A Healthy Dose of Inclusion

A version of this post was originally published on Mental Health on the Mighty in March 2021.

My whole life, I always knew I learned differently than most others. I never thought it was bad, just different. I couldn’t study in bright, loud or busy areas for example, and I knew I could never work in such environments. For months I suspected I was autistic. Getting diagnosed with autism included a 5-hour assessment priced at about $100 of total insurance co-payments. Once in grad school, I then had to send my diagnosis to the Disability Services Center here at University of Oxford. I hadn’t disclosed a disability until after term started, so it took about a week or so for the Disability Service to process my request. Once approved, I had an in-person meeting with the service to see how they could best meet my needs.

They were amazingly accommodating and helpful. I informed them of one of my most frustrating classes, where our professor barely engaged and instead let us students lead our class topic. None of us were prepared for the topic prior to the meeting, and I was unable to tell which of my classmates were saying something accurate and which ones were not. I was unable to take accurate notes because of this. Our professor would occasionally nod and go “Oh, interesting” in various tones. It seemed like everyone was able to discern “interesting” as correct, while “interesting!” was incorrect. Or vice versa. I wasn’t sure. After sharing this experience at my Disability Service meeting, I was able to receive a note-taker for some of my classes, and I was even allowed extra time on examinations. I also had the opportunity to be provided with a mentor who would help me improve on my study skills, and help me better improve on my tonal and non-verbal language interpretation for the term. I felt lucky and relieved to have that support. I doubt I would’ve graduated without it. But I can’t help thinking that, like so many autistic black women, I graduated undergrad without knowing I was autistic, and therefore without the help and support of disability services.

In the frustrating class, it was hard not to look around me and wonder if any of my classmates were struggling too. Did they actually need assistance but weren’t able to receive it because they weren’t diagnosed with autism? If so, is it really that hard for profs to just simply say “correct” or “incorrect”...?

My above reflection is just one mirror on how students with disabilities such as autism can struggle in an academic setting. The Center for Disease Control (CDC) estimates that the developmental disability prevalence in the US is 16%. These developmental disabilities include Autism, Attention Deficit HyperActivity (ADHD), blindness, and various other conditions. While disability condition diagnoses make up a significant portion of the workforce, having an inclusive academic environment can be beneficial to not only the intended demographic, but even the community at large.

While making sufficient academic working conditions conducive for neurodiverse and other communities with disabilities is still underway in several University settings, some Universities and other colleges are forging the path in addition to the minimum legislation that those diagnosed have the right to reasonable accommodation in many Universities. University of Bath in the United Kingdom for example created an Inclusive Universities Project to conduct focus groups for students with autism to ultimately raise awareness and develop support networks for those with various disabilities and mental health conditions. Some elite Business Schools around the world have also taken part in the inclusion wave. HEC Paris Business school, Ivey Business School in Canada, and London School of Economics in the United Kingdom have all included recruitment and retainment schemes for those with autism and other neurodiverse conditions. For example, London School of Economics does not penalize spelling and grammar mistakes for neurodiverse students, and allows for 25 minutes extra time on examinations. HEC Paris currently allows their dyslexic students to request materials on more readable and orientation-centered colored paper. While this is considerable progress, it is imperative that more University’s, college’s and their departments emulate inclusive practices as well as create and iterate on better working environments for their students.

One reason it is important for Universities and colleges to accommodate those with disabilities may be due to the current barriers hindering members of certain communities from receiving an official diagnosis. An example of a disability that may have barriers to access a diagnosis is autism. Autism is a developmental disability that affects social interaction, verbal and non-verbal communication . While 1 in 54 youth are diagnosed with autism, diagnosis is four times more common in males than in females—although there is no proof that females have lower rates of autism. Differences in presentation of symptoms is one reason for this contrast in diagnosis. Even more strikingly, while autism prevalence affects all communities equally, the CDC notes that racial and ethnic minority groups are receiving a diagnosis significantly less often than their white counterparts.

While there are disparities like the above in the US and other Western nations, these are exacerbated in the developing world, where nearly all neurodiverse youth go undiagnosed. My friend and neighbor from my Fulbright endeavor and soon-to-be future classmate, Boluwatife Ikwunne, MD, has the following to say about the lack of autism diagnosis among Nigerians-the largest African demographic to study abroad in the United States.

“In Nigeria, autism is often undiagnosed and left unmanaged. This is largely due to poor awareness, a lack of screening tools and unavailable/ inaccessible supportive facilities. A national policy on neurodevelopmental disorders does not exist, meaning that neurodiverse students do not have access to reasonable accommodation facilities or other inclusive measures to aid learning and improve their quality of life.”

Boluwatife Ikwunne, MD/Rhodes Scholar-elect

It is clear that Universities and colleges need to reflect on the ethnic, racial, gender and various cultural differences to conclude that simple, low-cost accomodation is the best for undiagnosed students. Without it, most students, possibly such as some diverse and international students as Dr. Ikwunne mentioned, may not be able to receive accommodation for a disability- simply because they aren’t aware that said disability exists.

Presently, one needs an official diagnosis for most disabilities to receive accommodation in academic settings. Often, this approach is used to ensure that students are discouraged from taking advantage of certain accommodations that are necessary for some with disabilities. Receiving extra time on a test when it is unnecessary is an example of such. However, one should consider if autism and similar disabilities are inaccessible for some communities due to factors such as stigma, cost and time constraints.

Given such barriers of access, there are several possible ways Universities can accommodate their students with minimal effort and financial cost. It is no secret that most student centers contain large rooms often filled with lots of loud voices and other stimuli that may be overwhelming. In stark contrast, the quieter rooms in such centers are often reserved for studying, with minimal engagement allotted between students. The Neurodiversity Hub, states that engaging with students, speaking explicitly,including tailored support services, and limiting the use of: bright lights, loud noises, and open-floor planning are simple examples of enabling an inclusive work environment. Creating a diverse array of social and study environments for all personalities and neurotypes in student centers would enable a great first step in being more inclusive.

Taken together, academic environments should not solely rely on an official diagnosis to be accommodating in such settings. This is important because environments that are not conducive to a students neurotype, health, or personality can be detrimental to one’s stress level or mental health.On top of a new life event such as beginning a new school, declaring a major, moving away from home or away from most previous high school classmates, can all lead to social isolation as well as to serious mental illnesses such as severe depression, anxiety, and suicidal ideation. Exacerbated by the pandemic, social isolation and loneliness levels have reached an all time high, with results that could be catastrophic for a student’s well-being for years to come. In blunt terms, neglecting feasible accommodation could wreak havoc on a students academic output, and, most importantly, on their well-being for life.

Additionally, while not accommodating those with unique needs (or waiting for a formal request to do so) can be detrimental, accommodating these needs can have a positive impact on all. An infamous example is the invention of SMS texts. Finnish inventors Matti Makkonen et al., originally invented SMS texting to be an alternative to voice conversations for deaf individuals and others who are hard of hearing. The use of SMS texting is now ubiquitous as it proved to be efficient for both personal and professional use while also saving their intended company ample bandwidth. There are several other examples of accommodation to the minority that led to prosperity and convenience for the majority. Ramps, elevators, and automatic doors being additional classic examples.

It’s evident that inclusive school settings lessens stress and decreases extreme mental health challenges. Accommodating those with diverse needs can also have a greater impact on the entire University community at-large.

A diverse and broad environment that can both incorporate and inspire those with unique needs and personalities can be beneficial to all students. It is time our Universities and colleges accommodate diverse needs, and it is time all of us advocate for every community. We can advocate by listening to and creating a platform for those in minority and/or disabled communities to communicate their needs and demands for their various schools to implement willingly. Here at Oxford, we have a very accepted Student Disability Committee as part of the Student Union, which spear-heads inclusion initiatives while also comforting fellow students through various Facebook groups such as for autistic students at Oxford.

For corporations, we can also use discernment while consuming in order to support companies whose employees feel included and heard in their work environment. All of these small steps can enable a more inclusive and as a result dynamic enviorment for neurodiverse and/or disabled students.

To conclude, it may not be necessary to wait for official permission or an urgent need to accommodate those with disabilities. Like administrators simply requesting my aforementioned professor be more direct for all my classmates, accommodating individuals with various needs is often simple to do. The positive effects to the University and College community and —ultimately— the well-being of their students will be vast.