What is Chronic Illness?

Students who have a chronic illness may experience a disability as a result of their condition. Unlike many other disabilities, however, the limitations that impact their academic success may come and go over time. This means that they may begin the semester feeling relatively well, then experience a flare-up, relapse, or other change in health status.

In the postsecondary education context, it is up to each individual student with a disability to decide whether to register with DRS and whether to disclose the presence of a disability to professors.  In the case of a student living with a chronic illness, the disclosure decision may hinge upon how the student is feeling during the semester in question. The tendency of symptoms – and therefore functional limitations – to wax and wane leads some students to avoid disclosure early in the semester, in the hope that their health will remain stable. Therefore, faculty should be prepared for disclosure at any point in the semester.  This makes universal design measures especially appealing; because they are built into the course structure from the beginning, they are in place should a chronic illness interfere.

In a brief 2010 International Women’s Day address, Carolina Pineda identifies four reasons why chronic illnesses make it difficult for students to succeed in post-secondary education:

1. Invisibility: Chronic illness is one type of disability that instructors won’t know about unless the student reveals it. But invisibility entails a further consequence: those who have never lived with chronic illness may be inclined to think that the student is exaggerating or even making up the problems caused by the illness or treatment.
2. Unpredictability: Many chronic conditions ebb and flow in an unpredictable way, creating the potential for major disruptions of learning and course work. 
3. Social stigma: Because some degree of social stigma is still carried by chronic illnesses (especially those, like chronic fatigue syndrome, that are not universally recognized), students often hesitate to disclose an illness unless absolutely necessary. Their reluctance to discuss their condition may extend beyond the classroom to their peers, increasing their sense of isolation as a consequence.
4. Tighter limits: The effects of chronic illness often prevent students from holding a job while in school; this increases the financial burden of college. Even so, they may have less productive time available on a typical day than their professors expect.

A common theme in the reflections of adults with chronic illness is the frustration they feel when someone who does not have to cope with that illness expresses skepticism about their limitations or expects them to simply think positively and get past it. It is crucial for faculty to be sensitive to their own assumptions when responding to a student who has disclosed that s/he has difficulties related to a chronic illness. The Resources section below provides links to several sources of personal accounts of life with chronic illness. Faculty who have no experience with the wide variety of chronic illnesses can explore these to get a sense of how chronic illness can reshape one’s life and horizons.

Challenges and Strategies

The table below lists several challenges a student may confront related to his/her illness, and suggests strategies – aside from accommodations determined by DRS – that faculty might deploy to mitigate their academic impact.  Beside each strategy are the letters “UDL” ; this indicates consistency with Universal Design for Learning. The instructor implements the given measure for the whole class, so that not only the student with a disability benefits from it.  This also assures that a student with a disability is not unnecessarily singled out or identified as needing special provisions