For my Universally Designed Lesson Planning Project #1, I choose to look at college students, as that is the population that I currently work with and am taking classes to work with. I am focusing on students with chronic illnesses as learners, but more specifically students with Postural Orthostatic Tachycardia Syndrome or POTS. This is my main disability, so I felt I would be able to relate my own experience of being a college student with POTS to this assignment.

POTS, also known as Orthostatic Intolerance, is a disorder of the autonomic nervous system or dysautonomia (Christensen, 2002). As described in the article, “Standing up to gravity,” the autonomic nervous system is responsible for increasing heart rate and constricting blood vessels when a person without Orthostatic Intolerance goes from sitting or lying to standing. In a person with POTS, rather than maintaining blood pressure, the blood pressure falls, causing symptoms in the individual. While these symptoms are exacerbated by standing, people with POTS are most frequently symptomatic after moving to an upright position, and symptoms may be mediated by lying down, and allowing the autonomic nervous system to not have to work so hard to regulate blood pressure. The most common symptoms are “orthostatic palpitations and tachycardia, lightheadedness, disabling fatigue, exercise intolerance… cognitive impairment” (Karas, Grubb, Boehm & Kip, 2006) as well as “nausea… headache [and] pallor” (Christensen, 2002).

With an understanding of what POTS is, we can try to look at this group in terms of what their strengths and weaknesses would be as learners. To begin with, people with POTS may have difficulty sitting or standing for prolonged periods of time. This can be troublesome with college level courses, as most range from about an hour to three hours in lengths, where the student usually spends most of the time sitting. If the student was taking lab classes, such as for a science degree, they also may be standing for long periods of time. In a traditional college class environment, people with POTS may not be able to make it through a class without becoming symptomatic. However, people with POTS would have the potential to be very successful in non-traditional classrooms, such as online courses. It is also possible that on days where the student couldn’t attend class, they could have the class video-taped, they could teleconference into the class, or have notes taken for them. For lab classes, being able to do the lab work in smaller time periods or with the help of a partner who could do most of the standing an moving around could prove to make the learning environment successful for the person with POTS.

These are examples of one of the best characteristics of people with POTS as learners; they are familiar with having to be creative. This comes from the fact that POTS is a relatively new diagnosis, with little information on ways to mediate it (some ideas for regulation were discussed in “A status report on chronic fatigue syndrome”), so people with POTS have had experience with navigating and “working” the system. They have had to become creative with how they experience their day to day life, knowing that even a trip to the grocery store can become an intolerable experience. Knowing this, I believe that people with POTS tend to have more experience thinking outside the box and being flexible. They probably haven’t been able to do a number of daily tasks in the traditional way, so they may be able to view alternatives to traditional lesson instruction as well.

People with POTS may also have difficulty as learners because of the cognitive impairment associated with the syndrome. They are known to have impaired concentration, difficulty finding the word they want to use, and mental fog, or clouding of consciousness. This could make the learning process very frustrating, as they may have trouble reaching the information they are trying to attain, and could be made worse by timed exercises and classes based on specific vocabulary (since they may have trouble remembering a specific word).

Based on their personal experience, people with POTS may be more patient or less patient, as learners, based on their previous experience. They may be more patient learners because it probably hasn’t been easy for them to obtain diagnosis, and therefore, able to obtain accommodations from their institution of learning. Traditionally, a tilt table test is done to prove that a person has POTS. However, this may not be an accurate measure for all patients (Natelson & Lange, 2002). In addition to this, many doctors are as yet not aware of this as a diagnosis, so may not even know to order a tilt table test (I am still usually the one explaining what POTS is to the doctors who need to treat me for it!). This could mean that the person with POTS becomes very patient, having had to wait a long time for diagnosis, which could translate to how they are in the learning environment. On the flip side, they also could be very impatient, having had to wait such a long time for diagnosis or having had their condition challenged by medical professionals. As an example, in the paper “POTS versus deconditioning: the same or different,” it is challenged as to whether people with POTS have merely become deconditioned because of their lack of movement and that the deconditioning is actually what they are experiencing as symptoms (Joyner &Masuki, 2008). Since POTS patients have likely been challenged over whether their symptoms are psychogenic, they may be very impatient and guarded as learners.

As an example of a person with POTS pursuing a college education, I have included a link to “Chronically Kyli.” In this video, Kyli talks about how her POTS can influence her experience of signing up for college courses. While Kyli does show some creativity in trying to take some non-traditional courses and starts out as patient, over the course of her experience she becomes symptomatic, including weaknesses, dizziness, and what sounds like mental clouding. She also talks about how other people willingness to help her mediates her experience in the college environment. Here is the link:



Christensen, D. (2002). Standing up to gravity. Science News, 161(24), 376-377. Retrieved from

Joyner, M. J., & Masuki, S. (2008). POTS versus deconditioning: The same or different? Clinical Autonomic Research, 18(6), 300-307. Retrieved from

Karas, B., Grubb, B. P., Boehm, K., & Kip, K. (2006). The postural orthostatic tachycardia syndrome. Pacing and Clinical Electrophisiology, 23(3), 344-351. Retrieved from

Natelson, B. H., & Lange, G. (2002). A status report on chronic fatigue syndrome. Environmental Health Perspectives, 110(4), 673-677. Retrieved from