The NP’s Role in School-Based Support for Students with Disabilities

Led by contributors
  • Maria Milazzo, PhD, RN, CPNP-PC
  • Megan Arbour, PhD, RN, CNM, CNE, FACNM
  • Bonni Cohen, PhD, DNP, RN, FNP-C, CNE, FAANP
  • Joanne Keefe, DNP, RN, MPH, FNP, CNE
  • Stephanie Cawthon, PhD

    • This article examines how nurse practitioners can support disabled students through early identification, educational advocacy, transition planning, and collaboration with schools across K-12 and higher education settings.

    Journal cover with a red gradient background featuring large silver “JNP” lettering centered across the page. Below the title, white text reads “The Journal for Nurse Practitioners,” followed by the tagline “Shaping Policy, Improving Practice” inside a blue horizontal banner. Thin vertical blue, teal, and orange lines extend upward and downward along the left side of the cover, intersected by a horizontal blue line across the middle. The top banner includes the American Association of Nurse Practitioners logo on the left, publication details reading “Volume 22, Number 5, May 2026” on the right, and an Elsevier logo in the upper right corner.

    Many disabled and neurodivergent students navigate educational systems where health care, accommodations, and academic planning remain disconnected. Delayed identification, inconsistent support, and limited understanding of disability-related laws can affect both educational and health outcomes.

    Drawing from National Disability Center for Student Success data, federal disability law, clinical vignettes, and existing research on neurodivergence, chronic illness, and postsecondary transition, the article outlines how nurse practitioners can support students across primary school, secondary school, and higher education settings.

    The article also examines how nurse practitioners can help students navigate IDEA, Section 504, and ADA protections while strengthening self-advocacy, transition planning, mental health support, and continuity of care.

    What’s Inside:

    43%

    Undergraduate students identified as having one or more disabilities

    50%

    Disabled undergraduate students received their first disability diagnosis during college

    15%

    Disabled undergraduate students reported receiving accommodations in high school

    Sources: National Disability Center for Student Success (2025); Milazzo et al. (2026).

    Key Findings

    Nurse practitioners often serve as an early connection point for disability-related concerns.

    Nurse practitioners regularly encounter students experiencing academic, behavioral, or emotional challenges connected to disability and neurodivergence. National estimates indicate that 25% of the population lives with at least one disability, 20% identify as neurodivergent, and 30% of youth live with chronic illness (Varadaraj et al. 2021; Doyle 2020; Wisk & Sharma 2025).

    Students with non-apparent disabilities are frequently overlooked in school settings.

    Students who do not visibly struggle or fail classes may not receive evaluations or support, particularly in under-resourced schools. During the 2022-2023 school year, 15% of public school students received special education services, with 32% qualifying under learning disabilities (US Code 2025; Stone et al. 2023).

    College disability support systems require students to self-disclose and self-advocate.

    Unlike K-12 settings under IDEA, higher education accommodations rely on students independently requesting support through ADA and Section 504 processes. 36% of students with disabilities did not report their disability in college, and fewer than half who disclosed informed Disability Support Services (NDCSS 2025)

    Delayed disability identification can affect both academic and mental health outcomes.

    50% of disabled undergraduate students in the NDCSS dataset received their first disability diagnosis during college. Students who remain unidentified may experience anxiety, depression, academic difficulties, and missed opportunities for support throughout their education (NDCSS 2025; Huynh et al. 2024).

    Chronic illness can shape school participation, independence, and daily routines.

    Youth with chronic conditions often manage fluctuating symptoms, absences, fatigue, and social or academic disruptions while navigating school expectations. Conditions such as multiple sclerosis, diabetes, epilepsy, migraines, and autoimmune disorders may require flexible accommodations and coordinated support systems (Daly et al. 2022; NDCSS 2025).

    Disclosure decisions are shaped by stigma, prior experie

    Students described balancing the need for accommodations with concerns about judgment, documentation requirements, and perceptions from faculty or peers. One student explained, “I don’t want to take the MS card,” reflecting tensions between seeking support and avoiding perceived special treatment. Disclosure experiences directly influence access to support and student well-being (NDCSS 2025; Milazzo 2019).

    Top Recommendations for Nurse Practitioners

    Supporting disabled and neurodivergent students requires coordination across health care, education, disability services, and transition planning. The findings emphasize that nurse practitioners play an important role not only in clinical care, but also in early identification, advocacy, communication, and long-term student support across educational settings.

    Expand Early Screening

    Move beyond a “wait to fail” model by discussing academic, behavioral, and emotional concerns early. The article encourages including dyslexia, ADHD, and other neurodivergent diagnoses within differential diagnosis conversations.

    Support Family Advocacy

    Validate caregiver concerns, assist with written requests for evaluations, and help families understand IDEA, Section 504, and ADA protections.

    Strengthen Documentation Practices

    Provide documentation that explains how conditions affect major life activities, academic participation, concentration, mobility, or communication to support accommodation eligibility decisions.

    Prepare Students for Self-Advocacy

    Encourage students to practice describing their disability-related needs, accommodations, housing considerations, and support preferences before entering higher education settings. 

    Increase School Collaboration

    Coordinate with school nurses, educators, counselors, disability support services, rehabilitation specialists, and mental health professionals to support continuity of care.

    Support Mental Health Transitions

    Support students navigating anxiety, sensory overload, executive functioning challenges, and independent health management during educational transitions. 

    image of the National Disability Center for Student Success's website on various devices, phone, tablet and desktop computer

    ”“Before I disclose [my autism and ADHD], my behavior might seem
    like I don’t care or I’m not trying. But after I talk to them, they’re
    much warmer and understanding.”

    Disabled Student

    Recommended Resources

    References

    1. Daly, B. P., Litke, S., Kiely, J., et al. (2022). Effectively supporting youth with chronic illness in schools. Pediatric Clinics of North America, 69(4), 695-707. https://doi.org/10.1016/j.pcl.2022.04.013

    2. Doyle, N. (2020). Neurodiversity at work: A biopsychosocial model and the impact on working adults. British Medical Bulletin, 135(1), 108-125. https://doi.org/10.1093/bmb/ldaa021

    3. Huynh, G., Masood, S., Mohsin, H., & Daniyan, A. (2024). The impact of late ADHD diagnosis on mental health outcomes in females. Social Sciences & Humanities Open, 10, 100977. https://doi.org/10.1016/j.ssaho.2024.100977

    4. Milazzo, M. C. (2019). Lessons About Living Well at the Intersection of Adolescence and Multiple Sclerosis (Doctoral dissertation). State University of New York, Stony Brook.

    5. National Disability Center for Student Success. (2025). Access Leads to Achievement: A National Report on Disabled College Student Experiences. https://nationaldisabilitycenter.org/resources/national-report/

    6. Stone, L. A., Benoit, L., Martin, A., & Hafler, J. (2023). Barriers to identifying learning disabilities: A qualitative study of clinicians and educators. Academic Pediatrics, 23(6), 1166-1174. https://doi.org/10.1016/j.acap.2022.12.008

    7. US Code. (2025). Education of Individuals with Disabilities; 20 USC Chapter 33, Subchapter I: General Provisions. https://uscode.house.gov/view.xhtml?path=/prelim@title20/chapter33/subchapter1&edition=prelim

    8. Varadaraj, V., Deal, J. A., Campanile, J., Reed, N. S., & Swenor, B. K. (2021). National prevalence of disability and disability types among adults in the US, 2019. JAMA Network Open, 4(10), e2130358. https://doi.org/10.1001/jamanetworkopen.2021.30358

    9. Wisk, L. E., & Sharma, N. (2025). Prevalence and trends in pediatric-onset chronic conditions in the United States, 1999-2018. Academic Pediatrics, 25(4), 102810. https://doi.org/10.1016/j.acap.2025.102810