A student with a learning difference (LD) in mathematics has difficulty retrieving basic arithmetic facts from memory, identifying or organizing numbers, sequencing numbers or mathematical processes, and solving complex mathematical calculations accurately under time constraints.

A student who is diagnosed with Math LD may or may not have processing difficulties with reading or writing. A student with Math LD may experience a deficit in processing and remembering visual information impeding the counting and sequencing processes. Some students with Math LD have difficulty with lower level processes such as simple arithmetic and sequencing but have no difficulty with higher level abstract mathematical concepts.

Possible Observations:

• May reverse, rotate, substitute, omit, or transpose figures, equations, or numbers
• May have difficulty differentiating between mathematical symbols
• May have difficulty appropriately lining up columns of numbers
• May be unable to quickly perform mental mathematics
• May have difficulty generating or understanding diagrams
• May have difficulty solving complex problems with multiple steps under time constraint

Students diagnosed with a learning difference (LD) in reading have difficulty recognizing, decoding, or comprehending written words.

A person with a learning difference in reading may have difficulty connecting sounds with the letters that represent them. This difficulty may manifest during silent reading or when reading aloud. A learning difference in reading often affects all areas of a person's educational experience because much educational content is transmitted through text.

Possible Observations:

• May be reluctant to read out loud in class
• May read at a slower pace than peers
• May have difficulty with pronunciation of unfamiliar words
• May have difficulty summarizing text
• May rely entirely on auditory information from class
• May have difficulty organizing or synthesizing information from text
• May demonstrate poor comprehension of written materials

Students diagnosed with a learning difference (LD) in writing have difficulties in organizing information into written form.

A student with a difference in writing may encounter a wide range of difficulties when generating written output. When conceptualizing a written work, a student may have great difficulty organizing thoughts into sentence or paragraph compositions. The inability to correctly choose words spelled correctly may cause a student with a writing disability to write simple sentences and avoid using some vocabulary because they are not confident in either their spelling or their correct use of vocabulary.

Possible Observations:

• May have difficulty organizing ideas and structuring them formally
• May produce text containing incomplete thoughts or run-on sentences
• May frequently misspell words or reverse and rotate letters
• May write in a short and informal way, lacking detail
• May use a limited vocabulary of comfortable terms
• May write with simplified grammar use or show difficulty using grammar correctly

When a person is diagnosed with a learning difference (LD) that is not specified as a reading, writing, or math disability, it is often because the person has a combination of reading, writing, or math difficulties. These difficulties are most often symptoms of processing deficits.

A person who has a learning difference not otherwise specified may have deficits in auditory processing, visual processing, speed of processing, or any combination of these. These processing difficulties make it difficult for a student to learn information as efficiently as a student without a learning disability.

Possible Observations:

• May rely entirely on one sensory modality (auditory or visual) in the classroom
• May have difficulty organizing or synthesizing information
• May have difficulty picturing mechanical processes or concepts
• May have difficulty identifying critical information
• May have difficulty comprehending patterns
• May have difficulty performing steps in proper order
• May have difficulty understanding spatial concepts

The term sleep disorder refers to a broad range of conditions including insomnia, sleep apnea, restless leg syndrome and narcolepsy.

Sleep disorder is a general term for a result in an inability to maintain a functional sleep pattern. This may manifest as a significantly reduced ability to get needed sleep or an inability to prevent the onset of sleep at inappropriate times. Sleep apnea is a common condition impacting the ability to get enough air during sleep resulting in oxygen deprivation. 

Restless leg syndrome causes an urge to move when lying down thereby preventing sleep. Insomnia is the inability to go to sleep or stay asleep. Narcolepsy is a nervous system disorder characterized by generally unpredictable bouts of extreme drowsiness which often result in the student falling asleep.

Possible Observations:

• May appear tired
• May be distracted
• May be frequently absent
• Difficulty attending to lecture or staying awake in class

Repetitive stress syndrome is a group of muscular conditions resulting from repeated motions performed in daily or work activities. Repetitive stress syndrome occurs most commonly in the hands, wrists, elbows, and shoulders.

Repetitive stress syndrome is characterized by pain, numbness, tingling, and the loss of flexibility and strength of the affected area. Left untreated these conditions can cause damage to the soft tissues of the body, and compression of the nerves or tissue. Treatment options include reducing or stopping the motions that cause symptoms, taking rest breaks, and adopting stretching and relaxation exercises.

Possible Observations:

• Difficulty completing in-class assignments requiring writing or fine motor skills
• Requests for assistance on tasks that require repeated motion

Respiratory disorders are conditions that affect the pulmonary system and impact students' ability to breathe effectively. Depending on the type of lung disease, symptoms can consist of wheezing, inability to take a deep breath, inability to exhale fully, or chronic coughing.

Respiratory disorders include chronic lung disorders (e.g. asthma, bronchitis), chronic sinus infections, and occupational lung diseases (e.g. asbestosis). Symptoms vary depending on the type of respiratory disorder but may include wheezing, shortness of breath, coughing, chest pain or tightness, runny nose, and fatigue. The most common chronic respiratory disorders are chronic sinusitis, chronic bronchitis, asthma, chronic obstructive pulmonary disease and emphysema. Respiratory disorders can impact more than just breathing, as lack of oxygen can impair students' energy, ability to concentrate, and physical endurance.

Possible Observations:

• Might be absent more frequently than other students
• Might use an inhaler or supplemental oxygen
• Might have difficulty with stairs or vigorous physical activity
• May need to avoid contracting colds or viruses

Blood disorders are conditions involving the various components and functions of blood in the body: red blood cells, white blood cells, platelets, bone marrow, lymph nodes, spleen, or blood clotting. Hemophilia, anemia, sickle-cell disease, and blood clots are a few well-known blood disorders.

Blood disorders and their characteristics vary widely and some blood disorders are genetically inherited (e.g. hemophilia) while others can be due to environment or conditional factors (e.g. anemia, blood clots). 

Depending on the disorder, a student may be frequently absent, appear tired, gaunt or pale. Blood disorders may not impact a student's cognitive abilities themselves but treatment, exhaustion, or side effects of medication may impact the ability to effectively or efficiently demonstrate their knowledge or understanding of concepts in class or in testing situations.

Possible Observations:

• Physical weakness
• Fatigue
• Periodic absences

An autoimmune disorder is a condition that occurs when the body's immune system mistakenly produces antibodies that destroy normal, healthy body tissues.

There are more than 80 recognized autoimmune disorders. Some examples of autoimmune disorders are Addison's Disease, Grave's Disease, Hashimoto's Thyroiditis, and lupus. In these disorders, the body's immune system mistakenly produces antibodies in response to normal, healthy body tissues which then attack and destroy the latter. 

The symptoms of autoimmune disorders vary depending on which disease the person has, but many persons with autoimmune disorders experience dizziness, fatigue, a general feeling of illness, and sometimes a persistent low fever.

Possible Observations:

• May become fatigued easily
• May have reduced physical strength
• May be frequently absent due to treatment or illness
• May have stiffness or pain
• May experience weight loss or weight gain
• May have reduced motor skills

Arthritis is inflammation of the joints but is often used to describe any disease that affects the joints. The most common arthritis in student populations is rheumatoid arthritis which is a condition where the body's immune system attacks the thin membrane that lines the joints, causing pain, swelling, and inflammation.

Students with arthritis experience swelling in one or more joints, early morning pain and stiffness, recurring pain or tenderness, and weakness combined with joint pain. Skin, joint, kidney, lung, heart, nervous system, and blood cell infections may accompany fatigue and difficulty in sleeping for students with arthritis.

Possible Observations:

• May have difficulty writing
• May need to stand during long classes
• May occasionally miss class due to flare ups

Cancer treatment consists of a variety of medical therapies that can reduce, control, or eliminate cancer cells in a person's body. There are many treatments for cancer; the most common are surgery, chemotherapy, and radiation. Cancer treatments can cause significant side effects due to the nature of the treatment.

Chemotherapy kills both cancer and healthy cells which can cause side effects such as physical and cognitive fatigue, nausea, pain, immune suppression, etc. Students who are undergoing cancer treatment may require accommodation to continue with school during and after treatment.

Possible Observations:

• May be more frequently absent for treatment and recovery
• May experience physical and cognitive fatigue
• May need to leave class unexpectedly
• May need to be absent to avoid contracting infection

Heart conditions include a variety of diseases or disorders affecting the heart and circulatory system. Students may not appear to have any symptoms, but observable symptoms may include weakness, fatigue, fainting, sweating, or nausea.

Some examples of heart conditions are heart attacks, arrhythmia, coronary artery disease, congenital or inherited heart conditions, cardiomyopathy, and valve disorders. In addition to those that may be observable, students may have an unusual heartbeat rhythm, palpitations, shortness of breath, chest discomfort, or pain.

A stroke occurs when a blood clot or vascular rupture interrupts blood flow to the brain. When the brain does not receive adequate blood flow, brain cells don't receive oxygen and nutrients from the blood. Without necessary oxygen, brain cells die and brain damage occurs.

Stroke is a leading cause of adult disability. How a student is affected by a stroke depends on where in the brain the stroke takes place and how much of the brain is damaged. When brain cells die during a stroke, abilities (e.g. speech, movement, or memory) controlled by that area of the brain might be impacted.

Possible Observations:

• May actively avoid confrontational situations such as debates
• Might be absent more often than other students
• Might appear tired or fatigued
• May ask to be excused from strenuous physical activities
• Impulsiveness
• Visual field impairments
• Short term memory difficulties
• Speech difficulties (aphasia)
• A need for frequent feedback or clarification of tasks
• Difficulties making generalizations
• Coordination or balance problems
• Paralysis

The human immunodeficiency virus (HIV) is a virus that damages the cells of the immune system. As HIV infection progresses, the immune system weakens and the body becomes less able to fight infection. Acquired immunodeficiency syndrome (AIDS) is defined as the presence in the body of twenty or more opportunistic infections or HIV-related cancers.

The symptoms and severity of HIV vary widely and can fluctuate over time. Students with HIV may appear to have no symptoms at all or may have flu-like symptoms. Treatment with medication is successful in slowing the progression of the disease sometimes for substantial time periods. The human immunodeficiency virus (HIV) is a virus that damages the cells of the immune system. As HIV infection progresses, the immune system weakens and the body becomes less able to fight infection.

Possible Observations:

• May be absent more often than other students.
• May need to actively avoid exposure to infections or viruses.
• Will need to avoid activities that might lead to cuts or abrasions

Initially students with Lyme disease may have flu-like symptoms, fever and fatigue. As the illness progresses, symptoms such as heart palpitations, migratory joint and muscle pain, severe headaches, neurological problems (e.g. meningitis, Bell's palsy), and central nervous problems can impact memory and cognition.

Lyme disease is the most common vector-borne disease in the United States. It is caused by the spirochete bacterium Borrelia burgdorferi, and it is transmitted to humans by the "bites" of certain kinds of ticks. Early in the illness Lyme disease can be confused with the flu, but as the disease progresses it can lead to cardiac, musculoskeletal, neurological, or other system involvement. Patients with chronic Lyme disease often experience severe headaches, fatigue, pain, insomnia, and memory problems.

Possible Observations:

• May be absent more often than other students
• May experience seizures
• May exhibit anxious behavior
• May drop items or have tremors
• May experience memory problems intermittently

Epilepsy is a neurological condition impacting the nervous system causing seizures.

In epilepsy, the normal pattern of neural activity is disrupted causing seizures. Depending on where in the brain the seizure takes place a student may experience convulsions, muscle spasms, or loss of consciousness. Most seizures only last a minute or two but the resulting confusion or exhaustion may last longer. 

Some students may be aware of seizure triggers (situations or events that may bring on a seizure) but others have no known triggers. Most individuals with epilepsy are able to control the severity or frequency of seizures through medication. However stress, sleep patterns, and visual and sound patterns may trigger seizures. 

For a period after a seizure, students may exhibit fatigue, short-term memory deficits, difficulty writing, or appear disoriented.

Possible Observations:

• May appear disoriented
• May leave classroom abruptly
• May experience petit or grand seizures

Cerebral Palsy (CP) is a neurological disorder that appears in infancy or early childhood and permanently impacts body movement and muscle coordination but does not progress over time.

Cerebral palsy is not a disease. It is caused by abnormalities in the parts of the brain that control muscle movement. Symptoms may include but are not limited to: muscle weakness, abnormal posture, poor muscle control and lack of coordination, muscle spasms or seizures, impaired speech, and cognitive limitations that result in learning disabilities.

Possible Observations:

• May have difficulty controlling arms or legs
• May drool extensively as a result of poor muscle control
• May be nonverbal or difficult to understand when speaking
• May have difficulty with fine motor coordination
• May experience visual difficulties
• May have difficulty with hearing
• May have difficulty with short- or long-term memory
• May have difficulty with processing information accurately and quickly
• May have trouble focusing on more than one task
• May exhibit distracting behaviors or vocalizations as a result of the inability to control muscles
• Voice may be loud as a result of a lack of ability to control the muscles that allow voice modulation

Cystic fibrosis is a disorder that causes severe lung damage and nutritional deficiencies.

Cystic fibrosis is a genetic condition that causes thickening of the mucus and sweat glands, clogging the lungs, making breathing difficult and facilitating infection due to bacteria growth. Additionally, students with cystic fibrosis may have issues with nutrient absorption, hydration, and diabetes. The symptoms of cystic fibrosis can vary over time but almost always become worse as the student ages. 

Additionally, because the symptoms and severity vary by individual and over time, students with cystic fibrosis may show no clear symptoms or may appear tired, weak, or have noticeable breathing problems. Some students will be awaiting the opportunity for a lung transplant and as they are highly susceptible to infection may need to avoid contracting viruses or infection.

Possible Observations:

• May need to leave class if breathing becomes difficult
• May need to be absent more frequently than other students
• May need to withdraw for medical reasons
• May have difficulty with extreme cold

Fibromyalgia is a chronic condition resulting from overactive nerve firing that causes physical fatigue and muscle pain. Students with fibromyalgia may experience stiffness, headaches, tingling, numbness, difficulty sleeping, and problems with cognition and memory.

Students with fibromyalgia may have a variety of additional symptoms including sleep disturbances, fatigue, problems with cognitive functioning, headaches, and environmental sensitivities. Anxiety and depression often accompany fibromyalgia but should be treated distinctly.

Possible Observations:

• May be absent more frequently than other students
• May require special seating or carry pillows, etc.

The term little person refers to individuals of short stature, typically persons under a height of 4 '10". Little people often, but not always, have medical or genetic conditions causing their short stature.

Regardless of their medical conditions or label, little people generally require accommodations for their height restriction and mobility concerns.

Possible Observations:

• Assistance in reaching materials that are placed too high
• Request a smaller keyboard, desk, chair, or other equipment
• Use of a wheelchair or scooter to move around more quickly

Ménière's Disease is an inner ear disorder that causes sudden unexpected vertigo, dizziness, and balance issues as well as tinnitus, pressure or pain in the ear, and intermittent hearing loss.

Students with Ménière's Disease have very little warning of dizziness, balance issues, pain, or intermittent hearing loss. Other occasional symptoms include headaches, abdominal discomfort, and nausea as a result of the vertigo. Students with Ménière's Disease tend to recover hearing in between episodes but as the episodes continue their hearing ability will deteriorate.

Possible Observations:

• Might have headaches or ear pain
• May occasionally have difficulty hearing or understanding what is said
• May appear dizzy
• May need to leave the classroom unexpectedly
• May wait until the other students leave to avoid being in a crowd of students
• May require a hearing assistance system or transcription

Multiple Sclerosis (MS) is a chronic condition that attacks the central nervous system eventually causing permanent damage. The symptoms often vary depending on the amount and location of the damage and can disappear for months at a time. Ultimately MS can cause permanent nerve damage.

Multiple Sclerosis is a disorder in which the immune system destroys the protective covering of the body's nerves interfering with communication between the brain and the body. The damage may interrupt or distort messages between the nerves and the brain producing variable symptoms. Multiple Sclerosis may occur at any age but most commonly begins in individuals between the ages of 20 and 40.

Possible Observations:

• May exhibit clumsiness or lack of coordination
• May use a cane on some occasions but not others
• May be absent in extreme weather conditions
• May leave the classroom unexpectedly
• May demonstrate muscle weakness and be unable to write without assistive technology

Muscular dystrophy is a group of genetic muscle diseases characterized by progressive weakness and degeneration of the skeletal muscles that control movement. There are many diseases that fall in this category differing in rate of progression, age of onset, or extent of muscle weakness.

Students with muscular dystrophy have muscle fibers that are unusually susceptible to damage. Over time, muscles become weaker. Although voluntary muscles are usually most often involved, certain types of muscular dystrophy affect heart muscles or other involuntary muscles and organs. All muscles may be affected or only specific groups of muscles such as shoulder, pelvic, or facial muscles. MD can cause delays in muscle motor skills, drooling, frequent falls, loss of muscle strength, and problems walking.

Possible Observations:

• Difficulty handling handouts or textbooks
• Difficulty participating in laboratories
• Inability to take notes
• May be absent more often than other students
• May use assistive technology to participate in class

A student with restricted limb use is missing or cannot use one or more of their appendages.

Students with restricted limb use may require assistance in a variety of tasks requiring fine or gross motor skills. Students with restricted limb use may use prosthetics or other assistive technologies to compensate. Such restrictions may be caused by conditions present at birth, while others are the result of illness or physical injury. 

Students' needs in an academic setting will vary depending on the kind of restriction and accommodations present.

Possible Observations:

• May have difficulty grasping objects such as a pen
• May have difficulty with typing or handwriting
• May have spastic or jerking hand or arm movement
• May experience muscle fatigue from motor tasks
• May be unable to lift objects
• May be unable to turn pages of a book
• May have a service animal for balance
• May have difficulty walking or be unable to walk

Spina bifida is a birth defect where part of the spinal cord does not close properly during fetal development. Spinal birth defects are associated with learning disabilities, skin problems, latex allergies, urinary tract infections, gastrointestinal problems, and depression.

Spina bifida is the most common type of neural tube defect. The improper development of the spinal cord can result in exposed nerves and malformation of the spine. It most often causes some degree of paralysis; the degree of the paralysis depends on the location and severity of the defect.

Possible Observations:

• Might experience learning difficulties
• Might be able to walk but it can cause pain
• Might be absent more than other students
• Might use a wheelchair, scooter, or crutches

Tourette syndrome is a neurological condition characterized by motor and vocal tics. These tics are repetitive involuntary movements that most commonly occur as eye blinks, shoulder shrugs, facial grimaces, or head jerking.

Tourette syndrome is clinically defined as multiple motor or vocal tics that repeatedly occur for longer than one year. Students with Tourette syndrome can exhibit a wide variety of tics which may increase with excitement or under stress. Motor tics can occur in only one part of the body or they may present as full body tics (e.g. jumping, startling). Although frequently portrayed in the media as a key characteristic of Tourette syndrome, the involuntary expression of socially unacceptable language (called coprolalia) is an uncommon symptom of the condition.

Tourette syndrome can be confused with tourettism, which refers to tics in the absence of Tourette syndrome; these tics are often associated with other conditions such as Fragile X syndrome and Klinefelter's syndrome. Both Tourette syndrome and conditions causing tourettism have been associated with learning disabilities; therefore, it is important to examine the possibility of comorbidity learning problems when considering accommodations for students with Tourette syndrome or tourettism.

Possible Observations:

• May startle easily
• May require assistance when fine motor skills are required
• May appear to blink constantly
• May have unusual speech patterns or have a stutter
• May exhibit tremors
• May exhibit facial tics or have spasms of the arms or legs

Attention Deficit Hyperactivity Disorder (AD/HD) is a neurobiological disorder resulting from problems in the dopamine neurotransmitter systems in the brain. It consists of deficits in behavioral inhibition, sustained attention, and resistance to distraction, and the regulation of one's activity level to the demands of a situation (hyperactivity or restlessness).

Attention Deficit / Hyperactivity Disorder is characterized by symptoms of inattention, hyperactivity and impulsiveness. Students with AD/HD have difficulty with attending to details, sustaining attention, and following through on instructions. They will tend to avoid tasks that take significant amounts of time, have difficulty with social interactions and be easily distracted by extraneous stimuli. The term 'attention deficit' is somewhat misleading as individuals with AD/HD actually have difficulty regulating attention rather than having a deficit in attention. Another aspect of AD/HD is hyperfocus where the individual locks onto another person or activity to the exclusion of everything else in the environment.

The hyperactivity aspect of the disorder involves difficulty in finishing tasks, sitting still for long periods, and a tendency to be impulsive especially in stressful situations when the student is feeling rushed to make a decision. Difficulty processing auditory information is often a characteristic of AD/HD

Possible Observations:

• May seem easily distracted or have a hard time focusing on lectures
• May have difficulty taking notes
• May have problems completing tasks
• Focus on areas of interest to the exclusion of other critical information
• Have difficulty organizing information or following directions
• Make inappropriate comments
• Display widely varying performance

Clinical depression is a medical condition with both cognitive and physical effects. It is marked by low mood, fatigue, being socially withdrawn, and a general loss of interest in previously valued activities.

Clinical depression often involves feelings of sadness for extended periods of time, loss of interest in life, hopelessness, decreased energy, and inability to focus. It can affect a person's ability to perform usual tasks and activities of daily living.

Possible Observations:

• May appear tired or sleepy
• May articulate persistent negative feelings
• May demonstrate a lack of interest or engagement in class
• May exhibit reduced energy and stamina
• May have poor class attendance
• May have difficulty concentrating, remembering, or making decisions
• May have difficulty with organization and meeting deadlines
• May have difficulty tracking conversations or lectures
• May have difficulties with communication or difficulties in social situations

Students with anxiety disorders experience chronic feelings of worry or apprehension that may or may not be precipitated by phobias. In extreme cases the anxiety may express itself in panic attacks.

Anxiety disorders affect about 40 million American adults age 18 years and older in a given year causing them to be filled with fearfulness and uncertainty. Unlike the relatively brief anxiety caused by a stressful event such as giving a speech, anxiety disorders last at least 6 months and can get worse if left untreated. Students with anxiety disorders may have excessive but non-specific worries about just about anything in their environment. They may have difficulty concentrating, falling and staying asleep, and may startle easily.

Possible Observations:

• Poor attendance
• Anxious behavior during a spirited discussion or debate
• Absence when scheduled to do a presentation
• Lack of participation in class discussions
• Extreme nervousness or irritability
• Lack of ability to concentrate

Obsessive Compulsive Disorder (OCD) is an anxiety disorder in which a student persistently focuses on obsessive thoughts, irrational fears, or repetitive rituals and routines.

OCD is an anxiety disorder in which a student persists in thinking about irrational fears that cause them significant stress; in an effort to ease their distress, the student is driven to engage in repetitive behaviors. The irrational thoughts and fears are often focused on a theme, such as a fear of germs or a fear of bad luck, and the repetitive behaviors often follow that theme (e.g. repeatedly washing hands, making certain the number of repetitions is a lucky number).

Students with OCD are not just perfectionists; their obsessive thoughts and compulsive behaviors cause significant distress and interfere with their quality of life.

Possible Observations:

• Student may frequently be absent or late to class
• Students may act withdrawn or distracted
• Students' interactions may be awkward or disjointed
• Students may perseverate about seemingly trivial things
• Students may seem anxious
• Student may exhibit repetitive behaviors

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that generally occurs after seeing or living through a dangerous or traumatic event.

In a dangerous situation, fear triggers a physical response to either flee from the danger or to defend against the danger. People who have PTSD have persistent feelings of stress or fright even when they are no longer in danger. Students who have PTSD include survivors of physical or sexual assault or abuse, accidents, disasters, combat or other serious events. Others get PTSD after a friend or family member is harmed or they experience the sudden, unexpected death of a loved one. 

Students with PTSD experience flashbacks reliving the trauma that can be triggered by words, objects or situations that are reminders of the original trauma. They often avoid engaging in events or going places that are reminders of the experience. Students who have experienced physical abuse or assault may be hyper vigilant and avoid being touched or startled easily. Having such responses are not unusual after a traumatic event but in a student with PTSD the responses persist for months or years.

Possible Observations:

• May startle easily
• May react emotionally to discussions that trigger reminders of the trauma (e.g. low noises, descriptions of abuse or assault)
• May avoid activities that could trigger memories
• May exhibit hypervigilance
• May have difficulty with concentration

Personality disorders consist of a chronic pattern of thinking and behaving that is inflexible, dysfunctional, and may be detrimental to the student and to relationships. The symptoms of personality disorders vary depending on the specific type of disorder, but almost all students with personality disorders have difficulty dealing with everyday stresses and may have dysfunctional interactions with others.

Personality disorders, according to the American Psychological Association, are characterized by an "enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it". These behaviors frequently lead to distress in life or impairment of the ability to go about routine functions at work, school or social situations.

Possible Observations:

• Irrational suspicion, distrust of others
• Rigid patterns of thinking
• Attention-seeking behavior
• Sudden mood swings
• Students might seem uninterested in relationships, aloof, or distrustful of others
• Student might make grandiose claims
• Student might be argumentative or defensive
• May tend to blame failure or disappointment on others
• Constant need to seek approval from others
• Self-centeredness or a need to be the center of attention
• May be overly sensitive to criticism
• Low tolerance for delayed gratification or frustration
• Impulsiveness

Bipolar disorder is a mental illness involving moods that can swing from overly high and irritable (mania) to sad and hopeless (depressed), and then back again, with periods of normal mood in between.

The essential feature of bipolar disorder is a course of one or more manic or mixed episodes. Often students have also had one or more major depressive episodes. A person in a manic episode will exhibit boundless energy, ambition, and self-esteem and may also demonstrate risk-taking behavior and irritability. Alternately, major depressive episodes are characterized by depressed (low) mood, loss of pleasure in previously enjoyed activities, changes in appetite and psychomotor activity; difficulty concentrating, thinking, and making decisions; and exceptionally low self-esteem demonstrated by negative self-statements. 

Possible Observations:

• Periods when they show a lack of interest or engagement in class
• Distinct, severe changes in mood (from persistently sad or flat, to active or anxious)
• Problems making decisions and concentrating in class
• Poor class attendance
• Negative self-statements
• Excessive activity and physical motor restlessness
• Impulsivity (high-risk behavior, beginning an inordinate number of new projects)
• Inflated self-esteem and estimation of abilities, grandiosity
• Problems remembering or organizing information
• Difficulty meeting deadlines
• Difficulty handling stress or emotions

Schizophrenia is a chronic and severe psychiatric disorder. Students with untreated schizophrenia may hear voices, believe that they are being controlled by others or are being plotted against. These fears make them withdrawn or agitated. Treatment relieves many symptoms of the disease but some symptoms will persist at some level even with medication.

Students with schizophrenia may lose touch with reality and remember or believe that they have heard, seen or otherwise experienced things that haven't happened. Most often they will report that they have heard "voices." Students whose medication is not working optimally may have delusions and believe that others are plotting against them or that they have special abilities.

Possible Observations:

• May appear to have flat affect (face does not move or speech is dull or monotone)
• Show lack of ability to begin and sustain planned activities
• Speak little even when forced to interact
• Monopolize conversation
• Appear to ignore other students and normal rules of engagement