Prioritizing the Learner

Imagine handing learners a training manual filled with dense, jargon-heavy text and lengthy explanations. Training doesn’t have to feel like a struggle. In fact, successful training modules are accessible, engaging, and even enjoyable. As a bonus, well-executed work-related training offers employees the opportunity to take a welcomed break from their daily routines.

Why Plain Language Matters

Plain language is a writing style that is clear, easy to follow, and uses simple words and phrases while avoiding unnecessary complexity or jargon.

• Example using complex and jargon-filled language: “The institution leverages a comprehensive cognitive training model with an emphasis on advanced problem-solving techniques, optimizing individual learning trajectories while fostering robust cognitive restructuring.”
• Example using simple, plain, and clear language: “At this learning center, educators use a training method that emphasizes problem-solving skills. They help learners improve their understanding by guiding them through different approaches to tackle challenges.”

The second example is more effective because it uses simplified language and direct explanations. The content becomes learner friendly and easier to grasp.

The Importance of Plain Language Writing

In the world of online learning, plain language writing is a powerful tool for designing effective courses.

Tips to write for clarity and understanding:

• Put information in logical order, with the important details first. For example: “’Designing Accessible Outdoor Spaces’ is a new course that will be offered this fall” is easier to grasp right away than “There is a new course offering coming this fall called ‘Designing Accessible Outdoor Spaces.’”
• Use active voice, with a clear “actor” in your writing. For example: “You must enroll in the course by Tuesday, April 9, 2024” is more clear than “Course enrollments must be completed by Tuesday April 9, 2024.”
• Use language familiar to your target audience and provide definitions for any unusual words. For example, let’s look at the unusual word “contagion” (disease that is easily spread). Tuberculosis is an airborne contagion, which means this disease is easily spread through the air by coughing, sneezing and spitting.
• Spell out acronyms as they are introduced and occasionally throughout the text. For example: “Every year, he donates $200 to the Society for the Prevention of Cruelty to Animals (SPCA).”

Plain Language Adoption Success Story

In 2022 the OM Team determined that a set of onboarding modules for a private research university needed to be revised. The original modules were dense and text-heavy, making it difficult for learners to understand and engage with the content.

By embracing plain language and rebranding the modules, the creators were able to make the training concise, clear, and easy to understand. Learners responded enthusiastically to the new content.

Data showed a 44% increase in learner engagement and better understanding of the onboarding material. This success story demonstrates how plain language can lead to more effective and enjoyable learning experiences.

Final Thoughts

Plain language is not just a buzzword. It’s a powerful writing approach in successful course design. By embracing clarity and simplicity, course creators can transform their learning materials and uplift the learning experience for everyone.

You can find out more about using plain language and other accessibility topics by visiting Oleb Media and signing up for our newsletter: The Digital Inclusion News. You are also encouraged to download our guide on plain language: The Course and Content Creator’s Guide to Writing in Plain Language.

Blind and low vision musicians from as far away as Australia along with numerous performers from the U.S. will participate in WhiteStickFest, an online celebration on October 15, 2021, which is International White Cane Day. White Cane Day is an annual commemoration of the achievements of blind and low vision individuals, and of that important symbol of blindness, the white cane, which is a tool of independence for the blind and visually impaired community. The event is a co-production of Platinum Cre8ive and Vision Australia Radio. Platinum Cre8tive works with artists and bands to help them find and develop their unique musical voice and present it to the world, with an emphasis on creative people with disabilities. Vision Australia incorporates ten radio stations that offer a wide range of programming services for the blind. WhiteStickFest is sponsored by tour operator Cocky Guides, which specializes in presenting destinations for blind, low vision and deaf travelers. Also sponsoring the event is Oleb Books — a disability publishing house.

WhiteStickFest Performer: Diane Schuur

WhiteStickFest will offer a diverse array of performers, including Diane Schuur, a Grammy-winning jazz singer and pianist. Schuur tells the Disability Tribune that the white cane represents for her a freedom she would not otherwise have.

“So in celebrating International White Cane Day, I believe we celebrate freedom for those with vision impairment,” she said. “And by celebration, I mean that it is important to acknowledge and celebrate our special abilities, each and every one of us.”

Schuur has always been drawn to music and cites jazz legend Dinah Washington as a major influence. Blind since birth, Schuur found comfort in singing when she was a child. Her musical career has taken her to the heights of the jazz world and includes performing at venues such as the Kennedy Center and Carnegie Hall, as well as numerous appearances on television. She has worked with Ray Charles and The Count Basie Orchestra.

“I believe that my lack of vision enhanced my other senses, which play such an important role in performance,” Schuur said. “My hearing and my sense of rhythm is what I rely upon for music and in my world in general. I am so grateful that my parents encouraged my music and that I was able to take piano lessons at the Washington State School for the Blind. I will forever be a student and still take vocal lessons on a regular basis. Having my inspiration supported by others, particularly as a young person, propelled me along my path.”

Schuur wants people to know that in spite of her disability, she remains an independent person. She lives alone with her Blue Point Persian cat Puss Puss, and is able to work and manage her needs.

“I put a focus on the gifts I was given, including a strong memory, and have gratitude for a beautiful Earth and the people I share it with,” she said. “I use song to express myself creatively. There is a special feeling and experience I receive when leading a band and that is a deep-seated joy I wish to share with those in the audience. I may not be able to see their smiles, but I can feel their loving response and understanding in my heart.”

Schuur said she’s really excited about the music she’ll be sharing during the WhiteStickFest. She enjoys singing with a large group of musicians and recently recorded a song with a big band, which will be her piece in the WhiteStickFest. The whole idea of the Fest appeals to her. She likes the concept of spreading the word around the globe about who the blind are and who she is.

“My white cane, which I nicknamed Ponchita, has taken me to many places and allowed me to walk with confidence,” she said. “I have a nickname for many people and things, always given as a sign of affection. Go, Ponchita!”

WhiteStickFest Performer: Shayy Winn

Also performing in the WhiteStickFest is Shayy Winn, a contestant on season 17 of “American Idol.” Shayy is an R&B singer who possesses a powerful voice.

“To me, International White Cane Day means a celebration of my confidence and my journey,” Shayy said.

Shayy admits that she was nervous when she performed on “American Idol.” “But the feedback and response I received from people all over the world was amazing,” she said. “I wouldn’t trade it for the world.”

Shayy, who exudes confidence, does not consider herself disabled. “I hope the audience will realize that having a white cane is not a disability,” she said. “It means we have a different ability.”

WhiteStickFest Performer: Mac Potts

Mac Potts, also one of the day’s performers, is another person who sees himself as differently abled.

“Honestly, I don’t even identify with my blindness, because a lot of the times it’s just not relevant,” Potts says. “However, for those who do struggle from low self esteem because of a disability, or for those who doubt the possibilities of people with disabilities, I do like to put myself out there to make a difference in the lives of both.”

Potts refers to his music as “piano pop”. On his YouTube page he can be seen singing and accompanying himself on the piano, to the delight of his followers, who post comments in support of him. He likes the idea of having a White Cane Day, a day designated to acknowledge a method in which blind people get around.

“For some people, it’s like an attachment of their body,” he said of the white cane. “For myself, not so much. Yes, using a cane is helpful, but I don’t travel alone very much. I’m independent in my own house and in my business dealings, but I do rely more on other people to help navigate me.”

He notes a common misconception about blind people: that they can’t relate to something that is usually enjoyed by sighted individuals.

“Mine is football,” he said. “Football season is in full swing and I really enjoy watching it. I root for the Seattle Seahawks, who aren’t doing that well this year as of right now. Bummer! But I also watch as many other games as I can, and I do root for other teams based on cool personal testimonies of certain players or historical events, such as the Cleveland Browns actually being a good team after being garbage for almost 20 years. They’ve also never made it to a Super Bowl, so that would be pretty cool to watch.”

Potts enjoys being part of programs like the WhiteStickFest.

“Because it features talented individuals,” he said. “And they all have a common goal, either because they have a disability themselves, or because they really like to be all inclusive for people like myself that have a disability. It’s just fun to get my name out there and be a part of something like this.”

When he appears on the WhiteStickFest, Potts will be performing a song by a well respected blind artist who, according to Potts, has written hundreds, perhaps even thousands of great songs, though he declined to say who the artist is.

“I picked one (a song) that wasn’t so obvious, but it really fits my voice well,” he said.

How to Watch WhiteStickFest

More than 22 blind and low vision musical artists will perform on the WhiteStickFest, along with several sighted performers. The concert is being produced in Australia on October 15, 2021. Due to time zone differences, the concert will actually air live in the U.S. at around 8pm (depending on which time zone you live in) on October 14. The concert is scheduled to run for two hours and will remain online after the live event, so it can be retrieved at any time on the 15th, which is the actual White Cane Day. The concert can be accessed at the WhiteStickFest website: https://www.whitestickfest.org/

Photo Credit: Tim Courtney

I encourage you to click through to read the full interview, which includes tips like improving how you use and create the alternative text (“alt text”) on your website and social media accounts. Here’s an excerpt:

Alternative text is a written description of what is shown in an image. It can also help assistive technology, such as screen reading tools, to interpret images. It’s a useful tool, but many users overlook it and some don’t use it correctly.

All images should include well-written alternative text. Facebook, Twitter and Instagram have built-in alternative text features, but the generated text isn’t always reliable.

Digital inclusion specialist Belo Miguel Cipriani navigates social media with the help of assistive technology after becoming blind in 2007. He sometimes finds himself unable to decipher an image due to faulty alternative text.

“When it comes to social media, often what I hear is ‘image, image,’ or ‘image 024’ with a super long number,” Cipriani said.

“I wouldn’t rely on anything automated.” Cipriani said. “Anything that’s providing important information should be created manually. You don’t want the information to be missing important pieces.”

There are a few best practices for writing alternative text that should sound familiar to journalists. Some of them include: Use correct grammar, be concise and specific, and include all relevant details.

Cipriani said adverbs can cloud the clarity of the alternative text. His advice: Don’t use them at all.

Read the full interview on the Poynter Institute website and I encourage you to leave your comments below. Also, Oleb Media will be launching The Alt Text Master Class soon, so sign up to our newsletter to get the latest updates on when to expect the class to start — and much more.

Your 2021 Accessible Travel Checklist

Credit: The National WWII Museum

1. New Orleans, LA – The National WWII Museum

Rated the #3 museum in the United States, according to the 2018 TripAdvisor Travelers’ Choice Awards, The National WWII Museum is continually enhancing its offerings to ensure that all history enthusiasts can explore its 300,000 sq. ft. of immersive exhibits and multimedia experiences safely and comfortably, including renewing its Sensory Inclusive certification with KultureCity. In addition to offering daily sensory bags with noise-cancelling headphones, sunglasses, fidgets, Feeling Zone thermometers, non-verbal cards and a KultureCity lanyard, the Museum has launched Sensory Friendly Mornings. Occurring the last Saturday of each month, the museum experience will be modified to make the visit more sensory-friendly for pre-registered guests by lowering the sound volume in louder areas, alerting visitors in areas where headphones are recommended, and offering designated Quiet Areas including private Quiet Rooms as needed. Guests will also receive a Social Story ahead of time to help plan their visit based on the content and advisories of each building. Additional information can be found here.

2. Various Destinations – Intrepid Travel

World leading adventure tour operator, Intrepid Travel, offers Tailor-Made trips, ideal for those looking to dream and design a trip that cannot be Googled. Tailor-Made trips offer fully custom or ready-made itineraries that can be personalized or adapted to suit the group’s comfort level, and to travelers with a disability. Travelers will have access to destination specialists who have expert local knowledge and will have the flexibility to choose when and where they’d like to begin their trip, thanks to flexible booking. Choose from unique accommodations with great character, and select the number of meals, public or private transport, number of activities, and more. A local guide will escort the group every step of the way. Whether the group is celebrating a special occasion or embarking on a special adventure, Tailor-Made trips offer authentic local experiences that you won’t find in a search engine. For example, Intrepid previously worked with athlete Dan Berlin to become the first blind person to run the Inca Trail in a single day in an astonishing 13 hours. Due to the ongoing impact of COVID-19, Intrepid Travel has made a number of updates to their safety guidelines, flexible booking conditions and trip departures.

3. Various Locations – Wheel the World

As a leader in the accessible travel category, and rated #1 by Lonely Planet in diversity and inclusion, Wheel the World offers a platform of accessible tours, experiences, accommodation and travel – encouraging exploration of the world and creating an atmosphere of unity among people with disabilities, their companions, and nature. From international surf trips, to rainforest tours, to volcano trekking, to dune bashing, Wheel of the World offers adventure in 40 destinations around the world and on every continent. With a mission to create experiences that are adaptive to specific needs, they plan trip recommendations based on individual questionnaire answers and are available 24/7 should you need assistance while abroad. Additional information on specific destinations can be found here.

Credit: Morgan’s Wonderland

4. San Antonio, TX – Morgan’s Wonderland

Opened in April of 2010, Morgan’s Wonderland is a first of its kind amusement park, designed entirely with special needs individuals in mind. The park features 25 Ultra-Accessible attractions including a sensory village, ferris wheel, swings and the water park, Morgan’s Inspiration Island, with no entry cost for those with special needs. Some highlights throughout the park include:

• Sensory Village – Imaginations can run wild at Morgan’s Wonderland’s Sensory Village, a make-believe community that encourages creativity. Visitors can head to the Fix-It Shop for a simulated test drive or visit Paramount Theater to watch interactive videos. Younger guests can stop by the Village Market grocery store and go on imaginary shopping trips, before heading to KMWL-TV to see themselves on TV.
• Whirling Wonder – This colorful ferris wheel takes guests on a mile ride, high up in the sky, for panoramic views of Morgan’s Wonderland. Located next to Starlight Amphitheater, right on the shoreline of Morgan Wonderland’s 8-acre lake, Whirling Wonder takes guests up five and a half stories and is visible from over a half-mile away.
• Wheelchair Swings – Kids of all ages can safely soar through the air on more than 30 traditional or adaptive swings, including those designed to accommodate wheelchairs.
• Morgan’s Inspiration Island – Keeping with the mission of Morgan’s Wonderland of being a safe and inclusive place to play, Morgan’s Inspiration Island is a tropical-like paradise filled with colorful splash pads, slides and a river boat adventure ride. Waterproof wheelchairs are even available to rent so that every visitor can partake in the fun.

Credit: Visit St. Pete/Clearwater

5. Florida – St. Pete/Clearwater

St. Pete/Clearwater aims to be a fun-filled, accessible vacation destination for individuals and families, whether they prefer sun-drenched beaches or want to experience the vibrant cultural/arts scene of the region.

• The Dali Museum – The Dali Museum wants every traveler to enjoy their visit. The museum offers a limited number of wheelchairs for public use within the building on a first come, first serve basis. For visitors with auditory needs, free audio content can be accessed by downloading the Dalí Museum App, including audio descriptions of selected artworks. The museum also offers a limited supply of courtesy Induction Neck loops, and ASL interpretation can be requested 2 weeks prior to visits at no charge. For visitors with vision needs, The Dalí Museum App interfaces with personal device Voice Over or TalkBack verbal description capabilities. For visitors with cognitive impairment needs, quiet hours are offered at the Museum on Sundays from 10am until noon.
• Museum of Fine Art – The MFA welcomes families with children with sensory sensitivities to explore the galleries on “Sensory Saturdays” every second Saturday of the month, from 10 am to 12 pm. During this time, all rotating audio components will be turned down or muted to ensure a calm environment. Visitors will receive a pre-packaged sensory bag with a guiding prompt, sketching materials, or other sensory-friendly activities.
• Great Explorations Children’s Museum- Great Explorations is listed as Autism Friendly in the Center for Autism and Related Disabilities (CARD) Autism Friendly Business Directory. The museum’s full and part-time staff has attended trainings with CARD staff to increase awareness of the needs of visitors on the autism spectrum, and to enhance the team’s ability to respond effectively and sensitively to these needs. Great Explorations is also accessible to wheelchair users and other visitors who need to avoid stairs.
• Tradewinds Island Resort on St. Pete Beach – As a designated special needs friendly resort by Be Friendlier, Tradewinds staff undergoes continuous training to ensure they understand sensitivities, developmental disabilities and unique situations so they are equipped to help all families and children enjoy their stay. The resort offers a Be Friendlier safety kit (for a small replacement charge) complete with door alarms, extra batteries, visual aide “STOP” prompt signs, corner guards, stove knob covers, and outlet covers. Tradewinds also offers waterproof temporary safety tattoos with room for phone/room numbers, and gluten-free menu options for those with dietary restrictions.

6. Florida – The Beaches of Fort Myers and Sanibel 

As an inclusive destination, The Beaches of Fort Myers and Sanibel features easy, accessible tourism information for persons with disabilities. A full guide details access to everything from getting to and from the airport, visiting attractions and best places to stay. Highlights include:

• Airport – accessible parking, bathrooms and multiple ramps for wheelchair access.
• Ground transportation – public bus transportation provided by LeeTran with discounted passes and accessible vehicles available for rent at multiple locations including Avis and Advantage.
• Visiting attractions – 
  • Arts & Entertainment: Multiple art venues including Alliance for the Arts and Edison & Ford Winter Estates have accessible parking, entrance, restrooms, and seating, as well as audio described performances and pre-show touch tours for the visually impaired.
  • Beaches, Parks and Nature: Accessible parking, entrance, bathrooms and rentals at multiple locations including Bowman’s Beach Park, Cayo Costa State Park, and J.N. “Ding” Darling National Wildlife Refuge.
  • Outdoor Activities & Sports: Accessible baseball/softball fields, stadium, soccer fields and restrooms at multiple locations including JetBlue Park and Mike Greenwell’s Bat-A-Ball & Family Fun Park.
  • Shopping: Accessible parking and entry with ramps and curb cuts, plus accessible restrooms and fitting rooms at multiple locations including Edison Mall and Miromar Outlets.
  • Tours: Captain Bubby’s IsLAND Tours offers tour service throughout Lee County using a van equipped with adaptations for physically challenged and/or visually impaired. 

Credit: Costa Rica Tourism Board

7. Costa Rica

New, innovative design and growing social awareness in Costa Rica are poised to make the Central American country’s natural wonders available to all. Costa Rica’s tourism industry is actively working to create more accessible travel experiences throughout the country, though several national parks, beaches and cultural attractions already possess disability-friendly designs.

• National Parks: Several of Costa Rica’s top national parks offer a range of accessible tours and accommodations. Manuel Antonio National Park opened a universal wheel-chair friendly trail called “El Manglar,” or the mangrove, in February 2018 for those with limited mobility. The trail, built over a mangrove, goes from the main national park entrance down to Espadilla Sur Beach and connects with other existing trails. El Manglar has 10 bays with information in Braille about the characteristics and attractions of each area of the park. Arenal Volcano National Park, home to the active Arenal Volcano, offers a completely handicap accessible experience with its trails at the “La Peninsula” zone. Carara National Park features low-incline paved trails, Braille and other information aids.
• Beaches: Costa Rica’s Jacó Beach is the first beach in Central America to be fully accessible to people with disabilities. In March 2019, Jacó Beach inaugurated a 206-foot long ramp constructed out of recycled plastic, which gives wheelchair users complete access to the shore and simultaneously reflects the country’s sustainability mission. Earlier this year, Playa Hermosa was declared another completely accessible beach in Costa Rica, with features including disability-friendly toilets, changing sinks and showers, and a transfer crane for those in wheelchairs. The beach features 52 meters of retractable walkway, made of recycled wood generated from 2,600 kilos of plastic, which provides access to the ocean. Costa Rica has an “Accessible Beach” program, led by the Costa Rican Accessible Tourism Network Association with the support of the Costa Rica Tourism Board, that works to make all beaches in the country more accessible by providing the proper equipment.
• Downtown San José: Travelers can rest assured that the sidewalks and pedestrian streets, as well as various cultural attractions of Costa Rica’s capital city of San José are disability-friendly. The remarkable National Museum, Jade Museum and Gold Museum are completely wheelchair accessible.

8. The Presidio Tunnel Tops – San Francisco, California

The Presidio Tunnel Tops project, comprising 14 acres of new national park land—will be an iconic “must see” San Francisco destination for the local community and visitors, offering a much needed sustainable green space to the city when it debuts in spring 2022. Thoughtfully designed by James Corner Field Operations (the firm behind New York City’s famed High Line), the Presidio Tunnel Tops will feature scenic overlooks with stunning views of the Golden Gate Bridge and the City, paths and gardens, a welcome plaza with food and visitor services, a campfire circle, picnic grounds and more. The Presidio Tunnel Tops will welcome people from all backgrounds and abilities to an inclusive and safe space, providing a green oasis right within the city limits. To accommodate visitors with disabilities specifically, the park provides accessible city park space for all and a direct connection from the Main Post where wheelchairs and other necessities can be found.  Additionally, Presidio Park has wheelchair accessible nature trails — from concrete and asphalt sidewalks to hard-packed sand and gravel — running throughout the park so everyone can enjoy the native wildlife. The buildings in the park, such as the Visitor Center, Walt Disney Family Museum, and Main Post are all wheelchair accessible. In 2019, The Presidio hosted a focus group with disabled individuals to provide feedback on accessibility at the park and how they could improve the experience for wheelchair users.

How many of the above accessible travel destinations have you visited or do you plan to visit? Do you have other accessible travel tips to share? Please let us know in the comments below!

Out of a list of the 72 most popular federal websites, only four sites earned perfect scores when tested for compliance with Section 508 of the Rehabilitation Act. The four sites that passed the test include:

• Centers for Disease Control and Prevention
• Department of Health and Human Services
• U.S. Citizen and Immigration Services
• The White House

The lowest-scoring federal websites for accessibility include:

• National Highway Traffic Safety Administration
• United States Marine Corps
• Energy Information Administration

“Web accessibility should be a top priority for the federal government,” said ITIF Vice President Daniel Castro, who co-authored the report. “Creating an accessible website requires taking into account the fact that not every user will be able to see or hear content, or use a keyboard or mouse to navigate. Web developers should adhere to accessible-design principles, such as using high-contrast colors, providing text alternatives to audio and visual content, avoiding the use of flashing animations that might cause seizures, and using labels for buttons so people using a screen reader can navigate the site. Following those design principles will not only help people with disabilities, but also ensure all users can navigate federal websites more easily.”

According to the CDC, 61 million adults in the United States live with a disability. Not only should web accessibility be a top priority for the federal government, it should be a top priority for all types of businesses and organizations.

Getting started with digital accessibility can feel like a huge task – especially without a technology background. Oleb Media specializes in helping organizations create a digital inclusion strategy so that they can operationalize digital accessibility and foster the most inclusive digital presence. Please contact us for a free one hour consultation.

Conversing with friends and family, singing, reading, and reciting poems are effective among the many effective and natural techniques that children enjoy. Children learn best when they repeat content and keep up with speech practice sessions under an expert professional’s guidance.

As a supportive tool, online apps ensure that your child can continue online speech therapy lessons from the safe and comforting environment of their home. Check out some of the best tools available today.

Articulation Station from Little Bee Speech

Articulation Station is one of the most popular apps for kids with speech disabilities. The basic version is free and available for download on your iPad or iPhone. But, if you think your child really seems to engage with the offerings, you could invest in the Articulation Station Pro.

The program has six different kinds of activities. These include matching games that link sounds and objects as well as colorful flashcards. The exciting thing about this app is that it allows you to create customized flashcards, so you child can get excited about practicing with favorite animals, objects, and toys.

Talking Pierre the Parrot from Outfit7 Limited

Listening to the sound of their own voices provides feedback to kids as they practice difficult areas of speech. They gain insight on their own expression of words and pronunciation as their speech skills improve. Talking Pierre the Parrot is a free online app that repeats your child’s words in a funny voice—a surefire way to make many little ones giggle. The graphics are delightful for a child and motivates them to speak and repeat. There’s a lot of slapstick humor here, designed to keep a child’s attention. Pierre is just fine after getting squished with mock guitars or soaked in water. The app is compatible with your Apple products.

Fluency Tracker from Smarty Ears

The Fluency Tracker app has been specifically designed to help kids with stuttering. Stammering can make your child feel self-conscious and nervous in social situations. They may shy away from speaking. Practicing with this app helps kids develop positivity toward speech by identifying the situations when stuttering is more pronounced. For instance, in specific situations, when doing certain activities or interacting with particular people. Parents can enter data into the app for an anxiety analysis to help therapists devise the ideal speech programs and exercises for the child. Fluency Trackers costs $9.99 for use on the iPhone.

Speech Tutor

The Speech Tutor apps take speech therapy to the next level by providing images and simulations of the mouth, tongue, and throat. This one can appeal to older children who want to know how and why their body works. Children can watch the movement to develop an understanding of how sounds are produced. The app has a total of 132 animations showing the front and sideways section of the mouth.

Kids can watch and try to imitate the movements to figure out how to make the sounds and speak clearly. Speech Tutor is also available for your iPad or iPhone for a cost of $9.99. Parents can get the app to work with their kids at home. Many speech-language experts may also use the app when providing sessions in a professional capacity.

Let’s Be Social

This one’s for the grownups. The Let’s Be Social app has been designed to help adults help their children with common communication challenges of the autistic spectrum. The app provides a total of 40 lessons sectioned into five different skillsets that the child can develop. For instance, navigating their way through peer groups, coping with changing life situations, bonding with friends and family, interacting with other people, and understanding school behavior expectations. Let’s Be Social has an intuitive interface and helps caregivers identify the child’s reactions. You can purchase the app for your iPad for a cost of $9.99.

TallyTots

TallyTots is ideal for kids who are learning to pick up basic speech and language skills like stringing two or more words together to build sentences, understanding action words and verbs, and abstract concepts. The app is compatible with Apple products and you can expect to pay around $2.99 for the app that includes up to 20 mini-games and puzzles. These fun games are formulated to help kids learn numbers and counting up to 100. Songs are incorporated for kids to sing along, while images teach how to understand the concepts of quantity and sorting things according to size and shape.

With a bit of research, parents can find a wide selection of online apps to help their kids with their speech and language disabilities. Choose the app with features suitable for your child’s unique needs. Make learning fun by joining the games to turn it into a positive experience rather than a chore.

If someone you know with intellectual disabilities has behaviors, they’re normal. Everyone has behaviors.

When I’m in pain, I might squint my eyes, grimace and curl up in a ball, or I might scream and yell out causing alarm and anxiety to those around me. If my head hurts, I can get grumpy and want to cover my head to block out light and my ears to block out sound, or maybe just move to a quiet room. The list goes on and on…

Behaviors as a Language

When we hear the term “behaviors” relating to people with intellectual and development disabilities (IDD), what is usually being referred to are adverse actions that cause some sort of harm to or disrupt the lives of the person with disabilities or others around them. What’s often missed is that these behaviors are rarely “just because someone has a disability and that’s just what they do.” With careful investigation and an understanding of the “language” of behaviors, a cause can often be found. And, even better, many of these causes do not need treatment with antipsychotic medications.

The less able we are to communicate with words, the more likely we are to communicate with gestures and actions. Have you ever found yourself using hand gestures when trying to communicate with someone from another country that doesn’t speak your language? Actions do sometimes speak louder than words. When you walk by someone and they have their head down, they’re holding their right cheek and have a grimace on their face, you may be on the right track assuming that they may be experiencing some sort of dental pain. Learning patterns of particular behaviors can often help pinpoint the cause of them.

Let’s talk about a few categories of fixable causes for adverse behaviors.

Environment

What do you do when you are hot, or cold? Do you remove your clothing? Would you “steal” someone’s blanket from them? You might ask first for the blanket, but what if you were not a person who communicates with words? What if you are in a room that’s really noisy and your head hurts? You’d likely want to move to a quieter place. But, how about if you could not move yourself or communicate to someone else what you are feeling? Might you yell and become agitated?

We should think about environmental causes of distress. Many of these can quickly be remedied and can make a difference in a person’s overall state of distress.

Sensory Issues

Some people have aversions to various sensations. One of mine is something cold touching my skin. When a person with cold hands touches me, it literally feels something like a shock that makes me recoil and even sometimes give an angry look and a gruff vocalization.

Could the feel of a particular clothing item be causing distress? Is there a repetitive sound that is exceedingly irritating to some and not to others? Could certain food textures feel repulsive to someone causing them to spit the food out? The answer to these is “yes.”

Look at what a person is experiencing in sight, sound, taste, touch, and smell when a particular challenging behavior presents itself.  It’s possible that you might identify a pattern that points to something that is easily avoidable.

Social

There are people we like being around and people we don’t. There may not be anything particularly “wrong” with that person at all. It’s just a preference. If we have no real choice about who is around us for hours at a time, we may express our preferences through agitation, resistance, self-abusive behavior or aggression toward others.

Learned Behavior

We should also consider the possibility that a person is doing something adverse because they learned that stopping that behavior will get them something desirable. “If you quiet down, I’ll give you a soda.” What is being taught here? I get noisy, then I quiet down, I get a soda.

Medical

As a physician, this is the area that causes me the most concern. To know that there are people who are in pain and are suffering with underlying health conditions that are not being diagnosed, or worse, inaccurately diagnosed as a psychiatric condition, is disturbing.  Clinicians simply MUST learn the language of behaviors and to see them as valid presenting symptoms of illness rather than just “something that people with disabilities do.”  There are a number of behaviors that can point to specific underlying health conditions that are too numerous to share here, but I want to give you a few examples:

• Spitting out food may be caused by pain when someone chews due to a dental abscess
• Becoming agitated and aggressive when heading towards the dining table may be a sign that a person experiences something painful before, during, or after eating such as reflux or aspiration
• Constantly putting their hands in their pants could be a sign of a genitourinary issue like a urinary tract infection or a yeast infection
• Screaming or resisting taking a bath could be a sign that something ‘bad” happens when their clothes come off such as abuse
• Waking up in the middle of the night screaming could be a sign of gastroesophageal reflux
• Becoming withdrawn, less alert, and less interactive could be a sign of constipation
• Being “hard to reach” could be associated with seizures
• Scratching and hitting one’s chest along with anxiousness could be a sign of chest pain

Learn More About Easily Treatable Behaviors

I’ve seen many people in my clinical career on psychotropic medications in an attempt to reduce some of these behaviors only to find later that there was an underlying, treatable cause. Imagine if you were experiencing painful acid reflux that caused agitation, could tell no one, and were then sedated so that you would no longer “act out.” You’d still have the painful reflux, you just might be too sleepy to try to let someone know through your behavior. We can do better than this! Educating families, supporters, and clinicians in the language of behavior of people with IDD can go a long way to relieving unnecessary suffering.

Take time to learn more about behavioral manifestations of underlying medical, environmental, social, and sensory conditions. Then, share what you learn with supporters of people with IDD and clinicians who treat them. It just might make a big difference in the quality of life of someone close to you who can speak for themselves.

Dr. Escudé is a board-certified fellow of the American Academy of Family Physicians and one of the few Fellows of the American Academy of Developmental Medicine. He is the president of Health Risk Screening, Inc. which specializes in risk identification and mitigation in people with IDD and other vulnerabilities. HRSTonline.com. He is the author of Clinical Pearls in IDD Healthcare and the Curriculum in IDD Healthcare, an online course for physicians, nurses and other clinicians that teaches the fundamentals of IDD healthcare.

Parkinson’s disease (PD) is one of those conditions that affects a person’s quality of life in many ways. This year, 2020, researchers estimate almost 1 million people will be living with this disease according to the Parkinson’s Foundation. Although approximately 60,000 people in the United States are diagnosed with this life-changing disease each year, it seems to affect men more than women. Studies show that men are 1.5 times more likely to have PD.

What is Parkinson’s Disease?

People with Parkinson’s disease face challenges with movement. It is a neurological disorder that happens when the brain produces less and less dopamine, a chemical in the brain referred to as the “feel-good neurotransmitter.” Dopamine is released in the brain during or after experiencing feelings of pleasure. For example, eating the forbidden bowl of ice cream or taking a cool shower after running a marathon. It is also responsible for improving mood, alertness and controls movement. People who believe they have this disease should seek medical advice, diagnosis or treatment immediately.

Most Common Symptoms of Parkinson’s Disease

Symptoms of Parkinson’s disease gradually develop. The symptoms may manifest differently from person to person. The most common symptoms include:

• shaky hands or tremors in the hands, arms, legs or jaws
• slow movements called bradykinesia
• muscle stiffness that affects your range of motion
• Problems with posture and balance that affects walking or standing

These are just a few PD symptoms that progressively get worse over time. Other problems that may develop as the disease progresses include the inability to perform routine tasks for daily living such as eating, bathing, dressing, talking and writing. Parkinson’s patients also often have symptoms around vision and bladder control. Although there is no cure for Parkinson’s disease, the good news is there are assistive devices to help patients perform daily activities.

Specially Designed Devices for Parkinson’s Patients

Patients with Parkinson’s disease may find performing certain everyday tasks challenging. Sitting down to eat, taking a bath or shower, getting dressed or going for a walk can be challenging for people with Parkinson’s, even dangerous. As we age, accidental falls become commonplace. However, people with Parkinson’s risk of falling is two times greater than the average older adult.

There is a simple solution to help people with Parkinson’s disease regain their sense of independence — to use specially designed adaptive devices made specifically for Parkinson’s patients. A few of those devices are listed below along with a brief description of what they do.

Eating and Drinking Aids for Parkinson’s Patients

There are several options for assistance with eating and drinking. A few of those options include eating with heavy weighted eating utensils or utensils with handles that swivel. Weighted eating utensils are designed to help steady the hand while utensils with swiveling handles help steady the eating utensil. Likewise with weighted drinking cups and cups with swiveling handles. The weight of the cup keeps the shaking hand steady and the swiveling handle keeps the cup steady when filled with liquid.

In addition to eating utensils and drinking adaptive devices, using inner-lip plates and bowls with non-skid bottoms are also options. For those having trouble getting food onto the eating utensil, adding plate guards will help. Another option is placing Dycem under plates and bowls. This special non-slip material keeps plates and bowls from sliding off the table.

Dressing and Grooming Aids for Parkinson’s Patients

Essential hand tremors associated with Parkinson’s disease make it challenging to button your shirt or brush your teeth. Just like the weighted eating utensils, there are weighted button aids and weighted universal holders. The weighted universal holder works with your toothbrush, razor, hair comb and hair brush. Just add any one of these personal grooming items to the weighted handle and it helps steady the hand for users to complete the task.

Bathing and Toileting Aids for Parkinson’s Patients

The best solution for bathing is to add grab bars or tub rails. Installation is usually easy and the devices are relatively inexpensive. Use the grab bars or tub rails to steady yourself while bathing. In addition, add toilet rails around the toilet or raised toilet seats to prevent accidental falls when using the toilet.

Mobility Aids and for Parkinson’s Patients

Parkinson’s patients who have problems with walking or standing, should consider investing in a mobility walker or rollator. They both are designed to help you steady yourself while walking or standing, and the rollator offers a convenient seat for resting.

These are just a few adaptive devices to aid Parkinson’s patients. The use of these enable users to maintain their independence to perform daily living activities for themselves. There may be times when assistance from a caregiver or family member is required. In those cases, don’t hesitate to ask for help.

A storyline I’ve heard recounted many times in my work as a physician in this field is that doctors just don’t understand the healthcare needs of my loved one who has a disability. “They were rude.” “The doctor just wanted to start him on a behavior medication.” “He didn’t listen to what I had to say.” “She told me that we should just put him on hospice because he didn’t have any quality of life.” These and other disheartening comments by clinicians make my profession look insensitive and incompetent in regards to providing healthcare for people with intellectual disabilities. And as much as I hate to say it, there’s some truth to it.

Person-centered Oath

The reason goes beyond that healthcare providers are just plain insensitive to the needs of people. I would even suggest the opposite. In fact, we take an oath at the beginning of our career, the Hippocratic Oath, that includes statements like these as excerpted from the modern version of the oath:

• “I will remember that there is art to medicine as well as science, and that warmth, sympathy and understanding may outweigh the surgeon’s knife or the chemist’s drug.”
• “I will not be ashamed to say ‘I know not,’ nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.”
• “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability.”
• “I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”

It’s not a lack of compassion, it’s a lack of understanding

Facts:

• There are numerous incorrect assumptions and stereotypes about people with dis­abilities made by healthcare providers.¹
• Physicians report a lack of experience with the IDD population and the training nec­essary to provide healthcare to individuals with IDD. ²
• Medical students who do not receive any training on or experience with the IDD population have been found to exhibit poorer performance caring for patients with IDD in tasks varying from taking a medical history, conducting physical exams and ordering laboratory tests. ³
• There is evidence that early and frequent experiences with people with disabilities can improve medical students’ knowledge and attitudes about disability, thereby increasing their comfort level in providing care to people with disabilities. ⁴

Humble beginnings

People with intellectual and developmental disabilities (IDD) have health disparities including reduced rates of cancer screenings and dental care. And unfortunately, many healthcare providers have received little training in how to meet the healthcare needs of people with IDD. I was one of them.

After I began working at a regional center for people with severe and profound levels of IDD, I quickly learned that my medical school and residency training did not provide me with the necessary skills and experience to provide adequate healthcare for people with disabilities. What I learned, I learned from the nurses and direct support professionals that had been working there for years. It wasn’t that the disease conditions were any different, it was that they presented in a different way, with different frequencies and that communication of symptoms was largely non-verbal. I had to learn to understand the language of behavior and how subtle changes in a person’s behavior were often the sign of a brewing health condition and not “just because they have a disability.” Unfortunately, these things aren’t taught in medical school or most other health professional schools, for that matter.

On-the-job training

I’m proof that it’s possible to teach an old dog new tricks! Here are some bits of information called “Clinical Pearls” I’ve learned along the way…

• Just because someone has a disability doesn’t mean that their life is less worthy of good healthcare and life opportunities. A different quality of life does not equal a lower quality of life.
• Disruptive or aggressive behavior is less likely to be “just because a person has a disability” and more often because there is an underlying reason that can be improved upon. I might be that a person is experiencing pain from a dental abscess or an ingrown toenail, for instance. It could be that they are in a restrictive environment that does not foster independence and personal choice. Or it could be because they are experiencing side effects from a mediation, and it might even be a medication that they should not be taking in the first place. There are many reasons for untoward behavior. The last thing that should be done is to start someone on a medication “to reduce their behavior” without evaluating every other possible cause. Unfortunately, this is often first-line treatment.
• Never, never refer someone to hospice or make them a “Do Not Resuscitate” on the basis of their disability alone. This decision may be appropriate under certain circumstances, but never just because they have a disability.
• Constipation is a MAJOR problem in this field of healthcare. I would have never though that constipation could cause all of the things it does, or that I would be treating people for this condition to the degree that I did in clinical practice. I emphasize this issue so much in my lectures that I’ve been called “the Constipation Doctor” more than once. What an honor!
• There are physical, positioning and movement techniques that can aid in swallowing, digestion and bowel elimination. Feeding tubes and medications are not the only solutions.
• The overuse of medications, especially psychotropic medications, is rampant in this field of healthcare. Along with it comes increased potential for side effects and interactions. Sometimes taking people off medications actually leads to improvement.
• Pica behavior can be a sign of undiagnosed gastrointestinal issues including gastroesophageal reflux disease.

And the list goes on and on and on….. There are so many of these, that I’ve compiled them into a book.

Resources for people with intellectual and developmental disabilities

In the past, families and supporters who had frustrating healthcare experiences could do little more than grumble about the lack of availability of clinicians who understood their loved one’s needs. That’s no longer the case. Here are a few newly available resources.

• The Clinical Pearls in IDD Healthcare. Is a book that contains 55 “Pearls” learned “the hard way” so other clinicians, supporters and family members of people with IDD don’t have to. It’s written in a format that each “Pearl” is a separate page of cardstock arranged in a binder format so that you can take one out and share it with healthcare providers and others when they are in need of a bit more information about a particular topic.
• For more in-depth clinical education, a revolutionary online training program called the “Curriculum in IDD Healthcare” is now available. This six-module course teaches clinicians, especially physicians and nurses, the fundamentals of IDD Healthcare. It’s interactive and includes continuing education credits for both doctors and nurses.
• The Vanderbilt Kennedy University Center For Excellence in Developmental Disabilities has developed an IDD Toolkit to assist clinicians in providing better healthcare for people with IDD. There are several important and useful forms to aid clinicians in meeting the healthcare needs of people with disabilities.
• The American Academy of Developmental Medicine and Dentistry is an organization supporting healthcare professionals in learning how to improve the quality of healthcare for people with IDD. They are a tremendous resource for clinicians looking for ways to grow their skills in providing healthcare for people with disabilities.
• The Developmental Disabilities Nurses Association is an organization dedicated to educating, empowering, and advocating for nurses practicing in the specialty of developmental disability nursing. Nurses can connect with the organization to further their skills and knowledge in this field of medicine.

When we educate clinicians, we save lives

Families and supporters of people with disabilities now have important and effective resources that they can offer, recommend, or directly provide to healthcare professionals to improve their knowledge and understanding of this important facet of medical care. Tell your physicians, nurses, hospital emergency room staff dentists and others about these resources. You might even want to provide them access. For those that have loved ones that are supported by agencies and organizations, let them know about these materials. Advocate to your local nursing and medical schools to include these offerings to their students.  Better training equates to better healthcare and better outcomes.

Right, not privilege

Healthcare is a right. And, everyone has the right to receive basic healthcare that alleviates suffering and improves quality of life. People with disabilities should have access to the same quality of healthcare that everyone does. I firmly believe that everyone, with or without a disability, should be able to present to any clinicians’ office or hospital and receive a basic level of capable, compassionate, and appropriate healthcare. If you’re a clinician, you owe it to yourself and to your patients to become educated in this area of medicine. If you’re a family member or supporter, you now can do more than just lament about the need for better trained-clinicians.

Remember: When we Educate Clinicians, We Save Lives

About the author:

Dr. Craig Escudé is a board-certified Fellow of the American Academy of Family Physicians and the American Academy of Developmental Medicine, and is the President of Health Risk Screening, Inc. He served as medical director of Hudspeth Regional Center in Mississippi and is the founder of DETECT, the Developmental Evaluation, Training and Educational Consultative Team of Mississippi. He has more than 20 years of clinical experience providing medical care for people with IDD and complex medical conditions and is the author of Clinical Pearls in IDD Healthcare and the Curriculum in IDD Healthcare.

¹ (National Council on Disability. The Current State of Health Care for People with Disabilities 2009)

² (Reichard and Turnbull, 2004)

³ (Brown, Graham, Richeson, Wu, and McDermott, 2010)

⁴ (Brown, Graham, Richeson, Wu, and McDermott, 2010; Jackson, 2007; Larson McNeal, Carrothers and Premo, 2002; Long-Bellil et al., 2011; Rose, Kent and Rose, 2011; Thistlethwaite and Ewart, 2003; Tracy and Iacono, 2008)

In July, the National Association of Councils on Developmental Disabilities held a disability voter registration week. The goal was simple: get more people with disabilities registered to vote so that they can cast their ballots. A Facebook Live event was held on July 16 with Donna Meltzer, CEO of NACDD, and actress Emily Kranking, an NACDD consultant and disability advocate who lives with hemiplegic cerebral palsy and dysarthria, a speech condition.

The NACDD has also launched One Vote Now, a website made possible by a grant from Craigslist founder Craig Newmark through Craig Newmark Philanthropies. OVN touts itself as “your central hub to find information about how to vote in the 2020 election.”

Helping people with disabilities vote

NACDD and OVN recognize that structural barriers have often made it more difficult for the disability community to vote. OVN therefore gathers and shares information to make voting more accessible to those with disabilities. The site offers users the tools to register to vote. OVN shares how people with disabilities can either request an absentee ballot or how to vote in person. They also provide resources on how people can do their research on candidates and policies and provides tools that help people with intellectual and developmental disabilities take part in the elections process.

“Our democracy is strongest when every voice can be heard,” Meltzer said in a press release. “More work needs to be done to ensure that every voter can cast a ballot that is counted, and we are here to make sure that the needs of people with developmental disabilities are accounted for in the general election.”

On September 3, OVN participated in a “registered and ready virtual rally” with no less than former First Lady Michelle Obama. The rally was organized by When We All Vote, a non-profit, non-partisan organization that seeks to increase participation in every election. That organization was launched in 2018 by Mrs. Obama, Tom Hanks, Broadway star Lin-Manuel Miranda, Janelle Monae, Chris Paul and singers Faith Hill and Tim McGraw.

Meltzer’s career has focused primarily on advocacy for people with developmental disabilities. She began her profession by accident during the 1980s, when she landed an internship on Capitol Hill. She ended up working for Congressman Tony Coelho, who is commonly known as the father of the Americans with Disabilities Act (ADA).

“When he was in Congress, he was very engaged in disability issues,” Meltzer said of Coelho. “He himself has epilepsy. Following my time working for him I did work for the Epilepsy Foundation, that’s where I cut my teeth doing policy work. But it was really working for Tony and getting engaged in the disability world, and I just decided that this was my place, where I could really make a difference in our world.”

Are you registered to vote?

Meltzer noted that NACDD had been actively engaged in Disability Voter Registration for several years.

“We have been very actively engaged in promoting, making sure that people with disabilities are aware that it’s happening,” she said. “One of the things that we always let people know through our One Vote Now site and other publications of NACDD is that you can still register to vote up to anytime up until the final deadline set up by your Board of Elections. But it’s really just a week to think about ‘hey, am I registered, how do I register, what do I need to know’, and so we use our One Vote Now site to get out information about that. It’s important to register early, to make sure you have everything set because of the pandemic, because we know that voting is going to be a little more challenging this year, and there’s many more things that people need to know about the vote — how to get to the polls, what’s going to happen on Election Day, should I vote in person or by mail — we want to make sure that people have a lot of information about all of those things that they need to know, and the first step of course is registering to vote.”

Disability Voter Registration Week was a launching pad for the disability community to start planning for Election Day. The first thing for people to do is to make sure they’re registered to vote.

Make your Election Day plan now

“It’s a great time to take action, to register to vote,” Meltzler said. “Or at least begin your process of planning for Election Day. Maybe it’s easy to think ‘I am registered, I did that last year, so I’m good, so maybe I should start double checking and making a plan for Election Day.'”

Meltzer emphasized that planning was especially important this year as there are a number of things for disabled voters to consider. A voter must decide if they’re going to go and vote in person if that’s available to them where they live, or if they will need an absentee ballot, or do they live in an all-mail-in state.

“So we really used that voter registration week as sort of that now’s the time kind of method,” Meltzer said. “Start thinking about the elections now, start planning for Election Day now, and so it’s really like a marker in time.”

Transportation to the polls, accessibility at polling places and getting understandable information before Election Day are among the issues faced by people with disabilities.

“Come Election Day, when people are at the polling places, we have seen numerous things happen over the years, including barriers to getting in the door, to not enough trained poll workers to help somebody with physical disabilities navigate the space,” Meltzer said.

Meltzer has also seen instances in which people with intellectual disabilities have been told that they cannot vote unless they are accompanied by a guardian.

“That’s against the law,” she said. “So there are loads of challenges, so each year we strive to identify what challenges there are and try to address them in real time. In our modern world of having things like apps, if you are at a polling place and you are facing discrimination then and there, you can make a call, you can use the app to reach out to whoever the app is connected to that can help you solve the problem. We do partner with other organizations that collect data on that, where there has been discrimination or voter suppression. We try to cover the gamut; we try to think about and learn from our constituents what are all the potential challenges that people have and how are we going to solve them and provide solutions and alternatives.”

Visit One Vote Now

One Vote Now features a blog. Recent postings have included a commemoration of the 100th anniversary of women gaining the right to vote, as well as a piece on the Voting Rights Act and voting suppression in minority populations. Meltzer points out that people with disabilities have struggled for the right to vote as well.

“Ideally, what we’d like to see is all kinds of options,” she said. “So that those who choose to be at a polling place can do that, and those who choose to stay home where they feel physically safe from Covid, safe from whatever, and not having to deal with the challenges of transportation, standing in long lines, and not having enough poll workers there to manage a good and smooth process is a better choice. Choice is the name of the game here.”

Please visit One Vote Now for more information: https://www.onevotenow.org/

Photo credit: Wisconsin DD Council