A Resource Module for Student Veterans with Disabilities in Higher Education

 

MODULE GOALS: To provide student veterans with disabilities with information for providing effective services and resources in higher education.

OBJECTIVES:
  1. To highlight primary laws that guide services for postsecondary student veterans with disabilities.
  2. To examine the demographic and educational backgrounds of students and military service members.
  3. To understand the types of disabilities that service members and student veterans acquire during their service to their country.
  4. To identify academic and social supports for service members and students veterans at postsecondary institutions.
  5. To disseminate website resources that can provide additional information and resources to student veterans and their families.
 INTRODUCTION:
 
As the wars in Iraq and Afghanistan phase out, student veterans and military service members are actively seeking to transition into postsecondary education settings with the support of the Post-9/11 GI Bill. The American with Disabilities Act Amendment Act (ADAAA) and Section 504 of the Rehabilitation Act (amended as Title IV of Workforce Investment Act (WIA)) provides protections for student veterans with disabilities. To assist student veterans with disabilities, it is important to understand the challenges they face as they return to the postsecondary environment. While student veterans with disabilities bring several unique challenges, they also bring their own set of strengths to a campus: leadership, teamwork, resilience, and self-discipline (Church, 2009). Student veterans and military service members benefit from a variety of academic and social supports that increase their ability to experience success in college. This module is designed as a resource to assist student veterans to understand the individualized services and resources offered to student veterans with disabilities on postsecondary campuses.
 
KEY QUESTIONS:
  1. What are the primary laws that guide services for postsecondary student veterans with disabilities?
  2. What is Section 504 of the Rehabilitation Act (amended as Title IV of WIA) and how does it provide protection for student veterans with disabilities?
  3. How does The Americans with Disabilities Act (and amendments) provide protection for student veterans with disabilities?
  4. What benefits does the Veterans Assistance Act of 2008 (GI Bill) provide for students with disabilities?
  5. What documentation is available to help guide student veterans through the self-identification and tuition benefits process?
  6. What is the current profile of student veterans and military service members?
  7. What are the common types of disabilities that student veterans and military service members are diagnosed with each year?
  8. What types of services and supports have the potential to benefit student veterans with disabilities?
  9. Why is it important for universities to continue to focus on developing their support services for student veterans?
  10. What Disability Resource and Support (DR/S) student veteran programs are currently in place for student veterans with disabilities at institutes of higher education?
  

What are the primary laws that guide services for postsecondary student veterans with disabilities?

It is the legal right for student veterans with disabilities who meet the admissions requirements of a particular postsecondary institution to have access to that institution’s academic and extracurricular offerings (Grossman, 2009). In essence, the rights of postsecondary student veterans with disabilities are grounded in two pieces of civil rights law: the Americans with Disabilities Act and Amendments (as amended 2008) and the Rehabilitation Act of 1973 (amended as Title IV of the Workforce Investment Act (WIA) of 1998) (Grossman, 2009). Furthermore, student veterans should be aware of the additional education benefits of the Veterans Assistance Act of 2008.

What is Section 504 of the Rehabilitation Act (amended as Title IV of WIA) and how does it provide protection for student veterans with disabilities?

  • The regulations of the Office for Civil Rights (OCR) of the United States Department of Education give additional guidance on “academic adjustments” in postsecondary education (34 C.F.R. Part 104, 104.44). The regulations state that adjustments should:

a) Ensure that a postsecondary institution’s academic requirements do not discriminate against a qualified individual with a disability.

b) Ensure that auxiliary aids that meet the student’s needs are available. (Subpart E of 34 CFR 104).

  • Specifically, Section 504 of the Rehabilitation Act of 1973 (reauthorized as Title IV of the WIA in 1998) provides access and support to qualified students with disabilities in public postsecondary institutions, which includes student veterans with disabilities.
  • Section 504 prohibits discrimination against students with disabilities based on their disability (OCR, 2011). For example, a student veteran cannot be denied admission based on his or her disability. 
  • Section 504 requires that public institutions provide modifications, services, and auxiliary aids to qualified students with a documented disability so that they are able to access the academic program content (Katsiyannis, Zahang, Landmark, & Reber, 2009; OCR, 2011). Public institutions are institutions that receive funding (even partial) from the federal government.
  • Please note that services should be provided on a case-by-case basis. If a student meets a particular disability requirement, then the student and the DR/S provider should work together to determine services. It is up to the student to self-disclose his or her disability.
  • The law states that “Qualified Students” are students who meet the admissions requirements of the postsecondary educational institution (OCR, 2011).
  • “Students with a Disability” refers to students who meet the federal definition of disability. The federal definition states that an individual qualifies as having a disability if he or she:

a) Has a physical or mental impairment that limits major life activities: “any physiological disorder or any mental” or “psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.” Major life activities include, but are not limited to: caring for one’s self, performing manual tasks, walking seeing, hearing, speaking, breathing, learning, and working.

b) Has a record of such impairment: “Has a history of” or has been classified as “having a mental or physical impairment that substantially limits one or more life activities”

c) Is regarded as having such an impairment: A person who has a physical or mental impairment that does not substantially limit major life activities but that is treated by a recipient as constituting such a limitation; has a physical or mental impairment that substantially limits major life activities only as a result of the attitudes of others toward such impairment; or has none of the impairments but is treated by a recipient as having such an impairment.

  • The documentation that is required to verify a student’s disability varies across postsecondary educational institutions because institutions set their own documentation and identification requirements (Dukes & Shaw, 2004).  

How does The Americans with Disabilities Act (and amendments) provide protection for student veterans with disabilities?

The ADA, originally authorized in 1990, and its amendments, authorized in 2008, extend access to and support within postsecondary education to individuals with disabilities at private and public institutions. The ADA does not explicitly reference the discrimination of students with disabilities in institutions of higher education. However, institutions that receive federal funding fall under the Act’s Title II provisions. Title II explicitly mandates that all state or local “public entities” may not discriminate on the basis of disability against individuals with disabilities (ADA, II-1.2000). Additionally, Title III of the Act expanded protection to students with disabilities enrolled in private institutions.

The definition of “disability” is the same as the Rehabilitation Act of 1973.

  • Guarantees qualified student veterans with disabilities support in the postsecondary setting. 
  • Mandates that public entities must make appropriate academic adjustments and provide auxiliary aids by stating that these entities “shall furnish appropriate auxiliary aids and services where necessary to afford an individual with a disability an equal opportunity to participate in, and enjoy the benefits of, a service, program, or activity” (OCR, 1998). Postsecondary institutions may not be required to provide auxiliary aids, accommodations, and/or modifications. Reasons include, but are not limited to:
  1. If they create “undue” financial hardship for the university,
  2. Require a fundamental alteration to the program, violate accreditation requirements, or
  3. Require the waiver of essential program or licensing requirements within an academic course of study (Burke, et al., 2010; General Counsel, 2010; OCR, 1998).

The amendments to the ADA preserved the original Congressional intent of the law and implemented clarifications that benefit student veterans with disabilities. Specifically, the amendments to the ADA, passed in 2008, retracted several court decisions known as the “Sutton Trilogy” that narrowed the law and made it more difficult for individuals to meet the law’s definition of disability and receive appropriate supports (Grossman, 2009). For example, due to the passage of the ADA amendments, mitigating measures, such as medication that treats the disability can no longer be taken into consideration in determining disability status (ADA Amendment Regulations, 2011). The ADA amendments benefit student veterans with disabilities (Grossman, 2009). Specifically, the following clarifications within the amendments provide greater protection for student veterans with disabilities:

  1. The regulations establish that an impairment may be “substantially limiting” even if its impact is only episodic, as might occur for example with epilepsy or certain mental health issues.
  2. The ADA amendments expand the list of major life activities to include: “… seeing, hearing, eating, sleeping, walking, … learning, reading, concentrating, thinking and communicating” and a list of “major bodily functions” such as of the “immune system … digestive, bowel, bladder … brain … and circulatory functions.”
  3. The amendments to the ADA also expand who is “perceived as disabled.” Individuals are now considered to be “perceived as disabled” if the individual is treated adversely, whether or not the impairment actually limits a major life activity. Grossman (2009) provides the example how this provision could benefit a veteran with a disability: “ a person, perceived as having a psychiatric condition will be protected from adverse treatment based on myths and stereotypes about persons with psychiatric disabilities even if he or she cannot establish that he or she has such a disability.” 
  4. The amendments clarify that most mitigating measures, except for eyeglasses, cannot be taken into consideration for determining whether a student qualifies as having a disability. For example, prior to the passage of the ADA amendments, an individual who took medication for mental health issues, could be denied protection under the ADA or Section 504. Now, such mitigating measures cannot be taken into consideration (ADA Amendment Regulations, 2011).
 

What benefits does the post Veterans Assistance Act of 2008 (GI Bill) provide for students with disabilities?

Authorized in 2008 and effective August 1, 2009, The Veterans Assistance Act of 2008 (P.L. 110-252, also known as the New GI Bill) provides student veterans a variety of important benefits such as financial support for education and housing. To qualify, military veterans must have served for least 90 days of aggregate service after September 10, 2001, or have been discharged with a service-connected disability after 30 days of service. Specifically, the Veterans Assistant Act of 2008 provides veterans:

  • Tuition support for student veterans attending public, in-state postsecondary institutions. The following chart, prepared by the United States Department of Veterans Affairs outlines the tuition support allocated to student active duty veterans based on their service:

 Member Serves

Percentage of Maximum Benefit Payable
At least 36 months
100%

At least 30 continuous days on active duty and must be discharged due to service-connected disability

 
100%

At least 30 months, but less than 36 months

90%

At least 24 months, but less than 30 months

80%

At least 18 months, but less than 24 months

70%

At least 12 months, but less than 18 months

60%

At least 06 months, but less than 12 months

50%

At least 90 days, but less than 06 months

40%

                                                                                                                                                                                                                                                                                                                                                           Table Adapted from https://gibill.custhelp.com/app/answers/detail/a_id/947

  • The bill also allocates $17,500 per academic year in tuition assistance to support student veterans attending private or foreign postsecondary institutions. 
  • If the veteran would like to attend a private or out of state public school, he or she can investigate the Yellow Ribbon Program for further possible funding: http://gibill.va.gov/benefits/post_911_gibill/yellow_ribbon_program.html
  • The Post/ 911 GI Bill also allocates books and supplies stipends, trainings, and in some cases, housing allowances for student veterans. 

What documentation guidance is available to help guide student veterans through the self-identification and tuition benefits process?

Vance and Miller (2009) identified the following resources as being helpful for assisting student veterans gain access to their medical records and other documentation that could be requested by a postsecondary educational institution:

  • DD Form 214, Certificate of Release or Discharge from Active Duty.

When a service member completes active duty, this form, which verifies a person’s active military duty, is issued. Please review the following comprehensive website for instructions for obtaining the DD Form 214: http://dd214.us/methods.html.

  • Standard Form SF-180, Request Pertaining to Military Records.

This form provides a student with the opportunity to obtain missing records. A student veteran may submit this form to The National Personnel Records Center, Military Personnel Records, 9700 Page Avenue, St. Louis, Missouri 63132-5100.

  • Recent student veterans can use the following link to request their records: http://www.va.gov/vaforms/search_action.asp
  • VA Form 10-5345 (May 2005). This form allows a student veteran to request for and authorize the release of his or her medical records or health information: http://www.va.gov/vaforms/medical/pdf/vha-10-5345-fill.pdf
  • VA Form 105345a (May 2005). The form is the individuals’ request for a copy of their own health information. It allows a veteran to request his or her medical records. The form can be found at: http://www.va.gov/vaforms/medical/pdf/vha-10-5345a-fill.pdf. This form should be submitted to the Department of Veterans Affairs, Records Management Center, P.O. Box 5020, St. Louis, Missouri 63115-5020.
  • University-specific disability self-disclosure documents. These documents are university-specific and enable a student with a disability to self-disclose his or her disability. They will therefore differ across universities.

What is the current student profile of student veterans and military service members?

Radford (2011) conducted a profile of military service members and veterans enrolled in undergraduate and graduate education in 2007-2008. The profile is based upon two nationally representative studies: 2007-08 National Postsecondary Student Aid Study (NPSAS:08) and the 2004/09 Beginning Postsecondary Students Longitudinal Study (BPS:04/09). A brief overview of the most recent student profile of student veterans and military service members is listed below:

 

Military Undergraduate Enrollment

Military Graduate Enrollment

4% of the undergraduate population

4% of the graduate population

657,000 student veterans enrolled

107,000 student veterans enrolled

215,000 active and reserve military service members enrolled

38,000 active and reserve military service members enrolled

Majority are males (73%)

Majority are males (65%)

Age range: 24-29 (over 50%)

Age range: over 40 and older (nearly 40%)

Race: white (60%) and minorities (40%), which includes African Americans, Hispanic, Asian, and other

Race: white (60%) and minorities (40%), which includes African Americans, Hispanic, Asian, and other

Married while enrolled in college

Married with a child enrolled in college

(Radford, 2011)
 

Military undergraduate students tend to select private, nonprofit four-year institutions to obtain their bachelor’s degree.  The common majors that military students are inclined to select are computer and information sciences, engineering and engineering technology, health care, and business. Student veterans and military service members take about seven or more years after receiving their bachelor’s degree to enroll into graduate school. Military graduate students attend school part-time and enroll in distance education courses. Radford (2011) highlights that only small amount of military member receive their GI Bill Education benefits. During 2007-08 year, only 38% of military undergraduates and 20% of military graduates utilized their education benefits (Radford, 2011). The National Center for Veterans Analysis and Statistics (2011) evaluated the educational attainment of veterans from 2000-2009. During this time period, veterans have increasingly attained Bachelor’s degrees and advanced degrees. However, veterans are more likely to achieve some type of college education (i.e., Associate’s degree) than a Bachelor’s degree when compared to their nonmilitary peers (NCVAS, 2011). There is limited national data on the demographics of student veterans with disabilities regarding enrollment and completion at postsecondary educational institutions.

What are the common types of disabilities that student veterans and military service members are diagnosed with each year?

The common types of disabilities that student veterans and military service members are diagnosed with each year include physical & sensory disabilities, traumatic brain injury, post-traumatic stress disorder, and other mental health disabilities. Each disability section is outlined with a brief overview of how veterans and military service members might acquire the disability, accommodations and strategies for student veterans with disabilities, and additional resources and information to give to military service members regarding that particular disability. Accommodations and strategies should be individualized to all military service members and student veterans. The accommodations and strategies shared in the module are simply what the literature has pointed to as the most common for each specific disability.

Physical & Sensory Disabilities
 
Military service members and veterans have physical disabilities from the result of war such as burns, amputations and orthopedic injuries, and spinal cord injuries (Church, 2009). Blimes (2007) reported that that 20% of soldiers faced some type of brain trauma and/or spinal injuries while serving in Iraq. Another 20% of military service members and veterans acquired major injuries in amputations, blindness, partial blindness or deafness, and serious burns (Blimes, 2007). Blasts are due to Improvised Explosive Devices (IEDs). IEDs are the leading cause of injuries for our soldiers and veterans (Church, 2009). 
 
How might physical disabilities (e.g. spinal cord injuries, amputations, & sensory disabilities) affect a military student’s performance in the classroom? 
  • Interference with physical dexterity to complete laboratory, computer or writing assignments
  • Difficulty with prolonged sitting or standing at a lab table
  • Mobility challenges to and from the classroom and other activities
  • Difficulty hearing lecture, discussion or advising sessions
  • Difficulty seeing the board, reading course materials, creating written assignments
  • Difficulty accessing the course website or electronic resources
  • Lack of traditional means of accommodations (American Sign Language (ASL), Braille) due to acquired nature.

(From “Returning Veterans on Campus with War Related Injuries and the Long Road Back Home” by Thomas E. Church, 2009, Journal of Postsecondary Education and Disability, Volume 22, p. 45. Adapted with permission.)

What accommodations and strategies are helpful for students with physical disabilities?

These accommodations and strategies should not be viewed as a menu of accommodations for postsecondary students with disabilities. These have been found in the literature to be helpful for students with this type of disability.

  • Notetaker, lab assistant, group lab assignments
  • Classrooms, labs, and field trips in accessible locations
  • Adjustable tables, lab equipment located within reach
  • Classroom assignments made available in electronic format
  • Computer or laptop equipped with special input device (e.g., speech input, Morse code, and alternative keyboard.)

(From “Mobility Impairments” by University of Washington DO-IT, 2004. Reprinted with permission.)

What accommodations and strategies are helpful for students who are diagnosed as deaf or hard of hearing? 

These accommodations and strategies should not be viewed as a menu of accommodations for postsecondary students with disabilities. These have been found in the literature to be helpful for students with this type of disability.

  • Interpreter, real-time captioning, FM system, Notetaker
  • Open or closed-captioned films, use of visual aids
  • Written assignments, lab instructions, demonstrations summaries
  • Visual warning system for lab emergencies
  • Use of electronic mail for class and private discussions
  • Preferential seating and the elimination of unnecessary background noise

(From “Hearing Impairments” by University of Washington DO-IT, 2004. Reprinted with permission.)

What accommodations and strategies are helpful for students who are diagnosed as blind?

These accommodations and strategies should not be viewed as a menu of accommodations for postsecondary students with disabilities. These have been found in the literature to be helpful for students with this type of disability.

  • Audiotaped, Braille or electronic-formatted lecture notes, handouts, and texts
  • Verbal descriptions of visual aids and use of Accessible Instructional Materials
  • Raised-line drawings and tactile models of graphic materials
  • Braille lab signs and equipment labels, auditory lab warning signals
  • Adaptive lab equipment (e.g. talking thermometers and calculators, light probes, and tactile timers)
  • Computer with optical character reader, speech output, Braille screen display and printer output.

(From “Blindness” and “Low Vision”by University of Washington DO-IT, 2004. Reprinted with permission.) 

Physical and Sensory Disability Resources
  • Alexander Graham Bell Association for the Deaf and Hard of Hearing—The Alexander Graham Bell Association for the Deaf and Hard of Hearing, nonprofit organization, provides resources and information for families, health care providers, and educators to understand the importance of early diagnosis and intervention.  The AG Bell’s mission is to provide the tools to help children and adults with hearing loss succeed in society. http://listeningandspokenlanguage.org
  • Blind Rehabilitation Services—Blind Rehabilitation Services (BRS) is under the U.S. Department of Veterans Affairs. BRS is dedicated to supporting veterans who have some type of visual impairment in helping them transition into civilian life with supports needed to be successful in the community. BRS provides information and resources to families to assist them in understanding the impact visual impairment has on the veterans and their transition to civilian life. http://www.va.gov/blindrehab/
  • Blinded Veterans Association (BVA)—The Blinded Veterans Association (BVA) is an organization that is made of up of veterans who are blind to assist veterans who have recently become blind or have been diagnosed with a visual impairment. BVA has a variety of programs, including employment training and placement, to assist veterans with visual impairment to transition back into civilian life. http://www.bva.org/
  • Columbia Lighthouse for the Blind—The Columbia Lighthouse for the Blind is devoted in assisting individuals who are blind or visually impaired in the greater Washington, D.C. area to address challenges of vision loss. The mission of the Columbia Lighthouse for the Blind is to provide the tools for individuals with visual impairments to continue to be productive members of society. http://www.clb.org/
  • The Reeve Foundation’s Paralysis Resource Center—The Reeve Foundation’s Paralysis Resource Center provides information and resources on spinal cord injury, paralysis, and mobility related disabilities. The Paralysis Resource Guide is a comprehensive information tool for individuals with paralysis and their families. It is free to download on the website! http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.4451921/k.24E/Reeve_Foundations_Paralysis_Resource_Center.htm
  • Hearing Loss Association of America (HLAA)—The Hearing Loss Association of American is an organization that represents individuals with hearing loss.  They provide resources, support, and awareness to individuals with hearing loss and their families to impact public policy and research. HLAA Chapters and state organizations all over the country. http://www.hearingloss.org/
  • National Association for the Deaf (NAD)—The National Association for the Deaf (NAD) is a civil rights organization for people who are deaf and hard of hearing. NAD is involved in the areas of early intervention, education, employment, health care, technology, telecommunications, and youth leadership for people who are deaf and hard of hearing. http://www.nad.org/
  • Paralyzed Veterans of America—The Paralyzed Veterans of America is organization that assists veterans with spinal cord injuries. Paralyzed Veterans of America is dedicated to veterans’ service, medical research, and civil rights for individuals with spinal cord injuries. They have 34 chapters in which veterans can be involved in to disseminate information and resources to veterans and their families. http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6305401/k.BCBB/Home.htm
  • The American Speech-Language-Hearing Association—The American Speech-Language-Hearing Association is a professional association for audiologists, speech-language pathologists, and speech, language, and hearing scientists. The association provides professional development opportunities for professionals to advocate and advance the field through their work with their clients. http://asha.org/default.htm
  • The National Captioning Institute (NCI)—The National Captioning Institute is designed to provide media access to individuals with disabilities in the areas of television, web captioning, subtitling, translation, transcription, and described video needs. NCI informs individuals about the related laws about captioning, the educational uses of captioning, and decoder repair. NCI receives calls to answer questions regarding captioning and other inquiries. http://www.ncicap.org/
 
Traumatic Brain Injury (TBI)
 
A person can acquire a TBI by “…a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain”  (U.S. Department of Health and Human Services Centers for Disease Control and Prevention, 2011). Individuals in the military have a higher risk of acquiring a TBI due to being deployed to war zones.  The primary causes of TBI in the military are due to (Defense & Veterans Brain Injury Center, 2011):
  • Bullets, fragments, blasts
  • Falls
  • Motor vehicle traffic crashes
  • Assaults

Troops are reporting TBI as they return home from Iraq and Afghanistan.  In a survey that interviewed 1,965 individuals, conducted by the RAND team, it was estimated that 19.5% of military service members reported experiencing a probable TBI during deployment (RAND Corporation, 2008). The Department of Defense reported that 30,304 service members sustained a TBI related injury (Defense and Veterans Brain Injury Center, 2011). It is important to understand how a TBI might affect student’s performance in the classroom as well as accommodations that will enable students to be successful in the educational environment.

How might TBI affect a military student’s performance in the classroom?

  • Cognitive problems such as judgment, attention, concentration, processing new information, distraction, language abilities, sequencing, short-term memory, slower thinking
  • Perceptual problems such as hearing, vision, orientation to space and time, touch, balance and pain sensitivity
  • Physical problems, which include; motor skills, endurance fatigue, speech, headaches and seizures
  • Behavioral and emotional problems such as irritability, impatience, problems with impulse control, stress, self awareness, mood swings, personality changes, reading social cues and dependence/independence
  • Psychiatric problems may include depression, hallucinations, paranoia and suicidal thoughts
  • Symptoms may increase during times of fatigue and stimulus overload
  • Decreased ability to self monitor and establish an appropriate pace of learning or working activity
  • Mild TBI patients’ behavior may mimic PTSD and other mental health symptoms, which can contribute to problems in obtaining appropriate services

(From “Returning Veterans on Campus with War Related Injuries and the Long Road Back Home” by Thomas E. Church, 2009, Journal of Postsecondary Education and Disability, Volume 22, p. 46-47. Adapted with permission.)

What accommodations and strategies are helpful for students with TBI?

These accommodations and strategies should not be viewed as a menu of accommodations for postsecondary students with disabilities. These have been found in the literature to be helpful for students with this type of disability.

  • Coaching
  • Scheduling (e.g. alarm clocks, planners, pagers, breaks)
  • Checklists
  • Memory strategies and memory aid devices (e.g. tape recorders)
  • Adaptive Technology
  • Peer Mentor Support Programs

(Church, 2009, p. 45) 

TBI Resources:
  • Brain Injury Association of America (BIAA)—The Brain Injury Association of America (BIAA) provides awareness and advocacy related to brain injury. BIAA support efforts in advocacy, education and research to enhance the lives of individuals with TBI. http://www.biausa.org/
  • Defense and Veterans Brain Injuries Center (DVBIC)—The Defense and Veterans Brain Injury Center (DVBIC) is an important component of the U.S. military health system. Currently, there are 17 sites across the country supported by the DC headquarters that is designed to treat, support, train, and monitor service members, veterans, and providers for veterans with TBI. http://dvbic.dcoe.mil
  • Department of Health and Human Services Centers for Disease Control and Prevention--Facts for Physicians about Mild Traumatic Brain Injury is a toolkit designed to provide information and resources to physicians about mild traumatic brain injury (MTBI). The toolkit defines MTBI, the magnitude of MTBI as well as symptoms and preventive measures of obtaining a MTB. http://www.cdc.gov/concussion/headsup/pdf/Facts_for_Physicians_booklet-a.pdf
  • Institute of Medicine (IOM), Gulf War and Health, Vol. VII, Long Term Consequences of Traumatic Brain Injury is a free publication that outlines the biology of TBI, epidemiology of adult TBI, and evaluates the literature on major cohort studies of TBI. http://www.nap.edu/catalog/12436.html
  • National Association of State Head Injury Administrators (NASHIA)—The National Association of State Head Injury Administrators (NASHIA) is deeply involved in address state issues related to TBI. NASHIA is designed to ensure that states are providing services and supports to individuals with TBI. NASHIA is dedicated to education and training and raising public awareness to state governments as well as federal entities, national associations, and TBI stakeholders. http://www.nashia.org/
  • National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education—The National Institute on Disability and Rehabilitation Research (NIDRR) is committed to supporting comprehensive research relating to the field of rehabilitation research of individuals with disabilities. NIDDR is involved with several programs and projects that are designed to enrich the lives of individuals with disabilities from birth to adulthood. http://www2.ed.gov/about/offices/list/osers/nidrr/index.html?src=mr
  • National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH)—The National Institute of Neurological Disorders and Stroke (NINDS) is a part of the National Institutes of Health developed to combat neurological disease all over the world. NINDS supports and conducts research, disseminates grants, provides fellowships, and disseminates best practices on neurological disorders. http://www.ninds.nih.gov/
  • North American Brain Injury Society (NABIS)—The North American Brain Injury Society (NABIS) is a society of multidisciplinary brain injury professionals. The society is designed to bridge the gap between research and practice. The society encourages practitioners in the field to incorporate research best practices into the field. http://www.nabis.org/
  • RAND Center for Military Health Policy Research--Invisible Wounds Mental Health and Cognitive Care Needs of America’s Returning Veterans—The Rand Center for Military Health Policy Research released a research brief on the invisible wounds mental health and cognitive needs of our military service members and veteranshttp://www.rand.org/pubs/research_briefs/RB9336.html
 
Post-Traumatic Disorder (PTSD)
 
In the DSM-IV, Post-Traumatic Stress Disorder (PTSD) is defined as the “…re-experiencing of an extremely traumatic event accompanied by symptoms of increased arousal and by avoidance of stimuli associated with the trauma” (American Psychiatric Association, 2008, p. 429). Military veterans and service members in increasing numbers are becoming diagnosed with PTSD. It is estimated that nearly 18.5% of returning military service members have PTSD or depression (RAND Corporation, 2008). The symptoms of PTSD can consists of “…flashbacks or bad dreams, emotional numbness, intense worry, guilt, angry outbursts, feeling “on edge,” or avoiding thoughts and situations that remind of the trauma” (National Institute of Mental Health, 2011).
 
How might PTSD affect a military student’s performance in the classroom?
  • Interference with cognitive skills, judgments, memory, concentration, organizational skills and motivation
  • Difficulty coping or performing under pressure
  • Side effects from medication such as fatigue, drowsiness, slow response time and problems initiating interpersonal contact
  • Problems sustaining concentration and difficulty retaining verbal directions, problems maintaining stamina and combating drowsiness due to medications
  • Difficulty managing assignments and performing multiple tasks with time pressures, and prioritizing tasks
  • Difficulty interacting with others and responding appropriately to social cues
  • Problems with authority figures and approaching instructors
  • Problems with negative feedback and interpreting criticism
  • Problems with unexpected changes in coursework, and dealing with interruptions
  • Anxiety resulting in poor performance
  • Unpredictable absences
  • Problems with frightening thoughts, flashbacks and reminders
  • Distrusts of systems and alienation
  • Possible social withdrawal
  • Sleep difficulties

(From “Returning Veterans on Campus with War Related Injuries and the Long Road Back Home” by Thomas E. Church, 2009, Journal of Postsecondary Education and Disability, Volume 22, p. 50-52. Adapted with permission.)

What accommodations and strategies are helpful for students with PTSD? 

These accommodations and strategies should not be viewed as a menu of accommodations for postsecondary students with disabilities. These have been found in the literature to be helpful for students with this type of disability.

Classroom Accommodations

  • Preferential seating, especially near the door for breaks
  • Prearranged or frequent breaks
  • Memory strategies and memory aid devices (e.g. tape recorders)
  • Notetaker or photocopy of class notes
  • Early availability of syllabus and textbooks
  • Availability of course materials (lectures, handouts)
  • Private feedback on academic performance

 (From “Academic Accommodations for Students with Psychiatric Disabilities” by Alfred Souma, Nancy Rickerson, & Sheryl Burgstahler, 2012, Washington DO-IT, p. 3, Reprinted with Permission.)

Examination Accommodations
  • Exam in alternate format
  • Assistive computer software
  • Extended time
  • Exams individually proctored, including in the hospital
  • Exam in a separate, quiet, and non-distracting room
  • Increased frequency of exams

(From “Academic Accommodations for Students with Psychiatric Disabilities” by Alfred Souma, Nancy Rickerson, & Sheryl Burgstahler, 2012, Washington DO-IT, p. 3, Reprinted with Permission.)

Assignment Accommodations
  • Substitute assignments in specific circumstances
  • Advance notice of assignments
  • Permission to submit assignments handwritten rather than typed
  • Written assignments in lieu of oral presentations or vice versa
  • Assignments completed in dramatic formats
  • Assignment assistance during hospitalization
  • Extended time to complete assignments

(From “Academic Accommodations for Students with Psychiatric Disabilities” by Alfred Souma, Nancy Rickerson, & Sheryl Burgstahler, 2012, Washington DO-IT, p. 3, Reprinted with Permission.)

 
PTSD Resources:
  • Afterdeployment.org—Afterdeployment.org is a website that provides wellness resources for military service members and veterans. Afterdeployment provides information on topics and assessments that affect the military community such as anxiety, PTSD, resilience and depression. http://www.afterdeployment.org/
  • American Academy of Psychiatry and the Law (AAPL)—The American Academy of Psychiatry and the Law is an organization of psychiatrists that focus on the field of forensic psychiatry. AAPL focus on areas including violence, mental disability, ethics and human rights, and confidentiality. AAPL encourage research into these areas and to disseminate best practices in the field in national and regional meetings. www.aapl.org
  • American Psychiatric Association (APA)—The American Psychiatric Association (APA) represents over 36,000 psychiatric physicians. The APA has five professional journals that disseminate research on care and treatment of individuals with mental disorders, intellectual disabilities, and substance use disorders. The APA disseminates research to families and to psychiatrists in the field to enrich the lives of people with disabilities. www.psych.org
  • American Psychological Association (APA)—The American Psychological Association is an organization that represents over 137,000 researchers, educators, clinicians, consultants, and students that focus on the field of psychology. The APA assists professionals in understanding and evaluating the research in the field to further best practices to improve the health and lives of people in this country and around the world. www.apa.org
  • Anxiety Disorders Association of America (ADAA)—The Anxiety Disorders Association of America (ADAA) is dedicated to bringing awareness and research for anxiety, depression, and stress-related disorders. The ADAA disseminates information and resources to families and professionals on the latest research on anxiety disorders. http://www.adaa.org/understanding-anxiety
  • National Center for PTSD—The National Center for PTSD is a center within the Department of Veterans Affairs. The National Center for PTSD is a center of excellence for research and education on research and treatment of PTSD. There are seven divisions from across the country that forms The National Center for PTSD. http://www.ptsd.va.gov/
  • National Alliance on Mental Illness (NAMI) Veteran Resource Center---The NAMI Veterans Resource Center provides a variety of resources on treatment, resources for families, resources for news and media, and online discussion regarding PTSD affecting returning military service members and veterans. http://www.nami.org/template.cfm?section=ptsd
  • National Institute of Mental Health (NIMH)—The National Institute of Mental Health (NIMH) conducts clinical research on mental illnesses to spearhead new avenues for prevention, recovery, and cure. NIMH disseminates educational resources on mental health research to families and educators to bring awareness of the brain’s inner workings to youth. www.nimh.nih.gov
  • National Mental Health Association (MHA)—The Mental Health Association is an advocacy association that advocates for individuals with mental and substance use conditions to ensure that their voice is heard in regards to research in the area of mental health and mental health policies that affect legislation. www.nmha.org
  • Not Alone—Not Alone is an organization that offers programs, resources and services to veterans and military service members with PTSD and combat stress. Not Alone provides a confidential and anonymous community in which veterans and military service members can access mental health resources and information. http://www.massvetsadvisor.org/details/10756/Not_Alone_
 
Other Mental Health Disabilities
 
Student veterans experience an array of psychological and emotional issues upon returning from Iraq and Afghanistan. As soldiers volunteer for multiple deployments the chances increase significantly in experiencing anxiety and depression from the first deployment (12%) to the third deployment (27%) (Church, 2009). A recent study evaluated student veterans exploring possible psychological symptoms and suicide risks on college and university campuses. Rudd, Goulding, & Bryan (2011) discovered nearly 35% of their sample faced “severe anxiety”, 24% “severe depression”, and 46% “significant symptoms of PTSD” (p. 358).  In addition, student veterans were found to be experiencing thoughts about suicide (46%) as well as having a plan for suicide (20%) with some student veterans attempting suicide (7%) (Rudd et al., p. 358). The study identified a possible link between significant PTSD symptoms and suicide attempts. Rudd, Goulding, & Ryan (2011) reported that 82% of suicide attempts are individuals with significant PTSD symptoms.  The DoD task force reported a shocking statistic that over 1,100 members of the Armed Forces committed suicide from 2005 to 2009 (United States Department of Defense, Task Force on the Prevention of Suicide by Members of the Armed Forces, 2010). It was calculated that an average of 1 military service member committed suicide approximately every 36 hours (United States Department of Defense, Task Force on the Prevention of Suicide by Members of the Armed Forces, 2010). As more military service members and veterans transition to college life, awareness and education of mental health disorders is vital to share with the college student veteran community.
 
How might other mental health disabilities affect a military student’s performance in the classroom?
  • Interference with cognitive skills, judgments, memory, concentration, organizational skills and motivation
  • Difficulty coping or performing under pressure
  • Side effects from medication such as fatigue, drowsiness, slow response time and problems initiating interpersonal contact
  • Problems sustaining concentration and difficulty retaining verbal directions, problems maintaining stamina and combating drowsiness due to medications
  • Difficulty managing assignments and performing multiple tasks with time pressures, and prioritizing tasks
  • Difficulty interacting with others and responding appropriately to social cues
  • Problems with authority figures and approaching instructors
  • Problems with negative feedback and interpreting criticism
  • Problems with unexpected changes in coursework, and dealing with interruptions
  • Anxiety resulting in poor performance
  • Unpredictable absences
  • Problems with frightening thoughts, flashbacks and reminders
  • Distrusts of systems and alienation
  • Possible social withdrawal
  • Sleep difficulties

(From “Returning Veterans on Campus with War Related Injuries and the Long Road Back Home” by Thomas E. Church, 2009, Journal of Postsecondary Education and Disability, Volume 22, p. 50-52. Adapted with permission.)

What accommodations and strategies are helpful for students with other mental health disabilities?

These accommodations and strategies should not be viewed as a menu of accommodations for postsecondary students with disabilities. These have been found in the literature to be helpful for students with this type of disability.

  • Note takers
  • Early notification of projects, exams, and assignments to reduce stress
  • Flexible attendance requirements
  • An encouraging, validating, academic environment
  • Alternative testing arrangements in a quiet room
  • Assignments available in an electronic format
  • Web page or email distribution of course materials and lecture notes

(From “Mental Illness” by University of Washington DO-IT, 2004. Reprinted with permission.)

 
Other Mental Health Resources:
  • Depression and Bipolar Support Alliance (DBSA)—The Depression and Bipolar Support Alliance (DBSA) is an organization that is designed to assist and improve the lives of individuals with mood disorders. There is a strong grassroots network that enables DBSA to have about 1,000 patient-run support groups in the United States. DBSA has provides free educational publications on their website that have been reviewed by patients. DBSA has Spanish-language resources as well at www.DBSAlianza.orghttp://www.dbsalliance.org/site/PageServer?pagename=home
  • DoD/VA Suicide Outreach Resources for Suicide Prevention—The Department of Defense and Department of Veterans Affairs have provided a website that provides resources for suicide prevention for military service members and veterans. Resources include self-assessments, wellness library, PSA videos, educational resources, and news and reports. http://www.suicideoutreach.org/
  • MakeTheConnection.net--Make the Connection is a public awareness campaign brought by the Department of Veterans Affairs to encourage veterans to reach to other veterans and their families. The website is a one-stop resource for veterans and families can explore and research information about physical and mental health conditions. http://maketheconnection.net/
  • The Association for Behavioral and Cognitive Therapy (ABCT)—The Association for Behavioral and Cognitive Therapy (ABCT) is a professional organization that promotes behavioral and cognitive therapy in treating several psychological and mental health disorders. The ABCT provides information and resources for professionals, educators, and students interested in learning about this type of treatment. http://abct.org/Public/?m=mPublic&fa=dPublic
  • Veterans Chat and Veterans Crisis Line—The Veterans Crisis Line is for veterans, family/friend, active duty/reserve & guard that are facing a personal crisis. The crisis line and online chat is confidential can be used 24 hours a day, 7 days a week, and 365 days a year. The crisis line is available for any type of crisis situation. http://www.veteranscrisisline.net/ChatTermsOfService.aspx

What types of services and supports have the potential to benefit student veterans with disabilities?

A variety of accommodations and supports have been identified to be effective in supporting student veterans with disabilities in the postsecondary educational setting (Vance & Miller, 2009). Supports have been found to be most effective when they are individualized, innovative, and consider the background of student veterans with disabilities. Student veterans with disabilities should contact their respective college or university’s Disability Support Service office to learn about current programs and services that are offered to student veterans. DR/S providers should actively collaborate and provide campus-wide supports that have the ability to improve educational outcomes for all students.

  • Individualized Services and Accommodations. Providing accommodations should never be a “one size fits all” mindset. The same goes for providing service to student veterans with disabilities.
  • Innovative Services and Accommodations. Services and accommodations may need to be innovative. As Vance and Miller (2009) note, “the traditional forms of providing accommodation may not be as effective with today’s veteran population since most colleges and universities have not had a great deal of experience in accommodating students with the types of disabilities common among wounded warriors.” The Office for Civil Rights issued a “Dear Colleague” letter in 2008 in which it noted that providing innovative accommodations to student veterans with disabilities should be a focus for all service providers since “traditional means of support” may not be sufficient. http://www2.ed.gov/about/offices/list/ocr/letters/colleague-20080725.html 

Why is it important for universities to continue to focus on developing their support services for student veterans?

As mentioned, student veterans are often hesitant to self-identify disabilities attained during their military service and therefore the university must identify and implement innovative practices to reach this group of students (Shackelford, 2009).  This especially becomes the case with invisible disabilities, such as TBI (Shackelford, 2009). As a result, serious academic issues have the potential to develop and negatively impact the student veteran’s postsecondary experience. Many programs are still in the development stage--only approximately 16% of postsecondary institutions identified their ability to serve veterans with disabilities as “above average” (Vance & Miller, 2009) and therefore universities must continue to develop their programs to support veterans.

What Disability Resource and Support (DR/S) student veteran programs are currently in place for student veterans with disabilities at institutes of higher education?

Combat2College at Montgomery College, MD is a campus-wide program that provides supports for student veterans. The program is designed to facilitate a positive and inclusive postsecondary educational experience for student veterans with disabilities and should therefore be considered when campuses set out to design their own programs. 

Combat2College at Montgomery College (MD) http://cms.montgomerycollege.edu/edu/tertiary1.aspx?urlid=53;

Developed jointly by Montgomery College, Rockville Campus, National Rehabilitation Hospital of Washington, DC, National Center for PTSD, and Veterans Administration Medical Center, Combat2College provides student veterans support through enrollment support, academic advising, and social support. The program involves the institution’s DR/S office, but is an initiative focused on all veterans, and therefore is an inclusive program. The program was designed with the following core objectives:

  1. To facilitate an inclusive college experience for all student veterans.
  2. To remove stigmas by emphasizing how a student’s military experience can positively contribute to their postsecondary educational experience and should be viewed as a positive asset. The program recognizes that veterans may experience issues associated with his or her military experience, but that these issues should be coped with appropriately and that the focus should be on developing a positive view.
  3. To provide appropriate clinical and psychosocial resources for veterans in need.
  4. Providing numerous outlets for veterans to connect and build camaraderie.
  5. Accomplishing what is feasible on the given campus, such as faculty training and other opportunities that directly impact student veterans.

Combat2College provides numerous resources for student veterans, including formal and informal courses, literature and training material, and the opportunity to receive support from outside veteran’s organizations. 

ADDITIONAL WEBSITES:
 
Able Forces, Inc.
AbleForces, Inc. is a veteran-owned non-profit organization providing professional, career-oriented employment exclusively to wounded warriors and veterans with disabilities. www.ableforces.org
 
National Resource Directory
The National Resource Directory is a website that connects military service members and student veterans and their families to resources and information on variety of topics such as employment, education and training, and housing. https://www.ebenefits.va.gov/ebenefits/nrd
 
Student Veterans of America
Student Veterans of American provides military veterans with the resources, support, and advocacy needed to succeed in higher education and following graduation. www.studentveterans.org
 
The National Veterans Center
The mission of the National Veterans Center is to provide career-oriented employment and community-based job preparation training to Veterans with significant disabilities, with an emphasis on Wounded Warriors and Disabled Veterans living with Physical Disabilities, Post Traumatic Stress Disorder (PTSD), and Traumatic Brain Injury. http://www.nationalveteranscenter.org
 
Wounded to Work Institute
The Wounded to Work Institute provides education and support to employers around the world who have an equal desire to provide education and career training to military personnel who have been injured in the service of their country. www.woundedtowork.org
 
Wounded Warrior Project
The Wounded Warrior Project fosters the most successful, well-adjusted generation of wounded warriors in our nation’s history. www.woundedwarriorproject.org.
 
ASSESSMENT/EVALUATION:
  1. What are the major laws that impact student veterans with disabilities in postsecondary education? How do these laws interact? How can DR/S providers provide support and guidance for student veterans with disabilities to navigate these laws?
  2. What are the common types of disabilities reported by student veterans with disabilities? Why is it important to look beyond a “menu” of services and to provide individualized supports to each student?
  3. Describe why taking a student’s prior experiences and individual needs into account important for providing services to student veterans with disabilities? Please give one example of a how a DR/S provider could use a student’s prior experience to individualize his or her supports in the postsecondary environment.
  4. Reviewing the “student veteran programs,” what is one initiative that could be implemented on your campus this year to improve services for student veterans with disabilities?
 
WRAP-UP:
 
Student veterans with disabilities and military service members come from a variety of cultural, educational, and military backgrounds. Moreover, most veterans with disabilities have acquired their disability during their military service. It is therefore an adjustment for student veterans to transition from a military culture and language to a disability adult service culture and language. As such, there is no “one size fits all” approach to meeting the needs of these diverse students and individualized supports and services should be considered for each student. Student veterans with disabilities also need education and training about their legal protections, disability-specific needs, and current academic and social supports offered on university campuses. In addition, collaboration is the key in creating academic services and social supports as well as programs to benefit student veterans with disabilities and military service members on postsecondary campuses. To fully support this group of students, DR/S Coordinators/Providers need to evaluate their own campuses to determine the strengths and gaps in delivering effective supports and services to the student veteran population.
 
Elizabeth Shook Torres is a doctoral student in the Education and Neuroscience Selective Excellence program at The George Washington University in Washington, D.C. Ms. Shook Torres focuses her doctoral research on postsecondary transition issues for students with disabilities and is a contributor to the HEATH Resource Center in Washington, D.C. Prior to pursuing her doctorate, Ms. Shook Torres served as a special education and transition coordinator for the District of Columbia Public School System. She holds an M.A. in Transition Special Education from The George Washington University and a B.A. from Vassar College.
 
Jessica Queener is the Project Director Research Associate of the HEATH Resource Center at the National Youth Transitions Center in Washington, D.C. Ms. Queener is a doctoral candidate in the Education and Neuroscience Excellence program at The George Washington University. Ms. Queener concentrates her research in the area of transition related to postsecondary education for students with disabilities. Ms. Queener began her career as the self-determination coordinator at the University of Tennessee in Knoxville, T.N. She has earned a M.A. in Transition Special Education from the George Washington University and a B.A. from the University of Tennessee.
 
REFERENCES:
 
Americans with Disabilities Act of 1990 42 U.S.C. §§ 12101 et seq. (Amended 2008).

American Psychiatric Association. (2008). Diagnostic and Statistical Manual of Mental  Disorders (Vol. 4). Washington, DC: American Psychiatric Association.

Bilmes, L. (2007, January ). Soliders Returning from Iraq and Afghanistan: The Long-term Costs of Providing Veterans Medical Care and Disability Benefits. Retrieved May 2012, from Harvard Kennedy School of Government: http://web.hks.harvard.edu/publications/workingpapers/citation.aspx?PubId=4329

Bleiberg, J., et al. (n.d.) Combat2College: Facilitating college success for combat veterans.

Burke, L. A., Friedl, J., & Rigler, M. (2010). The 2008 amendments to the Americans with Disabilities Act: Implications for student affairs practitioners, 47, 63- 77.

Church, T. (2009). Returning Veterans on Campus with War Related Injuries and the Long Road Back Home. Journal of Postsecondary Education and Disability , 22 (1), 43-56.

Defense & Veterans Brain Injury Center. (2011). TBI Facts. Retrieved May 2012, from Defense & Veterans Brain Injury Center: http://www.dvbic.org/TBI---The-Military/TBI-Facts.aspx

Defense and Veterans Brain Injury Center. (2011). DOD Worldwide Numbers for Traumatic Brain Injury. Retrieved May 2012, from Defense and Veterans Brain Injury Center: http://www.dvbic.org/TBI-Numbers.aspx

Dukes, L. L., & Shaw, S. (2004). Perceived personnel development needs of postsecondary disabilities services professionals. Teacher Education and Special Education, 27(2), 134-146. doi: 10.1177/088840640402700205

General Counsel at The University of Wisconsin (2010). Overview of title II of the Americans with Disabilities Act: Students. Retrieved from

Grossman, P. D. (2009). Forward with a challenge: Leading our campuses away from the perfect storm. Journal of Postsecondary Education and Disability , 22 (1), 4-9.

Katsiyannnis, A., Zhang, D., Landmark, L., & Reber, A. (2009). Postsecondary education for individuals with disabilities. Journal of Disability Policy Studies, 20(1), 35-45. doi:10.1177/1044207308324896

National Center for Veterans Analysis and Statistics (NCVAS). (2011, January). Educational Attainment of Veterans: 2000-2009. Retrieved June 2012, from National Center for Veterans Analysis and Statistics: http://www.va.gov/vetdata/Report.asp

National Institute of Mental Health. (2011, October). Post Traumatic Stress Disorder Research Fact Sheet. Retrieved May 2012, from National Institute of Mental Health: http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-research-fact-sheet/index.shtml

Office for Civil Rights (OCR). (1998). Auxilary aids and services for postsecondary students with disabilities. Retrieved from http://www2.ed.gov/about/offices/list /ocr/docs/auxaids.html

Office for Civil Rights (OCR) (2011). Students with disabilities preparing for postsecondary education: Know your rights and responsibilities. Retrieved from

Radford, A. (2011, September). National Center for Education Statistics. Retrieved May 2012, from Publications and Products: http://nces.ed.gov/pubs2011/2011163.pdf

RAND Corporation. (2008). Invisible Wounds Mental Health and Cognitive Care Needs of America's Returning Veterans. Retrieved May 2012, from RAND Corporation: http://www.rand.org/pubs/research_briefs/RB9336.html

Rudd, D. M., Goulding, J., & Bryan, C. (2011). Student Veterans: A National Survey Exploring Psychological Symptoms and Suicide Risk. Professional Psychology: Research and Practice , 42 (5), 354-360.

Sander, L. (2008). Veterans journey from "combat to college" on a Maryland Campus. The Chronicle of Higher Education. Retrieved from http://chronicle.com/article/On-a-Maryland-Campus-Veterans/131399/

Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. § 794.

Shackelford, A. L. (2009), Documenting the needs of student veterans with disabilities.

Journal of Postsecondary Education and Disability , 22 (1), 36-42.

Souma, A., Rickerson, N., & Burgstahler, S. (2012). Achieving equal access through accommodations and universal design. Retrieved May 2012, from University of Washington DO-IT: http://www.washington.edu/doit/Brochures/Academics/psych.html

The Post-9/11 Veterans Assistance Act of 2008, H.R. 2642; Public Law 110-252.

U.S. Department of Health and Human Services Centers for Disease Control and Prevention. (2011, October). Get the Stats on Traumatic Brain Injury in the United States. Retrieved May 2012, from Centers for Disease Control and Prevention: http://www.cdc.gov/traumaticbraininjury/pdf/BlueBook_factsheet-a.pdf

United States Department of Defense, Task Force on the Prevention of Suicide by Members of the Armed Forces. (2010). The challenge and the promise: Strengthening the force, preventing suicide and saving lives: Final report of the Department of Defense task force on the prevention of suicide by members of the armed forces. Retrieved May 2012, from Department of Defense: http://www.health.mil/dhb/downloads/Suicide%20Prevention%20Task%20Force%20final%20report%208-23-10.pdf

University of Washington DO-IT. (2004). Accommodations and Universal Design. Retrieved May 2012, from University of Washington DO-IT: http://www.washington.edu/doit/Faculty/Strategies/Disability/

Vance, M. L., & Miller, W. K. (2009). Serving wounded warriors: Current practices in postsecondary education. Journal of Postsecondary Education and Disability , 22 (1), 18-35.