Voices of Undergraduate Students With Disabilities During the COVID-19 Pandemic
A Pilot Study
Abstract
Abstract. Social distancing, lockdown, and other restrictive measures imposed because of the COVID-19 pandemic led universities to transfer to remote online instruction. Several studies examined the impact of online instruction on students’ academic and socioemotional performance, whereas only limited research evidence exists concerning the performance of university students with disabilities (SWD) during online learning. This exploratory qualitative study aims to understand the experiences of nine undergraduate SWD during the COVID-19 pandemic. A thematic analysis revealed that SWD experienced multiple adversities related to academic (e.g., accommodations, communication with university instructors, academic advisor) and socioemotional (stress, routine disruption, lockdown effects) areas. We compared and contrasted our study findings with existing literature on creating equitable academic environments and reducing access barriers for all students.
The World Health Organization (WHO, 2020a) declared the coronavirus outbreak a global pandemic in March 2020. By August 2021, there were more than 209 million confirmed COVID-19 cases around the globe, including more than 4 million deaths (WHO, 2021a). Four genetic variants of the COVID-19 have been classified as posing an increased risk to public health (WHO, 2021b). The pandemic outbreak forced national authorities, in conjunction with the WHO, to develop an immediate response strategy to stop further transmission of COVID-19 and to collaborate with the international scientific community to identify preventative and remediating measures (WHO, 2020b). Current national efforts are concentrated on monitoring and controlling virus transmissions through testing and screening, imposing social measures (e.g., physical distancing, local or regional lockdowns, mask-wearing, travel restrictions, work-from-home programs, online instruction), introducing national deployment and vaccination plans against COVID-19, and building vaccine confidence and overcoming hesitancy (Figueroa, 2021; WHO, 2021c). Rapid research developments with public and private funds (European Commission, 2020; WHO, 2020c) led to the production, clinical testing, and manufacturing of various vaccines across continents, documenting their efficacy on initial COVID-19 variants (e.g., Baden et al., 2021; Logunov et al., 2021; Polack et al., 2020; Voysey et al., 2021), while more research is currently underway to investigate the long-term impact of vaccines on the latest COVID-19 variants (e.g., Pouwels et al., 2021). Additionally, ongoing randomized clinical trials are examining the effectiveness of pharmacologic and nonpharmacologic treatments as well as other preventative treatments (e.g., vitamin C, zinc oxide, social distancing, etc.) (see COVID-NMA, 2021, for live updates).
In their efforts to control the COVID-19 transmission, during the last 18 months, higher education institutions transferred all conventional courses to remote learning (e.g., Meleo-Erwin et al., 2021; Pokhrel & Chhetri, 2021). The COVID-19 pandemic pushed universities to make a paradigm shift for online course delivery by employing e-learning tools, compatible software, and online platforms. Transitioning from face-to-face to online instruction drove instructors and students into “unfamiliar terrain” (Carolan et al., 2020, p. 1), as new teaching, assessment, and evaluation methods were introduced (e.g., Johnson et al., 2020; Sahu, 2020). Research evidence on student adaptability to online learning revealed a range of difficulties related to online participation (e.g., work and information overload received from instructors), technical issues (e.g., inadaptability and unfamiliarity of the e-learning platform), and personal health challenges (e.g., stress, anxiety) (Al-Kumaim et al., 2021).
One student body that is particularly vulnerable to academic and psychological risks during the COVID-19 pandemic was students with disabilities (SWD) (Pokhrel & Chhetri, 2021; United Nations, 2020a, 2020b). According to Heward and colleagues (2017), SWD are persons whose physical, sensory, cognitive, and/or emotional characteristics differ from the norm to such an extent that they require an individualized education plan and related services and accommodations to fully participate in instructional processes. Recent policy briefs of the United Nations (UN, 2020a, 2020b) stated that the COVID-19 crisis significantly affected SWD and exacerbated pre-existing social and educational inequalities between students with and without disabilities. According to UN reports, SWD experienced difficulties with accessible software and learning materials, acquiring appropriate accommodations, receiving therapies, and feeling supported by their milieu. Researchers across the globe studied the impact of COVID-19 on various aspects of people with disabilities such as the availability of remote instruction and campus counseling resources for university SWD (e.g., Meleo-Erwin et al., 2021), the living conditions (Navas et al., 2021), or the health, well-being, and accessing services of adults with intellectual and developmental disabilities (e.g., Rosencrans et al., 2021), the mental health of parents and their children with disability (e.g., Asbury et al., 2021; Bentenuto et al., 2021; Trzcińska-Król, 2020), the delivery of therapy services for children with disabilities (e.g., Murphy et al., 2021), and the mental health of adults with disabilities (e.g., Pettinicchio et al., 2021).
Before the COVID-19 pandemic, academic institutions were slowly paving the way to depart from traditional conventional teaching to online courses. The growing student diversity and globalization trends had generally put pressure on universities to explore distance education while maintaining traditional course instruction. Nonetheless, the shift to online course delivery presented universities with several challenges. According to Chen (2009), the main barriers to adopting distance education courses included program expenditure (course development costs, platform maintenance costs) as well as faculty participation (limited interest, need for incentives, increased workload). However, in cases where online courses were designed and offered by academic institutions, SWD tended to be overlooked because of accessibility issues related to e-learning platforms, course materials, and instructional delivery (Edmonds, 2004).
The coronavirus outbreak obliged universities to rapidly offer traditional courses online with no sufficient time available to address the above accessibility issues (Logan et al., 2021; Meleo-Erwin et al., 2021). Interestingly, few research studies have been conducted thus far concerning the academic and socioemotional performance of university SWD during online instruction under pandemic conditions. Such empirical evidence is not encouraging about the effective inclusion and equal participation of university SWD in online learning environments. For instance, the study by Soria et al. (2020) investigated the experiences of 1,788 university SWD across nine academic institutions and produced several findings, including the hardships SWD face with financial costs (e.g., technology expenditure for online courses), limited university academic support, emotional distress and insecurity, and higher rates of mental-health issues compared to students without disabilities. Similarly, Zhang and colleagues (2020) examined the education and mental health of university SWD, utilizing a similar data collection method as in the study by Soria et al. (i.e., a survey) to compare a sample of university students with (n = 147) and without disabilities (n = 119). Their research documented that SWD reported higher COVID-19-related stressors (e.g., anxiety, stress, insomnia, lack of concentration, isolation) than peers without disabilities. Results for academic performance showed that university SWD were more concerned about classes going online and perceived significant consequences of online courses (e.g., worse grades, being unable to meet academic requirements online) compared to peers without disabilities.
More recently, Logan and colleagues (2021) and Ngubane-Mokiwa and Zongozz (2021) conducted qualitative research with university SWD in the United States and South Africa, respectively. Logan et al. conducted individual interviews with 66 undergraduate SWD in the STEM field and found that the online platforms presented unique challenges to SWD which could have been minimized by implementing accommodations. These researchers concluded that instructors and disability resource centers were not always in direct communication, which prevented SWD from receiving the appropriate accommodations necessary for their online STEM courses. The qualitative research of Ngubane-Mokiwa and Zongozz (2021) pointed out that COVID-19 exacerbated educational inequalities for SWD during online learning as higher education institutions followed exclusionary practices in exam administration and course delivery. Students were not provided with the appropriate support (e.g., assistive technology) nor were they tested on time compared with their peers without disabilities.
University SWD represent a heterogeneous group with varying accessibility and socioemotional needs. According to Article 24 “Education” of the UN’s Convention on the Rights of Persons with Disabilities (United Nations, 2006), governments are responsible for ensuring equal and equitable access to university SWD through reasonable accommodations and related services. The Republic of Cyprus ratified that UN human rights treaty and enacted a series of legislative acts to support the rights and the education of people with disabilities (e.g., “The Convention on the Rights of People with Disabilities and Related Topics Law of 2011,” “The People with Disabilities Law of 2000,” “The Education and Training of Students with Special Needs Law of 1999”). While international policies and national legislations provide the context in which universities ought to become inclusive and equitable, it is essential to understand how university SWD experience such academic contexts and to what extent they participate fully in classes and campus life with the appropriate accommodations and related services (e.g., advising). Furthermore, given the dearth of empirical evidence of the impact of the COVID-19 pandemic on the online learning participation of SWD, it is important to directly explore and record their voices and experiences to improve institutional policy and practices.
The current study was part of a larger funded project, whose goal was to investigate the impact of the COVID-19 outbreak on the academic and socioemotional needs of SWD at the secondary and university level during remote instruction. Specifically, the project consisted of two major studies. The first targeted secondary-level SWD and their families, where the research team sought to examine how online instruction under COVID-19 conditions affected student academic performance, and what type of special education and family supports were provided. The second study was conducted in two chronological stages, specifically exploring the academic and socioemotional needs of university-level SWD during remote learning and identifying ways to support their needs at the institutional level. The first stage took place in April 2021 and focused on a small sample of undergraduate SWD, where the research team pilot-tested its data-collection instruments (interview protocol, survey questionnaire); the second stage ended in July 2021 and included a larger sample of both undergraduate and graduate university SWD.
This paper reports the findings of the first stage of the second study. In our pilot study, we studied the voices of nine (n = 9) undergraduate SWD. The specific research questions addressed were:
- (a)How did undergraduate SWD experience academic online teaching (e.g., online course delivery, accommodations, communication with academic advisor) during the COVID-19 pandemic period?
- (b)In what ways did the COVID-19 pandemic affect the socioemotional well-being of undergraduate SWD (e.g., stress, routines, lockdown effects)?
Methods
Sample
After receiving ethical clearance, the research team contacted via email and/or telephone student disability and/or counseling services across six public and private universities in Cyprus in January 2021. Officers were asked to email the study invitation and consent form to their university students who had presented a documented disability. Students with disabilities who were interested in participating in the study first completed the online consent form and then proceeded to complete an anonymous online questionnaire. If the SWD were still interested in participating in the study, then they next provided their contact information (e.g., email, name, phone number) at the end of the online survey, so that the research team could contact them directly for an individual interview. Survey respondents were 62 university SWD across six universities coming from undergraduate and graduate levels; 9 of the undergraduate students chose to proceed with interview participation. Students who completed both research activities were awarded a EUR 20 voucher as a token of appreciation. Data collection for the pilot study ended in April 2021.
The target population of the pilot study derived from the three participating universities and comprised approximately 250 SWD, 24.8% of whom responded to the online survey invitation. Within that accessible population, 14.5% of the SWD participated in an individual interview. Given that the pilot study followed a qualitative approach, the focus lay on an in-depth understanding of the interview sample by targeting participants who would best answer the research questions (Check & Schutt, 2011; Hancock & Algozzine, 2016). Therefore, the study’s sample size was defined by the nature of the research (Kumar, 2019; Patton, 2014; Schratz, 2020).
Table 1 presents the demographics of the interview sample based on sex, university, disability category, program, and academic year of study. All participants were undergraduate students from different academic fields such as social sciences, life and health sciences, and natural sciences. As Table 1 shows, most interviewees presented cognitive (e.g., specific learning disabilities, attention deficit hyperactivity disorder), or emotional difficulties (e.g., anxiety disorder).
Setting
Table 1 reveals that participants came from three academic institutions. Universities 1 and 2 were public and University 3 was private. According to the Cyprus legislation of the “Education and Training of Students with Special Needs Law 1999” [i.e., 113(I)/99] and its subsequent regulations (Cyprus Ministry of Education and Culture, 1999), the state is responsible for providing the least restrictive environment possible for SWD. Specifically, the law and its regulations mandate the provision of support services to SWD, including individualized educational plans, assistive technology resources, accessible buildings, and other academic accommodations (e.g., exam modifications, part-time enrollment, translators, etc.). According to the 113(I)/99 Law, all public universities are obligated to provide all necessary accommodations and reasonable modifications to SWD, while private universities are only encouraged to do so. Unlike private universities, public universities receive governmental funding for ensuring the delivery of appropriate academic supports to SWD. Although the number of SWD is rising slowly in both public and private tertiary education (Cyprus Statistical Service, 2021), issues still remain with the deliverance to SWD of the appropriate provisions for assessing student needs and providing equitable access to services and academic supports. Researchers found that higher-education institutions in Cyprus should revisit their admissions policy as well as the inclusive practices incorporated into their conventional courses (e.g., Hadjikakou & Hartas, 2008; Hadjikakou et al., 2010).
During the COVID-19 pandemic period, public universities started the academic year 2020–2021 with a combination of face-to-face and hybrid formats, but in the middle of the first semester, they entered into full online instruction and retained the same instructional delivery mode through the end of the academic year because of the high increase of COVID-19 cases. The private university offered all courses online for the entire academic year. As far as the research team was aware, all three universities did not issue any announcements for specific supports to SWD during online instruction. All three universities had extensive experience in conventional and online course delivery.
Research Design
This exploratory qualitative research design used specific principles and guidelines from qualitative research to describe and explore the perspectives of university SWD on the impact of COVID-19 on their academic and socioemotional well-being (Creswell, 2018; Thomas, 2015). This design allowed for an in-depth and richer study of the target phenomenon (i.e., COVID-19 and SWD), for which the research team had preliminary knowledge. Additionally, the exploratory nature of the research design emphasized the “voice” of the participants, focusing on exploring and understanding their perceptions attributed to a social “problem” (Merriam & Associates, 2002).
Participant voices were studied thoroughly via semistructured interviews. Interviewing allows the collection of information about people’s beliefs and preferences and the in-depth exploration of participants’ motivations, experiences, and reasoning (Drever, 2003). Even though interviews are a very time-consuming process, particularly the transcription and data-analysis processes, we chose to conduct them because they empower the vantage point of the participants (Taylor, 2005; Low, 2007). Therefore, the use of semistructured interviews enabled participants to discuss not only the topics intended but also ideas that were digressions raised by participants themselves (Elliot, 1991). Given the governmental restrictions of social distancing and lockdown measures, the research team chose to conduct the interviews online. The benefits of online videoconferencing include convenient time scheduling and location for participants, such as talking while being in their home environment where they feel more comfortable (Deakin & Wakefield, 2014; Janghorban et al., 2014). In our study, it was particularly convenient for students with physical disabilities, who depended on their milieu for any transportation. Furthermore, online interviewing allows the use of a video camera, which enhances interactive communication and observation of the interviewees’ nonverbal and social cues (Cater, 2011; Stewart & Williams, 2005). Despite the reported benefits, the necessity of access to high-speed internet, familiarity with online communication, and possession of digital literacy may be factors that hinder the quality of online interviewing (Deakin & Wakefield, 2014; Hamilton & Bowers, 2006). Some students were not familiar with the selected videoconferencing platform suggested by the research team (i.e., CISCO WebEx), in which case the interviews were conducted with alternative online platforms that were more familiar to students (e.g., Microsoft Teams, Zoom, Skype, etc.). To eliminate accessibility obstacles with the online platform, the research team provided detailed written instructions via email to all participants and then followed up with a phone call to ensure that all participants were able to have smooth online access to the e-platform. The research team facilitated the interviewees’ efforts by giving them time to connect and were always ready to ask them to repeat their responses to ensure proper recording (Sigelman et al., 1982).
Data Analysis
We applied a process of inductive thematic analysis, which allowed the identification of themes emerging directly from raw data (Boyatzis, 1998). The research team utilized this type of qualitative analysis for several reasons. First, study data need not fit into some pre-existing coding frame or the research team’s analytical preconception (Braun & Clarke, 2006); it gave space to the participant voices, which may have otherwise gone unheard (Boyatzis, 1998). Second, this analytic process describes how data are organized into patterns of semantic content and summarized for interpretation, theorizing their significance, their broader meanings, and their implications (Patton, 2014) concerning previous literature (Frith & Gleeson, 2004). Finally, the inductive thematic analysis allowed us to produce detailed and complex accounts of findings that emerge from data (Roulston, 2001).
Student interviews were audio-recorded and transcribed for thematic analysis, which was carried out in two stages. The first stage is data preparation (Harris, 1995): The audio recordings were transcribed using the free-access Live-Transcribe application, which converted the oral speech into written text. Then, the researchers listened again to each interview while correcting the transcribed text. Each interview transcription was turned into a Word document. All data were saved in a password-protected folder and stored both online as well as locally. The interview transcripts were first typed and saved in Greek. After completion of the thematic analysis, we translated the extracts selected into English to report them here.
The second stage was data manipulation (Harris, 1995). Data from all respondents were entered into the N-VIVO V.12 software. Conceptual codes were used to code the interview data to identify the themes of the study (Vaismoradi et al., 2016). That is, the interviewees’ answers were summarized using specific codes that initially seemed to arise constantly in each interview and were later collated across interviews. The interpretation of such coding resulted in the data-analysis themes. We explored and discussed the themes regarding the relevant literature. The thematic analysis of the interview transcriptions yielded two major themes – academic domain and socioemotional domain – from 268 coded units and seven categories. Table 2 shows a detailed breakdown of the themes, categories, and qualitative lexicon identified per category.
Research Procedures
We followed a two-step procedure to conduct the exploratory research study.
Step 1: Development of Interview Guide
The four-part interview protocol was scripted to allow consistency in the content covered during administration. It also allowed flexibility in the number of questions asked since the interview was semistructured. The first section included a brief overview of the study objectives and participant demographics. The next part pertained to the socioemotional domain, with probing questions concerning student feelings and thoughts on the continuous increase of COVID-19 cases and its possible impact on their daily routine activities. The third section comprised remote online instruction and how it had impacted their academic responsibilities and types of accommodations. The final section invited participants to share their plans upon exiting the pandemic period, to provide suggestions about academic supports for SWD, and to share any further comments on issues not discussed earlier.
Step 2: Procedures of Interview Administration
Interview administration averaged approximately 40 minutes per participant. Because of the COVID-19 restrictions, interviews took place online via a preferred platform (e.g., Skype, Zoom, WebEx, MS Teams) at a predetermined date and time suitable for each participant. The university students chose to have their cameras on or off. All interviews except one (i.e., Marina) were conducted with cameras running. Each research team member conducted three interviews. All interviewers followed the same interview protocol, and they also had the opportunity to pose additional questions depending on the interviewees’ responses. To ensure consistency in the interview administration, the research team met before the start of the interviews as well as between interviews to review the administration steps and the interview protocol. Administration steps included: (1) developing rapport and building a trustful relationship with each participant so that they would feel comfortable, unthreatened, and safe about providing the researcher with the prerequisite data (Costley, 2000); (2) beginning with a greeting and introducing the study objectives and the purpose of the meeting; (3) asking for consent to record the meeting to improve the interviewer’s note-taking accuracy; (4) starting the interview questions while actively listening to student responses and waiting to discover information – on occasions where participants digressed, the interviewer continued listening for a few minutes and then rephrased the question; (5) concluding the interview by thanking participants and reminding them about receiving their token of appreciation by email.
Credibility Measures
We administered two measures to establish the credibility of the study. First, we maintained an audit trail to keep track of interviews conducted at specific times and on specific dates. Second, we re-read all transcripts at least twice to ensure transcription accuracy. The transcription process took place immediately at the end of each interview to ensure the precise recording of student voices.
Reflexivity
The research team conducted regular meetings to discuss possible issues deriving from the interview administration and the transcriptions of the interviewees. We read the interview transcripts to become more familiar with the data before conducting the thematic analysis. During this process, each team member repeatedly reflected on and carefully documented every step of the procedures followed for the data analysis. The team members critically evaluated their values and understanding of the data content, made the most rational connections, and engaged in discussions to draw the most sensible conclusions of the topic under study (Guba & Lincoln, 1992; Schwartz-Shea & Yanow, 2012). Furthermore, we created an online shared Google document, which was visited frequently by the team members. It provided a holistic account of study procedures related to sample size, interview administration process, and transcription. This tool enabled increased reflexivity among team members, thus ensuring the team’s constant involvement with the study procedures (Baxter & Jack, 2008; King et al., 2019).
Results
Academic Domain
Online Course Delivery
This category pertained to the feelings and struggles undergraduate SWD had experienced during online courses during the COVID-19 academic period. All participants were strongly in favor of conventional courses, where physical contact and face-to-face communication were feasible. Online instruction brought feelings of stress and exhaustion to SWD and more so to those with cognitive and physical difficulties. For instance, Elena, with specific learning disabilities (SLD), explained that …
I don’t like taking online courses. I fall asleep, and I tend to not pay attention … I can’t concentrate … because I don’t like simply listening to a voice coming through my computer. It makes me feel tired … I’ve tried, but I can’t change this.
Likewise, Natalia, with quadriplegia, emphasized that being restricted in one location for many hours is exhausting:
It is tiring … You are asked to stay focused in front of your computer for so many hours … Even during short breaks between online courses, I barely have time enough to eat or drink something.
Participants with emotional and cognitive challenges tended to express low motivation to learn. Specifically, three interviewees lost their interest in gaining new knowledge or even completing assigned tasks during online courses. Marina with anxiety disorder stated that …
I lost interest in studying … I am locked up all the time at home. Unlike in conventional courses, where I could go to the campus, study in the library, and return home to rest or study a bit more. During online courses, I attend courses in the morning and in the afternoon, with very short breaks in between … I had issues with staying organized and interested in the lesson.
Along the same lines, Yannis, with muscular dystrophy pointed out that …
Our instructor would encourage us to participate online, but many students did not feel like participating … The whole instructional approach was impersonal …
According to participants’ responses, online course delivery produced negative feelings about meeting course requirements. On some occasions, students felt that the degree of difficulty of exams and assignments had increased during online courses. Specifically, Nicos, with SLD, shared that …
My academic performance was lower [than that in conventional courses] because the online exams were more difficult … They were with open books and had open-ended questions asking critical thinking …
Similarly, Stavros with SLD noted that …
The way we were tested [i.e., with open books] and the lack of direct communication with our instructor lowered my academic performance …
Accommodations
All participants shared examples of accommodations provided during exams and assignments (e.g., extra time, tutoring, reader) as well as any obstacles faced when receiving such support. Interviewees explained that it was easier to request instructors to provide the necessary accommodations in conventional courses. With online courses, direct communication and physical contact were not possible, and the instructors were not always responsive in providing accommodations. Marina, with emotional difficulties, described it more clearly as follows:
It is difficult to remind your instructor [for your accommodations] in front of others during online courses … Some instructors even forget which students they need to provide such supports. The instructor’s responsiveness varied even though the university [disability services] would inform them … Some [instructors] would forget, and I could not ask for extra time during the exam. Once while taking a test, I asked one of my instructors for extra time, and [he] said, “I cannot change your time because the exam time has already been programmed”…
Elena pointed out the delay in receiving academic supports, which exacerbated her feelings of stress and anxiety.
The most disappointing for me was when I realized that my instructors had not been informed on time about my SLD and my accommodations. I had a panic attack! … It was not until the middle of the semester that the university notified them about my needs.
An additional accommodation obstacle participants shared was the lack of readjustment of specific supports during online course requirements. Some participants explained that certain accommodations for exams or assignments needed to be revisited as students felt that they had not been receiving sufficient support. Anna with ADHD explained:
I wish I could have more breaks during an exam and not have to sit still for 3 hours in front of the computer … Because I was not permitted to get out of my seat [during the exam], I tried to finish my exam as fast as I could …
Natalia, with quadriplegia, pointed out that the delivery of extra time during an online exam or assignments did not suffice:
I had been given extra time during face-to-face exams. But for online exams, the same time is not sufficient … Attending classes online makes for an intensive schedule. Given my physical condition, I am slow in typing, I don’t have a reader, nor do I receive any tutoring from the university … I would definitely benefit from receiving extra time to complete my assignments online.
Communication
Participants experienced challenges when communicating with instructors for support during online classes or when discussing academic issues with their academic advisor. Specifically, three students shared that they were not at ease contacting their instructors via email. For instance, Nicos with SLD reasoned as follows:
It is definitely a difficult period [i.e., the pandemic] for everyone, especially when you are a person with a disability. Your daily struggle to keep up with deadlines and academic responsibilities is not easy … Our instructors have been supportive, but the current situation makes it more difficult to get things done.
Unlike Nicos’ case, Marina, with anxiety issues, had a different standing about communicating with her instructors:
It is not always easy to communicate directly with your instructors. If I had a question during an online class, I would not want to stay and ask it in front of others. Besides, there was not sufficient time to ask at the end of an online class … So, I would email them [instructors] but they were late in responding. They would provide online office hours, but they did not suffice for everyone … That’s why I ended up asking classmates rather than my instructor …
When asked about their level of satisfaction during interactions with their academic advisors, all participants positioned positively about the support they would receive. Such an example comes from Elena with SLD:
I am very satisfied with my communication with my academic advisor. When I finished my exams, they cared about my academic progress and my overall well-being. My advisor guided me to select courses for the next semester and was always responsive to my emails … That is something all students need.
Suggestions for Improvement
In this category, four interviewees provided suggestions for improving their academic and overall well-being during online courses. Suggestions included maintaining systematic and individual communication with instructors for supporting their learning, readjusting some of the accommodations during online exams (e.g., extra time, avoiding deducting double points for any incorrect multiple-choice items), providing more psychological support during intensive course requirements, and inviting the academic community to create fun opportunities to bring students with and without disabilities together.
Socioemotional Domain
Stress
According to the findings, struggles to readjust to daily routines brought several negative feelings of stress and collateral effects of boredom, anger, and sadness. More specifically, all participants explained that the rapid increase of COVID-19 cases created feelings of anxiety and nervousness because they were restricted to the home.
Yannis, with muscular dystrophy, stated that …
Yes, the whole [COVID-19] situation brought me stress and anxiety … I get stressed about becoming sick. When I feel I might have a symptom like COVID-19, I get frightened. I avoid socializing with others until I can get vaccinated … I stay with my family so I have some company … But, I wish I had another friend with me at home …
Marina, with anxiety disorder, explained that her stress levels had increased dramatically over the pandemic.
I have been experiencing daily headaches, increased panic attacks, chills, unrestful night sleeps, increased levels of stress … It all stems from my anxiety toward COVID-19.
Further to Yannis’ and Marina’s experiences is Elena’s account about her becoming stressed with the rapid COVID-19 cases:
Let’s take things from the beginning … It was my last year in high school when the pandemic broke. I started thinking about my high-school graduation, going on vacation, spending my last days with my classmates … These are life events I wanted to experience … Everything was canceled … It was a psychological war for me … After entering the university, I started classes, and I ended up being locked down at home for at least a month … It has been extremely difficult for me to adjust to this pandemic. My well-being has been affected for sure … I get easily stressed. I often find myself having chills, fearing that I have caught COVID-19 … It still is a psychological war for me.
Interestingly enough, only one participant provided a more rational approach to handling stress and anxiety during the pandemic. Stavros, with SLD, who was studying nursing, explained:
I don’t feel scared. When you follow the protective measures, it is not easy to get infected with COVID-19. Besides, as nurses, we are always in danger of getting infected by other diseases. We have been taught how to protect ourselves by wearing a mask, how to dress appropriately before approaching a patient … I was not feeling afraid because I knew my chances of getting sick were slim as I was protecting myself appropriately.
Routines
This category focused on how interviewees had to readjust their daily routines to cope with stress. They shared that they had to improvise several ideas about spending their time creatively, such as socializing through online media, doing house chores, reading for pleasure, listening to music, writing, spending time with pets. Veronica, who had SLD and monoplegia, took a positive behavioral stand toward her negative feelings:
Initially, I was very stressed, especially when I would watch on the news that people were dying because of COVID-19. The fact that you are required to stay home to protect your and your family’s health did not help my psychological well-being … I have to stay home all day. But it is what it is. I have tried to do gymnastics at home or even spend more time with my mom.
Similarly, Elena managed to change her routines over time during this pandemic:
You know, during the initial lockdown, I would stay home all day eating ice cream and watching movies. I did not do any physical exercises. Now [i.e., during the second lockdown], I have readjusted things. I go out with my friends, I clean my apartment, I cook, I go out for a walk.
All but one student responded favorably about making changes in their life because of COVID-19 restrictions. Marina, with anxiety disorder, was still not able to adjust her life routines and struggled severely with her anxiety disorder:
My routine [before COVID-19] was very structured. I went to work, attended classes, and afterward hung out with my friends. Now, we are most of the time locked up in a room. Life now is so monotonous. I even work from home now. On the one hand, I get it: We are protected by this virus when we isolate ourselves. On the other hand, being lonely is very difficult for people who live alone. I have been having a hard time studying and concentrating.
Lockdown Effects
Based on the responses of the interviewees, five SWD spent their time creatively without sharing any concerning thoughts and feelings about being restricted. However, the rest of the students (Elena, Marina, Natalia, Chryso) seemed to struggle to cope with the restrictions of the lockdown effects. According to Marina’s account …
I was not feeling well psychologically during the lockdown. My symptoms of anxiety increased, and I was unable to study for my courses … This negatively affected my grades this semester.
Further, Elena shared several times her psychological issues about dealing with COVID-19. During the lockdown, she mentioned her opposition to adhering to the lockdown order:
I keep up with my daily activities. I hang out. I don’t care anymore. My family is in Greece now, so they are not close to me. So, I don’t run the risk of infecting them if I catch the virus.
Discussion
Using semistructured interviewing, the present pilot study aimed at understanding the academic and socioemotional needs of nine undergraduate SWD during remote online instruction during the COVID-19 pandemic. The main qualitative findings revealed that SWD experienced several challenges related to academic (e.g., accommodations, communication with university instructors, academic advisor) and socioemotional (stress, routine disruption, lockdown effects) domains. Our study findings support previous research documenting the challenges SWD faced during online instruction and document the barriers to equal and full academic participation during the pandemic (Meleo-Erwin et al., 2021; Soria et al., 2020; Zhang et al., 2020). Specifically, students with cognitive and/or emotional difficulties experienced difficulties paying attention online for long periods, received insufficient communication and guidance from instructors, and some developed low motivation for learning. Similarly, Horgos and her colleagues (2020) found that students with emotional or mental-health conditions were less likely to agree that the university had supported them during online instruction. Instead, they experienced more challenges (e.g., lack of adequate study spaces and lack of technology necessary to complete online learning) than students without disabilities. Zhang and colleagues (2020) concluded that university SWD experienced more adversities with online instruction than their peers without disabilities during the pandemic period. In fact, SWD reported signs of distress, difficulty with concentration, insomnia, isolation as well as expressing worries about receiving low grades and being unable to meet online course requirements.
In our study, students with physical disabilities (e.g., muscular dystrophy, quadriplegia) developed a feeling of physical and emotional exhaustion upon switching from one online class to another and with limited time to rest, while longer timeouts provided as an online exam accommodation were insufficient. Similarly, Soria et al. (2020) showed that undergraduate students with physical, learning, neurodevelopmental, and cognitive disabilities experienced higher rates of major depressive disorder and generalized anxiety disorder than students without disabilities. SWD were also significantly less likely than students without disabilities to feel that universities supported them during the COVID-19 pandemic.
As documented in the international literature, over time SWD face many accessibility obstacles to higher education, including institutional, attitudinal, and disability-specific barriers (e.g., Strnadová et al., 2015). Hadjikakou and colleagues (2010) examined the voices of Cypriot SWD in tertiary institutions and found that university officers lacked disability awareness: There was no clear and welcoming policy admission entry for SWD, and no formal policy existed for supporting SWD during the semester. When such barriers ensue, SWD tend to feel more distressed and worried about their academic survival. SWD need to function under a structured and supportive learning environment, where effective supports (e.g., academic advisor) and academic accommodations are already in place (Heward et al. (2017)). The academic advisor is frequently the student’s only connection to the university who could potentially have a significant impact on student’s academic career and level of satisfaction with their college choice. Hong (2015) examined the voices of 16 university SWD and found that the student academic advisor was listed as the second most cited barrier. Advisors who demonstrate a lack of knowledge and responsiveness to the inquiries of SWD create a distressing academic relationship with their advisees. Unlike Hong’s findings, however, in our study, all but one participant positively mentioned the relationship with their academic advisor.
When designing and delivering online courses, instructors ought to think inclusively and holistically by accommodating the needs of their diverse learners. Instructors should first try to understand and identify barriers to online learning for a specific student and then seek possible options to facilitate the learner’s needs (Rice & Dykman, 2018). Previous research indicated that the successful inclusion of university SWD depended significantly on accommodations provided by disability services (Abu-Hamour, 2013). Usually, the primary accommodation given is extended time (Terras et al., 2015), which is considered one of the “easier” accommodations instructors can deliver, irrespective of a student’s disability (Phillips et al., 2012). According to our findings, accommodations were not always delivered on time or sufficiently, which elevated the stress level of SWD when requesting them in front of their classmates. It was also evident in some interviewees’ responses (e.g., Marina, Elena) that instructors were not even aware of possible student accommodations. Phillips et al. (2012) examined the online accommodation experiences of faculty at one public university and found that the faculty had the perception that SWD chose to self-accommodate or, for whatever reason, chose not to request any accommodations from their online instructors. According to Getzel and Thoma (2008), SWD experienced several difficulties when asked to take the responsibility of managing their accommodations along with their academic courses. One such difficulty is the perception SWD exhibit that their disabilities may negatively impact their ability to succeed in online courses (Roberts et al., 2011). Thus, SWD may not report their disabilities since they are unaware of their functional limitations and are unsure what accommodations to request in online settings which might meet their needs (e.g., Hong, 2015). It is important to note that some accommodations may be ineffective and inappropriate since they are assigned based on the student’s disability rather than the student’s actual contextual and functional needs (Kurth & Mellard, 2006). Adhering more closely to the principles of universal design could give an alternative form of assessment compared to more traditional timed tests (Barnard-Brak et al., 2010) and would improve distance education not only for SWD but for all types of learners (Catalano, 2014).
Another important aspect of this study was understanding how the socioemotional well-being of SWD was impacted during the pandemic. All participants extensively described their stress and anxiety levels resulting from negative thoughts related to COVID-19 and its restrictive measures (e.g., getting possible COVID-19 symptoms, having family members being affected). Although the lockdown proved to prevent the spread of COVID-19 (Abdullah et al., 2020; Atalan, 2020), prolonged impositions can be detrimental to SWD (Scheer & Laubenstein, 2021). Our results are consistent with previous studies that demonstrate SWD presenting increased levels of stress, distress, and anxiety during the COVID-19 pandemic (e.g., Soria et al., 2020; Zhang et al., 2020). Previous studies also showed that SWD have persistent difficulties interpreting their complicated emotions (e.g., Margalit, 2004). As a result, they are more likely to have a limited ability to cope with negative emotions and apply avoidance to cope with unpleasant feelings (e.g., Margalit & Al-Yagon, 2002). One such example in our study was Marina, who repeatedly described how her anxiety symptoms had exacerbated and had prevented her from functioning well both emotionally and academically.
Furthermore, we found that almost all participants readjusted their daily routines while staying at home. Almost all participants developed new routines (e.g., writing, cleaning, cooking, exercising, walking pets) to tackle boredom and reduce the feelings of stress and anxiety. According to Ravalli and Musumeci (2020), maintaining a regular workout routine in a natural environment or at home is a revitalized approach for confronting the physical and mental effects of inactivity as well as managing stress and anxiety.
Implications for Practice
The coronavirus is a serious public health issue that tends to remain in our lives longer (Figueroa, 2021). It is time for universities to take advantage of the lessons learned from the COVID-19 pandemic and online instruction and reflect on their existing policies and practices whether they are welcoming and universally designed for SWD (Collins et al., 2019; Moriña, 2017; UN, 2006). To this end, this pilot study provides several implications for practice. First, academic institutions need to revisit their admission-entry procedures and forms by providing SWD with a welcoming and smooth process to disclose information about their needs. Second, disability officers should inform instructors about student accommodations during the early weeks of the semester and then again in the middle and at the end of each semester. Providing access to academic support and tools to SWD is a fundamental principle of accessibility and inclusion in higher education (Meleo-Erwin et al., 2021). Finally, the university counseling services should provide emotional and social skill support to SWD in the areas of self-determination and assertiveness to empower them to clearly and convincingly identify and articulate their needs and goals to their instructors and advisors.
Study Limitations and Suggestions for Future Research
All research studies present certain limitations that need to be acknowledged to allow improvements in future replication efforts. First, accessing the highest possible number of students was pivotal to this pilot study, which aimed to give prominence to the students’ voices. It is obvious that we had no control over the sex of participants nor even over the number of students enrolled at each university. We recruited the maximum number of students who could be accessed, and all were included. However, this study does not aim to make generalizations or suggest how the participants’ sex affected their beliefs. Future replications with larger samples could permit comparisons across types of disability and sex. Second, we did not have enough data available to indicate in-depth how the concerns and perceptions of the participants differed based on the type of their disability. This may be further explored and analyzed upon the completion of the data collection of the larger project. Finally, translating data from Greek to English may be considered another limitation. Although every effort was made in the translation process to keep the actual content of the participants’ perspectives, it was not always feasible to report students’ idiomatic expressions. These were paraphrased to follow the terminology and grammatical and syntactical structure of the English language (Filep, 2009). Nonetheless, the translation was scrupulously done to ensure its accuracy in English.
Conclusion
This exploratory qualitative research study reveals the voices of a vulnerable group toward the struggles they experienced in academic and socioemotional domains during the COVID-19 pandemic. Supporting university SWD requires a shift in policy and practice toward inclusive education for all (Collins et al., 2019; Dickinson & Gronseth, 2020). As universities welcome student diversity, it is important to establish clear procedures and systems of support to provide equitable learning opportunities and reduce access barriers for all students.
Data collection was partially supported by a small grant obtained by the Youth Board of Cyprus.
References
(2020). Global lockdown: An effective safeguard in responding to the threat of COVID-19. Journal of Evaluation in Clinical Practice, 26(6), 1592–1598. https://doi.org/10.1111/jep.13483
(2013). Faculty attitudes toward students with disabilities in a public university in Jordan. International Education Studies, 6(12), 74–81. https://doi.org/10.5539/ies.v6n12p74
(2021). Exploring the impact of the COVID-19 pandemic on university students’ learning life: An integrated conceptual motivational model for sustainable and healthy online learning. Sustainability, 13(5), Article 2546. https://doi.org/10.3390/su13052546
(2021). How is COVID-19 affecting the mental health of children with special educational needs and disabilities and their families? Journal of Autism and Developmental Disorders, 51(5), 1772–1780. https://doi.org/10.1007/s10803-020-04577-2
(2020). Is the lockdown important to prevent the COVID-19 pandemic? Effects on psychology, environment and economy-perspective. Annals of Medicine Surgery, 56, 38–42. https://doi.org/10.1016/j.amsu.2020.06.010
(2010). Accommodation strategies of college students with disabilities. The Qualitative Report, 15(2), 411–429. https://doi.org/10.46743/2160-3715/2010.1158
(2008). Qualitative case study methodology: Study design and implementation for novice researchers. The Qualitative Report, 13(4), 544–559. https://doi.org/10.46743/2160-3715/2008.1573
(2021). Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. New England Journal of Medicine, 384(5), 403–416. https://doi.org/10.1056/NEJMoa2035389
(2021). Psychological impact of COVID-19 pandemic in Italian families of children with neurodevelopmental disorders. Research in Developmental Disabilities, 109, 103840. https://doi.org/10.1016/j.ridd.2020.103840
(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. https://doi.org/10.1191/1478088706qp063oa
(1998). Thematic analysis and code development: Transforming qualitative Information. Sage.
(2020). COVID-19: Disruptive impacts and transformative opportunities in undergraduate nurse education. Nurse Education in Practice, 46, 1–2. https://doi.org/10.1016/j.nepr.2020.102807
(2014). Improving distance education for students with special needs: A qualitative study of students’ experiences with an online library research course. Journal of Library & Information Services in Distance Learning, 8(1–2), 17–31. https://doi.org/10.1080/1533290X.2014.902416
(2011). Skype a cost-effective method for qualitative research. Rehabilitation Counselors & Educators Journal, 4, 10–17.
(2011). Research methods in education. Sage.
(2009). Barriers to adoption of technology mediated distance education in higher-education institutions. Quarterly Review of Distance Education, 10(4), 333–338.
(2019). Bringing everyone on the same journey: Revisiting inclusion in higher education. Studies in Higher Education, 44(8), 1475–1487. https://doi.org/10.1080/03075079.2018.1450852
(2000).
Collecting the views of young people with moderate learning difficulties . In A. LewisG. LindsayEds., Researching children’s perspectives (pp. 163–172). Open University Press.. (2021). The COVID-NMA initiative: A living mapping and living systematic review of COVID-19 trials. https://covidnma.com
(2018). Educational research: Planning, conducting, and evaluating quantitative and qualitative research (6th ed.). Pearson Prentice Hall.
. (1999). The education and training of students with special needs law of 1999. The Republic of Cyprus.
. (2021). Research findings: Annual research report in education 2018–2019. https://www.mof.gov.cy/mof/cystat/statistics.nsf/populationcondition_24main_gr/populationcondition_24main_gr?OpenForm&sub=4&sel=1
(2014). Skype interviewing: Reflections of two PhD researchers. Qualitative Research, 14(5), 603–616. https://doi.org/10.1177/1468794113488126
(2020). Application of universal design for learning (UDL) principles to surgical education during the COVID-19 pandemic. Journal of Surgical Education, 77(5), 1008–1012. https://doi.org/10.1016/j.jsurg.2020.06.005
(2003). Using semi-structured interviews in small-scale research: A teacher’s guide. The SCRE Centre.
(2004). Providing access to students with disabilities in online distance education: Legal and technical concerns for higher education. American Journal of Distance Education, 18(1), 51–62. https://doi.org/10.1207/s15389286ajde1801_5
(1991). Action research for educational change: Developing teachers and teaching. Open University Press.
. (2020). Communication from the commission on the EU strategy for COVID-19 vaccines.
(2004). Clothing and embodiment: Men managing body image and appearance. Psychology of Men and Masculinity, 5(1), 40–48. https://doi.org/10.1037/1524-9220.5.1.40
(2021). COVID-19 vaccines as an additional tool to control COVID-19 transmission: A public health research perspective. Presentation at the WHO consultation meeting on 13 August 2021. https://www.who.int/news-room/events/detail/2021/08/13/default-calendar/who-consultation-on-covid-19-vaccines-research-13-august-2021
(2009). Interview and translation strategies: Coping with multilingual settings and data. Social Geography, 4, 59–70. https://doi.org/10.5194/sgd-5-25-2009
(2008). Experiences of college students with disabilities and the importance of self-determination in higher education settings. Career Development for Exceptional Individuals, 31(2), 77–84. https://doi.org/10.1177/0885728808317658
(1992). Effective evaluation: Improving the usefulness of evaluation results through responsive and naturalistic approaches. Jossey Bass.
(2008). Higher education provision for students with disabilities in Cyprus. Higher education, 55, 103–119. https://doi.org/10.1007/s10734-007-9070-8
(2010). The experiences of students with mobility disabilities in Cypriot higher education institutions: Listening to their voices. International Journal of Disability, Development and Education, 57(4), 403–426. https://doi.org/10.1080/1034912X.2010.524445
(2006). Internet recruitment and e-mail interviews in qualitative studies. Qualitative Health Research, 16(6), 821–835. https://doi.org/10.1177/1049732306287599
(2016). Doing case study research: A practical guide for beginning researchers (3rd ed.). Teachers College Press.
(1995). Qualitative data: Advice for good management. University of Sheffield.
(2017). Exceptional children: An introduction to special education (11th ed.). Pearson.
(2015). Qualitative analysis of the barriers college students with disabilities experience in higher education. Journal of College Student Development, 56(3), 209–226. https://doi.org/10.1353/csd.2015.0032
(2020). The Impact of the COVID-19 pandemic on undergraduate and graduate students with emotional or mental health concerns or conditions. UC Berkeley, Center for Studies in Higher Education. https://escholarship.org/uc/item/83m75056
(2014). Skype interviewing: The new generation of online synchronous interview in qualitative research. International Journal of Qualitative Studies on Health and Wellbeing, 9(1), 1–3. https://doi.org/10.3402/qhw.v9.24152
(2020). US faculty and administrators’ experiences and approaches in the early weeks of the COVID-19 pandemic. Online Learning, 21, 6–21. https://doi.org/10.24059/olj.v24i2.2285
(2019). Interviews in qualitative research (2nd ed.). Sage.
(2019). Research methodology: A step by step guide for beginners (5th ed.). Sage.
(2006). Student perceptions of the accommodation process in postsecondary education. The Journal of Postsecondary Education and Disability, 19(1), 71–84.
(2021). COVID-19 and undergraduates with disabilities: Challenges resulting from the rapid transition to online course delivery for students with disabilities in undergraduate STEM at large-enrollment institutions. CBE: Life Sciences Education, 20(36), 1–17. https://doi.org/10.1187/cbe.21-02-0028
. (2021). Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: An interim analysis of a randomized controlled phase 3 trial in Russia. The Lancet, 397(10275), 671–681. https://doi.org/10.1016/S0140-6736(21)00234-8
(2007).
Unstructured interviews and health research . In M. SaksJ. AllsopEds., Health research: Qualitative, quantitative and mixed methods (pp. 74–91). Sage.(2004). Second-generation research on resilience: Social-emotional aspects of children with learning disabilities. Learning Disabilities Research and Practice, 19, 45–48. https://doi.org/10.1111/j.1540-5826.2004.00088.x
(2002).
The loneliness experience of children with learning disabilities . In B. Y. L. WongM. DonahueEds., The social dimensions of learning disabilities (pp. 53–75). Erlbaum.(2021). Online support information for students with disabilities in colleges and universities during the COVID-19 pandemic. Disability and Health Journal, 14(1), Article 101013. https://doi.org/10.1016/j.dhjo.2020.101013
. (2002). Qualitative research in practice: Examples for discussion and analysis. Jossey Bass.
(2017). Inclusive education in higher education: challenges and opportunities. European Journal of Special Needs Education, 32(1), 3–17. https://doi.org/10.1080/08856257.2016.1254964
(2021). The impact of the novel coronavirus disease 2019 on therapy service delivery for children with disabilities. The Journal of Pediatrics, 231, 168–177. https://doi.org/10.1016/j.jpeds.2020.12.060
(2021). Supports for people with intellectual and developmental disabilities during the COVID-19 pandemic from their own perspective. Research in Developmental Disabilities, 108, Article 103813. https://doi.org/10.1016/j.ridd.2020.103813
(2021). Exclusion reloaded: The chronicles of COVID-19 on students with disabilities in a South African open distance learning context. Journal of Intellectual Disability and Diagnosis, 9(1), 137–147. https://doi.org/10.6000/2292-2598.2021.09.01.17
(2014). Qualitative evaluation and research methods (4th ed.). Sage.
(2021). Findings from an online survey on the mental health effects of COVID-19 on Canadians with disabilities and chronic health conditions. Disability and Health Journal, 14(3), Article 101085. https://doi.org/10.1016/j.dhjo.2021.101085
(2012). Online disability accommodations: Faculty experiences at one public university. Journal of Postsecondary Education and Disability, 25(4), 331–344.
(2020). Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. New England Journal of Medicine, 383(27), 2603–2615. https://doi.org/10.1056/NEJMoa2034577
(2021). A literature review on impact of COVID-19 pandemic on teaching and learning. Higher Education for the Future, 8(1), 133–141. https://doi.org/10.1177/2347631120983481
. (2021). Impact of delta on viral burden and vaccine effectiveness against new SARS-CoV-2 infections in the UK. medRxiv. https://www.ndm.ox.ac.uk/files/coronavirus/covid-19-infection-survey/finalfinalcombinedve20210816.pdf
(2020). Coronavirus outbreak in Italy: Physiological benefits of home-based exercise during pandemic. Journal of Functional Morphology and Kinesiology, 5(2), 31–36. https://doi.org/10.3390/jfmk5020031
(2018). The emerging research base on online learning and students with disabilities in handbook of research on K-12 online and blending learning (2nd ed.). ETC Press.
(2011). Students with disabilities and online learning: A cross-institutional study of perceived satisfaction with accessibility compliance and services. Internet and Higher Education, 14(4), 242–250. https://doi.org/10.1016/j.iheduc.2011.05.004
(2021). The impact of the COVID-19 pandemic on the health, well-being, and access to services of people with intellectual and developmental disabilities. Research in Developmental Disabilities, 114, Article 103985. https://doi.org/10.1016/j.ridd.2021.103985
(2001). Data analysis and theorizing as ideology. Qualitative Research, 1(3), 279–302.
(2020). Closure of universities because of coronavirus disease 2019 (COVID-19): Impact on education and mental health of students and academic staff. Cureus, 12(4), Article e7541. https://doi.org/10.7759/cureus.7541
(2021, January 15). The impact of COVID-19 on mental health and psycho-social conditions of students with and without special educational needs in emotional and behavioral disorders in Germany. https://doi.org/10.35542/osf.io/qfsv2
(2020). Qualitative voices in educational research. Routledge.
(2012). Interpretive research design: Concepts and processes. Routledge.
(1982). Evaluating alternative techniques of questioning mentally retarded persons. American Journal of Mental Deficiency, 86, 511–518.
(2020). The experiences of undergraduate students with physical, learning, neurodevelopmental, and cognitive disabilities during the pandemic. UC Berkeley, Center for Studies in Higher Education. https://escholarship.org/uc/item/7xh5c78h
(2005). Researching online populations: The use of online focus groups for social research. Qualitative Research, 5(4), 395–416. https://doi.org/10.1177/1468794105056916
(2015). Voices of university students with disabilities: Inclusive education on the tertiary level – A reality or a distant dream? International Journal of Inclusive Education, 19(10), 1080–1095. https://doi.org/10.1080/13603116.2015.1037868
(2005).
Interviewing . In I. HollowayEd., Qualitative research in nursing and health care (pp. 37–55). Open University Press.(2015). Disability accommodations in online courses: The graduate student experience. Journal of Postsecondary Education and Disability, 28(3), 329–340.
(2015). How to do your case study: A guide for students and researchers (2nd ed.). Sage.
(2020). Students with special educational needs in distance learning during the COVID-19 pandemic – Parents’ opinions. Interdisciplinary Contexts of Special Pedagogy, 29, 173–191. https://doi.org/10.14746/ikps.2020.29.08
. (2006). Convention on the rights of persons with disabilities resolution adopted by the general assembly. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html
. (2020a). Policy brief: A disability-inclusive response to COVID-19.
. (2020b). Policy brief: The impact of COVID-10 on children.
(2016). Theme development in qualitative content analysis and thematic analysis. Journal of Nursing Education and Practice, 6(5), 100–110. https://doi.org/10.5430/jnep.v6n5p100
. (2021). Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: An interim analysis of four randomized controlled trials in Brazil, South Africa, and the UK. The Lancet, 397(10269), 99–111. https://doi.org/10.1016/S0140-6736(20)32661-1
. (2020a). Virtual press conference on COVID-19–11 March of 2020. https://www.who.int/docs/default-source/coronaviruse/transcripts/who-audio-emergencies-coronavirus-press-conference-full-and-final-11mar2020.pdf?sfvrsn=cb432bb3_2
. (2020b). 2019 novel coronavirus (2019-nCov): Strategic preparedness and response plan. WHO.
. (2020c). Access to COVID-19 tools (ACT) accelerator: A global collaboration to accelerate the development, production and equitable access of new COVID-19 diagnostics, therapeutics and vaccines. WHO.
. (2021a). WHO coronavirus (COVID-19) dashboard. https://covid19.who.int/
. (2021b). Tracking SARS-CoV-2 variants. https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/
. (2021c). Guidance on developing a national deployment and vaccination plan for COVID-19 vaccines: Interim guidance. WHO.
(2020). How does COVID-19 impact students with disabilities/health concerns. ArXiv preprint. https://arxiv.org/abs/2005.05438
