacy in the transition from high school to postsecondary education (Keenan et al., 2019). “Self-advocacy” refers to the tendency to recognize and communicate an individual's needs and rights (Holzberg et al., 2019). Test and colleagues (2005) proposed four components of self-advocacy, including knowledge of self (e.g., strengths, needs), knowledge of rights (e.g., resources, legal protections), communication (e.g., assertiveness, persuasion), and leadership (e.g., organizational participation, political action). Students who demonstrate characteristics of self-advocacy are more likely to achieve academic success in postsecondary education (Fleming et al., 2017).

Researchers have investigated the use of instructional interventions aimed at developing self-advocacy skills that can support access to postsecondary accommodations. Specifically, studies have investigated the impact of a self-advocacy and conflict resolution (SACR) instruction on the ability of high school students (Holzberg et al., 2019; Lopez et al., 2020) and college students (Walker & Test, 2011) with LD and/or ADHD to request academic accommodations during role-plays.

SACR instruction uses scripted lessons to teach students self-advocacy and conflict-resolution behaviors. Holzberg and colleagues’ (2019) multilesson intervention included target behaviors for the students to apply when discussing accommodations in role-play meetings with a professor. The students were taught to (a) begin the conversation with the statement “I want to talk to you about my accommodations from ODS [the Office of Disability Services]” (self-advocacy) and (b) use the statement “I understand you have some concerns about this accommodation. May I ask what bothers you?” (conflict resolution) if the professor expressed discomfort about an accommodation (Holzberg et al., 2019, p. 169).

In Lopez and colleagues’ (2020) study, participants role-played the steps of requesting accommodations in a series of video-recorded sessions that scaffolded skills from SACR instruction. After each session, participants viewed the recording and wrote a reflection on their behavior. Participants were subsequently asked to generalize the skills by contacting their teachers to arrange a meeting to discuss accommodations. These studies have found a functional relationship between SACR instruction and the ability of students with LD and/or ADHD to request accommodations, either with a high school teacher (Lopez et al., 2020) or a college professor (Holzberg et al., 2019; Walker & Test, 2011)

Given the evidence that students with LD and students with ADHD underutilize accommodations that could support positive outcomes, it is important to understand how these groups of students can be better prepared to access accommodations in postsecondary education. The purpose of the present study was to work backward to inform instruction to prepare high school students to advocate for accommodations by examining how current postsecondary students with LD and students with ADHD discuss accommodations with professors. As Trainor and colleagues (2020) argued, improving efforts to teach high school students with disabilities discrete skills must account for the cultural factors they will face when enacting these skills in their lives after high school. Examining how students actually advocate for academic accommodations, in the moment of dialogue, is challenging because observing or recording a conversation between a student or professor would likely be intrusive to both the student and professor. To circumvent this challenge, the present study attempted to replicate elements of this context using a clinical simulation (Dotger, 2015) in which actors were trained to portray a professor in a meeting with students. Rather than examine skill development via instruction toward predetermined competencies, the study sought to understand how students advocate for academic accommodations from the students’ perspectives.

The study was guided by the following research questions:

Research Question 1 (RQ1): How do postsecondary students with disabilities engage in a simulated discussion about academic accommodations with a standardized professor?

Research Question 2 (RQ2): How do postsecondary students with disabilities reflect upon a simulated discussion about academic accommodations with a standardized professor?

Methods

Simulation design

Clinical simulations have been used since the 1960s to train novice medical students in acquiring diagnostic and treatment skills (Barrows, 1987), and more recently, adapted as an instructional tool in teacher education (Dotger, 2015). Each simulation takes place in a room with wall-mounted recording equipment. Participating students encounter standardized individuals, such as a patient in medical education, or a concerned parent in teacher education. A “standardized individual” is an actor who has been trained to communicate a problem in a consistent manner to all participating students. Students are not instructed on how to engage with the individual. Rather, the simulation provides an opportunity to observe how students use their current skills and judgment to respond. Clinical simulation provides a low-risk environment for participating students to practice skills and an opportunity to reflect on their responses to the standardized individual by watching and analyzing the video of their simulation (Dotger, 2015).

The first and third authors designed a simulation protocol for the current study, in which postsecondary students initiate a meeting to discuss academic accommodations with a standardized individual – an actor who was trained to portray a university professor. A protocol was developed for the character sketch and verbal cues of the standardized individual. The protocol was developed through individual semistructured interviews with five disability services staff members and a group interview with four university students who were registered with their university's Disability Services Office. The four students self-identified with the following disabilities: (a) LD, (b) ADHD, (c) ADHD and auditory processing disorder, and (d) multiple disabilities, including LD and a brain injury.

In the interviews, the first author elicited students’ and staff members’ experiences of the most common dispositions and verbal communications expressed by professors in response to requests for accommodations. Based on the interviews, a protocol was developed for a standardized professor, Alicia/Alan Williams—a midcareer professor who is generally supportive of students’ use of accommodations. Professor Williams occasionally makes suggestions or politely expresses concern about how a student might use an accommodation, though they have never explicitly denied a student's use of an accommodation.

A nearby medical university provided access to standardized individuals – professional actors who would portray Professor Williams. Four middle-aged actors, one African American female, one white female, and two white males were trained to enact Professor Williams’ character. The first and third authors explained Professor Williams’ disposition toward accommodations and trained the actors to communicate using general conversational guidelines and verbal cues related to specific accommodations. The actors portraying Professor Williams were instructed to exchange greetings with the student when the student entered the room and engage in small talk (e.g., “How is your semester going so far?”). If the student did not follow with a request or state the purpose of the meeting, the actors were trained to ask, “What can I help you with today?” After the student stated their intent to discuss accommodations, the actors were trained to ask to see the student's letter of accommodations (if the student did not already voluntarily hand the letter to the actor). Once the actors had briefly read the letter of accommodations, the actors were trained to begin to enact the following verbal cues:

After receiving the letter of accommodations, ask the student, “What does your disability mean for you as a student in this class?”

Discuss exam modifications. Ask, “Do you typically take tests at the Disability Services Office?” If the student responds yes, suggest, “Some students in the past have preferred to take exams with me so they don’t miss any questions that come up during the exam.”

For additional accommodations, politely express one of the following:

Concern about the use of laptops being distracting when used for note-taking.

Suggestion that handwriting notes may be better for memory than typing notes, according to a recent study.

Concern about intellectual property if audio-recorded lectures are posted online.

Concern about students not showing up to class when they receive advance access to presentation materials (e.g., PowerPoint slides).

Concern about students falling behind when receiving assignment extensions.

After delivering the verbal cues and engaging in a discussion with the student about their accommodations, the actors were trained to end the meeting by asking the student, “Is there anything else that you wanted to talk about today?”

While a scripted clinical simulation such as this is unlikely to fully replicate a real-life situation, it is intended to provide an approximation of an authentic context (Dotger, 2015). To date, 28 students from two universities have participated in the simulated meeting using the Professor Williams simulation protocol. Students have expressed that the simulated meeting is generally realistic in that it is representative of their communication with professors; they describe their disability and need for accommodations as they have when meeting with real professors, and concerns or suggestions expressed by Professor Williams in the simulation are consistent with statements made by actual professors. Students have also reported that they sometimes speak to a professor about accommodations in the classroom, rather than in an office (as in the simulated meeting). Some students have reported that Professor Williams speaks more than typical professors, making for a longer conversation (Freedman et al., 2020). This is not surprising given that the standardized professor is instructed to communicate several verbal cues.

Participants

Participants were enrolled at a private 4-year university in the Northeastern United States with an enrollment of approximately 22 000 students. The undergraduate cost of tuition is approximately $60 000 a year. The racial/ethnic makeup of the student body is White (56%), Hispanic/Latino (9%), Black/African American (6%), Asian (6%), two or more races (3%), unknown (3%), American Indian/Alaska Native (less than 1%), and Native Hawaiian/Pacific Islander (less than 1%). An additional 15% percent of students are categorized as nonresident aliens. Approximately 8% of students are registered with the university's Disability Services Office. Participants were recruited via an email sent to a listserv of the Disability Services Office. To participate in the study, students needed to be enrolled at the university and registered with the Disability Services Office. Fifteen students consented to participate. Table 1 provides self-identifying demographics for the participants (N = 10) who identified with LD and/or ADHD. Data from five additional participants who did not identify with LD or ADHD are excluded from this analysis.

Table 1.

Simulation participants’ demographic information (N = 10).

Name	Age	Gender	Race	Year	Disability category
Allison	19	F	White	Freshman	Testing anxiety; ADHD
Caroline	18	F	White	Freshman	Slow processing, learning disability
Chris	21	M	White	Senior	ADHD
Elissa	20	F	White	Junior	ADHD; Mild dyslexia
Jared	18	M	White	Freshman	ADHD
Kamilla	21	F	White	Senior	Generalized anxiety; obsessive–compulsive disorder; ADHD combined type
Marissa	19	F	White	Sophomore	Learning disability
Mark	18	M	Hispanic	Freshman	Learning disability, dyslexia, auditory processing
Nick	18	M	White	Freshman	ADHD
Scott	20	M	White	Junior	ADHD

Procedure

One week prior to the simulation, participants received a description of the simulation, which included a list of assignments on Professor Williams’ syllabus and provided a description of the first class in which Professor Williams lectured using presentation slides. Participants arrived at the Simulation Center of the nearby medical university for the simulation. Participants were provided with a copy of their letter of accommodations, with identifying information removed. Participants were informed that they would enter a room to meet an actor-portrayed professor for a conversation that would be recorded by wall-mounted cameras.

Small-group debriefing interview

After completing the simulation, participants were escorted by the first author in groups of three to another room for a video-recorded debriefing of their experiences. The purpose of this interview was to gain participants’ immediate reaction to the simulation, alongside peers who had simultaneously met with a different actor portraying Professor Williams. The interview followed a semistructured protocol in which participants were asked to share, (a) what they said or heard during the meeting with Professor Williams, (b) how they would describe their approach to the conversation, (c) how Professor Williams responded to their request to use accommodations, (d) how it felt to participate in the simulated meeting, and (e) how they felt about their responses to Professor Williams’ questions or concerns. These topics were chosen to prompt students to assess their self-advocacy, to understand the emotional experience of participating in a simulated meeting, and to gauge how they perceived the actor-portrayed professor (i.e., did they perceive Professor Williams as generally supportive of the use of accommodations?).

Individual postsimulation interview

Five of the 10 participants accepted the invitation to return to an office on campus the following week to watch the video of their simulated meeting and participate in an audio-recorded interview. Upon entering the office, students found a laptop set up with the video file of the simulated meeting and were informed that they could pause the video at any time to share what they noticed, or watch the video in its entirety.

After students shared their reactions to specific moments in the video, the first author continued the interview by asking about the following: (a) to what extent the simulation was reflective of typical real-life conversations with a professor?, (b) how they would describe Professor Williams’ attitude toward their accommodations, (c) whether they perceived Professor Williams’ gender, race, or age as having any impact on the conversation, (d) whether they felt that they benefited or learned anything from the experience, and (e) whether they felt the simulation would be a useful exercise for other students. The primary focus of this interview was to understand what the participants perceived as significant as they reflected on specific aspects of their communication in the meeting. These additional topics were intended to gain further insight into how students viewed the simulation and to assess its value as an opportunity to practice discussing accommodations.

Data collection and analysis

Videos of the simulation, videos of small-group debriefings, and audio recordings of follow-up interviews were transcribed verbatim. The shortest meeting was 2 min and 4 s and the longest was 9 min and 59 s. Videos of the simulated meeting were first analyzed by the first and second authors for content using deductive coding. Deductive coding involves establishing predetermined codes with which to provide a structure for initially organizing data (Savin-Baden & Major, 2013). In this case, predetermined codes were chosen according to the verbal cues from the actors’ protocol that were communicated by the standardized professor to participants. For example, all data segments were grouped together from participant responses to Verbal Cue 1, when Professor Williams asked, “What does your disability mean for you as a student in this class?” In some instances, participants preempted the verbal cue, such as by expressing the impact of an accommodation before Professor Williams could ask their question. These data segments were also coded as Verbal Cue 1 because of their similar content.

Once the data were coded according to the verbal cues, a second round of analysis was conducted by the first and second authors using process coding. Process coding uses gerunds to describe human actions in data (Saldaña, 2021). Process coding is appropriate for analyzing action “in response to situations, or problems, often with the purpose of reaching a goal, or handling a problem” (Corbin & Strauss, 2008, pp. 96–97). This type of coding was chosen because of the action-oriented situation of students enacting self-advocacy in a request for accommodations. Because the intentions of students were not always observable in the simulation, the researchers used data from the small-group debriefings and follow-up interviews to confirm the intentions of participants’ verbal statements and assigned gerunds. For example, when a participant explained in the follow-up interview that their statement to Professor Williams was made because they were reluctant to convey their need for an accommodation, the data segment was coded using the gerund of “underplaying” their need for an accommodation.

The authors grouped the data into categories of similar actions to identify three themes: framing the conversation, describing characteristics and support needs, and responding to questions or concerns about the use of accommodations. These themes were developed with sensitivity to existing conceptualizations of self-advocacy, including a focus on how students describe their disability and needs, and advocate to obtain resources while navigating potential conflict (Holzberg et al., 2019; Test et al., 2005).

The authors did not distinguish between participants with ADHD and participants with LD in the analysis, as previous research has found that the two groups of students exhibit similar characteristics in the context of advocating for the use of accommodations (Holzberg et al., 2019; Lopez et al., 2020). Further, the participants in this study overlapped significantly in the accommodations that they were to discuss (e.g., all participants had the accommodation of extended time on exams, and eight out of 10 had the accommodation to use a laptop or recording device for note-taking). Table 2 describes the themes and the analytical codes with which they are grounded. Statements from the postsimulation interviews are included in the findings to elaborate on participants’ intentions during the simulated meeting.

Table 2.

Themes and associated analytical codes.

Themes	Codes
Framing the conversation	Stating the purpose of the meeting Seeking permission/agreement to use an accommodation Sharing how accommodations support their success
Describing characteristics and needs	Describing aspects of their disability and/or related challenges Addressing specific accommodation(s) and their purpose or benefits Underplaying/qualifying the impact of their disability and need for accommodations
Responding to questions or concerns about the use of accommodations	Remaining noncommittal Reiterating their original preference Changing their original preference Compromising and/or suggesting alternative uses of the accommodation Ensuring that the accommodation will not cause a problem Explaining the accommodation and its purpose

Findings

Framing the conversation

Nine of the 10 students began by stating that their purpose in the meeting was to discuss accommodations. One student, Allison, did not refer to accommodations specifically, instead explaining that she is “involved with the Disability Services Office.” Six of the 10 students qualified their statements with the word “just” (e.g., Caroline: “I just wanted to talk to you about my accommodations for the class …”). Students most commonly referred to specific accommodations, such as receiving PowerPoint slides in advance or receiving extended time to complete exams. Table 3 provides examples of how students began their conversation with Professor Williams, either by stating the purpose of the meeting, seeking permission or agreement to use an accommodation, or sharing how accommodations support their success

Table 3.

Examples of students’ statements framing the conversation.

Student	Data Segment
Allison	I’m involved with the Disability Services Office [DSO] … I would like to just discuss with you kind of how it affects me in the classroom as well as what I kind of need to be the most successful in the class.
Caroline	I just wanted to talk to you about my accommodations for the class because I was admitted into DSO, which is the center for learning disabilities. The letter basically says I have certain accessibility. But I guess I just wanted to talk to you about how I can … succeed while using my accommodations.
Chris	These are my accommodations.
Marissa	So, I did this basically to sit down and discuss my accommodations with you … Some professors choose to not accommodate some of them and some do all of them.
Scott	I just wanted to talk to you about my accommodations. What I mainly need is extra time … and I use my computer in class, if that's okay with you.

When addressing specific accommodations, five students either sought permission to use an accommodation or framed the accommodations as contingent upon the professor's agreement. For example, Scott immediately stated his need to use a laptop computer in class, adding “if that's okay with you.” Marissa introduced her accommodations by explaining, “Some professors choose to not accommodate some of them,” thereby proactively acknowledging the possibility that Professor Williams might not allow the use of certain accommodations. Three students referred more broadly to accommodations being important for their success, such as Caroline, who explained that she wanted to discuss how she could “succeed while using my accommodations.” The remaining seven students yielded after their initial statement, and Professor Williams proceeded to communicate the next verbal cue.

Describing characteristics and support needs

In response to the standardized professor's question, “What does your disability mean for you as a student in my class?,” seven participants connected their need for an accommodation to a specific benefit that it provides. For example, Jared explained, “It's just like I have trouble processing. So, like it's hard for me to like read and then pay attention also. I have ADHD.” Mark linked difficulties with note-taking to the benefits of accessing lecture slides in advance: “The biggest thing is note taking. I’m a little slow. So, having PowerPoints in advance is useful.” Table 4 provides examples of the responses that this question elicited from students, as they described characteristics of their disability and their need for supports.

Table 4.

Examples of students’ descriptions of their disability and needs.

Student	Data Segment
Jared	It's just like I have trouble processing. So, like it's hard for me to like read and then pay attention also. I have ADHD.
Kamilla	I have time and a half, extended time in testing … so I will probably need to take those at DSO. That's where I usually take exams.
Mark Nick	… note taking … I’m a little slow. So having PowerPoints in advance is useful. For extended time, I usually finish tests on time, but I feel rushed. So, I get extended time and I feel, like, calm and composed … I know I can get it right and double-check it.
Scott	I don’t really use all of [the accommodations] … I have learned to deal with [my ADHD] over the years. So, you should expect me to be hardworking like every other student.

Another notable tendency was students minimizing and/or qualifying their need for accommodations. Qualifying the need for accommodations occurred in subtle ways throughout the conversations, such as when Kamilla softened her statement to “probably” needing to complete tests at the Disability Services Office. Others more directly underplayed their need for accommodations. For example, Scott told Professor Williams that he did not use all of his accommodations and that ADHD had a minimal impact on his performance in class. Scott emphasized his resilience instead: “I have learned to deal with it over the years. So, you should expect me to be hardworking like every other student.” In the follow-up interview, Scott elaborated on why he intentionally underplayed the impact of his disability and need for accommodations to Professor Williams:

I feel as if a kid comes to a professor and has something that is different from the normal, they are automatically going to think … they are a little bit less. … So, by me saying I am still going to work really hard, I think that sends a message to them … to counterbalance, ok I have accommodations but …I am going to work hard and I need this accommodation.

Scott further shared that he did not request to use accommodations in courses in his major field of study because of his concern that this would harm his future job opportunities if faculty members who have professional connections perceive him as less capable.

Responding to questions or concerns about the use of accommodations

The standardized professor was instructed to raise a question, concern, or suggestion about an accommodation. Regarding exam accommodations, Professor Williams suggested that students might prefer to complete exams in the classroom with the professor, rather than in a separate testing environment so that they “don’t miss any questions that come up during the test.” Table 5 provides examples of students’ responses, including reiterating their original preference of where they would like to complete exams, asking a clarifying question, remaining noncommittal about the exam location, and changing their original preferences.

Table 5.

Examples of students’ responses to Professor Williams’ suggestion about testing location.

Student	Data Segment
Caroline	Yeah. No, I think that's a good … I mean, the thing about that though is that, I kind of prefer the quiet of DSO because I’m in a room … I’ve come to learn that I get easily distracted. So, like a sneeze could just like this [snaps finger] divert my attention … But I guess like, depending on how well I know the material, I would let you know if I feel more comfortable taking it [the test] in class.
Chris	Yeah, If I do that, do I get the extra time? … Okay.
Kamilla	Yeah. I know in the past … the professor usually calls DSO and makes the students taking the test there aware of the change … in the test.
Marissa	Sometimes I’ll choose to just stay in the class, especially if it's a class I’m struggling with. Just so I can ask professors themselves questions because it's kind of difficult [to ask questions] when you are in the DSO office …

Only three students responded by reiterating their original preference. For example, Kamilla explained to Professor Williams that the professor could communicate last-minute changes or questions regarding exams to the student by calling the Disability Services Office, thereby allowing her access to the professor while having her preferred reduced-distraction environment. Chris asked whether he would still receive extra time if he completed the exam in the classroom or in Professor Williams’ office, as opposed to the testing center at the Disability Services Office.

The standardized professor was also instructed to express a concern about accommodations that were not related to exams, such as that students might fall behind in the course if they receive extended assignment deadlines. Students expressed understanding and/or agreement with Professor Williams’ concern about an accommodation, followed by a variety of responses. Table 6 provides examples of students’ responses to a concern that Professor Williams raised. Six students attempted to provide reassurance that Professor Williams’ concern would not become a problem. For example, regarding use of his laptop, Scott told Professor Williams, “I’ll make sure it's not a distraction.” When Professor Williams expressed concern about students not attending class if they receive slides in advance, Caroline initially responded, “I don’t blame you,” before reassuring Professor Williams, “I’m not one of those students. I mean the only reason I wouldn’t show up to class is because I’m extremely ill or something.”

Table 6.

Examples of students’ responses to Professor Williams’ concern regarding an accommodation.

Student	Professor Williams’ Concern	Data Segment
Allison	Students do not attend class if slides are given in advance.	[receiving slides] The evening before would be totally fine or just a few hours before class … even after …
Caroline	Students do not attend class if slides are given in advance.	I don’t blame you … I’m not one of those students …
Elissa	Use of laptops in class can be distracting.	If it's under a paragraph of notes, it's totally handwritten.
Marissa	Students may not come to class if lecture slides are provided in advance.	A lot of professors have said that to me … if I have the PowerPoints, I can focus more on what you are saying.
Scott	Use of laptops in class can be distracting.	I’ll make sure it's not a distraction … I’ll do both [write and type].

Two students responded by attempting to compromise on how they would use an accommodation. For example, Elissa offered to only sometimes use her laptop to type notes in class. But later she indicated in the follow-up interview that she would actually “prefer to type [notes] all the time,” but because Professor Williams did not “like computers in class,” she felt pressure to compromise. “I gave in there when I know I need a computer,” Elissa acknowledged. Elissa's simulation was conducted with a male standardized professor. In response to the postsimulation interview question about the potential impact of Professor Williams's gender, Elissa explained that she was not comfortable asserting her needs to a male professor, whereas she feels more willing to express disagreement with a female professor.

In another example of compromising, Allison proposed alternatives to receiving lecture slides before class, including offering to wait to receive slides until after class, which would effectively negate the use of the “advance access” accommodation to lecture slides. In her postsimulation interview, Allison reflected that watching the video of the simulation helped her to recognize the need to be more assertive. “After having this simulation,” she said, “I think I would … leave it less up in the air regarding taking [the exam] in a separate testing space or also with receiving the PowerPoint notes … the day before.” Finally, four students responded to a concern by elaborating on the purpose of the accommodation. For example, Marissa explained to Professor Williams that by having lecture slides in advance, “now I can focus more on what you are saying about the notes.”

Postsimulation interviews revealed further insights into what students gained from participating in the simulation and watching the video recording. For example, Scott explained that watching the video allowed him to recognize when he had difficulty responding to a question from a professor. “It was cool to see [in the video] when I didn’t really know how to respond,” he explained, “you could see my breaks.” After watching their video, others identified areas that they could improve. Mark noted that he wasn’t satisfied with his explanation about how he uses a recording device [smart pen] to record notes. “I definitely think I could explain the smart pen better,” he reflected. Allison realized that she should prepare better to talk about her accommodations so that she “would feel more comfortable talking about it and be able to answer [the professor's] questions.” Elissa explained that watching the video showed her that she was too appeasing to professors, leading her to compromise on accommodations that she would prefer to fully utilize. “I feel like I do that a lot,” Elissa said, and noted that she did not like conflict. Elissa expressed that she would talk to a disability services counselor about her previous LD evaluation so that she could “talk about the reasons behind each of my accommodations” in future conversations so she could be more assertive and let the professor know that “I have [accommodations] for a reason.” Watching the video led Kamilla to recognize how she can become “defensive” and “over-explain” her accommodations when talking to a professor. “I’m so wrapped up in the emotion … I’m not even able to … realize that I’m doing it. …” Kamilla explained that, in the future, she will “try to take more of a step back…and let them ask me the questions before I start feeling the need to explain everything.” Kamilla felt that this adjustment “will allow for more open lines of communication.”

Discussion

This study aimed to inform self-advocacy instruction by investigating how current postsecondary students with LD and with ADHD advocate for their needs when requesting accommodations. While role-playing or simulations cannot fully reflect the context they intend to simulate, data from this study provide evidence that students’ engagement in the simulation was indicative of how students request accommodations from a professor. First, the findings demonstrate tendencies in how students with LD and students with ADHD advocate for accommodations, including the tendency to be hesitant about asserting their preferences and needs for accommodations. The finding that participants often did not assert their needs, despite being informed that they were participating in a simulated meeting with an actor who they would likely never meet again, indicates authenticity in replicating the relational dynamics that students encounter when requesting accommodations. The analysis demonstrates patterns in how both students with LD and with ADHD frame the impact of their disability when requesting accommodations and responding to questions and concerns from a professor (RQ 1).

Second, investigating students’ postsimulation reactions provides insights into how students’ approaches to advocating for their needs are influenced by the dynamics of a student-professor relationship, while also pointing to the benefits of practicing self-advocacy through simulated meetings. Finally, watching video recordings of the meeting led students to self-assess their ability to advocate for accommodations, analyze their emotions and methods of communicating with a professor in situ, and identify changes they would make in future conversations about accommodations (RQ2).

Instruction for students with LD and with ADHD to advocate for accommodations once enrolled in postsecondary education is not guaranteed. It is critical for students to receive self-advocacy instruction as part of K-12 transition practices. Findings from this study can inform research into the use of instructional interventions to teach high school students with LD and with ADHD self-advocacy skills needed to request academic accommodations (e.g., Holzberg et al., 2019; Lopez et al., 2020). Students’ communication with Professor Williams in this study reinforces the importance of components of self-advocacy as previously conceptualized by Test and colleagues (2005), such as the need for students to demonstrate knowledge of self (e.g., explaining their needs and how an accommodation addresses those needs) and knowledge of resources (e.g., institutional processes related to their accommodations). Further, the findings support the relevancy of target skills from the SACR intervention used in previous research to teach students to request academic accommodations from a professor. Target behaviors in SACR instruction, including identifying disability status and explaining their disability in functional terms (Holzberg et al., 2019), were demonstrated by students in the present study and appear to be critical for effectively requesting accommodations.

The findings of this study do not offer conclusive differences between how students with LD and students with ADHD advocate for accommodations. Instead, they suggest that the two groups of students exhibit similar behaviors and encounter similar challenges when advocating for accommodations. We attribute this to the overlap in accommodations between students with LD and students with ADHD and that the simulation design and data analysis were based on verbal cues that were aligned with the accommodations. While more research is needed to understand how self-advocacy instruction might be differentiated for students with LD, with ADHD, and with comorbid diagnoses, Holzberg and colleagues (2019) suggest that the core components of self-advocacy described earlier are relevant for preparing students with high-incidence disabilities to discuss accommodations with a professor.

Further, efforts to teach self-advocacy may need to more fully account for what self-advocacy in postsecondary education entails. For some students, a desire to maintain a positive relationship with a professor appears to take precedence over asserting their need for accommodations. This was evidenced by students in this study underplaying their need for an accommodation, not asserting how they preferred to use an accommodation, or compromising to the extent that they would essentially forego using the accommodation (e.g., offering to receive “advance access” to lecture slides after class). These findings underscore Trainor and colleagues’ (2020) assertion that transition instruction should be informed by investigating the cultural context in which students must enact target skills.

The findings of the current study point to a concerning reality: Even if effective instructional interventions to teach high school students self-advocacy skills are implemented, the cultural environment of postsecondary education may lead students to underutilize or altogether forego the use of academic accommodations that have been shown to be critical to their success. Further, underutilization of accommodations cannot be attributed solely to a lack of self-advocacy knowledge and skills; some of the same students who did not assert their preferences in the simulated meeting also indicated postsimulation a knowledge of their rights and an awareness of alternatives to how they could have addressed conflict. Far from being a failure to advocate, the tendencies of some students to hide aspects of their disability characteristics and needs appear to be deliberate tactics. Such tactics align with previous research suggesting that students manage the competing interests of asserting their needs, while attempting to position themselves as capable students who will not be a burden on their professor (Lyman et al., 2016).

Limitations

Certain limitations should be considered when interpreting the findings of this study. First, there was a lack of racial diversity, with no participants identifying as Black or African American and only one participant identifying in each of the categories of Hispanic and Asian. Second, the study was conducted at a 4-year private university and may not reflect the experiences of students enrolled in other types of postsecondary institutions. Further research is needed with samples that reflect the diverse characteristics of postsecondary students with disabilities. Finally, the study did not report students’ prior exposure to self-advocacy instruction, nor their receipt of transition support in secondary education. Prior experiences and support likely contributed to differences in students’ engagement in the simulated meeting.

Implications for practice

The findings of this study have implications for preparing high school students with LD and with ADHD to advocate for postsecondary academic accommodations. The use of simulated meetings or similar self-advocacy instruction should prepare students with both an understanding of their accommodations and the relational dynamics in which they must communicate their needs. Self-advocacy instruction should address students’ knowledge of their rights, responsibilities, and institutional processes for accessing accommodations (Keenan et al., 2019), while also fostering students’ awareness of their needs and the benefits of individual accommodations (Holzberg et al., 2019). For example, high school students could be given a college syllabus and asked to practice identifying which accommodations from their IEP or 504 plan would be most relevant and beneficial for the specific course based on the assignments and structure of the course. A simulated meeting with a professor could also be adapted to a meeting with a postsecondary Office of Disability Services staff member. Articulating a need for academic accommodations and providing satisfactory documentation of a disability to a staff member is a critical initial step to procuring accommodations. Students should also practice meeting with diverse and unfamiliar individuals, including those who have different gender and racial identities than their own. This may help to prepare students for potentially unanticipated dynamics, such as the gendered power dynamics described by a female participant in this study and identified in prior research (Mamboleo et al., 2020), which may lead female students to be hesitant to voice their needs.

The use of simulated meetings provides an example that transition practitioners can use to assess students’ progress in the area of self-advocacy, such as how they explain the benefits of an accommodation or navigate conflict when requesting an accommodation. Postsimulation interviews from this study suggest that pairing a simulated meeting with structured reflection is a practice that can support students to assess how they can best advocate for accommodations. Individually or in small groups, practitioners can facilitate structured reflection by guiding students’ analysis of audio or video recordings of dialogue. Reflection can support students to make adjustments in future discussions, such as determining ahead of time which aspects of their accommodations are nonnegotiable, how to respond to questions about information that they would rather keep private, and when it might be appropriate to refer a professor to a Disability Services staff member to resolve a conflict. As suggested by one participant, Elissa, existing simulation videos or deidentified transcripts could also be shown to students transitioning to postsecondary education as a way to model different approaches to discussing accommodations. “Just watching [a video of a simulated meeting] might help,” Elissa suggested, “because … you are unsure what usually happens. What does a professor usually say?”

Self-advocacy instruction focused on accessing postsecondary supports could also be integrated into general education. Such efforts could allow students with and without disabilities to practice advocating for supports that are available to all postsecondary students (e.g., career center, tutoring). Teaching students to access universal supports, as well as how to articulate the benefits of these supports, can align self-advocacy instruction with college and career readiness in general education curricula (Morningstar et al., 2017). Self-advocacy can also be integrated into self-determination instruction, such as the Self-Determined Learning Model of Instruction (Raley et al., 2021), in secondary core-content classes, where it can prepare students with and without disabilities to enact self-advocacy beyond high school.

Finally, the findings of this study suggest that self-advocacy instruction alone is unlikely to remedy the problem of students underutilizing accommodations. Current postsecondary policies put an undue onus on students’ self-advocacy and position them such that requesting accommodations is a stigmatizing experience of seeking differential treatment (Dolmage, 2017). Alternatively, universal design is one promising framework for changing administrative and instructional approaches to accommodations that can reduce the burden placed on students with disabilities. As Drelick and colleagues (2022) describe, faculty, administrators, and students can collaborate using universal design principles to develop classroom policies and practices that proactively address many of the needs of students with disabilities. When the adjustments needed to make accommodations are reflected in classroom instruction, students may be less likely to fear disclosing a disability as they recognize that many of their needs are already being anticipated.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

References

Barrows

H. S.

(1987). Simulated (standardized) patients and other human simulations. Health Sciences Consortium.

Blasey

Wang

Blasey

(2022). Accommodation use and academic outcomes for college students with disabilities. Psychological Reports, 126(4), 1891–1909. https://doi.org/00332941221078011

Corbin

Strauss

(2008). Basics of qualitative research: Techniques and procedures for developing grounded theory (3rd ed.). Sage.

Denhart

(2008). Deconstructing barriers: perceptions of students labeled with learning disabilities in higher education. Journal of Learning Disabilities, 41(6), 483–497. https://doi.org/10.1177/0022219408321151

Dolmage

J. T.

(2017). Academic ableism: Disability and higher education. University of Michigan Press.

Dotger

B. H.

(2015). Core pedagogy: Individual uncertainty, shared practice, formative ethos. Journal of Teacher Education, 66(3), 215–226. https://doi.org/10.1177/0022487115570093

Drelick

A. M.

Freedman

J. E.

Woodfield

C. L.

Woodruff

(2022). Promoting student-generated applications of universal design to address accommodations (practice brief). Journal of Postsecondary Education & Disability, 35(1), 79–87. https://web.p.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=0&sid=2dd7cbdb-94fa-4e18-b6ce-d2eb37cfe59d%40redis

DuPaul

G. J.

Gormley

M. J.

Anastopoulos

A. D.

Weyandt

L. L.

Labban

Sass

A. J.

Postler

K. B.

(2021). Academic trajectories of college students with and without ADHD: Predictors of four-year outcomes. Journal of Clinical Child & Adolescent Psychology, 50(6), 828–843. https://doi.org/10.1080/15374416.2020.1867990

Evans

N. J.

Broido

E. M.

Brown

K. R.

Wilke

A. K.

(2017). Disability in higher education: A social justice approach. John Wiley & Sons.

10.

Fleming

A. R.

Plotner

A. J.

Oertle

K. M.

(2017). College students with disabilities: the relationship between student characteristics, the academic environment, and performance. Journal of Postsecondary Education and Disability, 30(3), 209–221.

11.

Freedman

J. E.

Woodfield

C. L.

Dotger

B. H.

(2020). Using simulated meetings to practice advocating for disability-related accommodations (practice brief). Journal of Postsecondary Education and Disability, 33(4), 387–394. https://files.eric.ed.gov/fulltext/EJ1293020.pdf

12.

Hechtman

Swanson

J. M.

Sibley

M. H.

Stehli

Owens

E. B.

Mitchell

J. T.

Stern

(2016). Functional adult outcomes 16 years after childhood diagnosis of attention-deficit/hyperactivity disorder: MTA results. Journal of the American Academy of Child & Adolescent Psychiatry, 55(11), 945–952. https://doi.org/10.1016/j.jaac.2016.07.774

13.

Holzberg

D. G.

Test

D. W.

Rusher

D. E.

(2019). Self-advocacy instruction to teach high school seniors with mild disabilities to access accommodations in college. Remedial and Special Education, 40(3), 166–176. https://doi.org/10.1177/0741932517752059

14.

Keenan

W. R.

Madaus

J. W.

Lombardi

A. R.

Dukes

I. I. I.

(2019). Impact of the Americans with disabilities act amendments act on documentation for students with disabilities in transition to college: implications for practitioners. Career Development and Transition for Exceptional Individuals, 42(1), 56–63. https://doi.org/10.1177/2165143418809691

15.

Kim

W. H.

Lee

(2016). The effect of accommodation on academic performance of college students with disabilities. Rehabilitation Counseling Bulletin, 60(1), 40–50. https://doi.org/10.1177/0034355215605259

16.

Lopez

N. J.

Uphold

N. M.

Douglas

K. H.

Freeman-Green

(2020). Teaching high school students with disabilities to advocate for academic accommodations. The Journal of Special Education, 54(3), 146–156. https://doi.org/10.1177/0022466919892955

17.

Lyman

Beecher

M. E.

Griner

Brooks

Call

Jackson

(2016). What keeps students with disabilities from using accommodations in postsecondary education? A qualitative review. Journal of Postsecondary Education and Disability, 29(2), 123–140. https://files.eric.ed.gov/fulltext/EJ1112978.pdf

18.

Mamboleo

Dong

Fais

(2020). Factors associated with disability self-disclosure to their professors among college students with disabilities. Career Development and Transition for Exceptional Individuals, 43(2), 78–88. https://doi.org/10.1177/2165143419893360

19.

McGregor

K. K.

Langenfeld

Van Horne

Oleson

Anson

Jacobson

(2016). The university experiences of students with learning disabilities. Learning Disabilities Research and Practice, 31(2), 90–102. https://doi.org/10.1111/ldrp.12102

20.

Morningstar

M. E.

Lombardi

Fowler

C. H.

Test

D. W.

(2017). A college and career readiness framework for secondary students with disabilities. Career Development and Transition for Exceptional Individuals, 40(2), 79–91. https://doi.org/10.1177/2165143415589926

21.

Newman

L. A.

Madaus

J. W.

Lalor

A. R.

Javitz

H. S.

(2019). Support receipt: Effect on postsecondary success of students with learning disabilities. Career Development and Transition for Exceptional Individuals, 42(1), 6–16. https://doi.org/10.1177/2165143418811288

22.

Raley

S. K.

Shogren

K. A.

Rifenbark

G. G.

Lane

K. L.

Pace

J. R.

(2021). The impact of the self-determined learning model of instruction on student self-determination in inclusive, secondary classrooms. Remedial and Special Education, 42(6). https://doi.org/10.1177/0741932520984842

23.

Rojewski

J. W.

Lee

I. H.

Gregg

(2015). Causal effects of inclusion on postsecondary education outcomes of individuals with high-incidence disabilities. Journal of Disability Policy Studies, 25(4), 210–219. https://doi.org/10.1177/1044207313505648

24.

Saldaña

(2021). The Coding Manual for Qualitative Researchers. Sage.

25.

Savin-Baden

Major

C. H.

(2013). Qualitative Research: The Essential Guide to Theory and Practice. Routledge.

26.

Test

D. W.

Fowler

C. H.

Wood

W. M.

Brewer

D. M.

Eddy

(2005). A conceptual framework of self-advocacy for students with disabilities. Remedial and Special Education, 26(1), 43–54. https://doi.org/10.1177/07419325050260010601

27.

Trainor

A. A.

Carter

E. W.

Karpur

Martin

J. E.

Mazzotti

V. L.

Morningstar

M. E.

Rojewski

J. W.

(2020). A framework for research in transition: Identifying important areas and intersections for future study. Career Development and Transition for Exceptional Individuals, 43(1), 5–17. https://doi.org/10.1177/2165143419864551

28.

Walker

A. R.

Test

D. W.

(2011). Using a self-advocacy intervention on African American college students’ ability to request academic accommodations. Learning Disabilities Research & Practice, 26(3), 134–144. https://doi.org/10.1111/j.1540-5826.2011.00333.x