People with Disabilities

This document was authored by Moira Horgan Jones of M. Jones Consulting.
©1997 The Canadian Centre on Disability Studies


This guide has been separated into sections based on disability type. In each section, you will find a general description of, and terminology relating to, each disability; a list of many of the assistive devices which are available to people with these disabilities; tips in etiquette when interacting with people with disabilities; and a discussion of the types of accommodations you can make for people with different disabilities when you are meeting with them.

In creating the sections for this guide, we tried to make categories that made sense from an organizational point of view. As we repeat often in this guide, people with disabilities are unique, and are affected in very individual ways by their disabilities. As you read you will find flaws in our method of classification. There is definitely an overlap among these categories, particularly in the “Other Disabilities” section. This guide does not presume to make the final statement on disability classification. Our purpose here is to offer some basic information that can be used as a quick reference for people who serve people with disabilities. However crude or incomplete, we have organized the information in such a way that we hope will assist you in serving people in a sensitive manner.

The following are anchored links that will take you to the specific section in this document:


People with Visual Disabilities

People with Hearing Disabilities

People with a Physical Disability

People with an Intellectual Disability

People with Learning Disabilities

People with Psychiatric Disabilities

People with Other Disabilities

People with Traumatic Brain Injury

Quiz ...........



How We Communicate with People with Disabilities
Providing Services to Clients with Disabilities
Organizations of People with Disabilities
Business Resources for People with Disabilities
Language and Disability
Linguistic Portrayal of People with Disabilities
Derogatory Labelling
Depersonalizing or Impersonal Reference
What Is the Difference Between Disability, Impairment and Handicap?
Representation of People with Disabilities in Case Materials and Illustrations

How We Communicate with People with Disabilities

Sensitivity to the way in which we present information relating to people with disabilities can be instrumental in overcoming negative attitudes and promoting positive ones.  If  we want people to feel welcome we need to put out the "welcome mat"

Providing Services to Clients with Disabilities

Understanding how the needs of clients with disabilities differ from other clients lays the foundation for effective decision making on disability related issues.

Organizations of People with Disabilities

Getting help from those in the know is essential to our understanding of how we may best serve our clients. In Canada we have a network of organizations who have devoted their energies to research, service, and adaptations for each unique disability such as visual, hearing, mobility, developmental, and learning to name a few.

Business Resources for People with Disabilities

Tools and resources are fundamental to starting and expanding a business. Knowing how to adapt existing resources can be the key to success or failure in supporting a new entrepreneur with a disability.

Language and Disability

The portrayal of people with disabilities has been fraught with contradictions because of ambivalent attitudes towards disability. People with disabilities have often been described as helpless people to be pitied and cared for. Because people are often uncomfortable or embarrassed about disability, many euphemisms have been created to describe disability and people with disabilities.

Linguistic Portrayal of People with Disabilities

Discriminatory language in relation to the portrayal of people with disabilities is characterized by derogatory labelling, by depersonalizing, by emphasizing the disability rather than the person, and by stereotyping.

Derogatory Labelling

The discriminatory nature of derogatory labels used to describe members of minority groups is often obvious. However, in the case of people with disabilities, labels such as cripple, invalid, deaf and dumb, or retarded are still commonly used,  and should be avoided.  Some acceptable alternatives for such labels are persons with a mobility impairment, person with Down’s syndrome, person with hearing and speech disabilities, person with an intellectual disability.

Depersonalizing or Impersonal Reference

Often people with a disability are referred to collectively as the disabled, the handicapped, the mentally retarded, the blind, the deaf, spastics, epileptics, etc.  These terms have the effect of depersonalizing the description of people and equating the person with the disability.  These impersonal references to people with disabilities should be avoided. The following terms are generally preferred as they recognize that the disability is only one characteristic of the person or persons:

  • person with a disability

  • people with disabilities

  • clients / employees with disabilities

If it is necessary or desirable to be more specific about the disability involved, the same strategy is recommended that is, not to focus entirely on the person’s disability in the description.

Tip: Do not put the disability first and the person second.


The portrayal of people with disabilities as helpless, mindless, suffering, being deserving of the sympathy and attention is one of many powerful stereotypes which has led and continues to lead to discriminatory treatment of people with disabilities.  People with disabilities should be referred to in a positive manner. Positive portrayal of people with disabilities is mainly a matter of presenting them as individuals with a variety of qualities.  It does not mean that a person’s disability should be hidden, ignored or seen as irrelevant. However, it should not be the focus of description except when the topic is disability. Be careful not to imply that people with disabilities are to be pitied, feared  or ignored, or that they are somehow more heroic, courageous, patient or special than others. Never use the terms normal or able bodied in contrast. Never use the terms victim or sufferer to refer to a person who has or had an illness, disease or disability. These terms dehumanize the person and emphasize  powerlessness.  For example, victims of AIDS.

A person in a wheelchair is a wheelchair user or simply uses a wheelchair. Avoid terms that define the disability as a limitation, such as “confined to a wheelchair” or “wheelchair bound”.

What Is the Difference Between Disability, Impairment and Handicap?

Disabilities or impairments require individuals to find non-traditional methods to perform certain activities and to achieve certain goals.  Frequently, however, the individual’s abilities are restricted further by handicaps.

A handicap is a function of the relationship between the individual and the social and physical environment. It refers to the external circumstances which place people with disabilities at a disadvantage in relation to their peers and the norms of society.  Handicaps include physical barriers such as inaccessible entrances to buildings, barriers to education and employment opportunities and negative public attitudes.

In the 1800's, the City of London, England allowed only people with a visible disfigurement to beg on city streets. These people were called "cap in hand." Thus the word handicapped evolved.

Representation of People with Disabilities in Case Materials and Illustrations

It is important to extend the non-discriminatory portrayal of people with disabilities to their presentation in case materials and illustrations. For example, people with disabilities should not be excluded from illustrations unrelated to the topic of disability, nor should they be portrayed as oddities or as objects of curiosity.

People First

For many people using this guide, this will be their first introduction to interacting with people with disabilities, while others may have friends, family or other people in their lives who are disabled, and from whom they have learned. Often those of us who are unfamiliar with people who speak, move or think differently feel uncomfortable when we meet someone who is different. This is mainly because we are not sure how we are supposed to act, or how we can assist a person with a disability. The key is that we should act just as we would with a person who is non-disabled. A person using a wheelchair, a guide dog or an artificial limb is a person with hopes and dreams, just like us, who happen to do some everyday tasks differently than we do but they still do them. The problem is, that until we are familiar with the outward indicators of someone’s disability (such as a wheelchair), we may tend to see that indicator first, before we see the person.

The message we try to convey throughout this is that people with disabilities are people first; their disability is secondary. And yet, the other message we are sending is that people with disabilities must be ensured full access to participation in all facets of daily life, and so may need some accommodations that will enable them to accomplish that. While this might sound like a contradiction, it will become a matter of course once all people with disabilities are afforded the same respect that other members of society receive. This guide is intended to break down the barriers of unfamiliarity, so that when we meet someone with a disability, we all see the person first.

It is important to be sensitive to others’ needs, but we must also guard against acting in the other extreme and being overly sensitive or aware of a person’s disability. This can make you, and your client, uncomfortable.

No Assumptions

Another point which is repeated throughout this guide is that we must make no assumptions when serving and interacting with a person with a disability, either about their disability or their need for assistance. This is connected to the previous point about serving people, and not disabilities. People with disabilities often perform tasks differently from non-disabled people because of their impairments and, like non-disabled people, have developed routines and methods for getting things done that seem to work for them. Non-disabled people, though, often see someone performing a task differently, and assume that the person needs assistance (in order to do it the same way as others). This assumption is wrong.

Tip: If we begin by remembering that people with disabilities are simply individuals who do things in their own way, we will avoid ‘unwanted helping”. The fastest way of finding out IF someone needs assistance, and if so, HOW they can be assisted, is to ask them.

Disclosure and Privacy What You Need to Know

A disability is very personal information about someone. Some people are unable to conceal the presence of their disability because of the visibility of the assistive devices they use, while others appear non-disabled to the outside observer. Nevertheless, both individuals have a right to privacy and total confidentiality regarding their disability. Confidentiality may be considered even more crucial in towns where people know one another. People need to know that when they disclose their disability for the purpose of qualifying for this program that their disclosure will be held in total confidence. For some people, revealing their disability to a stranger is a very difficult task.

tip: As a service provider, you need to create an atmosphere of sensitivity and accommodation that permits people to disclose their disability in a private and confidential manner.

Remember that it is unlawful to seek information about a person’s medical history without their permission. Perhaps more importantly, you should only seek details about a person’s disability that are related to your business relationship, and how you can accommodate any special needs that they might have. Personal curiosity about a person’s disability has no place in business.

Common Sense

Finally, a word about common sense in using this guide and providing good service. We have indicated terminology and tips in etiquette that reflect current thinking on interacting with people with disabilities with dignity and sensitivity. Likewise, we have suggested different ways that people with various disabilities may be accommodated during meetings or other interactions.

However, everyone is different. Some of our suggestions may be contradicted by requests for the use of different terminology or assistance by some of your clients, while others won’t want you to do anything special for them. Common sense should prevail. If a person indicates a preference to be treated in a specific way, then that is how they should be treated (this goes back to asking the individual what they prefer). This material should serve as a guide, and is by no means the final word on this topic.

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People with Visual Disabilities

Description and Terminology

Visual disabilities include a wide range of visual impairments that cannot be corrected with glasses. There are many forms and degrees of visual disability. Some people are legally blind (meaning they have 10 percent or less of average vision). Nine in ten people who are legally blind have some degree of vision, so that they might see light or shadows, colour or shapes. Other people with visual disability can see only a part of the colour spectrum, while others may see only using peripheral vision. Because of this variation, it is important to treat each person with a disability as an individual. When referring to people with all types of disability, it is important to remember to place the person before the disability, and to avoid treating all people with visual impairments as if they were the same. Treating all people with a visual disability can lead to a “stereotype”, or a distorted picture of the person with respect to their abilities. Some common misconceptions about people with visual impairments support these stereotypes, and are misleading to someone who is trying to understand the nature of visual impairments, or to serve people with visual disabilities. For example, some believe that people who are blind have a better sense of hearing. In fact, there is no physical advantage to someone with a visual impairment, though some people may have learned to use their other senses very effectively. Likewise, some people think that you shouldn’t use expressions like “Look at that”, “Did you see”, “Watch out for the...” However, people with visual disabilities use these expressions just like other people. It does not offend them.

With these things in mind, we refer to a “person with a visual disability”, a “person who is blind”, a “person with a visual impairment”, rather than referring to “the blind’, “the visually handicapped”, etc. The way we speak is important in shaping how we see the world around us, and while these changes in terminology might seem trivial, they are important in helping us all to re-think the way we interact with people with disabilities in our society.

Assistive Devices

The range of visual disabilities that people have means that there is a wide range of assistive devices that a person with a visual disability might use. Just because someone does not use a guide dog or a white cane does not mean that they do not have a visual disability. Some of the assistive devices used by people with visual disabilities follow.

White Cane - a lightweight cane which warns of obstructions and changes in the levels of the walking area.

Guide Dog - trained to lead persons with a visual disability. These dogs have a harness and a U shaped handle held in the owner’s left hand unless circumstances require that the dog be obtained for the right hand.

Braille - only one to three per cent of the blind population uses Braille, (a code of size raised dots), to read. It is read using the fingertips. Some people use Braille watches to tell time.

Magnifying Glasses and Heavy Lenses - used to read print.

Monocular - used to read street signs, print on blackboard etc.

Talking Books - recordings of reading materials on cassette.

Closed Circuit TV - electronically enlarges printed material-up to 16 times on a television screen.

Reading Machines - read print audibly by computerized speech, or by producing a tactile image of each letter to be read with the fingers.

Talking calculator - performs functions of a basic calculator and speaks each entry and result.

Screen reader - an IBM computer component which provides audible reading of what is on the screen.

Etiquette in Interacting with a Person with a Visual Disability

When interacting with a person with a visual disability, non-disabled persons may feel uncomfortable because they are uncertain as to how to assist or approach the person.

As discussed above, the key is to avoid treating all people with a visual disability the same. Different people will need different types of accommodations or assistance. As well, non-disabled people must not assume that assistance is always needed. The best approach is to ask if help is needed, and let the person describe what they need. These basic strategies of interacting with people with disabilities apply to all people, including women who are pregnant, seniors, a friend who has broken their leg, etc. don’t assume that someone needs taking care of - ask first.
Nevertheless, there are some things that non-disabled people can do when meeting with a person with a visual disability, as a client, co-worker, associate or employee.

Identify yourself and let the person know that you are speaking to him/her.

A light touch on the shoulder or arm will orient the person as to where you are.

To guide someone, let him/her take your arm. They will be guided by the motion of your body while you walk. You may also indicate changes in the walking surface or other obstacles. To seat a blind person, place their hand on the back of the chair. They will seat themselves.

Never distract or pet a guide dog while it is on duty without permission of the owner. Guide dogs are working dogs.

Always let someone know when you are leaving so that they will not continue the conversation after you have left.

In North America, eye contact is a very important part of communicating and doing business. Typically, a person with a visual disability will not practice this, and for some blind people, the tendency will be for them to lower their faces rather than direct them toward the speaker face-on. While this may be disconcerting for a non-disabled person at first, this lack of eye contact does not mean that the person is disinterested in the conversation.

Having a Meeting Accommodations to Physical Space

Not everyone with a disability will inform you of their impairment in advance. If they do, you have the opportunity to describe your meeting facilities and ask if they sound accessible to the individual. If not, or if there is some doubt, suggest another meeting place which might better accommodate the individual. If you find yourself in a meeting with someone with a visual disability without knowing about it in advance, don’t panic. Ask the individual if they require any assistance; they will advise you what, if anything, they might need.

There are some basic adjustments to a meeting space that can make it easier for a person with a visual disability, indeed everyone, to get around. These adjustments might be made permanent design features of your office space. These adjustments include unobstructed hallways and space around tables and chairs for easy movement; smooth, firm and level floor finishes; non-slip mats or mats fitted in specifically designed floor recesses; low-pile carpeting that is securely attached to the floor; a contrasting colour such as yellow, at the edges of stairs, which clearly indicate individual stairs; and bright lighting which allows the individual to read materials.

Written materials and brochures are best printed in high contrast (black and white or yellow), and in a 12 or 14 point upper and lower case font with serif.

Signage should also be well-lit, clear, easy to read and touch, and free from obstacles that prevent people from approaching them.
As with print materials, lettering that contrasts with the background, and upper and lower case serif fonts, are easier to read.

Providing Materials in an Alternative Format

Today, when serving clients, meeting with colleagues, and generally doing business, most information is transmitted in written form, particularly with the popularization of electronic mail. When doing business with a person with a visual disability, documents need to be made available in an alternative format, for example on cassette, in large print (usually 20 point or larger), and for a few people, in Braille (remember that only a small proportion of people who are blind read Braille).

The key to providing service is not necessarily to reproduce all of your documentation on cassette, or in Braille format, but to establish a policy that outlines how and where documents can be taped, or translated into Braille, should someone request them.

As with other situations, ask the person in what format they typically like to receive documents. In a meeting situation, these can be prepared in advance. As a rule of thumb, documents that are written in 14 point are most accessible to the general public, including people with some mild visual disabilities.

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People with Hearing Disabilities

Description and Terminology

According to Statistics Canada, more than half a million Canadian adults under the age of 65 have hearing disabilities. This category includes a wide range of hearing loss from partial to total. Because so much of our everyday communication relies on spoken word, being aware that someone has a hearing disability, and the extent of their hearing loss, is important in being able to communicate with them effectively. As with all people with a disability, it is important to place the person first, so that we refer to “a person who is deaf” or a “person who is hard of hearing”, instead of “a deaf person”, “the deaf”, or “the hard of hearing”.

It is also important to avoid using words like “deaf and dumb” and “deaf mute”, not only because of the negative connotations of the word dumb, but also because most people who are deaf are physically capable of speech, but do not because they are unable to hear the sound of their own voices.

The term “hearing disabilities” is a general one, referring to a wide range of impairments from partial to total hearing loss. Among people with hearing disabilities, there are two general groups:

  1. people who are called deaf, and rely mainly on sign language as a principal means of communication;

  2. and people who are hard of hearing, who typically have functional speech and who communicate primarily through speech.

Some people belonging to the first group consider themselves part of a distinct cultural community which has evolved around sign language, and object to being labelled as people with disabilities. When referring to a person or group of people who are deaf, avoid using the broader and less accurate term “hearing disabilities” instead use “hearing disabilities” when speaking about persons with different degrees of hearing loss. 1

Tip: Just as with anyone else, it is important not to treat the people with hearing disabilities as if they are all the same.

Methods of Communication

Individuals will use different methods of communication depending on the type of hearing disability they have. There are three methods by which people with hearing disabilities communicate:

oral / aural (combination of speech reading (lip reading) and use of residual hearing), manual (sign language) and written language.

People who are Hard of Hearing

A hearing loss usually involves a loss of certain frequencies of sound, not simply a reduction in overall amplification of sounds. People who are hard of hearing generally hear some frequencies better than others, and so will hear some people’s voices better than others, depending on the pitch of the speaker’s voice. Most people who are hard of hearing use speech and hearing to communicate, but may supplement these methods with cues from speaker’s body language, and facial expressions. Those with more extreme hearing loss may use hearing aids to amplify sound. Hearing aids do not restore lost frequencies, and cannot amplify selected sounds. As a result, environmental noises such as air conditioners and overhead lighting are also amplified, which can make it more difficult for a person to hear, depending on the situation. People who are hard of hearing may also speech read, but contrary to popular belief a speech reader typically only deciphers approximately 30 percent of what is being said. In situations where accurate communication is essential, it is best not to rely on speech reading as the primary mode of communication (see “Meeting with Someone who Uses an Interpreter” below.)

People Who are Deaf

People who are deaf typically use sign language as their primary means of communication. It is estimated that between 46,000 and 260,000 Canadians are deaf. The time at which a person becomes deaf impacts on their ability to use speech. Usually, people who are born deaf, or lose their hearing before they learn the spoken word never learn to speak. People who lose their hearing after they have learned spoken language skills continue to speak, but the quality of their speech tends to deteriorate over time due to a lack of auditory feedback 1. When communicating among themselves, deaf people will usually use sign language. To communicate with non-deaf people, a deaf person may use a combination of sign language (through an interpreter), speech reading, and written communication.

It is sometimes easy to stereotype people based on our lack of understanding of their disability, and assume that they are unable to do certain things. For example, some people assume that deaf people cannot enjoy music.

Music appreciation is of course a very personal matter for everyone, and there are many students of music who have proven themselves to be as proficient as their non-disabled counterparts. Likewise, simply because someone is deaf does not mean that they cannot live alone. The following discusses many adaptations to someone’s home that can assist a person who is deaf to live independently.

The message is consistent when we are talking about people with any type of impairment; people with disabilities are individuals, and need to be treated that way.

Assistive Devices

Depending on the severity of the person’s hearing disability, different devices aid in their communication with non-hearing impaired people. Some of the devices available to people with hearing disabilities are as follows:

Hearing Aid - a battery-powered device which uses a microphone to pick up sound waves and direct them into the ear canal through an ear mould section placed in the ear.

Teletypewriter(TTY) - Transmits from one telephone to another when both are equipped with this transmitter/receiver device. Conversation is typed onto a keyboard at one end and transmitted to a visual display board in typed form at the other.

Telephone Amplification Devices - are compatible with hearing aids and have a volume control switch to adjust phone volume to individual needs.

Message Relay Service - a service offered by telephone companies across Canada which allows people who do not have access to a TTY to communicate with someone who does.

Hearing Ear Dog - trained to alert people with hearing disabilities to sounds such as alarm clocks, smoke alarms, telephones, door bells or knocks, babies crying, etc.

Closed Captioning - a special decoder attached to a television causes captioning to appear at the bottom of the screen for those programs which provide captioning.

The Infrared, FM systems - amplification systems which can be used in classrooms, auditoriums and other large rooms to transmit sounds from a speaker directly to the receiver of a person with a disability.

Signalling Devices - sound detecting devices which convert smoke and fire alarms, door bells, phones or alarm clock sounds into flashing lights.

Sign Language Interpreter - a person who translates speech into manual communication for a sign language user, and then translates the signed reply into speech for those who do not know sign language.

Oral Interpreter - person who mouths the words of a speaker to facilitate speech reading.

Phone Communicator - An IBM computer component which enables a deaf person to communicate with anyone who has a touch tone phone, a computer or TTY.

Speech Viewer - an IBM Computer component used to teach speech to people who are deaf.

Etiquette in Interacting with a Person with a Hearing Disability

When interacting with a person with a hearing disability, often non-disabled persons feel uncomfortable, because they are unfamiliar and uncertain as to how to assist or approach the person. As discussed above, the key is to avoid treating all people with a hearing disability the same. Different people will need different types of accommodations or assistance. As well, non-disabled people must not assume that assistance is always needed. The best approach is to ask if help is needed, and let the person describe what they need.

Nevertheless, there are some things that non-disabled people can do when meeting with person with a hearing disability, as a client, a co-worker, associate or employee;

Tips: It is important to be flexible and patient when finding the most efficient way of communicating with a person who is deaf. Some methods, like writing, can be time consuming, while others, like speech reading, are not very accurate.

Do not assume that someone who is deaf knows sign language or speech reads. If they do not tell you, ask them what their preferred method of communication is.

When speaking with a person, who is deaf or hard of hearing, face the person and give them an unobstructed view of your mouth and face. Avoid holding things near your mouth, or waving your hands in front of your face; these things can be distracting.

Speak in a normal tone of voice unless the individual asks you to change the pitch or rate of your speech.

Use facial expressions and body language to convey tone. Sarcasm or seriousness may be lost to a person with a hearing disability unless they are conveyed to them using other means.

If you are unable to understand the speech of a person with a hearing impairment, ask them to repeat themselves. If this does not work, try using written notes. Again, be patient, and remember that the goal here is to communicate your ideas to one another. Use whatever works. If you know some sign language, try using it. Even if you are inexperienced or a novice, the gesture will no doubt be appreciated.

Never walk in between two people who are conversing using sign language, you are interrupting them.

If a person uses an interpreter, remember to address your comments and questions to the individual with the disability, not the interpreter. This may feel awkward at first, because eye contact is so important in North American culture, and may take some getting used to.

Meeting with Someone who Uses an Interpreter

When meeting with a person who has a hearing disability, it is important to determine what assistance they may need. If they inform you of their disability before the meeting, you have an opportunity to plan in advance. Meetings that are technical, complex, lengthy or very important are situations where an interpreter should be provided for a person whose preferred method of communication is sign language. (Without prior knowledge of their impairment, you are not expected to book an interpreter). Some people prefer to work with certain interpreters, so it is best to ask them if they have a preference before booking one. If you are unsure where to book an interpreter, ask the person who is deaf. Be prepared to give the interpreter technical documents, a list of technical language, or other information about the meeting, in advance.

During the meeting, the best place for an interpreter is usually beside the principal speaker and opposite the person who is deaf, but it is best to leave such details to the individual to decide. They will likely choose the best arrangement for effective communication. Interpreting is physically and mentally demanding, so plan for frequent breaks. For meetings scheduled to last longer than 2 hours, it is best to book two interpreters; they will alternate. During the meeting, speak in your usual tone and at your normal rate. The interpreter will tell you if something needs to be repeated, or if you need to slow down. Finally, ensure that one person speaks at a time.

Meeting with Someone who is Hard of Hearing

When meeting with someone who is hard of hearing, ask them f they need assistance. They may want to sit where they have an unobstructed view of the speaker or speakers.

If the person uses a hearing aid, ask them if there are any environmental distractions (such as background music, air conditioner) which need to be turned off. These are all accommodations that can be made in advance, or, without prior knowledge of their impairment, at the time of the meeting.


1. Working Solutions, The Employer's Companion on Disability and Employment, The Canadian Council on Disability and Work
People with Physical Disabilities

Description and Terminology

In 1991,Statistics Canada estimated that in Canada, approximately 1.2 million adults under the age of 65 have a physical disability. Physical disabilities are those which restrict a person’s ability to move around, to perform manual tasks, or to participate in certain activities. A physical disability can be present at birth (e.g. spina bifida), can be caused by a disease (e.g. multiple sclerosis), or may be the result of an accident (e.g. spinal cord injury).

Not all disabilities are visible, meaning that by looking at someone, you can tell that they have a disability. People who use assistive devices, such as a wheelchair, cane or scooter, have highly visible disabilities, because of the presence of the aid. Others, such as people with back injuries, may have difficulty lifting or sitting for long periods, but appear otherwise non-disabled. Similarly, a person with multiple sclerosis maybe able to perform most activities, but may have periodic lower levels of endurance. Still other people may have periodic or episodic disabilities, such as arthritis, combined with long periods during which they are disability-free. The nature of some disabilities makes them less visible than others, but there are still ways that we can change workplaces and public spaces to make them more accessible to people with these less visible impairments.

Up until recently, the language used to refer to people with physical disabilities has placed the disability before the person, and has given the impression that the individual has no control or autonomy over their life. Words like “confined to a wheelchair”, “stricken with polio”, “a victim of cerebral palsy” all give the impression of weak, dependent people. Other terms like “a cripple”, or “a spastic” removed the individual completely, leaving only the disability. These terms reinforce stereotypes that people with physical disabilities are unable to live alone or cannot work. In fact, people with physical disabilities enjoy their independence as much as non-disabled people, and should have an equal opportunity to work at jobs for which they are qualified.

The use of these terms creates attitudinal and other barriers that prevent people with physical disabilities from full participation in everyday life, and should therefore not be used. Instead, always place the person first, and in control for example, “a wheelchair user”, “a person with muscular dystrophy”, “a person who has cerebral palsy, diabetes,...”etc.

While some people believe that words like “let’s get rolling”, “can I give you a hand”, “let’s go for a walk” should be avoided when talking to people with disabilities, they are wrong; there is no need to use special language when talking to a person with a disability.
Assistive Devices

The term “people with physical disabilities” refers to a wide range and degrees of impairment, for which a variety of assistive devices are available. Once again, though, just because someone does not use an assistive device does not mean that they do not have a physical disability. Some of the devices commonly used are as follows:

  • Manual and battery-operated wheelchairs

  • Artificial limbs

  • Specially equipped cars and vans

  • Hands-free telephones operated with speakers or head-sets

  • Appliance control systems

  • Bathroom grab bars, poles and tub rails

  • Stairlifts

  • Crutches

  • Quadraped and rectangular canes

  • Walkers

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Etiquette in Interacting with a Person with a Physical Disability

Tips: When you meet a person with a physical disability who appears to be having some trouble doing something, don’t assume that your help is needed or wanted; ask first. If your offer of help is accepted, ask the person how you might help them. For example, a wheelchair user having difficulty getting their chair up and over a curb might not want you to simply push them from behind.

The individual with the disability generally has a lot of experience in dealing with such problems, and will typically direct a helper in the most effective way of dealing with the situation.

If you are speaking for any length of time with a person who uses a wheelchair, consider asking them if they would like to move to a place where you could sit and speak to them at eye level. For long conversations, this arrangement is more comfortable for both parties, but isn’t necessary in all situations. Use common sense if your neck hurts from looking down, chances are the other person’s neck hurts from looking up, and you should probably move. But it is also possible to be overly conscious of the person’s disability, which might also make them, and you, uncomfortable. If in doubt, ask the person with the disability for their preference.

A person’s wheelchair is considered an extension of their personal space. Just as it is inappropriate to lean against someone you are speaking with, don’t lean against, push or pull someone’s wheelchair without their express permission. In particular, don’t move someone’s wheelchair without being asked to, even if you are trying to make space for someone else to get by.

Be aware of structural barriers in restaurants, movie theatres and other public spaces when choosing places to socialize with a person who uses a wheelchair.

Shaking Hands

Shaking hands is an important part of North American culture, particularly when doing business. Don’t be afraid to shake hands with a person who is missing a limb, who has an artificial limb, or whose hands might be holding crutches, etc.

Tip: Let the person with the disability decide on the type and strength of handshake.

While it might feel awkward at first touching hands with someone who has a stump or a hook, touching the person’s hand or prosthesis is a good way of letting them know that you see her or him as a person first. 2

Understanding Someone who has Speech Difficulties

Some people have disabilities which affect their speech. If you do not understand someone, don’t pretend that you do. Simply ask them to repeat themselves until you do understand, or suggest an alternative method of communication, such as writing.

Having a Meeting Accommodations to Physical Space

For most people with a physical disability, accessible spaces are the key to ensuring their participation in society, including everything from parking for wheelchair users that is close to building entrances to restrooms which allow free access to toilet and washing facilities. When scheduling a meeting with a person with a physical disability, ensure that all obstacles are removed from the meeting space, and that the building you are meeting in is accessible (i.e. has a ramp if there are steps at the front, has doors which are easy to open or are automatic). Describe the building to the individual in advance and ask them if they think it is an appropriate meeting place. If not, suggest another place that does not have the same problems of access. At a meeting including people with physical disabilities, ask them if there are any accommodations which would make them more comfortable. This is the best way of ensuring the full involvement of all participants, particularly if you did not have prior knowledge of the person’s disability and were unable to make advance arrangements. Many accommodations to workplaces and businesses that make them accessible to people with physical disabilities also benefit people making large deliveries and parents with young children in strollers. There are minimum widths for doorways and halls that accommodate a wheelchair comfortably. If you are concerned about the accessibility of your building (perhaps it is very old), take some basic measurements before holding a meeting that includes wheelchair users.

Alternatively, describe it to the person with the disability and ask them what they think. Alternative meeting places are always an option.
People who use other mobility aids such as crutches, canes and scooters need sufficient space to store their aids nearby. Desks and counters that are between 400 mm (16 inches) and 460 mm (34 inches) in height are ideal, permitting staff to see a person who is short or who uses a wheelchair. These are only a few of the most common accommodations that increase the accessibility of a building for people with physical disabilities. For more comprehensive examples and suggestions, consult an expert source that specializes in barrier-free design.

2 Working Solutions, The Employer's Companion on Disability and Employment, The Canadian Council on Disability and Work
People with Intellectual Disabilities

Description and Terminology

Intellectual disabilities are disabilities which are the result of an impairment in an individual’s learning or cognitive processes. This means that a person with an intellectual disability might have difficulty learning, remembering, or reasoning. It is not certain why many intellectual disabilities occur. Some are caused before birth by an infection during pregnancy, complications during birth, substance abuse by the pregnant mother (fetal alcohol syndrome), or premature birth. Other causes include childhood illness, ingestion of toxic substances (such as lead paint) in infancy, and genetic causes (such as Down’s Syndrome).

People with intellectual disabilities are also known as mentally handicapped, mentally retarded, intellectually disabled, and mentally disabled, to name a few.

These terms focus attention to the disability away from the individual, and reinforce assumptions that the person is not able to work, cannot learn and must be taken care of. These beliefs are misconceptions.

In fact, the realities and opportunities open to a person with a developmental disability are many and varied. Only one per cent of people with intellectual disabilities are totally dependent and require permanent care. The majority (80 percent) of people with intellectual disabilities have mild disabilities and, given the opportunity, are capable of achieving both academic and employment successes. Estimates of the prevalence of intellectual disabilities in the working age population in Canada range from one to three percent of the population (between 160,000 to 480,000 people), although only about 11 per cent of people with such disabilities are employed. This means that a large number of Canadians are not working, likely due to barriers created by the general public’s lack of understanding about intellectual disabilities. Sometimes, the barriers created by attitudes are harder to remove than those created by physical structures. Remembering to refer to the person before the disability helps to break down those barriers.

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Etiquette when Meeting a Person with an Intellectual Disability

Sometimes people describe a person with an intellectual disability as functioning with skills comparable to a child of a certain age a comparison which can be misleading.

Regardless of the level of their capabilities, remember that you are meeting with an adult, not a child, and treat her or him accordingly.
It is still a good idea to choose simpler language, and speak with shorter sentences, but don’t talk down to the person.

Effective Communication

In some cases, it might be impossible for you to know that a person with whom you are meeting has an intellectual disability, unless they have disclosed this to you in advance. The only reason why the presence of the person’s disability might arise is if you are having difficulty communicating a set of ideas to the person. In other cases, you may be informed in advance. The following provides some guidelines to more effective communication with a person with an intellectual disability.

Use simpler language and uncomplicated sentences.

A good check to see if you are being understood is to have the individual repeat back to you what you have said.

Some people with intellectual disabilities may have difficulty absorbing the information orally or in written form, so try demonstrating a certain concept using pictures, or a physical demonstration.

Some individuals may be accompanied by a support person. While this person may be able to facilitate communication between you, it is important to speak to the individual and not the advocate, unless told otherwise.

For people with intellectual disabilities, some of their greatest problems are the result of negative attitudes of people serving or working with them. Consider sensitivity training which challenges stereotypes and misconceptions about such disabilities for your own workforce. The Canadian Council on Rehabilitation and Work (CCRW) is a popular provider of this type of training.

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People with Learning Disabilities

Description and Terminology

Approximately one in ten Canadians has a learning disability, which is a problem with their neurological system that distorts the transmission of information from their senses to their brain. Learning disabilities are not caused by developmental disabilities in fact, they affect people of all levels of intelligence. Learning disabilities are not caused by hearing, visual, physical or psychiatric disabilities either, but people with these other disabilities may also have a learning disability.

When we refer to people with learning disabilities, words like “stupid” and “idiot” have no place. Just as when referring to people with other disabilities, we place the individual first.

Some people believe that people with learning disabilities are simply stupid, or that if someone has a learning disability they are unable to do well in school. These are both misconceptions.

The challenge for people with learning disabilities is to find ways of learning, support and encouragement, and learning environments which will help them get around their disability.

Some characteristics of people with learning disabilities include a major inability to focus their attention; difficulty expressing themselves in written form or orally, even if they understand the material at hand; and social problems due to immature or egocentric behaviour. Some people may have difficulty with one mode of communication, such as reading or writing. Others may have no trouble performing these tasks individually, but once combined find them extremely difficult, such as listening and taking notes in a meeting.

Learning disabilities are what are called “invisible disabilities”, meaning that without being told, a stranger is unaware of it. Like all disabilities, learning disabilities are as unique as the people who have them. When made aware that a client has a learning disability, it is important to treat each person individually.

Assistive Devices

Devices which support a person’s learning strengths are valuable tools for the person with a learning disability. These include:

  • Dictaphones and tape recorders for people who have difficulty communicating in handwriting,

  • calculators for people who have problems with numbers,

  • computers for people who have problems with their handwriting.

  • Meeting with a Person with a Learning Disability

  • Multimedia Communication

For someone with any type of learning disability, disclosure of their disability to a stranger will likely depend on the perceived benefits versus risks of doing so. If a service provider has a proven record of providing accommodating and personalized service to people of all abilities, a person with a learning disability might be more likely to self disclose their preferred methods of communication and learning.

Policies which prepare a service provider to be able to communicate information in a variety of ways demonstrate to a potential client that diversity is valued in their organization, and prevent delays by preparing the service provider in advance.

If someone discloses their learning disability in advance of a meeting, take the opportunity to ask them what their preferred methods of communication are, and see if you can accommodate him/her.

Many people do not disclose a learning disability, particularly if they have developed effective means of coping with it. However, being aware that all people learn in different ways regardless of the presence of a diagnosed learning disability, can help a service provider be more creative in her or his presentation methods. By taking a multi-media approach that is, to have a combination of oral presentation, written information, even visual slides or videos, included as part of a meeting - all participants will benefit from a more interesting and stimulating presentation.

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People with Psychiatric Disabilities

Description and Terminology

According to the Canadian Mental Health Association three to five per cent of the Canadian population has a chronic mental illness, and one in six Canadians is likely to seek help for a mental health problem during their lifetime. Psychiatric disabilities are the result of underlying conditions, and cause disturbed thoughts, feelings or behaviours which can make it very difficult for a person to meet their family, social and work responsibilities.

The causes of psychiatric illnesses are many. Some are the result of disturbances in the functioning of the brain, such as a chemical imbalance, and are unrelated to any external trauma (though external stresses may trigger a mental illness in a person). Some illnesses are brought on by an isolated external event, such as the death of a loved one while still others result from prolonged periods of trauma, such as sexual, emotional or physical abuse. Psychiatric disabilities vary in their duration. Some conditions may be resolved after a short period of time, while others may be chronic and last through a person’s lifetime. Some people may have a single episode of mental illness, while others may have episodic conditions which recur throughout their lifetime, with frequent periods where they are disability free.

Some psychiatric conditions are resolved through “talk therapy” and the passage of time, while others respond best to a combination of counselling and drug therapies. While tranquillizers, antidepressants and other medications may help people cope and control the symptoms of their illnesses, they do not cure them, and may cause side effects such as nervousness, nausea, headaches, and lack of energy. For some people, the side effects of their medications are so extreme that they choose to live with their mental illness, rather than take the drugs.

When referring to a person with a psychiatric disability, there are a number of acceptable terms.

Always put the person before the disability, so that we refer to a person with a “mental illness”, “psychiatric disability”, “mental health problem” or “emotional disorder”.

If a person is presently healthy, but has experienced a mental health illness in the past, we refer to them as “persons with a history of mental health problems”.

Some people refer to themselves as “survivors of” a mental illness, the health system, etc., or as “consumers of mental health services”, terms which emphasize the empowerment of the individual.

Avoid terms like, “the mentally ill” or “a schizophrenic”, which tend to treat people with mental illnesses as if they were all the same. Do not use degrading terms like “crazy” or “psycho”.

Many people who have psychiatric disabilities do not appear to have a disability, as opposed to a person who is blind or deaf. Psychiatric disabilities are therefore “invisible disabilities”, and it is up to the person who is disabled to disclose the presence of their disability to those around them. Many choose to keep their disability a secret, out of fear that they will be stereotyped as incapable of employment or unreliable.
In some cases, a person with a psychiatric disability might benefit from telling their employer or service provider about their disability. The provision of minor accommodations or support in the workplace can be the difference between success or failure for the employee. It is therefore up to service providers and employers to create an atmosphere which is free of misconceptions and is accepting of difference, so that a person with a psychiatric disability might feel comfortable disclosing their disability.

Kinds of Psychiatric Disabilities

There is some debate as to whether employers or service providers of people with disabilities need detailed information on specific types of psychiatric disabilities. While some argue that information can help a service provider serve someone more effectively, others counter that most information is too general, and only reinforces stereotypes that people with mental illnesses are the same. Another important point is that the type of psychiatric disability that a person has is often irrelevant to providing them with a service. You would never ask for a detailed description of their disability. If the person wants to tell you that they have a bipolar disorder, that is up to them.

The following information is intended to give basic information about the most common psychiatric disorders that might help dispel some of the misconceptions about psychiatric illnesses. This information is by no means complete, however, and knowing something about a person’s illness does not mean that you know anything about their unique aspirations, experiences and goals in life. Remember to treat them as you would any other client.

Five of the most common psychiatric disabilities are schizophrenia, depression, bipolar disorder (“manic depression”), anxiety disorders and personality disorders.

Schizophrenia refers to a group of disorders with symptoms which can vary markedly from one person to another. Some of the more common symptoms are confused thinking, delusions, hallucinations, loss of contact with reality, peculiarities of mood, and withdrawal from the outside world. Contrary to what many people believe, schizophrenia is not the same thing as multiple personality disorder.

Depression is an affective disorder (disorders categorized by extremes of mood and emotion). A person experiencing severe depression feels a loss of self interest or pleasure in most or all of his or her usual activities, feelings of hopelessness and worthlessness, thoughts of death, and may exhibit suicidal behaviour. Severe depression is different from the kinds of ups and downs or depression that most people experience from time to time, in that it is much deeper and enduring.

Bipolar Disorder (“Manic Depression”) is also an affective disorder. A person with this disorder alternates between periods of excitement (“mania”) and depression. Symptoms of “manic” episode are extreme elation, hyperactivity, decreased need for sleep or food, and inflated self esteem. Delusions and hallucinations may also occur.

Anxiety Disorders include phobias (persistent and irrational fear of a particular object, activity or situation), panic attacks, and post traumatic stress disorder (anxiety following a psychologically stressful event, such as a violent crime). Anxiety disorders are different from normal anxiety experienced by most people, because it is so extreme that it prevents people with the disorder from pursuing or enjoying common activities.

Personality Disorders are deeply ingrained dysfunctional patterns of behaviour and thought that impair a person’s ability to conform to socially acceptable forms of behaviour, as well as to establish and maintain healthy social relationships. They include paranoia, compulsiveness, and antisocial behaviour.

Etiquette in Interacting with a Person with a Psychiatric Disability

In many cases, you will interact with people without knowing that they presently have, or have had, a mental illness. Beyond organizing your services in a way which is flexible, accepting and inclusive of all kinds of difference, there is little you can do for these people specifically.
If you are aware of someone’s psychiatric disability, however, there are a few things that you can do.

Never disclose a person’s disability to another person, unless you have been given express permission to do so.

People with psychiatric disabilities continue to be highly stigmatized, and are often treated with less respect and dignity than the general population. Understandably, many people with psychiatric disabilities choose to keep their disabilities a secret, particularly if they have achieved professional or community positions of influence or power.

When someone discloses their disability, never ask them questions about it which do not relate to the business you are discussing.

It is up to the individual to reveal information about their disability. Just as with people with other disabilities, questions about mental illnesses should be framed in terms of how your services can accommodate any special needs that the individual might have.


In many cases, meetings with people with psychiatric disabilities will proceed as with any non-disabled person. However, there are some accommodations that might benefit some people with mental illnesses during a meeting.

Tips: Some people who are taking medication may have excess thirst, and will need access to a constant supply of water or other beverage.

Be patient. Some people may be agitated or anxious due to their illness, or the medications they are taking, and may have difficulty remaining focused during a meeting.

Try to help them stay on topic, if the person is highly distracted, you might ask someone to take notes, or tape record the meeting, so they might have some reference material for afterwards.

Frequent breaks might also give the person a chance to walk off some of their energy.

Be flexible. A person might have to cancel a meeting at the last minute if they have suddenly become unwell.

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People with Other Disabilities

Description and Terminology

This guide discusses disabilities which are often the result of underlying diseases or conditions, and which cannot be easily classified into one of the previous guides. Some of the conditions discussed in this guide can result in disabilities covered in previous guides. For example, a person with advanced diabetes can go blind or lose their mobility as the result of amputation, so there is overlap. This chapter also includes people with traumatic brain injuries (head injuries), and people with communications disabilities (speech impairments).

The disabilities covered in this chapter are many and diverse, and so the following discussion relies on more generalities than did previous chapters. What connects many of the disabilities in this chapter is that they are “invisible” to outsiders. The difficulty for people with these invisible disabilities is that they may have problems receiving adequate support or accommodation in the work place or in public spaces.

As with any type of disability, we refer to “a person with” cancer, lupus, kidney disease, diabetes, epilepsy, allergies, as opposed to “a diabetic”, “an epileptic”, etc. The degree to which people with different diseases or conditions are disabled by their condition varies considerably, so we must remember to treat people as individuals first, and as individuals with specific disabilities second.

People with Other Disabilities

In this chapter, the distinction between a disease or underlying condition, and the resulting disability, needs be emphasized. A person with cancer is not necessarily disabled by the cancer, but by the chemotherapy or radiation treatments. Some of the ways in which other disabilities restrict peoples' lives follow.

Dietary restrictions mean that some people, such as a person with diabetes, heart disease or kidney disease, has to make special efforts when shopping and cooking, and may have difficulty eating in a restaurant or at someone’s home.

Fatigue and low levels of endurance restrict the number and types of activities some people can do. A person with kidney disease may be particularly tired right after dialysis treatments, with high energy levels the rest of the time, while a person with lupus may be capable of working intensely for short periods, but may then require additional rest and recovery time.

A person may be dependent on mechanical equipment, such as a person with kidney disease who is on dialysis, and may have to plan work and social activities around their dialysis schedule. A person with severe asthma may be dependent on a tank of oxygen, meaning that the types of outings a person can make are restricted, and must be carefully planned.

People with environmental sensitivities may be highly restricted in terms of where they can live, work or socialize.

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People with Traumatic Brain Injury

According to the Head Injury Association of Toronto, 45 traumatic brain injuries occur each day, totaling 16,000 per year. There are different types of traumatic brain injuries, only some of which are visible.

“Closed head injuries” are the result of rapid acceleration/deceleration that often occurs in traffic accidents which causes whiplash to the brain. (These are also known as “closed head” injuries). This whiplash places a great strain on the brain stem, from which a multitude of bodily functions are controlled, such as breathing, consciousness, heart beat, eye movements, swallowing and facial muscles, and pupil reactions.

“Open head injuries” leave a visible wound, such as that from a gun shot or other outside factor.

Another type of brain injury is caused by a lack of oxygen to the brain following drowning, stroke, and cardiac arrest, among others.

Types of Impairments Associated with Head Injuries

In many cases, traumatic brain injuries can cause physical disabilities, impaired learning ability, emotional and personality changes, although the extent and location of the injury will determine the severity and duration of the resulting impairments. Some impairments caused by brain injuries can be overcome through exercise and retraining, while others can be overcome through the use of assistive devices, or by changing their environment.

It should be noted that the impact of a head injury goes far beyond the person who sustained the injury to include their family and friends, particularly when the individual’s personality changes drastically.

Rehabilitation from head injuries can be slow and life-long.

Physical impairments include speech, vision, hearing and other sensory impairments, headaches, lack of coordination, spasticity of muscles, paralysis of one or both sides, and seizure disorders.

Cognitive impairments, such as memory deficits (short and long term), concentration, attention, perception, communication problems, slowness of thinking, difficulty reading and writing, and problems with planning, sequencing and judgment, can also result from a brain injury.

Psycho-social-behavioural-emotional impairments can also be caused by a head injury. These would include overwhelming fatigue, mood swings, denial, self-centeredness, anxiety, depression, lowered self-esteem, sexual dysfunction, restlessness, lack of motivation, inability to self-monitor, inability to cope, agitation, excessive laughing or crying, and difficulty relating to others.

Assistive Devices

The assistive devices used by people with disabilities resulting from head injuries relate specifically to their impairments. A person who has become paralyzed or blind will therefore use the same types of assistive devices as other people with physical or visual disabilities; a person who has sustained cognitive impairments will use the same types of assistive devices as other people with learning disabilities. Please refer to the appropriate section in this chapter for information on these devices.

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People with Communications Disabilities

The term communications disability is a general term used to refer to people who have a speech impairment, regardless of the underlying cause of this impairment. Forms of communications disabilities include:

  • aphasia, a language problem which is caused by a stroke or other brain injury;

  • slurred speech due to an underlying condition affecting muscular performance;

  • stuttering;

  • total or partial loss of voice box (laryngectomy), usually due to cancer;

  • or other poor speech habits which result in difficulties speaking.

Depending on the cause of the speech impairment, a person might be able to improve their speech through therapy, or may use an assistive device such as an artificial larynx. People with communications disabilities may also rely on other non-verbal means of communication, such as gestures and facial expressions, and written communication.

Assistive Devices

A person with aphasia may use multiple methods of communication, including speech, drawing and writing. Such a person might have a portable chalk board or other writing tool that they carry with them.

Two thirds of people who have had a total laryngectomy (their larynx, or “voice box”, removed) learn to speak using esophageal speech (forcing air into the esophagus and then pushing it out again to form words and sounds). Many prefer this method because the individual has two hands free and does not need any assistive devices. Others may use an artificial larynx (an electrolarynx which is battery powered, or a pneumatic larynx which is air powered) or a voice prosthesis to produce speech. One kind of electrolarynx looks like a small flashlight, with a disk that makes a humming sound. The device is held against the neck, and sound travels through the neck to the mouth. Another type of electrolarynx has a flexible plastic tube that carries sound to the person’s mouth from a hand-held device.

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Etiquette when Meeting Someone with an Invisible Disability

Many people with underlying conditions or diseases do not appear to have a disability from the outside.

Tips: If you are aware of someone’s disability, never disclose their condition or disease to someone else without the individual’s permission.
If you ever see someone who appears to be unwell, and are aware that he has an underlying condition like diabetes, offer your assistance.

Sometimes people don’t take their medication on time, which may cause the person to become disoriented, light-headed or dizzy. The individual will likely let you know if they need your help. Use your common sense in rare instances, if the person declines your offer, but you suspect they might be in danger and are too disoriented to accept your help, consider quietly moving the person to a more private location, and discretely calling for medical assistance.

If you are meeting someone who has difficulty speaking, do not try to speak for them. Take the time to listen to what they are saying.

Accommodations to Physical Space

Tips: When meeting in public places with a person with environmental sensitivities, discuss your plans with the individual to make sure the areas are safe for them.

People with hidden, underlying conditions that result in a disability may use assistive devices, such as masks to filter out environmental elements, an oxygen tank to assist a person with emphysema breathe, or an artificial larynx or voice prosthesis for a person who has lost her voice box.

Make sure that there is adequate space in your meeting room for assistive devices to be stored next to the individual. Make sure that there are electrical outlets nearby as well.

Having a Meeting with People who have Difficulty Communicating

Tips: In general, an atmosphere which promotes unhurried speaking and listening, and which focuses on the content of someone’s speech rather than their delivery, will facilitate communication with people with communications disabilities. Scheduling adequate time, and breaks during longer meetings, will assist in this. The following are suggestions related to specific underlying conditions.

If you are in a meeting with someone who uses an artificial larynx, ensure that adequate time has been scheduled for the meeting, because people who use these devices tend to speak more slowly.

For people who stutter, it is important to provide an unhurried speaking and listening atmosphere.

Maintain eye contact, without interrupting the speaker. Do not try to finish their sentences for them. In general, try to focus on what the person is saying, as opposed to how they are saying it.

Although a person’s intelligence remains intact, some people who sustain a head injury may have a slowness of thinking or a problem organizing or communicating their thoughts. In a meeting which includes a person with such impairments, patience and understanding will be required to give the person the time they need to express themselves. You may also have to assist them in staying focused or on topic.

People who have aphasia will need extra time in order to be able to express what they have to say.

The speech of some people with aphasia can be quite clear when they are well-rested, but becomes slurred and hard to understand if they become stressed or tired. In longer meetings, especially where a person with a speaking impairment will be doing a lot of talking, consider scheduling extra time for breaks. As a result of difficulties communicating their ideas and thoughts in conversation, people with aphasia may be seen as incompetent by those who do not understand the nature of their disability. Strategies which enable the person with aphasia to participate in conversation, and which validate the person’s contributions, are important. Training packages which teach “supported conversation” are available from agencies serving people with aphasia.

According to the Tourette Syndrome Foundation of Canada, a person with Tourette Syndrome (TS) has a neurological dysfunction characterized by tics, which are involuntary vocalizations or movements which occur repeatedly. People with TS often have some control over their tics which can last from seconds to hours; however, this control merely postpones more severe outbursts of symptoms. A person with TS needs to release their symptoms at some point during the day, but may be able to control them during a meeting.

Tics can be very distracting to others, especially at first. Patience in getting used to the person’s symptoms is important.

A person with TS may also have obsessions, compulsive behaviours, Attention Deficit Disorder, learning disabilities, behavioural problems, sleep disorders or difficulties with impulse control.

This means that a person with TS may find it difficult to sit still during a meeting, which could be distracting, or may have other behaviours which distract from the meeting’s agenda. In these situations, people need to be patient and allow the person to move around if they need to.


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Quiz ...........

Based on your knowledge, answer TRUE or FALSE to the questions below.

  1. A person may have a disability and not be handicapped.

  2. Persons with disabilities represent more than 15 percent of the Canadian population.

  3. “Mental illness” is synonymous with “Mental retardation”.

  4. Persons with cerebral palsy usually have an intellectual impairment.

  5. Intellectual impairment is curable.

  6. Paraplegia is an impairment caused by damage to the spinal cord.

  7. One cannot provide services to a deaf client without the aid of a sign language interpreter.

  8. Deaf persons can use a telephone to communicate.

  9. In order for a person using hearing aids to hear, one must always speak loudly.

  10. Braille is used by the majority of persons who are visually impaired.

  11. When guiding a person with visual impairment, it is preferable to hold his/her arm.

Answers to Quiz Questions

1. A person may have a disability and not be handicapped. -- True

People with disabilities are only handicapped when environmental barriers and/or peoples' attitudes interfere with or prevent activities that could otherwise be open to them.

2. Persons with disabilities represent more than 15% of the Canadian population. -- True

According to the 1991. Stastictics Canada Survey, 15.5 (4.2 million ) Canadians reported some level of disability. Of these an estimated 1,900,000 were between the ages of 15 and 64.

3. "Mental disability" is Synonymous with "mental illness" -- False

"mental disability" (or "intellectual disability") is characterized with a limited ability to learn. Although this condition is permanent (incurable), this does not prevent an intellectually disabled person from progressing and learning.
"Mental illness" (or "psychiatric disability") manifests itself as a disturbance which affects a person's thoughts feelings or behaviour to such an extent that his/her behaviour becomes incomprehensible and unaccectable for those around him/her. Contrary to mental disability, mental illness is curable.

4. Persons with cerebral palsy usually have an intellectual impairment -- False

Cerebral palsy refers to a stable neurological syndrome affecting an indvidual's coordination. In other words, cerebral palsy is mainly a physical condition and in no way affects an individual's intellectual abilities if they suffer from it. There are ways to facilitate communication with these individuals, who often have speech problems.

5. Intellectual impairment is curable. -- False

See question 3

6. Paraplegia is an impairment caused by damage to the spinal cord. -- True

Using the World Health Program's definition of impairment, disability and handicap, paralysis can be the result of a spinal cord injury (impairment), causing a functinal limitation to two limbs (paraplegia or four limbs (quadriplegia). This functional limitation defines the disability, and the handicap would be any external situation or condition that prevents the individual from performing daily routines, i.e. abscence of ramps, curb cuts, accessible buildings, washrooms etc.

7. One cannot provide services to a deaf client without the aid of a sign language interpreter. -- False

Although sign language interpretation should be provided upon request staff can assist a client who is deaf by means of written communication.

8. Deaf persons can use a phone to communicate. -- True

A person who is deaf can use a telephone. A Telecommunications Device for the Deaf (a TDD), Visual Ear or Bell Relay system enables some people to communicate by telephone.

9. In order for a person using hearing aids to hear, one must always speak loudly. -- False

Hearing aids are usually adjusted so the person who uses the can hear you speak with a normal tone of voice. It is important to look directly at a person who is hard of hearing and to speak clearly. Shouting is confusing and may only create distortions when filtered through a hearing aid.

10. Braille is used by the majority of persons who are visually impaired. -- False

Only about 2% of people who are visually impaired use Braille.

11. When guiding a person with a visual impairment, it is preferable to hold his/her arm -- False

You should always ask if the person needs assistance and then you should let the person who is blind take you by the arm.


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