Impact Feature Issue on the ADA and People with Intellectual Developmental, and Other Disabilities

Passed 25 years ago, the Americans with Disabilities Act (ADA) of 1990, a civil rights law, has provided guidelines for municipalities to pass codes that prohibit places of public accommodation to discriminate on the basis of disability. Consequently, the ADA has been instrumental in promoting barrier-free access for people with physical disabilities and, to a certain extent, people with vision and hearing loss, in private and public sectors in the United States. For example, it is not uncommon to see buildings with ramps, enlarged restroom stalls, and lowered switches and buttons that operate doors and lights, all with the intended purpose of accommodating someone with a physical disability.

While the ADA has provided greater assurance that people with physical disabilities have better access to and within buildings, this law has not as fully addressed many of the barriers that affect accessibility for people with intellectual and developmental disabilities (IDD). Upon closer examination, it becomes apparent that the ADA falls short in supporting people with IDD in a number of ways. This article identifies some of those remaining barriers to inclusion for people with IDD, and offers some ideas on how to address them today in ways consistent with the vision of the ADA.

Access to Affordable Technology

As society increasingly relies on computing and communication technologies to acquire, utilize, and disseminate knowledge, many people with IDD are being left behind because they do not have the financial means to afford these devices, services, and programs, and because some are not accessible. According to a Pew Research report, 91% of adults in the United States own a cell phone (Pew Research Center, 2013), yet many people with IDD cannot afford to own and pay for the service, especially one that accesses the Internet, due to a poverty rate of over 29% for those 18-64 years compared with 13% of the same age group in the general population (Institute on Disability, 2013). In a world where communication is increasingly done through personal devices such as a cell phone, people with IDD have been left far behind (Pew Research Center, 2012).

An excellent resource on this topic that identifies specific barriers and calls for widespread action to address them (including financial barriers) is, The Rights of People with Cognitive Disabilities to Technology and Information Access from the Coleman Institute for Cognitive Disabilities. The Coleman Institute also has an online database of research-based resources on the topic of access to information technology for people with cognitive disabilities; it’s titled the Cognitive Technology Database .

Wayfinding in the Built Environment

People with IDD need to access services inside and outside buildings, just like anyone else. However, a substantial barrier often faced by people with IDD is information that helps them locate a specific destination within that setting. This act of getting from one point to another desired location is known as wayfinding. Elements such as signage, directories, landmarks, maps, and human sources of information are just some of the considerations in wayfinding. Too often signage is the only element available. If signage is text-only, this becomes a barrier to navigating within that setting for people who do not read. As an alternative, landmarks can serve as orienting and path-marking devices and are accessible to virtually everyone, including people with IDD (Salmi, 2008). Pairing signage with a landmark can help with recall and direction-giving. For example, a directional sign containing building information paired with a water fountain, clock, or interactive landmark such as an ATM can help in orienting and remembering the building. With careful thought and planning, the wayfinding information in the built environment can be made much more accessible to people with IDD by using a number of strategies. For more information on strategies to improve wayfinding so it works for people with IDD, see Wayfinding Design: Hidden Barriers to Universal Access (http://www.informedesign.org/_news/aug_v05r-p.pdf ).

Access to Transportation

Many people with IDD do not own or drive a car and must rely on public transit or other funded transportation, if available where they reside. Individuals who do not live near public transit, or have access to other funded transportation services (such as paratransit), must rely on other individuals or personal contacts for transport. This makes it much more complicated to pursue the activities of daily living and quality of life. Transportation (or the lack thereof) can often be an insurmountable barrier to inclusion. It is imperative that states and municipalities ensure that all transportation providers are trained in ADA requirements, and use the technical assistance available to implement the ADA in ways that make all aspects of transportation accessible to people with IDD. One resource that offers training, technical assistance, and publications on the implementation of the ADA in transportation is Easter Seals Project ACTION. Project ACTION  has extensive resources, including creative solutions to meeting transportation needs.

Communication

There are two types of communication that frequently present barriers to inclusion for people with IDD: The systems necessary to aid in communication, and the act of communication between individuals. As an example of the first, phone systems, such as those typically used by clinics, present a barrier to people with IDD because they often require the listener to select a number on their phone in order to get to the appointment desk, and sometimes it can be multiple numbers. Many people with IDD require assistance with this process, a process that could readily be simplified with thoughtful design such as simplifying the call-in system and not requiring individuals to have to listen closely to which number to push. In “Telecommunications Access for People with Disabilities” the Federal Communications Commission (FCC) provides useful guidance for businesses and people with disabilities regarding ensuring accessible telecommunications systems, including interactive voice response systems that have menus of choices.

Communication between individuals is all too often hindered because individuals don’t have a way to communicate with one another in a straightforward manner. Using the healthcare setting example again, communication between the medical provider and an individual with a disability can be difficult due to the individual’s disability and the complexity of the topic. This barrier can exclude the individual from providing and receiving important medical information. There are tools such as a health advocacy document, sometimes called a health passport, that are designed to support individuals with IDD in sharing critical medical information with health care providers, some of whom might not be familiar with the individual or with IDD. A good example is Passport for Hospital/Clinic Visits from the Florida Center for Inclusive Communities (http://flfcic.fmhi.usf.edu/docs/FCIC_Health_Passport_Form_ Typeable_English.pdf). In addition, sometimes communication is difficult because the individual without disabilities is unsure of the basic etiquette in communicating with a person with disabilities. A good resource on this is Basic Disability Etiquette Tips from PACER Center.

Conclusion

Expanding thinking about accessibility and its true meaning for all Americans is imperative. The suggestions in this article are provided so that people can act today, but the best solution may be to introduce further amendments to the ADA that address the needs of people with IDD. Understanding the barriers to accessibility and inclusion that are present and recognizing areas for growth in understanding is crucial. Each and every one of us deserves the right to live life to its fullest and to enjoy the benefits of the richness of life. In its current state, ADA provides accessibility rights to a select few. It is time for the ADA to look to the future and be inclusive of all in its mandate