I think you have it just right, Ursula. It is the instructor's job to help the student in the classroom, not to interfere with their personal decisions regarding management of their disability. AND you are right when you say we would want to reach out to any student we saw struggling, for whatever reason, to offer assistance. It is important, when interacting with students with disabilities, that you make your observations and your recommendations based on their individual experience, and not on the basis of what you have seen in the past with someone else who appeared to be dealing with the same issues. But having said that, my general rule of thumb is, "it is NEVER inappropriate to offer assistance. It is simply inappropriate to give assistance that the individual hasn't agreed to."