REMOVING BARRIERS

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.

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

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.

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.

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.)

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.

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.

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.

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.

Chapter Two

Communication Aids and Alternative Formats

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.

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

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