Students’ Choices about and Preparations for Study Abroad

Reflecting on their pre-departure thoughts, young adults with non-apparent disabilities interviewed by MIUSA, including those with arthritis, diabetes, and learning disabilities, did not recall feeling as concerned as their parents about the upcoming study abroad program. 

This was especially true for individuals who have had their disability or diagnosis since an early age. Aside from the usual nerves, most felt comfortable with everyday management of their disability or condition, both in the United States and anticipating living abroad.

"One of the best things about having dyslexia is that, because of the way my brain works, I was forced at a young age to learn how to solve problems creatively and accomplish goals,” says Kevin Long who has volunteered in various countries and founded an international exchange organization. “I really look at it as a blessing. I was never handed these skills. I really had to develop them creatively."

Aside from the usual nerves, most felt comfortable with everyday management of their disability or condition, both in the United States and anticipating living abroad.

On the other hand, for an individual who has had disability since a very young age, international exchange may create a new experience: to have full responsibility of her or his own care, or to have to explain to others about his or her disability and accommodation needs.

“I never had [a sense of] ownership over my disability or my body, because I was so young when I was diagnosed. My school just told me what I had to do – you take your medication at this time, you go to physical therapy,” says Allegra Johnson, who has arthritis and studied abroad in Martinique and France. “I wasn’t the most [responsible] person with my health condition in college; I had a rebellious or denial period. In retrospect, I wish I had thought more thoroughly [about my arthritis] before I went overseas. There were things I let slide, and luckily, they ended up okay. I realized after I came back from studying abroad that I was going to have this [disability] as an adult and that I had to change the way I thought about it.”

Individuals whose disability was more recently diagnosed, or even students whose disabilities first occurred while they were abroad, often experienced more uncertainty. They found that management of their health and access needs while overseas required more energy.

“After an initial diagnosis of diabetes you go through what is termed ‘the honeymoon phase’ during which your insulin production comes back for a period. That happened to me while I was abroad,” says Chris Opsal, who studied in London. “My insulin needs decreased but I didn’t know that was supposed to happen, so I kept taking the same dose I was on and I kept being low all the time. Having been so newly diagnosed, and with the numbers appearing fine, I didn’t even know that I should have had a doctor reevaluate it with me. In retrospect, I don’t know if I should have gone abroad or not so soon after diagnosis, but I’m glad I did in many ways.”

Photo Caption: Talking with other travelers with disabilities can give students an idea of what to anticipate abroad for planning purposes.

The emotional transitions related to acceptance of a new disability can also impact the way that an individual experiences study abroad. One student, who asked not to be named, studied in Spain soon after being tested for and diagnosed with a learning disability. She recalls, “When I found out about my disability, I was ashamed; I couldn’t believe it. How did I get this far in my schooling and just now realize it? I didn’t ask for accommodations [overseas] because I didn’t want my study abroad experience to be just about my disability. Now, if I were to do another program, I might do it differently.”

On the other hand, being in Spain right after diagnosis gave another student, Angela Brown, a chance to incorporate the new disability into her identity, without pressure from family and friends, who were struggling to let go of their own pre-diagnosis image of her. The people that she met overseas only knew Brown as having lupus, and the fatigue that comes with it; this gave her a feeling of acceptance while there.

Uncertainty and the Need to Plan

Regardless of how students have managed their disability, many grapple with the tension between the program structure and the need for flexibility demanded by the typical, sometimes daily, fluctuations of their conditions. “My biggest issue is fatigue, and this concerned me about going abroad, because some days I have to spend all day in bed resting,” says Jennifer Marshall, who has had a brain injury for several years. “I thought it would be a social barrier, since I have to schedule naps in order to function regularly. But, I made many social connections with the students I studied with as well as people overseas. My advice to others would be to rest up, and don't be embarrassed about it.”

Betsy Valnes, who has a similar condition, adds, “To deal with fatigue, I use my discretion for when I have to call it quits for the day. Social activities are what I usually end up excusing myself from more so than meetings.” Finding a program that schedules group activities in the morning, and leaves the afternoon open may work best for those with reduced energy levels, suggests Terese Shelton, whose son also has a brain injury.

Photo Caption: Finding luggage that rolls and packing fewer clothes can help in saving energy and keeping organized as one moves from place to place abroad.

Individuals with other disabilities may miss out on some of the exchange activities if the schedule is too full and does not correspond with their energy levels on a given day. “Teaching abroad in France was a time in my life where I had no problem with my arthritis, but on study abroad trips, there were times when I would have to sit out on some things,” says Allegra Johnson. “Arthritis is not black and white; you can wake up one day and feel bad because the weather is lousy or because you overdid it the day before. I would say about 25% of the time I was having issues [of fatigue or pain], but I always felt like I was not an inconvenience, and that people wanted me to be on the program.”

Purnell, a U.S. high school for girls that conducts study programs to countries such as Ecuador, France and Spain, offers one example of a program design suited to the needs of their students, who have learning disabilities. The U.S. school contracts with a host language school in each country to provide three to four hours of instruction every morning, with a break in the middle. “It’s not intensely focused all day long, which is nice because in the afternoon we can go do cultural activities, where the students still practice the language but in a non-classroom setting,” remarked Amy Pasterczyk, the teacher who leads the trip to France.

Other uncertainties for students with non-apparent disabilities going abroad relate to “flares” or other changes in condition related to stress, environmental factors such as weather or sunlight, diet and level of activity. These “flares” may occur less frequently than ongoing fluctuations, but with greater intensity when they do happen. “The things that make Tourette’s tics bigger or louder is stress, nervousness, anxiety, and excitement, all at the same time,” says Emily Holmes who traveled to Japan. “So during the first couple of days [my tics] were big. I had to let people know that I didn’t know for how long it would last. As it turns out, I ended up being so comfortable that everything went down quickly.”

More difficult may be finding solutions if a student’s disability-related change in behavior or health condition is not short-lived, if group dynamics are unsupportive or if a change in condition requires the student to receive more attention than the group leader can provide. “[This can be] challenging. Some resident directors are better at working with this situation than others,” says Catharine Scruggs, Program Director at Council on International Educational Exchange (CIEE). Carol Larson who sends students abroad through the University of Pittsburgh agrees that it’s up to the exchange staff or faculty to address the reasons causing the issues, and to find solutions. “We have an intense mandatory faculty training before the group leaves, to address health and safety issues,” Larson explains, including disability-related factors.

"I would say about 25% of the time I was having issues [of fatigue or pain], but I always felt like I was not an inconvenience, and that people wanted me to be on the program.” Allegra Johnson

Some exchange programs address possible changes in behavior or condition directly in the pre-departure phase. Kathryn Hanrahan at Youth for Understanding (YFU), whose exchange program sends high school students abroad, provides an example: “Student with ADD or ADHD need to be aware that it is going to be a challenging program. If they are having difficulties here in the United States, then they will have difficulties there too, and excessive stress may change their condition somewhat. We let them know that if it becomes too much of a challenge for them to get through the program, then in their best interest we will bring them home early.”

Alternative Options and Unexpected Benefits

Considering the uncertainty of how the overseas setting will impact someone with a non-apparent disability, students can look into different types of study abroad programs, to find one with structure and supports that match their needs, suggests Lynnett Van Slyke, Director of Disability Services at the University of Pittsburgh. For example, a student might look for programs with on-site supports (e.g. English speaking physicians, counselors or other psychological assistance). According to Van Slyke, such services can offer benefits to both the student and the program. “[These are] cost-saving mechanisms in that they may prevent possible destabilization, inpatient hospitalization and early departure,” says Van Slyke. An overseas academic liaison or coach might be helpful for a student with attention or short-term memory issues that impact time management, prioritizing and organizational skills.  If these are not available, another solution might be to establish a weekly schedule for the U.S. campus staff to interact with the student through email.

Change in the environment doesn’t always have a negative impact on the student’s condition. “I was living in Spain, so I was benefiting from the lovely siesta,” says Angela Brown, who has lupus and enjoyed the two-hour rest period each afternoon. “The lifestyle was much more calm; the focus was on enjoying life, it wasn’t on being a workaholic. I have a workaholic tendency, and Spain really slowed down my pace in a really good way. I was much healthier and happier there. I was much less sick. I fit in very well.”

Similarly, some students with Asperger’s Syndrome, despite a preference for known routines, do quite well in adjusting to an overseas culture. This was true for Ted Koehler, who went to Japan on a student group exchange program. “After thirty minutes being there, it was like being in my own house! Surprisingly, I was very comfortable – for some reason, the cultural structure is less intimidating. I enjoyed being overseas very much and I got along very well with the Japanese people. The family homestay situation was structured. You know what is expected of you in Japan. It’s a more ritualistic society, and people with autism can be ritualistic. I knew the basic culture was family-oriented, so I could follow their structure.”

Photo Caption: The cultural differences in other countries can have a beneficial impact on some students with disabilities.

Mary Minn Sirag, a traveler with autism, explains that the uniqueness of a new place while traveling abroad coupled with less expectations on outsiders to know social cues may provide the right combination for people with autism and Asperger’s Syndrome. “People, including myself, thrive on novelty by being in a new setting or overseas. I become less unglued when I travel; it’s the right kind of challenge in that it is invigorating. I don’t need to have everything be in order like at home,” she explains. “Social faux-pas are often mistaken for cultural difference, which lowers social expectations and pressures on us. Foreigners often see autistic openness as charming and innocent rather than inappropriate and awkward. This defuses the social pressure we feel in our own national culture.”

Managing Stress and Proving Success

Most students with non-apparent disabilities find that the strategies to manage stressful conditions at home, often can get them through the stresses that they encounter during their experiences abroad.

“My second experience abroad to London was quite scary and exciting to me at the same time. The thought of being away from all of my support systems…and that I was going to have to do a lot of things on my own, gave me gave me a lot of self-doubt,” says Jennifer Marshall, who has mobility and cognitive disabilities related to a brain injury. “But at the same time, the experiences boosted my confidence and self-esteem because I can look back now and say, ‘I did those things.’”

“Some of the changes that occur with brain injury, especially with the frontal lobe contusion, are increased emotional volatility, reacting strongly to changing situations and having more difficulty dealing with stress,” explains Terese Shelton whose son, Gavin, has traveled to Norway since his brain injury. “While Gavin’s [mood changes] are subtle, he had to learn to calm himself. He loads his iPod with all his favorite music and he’d use that during his down periods to moderate his moods to a meditative state. It worked very well to help him relax inconspicuously.” 

"Often times when I’m having an issue with my obsessive-compulsive disorder, something about Japan will come into my mind. I’ll remember when the same kind of thing happened in Japan and it all turned out OK. I think, ‘OK if I did it in Japan, then I can figure it out now.’”  Emily Holmes

Following are perspectives from three students with different disabilities, about how they managed stress while in Japan, which is a culture very distinct from their own daily life in the United States:

• “I used to be very sensitive to noise, touch and smell but it wasn’t much of a problem in Japan. I went on a very crowded train and I didn’t panic or have those problems. Over time I have grown out of this somewhat – physical therapy and occupational therapy in the past has helped me,” says Ted Koehler who has Asperger’s Syndrome. “There may have been some times where I was a little anxious but it didn’t really disrupt me. I cope by thinking about things I like to do, like a certain Japanese [animation film] or video game I like, and just try to phase out the anxiety.”
• “Americans can be very grandiose, very angry, very happy, very sad, but in Japan the Japanese people have a very high level of tolerance in handling situations. So when things don’t go well, they don’t get as angry as Americans for the most part,” says Jonathon Kull who has AD/HD. “That was really helpful for me to adapt to that cultural aspect because when things didn’t go my way (because of language and cultural barriers I didn’t understand or messed up), I wouldn’t get as angry or upset."
• “Often times when I’m having an issue with my obsessive-compulsive disorder, something about Japan will come into my mind. I’ll remember when the same kind of thing happened in Japan and it all turned out OK. I think, ‘OK if I did it in Japan, then I can figure it out now,’” says Emily Holmes who, to address her issues with germs, talked with others in her exchange group in advance about touching her clothes and with exchange staff about finding 24-hour access to laundry machines. “I had to be flexible – it was be flexible or go home. I didn’t want to go home so I just pushed myself as much as I could. There were times when I just couldn’t push myself anymore, and listening to music helped. By pushing myself little bits at a time I was able to be successful, and I was able to make my life easier.”

The potentially stressful situations that these students encountered abroad challenged them to adapt and use strategies they had learned at home; conversely, they returned home with new ways to adapt and manage stress. “I think a lot of people with disabilities are stronger than people think they are,” says Kristin Faudree, who has dyslexia and studied abroad four times. “If they go through the lengths to put themselves out there [in a study abroad program] they are going to do whatever it takes to stay there.”

Choosing the Right Program

When trying to decide between different programs, students with disabilities, including those with non-apparent disabilities, need access to explicit information about whether and how an organization will meet their accommodation needs. Students with disabilities have the right to apply to any programs in which they meet the standard qualifications, and to be accepted to any program for which they are qualified. However, many students look for exchange providers that have laid the groundwork for accessibility and disability-related accommodations, or indicate readiness to do so.

“I believe that there’s always a way to accommodate a student that is determined and works hard. We certainly go out of our way to accommodate them [because] we love the diversity that students with disabilities offer to our program when they go. We ask them what kind of assistance they will need, so we can make sure it’s available where they are going,” says Lisa Baum, who works as a study abroad advisor at San Jose State University.

Brennan Rhodes who has a learning disability, chose International Studies Abroad as her exchange provider, because they told her early on that they could arrange accommodations for the extended time on tests she needed while in Spain. “I think once [some providers] hear ‘disability,’ they get frightened,” says Rhodes. In her experience, she discovered program staff often doesn’t know exactly what “reasonable accommodation” means or how to begin an interactive process with the student to determine what accommodations are needed and how they will be provided overseas. “I don’t see why someone shouldn’t be included in programs because they [need accommodations] and thus a whole population of human beings is overlooked,” she adds.

Photo Caption: Exchange administrators are encouraged to assess the host countries for disability and access-related services when doing site visits. The National Clearinghouse on Disability and Exchange can direct exchange programs to survey tools to use.

“For some exchange providers, there may be a budget issue if for example, a student needs extra tutoring because they have a learning disability.  It’s not a problem for CIEE, because we budget for inclusion ahead of time in all our programs so that we can cover it,” says Catharine Scruggs, Program Director for Council on International Educational Exchange (CIEE). “For example, one student with a learning disability took longer to understand the coursework, so [we arranged] a tutor and now she is doing very well and is completely caught up.” Exchange programs can learn more about budgeting for inclusion from the National Clearinghouse on Disability and Exchange.

Sometimes funding isn’t as much of an issue as reluctance of the home institution or program provider to ask for and negotiate with overseas hosts. Kristin Faudree, who has a learning disability, didn’t have the accommodations that she needed while studying in Chile. “Some programs, when asked to arrange for accommodations say that learning disabilities are not acknowledged abroad [and therefore accommodations aren’t available]. I understand this cross-cultural disability issue, but it doesn’t take much to prepare the family and school.  There are host families that are willing to work with you and teachers that are willing to work with you. I think that saying ‘It’s not acknowledged abroad’ is an easy way out for study abroad programs. ”

Disability service providers on campus can sometimes be helpful to study abroad professionals working with a student with a less familiar disability, says Carol Larson, Assistant Director for Outreach and Management at the University of Pittsburgh’s Study Abroad Office. Disability service offices can assist U.S. and overseas study abroad staff to understand better the student’s access needs and come up with practical accommodations overseas if needed. In the case with a student with narcolepsy, a sleep disorder, who traveled to New Zealand through the University of Pittsburgh,  accurate information provided by the campus disability services program helped to create better awareness, so the student had a successful study abroad experience. The same has been true for University of Pittsburgh students with epilepsy who traveled to Europe. “A few students [with epilepsy] have had bad days, but certainly was nothing that deterred them from wanting to go abroad again,” says Larson.

Some students with disabilities attend schools with smaller study abroad offices and/or less experience with disability planning. “I tried talking to the people in charge of study abroad at my school and they kept saying ‘We’ll see what we can do, we’ll try, we’re not sure.’ I was not in the mood for working for [accommodations] and not getting them. I didn’t understand why it had to be ‘We’ll see,’” says Emily Holmes, who has Tourette’s syndrome as well as psychiatric and learning disabilities. “At the time I didn’t know that MIUSA’s [National Clearinghouse on Disability and Exchange] supported people with disabilities in international exchanges, otherwise I would have contacted them when talking with the study abroad staff at my school.”

Photo Caption: Exchange programs and students with disabilities can learn more about their legal "rights and responsibilities" in the National Clearinghouse on Disability and Exchange's online publication by the same name.

Lynnett Van Slyke, a director of disability services for university students, also points out that some study abroad programs tend to unnecessarily shelter students with disabilities, so the result is that these students don’t get the same study abroad experience as their non-disabled peers.  A student who chooses a program that leans toward protectiveness may need to provide accurate information about their needs, capabilities and rights. “A lot of it is just about educating the providers, affiliates, and the overseas faculty that this is going to be OK, the student is going to be OK, you’re going to be OK,” says Van Slyke.

Some students with disabilities will want to look for programs that provide assurance of support in case disability or access-related issues arise. “Knowing that there’s someone to intercede on their behalf, or tutor if necessary gives [students with disabilities] a sense of security,” says Lisa Baum, who has dyslexia and is a study abroad advisor. Ted Koehler, who has Asperger’s Syndrome agrees, “I’d like to find a program that offers a safety net.  That will give me [confidence to be independent] and have a good time experiencing what is there, knowing that I have [support] if there are any problems.”

"All the museums and art galleries are free, so we had interactive classrooms, which is my preferred method of learning plus it cuts down on my reading and writing processing times!" Jennifer Marshall

Structure and size of the program are other variables that students consider in choosing a program. Students with some disabilities, for example those on the autism spectrum, may appreciate more structured itineraries, so they can know what to expect in advance of traveling. Other students may look for programs that combine interactive learning with classroom settings. “The best part about the London exchange is that we were able to go on field trips,” said Jennifer Marshall, who has a brain injury. “All the museums and art galleries are free, so we had interactive classrooms, which is my preferred method of learning plus it cuts down on my reading and writing processing times! I've looked into other interactive programs such as this, because I do better academically and my interest level increases when there are alternative ways to learn the materials.”

A smaller group program can provide more ready access to the faculty leader to get questions answered, receive additional attention and facilitate itineraries that can be designed around participant’s needs. “The language schools that we work with are amazing,” says Amy Pasterczyk who travels with groups between 5-15 high school students with learning disabilities. “The students live with homestay families and take language classes in the smaller city of Nice, France so that they are comfortable [with their skills] before they go to Paris. By the time we’re in the big city, the language is familiar and isn’t as intimidating.  If we were to send our students with the larger tour companies, with many different schools, getting on a tour bus going from site to site to site, it would be overwhelming.” Katherine Enslein, a student on Pasterczyk’s school program initially was nervous about traveling with other people, but was more relaxed by the second day of traveling together.  By the program’s end, after having spent a couple weeks living with the other students on the program, she says she really enjoyed the group concept.

“I think when you have kids with disabilities, you attach a lot of importance to their feeling comfortable, and having a sense of some familiarity to use as a base,” says Alison Enslein, Katherine’s mother. “Hopefully as she gets older, more mature and more confident, she will look at going abroad in a different way and feel comfortable going on her own.”

A smaller group program can provide more ready access to the faculty leader to get questions answered, and facilitate itineraries that can be designed around participant’s needs.

Experiencing one’s first exchange program closer to home is another option for some students. Both Betsy Valnes and Jennifer Marshall, who have brain injuries, went to Canada for their first out of country experience, and then moved on to countries farther away for later exchange programs.  “I had always had an interest in international and diversity issues. Going to the international music camp in Canada was a good first step, since it’s still close to home and Canada is fairly similar to the United States,” says Valnes who lives in South Dakota. “It was helpful to have things that were common to what I’m used to, and at the same time a chance to get to interact with hundreds of people from different areas.” For Marshall, a pre-freshman year summer program to Quebec provided her with a chance to test out her strategies for communicating with college faculty about accommodations she needed.

Summary

Many students who have health, psychiatric, learning, behavioral or other non-apparent disabilities are concerned to some extent about how fluctuations or exacerbations in their conditions will impact the experience abroad. Variables such as how long one has had the disability or has been responsible for one’s own care may have an effect on students’ confidence that they will be able to manage abroad. In general, however, exchange program alumni with non-apparent disabilities report that the challenges that they actually encountered while abroad, including fatigue and fluctuating disability conditions, didn’t detract from the value and enjoyment of the international experience.

Some students with non-apparent disabilities intentionally choose the type of international program that fit their needs, for example, a program with on-site counselors or tutors, small groups, a particular schedule or structure, or a program in a country similar to the United States. Other students choose programs that don’t specifically match their access needs, opting to exercise adaptability and flexibility, while working with the program to make the best possible access arrangements. Once one knows what to look for in a program, the considerations specific to one’s disability should not get in the way of studying overseas.

Suggestions based on Past Experiences:

1. Emotional transitions related to acceptance of a new disability can impact the way that an individual experiences study abroad. Sometimes being abroad can give students a chance to incorporate a new disability into their identity, without pressure from family and friends.
2. A program that schedules group activities in the morning and leaves the afternoon open may work best for those with reduced energy levels.
3. Some uncertainties relate to “flares” or other changes in condition related to stress, environmental factors such as weather or sunlight, diet and level of activity. These “flares” may occur less frequently than ongoing fluctuations, but with greater intensity abroad.
4. Students can find a study abroad program with structure and supports that match their needs. Examples include on-site support services such as English-speaking physicians, counselors, or an overseas academic liaison or coach.
5. Some students find that the social pressure and expectations they feel in their home culture are defused in interactions abroad, and some appreciate a cultural tradition of downtime or ritual.
6. After pushing themselves to be flexible when faced with the alternative of going home, many students complete the program and when they finally return home have new ways to adapt and manage stress, which boosts their confidence and self-esteem.
7. Listening to music can help get through stressful situations.
8. Students with disabilities have the right to apply to any program for which they meet the standard qualifications, and to be accepted to any program for which they are qualified.
9. Exchange administrators are encouraged to assess the host countries for disability and access-related services when doing site visits. They can learn about survey tools to use, and about budgeting for inclusion (e.g. extra tutoring for those with a learning disability) from the National Clearinghouse for Disability and Exchange.
10. The student and the campus disability service office can assist exchange program staff by providing accurate information about the student’s needs, capabilities and rights, and suggesting practical accommodations.
11. Students should consider structure and size of the program. Options include more structured itineraries; programs that combine interactive learning with classroom settings; and smaller group sizes that can provide more ready access to faculty.
12. In general, exchange program alumni with non-apparent disabilities report that the challenges they encountered while abroad didn’t detract from the value and enjoyment of the international experience.