According to recent Census estimates, about 15% of U.S. adults between the ages of 18 and 24 experience some form of physical, psychological, or intellectual disability (Taylor, 2018). Although these adults comprise a sizable segment of the population, they are less likely to graduate from high school or attend college than same-aged peers without a disability. These differences are striking:

  • In 2006, the aggregate U.S. high school graduation rate was about 75%, but for people with disabilities the high school graduation rate was only slightly more than 50% (Snyder, Dillow, & Hoffman, 2009).

  • Among all students that graduated from high school in 2006, overall about 65% enrolled in some type of postsecondary institution. However, less than 25% of high school graduates with a disability went on to any postsecondary institution (U.S. Department of Education, 2016; Snyder et al., 2009).

  • Higher education completion rates are significantly lower for people with disabilities as compared to the general population (Sanford et al., 2011). U.S. Department of Education data indicate that less than one-third (29%) of young adults with disabilities who enroll in a 4-year degree program complete it. This is compared to 42.2% of the general population (Sanford et al., 2011).

These observations raise concern because of the clear economic and work-related benefits associated with higher education (Kang, Dunn, & Blank, 2018). These concerns are exacerbated by indications that people with disabilities also appear to receive less return on their investment in a college education than their nondisabled peers. Recent U.S. Labor Force Statistics (for the 2017 period) indicate that people with a disability who had attained at least a bachelor’s degree were approximately three times less likely to be employed than those with no disability (Kang et al., 2018).

Motivated by these observations, the goal of this chapter is to provide a critical review of key ways in which people with disabilities have been, and may continue to be, underserved by higher education in the U.S. This review is based on Nancy Fraser’s (2005, 2007) social justice framework, which emphasizes that “overcoming injustice means dismantling institutionalized obstacles that prevent some people from participating on par with others as full partners in social interaction” (2008, p. 16). According to this framework, three dimensions are required in order for participatory parity—or social arrangements that allow for equal participation—to occur. These three dimensions are cultural recognition, economic redistribution, and political representation (Fraser, 2005, 2007). Importantly, these dimensions are autonomous but also overlap. For example, economic redistribution requires a shift in cultural recognition based on equal respect and opportunity, which tends to be informed by a shift in the political representation of a marginalized group. Additionally, their opposites—misrepresentation, misrecognition, and maldistribution—each represent a unique dimension of injustice needing to be addressed to achieve participatory parity.

Adapting this social justice framework, and working toward the aim of participatory parity, this chapter first provides a social history that contextualizes people with disabilities as a socially disadvantaged and marginalized group. This review also describes the important social strides people with disabilities have made, emphasizing the dominant role of higher education in the struggle for equal rights and full social participation. Then, and working toward an understanding of contemporary obstacles to participatory parity for students with disabilities in higher education, the next section presents meta-analysis findings concerning current experiences of students with disabilities in higher education. It should be noted that, except where indicated, this review and analysis is limited in scope to research conducted in the United States.

This discussion draws from the two-tiered construct introduced by disabled activists in the 1970s that differentiates impairment, or the presence of a biological condition, from disability, which refers to the inability of a society to meet or address the needs of people with impairments (UPIAS, 1974). The Union of Physically Impaired against Segregation (UPIAS), the UK-based organization that gave rise to this definition, articulated an understanding of disability as a form of oppression within a broader social, economic, and political context. This is well-articulated in its foundational document, Fundamental Principles of Disability (1975), which notes:

In our view, it is society which disables physically impaired people. Disability is something imposed on top of our impairments, by the way we are unnecessarily isolated and excluded from full participation in society. Disabled people are therefore an oppressed group in society (UPIAS, 1974, pp. 4–5).

The distinction made between a physical impairment and one’s ability to function in his/her social environment (i.e., one’s level of disability) forms the basis of social models of disability, which are now a dominant theoretical paradigm within the field of disability studies. This definition of impairment has been further expanded upon in recent years to include intellectual, behavioral, and psychological conditions in addition to physical conditions (Barnes, 2000).

Part One: Recognition of Disability as a Form of Social Inequality

Let us first then recognize that people with disabilities represent a group associated with unique social burdens akin to (but distinct from) women, race/ethnic minorities, and other socially disadvantaged groups. These differences matter in cultural, economic, and political terms. Indeed, from a social justice perspective, what most distinguishes disability as a social category are the associated cultural, economic, and political disadvantages, as opposed to the experience of physical, psychological, or intellectual differences.

Widespread recognition of disability as a disadvantaged social category is a relatively recent phenomenon. The celebration and enjoyment of disability as a social category is even more recent, as only in the late twentieth century has disability been associated with public celebrations of pride, acceptance, and achievement (Shakespeare, 1996). This greater cultural recognition can be attributed to social progress resulting from greater political representation in the form of disability activism and recent shifts in policy priorities. At a global level, for example, this is evident in the actions of the United Nations (UN) on disability rights. While the UN hailed the period from 1981 to 1992 as the “Decade of Disabled Persons,” it was not until 2001 that the UN General Assembly established a committee to create a convention to protect the rights of people with disabilities. The opening statement of the first report from this committee, titled Human Rights and Disability (Quinn et al., 2002, p. 1), noted:

Over 600 million people, or approximately 10 per cent of the world’s population, have a disability of one form or another. Over two thirds of them live in developing countries.Only 2 per cent of disabled children in the developing world receive any education or rehabilitation. The link between disability and poverty and social exclusion is direct and strong throughout the world.

A dramatic shift in perspective has taken place over the past two decades from an approach motivated by charity towards the disabled to one based on rights. In essence, the human rights perspective on disability means viewing people with disabilities as subjects and not as objects. It entails moving away from viewing people with disabilities as problems towards viewing them as holders of rights. Importantly, it means locating problems outside the disabled person and addressing the manner in which various economic and social processes accommodate the difference of disability—or not, as the case may be. The debate about the rights of the disabled is…connected to a larger debate about the place of difference in society.

This statement underscores the simple fact that full social recognition of disability as a disadvantaged social category is quite recent—and further suggests that a “dramatic shift in perspective” toward people with disabilities has taken place only recently. Few would argue. As Charlton (2000, p. 24) notes: “People with disabilities, at least as a group, may have been the first to join the ranks of the underclass. Since feudalism and even earlier, they have lived outside the economy and political process.” The important, historic shifts in social progress that have occurred in the past 20 years are profoundly evident if we consider developments in the experiences of people with disability in educational settings.

A Very Abridged Social History of Disability and Access to Education

Many targets of modern educational reform in the U.S. can be traced to the post-Civil War period from the 1860s through the 1920s. In this period, education was increasingly recognized as a conduit through which anyone, but perhaps particularly marginalized groups, could achieve individual advancement and social progress. However, there was a near-immediate backlash against access to education for women, racial/ethnic minorities, people with disabilities, and other groups. This backlash misrecognized people with disabilities in two important ways that deserve elaboration because of the devastating limits they would impose for many decades to come.

First, and most directly, authorities in the post-Civil War era vehemently objected to the admission of people with disabilities into mainstream institutions of higher learning (Braddock and Parish, 2003; Longmore, 2000, 2003). The dominant opinion upheld by the field of medicine was that people with disabilities needed to be rehabilitated and, failing that, were a threat to the economic viability of communities in the extent to which they were unable to perform occupational roles (Gallagher, 1985; Longmore, 2000, 2003). As an illustration, Gallagher (1985) cites a prominent orthopedic text from 1911, which suggested that “a failure in the moral training of the cripple means the evolution of an individual detestable in character, a menace and burden to the community, who is only too apt to graduate into the mendicant and criminal classes” (Gallagher, 1985, p. 30). Consistent with medical views, people with disabilities were treated as morally inferior and kept separated from mainstream institutions. Braddock and Parish (2003), for example, note that families commonly auctioned off the care of persons with disabilities and that banishing persons with disabilities from their homes and communities was relatively common during this time.

A second and more indirect development related to disability concerned the pseudo-medical proposition that educating women and racial/ethnic minorities would result in their disablement. One of the most famous examples comes from an influential Harvard-trained physician named Edward Clarke, who argued that “identical education” for women would inevitably lead to swift and permanent physical and psychological deterioration. In his well-known text Sex in Education: Or, A Fair Chance for the Girls, Clarke (1873, p. 127) describes the education of women as a “crime before God and humanity, that physiology protests against, and that experience weeps over,” further specifying that educated White women were “permanently disabled to a greater or lesser degree, or fatally injured.”

Other prominent physicians argued that the advanced education of racial/ethnic minorities would be even more injurious. Another influential report, authored by Abraham Flexner in 1910 (with support from the Carnegie Foundation and now referred to as the Flexner Report), provided a survey of U.S. medical schools and a summary of recommendations for medical education for the American Medical Association. Flexner’s report, echoing Clarke’s rhetoric, speculated that equal education for Black people would be intellectually and psychologically debilitating, suggesting that Black medical schools should not be as intellectually rigorous as medical schools attended by Whites. Flexner also argued that Black physicians should not treat White patients because of the risk that they might communicate diseases, concluding, “Self-protection not less than humanity offers weighty counsel in this matter; self-interest seconds philanthropy. The Negro must be educated not only for his sake, but for ours.”

The influence of sexist and racist rhetoric on subsequent educational reforms can hardly be understated and is the subject of numerous commentaries on education. How disability has been used to justify the exclusion of women and racial/ethnic minorities from educational institutions has received substantially less attention. This historic tendency is central to understanding why people with disabilities have been kept apart from mainstream educational institutions for so long. And, to be sure, there is ample evidence of the continued exclusion of people with disabilities, even as conditions for other marginalized groups improved.

Considerably more attention has been paid to identifying the subsequent historic changes that have increased opportunities for people with disabilities in higher education (Braddock & Parish, 2003; Cahill & Eggleston, 1995; Longmore, 2000, 2003; Silverstein, 2000). The U.S. involvement in World Wars I and II is viewed as especially influential in changing medical and lay perceptions of physical disabilities. The permanent impairments sustained by veterans in the name of national service could not readily be attributed to personal deficiencies or a lack of moral character (Braddock & Parish, 2003; Longmore, 2000). The expansion of educational programs for disabled veterans in the postwar period also created new and previously inaccessible opportunities for people with disabilities more generally. Along with veterans, other new voices joined the fight for disability rights in the first part of the twentieth century, including disabled workers and adult survivors of polio seeking equal educational access (Nielsen, 2012).

Within this social milieu, the civil rights movements of the 1960s further encouraged political organizing among people with various physical impairments, for the cause of disability rights (Braddock & Parish, 2003; Longmore, 2003). During this period, collective action for the rights of individuals with disabilities gained widespread momentum (Braddock & Parish, 2003; Cahill & Eggleston, 1995; Longmore, 2000, 2003; Silverstein, 2000). A vital element of this activity was the independent living movement, which originated on college campuses in California, Illinois, and New York. In its earliest days, the movement was focused on improving accessibility on several college campuses, and the more fundamental issue of college admissions (Patterson, 2012). Indeed, the movement is often said to have originated in 1962, when a polio survivor and quadriplegic named Edward Roberts was the first person with a disability to successfully sue a university for admission (Roberts, 1980). Roberts joined the student body at the University of California at Berkeley after reportedly being told by an admissions officer, “We tried cripples, and they don’t work” (Roberts, 1980). The movement quickly transcended its early focus on accessibility in higher education to address the more global needs for people with disabilities to be able to direct their own lives and actively participated in all aspects of community life (Nielsen, 2012; Patterson, 2012). This is also reflected in the founding document of the UPIAS in the United Kingdom:

As a group we are still often forced to put up with segregated and inferior facilities. We get sent to special schools, colleges or training centres. We are systematically channeled into segregated factories, centres, Homes, hostels and clubs. If we do manage to become mobile, it is often in antiquated tricycles or specially labeled transport. All these segregated forms of help represented progress in years past. But since the means for integration now undoubtedly exists, our confinement to segregated facilities is increasingly oppressive and dehumanising (UPIAS, 1974, p. 1).

The independent living movement in the U.S., joined by other advocacy groups, championed Congress’s passing of Section 504 of the Rehabilitation Act in 1973, which prohibited discrimination against persons with disabilities by any entity that received federal funds. This movement was later instrumental in the passing of the Americans with Disabilities Act (ADA) of 1990. The passing of the ADA marked a significant triumph for disability rights because of the new protections it offered. This landmark legislation assured that individuals could not be discriminated against because of a disability. The ADA required that employers, educational institutions, and all public institutions provide reasonable accommodations and access for people with disabilities (Braddock & Parish, 2003; Cahill & Eggleston, 1995; Kudlick, 2003; National Council on Disability, 1997).

Although 30 years have elapsed since the passing of the ADA, its implementation remains incomplete. In practice, this has meant that many children with disabilities still experience segregated and subpar educational facilities and have fewer opportunities to pursue higher education. Discussions about the inclusion of people with disabilities in higher education have, therefore, understandably tended to focus on the question of whether, or to what extent, people with disabilities are participating in higher education at all. Yet, participation means much more than accessing a classroom or course lesson; it should mean full immersion in the intellectual life of a college campus. Even the most abridged social history of disability can leave little doubt that people with disabilities have experienced social injustice in the form of misrecognition, misrepresentation, and maldistribution, which impact their ability to engage and succeed in higher education. However, our understanding of current challenges to participatory parity in higher education for people with disabilities is more tenuous.

Part Two: Participation of Students with Disabilities in Higher Education Today

What does participation now mean for students with disabilities pursuing higher education? To address this question, we conducted a systematic review of the current state of participation of people with disabilities in higher education since the passing of the ADA. Our analysis follows a modified version of PRIMSA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (Moher et al., 2009). PRIMSA provides a four-step process for conducting reviews: (1) record identification, (2) record screening, (3) determination of eligibility, and (4) inclusion. Figure 1 presents a flowchart for the current review, which we conducted from September to November 2019.

Fig. 1
A flow chart depicts the following. The initial search leads to selection by title, selection by abstract, duplicates removed with sub-sets of studies excluded, and the final yield.

A summary of the review process

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For this analysis we searched the PubMed and Web of Science databases for peer-reviewed articles containing the keywords “disabled students,” or “students with disabilities” and restricted the results to articles containing the keywords “college,” “university,” “higher education,” or “higher ed.” We limited our sample to English language articles that focused on students with disabilities in higher education that were published after the passing of the American’s with Disabilities Act in 1990. Irrelevant articles (e.g., studies about high school students, studies about teachers working with students with disabilities, etc.) were excluded from this study. Our initial database search results yielded 1081 articles, of which we determined that 281 were relevant to our study.

The goal of our analysis is to understand the participation of students with disabilities in higher education since the passing of the ADA in 1990. Specifically, we are interested in policies or practices that encourage inclusion or, conversely, maintain exclusion. We began with an open coding of the data to identify major themes present in the research literature. We identified seven distinct themes: assistive technology, accommodations, specialized education, program creation and evaluation, a call to action, graduation and/or persistence, and specific social justice perspective. Less frequent topics (n = 36) (e.g., enrollment and employment) were coded as “other.” Table 1 presents the distribution of major themes in the 245 articles we reviewed (excluding those coded as “other”).

Table 1 Frequency of major themes (N = 245) classified by three social justice dimensions in scholarly articles about disability and higher education
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After coding the articles for the presence of these seven themes, we used Fraser’s (2005, 2007) three dimensions of social justice—recognition, redistribution and representation—to guide our analysis. Following Fraser and Honneth’s (2003) recommendation, we applied these dimensions broadly: Recognition is the affirmation of a previously devalued characteristic (e.g., recognizing disability as a source of power and pride rather than a stigmatizing identity) as well as the examination of power structures that lead to unequal treatment; Redistribution is a call for a reallocation of resources and/or a large transformation existing structures; Representation acknowledges those that are entitled to participate in political and decision-making processes and those that have power to make policy decisions (Fraser & Honneth, 2003).

Table 1 presents the frequencies for each of the seven major themes identified above, as well as the social dimension category associated with each theme. Redistribution efforts are the most common social dimension (n = 140, 57.1%), followed by representation (n = 68, 27.8%) and recognition (n = 37, 15.1%). We discuss each of these dimensions in the order they are typically discussed in the literature (i.e., cultural recognition, economic redistribution, and political representation; Fraser, 2005, 2007).

Recognition-Oriented Themes

Data coded in this category provided some cultural recognition of disability as an identity or social category. Studies acknowledging this social justice dimension adapted an inclusive definition of disability, including physical, psychological, and intellectual or learning-based disabilities. It is notable, as previously indicated, that recognition-related themes were least prevalent in the literature on disability in higher education. Also noteworthy is that we found no studies that provided a generally positive or affirming description of disability or students with disabilities in higher education as an alternative to a negative description. Only one study included a description of a disability culture on a college campus (i.e., Forber-Pratt, 2019). Instead, students with disabilities were typically discussed as a marginalized or stigmatized group, as depressed, as lacking self-esteem, personal mastery, and a sense of self-determination.

The review also identifies few critiques of the power structures that maintain disability-related inequalities in higher education and contribute to disparities in graduation rates. Indeed, the lower rate of graduation from higher education among people with disabilities was acknowledged in less than 5% of the coded data.

We do find evidence that universities recognize that numerous units, including student organizations and clubs, first-year programs, internship programs, athletics programs, and academic advisors, have not included students with disabilities in the past. Their exclusion is typically framed in the literature as an opportunity to enhance social interaction or as a focus on efforts to reduce social isolation. There was less clear evidence linking past or current institutional practices and structures with the cultural recognition or misrecognition of people with disabilities on college campuses. Considerable attention has, however, been given to disability as a target for economic redistribution, as we elaborate on below.

Redistribution-Oriented Themes

Discussions related to disability and economic redistribution also overwhelmingly adapt an inclusive definition of disability rather than focusing on one type of disability. The exceptions (i.e., investigations focused solely on mental health or a learning disability) tended to examine the inadequacy of campus disability services to accommodate particular types of disabilities and highlighted the need for additional accommodations for nonphysical disabilities.

Much more common among investigations of accommodations—in fact, the most prevalent theme in this analysis—was a focus on whether an accommodation is necessary or helpful. These investigations share a cost/benefit mentality in their approach to the study of accommodations. This is achieved, primarily, in two ways: (1) by testing the use of accommodations in controlled environments, as is typical for evaluating test accommodations, and (2) by asking students with disabilities whether they are satisfied with their accommodations. The latter category was less common, though it should be noted that the focus of discussions in this category was on the experiences of successful students and college graduates. This was often with the goal of identifying the personal and environmental factors associated with the effective use of accommodations. We were not able to identify any information on the experiences of less successful students or individuals who had left college without graduating. This is a potentially important oversight in this literature, because an incomplete sample of students with disabilities may lead to an inaccurate or biased understanding of the accommodations that are overall most efficacious.

While most research on accommodations employed a general or abstract understanding of accommodation services, a substantial subset focused on the use of assistive technologies. Assistive technologies include any physical item or tool that assists a person with a disability to succeed in performing a task they might otherwise be unable to do independently or efficiently. These include tools such as mobility aids, orthotics, and hearing devices. They represent a unique component of accommodation services because they are specific and tangible. We identified assistive technologies as a separate theme from accommodations because they were overwhelmingly discussed as beneficial for academic engagement and psychosocial outcomes, with their cost being identified as the major detractor from their implementation. From a redistribution standpoint, the main takeaway from the literature on assistive technologies is that more economic resources are needed to further enhance their benefit.

Our review further reveals that academic disciplines are frequently exploring specialized educational strategies and best practices to remedy barriers faced by students with disabilities. Across a range of disciplines, from undergraduate STEM programs to graduate nursing and social work programs, we found evidence that disciplines are actively working to address the needs of disabled students within their programs. These discussions may bode well for the future inclusion of disability in higher education. However, most disciplines are only now or very recently acknowledging the unique situations of students with disabilities and exploring ways to make full participation possible. This consideration is further emphasized in representation-oriented discussions.

Representation-Oriented Themes

The representation category expands on discussions of student participation and resources to include the participation of people with disabilities in educational decision-making and positions of power. There are four themes in this category that differentiate it from literature in the other dimensions. First, this literature tends to be authored by people with disabilities. Within the time period constraints of our analysis, the inclusion of expert opinions of people with disabilities is relatively recent, but becoming more frequent. Second, unlike the trend in other categories toward an inclusive definition of disability, discussions related to representation tend to focus on a specific disability (e.g., autism) or category of disability (e.g., intellectual disabilities). Concerns related to physical disabilities and learning disabilities, voiced by scholars with these types of disabilities, were most prevalent. Unrepresented in this literature are the perspectives of people with psychological disabilities and behavioral health-related disabilities.

This literature is further unique because it typically includes some call to action and, in fact, some explicit demand for further research or direct action to improve the circumstances of students with disabilities. Strong language (e.g., “we must,” “it is morally imperative”) typifies this literature. Also, this literature tends to emphasize disability as a social justice imperative. For example, in a number of instances, the need for better services and programs for students with disabilities is described as a moral or social responsibility.

The fourth theme unique to discussions about representation concerns an intersectional framework or need to recognize how occupying numerous disadvantaged social statuses will further marginalize some students. This consideration was most frequently discussed in highlighting the experiences of LGBTQ students with disabilities. Hawke (2004), for example, note that LGBT students with disabilities tend to be excluded from LGBT communities on college campuses. They also rarely receive the same support through college services as students without disabilities (Hawke 2004). Several scholars also highlight the underutilization of support services by students who have disabilities and are racial or ethnic minorities or from a low-income background, and lack of cultural capital among these students. Their scholarship shares a commitment to recognizing and seeking to redress multiple and overlapping forms of disadvantage on college campuses.

Taken as a whole, scholarship on the representation of people with disabilities in educational decision-making and positions of power appears to be in its infancy. The novelty of this literature mirrors the dearth of scholarship on the cultural or social recognition of people with disabilities in higher education. At the same time, colleges and universities are increasingly acknowledging that economic redistribution is needed to enhance the benefits of accommodations and assistive technologies on college campuses. What do these trends mean in terms of the ability of people with disabilities to achieve participatory parity in higher education? To address this important question, we offer a set of observations in relation to the three main dimensions of this analysis.

Implications, Recommendations, and Concluding Thoughts

Fraser’s social justice framework (2005, 2007) relies upon what she describes as the “all affected principle,” which mandates that everyone involved with or affected by an institution has a moral obligation to change it. This meta-analysis and systematic review offers several insights for those seeking to address ableism in the academy.

First, with regard to the concept of cultural recognition, this review documents a prevailing narrative based on a derogatory or deficit understanding of disability. This narrative characterizes students with disabilities as a stigmatized group, and as one characterized by low psychological well-being (i.e., as depressed, and lacking self-esteem, personal mastery, and a sense of self-determination). One approach to changing this discourse may be for efforts to enhance institutional diversity and inclusion to engage with positive depictions of disability, and people with disabilities, in organizing extracurricular events and activities. Gallaudet University’s Deaf Life Museum provides an excellent example of this type of positive depiction. The museum’s rotating exhibits are further notable with their focus on civil rights leaders with disabilities, leaders of the women’s movement with disabilities, etc.

At the same time, further attention must also be devoted to understanding the power structures that have maintained disability-related inequalities in higher education. A helpful starting point would be to better reconcile the current underrepresentation of people with disabilities, women, and race/ethnic minorities, with their historic exclusion from higher education. As noted earlier in this chapter, the use of disability to justify the exclusion of women and race/ethnic minorities from educational institutions has received little scholarly interest, and this seems to be a promising direction for further inquiry.

The meta-analysis findings additionally demonstrate that numerous disciplines are exploring ways to better distribute educational programming to students with disabilities, by weighing the costs and benefits of different accommodation approaches. Assistive technologies are clearly shown to be efficacious, though research more typically investigates the personal and environmental factors associated with accommodation seeking among successful student populations. This approach may be problematic for two reasons: First, the focus on successful students may introduce a selection bias that masks the complexity of accommodation seeking among the broader population of students with disabilities. This could be remedied by future research including students with disabilities who are struggling academically and former students who were unsuccessful in coordinating accommodations. Second, by examining the personal challenges of individuals, we may overlook the structural constraints within which these challenges occur. A shift in focus could provide useful information on the financial and institutional constraints that have limited the use of assistive technologies at a structural rather than individual level.

Greater representation of scholars with disabilities in the academy would also help target redistribution efforts. This review demonstrates that scholars with disabilities can be strong advocates for college students with disabilities. Unfortunately, there is a dearth of literature by scholars with psychological and behavioral disabilities about the difficulties associated with these disabilities. One of the challenges this imposes is the need to grapple with the social challenges and forms of oppression that are unique to one form of disability versus another. This challenge multiplies exponentially when considering additional forms of disability and additional disadvantaged statuses such as gender or race/ethnicity. Also, the broader contexts within which different disabilities are embedded are often distinct. For example, psychiatric disabilities are largely addressed in autonomous systems, infrastructures, and policies, which is partly why the trajectories of many social movements associated with psychiatric disability issues have diverged substantially from the more mainstream disability rights movement.

The uneven growth in the representation of people with disabilities in the academy again calls to mind the question: What is needed to achieve participatory parity for people with disabilities in higher education? This review cannot offer a simple answer to this complex question. But, it does remind us of the disability rights rallying cry of, “Nothing about us without us.” This signals the vital role that people with disabilities must play in bringing about true transformation for people with disabilities in the academy.

While this review highlights ongoing challenges to participatory parity for people with disabilities in higher education, several important shortcomings should be noted. First, the systematic review methods we utilize are known for lacking theoretical sensitivity in categorizing complex data. Each of the major themes identified in this chapter encompasses complex experiences that should be elaborated on in future study. For example, the utilization and success of accommodations varies widely. The implementation of accommodations could easily be the subject of a systematic review in its own right. Also, our focus on the post-ADA context in the U.S. unfortunately neglects the experiences of people with physical disabilities who live in nations that do not have the same legislated protections. Further research in developing countries is especially needed to understand how the presence or absence of policies like the ADA inform the experiences of people with physical disabilities. Moreover, we synthesize research findings en masse that have been published over several decades in which considerable change has occurred in higher education. We recommend additional research attend to change over time in the themes discussed.