Advancing Disability Equity in Neurology

By Seth M. Keller, MD, FAAN

The American Academy of Neurology (AAN) recently published a landmark position paper affirming its commitment to advancing health equity for individuals with neurologic conditions and disabilities. This statement reinforces the AAN’s longstanding role as an advocate—not only for its members with disabilities but, critically, for patients who experience lifelong disability, whether from birth or acquired over time.

While this announcement may not come as a surprise, it brings renewed urgency to the persistent inequities facing people with disabilities—particularly individuals with intellectual and developmental disabilities (IDD). Despite decades of advocacy, access to quality neurologic care for this population remains deeply inadequate.

The AAN position paper highlights several key issues:

- Disparities in neurologic care are perpetuated by systemic ableism and inaccessible clinical environments.
- Workforce inclusion—specifically training and hiring health professionals with disabilities—can build trust and improve care quality.
- A shift in care models is needed. Rather than relying solely on rehabilitative approaches, neurology must embrace a model that centers lived experience, dignity, and quality of life.
- Accessible clinical equipment must become the standard—not the exception—for inclusive and equitable neurological care.

AAN Issues Position Statement to Advance Disability Equity in Neurology - - PracticalNeurology

“The formation of the AAN section on IDD was a vital first step, giving us a formal platform within the organization to advocate for policy change, education, and inclusion. ”

Historically, individuals with IDD have been subjected to cultural, systemic, and institutional marginalization. The disability rights movement has worked for decades to affirm that people with disabilities are full citizens, deserving of the same opportunities, care, and respect as anyone else. These civil rights efforts, especially during the 1960s and 70s, were instrumental in shaping public policy—including the landmark Americans with Disabilities Act (ADA) of 1990.

However, while the ADA laid the groundwork for physical accessibility and inclusion, it did not mandate equitable healthcare delivery. Even today, there are no binding national standards requiring medical practices to have adaptive equipment or mandating disability-specific training in medical education. This lack of structural accountability perpetuates health disparities and reinforces a cycle of neglect.

As a physician who has dedicated my career to advancing healthcare equity for individuals with IDD, I have witnessed these challenges firsthand. I’ve had the honor of serving as a leader within the American Academy of Developmental Medicine and Dentistry (AADMD) and was proud to found the AAN's Section on Adults with Intellectual and Developmental Disabilities.

One of the most glaring gaps is the difficulty in transitioning individuals with child-onset neurologic conditions—such as epilepsy, cerebral palsy, autism, and behavioral disorders—into competent, adult-centered neurologic care. Many adult neurologists remain ill-prepared or unwilling to care for this population due to inadequate training, bias, or lack of support infrastructure.

The journey toward equity has not been linear. Progress has often been slow, with forward steps met by systemic inertia or resistance. The effort to publish this AAN position statement took years of behind-the-scenes advocacy—both from within and outside the organization. Meaningful change, especially within large institutions, requires not just vision, but sustained, coordinated strategy.

The formation of the AAN section on IDD was a vital first step, giving us a formal platform within the organization to advocate for policy change, education, and inclusion. With persistence, we’ve made real gains: educational programming at the AAN Annual Meeting, the development of disability-focused content for neurologists, and growing acknowledgment of the need for inclusive practice guidelines.

Importantly, the AAN has been able to issue this bold position without fear of political reprisal, as it is a private organization not bound by federal oversight. This independence has allowed the Academy to speak with clarity and integrity about the need for equity in neurologic care.

Still, our work is far from over. People with IDD remain one of the most underserved groups in medicine. They are diverse, vibrant, and deserving of equitable care—but by every available metric, they continue to receive less. As advocates, clinicians, and supporters, we must demand inclusion, not just in theory, but in practice.

Having a clear, public stance from a major medical society like the AAN is essential. Without it, disability-focused education and care standards will never receive the institutional backing they need to thrive. But even with this position in place, we must hold our professional organizations accountable. Statements alone are not enough—we must translate words into measurable change in care quality and access.

Together, we must continue this critical movement to ensure that every person, regardless of ability, receives the dignity, respect, and healthcare they deserve.

About the Author

Seth M. Keller, MD, FAAN is a board-certified neurologist in private practice with Neurology Associates of South Jersey. He specializes in the evaluation and care of adults with Intellectual and Developmental Disabilities (IDD) with neurologic complications. Dr. Keller is on the Executive Board of the Arc of Burlington County as well as on the board for The Arc of New Jersey Mainstreaming Medical Care Board.  Dr. Keller is the Past President of the American Academy of Developmental Medicine and Dentistry (AADMD). He is the co-president of the National Task Group on Intellectual Disabilities and Dementia Practices (NTG). He is also the founder and past chair of the Adult IDD Section with the American Academy of Neurology.  Dr. Keller is actively involved in national and international I/DD health education as a speaker and webinar and workshop participant. He is a co- author on a number of articles and book chapters relating to aging and dementia in those with IDD. Raised in Philadelphia, PA, Dr. Keller received his bachelor’s degree from Temple University, earned his medical degree from The George Washington University School of Medicine in 1989, and completed his neurology internship and residency at Bethesda Naval Hospital. He also served as a neurologist at the U.S. Naval Hospital in Okinawa, Japan.