Working Together: An Employer's Resource for Workplace Accommodation

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Acknowledgements
Preface
Introduction
Job Accommodation Basics
Human Rights
Psychiatric Disabilities / Mental Illness
Schizophrenia
Visual Impairment
Learning Disabilities / Attention Deficit Disorder
Medical Conditions or Diseases
Developmental Disabilities
Deaf / Deafened / Hard of Hearing
Physical Disabilities
Brain Injuries
Aphasia
Hiring A Person With a Disability
References / Resources

Acknowledgements

Working Together: An Employer’s Resource for Workplace Accommodation was researched and written by Future Abilities and Creative Employment (F.A.C.E.) under the sponsorship of Human Resources Development Canada (HRDC). This resource includes information and/or feedback from people representing many organizations and agencies, specifically the Job Accommodation Network, The Canadian National Institute for the Blind, Human Resources Development Canada, Learning Disabilities Association York Region, Learning Disabilities Association of Ontario, Ontario Trillium Foundation, Canadian Human Rights Commission, Ontario Human Rights Commission, Canadian Paraplegic Association, Canadian Mental Health Association, Pat Arato Aphasia Centre, Schizophrenia Society of Ontario, and the Canadian Hearing Society of York Region.

F.A.C.E. is a registered not-for-profit organization that champions on behalf of persons with disabilities who are entering the workforce in York Region and Bradford West Gwillimbury. F.A.C.E. actively promotes solutions through partnerships, co-sponsorship and by directly recommending and assisting in the implementation of change. Our services include the production and distribution of information and educational material that assists employers and employment service providers to accommodate persons with disabilities in their organizations.

This edition of Working Together: An Employers Resource for Workplace Accommodation is the product of a partnership between F.A.C.E. and HRSDC Ontario Region.

For more information about F.A.C.E. contact us at:

465 Davis Drive, Unit 127,
Newmarket, Ontario,
L3Y 2P1;

(905) 830-9299 (Voice/ TTY).

For additional copies of this publication, please contact HRDC at (416) 954-8423 or Contact Us - Ontario Region

Preface

As an employer, you may already make accommodations for your employees. Many businesses accommodate staff who have special needs, such as allowing an employee to leave early to pick up a child in day care. This handbook looks specifically at the special needs of an employee with a disability. There are volumes written about accommodating persons with disabilities in the workplace. In addition to the printed material, the World Wide Web contains thousands of pages on the topic that cover it thoroughly. However, few employers would have the time to sort through this information to find answers to their questions on workplace accommodations.

This handbook, Working Together: An Employer's Resource for Workplace Accommodation, offers a single source for basic information about most disability groups, as well as examples of typical solutions that have worked for employers and their employees with disabilities. Working Together does not attempt to answer all questions surrounding workplace accommodations. The following pages highlight many of the themes and principles that are common to accommodating all persons with disabilities, as well as accommodations that are specific to particular disability groups.

Introduction

“Watch out for the competition.”
“Time is Money.”
“Optimize productive time.”

How many times have you heard words just like this: You know that a company's most important assets are their employees. Attracting and retaining skilled and efficient employees is essential to maintaining high levels of productivity and remaining competitive in today's rapidly changing marketplace.

Attracting and retaining skilled employees is not just the function of the Human Resources Manager or Recruiter. As an employer or manager you are responsible for the safety and well being of those you employ to work in your workplace. Sometimes, however, the workplace environment presents barriers to getting the job done effectively and efficiently. When that happens you need to find a way to break down the barriers so that your employee can continue to be productive. In breaking down the barriers you are in fact creating a job accommodation.

Job Accommodations are Tools for Getting the Job Done

What is job accommodation? It's any modification in a workplace or workplace procedure that enables a person to do their job - a job they have the skill and aptitude to do.

Generally, discussions regarding job accommodation are related to a disability. Not all employees with a disability require job accommodation. A 1991 Statistics Canada survey found that only four per cent of workers with disabilities required physical changes in their workplace. Where it is required, reports demonstrate that more than half of all accommodations cost less than $500.

Throughout this handbook, you will find information and practical advice about job accommodations for a range of specific disabilities. Job accommodation for employees with disabilities is a legal requirement for employers, so we've also included information on your responsibilities under the Ontario Human Rights Code.

We hope that this handbook, together with the many technical and information resources available, will assist you in creating a barrier-free workplace.

Typical workplace modifications include:

Alternatives to print formats such as Braille or tape
- Sign language interpretation
- TTY telephones
- Accessible buildings both inside and out
- Modifications to equipment or furnishings (counter height, tools)
- Specially-designed computer software
- Assistive devices such as calculators, electronic day timers
- Flexible working hours, part-time hours, job sharing

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Job Accommodation Basics

There are some fundamental principles that are common to all job accommodation. Accommodations for a specific disability will be found in later sections of this handbook.

There is No Substitute for Good Communication

Disclosing information to an employer or manager regarding a disability is a very personal decision. Only the person with the disability can make the decision to disclose. You may already have an employee with an "invisible disability," such as a mental illness or medical condition, who has not asked for or needed any modification to their workplace or environment. When an employee discloses their disability this is the first step in the process of determining whether or not job accommodation is actually needed.

It is important that your workplace environment is one where employees feel comfortable in disclosing information and seeking assistance.

An open environment can be created by:
- demonstrating respect for confidentiality and the dignity of each person
flexibility in administration of policies, procedures and working conditions
- positive attitudes that turn problems into challenges and learning opportunities
- willingness to explore creative solutions to situations
- an organizational climate where everyone feels included, valued and accepted
- using language that is free of stereotypes and focuses on the person not the disability

Once your and your employee begin talking about job accommodation, remember that:

The Key To Successful Accommodation lies in Individual Solutions

There is no formula for job accommodation. Disabilities and how individuals adapt to them are just like thumbprints - unique to each person. The foremost expert on what job accommodation will work best is the person with the disability.

Listen to what your employee tells you about their disability and what they think is needed.
Ask questions when you don't understand.
Use the resources available specializing in specific disability issues (see Resources section).
Feel free to be creative, flexible, and innovative in your response to accommodating your employee.
Your employee should have an opportunity to test any special equipment or devices before you purchase.

Some disabilities are not static, conditions may improve or deteriorate over time. It's important to maintain ongoing communication with your employee, and make changes to your accommodation plan when appropriate.

When planning job accommodations, keep in mind that a change which will benefit one person may have a negative impact on someone else, if implemented without consultation.

Installation of a flashing strobe light on a fire alarm will accommodate a deaf or hard of hearing employee. However, such a device can precipitate seizures in someone who has epilepsy. A graded ramp will accommodate a person using a wheelchair. However, an employee who is blind and uses a white cane won't have the curb necessary to detect level changes

In both cases there are solutions. The strobe light can still be installed, but will require sufficient time intervals between flashes. The ramp can incorporate a slight curb so it can work for the person using a white cane while still accessible for someone using a wheelchair.

To ensure that job accommodations are successful, you need to communicate with anyone who will be affected by the change proposed in your workplace.

Barrier-Free Buildings

An accessible physical workplace should include:
- Sufficient designated parking spaces close to employee entrances
- Pathways free of abrupt level changes or steps
- Ramps with proper grading and handrails
- Accessible corridors to common facilities (washrooms, telephones, etc.)
- Wide doorways for wheelchairs
- Elevators with lowered control panels and raised numbers, auditory signals, doors open for sufficient length of time
- Accessible signage (print size, colours, use of symbol, raised lettering)
Visual devices on emergency alarms

The Ontario Building Code outlines minimum barrier-free standards for construction. You may wish to consult the Canadian Standards Association Guidelines for Barrier-Free Design, or your local municipal building department. Fee-for-service barrier-free design consultants can provide accessibility audits and many non-profit organizations that serve persons with disabilities offer information and advice on modifications.

Accessible Meetings and Presentations

Today's workplace is team-oriented and technology-driven. Access to information and personal interaction are essential for employees to do their jobs successfully.

When Planning your next meeting, seminar or interview, consider the following:
- meeting note-taker
- amplification devices
- sufficient time for reading handouts or completion of forms and questionnaires
- appropriate meeting venue with accessible facilities (washrooms, telephones, dining areas)
- use of visual aids in presentations (overhead projectors and presentation software that is easy to use and highly visible)
- appropriate lighting and good air quality
- sign language interpreters

A Few Words About Language

Words have power. They not only convey information, but also attitudes. The biggest barriers to full participation, identified by persons with disabilities, are negative attitudes and assumptions about their abilities and potential.

As a manager or employer, it is important that your written and verbal communications in the workplace accurately describe people with disabilities. If you are unsure about the right words to use, don't be afraid to ask someone who does know.

Some basic principles to keep in mind:
- Always put the person before the disability (use "person with disability" not "disabled person"). The word disabled is an adjective not a noun
use precise terms that convey information accurately, factually and non judgmentally ("uses a wheelchair," not "confined to a wheelchair")
- don't categorize persons with disabilities or attribute personal characteristics ("inspirational," "courageous") refer to a disability only if it is essential information
- don't confuse "handicap" and "disability" (a person is handicapped by something; a person is not handicapped)
- don't use "normal" to describe persons who do not have a disclosed disability

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Human Rights

The Ontario Human Rights Code requires that accommodations be made for persons with disabilities in order for them to perform the essential duties of a job for which they are capable. Employers in fact have a "Duty to Accommodate." The Code also provides for exceptions where "Undue Hardship" is demonstrated.

Job accommodation must respect the dignity of the person with the disability, taking into account the individual's privacy, confidentiality, comfort, autonomy and self-esteem.

What is the first step in job accommodation?

The duties and responsibilities outlined in the job description will, in most cases, assist you in determining which direction you will take in accommodating your employee. You must consider whether a specific job function can be changed in how it is performed, if any equipment or technical aids could assist in job performance, or whether a job duty can be eliminated or transferred to another employee.

Are there exceptions to the requirement for accommodation?

Yes. Current legislation recognizes that in some circumstances a person with a disability may be unable perform the essential duties of a job. However, efforts to accommodate the employee's needs must be made before any such determination is made. In instances where job accommodation constitutes "undue hardship" for the employer, job accommodation is not required. The factors that are considered in determining "undue hardship" are:

cost
outside sources of funding, if any
health and safety requirements.

What are the standards in assessing “undue hardship”?

Guidelines provided by the Ontario Human Rights Commission outline the following criteria to be used in assessing whether an employment accommodation would cause "undue hardship":

only cost and health or safety factors may be considered (business inconvenience or customer preference, for example, do not constitute undue hardship)
costs due to decreased productivity, efficiency or effectiveness can only be used if they are measurable and demonstrated to be related to a proposed accommodation
unpredictable future possibilities cannot be used to assess accommodation needs in the present (prediction's about future deterioration of a person's ability will not be accepted)

When will costs be considered?

Costs will only constitute “undue hardship” if they are:

quantifiable (speculation is not acceptable)
shown to be related to the accommodation
so substantial that they would alter the essential nature of an enterprise or affect its viability (after consideration of: increased productivity, recovery of costs, depreciation or amortization, tax deductions/grants/loans)

Health and safety risks will only be considered if the degree of risk remaining after accommodation outweighs the benefits of enhanced equality for the employee with a disability.

An accommodation may require an employer to modify or waive an existing health or safety requirement. When the Ontario Human Rights Commission considers a modification or waiver for accommodation, they look at the:

willingness of a person with a disability to assume a risk related to his or her own health or safety
risk to others from a modification or waiver in a health or safety requirement
other types of risks the employer is assuming within their enterprise
types of risks tolerated within society, in similar types of enterprises, or in the legislated standards.

Detailed information and examples can be found in the Ontario Human Rights Commission's "Guidelines for Assessing Accommodation Requirements for Persons with Disabilities" (see Reference section).

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Psychiatric Disabilities / Mental Illness

The terms psychiatric disability and mental illness encompass a range of mental health problems that may limit job performance. It should be noted that having a mental illness will not always affect a person's ability to work. While it is estimated that one in six Canadians seek help for a mental health issue at some point in their lives, only three to five per cent of the population is chronically disabled by mental illness.

Some of the more common mental illnesses include:

Depression: feeling sad or hopeless, loss of interest in activities; insomnia/fatigue; recurring thoughts of death or suicide; limited ability to think or concentrate.
Bi-Polar Affective Disorder: (also known as manic-depression) periods of severe depression followed by periods of mania; inflated self-esteem, decreased need for sleep, agitated, extremely talkative and easily distracted.
Seasonal Affective Disorder: a form of major depression related to shortened periods of daylight during the fall and winter months.
Obsessive Compulsive Disorder: recurrent and persistent ideas or impulses; repetitive and intentional behaviours which can significantly interfere with normal routines.
Panic Disorder: attacks of sudden and intense fear causing physical symptoms such as shortness of breath, dizziness, sweating, choking, nausea, chest pain, fear of dying or of doing something uncontrolled.

The complex and cyclical or episodic nature of psychiatric disabilities make generalizations difficult. In addition, a person with mental illness may have multiple impairments affecting their mental abilities or behaviour.

The social stigma and misinformation associated with mental illness and psychiatric disorders can make it very uncomfortable for an employee to disclose their disability or seek job accommodation. This can be overcome by creating a work environment that includes:

- Positive, encouraging and welcoming behaviour
- A workplace culture where differences are not viewed as negative impediments and individual strengths are recognized
- The provision of diversity training to all employees; reinforcing the message that job accomodation is not preferential treatment or special privilege

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Schizophrenia

Schizophrenia is a psychotic disorder affecting thinking, perception, mood and behaviour. It is not a "split personality," nor is it an emotional disorder.

Symptoms appear in late adolescence or early adulthood, and can include hallucinations, delusions, paranoia, high anxiety, low stress tolerance, low motivation, lack of energy, inability to feel pleasure. Schizophrenia is an "episodic" disorder where symptoms come and go.

There is no cure for schizophrenia, although one-quarter of people with schizophrenia recover completely within ten years. Medication is the common treatment for schizophrenia.

A psychotic episode may involve hospitalization. The following information has been provided by the Schizophrenia Society of Ontario on handling a crisis situation:
- remain calm showing minimal emotion
- limit distractions, speak slowly and clearly in your usual voice
- repeat questions using the same words (don't rephrase question)
- have an emergency plan in place and ready access to necessary phone numbers

Not all persons with a psychiatric disability or schizophrenia will require job accommodation. For those that do, the need will vary as the individual's condition changes. Some proven methods have included:

1. For maintaining stamina throughout the work period:

flexible scheduling; job sharing; part-time hours
work from home; self-paced workload
longer or more frequent breaks; time off for counseling
use of job coaches

2. For maintaining concentration:

provision of private work space to reduce distractions
use of white noise or environmental sound machines
use of headsets for soothing music
natural or full-spectrum lighting
break large assignments into smaller increments

3. For organization, prioritization and time management:

daily to-do lists and check-off of completed items
calendars, electronic organizers with meetings and deadlines noted
allow meetings to be taped or provide written notes of meetings

4. For maintaining effective interaction with supervisors and coworkers:

make expectations clear, in writing, including timelines and the consequences of not meeting these expectations
establish long and short-term goals
make social functions welcoming but voluntary

5. For handling stress and emotions:

give praise for good performance
allow telephone calls during work to doctors, counselors, or other support
refer to employee assistance program (if one exists)

Note: Medications commonly used for persons with serious mental illness may produce side effects which could result in tremors or drowsiness. This can affect a person's fine motor control, making it difficult to perform certain functions or operate equipment (telephones, keyboards). In such cases, the use of technical aids should be considered.

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Visual Impairment

Visual Impairment is a term that refers to conditions ranging from limited vision to zero vision. A person with a visual acuity of 20/200 is able to read a letter at twenty feet that an unimpaired person can read at two hundred feet. A person whose visual acuity measures 20/200 or less is considered legally blind. Other visually impaired individuals are able to distinguish only light or darkness, or varying patterns and shapes.

The Canadian National Institute for the Blind (CNIB) defines "registered blind" as a visual acuity with the best possible corrective lenses, 20/200 or less. (Individuals may also be classified as blind if their field of vision, or the area that they can see, is less than 20 degrees across.) Individuals with low vision who have a visual acuity that is better than 20/200 may still require adaptive aids (ie. magnifiers, large print) and are eligible to access assistance from the CNIB.

Different types of vision impairment create different challenges. An individual's accommodation requirements will depend of the type of impairment involved. It is important that the entire workplace environment, including facilities, equipment and warning systems, be assessed for accessibility and safety.

In general, access to information is the hardest barrier for workers who are blind, visually impaired or deaf and blind to overcome.

Typical modifications provided in the workplace may include:
- Vision Aids: hand held magnifiers, telescope, close circuit televisions (CCTV), large print computer programs
- Tactile devices: Braille including computerized translations, Braille printers, paperless Braille computers which are compact and highly portable
- Audible devices: voice devices for computers, calculators, watches, tape recorders
- Job coaches or specialized career counselors to assist with job orientation, training, employment support, staff awareness workshops
- Readers, guidedogs, clerical assistance

With continued advances in computerized and digital technology, it is important that devices are tailored to the specific eye condition of the individual and the job duties. The employee should be directly involved in the selection of the device and provided with an opportunity to test it before implementation. Use of a CNIB or other outside specialist should also be considered.

Tips for communicating with a person who is blind:

ask how much they can see if you're not sure
speak in a normal tone of voice
identify yourself and indicate you are addressing the person by using their name or touching their arm;
tell them when you are leaving
let the person take your arm when walking - don't pull the person by the hand
describe surroundings; point out helpful details
give clear, accurate and specific directions; don't point
if you're not sure whether the person needs assistance, ask!

Use of guide dogs:

In Ontario, legislation provides that a person who is blind and uses a guide dog has the right of entrance to any public place. In the workplace, a guide dog is trained to lie quietly in an out-of-the-way place such as under a desk or counter. If a potential hazard or undue inconvenience may result from this arrangement, the guide dog may be left in another area.

When a new employee using a guide dog starts work, it is helpful to provide both with a tour of the workplace. During this time, other employees can ask questions and be introduced.

Points to keep in mind about guide dogs:

- It is reasonable to request that the dog be on a leash or in a harness if there are safety concerns. Provide a hook or other type of anchor at the employee's workspace
- The dog's owner establishes the rules for whether the dog is "working" or "resting"
- When at work, the guide dog will wear a harnes and should not be patted, fed or distraced by others
- When the dog is at rest, ask the owners permission before patting
- Assess whether allergies or fears on the part of coworkers call for seperation or rescheduling of employees
- In meeting situations, place the person with the guide dog in a corner or at the end of the table so that the dog can rest next to the owner without getting in the way of others

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Learning Disabilities / Attention Deficit Disorder

As an employer, you may be unaware that a new or existing employee has a learning disability until they actually disclose it. Many persons with a learning disability have found ways to compensate or self accommodate since childhood.

What is a Learning Disability?

The Learning Disabilities Association of Canada defines a learning disability as "a disorder that affects a person's ability to either interpret what they see and hear or to link information from different parts of the brain." People with learning disabilities have average or above average intelligence.

Learning disabilities take several forms, some of the more commonly known being: Dyslexia (interferes with reading), Dysgraphia (difficulty with writing, including spelling, handwriting and organization of ideas), and Dyscalcula (problems with mathematics and spatial relationships).

Some of the symptoms associated with learning disabilities include:

Visual: poor memory for visual information, letter reversals in writing
Auditory problems: poor memory for spoken information, speech problems
Motor skills: poor hand-eye coordination
Organizational skills: poor ability to organize time or space
Conceptual: poor social skills and peer relations, difficulty interpreting non-verbal language correctly

Because it is a lifelong condition, persons who have a learning disability have developed a variety of ways to overcome their specific barriers. However, low self-esteem and self-confidence can be a problem - one which your workplace environment can help to overcome with positive interactions and constructive feedback. Accommodation for these disabilities is often just a matter of doing things differently.

Today, a vast array of computers and technical devices are available to assist persons with learning disabilities. Some of these devices include:

voice input and voice output computer software
sophisticated organizer systems with reminders, checklists, calendars, alarm functions, to-do-lists
tape recorders and "dictaphone" machines
computer software to scan printed text and translate into speech
white noise systems to filter out external distractions
spelling, grammar and proofreading software
spreadsheets, calculators and coloured mylar templates

Before purchasing expensive technologies, it is important to investigate all available options and involve your employee in the process including the opportunity to test any equipment before making a decision.

In addition to technical devices, there are a number of other job accommodations that can be made for persons with learning disabilities, such as:

- Allow the employee to phone, rather than write, customers and coworkers
- Reinforce verbal instructions with written information, and vice versa
- Use pictures, charts or graphic symbols to convey printed information
- Break large tasks into smaller ones; allow one task to be completed at a time
- Provide additional time or deadline extensions
- Provide specific expectations and constructive feedback; use reminder systems
- Allow other employees to provide assistance; consider formal arrangement such as mentor or peer tutor relationship

Attention-Deficit Disorder is associated with a set of symptoms that include:

difficulty sustaining attention in tasks, listening, organization
easily distracted, forgetful
excessive talking and interruption, impatient, physically restless

When considering job accommodation for an employee with Attention-Deficit Disorder, it is important that the person's strengths and positive attributes are suited to the job. Someone who is frustrated and distracted in a position with mundane, repetitive tasks will thrive in a faster-paced role with varied duties and flexibility.

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Medical Conditions or Diseases

Medical conditions, injuries or diseases can cause barriers to proper job performance. Some of the medical conditions or diseases you may encounter are:

Arthritis

Arthritis is generally defined as an inflammation of a joint or joints characterized by pain and stiffness in the affected area. There are approximately 100 inflammatory and non inflammatory diseases that affect the body's joints, connective tissue and other supporting tissues such as tendons, cartilage, blood vessels and internal organs. The most common type of arthritis is osteoarthritis which can affect any joint but most commonly the feet, knees, hips, and fingers. Rheumatoid arthritis, the second most common type, affects the entire body causing weakness, fatigue, loss of appetite, muscle pain, and weight loss.

Multiple Sclerosis

A chronic disease of the central nervous system, multiple sclerosis (MS) causes destruction of a protective coating (myelin) around nerve cells. MS is often characterized by periods of remission and progression. Symptoms include numbness in limbs, paralysis, loss of vision, fatigue, loss of coordination, muscle weakness, slurred speech, vision difficulties, bladder or bowel problems.

Cancer

Cancer is any type of malignant growth or tumour, caused by abnormal and uncontrolled cell division.

Some generalized symptoms include weight loss, fever, fatigue. Specific symptoms will vary with the particular type of cancer involved.

HIV/AIDS

HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immunodeficiency Syndrome). AIDS is the diagnosis an HIV-infected person receives after developing one of the defined AIDS illnesses. Symptoms or limitations involved from the individual's inability to resist infection are: weight loss, chronic diarrhea, sight or respiratory impairment, sensitivity to light, fatigue, cognitive or neurological limitations.

Diabetes

Diabetes is a disease occurring when the body cannot use sugar as it should for growth and energy in daily activities. Depending on the type of diabetes and progression of this disease, insulin may be required. This is a protein hormone which helps the body use blood glucose for energy. A person with diabetes may experience eye problems, kidney or cardiovascular disease, nerve damage or periodontal (gum) disease. Conditions of low blood glucose levels (hypoglycemia) may cause the person to become cranky, tired, sweaty, hungry, confused, shaky. In some instances, loss of consciousness or seizure may result. Conditions of high blood glucose levels (hyperglycemia) may result in extreme thirst, frequent urination, fatigue, blurred vision, vomiting, weight loss.

Heart Conditions

There are a number of heart conditions with causes ranging from disease, injury, birth abnormality, to lifestyle. Depending on the individual and type of heart condition, there may be no noticeable effects. Where symptoms do exist, they may include angina (chest pain radiating down left arm or into jaw), sensations (fluttering, thumping, racing), edema (swelling and fluid retention in limbs or organs), lightheadedness, breathlessness, chronic fatigue or nausea.

Back Impairment

It is estimated that more than 80% of people experience back pain during their lifetime. Back impairments account for a large percentage of workplace injuries or illnesses and compensation claims. Functional limitations caused by back pain vary among individuals and type of occupation.

Medical conditions or diseases may require accommodation on a continual basis, or at certain intervals depending upon the individual. Medications used in treatment, as well as the psychological implications of certain illnesses, need to be considered when determining the correct job accommodation.

Accommodations that could be used:

For fatigue and/or weakness: reduce or eliminate physical exertion, scheduled rest breaks away from the workstation, flexible scheduling and use of leave time, ergonomic workstation design close to necessary equipment and facilities, parking close to entrance/exit, automatic door openers, lifting aids

For respiratory difficulties: adjustable ventilation, maintain an environment free from dust/smoke/fumes, "fragrance-free" workplace policy, moderate temperature changes, use fans, ventilation systems and air conditioners

For seizures and blackouts: eliminate the need for sharp object, eliminate blinking and flickering lights, use full spectrum or natural lighting, glare guards for computer monitors, adjust colour and intensity of computer monitor, decrease cursor speed of computer mouse, allow for periodic rest breaks and flexible hours

For temperature sensitivity: use additional fan, air conditioner or heater, ability to work form home during extreme heat or cold, proper ventilation system, provide separate temperature control

For visual impairment: use of magnifiers, use of computer accessibility software, alternate formats such as graphics, voice output technology, tactile, tape recorder or reader, reduction of glare including use of special glasses, allow for frequent breaks

For motor impairment:
Fine Motor: ergonomic design, alternative computer or telephone access, arm supports, writing and grip aids, page turner and book holder, note taker
Gross Motor: parking close to entrance/exit, accessible entrance and facilities, automatic doors, appropriate desk height if wheelchair or scooter used

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Developmental Disabilities

A developmental disability affects a person's cognitive abilities and adaptive skills. This type of disability generally manifests itself before a person reaches adulthood.

Common types of developmental disabilities include:

Down Syndrome
Cerebral Palsy
Autism
Fetal Alcohol Syndrome
Intellectual functioning below a specified IQ level

The degree of intellectual or functional impairment will vary greatly among individuals from mild (the majority) to severe limitations. Cognitive limitations may include difficulty with reading, writing, mathematical calculations, sequencing, coordination, memory, balance, problem solving or social skills.

Intellectual disabilities generally require a more creative approach to accommodation as the supports required are usually in the form of people not things.

Job coaches… are commonly used to assist in the orientation and training phase of employment for persons with developmental disabilities. A job coach helps the employee master tasks, learn to use equipment, adjust to work routines, and establish relationships with supervisors and coworkers.

Natural Supports… A system of natural supports provided by supervisors and coworkers can be particularly effective for a person with a developmental disability. In addition to teaching specific job tasks, workplace supporters provide an important social link that enhances communication and interpersonal skills. The natural supports that are created in the workplace can establish a sense of permanence and consistency that is difficult to create with a job coach.

Assistive Technology… may be required for accommodation. However, because persons who have a developmental disability have a range of learning and processing abilities, these solutions must be flexible and easily customized. Cognitive limitations are often not taken into account in the design and manufacturing of assistive technology, so careful and professional assessment is advisable.

Tips for effectively communicating with a person who has developmental disability:
- speak directly to the person (don't assume a need for a support person)
- give your full attention to the person and use good eye contact
- keep language simple and concise, sentences short
- rephrase if the person doesn't understand
- ask if you don't understand

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Deaf, Deafened or Hard of Hearing

Deafness or hearing loss encompasses a wide variety of hearing ranges and challenges and communication challenges.

To be deaf means that a person is either born or becomes deaf early in childhood and is educated as a deaf child. They are unable to understand speech through the use of ears alone. They may be able to communicate in auditory/ oral or sign language. If sign language is their first language it may have an impact on their reading and writing abilities.

To be hard of hearing means that a person does not hear all frequencies. They may use hearing aids to amplify sound but they are able to hear.

To be deafened means that a person becomes deaf after they have learned language.

There are a few things you should find out before deciding on the best form of accommodation for your deaf, hard of hearing or deafened employee.

Ask them:

to explain their deafness or hearing loss
how they prefer to communicate with others (sign language, read, write, lip read, use of hearing aid or amplification device)
how noise will affect them in the workplace

The answers to these and other questions that arise related to the specific job in question, will lead to a variety of accommodations to consider. Keep in mind that some approaches may not be appropriate given the person's literacy skills. A deaf person may be perfectly fluent in sign language but may be intimidated or embarrassed when asked to demonstrate their written skills.

Typical accommodations may include any or all of the following:

- written notes, or side-by-side computer communications
- E-mail and real-time Internet chat
- assistive listening devices - amplifies without background noise
- skilled and qualified sign language interpreters
- sign language or cultural sensitivity training for coworkers and supervisors
- improved lighting for group and other interactive situations
- open captioning for training materials
- TTY - telephone communication device where conversation is typed instead of spoken (may use Bell Relay Service without cost to communicate with anyone who does not have a similar device; computers can be used with some TTYs)
- Telephone devices - amplifiers including those for headsets, sound frequency devices to increase clarity
- Voice recognition or speech-to-text software
- Alternatives to voice mail messages (written by another party, pager, telephone relay message service)
- Environmental factors (background noise reduction, appropriateand sufficient lighting, seating and positioning arrangements)

Special attention should be paid to warning and emergency alarm systems.

Accommodations for these systems include:
Visual or tactile: light signals on alarms and/or wired to individual work area, vibrating pagers tied-in to alarm system
Buddy system: use of coworker to alert employee (only with alarm system)

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Physical Disabilities

Accommodation needs for persons with physical disabilities will vary from person to person. Assistive devices such as page turners, speech recognition software, alternative keyboards, and mouth sticks are only a few of the many aids available.

Mobility and Agility

The ability to move and the speed and quality of movement can be affected by a number of conditions or disabilities. A partial list includes: amputation, heart conditions, cancer, cumulative trauma disorders (including carpel tunnel syndrome, bursitis and tendonitis), back impairments, multiple sclerosis, cerebral palsy, arthritis.

The symptoms of impairment may fluctuate, and both mental health and physical mobility or agility may be involved. It is important to understand the condition causing the limitations, and discuss with your employee what accommodations and adaptations will be useful in accomplishing job duties.

Overall accessibility in your workplace (lighting, handrails, elevators, parking, etc.) is important for an employee with a mobility or agility impairment.

Other Considerations for accommodation may include:
- flexible work schedules or reduced work hours; work from home
- periodic rest breaks; self-paced workload
- ergonomic design in workstation; employee training in ergonomic principles including proper lifting, posture and use of equipment
- alternative computer and/or telephone access
- appropriate desk and chair height with materials in easy reach
- assistive devices such as arm support, page turner, book holder, writing and grip aids, foot rests
- note takers

Obstacles may be encountered for someone using a wheelchair in their workstation area, or in traveling into the work site. An accessibility audit will uncover what can be changed or adjusted such as table heights, parking space placement, etc.

Some people who use wheelchairs will require assistance with personal care while at work. As an employer, you are not responsible to provide this personal care assistance, but you may be required to make an accommodation related to personal care needs while at work.

Examples of accommodations related to personal care are:
personal attendant present to assist person with toileting, eating, grooming
rest breaks for repositioning, toileting, grooming
flexible scheduling and use of sick leave for medical care

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Brain Injuries

A brain injury, resulting from a head injury, particularly affects the frontal and temporal lobes of the brain. The results generally include changes in thought processes, behaviour and personality. The ways in which the changes manifest themselves will depend on the person's previous personality. A person with a brain injury will often have great difficulty in seeing and accepting the changes in their thinking and behaviour.

An acquired brain injury may result in:

communication disorders (see following section on aphasia)
physical limitations
visual problems
difficulty maintaining stamina and/or concentration, staying organized
poor memory
difficulty handling stress and emotions
difficulty taking direction
impulsive behaviour

You may wish to refer to sections elsewhere in this handbook on physical disabilities and vision impairments. The following are suggestions for possible accommodations related to other challenges associated with acquired brain injuries:

Memory and concentration

reduce distractions and interruptions, provide private work area
reduce clutter
break large tasks into smaller ones
allow employee to tape record meetings or use a portable computer
utilize reminder devices: sticky notes, calendars, notebooks, checklists
provide environmental cues to assist memory (labels, colour coding, posters, sound devices)

Supervisory issues

provide feedback and positive reinforcement
ensure job instructions and expectations are clear - put in writing including consequences if expectations not met
create an open environment for communication; deal with issues as soon as possible

Issues of change

Change in the office environment can be difficult for persons with acquired brain injuries. This must be recognized and any change managed in such a way that the employee can adapt. If a change in supervisors is taking place, it is desirable to maintain communication between the employee and the former and current supervisor. Regular meetings with the supervisor may be beneficial to discuss workplace issues, duties and productivity.

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Aphasia

Damage to the left side of the brain that is responsible for language functioning can result in aphasia. It is a disturbance of speech and language abilities and is most often acquired as the result of a stroke or head injury.

Aphasia may affect any of the following areas related to language: speaking, listening and understanding, reading, writing and arithmetic abilities. The adult with aphasia usually knows what he/she wants to say but has difficulty in the organization, retrieval and expression of words and sentences.

Aphasia affects communication - it does not affect intelligence. When an adult has difficulty understanding what is said, or in producing coherent speech, it is a communication breakdown related to brain damage, not to intelligence. The ability to socialize and maintain interpersonal relationships may be affected.

Communication with a person who has aphasia is challenging.

The following general tips may be helpful:
- use a slow-normal rate of speech and normal volume
- speak face-to-face whenever possible
- use symbols, graphics, pictures, key words to get your message across
- give the person with aphasia time to respond
- allow alternatives to speech where possible - gestures, writing, partial words
- questions requiring yes answers are advisable
- recognize the isolation caused by communication difficulties and foster relationships in the workplace where appropriate

Hiring a Person with a Disability

Many organizations that serve persons with disabilities offer employment services and resources, including the posting of job vacancies.

In setting up interviews, ask candidates whether they have any special needs to be accommodated for the meeting (eg. accessible site, interpreter, additional time for any tests or questionnaires, etc.).

In order to ensure that all applicants are considered exclusively on merit, ask all job candidates the same questions including whether any accommodation is needed to carry out essential job functions. Unless an applicant raises it, save any discussion of an individual's disability-related accommodation requirements until after a conditional offer of employment has been made, preferably in writing.

As the employer, you'll be clear about your expectations and priorities. Your employees also have a responsibility to raise any problems or challenges as they arise. Together, you can work out strategies and find appropriate solutions.

References

"Guidelines for Assessing Accommodation Requirements for Persons with Disabilities," 1992, Ontario Human Rights Commission

"Barrier-Free Employers: Practical Guide for Employment Accommodation for People with Disabilities," Canadian Human Rights Commission

"A Way with Words: Guidelines and appropriate terminology for the portrayal of persons with disabilities," 1998, Office for Disability Issues, Human Resources Development Canada

Online Resources

Paths to Equal Opportunity World Wide Web site