Vocational Independence Program

Last Friday, I had the opportunity to revisit a program I had first seen a number of years ago. The Vocational Independence Program at the New York Institute of Technology - VIP at NYIT - is now located on the campus of NYIT in Old Westbury, New York. This marks a new location from its original home in Central Islip, Long Island, when VIP first started in 1987.

VIP is one of only a limited number of programs nation-wide that provide a college-like experience for students who would not be able to manage the demands of a typical college program, but who can benefit from the post-secondary opportunity to improve their executive function, communication, social, independent living, and employment skills. It is recognized by the U.S. Department of Education as a Transition and Postsecondary Program for Students with Intellectual Disabilities.  This status makes it possible for students to apply for federal financial aid, although the cost of the program (similar to a private college) means that even if a student qualifies for some aid, the program may be beyond the means of many families.

VIP students typically have autism spectrum disorders, mild cognitive impairment, or significant learning differences. Some students take credit courses at NYIT, leading to an associates degree after three years and some take a course or two on a non-matriculated basis, but most focus on building the skills that will help them to function as independent adults. There is also a summer program for students considering VIP or planning to enter the following fall.

As noted by Walter Mayer, Associate Director of Admissions and Development, every student has a job coach, academic advisor, social counselor, independent living coach, and banking coach. By the third year of the three-year program, students are typically working three days per week at a VIP-sponsored internship with employers such as hotel chains, restaurants, retailers, hospitals, animal hospitals, and other businesses. Job placement support is also provided to graduates of the program. VIP notes that students finishing the program in 2017 had an 80 percent post graduation employment rate.

Students live on campus, in a dorm located at the adjacent State University of New York at Old Westbury campus, and move back and forth between the SUNY and NYIT campuses via shuttle buses. The residential aspect of the program is an important part of the skills-building that each student works on during their time at VIP.

While improved preparation and support programs at colleges have made college accessible to many students who might not otherwise be able to handle its social and academic demands, there are still many students whose disabilities make it difficult or impractical for them to be successful in a college program. Families want to give these students every opportunity to be successful in their personal and work lives and to give them the skills that will stay them them throughout their lives. The VIP Program is designed to help achieve these goals.

Dr. Yellin Contributes to New Book on Medical Education

We are pleased to announce the publication this week of Remediation in Medical Education: A Mid-Course Correction, featuring a chapter by Dr. Paul Yellin on "Learning Differences and Medical Education."

As many of our readers are aware, Dr. Yellin works regularly with medical students and other young adults in professional and graduate schools, helping them to deal with newly discovered or long-standing academic challenges to their academic success. In his chapter, he describes the wide range of normal variation in how medical students learn, describing both "learning variations" and "learning disabilities." He discusses various aspects of learning, which he calls "constructs" -- memory, attention, language, temporal-sequential ordering, spatial ordering, and higher order cognition -- and how difficulties in any of these constructs can impact academic success in light of the demands of medical training. He goes on to discuss the legal implications of a disability of learning and to offer strategies and resources for both medical students who struggle and their instructors.

Remediation in Medical Education edited by Adina Kalet, MD, MPH and Calvin Chou, MD, PhD (Springer, 2014), covers a wide range of issues relating to medical education, from how medical schools can provide remediation for struggling students, to how cultural issues can impede effective communication, to medical students with underlying disorders, such as autism spectrum disorders, that affect their interpersonal interactions. Both editors have worked extensively in the field of medical education and effective communication between physicians and patients.

Changes in Medical Education

Two recent articles in The New York Times focus on how medical education is changing. Both reflect the trend away from the traditional path of four years of hard science courses in college, followed by four years of medical school, where coursework continues to focus strictly on science based topics.

One move away from this is the growth in post-baccalaureate pre-med programs, where college graduates who have not taken the necessary science courses, or who are out in the working world but want to switch to a career in medicine, can prepare for medical school. According to the Times article, more than 15% of new medical students have gained admission after completing such programs and there are now 135 post-baccalaureate programs listed with the Association of American Medical Colleges (AAMC). These students may have studied poetry, history, or psychology in college and may have had work experience as teachers, artists, or marketers. They can bring a very different perspective to their medical education and their interactions with their patients.

Another trend involves changes to the medical school curriculum itself, towards what the Times piece calls "heart and soul and social science." The AAMC is making substantial changes to the Medical College Admission Test (MCAT) in an effort to look for strengths in areas other than just science, with the goal of admitting individuals to medical school who bring a broader skill set -- including the ability to connect to their patients, not just to analyze test results. Beginning in 2015, the MCAT will include sections on "Psychological, Social and Biological Foundations of Behavior" which are designed, according to the MCAT website, to recognize "the importance of socio-cultural and behavioral determinants of health and health outcomes." In addition, another new section called "Critical Analysis and Reasoning Skills" is intended to help identify applicants from diverse backgrounds. Students entering college this coming fall will be the first group to take the new MCAT when it is put in place in 2015.

Dr. Yellin's work as a consultant to the Office of Student Affairs at New York University School of Medicine and his extensive experience performing evaluations of medical students lead him to observe that whatever changes may occur to medical school admissions and curriculum, the academic demands of medical school will continue to be an issue for future physicians."Like other strong learners," he notes, "medical students will not get very far in their studies or careers without an understanding of how they actually learn and without developing a repertoire of strategies. Often, learning strategies that have worked for them in other environments don't work for them in the demanding setting of medical school. They need to develop new strategies for the extraordinary demands of the medical curriculum and that requires them to understand how they learn, since even very successful students will have stronger and weaker areas in their academic skills."

Photo: Alex Proimos/Flickr Creative Commons

"Flagging" on Law School Admission Tests

In a recent blog, we wrote about a report from the Government Accountability Office that looked at how testing companies were complying with the provisions of the Americans with Disabilities Act (ADA). At that time, we noted that the one testing organization that did not participate in the interviews or provide written information for the report was the Law School Admissions Council (LSAC), which administers the LSAT, the test which accredited law schools use in their admissions process.

Now, the American Bar Association (ABA), with almost 400,000 members, has called for the LSAC to change its policies on dealing with individuals with disabilities and to bring its test into line with such other high stakes tests as the SAT, ACT, and GRE. What makes this American Bar Association resolution so important is that it comes from the organization that accredits law schools and that requires law schools to use an admissions test. Although the ABA does not control the LSAT, it tacitly endorses its use. Pressure for change from the ABA may prove the best hope for change in how the LSAT functions and may move the LSAC to comply with the ABA resolution that the LSAC ensure that, "the reporting of test scores is consistent for all applicants and does not differentiate on the basis that an applicant received an accommodation for a disability."

The ADA requires that all testing organizations provide individuals with documented disabilities with accommodations such as extended time, extra breaks, or auxiliary aids, which aids should "best ensure" that the test reflects the test taker's abilities and not his or her disabilities. But most of the high stakes testing organizations go further and report the scores of individuals taking their test with accommodations in the same manner as those who take it without accommodations; they do not "flag" a score as having been earned through "non-standard administration." That was not always the case, and only happened after settlement of a federal lawsuit in 2000 and subsequent action by testing companies. The SATs continued to flag scores for students who received test accommodations until 2003.

What has the American Bar Association and others concerned is that the LSAT -- along with the MCAT, the Medical College Admissions Test -- continues to flag scores of students who take their tests with accommodations, in contrast to every other major high stakes test. The LSAC has stated that they continue to flag because, "it would be misleading to report scores earned with additional test time without some indication of the non standard administration." They further note, that "scores earned with additional time are not comparable to standard scores," even though the other testing organizations have concluded that this is not the case with their tests.

As might be expected, there have been lawsuits against the LSAC and even agreements with the Justice Department, but no case has resulted in changes to the flagging policy. We hope that this welcome action by the American Bar Association will be key to changing the flagging policy for the LSAT.

Photo used under Creative Commons

New Federal Report on Testing Accommodations

A review of the role of federal agencies in enforcing compliance with the Americans with Disabilities Act (ADA) by private testing agencies was recently released by the U.S. Government Accountability Office. We think the report provides a good overview of the subject of testing accommodations and makes interesting reading for those with an interest in this subject.

The review was prompted by concerns that organizations that administer such high stakes tests as the SAT, ACT, GRE, MCAT, and certification exams such as USMLE and MPRE operate without sufficient oversight by federal agencies charged with making sure they comply with the ADA. The testing organizations are required by the ADA to provide reasonable accommodations -- modifications such as extended time, use of special technologies, or special testing locations -- to enable students with documented disabilties to have full access to their tests. 

The GAO interviewed or obtained written information from most testing organizations except the Law School Admission Council (which administers the LSAT), which refused to cooperate. We don’t know why they declined to participate, but we are disappointed that they were not willing to discuss their approach to disability accommodations. The GAO also interviewed officials from a representative array of colleges and high schools, and reviewed complaints to the Departments of Justice, Education, and Health and Human Services, all of which (but primarily Justice) have some oversight of this issue.

The report noted that about two percent of the students taking high stakes examinations last year did so with testing accommodations -- some 179,000 of the 7.7 million individuals who took such tests. Of this number, about one-half were students with learning disabilities and one-quarter were students with ADD or ADHD. By far, the most frequently requested and granted accommodation was 50 percent extended time to take the exam.

The report concludes that the Department of Justice needs to take steps to better analyze the data it has available on complaints, to reach out to testing agencies, and to coordinate with other agencies such as the Departments of Education and Health and Human Services. In a statement included in the report, the Justice Department agreed with these recommendations and laid out steps they will be taking to implement such improvements.

Justice Department Ruling Has Major Implications for Test Accommodations

We love it when the law works. So, we were pleased to hear about what happened last week in the lawsuit brought by Dee Jones, a law student at Vermont Law School, who had filed a federal lawsuit against the National Conference of Bar Examiners.

Ms. Jones, who managed to be admitted to law school -- and to do well -- despite blindness and a learning difficulty, needed to take and pass the Multistate Professional Responsibility Examination (MPRE) to be licensed as an attorney. The test is developed under the auspices of the National Conference of Bar Examiners. However, Ms. Jones was denied the use of the test modifications and accommodations she requested, and which she had used successfully in college and law school -- a combination of Kurzweil 3000 and ZoomText software. Using these two technologies together provides simultaneous large font and audio versions of the test materials. Instead, the defendant organizations offered Jones accommodations from a menu they developed, which included a reader, or an audio recording of the test, or a Braille version of the exam.

Jones, aided by the National Federation of the Blind, sued and claimed that being limited to the accommodations that the testing organizations selected was a violation of the Americans with Disabilities Act (ADA). As her attorney, Daniel Goldstein, noted in an article in Vermont Today, "...it's like if you were a vegetarian and someone said, 'Okay, we won't give you the roast beef. Would you like the pork or the chicken?"

Adding to the problem was the looming date of the next exam, scheduled for August 11, 2011.

On July 21st, the U.S. Justice Department filed a Statement of Interest with the court, noting, "the United States does not interpret ... the ADA to simply require reasonable accommodations to Ms. Jones, but rather to require appropriate modifications or auxiliary aids to 'best ensure' that the exam measures Ms. Jones’ knowledge of professional responsibility issues and not her visual disabilities.

Based upon the Justice Department filing, and as noted in a press release from the U.S. Attorney in Vermont, the District Court granted Ms. Jones’ motion for a preliminary injunction and agreed with the Justice Department analysis of the controlling “best ensure” standard. As a result of the ruling by the District Court, the National Conference of Bar Examiners was ordered to allow Ms. Jones to take the MPRE on August 5, 2011 using the screen reading software that Ms. Jones used throughout law school as her primary reading method. We hope she did well.

As the long term impact of this preliminary injunction becomes more clear, we will look, in a future blog, at what this means for students who require accommodations.


Photo used under Creative Commons by Wikipedia Saves Public Art.

Learning Strategies for High Achieving Students

The Master Scholars Career Advising Program at the New York University School of Medicine and Dr. Lynn Buckvar-Keltz, the school's Associate Dean for Academic Affairs, hosted the annual presentation of Dr. Paul Yellin to the medical school student body last evening. Dr. Yellin's presentation, Strategies for Success in Medical School: The Impact of Normal Variations in Learning Profiles on Academic Performance in Medical Students, is part of his ongoing work with the the Dean of Academic Affairs and with individual medical students from NYU and other medical schools. Dr. Yellin also works with physicians who have completed medical school as well as young professionals in law and other fields.

Why would these students or recent graduates in highly demanding fields, who have been able to be admitted to competitive training programs, need the services of a physician who focuses his work on learning and school success? And why would a large number of first year students at the NYU Medical School take time away from their studies or leisure to attend Dr. Yellin's talk last night?

The answer, according to Dr. Yellin, is that it is not unusual for anyone to hit "bumps in the road" when entering a new phase of one's education or career. Some academically successful students first have difficulty late in their academic careers, when they find that the strategies they used in college are inadequate to permit them to succeed in professional programs, such as medical school. Tragically, some people who experience these setbacks prematurely abandon their chosen path because they assume that their struggles mean that they are "not cut out" for the path that they have chosen.

Dr. Yellin notes that once these struggling students or young professionals understand how they learn and how to use their cognitive and personal strengths to get past their areas of relative weakness, it is usually possible for them to bounce back and succeed. He adds that he has been consulting with NYU Medical School for almost ten years and that it has been enormously satisfying to see how the students with whom he has worked have been able to improve their performance and move ahead in their careers.

Ramapo: A Special Program

We are often reluctant to write about a program that is very small, or hasn't been around very long. But we are making an exception for a unique program for young people 18 and up who are struggling to take the next step to college or the workplace.

The Staff Assistant Program at Ramapo for Children is only a couple of years old, although Ramapo for Children  was founded in 1922. The mission of the larger organization is  "to serve children with a wide range of emotional, behavioral and learning disabilities in a dynamic and stimulating outdoor environment ... with adventure-based, experiential learning programs that promote positive character values, build social and learning competencies, and enhance self-esteem." During the summer, the camp program has several sessions of one, two, and three week programs. During much of the school year the camp is used by a variety of schools, public and private, for retreats that teach skill building and leadership skills to students of all ability levels.


The Staff Assistant Program operates from March through November on a rolling admissions basis. Young people and their families need to make a minimum 12 week commitment. The Staff Assistants function as assistants to counselors and other employees of Ramapo, all the time being mentored on a one-to-one basis by a skilled professional staff that really "gets it". The Staff Assistants are paid a weekly stipend (which comes out of the fees paid by their families; the only drawback to this program is that it is expensive, with annualized costs similar to attendance at a top college). They learn the nuts and bolts of managing their lives, working on everything that has tripped them up in their past endeavors -- time management, social interactions, budgeting, working skills -- yet they also have the chance to work with youngsters whose needs generally exceed their own. When the summer program is not in session, the Staff Assistants have more time to work on additional skills -- taking a course at the local community college, learning to drive, working at a part-time job in town, or participating in a community based organization, such as community theater. 


This all sounds pretty basic, but for young people who have graduated from high school and haven't been able to succeed in college or in the workplace choices can be very limited. And a place where these young adults can work with extraordinary staff and learn to help themselves by helping others can be a key step to their future success. 

Resilience and College Success

Yesterday almost 100 parents and high school students braved strong winds and a steady downpour to hear Dr. Yellin speak about "How to Help Struggling Students Make a Successful Transition to College and Adulthood: Resiliency, Neuroplasticity and Overcoming Early Challenges". This keynote talk was part of a conference sponsored by The Center for Learning Differences and the Compass Project and held on the campus of C.W. Post College.

Using information about recent studies in the fields of neuroscience and education, Dr. Yellin discussed how early struggles with learning can be overcome and that students who have the right kind of adult support, and who understand how they learn, can go on to successful adult lives even if they started out with substantial difficulties.


The conference then broke into separate sessions for the high school students, who meet college students with learning issues for a frank conversation about what they could expect as they move on to college, and a presentation for parents by Dr. Lisa Korman about the transition process from high school to college.

Finally, the entire group heard from representatives of local and national colleges who discussed their programs and the learning supports they offered. Students and parents had an opportunity to speak one-on-one with all of the college representatives and lingered to ask questions long after the program had concluded.

"It was just great," one parent reported. "Dr. Yellin's talk was terrific and we feel so much better informed about the kinds of college programs out there. It wasn't easy getting my kid up early on a Sunday morning but it was really worth it!"

Disclosing Differences

We recently had the opportunity to meet with Helen McDonald, the Director of Admissions at the Threshold Program, a post-secondary program for students with learning differences and cognitive limitations at Lesley University in Cambridge, Massachusetts. We also had a chance to speak with Threshold students and take a tour of its compact urban campus.

The Threshold Program was founded in 1982 and serves students from all over the country in its two year curriculum and additional one year Bridge and Transition programs. More than half of the Threshold students have physical or psychological conditions in addition to their learning difficulties and the average student enters with the reading and mathematical skills of a 4th or 5th grader. Clearly, this program is for students with profound learning issues, well beyond the vast majority of students we see at the Yellin Center.

One thing we learned during our visit is that the Threshold faculty has undertaken extensive surveys of its past students, and their research both validates the value of their program for the students it targets, and provides an important lesson for all students -- even for those with relatively minor learning difficulties or other kinds of disabilities. In a 1996 study entitled Beyond Threshold, faculty members Fran Osten and Carole Noveck surveyed employers of workers known to have learning disabilities. They asked how the timing of the workers' disclosures of their learning difficulties related to the employers' assessment of their workers. Not only did employers rate employees who disclosed their disabilties early on higher than those employees who did not disclose, or disclosed later in their employment, but 79% of the employees who disclosed their learning disabilities during the hiring process received raises and/or promotions compared to those who did not disclose early on -- only 25% of who received raises and/or promotions.

We believe this remarkable difference should be considered by all students who struggle with learning as they complete their education and move into the workplace.

Brehm School

A subject we have been concerned about for some time is the scarcity of schools for students with complex learning needs and concomitant social and emotional difficulties.

Part of the work we do at the Yellin Center involves helping families to find an appropriate school for their child when their current placement does not provide the kind of support their child requires. Most of the children we see can do fine in a regular class in their current school, when the strategies in our learning plan are put into place. But some children need a more supportive setting, and we then need to assist families in exploring private schools which can meet their child's more extensive needs.

We work directly with a number of these schools and have visited or spoken with many more. But too many of the best private schools for student with significant learning needs specifically limit their programs to students with "language based learning disabilities". That's fine if your child has straightforward reading or language difficulties , but leaves very few settings for the many children whose needs don't fit neatly into this category.

We recently had a terrific conversation with Dr. Richard Collins, Executive Director and Headmaster of the Brehm School, a private boarding school in Carbondale, Illinois, for students in grades 6-12. Brehm works with students with complex needs, who may have difficulties in more than one area of learning and whose learning difficulties are complicated by emotional issues and limited social skills. Their impressive curriculum includes integrated instruction to address all areas of deficit while building academic success.

Brehm also has a comprehensive transitional postgraduate program they call Options, which provides students with independent living with guidance and skills training while they also attend a local community college or complete a two year job training program.

Like so many of the best private school programs, Brehm is expensive and we know that a boarding school is something many families will not consider. But given the strength of their program and the kinds of learning and related issues they address, we think it is a program that parents should know about.