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·	From Theory To Practice

1. Disability issues and topics are inter-related and require a coordinated approach.

There is substantial evidence, from Canada and abroad, of relationships and linkages among employment, transportation, housing and living arrangements, personal support, income support, access to rehabilitation and training, and others.

A coordinated and holistic approach across federal government departments and other jurisdictions is needed to address the complexity of disability issues and their linkages in order to provide coordination between policies and approaches. Without some form of coordination, the result is frequently a fragmented effort, with inconsistencies, overlaps, and gaps within and across jurisdictions. For example, some income programs have an all-or-nothing approach inherent in their eligibility requirements, which label people as either fully employable or unemployable. This approach may act as a major disincentive to employment and reinforces the welfare trap.

2. Environmental barriers are a greater impediment to participation in society and to employment than functional limitations.

Barrier removal through legislation, provision of workplace accommodations and other means, has been identified as the key to social integration of people with disabilities.

The most commonly accepted definition of disability is from the World Health Organization (WHO). This definition states disability involves an interaction between the individual and the environment. Therefore, an individual's ability to function in society and to be employed depends as much on the openness of society to accommodate people with their differences as on the specific functional limitations that identify a person as "disabled". This principle has important implications for the development of policies and for the focus of evaluations.

3. People with disabilities vary in their characteristics and needs.

Persons with disabilities form a very diverse group, with very different life circumstances, types and severity of disability, and face a range of different barriers. A teenager with an invisible disability, such as a learning disability, finds herself confronted not only with the difficulties associated with a disability, but also with the lack of understanding and recognition of that disability by other people. Consequently, a range of interventions is required. In particular, personalized approaches, with services adapted to the particular needs of each individual, are most likely to be successful.

4. Many approaches to permit participation of people with disabilities can be low-cost, but require involvement of different sectors in society, frequently on a partnership basis.

A variety of approaches that facilitate participation of people with disabilities in employment and in independent living have proven cost-effective in reducing the direct and indirect costs of disability. This report identifies the cost-effectiveness of a number of interventions, such as disability management, workplace accommodations and supported employment, as well as measures intended to permit independent living in the community. In particular, early intervention in facilitating the return to work of employees who develop disabilities can be very cost-effective.

Most workplace accommodations are low in cost and many, such as modifications to the work task or rearrangement of the work site, require no additional expenditures. Costs are also minimal when accessibility is built into the design of facilities and generic programs, as opposed to retrofitting.

Attitudinal barriers and lack of information about the capabilities of people with disabilities have been found to be among the biggest obstacles to independent living and to employment. These can result in systemic discrimination and lack of opportunities for people with disabilities. The United States’ experience with its own disability legislation, the Americans with Disabilities Act (ADA), has demonstrated that changes in attitudes can effectively follow changes in behaviour when standards and expectations are clearly set out. The provision of clear standards and the availability of technical information and support have increased compliance by American employers and private and public facilities with the accessibility requirements of ADA.

5. Direct involvement of disabled individuals with programs, services and policies that affect them increases satisfaction and support, produces higher levels of functioning and greater success at community integration.

Direct funding to enable people with disabilities to purchase and direct their own attendant care and personal support services has been shown to be more effective and to result in greater satisfaction than traditional approaches, where professionals decide upon the needs without involving the individual.

Direct involvement of people with disabilities in policy reviews, such as with the Mainstream 1992 Review and the 1996 Federal Task Force on Disability Issues, has demonstrated effectiveness in developing consensus and support for the directions that need to be taken.

Similarly, there is evidence that the involvement of people with disabilities in evaluation studies can improve the quality and credibility of the evaluation, lead to more relevant and improved policies and programs and also lead to improved functioning of the individuals involved.