Introduction

Many people feel uncomfortable around individuals with disabilities. Much of this discomfort stems from lack of personal contact with people with disabilities, and a sense of awkwardness and uncertainty as to how to speak and act in their presence.

Communication Issues

This section offers suggestions for increasing effective communication and reducing anxiety when interacting with people with specific disabilities.

Hearing Impairments
  • Do not make assumptions about a person's ability to communicate or the way in which she/he does it. 
  • Find out what the person wants to use when communicating with you. S/he may want to use his/her own amplifier or communication device, may request that you write down what you are saying, lip-read, or use an interpreter.
  • When interacting with people who prefer lip reading, use a well-lit, glare-free area.
  • Face the person directly and continue speaking at a normal volume and rate.
  • Rephrase sentences rather than repeat them.
  • Do not cover your mouth or look away from the person, while you are talking.
  • Communicate in writing, if necessary.
  • When a sign language interpreter is present, omit phrases such as "please tell him/her that…" and address the person directly while the interpreter signs.
Visual Impairments
  • Ask if any particular assistance is needed.
  • Orient the person to the area, explaining where major furniture is located. If the person has been there before, you should inform him/her of any changes or new obstacles.
  • Keep doors fully open or closed to prevent accidents.
  • Offer to read written information for a person with a visual impairment, when appropriate.
  • If you are guiding someone, let him/her take your arm just above the elbow and guide rather than lead or propel the person. Give him/her clear instructions, such as "this is a step up" as opposed to "this is a step."
  • When giving directions, use specific words such as "straight ahead" or "forward." Refer to positions in terms of clock hands: "The chair is at your 2:00." Avoid vague terms such as "over there."
  • Don't assume the person will recognize you by your voice even though you have met before. Identify yourself and others with you, maintain normal voice volume, speak directly to the person, and maintain eye contact.
  • Do not presume that the person can’t see anything.
  • When preparing printed information, for a person with low vision it is best to seek their advice for their preferred format. General information for people with low vision should be provided in Arial 18 point bold.
  • The lighting needs of people with vision loss differ and may be significant. Many people see much more with stronger light and others do not. The most common concern is glare.
  • Avoid revolving doors. On stairs or on escalators, assist the person by putting his or her hand on the railing. It is important that the person is made aware of the fact that the stairs/ escalators are going up or down. Always give the person a choice of using stairs, escalators or elevator.
  • When seating a person with a vision impairment put their hand on the back of their chair and they will then be able to seat themselves.
  • Don’t leave a person with a vision impairment in an open area or leave without saying that you are doing so. When you leave, lead the person to a landmark, e.g. a reception desk, so they will feel more secure and oriented to the surrounding environment.
Speech Impairments
  • Listen patiently and avoid completing sentences for the person unless she/he looks to you for help.
  • If a person is using an electronic communication aid stand in front of the person and refrain from reading over their shoulder as they type. Wait for the person to construct his/her full message.
  • Ask one question at a time and wait for a reply.
  • If the person communicates primarily through speech and his/her speech is difficult to understand, you may find it helpful to:
    • Watch how the person says the words.
    • Take the time to get used to the person’s speech. It gets easier the more you listen and the person may need to repeat what he/she is saying a few times before you understand. This is especially the case if the person is using a speech or voice aid.
    • Tell the person if you don’t understand what he/she is saying. The person will either say it another way, show you what they are talking about, spell it out verbally, write it down, use a communication device or point to letters, words or pictures on their communication board.
Mobility Impairments
  • Ask if assistance is needed.
  • Do not remove a person's mobility aid, for example crutches, without the person's consent.
  • When talking to someone who is in a wheelchair and the conversation continues for more than a few minutes, sit down or kneel to be eye level. This avoids neck strain and is much more positive.
  • Don't lean on a person's wheelchair unless you have permission - it's his/her personal space.
  • Speak directly to the person and not with the person providing assistance.
Special Situations
Communicating over the telephone

Find out how the person wants to communicate with you on the telephone. S/he might want to use a device or a communication assistant. Alternatively, the individual might want you to ask questions to which s/he can answer, “yes” or, “no.” The person may prefer to use e-mail or fax. If you have a receptionist, ensure s/he knows how the person will communicate over the telephone.

Written communication

People with physical disabilities may have difficulty writing and may require a note-taker to transcribe or take notes.

Making text materials accessible
  • Ensure that text information is in formats that the person can access and understand. Some individuals may want information in enlarged font, electronic formats, Braille or they may require the assistance of someone who can help in reading and understanding documents.
Decision-making and consent

Depending on the type of decision to be made (e.g., health/medical, financial or personal), as well as skills and experience, most people with disabilities make their own decisions or, like others might rely on peers for advice.

  • In some special circumstances (e.g., a healthcare or legal setting), you may need to know if the person has a formal supported decision-making agreement that identifies the person(s) who can assist in making decisions and a process that fully respects the individual’s values, beliefs, experiences and preferences.
Obtaining signatures

Not being able to physically hold a pen does not mean that a person cannot approve or sign a document. People who cannot write and who understand the meaning of a document may use an alternative mode for signing. Alternatives range from a stamp, a thumb-print, or their authorization of a legally-appointed person to sign on their behalf.

Privacy

Be mindful of the individual’s right to privacy. While the person may rely on a support person to assist in daily activities, she/he may not want to share aspects of their personal life with that person. It is the person’s responsibility to negotiate privacy agreements with their communication assistant.

Compliance Issues
As service providers and advocates, psychologists and other mental health providers need to ensure that their services adequately meet legal and ethical obligations.

To improve compliance with the Americans with Disabilities Act, and to better meet the needs of individuals with disabilities:

  • Do not deny your services to a client with a disability. You may refer him/her if that individual requires treatment outside of your area of specialization.
  • Do not separate out or give unequal service to clients with disabilities unless you must do so to provide a service that is as effective as that provided to those without disabilities. Try to include individuals with disabilities in classes you may have for all your clients.
  • Watch for criteria that screen out clients with disabilities. For instance, do not require a driver's license for payment by check. Use policies, practices, and procedures in your office that can be modified for those with disabilities, such as making sure service animals are permitted in your office.
  • Provide auxiliary aids and services, such as readers, sign-language interpreters, Braille materials, large-print materials, videotapes and audio tapes, and computers, when necessary, to effectively communicate with your clients with disabilities. You may use alternative forms of communication, such as notepads and pencils, when these forms are as effective.
  • Evaluate your office for structural and architectural barriers that prevent individuals with disabilities from getting the services they need from you. Change these barriers when they can be readily changed (without much difficulty or expense).
  • Assess ramps, parking spaces, curb cuts, shelving, elevator control buttons, width of doorways, levered door handles, width of toilet partitions, height of toilet seats, and high-pile carpeting. Ensure that rooms are large enough to maneuver a walker or wheelchair.
  • Hire an architect or contractor familiar with ADA requirements when building new offices or remodeling.
Relevation Legislation

Rosa’s Law of 2010, S. 2781, 111th Congress
This bill makes changes in the language used to refer to individuals with disabilities. The law will change the phrase "mental retardation" to "intellectual disability" in all Federal statutes.

Americans with Disabilities Act of 1990, Pub. L. No. 101-336, 104 Stat. 328 (1990).

Resources

APA (2010). Publication manual of the American Psychological Association (6th Ed.). Washington, DC: American Psychological Association.
Chapter 3 specifically details the use of use ‘nonhandicapping’ language.

APA (2012). Guidelines for Assessment of and Intervention with Persons with Disabilities. American Psychologist, 67(1), 43-62.
The guidelines provide suggestions on ways psychologists can make their practices more accessible and disability-sensitive and on how they might enhance their working relationships with clients with disabilities.

Smart, J. & Smart, D. (2007). Models of Disability. In Dell Orto, A. & Power, P. (Eds.). The psychological and social impact of illness and disability: 5th Edition. (pp. 75-100). New York, NY: Springer Publishing Co.
This latest edition portrays a genuine perspective on life with disabilities. The book improves on the fourth edition with the inclusion of illness as a major impact on client care needs. Articles include theory, research and intervention approaches as well as anecdotes of the day to day experience of living with illness or disabilities.

United States Department of Labor. (n.d.) Communicating With and About People with Disabilities. Retrieved from: http://www.dol.gov/odep/pubs/fact/comucate.htm

What Psychologists should know about Disability. Retrieved from http://www.apa.org/topics/disability/diversity-training.aspx
In an effort to de-stigmatize disability and help psychologists work more effectively with people with disabilities, a pair of experts conducted this training with membership during APA’s 2012 meetings.

For more information or to receive this publication in an alternative format, please contact the Disability Issues Office at 202-336-6038 (voice), or via the Internet at http://www.apa.org/pi/disability/index.aspx.

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