REMOVING BARRIERS
Tips and Strategies to
Promote
Accessible
Communication
Produced by
The North Carolina Office
on Disability and Health
With
Woodward Communications
Produced by
The North Carolina Office on
Disability and Health
with Woodward Communications
Editor
Sally McCormick, Woodward
Communications
Design
Lorraine Woodward, Woodward
Communications
The North Carolina Office on
Disability and Health is a partnership effort with the
Women’s and Children’s Health
Section of the Department of Health and Human
Services and the Frank Porter
Graham Child Development Institute at the University of
North Carolina at Chapel Hill.
Through an integrated program of policy, practice, and
research, the North Carolina
Office on Disability and Health promotes the health and
wellness of persons with
disabilities in North Carolina.
© First
Edition 1999 The North Carolina Office on
Disability and Health.
Second Edition 2002 (Revised)
Permission is granted to reprint
this document. Please acknowledge the
North Carolina Office on
Disability and Health
Foreword
Chapter 1 1
Disability Awareness
Debunking the Myths 1
Interacting with People with 3
Disabilities
General 3
Hearing 3
Vision 4
DeafBlindness 4
Speech 5
Cognitive 5
Mobility/Wheelchair Users 6
Service Animals 6
People-first Language 7
Chapter 2 9
Communication Aids and
Alternative Formats
Printed Materials 9
Pros and Cons of Alternative 10
Formats
Large Print 11
Computer Disk 12
Audio Tape 13
Braille 15
Interpreters 16
TTY 17
Speech-to-Speech Service 18
Video Relay Service 18
Captioning 18
Chapter 3 19
Creating Inclusive Materials
Printed Materials 19
Tips to Enhance Readability 19
Use of Color 20
Paper Selection 21
Spanish 21
Web/Computer-based Materials 21
Videos 23
Personal Computer Presentations,
24
Overheads and Slides
Chapter 4 25
Media Relations
Reporting on People with 25
Disabilities
Interviewing People with 26
Disabilities
Hearing 27
Vision 27
Speech 27
Cognitive 27
Mobility/Wheelchair Users 28
Appendix A 29
Glossary of Terms
Appendix B 34
Making a TTY Call
Directions for Making a Call 34
TTY Communication Tips 36
TTY Abbreviations 37
Appendix C 38
Products for PC Users
Acknowledgements 39
Table of Contents
As disability awareness and sensitivity increases, many
professionals are looking
for resources to help them
improve their interactions with people with
disabilities. To meet this need,
the North Carolina Office on Disability and
Health has created this guide to
accessible communication to facilitate the inclusion of
people with disabilities and
increase the ease with which everyone relates to each other.
Removing Barriers: Tips and
Strategies to Promote Accessible Communication is a
compilation of materials
submitted by a number of organizations and individuals (see
Acknowledgements). Its purpose
is to be an easy-to-read, quick reference guide that
addresses the basics in
communicating with people with disabilities. This document is
not meant to be an exhaustive,
comprehensive resource but rather a good starting point
for communications professionals
and others to use in their work as well as private
lives.
This guide focuses on ways to
effectively communicate and interact with people with
disabilities by providing
information and tips that can be incorporated in the workplace
as well as in other activities
of daily community living. Most of the recommendations
are low- or no-cost approaches
that would be easy to implement in a variety of settings
including government, non
profits, advocacy agencies, private businesses, the general
public and the media.
This document is an excellent
resource for a number of people including communications
professionals, graphic artists,
printers, educators, the media and people with
disabilities. Even if you don’t
understand all the material or don’t need it for what you
do, share it with others who are
responsible for those areas. People with disabilities can
also share this guide with
others to facilitate improved communications and greater use
of alternative formats.
The information in this guide is
limited to communicating with people who have more
visible disabilities such as
hearing, vision, mobility, speech and cognitive limitations.
However, it is important to
recognize there are also "invisible" disabilities, such as
mental illness and serious
environmental allergies, that people need to be sensitive to
in their interactions with
others.
Many of the suggestions in this
guide constitute universal "best practices" in
communications. By incorporating
the recommendations, you are making improvements
that will benefit a wide
audience. We encourage you to use this and other
resources to enable everyone to
better communicate with each other and to promote
full inclusion of people with
disabilities.
Foreword
1
Chapter One
Disability Awareness
Amajor component to successful communications is being
comfortable with the
person with whom you are
interacting. For many people, there is some
awkwardness in communicating
with people with disabilities—they’re just not
sure how to act and what to say.
Should you look at people with a mobility or
disfiguring disability and risk
them thinking you’re staring at them, or do you ignore
them, avoiding eye contact and
risk making them feel ostracized? Should you help
someone who seems to be having
difficulty getting his/her wheelchair up an incline?
What do you do when you can’t
understand someone with a speech disability?
Learning more about disabilities
will increase the comfort level in interactions with
people with disabilities.
Because of medical advances, technology, the variety of
services available and an
attitude shift towards inclusion and integration, many people
with disabilities are active
members of their communities.
Debunking the Myths
In spite of significant changes
in the world of disability, it is important to recognize that
some people still have negative
stereotypes and misconceptions about people with
disabilities. One of the first
steps in improving communications with people with
disabilities is to discard and
disprove these myths that can put people with disabilities in
a separate “class.”
Following are some common
misconceptions and facts about people with disabilities.
Myth 1: People with disabilities are brave and courageous.
Fact: Adjusting to a disability actually requires adapting to a
lifestyle, not
bravery and courage.
Myth 2: Having a disability means you cannot be healthy.
Fact: Persons with disabilities can experience good health and
full participation
in community life. They benefit
from the same health-enhancing
activities as the general
population.
Myth 3: Wheelchair use is confining; users of wheelchairs are
“wheelchair-bound.”
Fact: A wheelchair, like a bicycle or an automobile, is a
personal assistive
device that enables someone to
get around.
Myth 4: Curious children should never be allowed to ask people
about their
disabilities.
Fact: Many children have a natural, uninhibited curiosity and ask
questions that
some adults might find
embarrassing. But scolding children for asking
questions may make them think
there is something "bad" about having a
disability. Most people with
disabilities won’t mind answering a child’s
uestions, but it’s courteous to
first ask if you can ask a personal question.
Myth 5: People with disabilities always need help.
Fact: Many people with disabilities are quite independent and
capable of
giving help. But if you want to
help someone with a disability, ask first
if he or she needs it.
Myth 6: The lives of people with disabilities are totally different
than those of
people without disabilities.
Fact: People with disabilities go to school, get married, work,
have families, do
laundry, grocery shop, laugh,
cry, pay taxes, get angry, have prejudices,
vote, plan and dream, just like
everyone else.
Myth 7: There’s nothing one person can do to help eliminate the
barriers
confronting people with
disabilities.
Fact: Everyone can contribute to change. You can help remove
barriers by:
n Understanding
the need for accessible parking and leaving it for those
who need it;
n Encouraging
participation of people with disabilities in community
activities by making sure that
meeting and event sites are accessible;
n Understanding
children’s curiosity about disabilities and people who
have them;
n Advocating
for a barrier-free environment;
n Speaking up
when negative words or phrases are used in connection
with disability;
n Writing
producers and editors a note of support when they portray
people with disabilities as they
do others in the media;
n Accepting
people with disabilities as individual human beings with
the same needs and feelings you
might have; and
n Hiring qualified
persons with disabilities whenever possible.
2
Interacting with People with
Disabilities
When interacting with people
with disabilities, it is important to extend them the same
courtesies and respect that are shown to others. However,
there are some rules of
etiquette that will help both
you and the person with the disability feel more
comfortable. Following are some
general recommendations as well as some disabilityspecific
tips to improve communication
and interaction skills.
In general
n Relax. Be
yourself. Don’t be embarrassed if you happen to use accepted, common
expressions such as "See
you later" or "Got to be running along" that seem to relate
to the person’s disability.
n Offer
assistance to a person with a disability if you feel like it, but wait until
your
offer is accepted BEFORE you
help. Listen to any instructions the person may want
to give.
n Be
considerate of the extra time it might take for a person with a disability to
get
things done or said. Let the
person set the pace in walking and talking.
n When talking
with someone who has a disability, speak directly to that person rather
than through a companion who may
be present.
n It is
appropriate to shake hands when introduced to a person with a disability.
People with limited hand use or
who wear an artificial limb do shake hands.
Hearing
This disability can range from
mild hearing loss to profound deafness. Some persons
who have hearing loss use
hearing aids. Others may rely on speechread (lip reading) or
sign language, but many do not.
Following are some ways to improve communication
with someone who is deaf or hard
of hearing.
n To get the
attention of a person who is deaf or hard of hearing, tap the person on the
shoulder or wave your hand.
n Follow the
person’s cues to find out if he/she prefers sign language, gesturing,
writing or speaking.
n Look
directly at the person and speak clearly, slowly and expressively to establish
if
the person can read your lips.
Those who do will rely on facial expressions and other
body language to help in
understanding. Remember, not all persons who are deaf or
hard of hearing can lip read.
3
n Speak in a
normal tone of voice. Talking too loudly or with exaggerated speech can
cause distortion of normal lip
movements. Shouting won’t help.
n Place
yourself facing the light source and keep your hands and food away from your
mouth when speaking. Do not try
to communicate while smoking or chewing gum.
Keep mustaches well trimmed.
n Try to
eliminate background noise.
n Written
notes can often facilitate communication.
n Encourage
feedback to assess clear understanding.
n If you have
trouble understanding the speech of a person who is deaf or hard of
hearing, let him/her know.
Vision
As with hearing loss, there is a wide range of
vision loss. People with low vision have limited
vision even with correction. Others may
have a total loss of vision and experience blindness.
These guidelines will facilitate
better communication with people with vision loss.
n When
greeting a person with a severe loss of vision, always identify yourself and
others who may be with you. Say,
for example, "On my right is Penelope Potts."
n When
conversing in a group, remember to say the name of the person to whom you
are speaking to give vocal cues.
n Speak in a
normal tone of voice, indicate when you move from one place to another
and let it be known when the
conversation is at an end.
n When you
offer to assist someone with a vision loss, allow the person to take
your arm. This will help you to
guide rather than propel or lead this person. When
offering seating, place the
person’s hand on the back or arm of the seat.
n Let the
person know if you move or need to end the conversation. Let the person
know if you leave or return to a
room.
n Use
specifics such as "left a hundred feet" or "right two
yards" when directing a
person with a vision loss.
DeafBlindness
There are varying degrees of
DeafBlindness. For example, one person may be
completely deaf and partially
sighted while another may be totally blind and hard of
hearing. For this reason, a
combination of communication guidelines listed previously
may be appropriate for people
who are DeafBlind. (NOTE: The words Deaf Blind are
written as either DeafBlind or
Deaf-Blind. There is some disagreement on the "right"
way within the DeafBlind
community.)
4
Speech
Speech disabilities are seldom
related to intelligence. A person who has had a stroke, is
severely hard of hearing or has
a stammer or other type of speech disability may be
difficult to understand.
Following are some guidelines for communicating with people
whose speech is slow or
difficult to understand.
n Give whole,
unhurried attention when you’re talking to a person who has difficulty
speaking. Allow extra time for
communication.
n Keep your
manner encouraging rather than correcting. Be patient—don’t speak for
the person.
n If
necessary, ask short questions that require short answers or a nod or shake of
the
head.
n Never pretend
to understand if you are having difficulty doing so. Repeat what you
understand. The person’s
reaction will clue you in and guide you to understanding.
n Use hand
gestures and notes.
Cognitive
Cognitive disabilities may be
attributed to brain injuries, developmental or learning
disabilities, or speech and
language disabilities.
The following techniques may be used
in communicating with persons
with cognitive disabilities:
n Be patient.
Take the time necessary to assure clear understanding. Give the person
time to put his/her thoughts
into words, especially when responding to a question.
n Use precise
language incorporating simpler words. When possible, use words that
relate to things you both can
see. Avoid using directional terms like right-left,
east-west.
n Be prepared
to give the person the same information more than once in different
ways.
n When asking
questions, phrase them to elicit accurate information. People with
cognitive disabilities may be
eager to please and may tell you what they think you
want to hear. Verify responses
by repeating each question in a different way.
n Give exact
instructions. For example, "Be back from lunch at 12:30," not
"Be back
in 30 minutes."
n Too many
directions at one time may be confusing.
n Depending on
the disability, the person may prefer information provided in written
or verbal form. Ask the person
how you can best relay the information.
5
Mobility/Wheelchair
Users
There are several rules for
interacting with people with mobility limitations, especially
those who use wheelchairs, that
will make everyone more comfortable.
n Remember
that any aid or equipment a person may use, such as a wheelchair, guide
cane, walker, crutch or
assistance animal, is part of that person’s personal space.
Don’t touch, push, pull or
otherwise physically interact with an individual’s body or
equipment unless you’re asked to
do so.
n When
speaking with someone in a wheelchair, talk directly to the person and try to
be at his/her eye level, but do
not kneel. If you must stand, step back slightly so the
person doesn’t have to strain
his/her neck to see you.
n When giving
directions to people with mobility limitations, consider distance,
weather conditions and physical
obstacles such as stairs, curbs and steep hills.
n Always ask
before you move a person in a wheelchair—out of courtesy, but also to
prevent disturbing the person’s
balance.
n If a person
transfers from a wheelchair to a car, barstool, bathtub, toilet, etc., leave
the wheelchair within easy
reach. Always make sure that a chair is locked before
helping a person transfer.
Service
Animals
An important component of
interacting with a person with a disability can be knowing
how to interact with that
person’s service animal. Service animals, such as guide dogs
for the blind and assistance
dogs and monkeys, should not be considered as pets. They
are working animals. Following
are a couple of rules for interacting with service
animals.
n Service
animals should not be petted or otherwise distracted when in harness.
n If the
animal is not in harness, permission from the animal’s companion should be
requested and received prior to
any interaction with the animal.
6
People-first Language
The way a society refers to
persons with disabilities shapes its beliefs and ideas about
them. Using appropriate terms
can foster positive attitudes about persons with
disabilities. One of the major
improvements in communicating with and about people
with disabilities is
"people-first" language. People-first language emphasizes the person,
not the disability. By placing
the person first, the disability is no longer the primary,
defining characteristic of an
individual but one of several aspects of the whole person.
For example, it is preferred to
say, “people with disabilities” instead of “the disabled.”
An exception to this rule is for
people who are deaf or hard of hearing. In general,
the deaf community does not like
to be referred to as having hearing impairments. It
prefers deaf or hard of hearing.
Use “hard of hearing” to refer to people who have
hearing loss but communicate in
spoken language. “People with hearing loss" is also
considered acceptable. Many
people who are deaf and communicate with sign language
consider themselves to be
members of a cultural and linguistic minority. They refer
to themselves as Deaf with a
capital "D" and may be offended by the term "hearing
impaired.”
Also, people with disabilities
may use the words disabled and crip to refer to
themselves. They would also be
likely to say, “I am blind,” or “I am a paraplegic.”
Using “crip” language is part of
the disability culture. However, people without
disabilities should not use this
terminology.
If you don’t know the
appropriate words to use, simply ask the person what is preferred.
Following is a chart of some
examples of people-first language. The glossary in
Appendix A also provides terms
and definitions to assist you in better communicating
with and about people with
disabilities.
7
8
People-first
Language
people with disabilities
people with mental retardation
he has a cognitive disability
my son has autism
she has Down syndrome
he has a learning disability
she has a physical disability
he’s of short stature or he’s
short
she has an emotional disability
he uses a wheelchair
typical kids or kids without
disabilities
he receives special ed services
or
additional support services
accessible parking, bathrooms,
etc.
she has a need for…
Labels Not
to Use
the handicapped or disabled
the mentally retarded
he’s retarded
my son is autistic
she’s a Downs kid, a mongoloid
he’s learning disabled
she’s crippled
he’s a dwarf (or midget)
she’s emotionally disturbed
he’s wheelchair bound or
confined to a
wheelchair
normal and/or healthy kids
he’s in special ed
handicapped parking, bathrooms,
etc.
she has a problem with…
People First Language
Numerous communication aids and accommodations are available
to enable
successful communication. These
may include the use of qualified interpreters
(sign language, oral or
tactile); materials in alternative formats such as large
print, audio tape, Braille and
computer disk; a reader; and assistive listening devices.
This chapter addresses some of
the aids available for people with disabilities.
Printed Materials
Printed materials can be a
significant barrier for people who have vision, learning and
cognitive disabilities.
Therefore, it is important to have alternative format options
available, typically in the form
of large print, Braille, audio tape and computer disk.
The original publication should
include information about alternative formats that are
available.
The following table outlines the
pros and cons to each of these alternative formats.
When possible, ask the recipient
which format he/she prefers.
9
Chapter Two
Communication Aids and
Alternative Formats
10
Pros and Cons of Alternative
Formats
Disabilities Formats Pros Cons
Vision Large Print Provides
access for many Long documents may
persons with low vision cause
eye strain.
Braille Good for complex Only 10
percent of
information, short reference
individuals who are
materials (less than 10 blind
read Braille.
pages), and for information
that is referred to repeatedly
Documents in Braille
such as meeting agendas are
bulky and heavy.
Vision and Mobility Audio recording Popular format that can be If materials are
long or
accessed and stored easily
complex, audio recordings
and conveniently present the
information in
one dimension that is
Eliminates the need to difficult
to reread, scan or
manipulate a publication use as
a reference source.
Audio tapes do not always
illuminate word spelling or
format of the text. Difficult
to communicate large tables
or complicated graphics/
illustrations.
Vision, Mobility Electronic Users can access text on Users must have access
to
and Hearing diskette or through online a computer, be equipped
resources using adaptive with a
modem (for online
devices such as Braille
resources) and have
display, speech output, adaptive
devices.
Braille printing, largescreen
magnification or Many software
interfaces
adaptive keyboard designs. are
graphically based
TTYs with an ASCII option or use
point-and-click
or PC-based TTY-compatible menus
for accessing the
modems allow users to
information. Braille
communicate electronically
translation software,
with an information center or
speech output devices,
bulletin board system, and TTYs
cannot access
reducing the dependence on this
type of information.
voice-only
telecommunications.
Easy and compact storage
Easy to use as a reference
document
Large Print
Many people with vision loss have some sight and can read
large print. Largeprint
material can be produced by
using a photocopier or a computer where a large type
size can be selected. There is
some disagreement as to whether the minimum type size
should be 16-point bold or
18-point bold. For people with low vision, 18-point bold
should be the minimum standard.
Even with type this size, most persons with low
vision use high
magnification to read it.
This is
Times Roman bold 16-point type
This is
Times Roman bold 18-point type
Here are some other tips for
producing large-print documents.
n The best
contrast with the least glare is bold or double-strike type on light yellow
paper. White paper produces too
much glare. Do not use red paper.
n If white
paper needs to be used, use an off-white paper that will still give good
contrast while producing less
glare than white.
n Avoid glossy
paper because it causes glare.
n The paper
should not be larger than standard 8.5” X 11”.
n Make sure
the weight of the paper is sufficient to prevent “show-through” printing.
n Use one-inch
margins and use right margins that are ragged, not justified.
n The gutter
margins (the adjoining inner margins of two facing pages in a book,
magazine, etc.) should be a
minimum of 22 mm (7/8 in.), and the outside margin
should be smaller but not less
than 13 mm (1/2 in.).
n The line of
text should be no longer than six inches (approximately 50-60 characters
per line). Anything longer than
six inches will not track well for people who use
magnifiers.
n Simplify
formatting. Remove formatting codes that make the document more
difficult to read. For example,
centered text is difficult for some people to track.
Text should begin at the left
margin. Avoid the use of columns. Use dot leaders for
tables of contents.
n Avoid complicated, decorative, or cursive fonts for text and headlines. Use a simple serif font,
such as Times New Roman, for text. Serifs are the fine lines
projecting from a letter.
For example, this “T” is a serif type style and
has small lines projecting down from the top
of the T and across the bottom. This “T” is san serif—it does not
have any extra lines.
11
n The font
should have normal white spaces between characters. Compressed fonts
and italics are difficult to
read.
n Set the main
body of text in caps and lower case.
n Avoid
hyphenation at the end of lines.
n Underlining
should not connect with the letters being underscored.
n Use one and
one fourth to double spacing between lines.
n There should
be no broken letters.
n Make sure
the ink coverage is dense.
n The color
contrast of typeface to background–either dark on light or light on
dark–should be high. A 70%
contrast is recommended.
n The color
contrast of drawings or other illustrations to background should be as high
as the type contrast.
n Photographs
need to have a wide range of gray-scale variation.
n Line
drawings or floor plans must be clear and bold, with limited detail and
minimum 14-point type.
n Don't place
any type or illustrations, such as watermarks, over other designs,
photographs, graphics or text.
n The document
should have a flexible binding, preferably one that allows the
publication to lie flat.
Producing large-print documents
does not have to be cost prohibitive, and documents
created on the computer can be
converted to large print relatively easily. The following
will affect the printing cost:
n Setup;
n Number of
copies;
n Required
turnaround time;
n Type
size–the larger the type, the more paper is needed; and
n Type of
paper; house-stock paper is less expensive.
Computer
Disk
Providing computer disks/ASCII
translation may be the most cost-effective means of
alternative media. Agrowing
number of people with low vision or blindness
prefer to receive materials on
computer disk that they can listen to by utilizing voiceoutput
or read with print-enlarging
hardware and software on their personal computers.
Whenever possible, the material
should be saved in several formats that can be made
12
available to consumers. These
would include commonly used word-processing software
packages, such as Word and
WordPerfect, and in ASCII (American Standard Code for
Information Interchange). In
Windows, the NotePad Accessory and on the Macintosh,
“Simple Text” are two
applications that will insure you have a “text”-formatted
document.
Some factors that will affect
the cost of the electronic formatting are:
n Scanning or
re-keying the document;
n Converting
features such as special characters, graphics, tables, sidebars;
illustrations, special symbols,
columns and boxes to text; and
n