Agarwal, N., & Kumar, V. (2017). An invisible student population: Accommodating and serving college students with lupus . Work , 56 (1), 165–173.

Journal Article

Agarwal, N., & Kumar, V. (2017). An invisible student population: Accommodating and serving college students with lupus. Work, 56(1), 165–173.


Extended time; Physical disability; Physical supports; Postsecondary; Speech recognition system; U.S. context; Word processing (for writing)




The episodic, fluctuating, and hidden—or "invisible" to casual observers—nature of lupus and other health conditions was investigated, yielding information and recommendations about academic supports and accommodations for the postsecondary education context. Accommodations were not specified at the outset of the investigation; details emphasizing accommodations for student work products and course exams were reported in the Findings section.


For this single-subject account, a postsecondary student with Systemic Lupus Erythematosus (SLE), or lupus, which is a chronic autoimmune disorder, participated. Sufficient personal information was relayed, the researchers noted, in order that readers could ascertain the degree to which the findings could be transferred, or applied to other settings and students. The location was apparently a university in Texas (U.S.).

Dependent Variable

Drawing source information from a larger study [Agarwal (2011)], this in-depth case study analysis encompassed a series of individual interviews with the identified student. Interviews were semi-structured with open-ended questions, and elaborated on the challenges, needs, and responsibilities of postsecondary students with lupus. Qualitative information provided by the participant was put into discussion with the academic research.


A set of recommendations was developed for accommodations and other support services that can be considered for addressing the academic needs of postsecondary students with lupus or other chronic autoimmune disorders and illnesses. The episodic and variable degree of impairment across an academic term indicated the need for a higher degree and frequency of communication and negotiation between student and faculty members than for some other students with disabilities for whom (their) accommodations might be ongoing or routine. Class session absence consideration and timing of completion of course requirements were recommended to be more flexible due to the need for medical care appointments and due to a chief matter for students: fatigue. Considerations beyond individual courses, such as an expanded flexibility in an academic program's course sequencing, were also offered. Recommendations included accommodations and academic supports typically considered for a range of disabilities, such as extended time on exams and assignments, as well as those to address pain and fine motor challenges such as ergonomic keyboards or speech-recognition for dictating instead. Other supports and services recommended included: provision of priority registration or pre-registration, reduced course loads, flexible attendance policies, frequent rest breaks, course incompletes, the provision of a note taker, online classes, counseling, campus transportation, and accessible parking according to the Americans with Disabilities Act (ADA).