From Awareness to Action
Building a National Movement for Disability-Inclusive Healthcare Education
By Dr. Seth Keller
Summary: This article calls for disability competency to become a core part of healthcare education. It explains how limited training contributes to communication barriers, delayed diagnoses, fragmented care, and poorer outcomes for people with disabilities, especially those with IDD. Highlighting the National Council on Disability’s 2025 framework and Project D.I.M.E., the authors urge accrediting bodies, educators, advocates, families, and policymakers to make disability-inclusive, patient-centered care a national standard.
Introduction
For decades, people with disabilities have experienced significant health disparities, poorer health outcomes, fragmented systems of care, and persistent barriers to accessing competent healthcare. While many factors contribute to these inequities, one of the most consistently identified—and most remediable—causes is the lack of disability-specific education and training across the healthcare professions.
Despite longstanding recommendations from federal agencies, disability organizations, healthcare professionals, and self-advocates, most physicians, nurses, physician assistants, nurses, therapists, dentists, psychologists, and other healthcare professionals continue to complete their training with little formal preparation in caring for people with disabilities. This educational gap affects individuals across the lifespan and is particularly evident for people with intellectual and developmental disabilities (IDD), who frequently encounter diagnostic overshadowing, communication barriers, inadequate transition planning, fragmented systems of care, and limited access to clinicians with disability expertise.
Today, however, something important is changing. Across the disability and healthcare communities, a growing coalition of organizations, educators, clinicians, researchers, self-advocates, and policymakers is increasingly recognizing that disability competency is not an optional educational enhancement—it is a core healthcare equity issue and a healthcare systems issue.
The National Council on Disability: A Federal Call for Change
Few organizations have been more consistent in highlighting the healthcare inequities experienced by people with disabilities than the National Council on Disability (NCD), the independent federal agency charged with advising Congress and the President on disability policy.
In its 2025 Framework to End Health Disparities of People with Disabilities, NCD identified comprehensive disability clinical-care curricula and disability competency training as essential healthcare equity strategies. NCD further emphasized that healthcare reform cannot succeed if clinicians are not prepared to care competently and respectfully for people with disabilities.
More recently, NCD sought public input regarding disability clinical-care education and competency training, noting that inadequate training contributes to discrimination, diagnostic overshadowing, delayed diagnoses, unsafe care, inequitable outcomes, and avoidable healthcare disparities.
The message from NCD is increasingly clear: healthcare reform without disability competency reform will leave millions of Americans behind.
Project D.I.M.E.: Moving from Recommendation to Requirement
Recognizing the urgency of this challenge, Project D.I.M.E. (Disability Inspired Medical Education) was launched as a national initiative to transform disability healthcare education. Led by Dr. Rick Rader and supported by the Orange Grove Center, Project D.I.M.E. seeks not merely to encourage disability education but to help establish disability clinical competency training as an expected and required component of healthcare professional preparation.
Project D.I.M.E. emerged from recognition that landmark reports and studies have identified the same educational deficiencies for decades. The initiative recognizes that improving healthcare outcomes ultimately requires changing healthcare education itself.
The initiative has attracted support from organizations including AADMD, disability-health leaders, educators, and advocacy organizations seeking meaningful systemic reform. Importantly, Project D.I.M.E. has helped shift the conversation from awareness toward implementation and accountability.
Why the ACGME Matters
One of the most important realities in graduate medical education is that lasting educational change often occurs only when expectations become incorporated into accreditation standards and training requirements.
The Accreditation Council for Graduate Medical Education (ACGME) serves as the primary accrediting body overseeing residency and fellowship training programs in the United States. Through its Common Program Requirements and specialty-specific requirements, the ACGME helps define what physicians are expected to learn during training and what residency programs are expected to teach.
As a result, the ACGME possesses extraordinary influence over the future direction of medical education.
When competencies are incorporated into ACGME requirements, residency programs must respond. Educational priorities change. Faculty development evolves. Curricula are created. Assessment tools emerge. Scholarly activity follows. Training programs allocate time, attention, and resources toward those competencies.
Historically, many critically important healthcare priorities—including patient safety, professionalism, communication skills, systems-based practice, health equity, quality improvement, and wellness—gained widespread implementation only after being incorporated into accreditation expectations.
Disability competency now stands at a similar crossroads.
For years, disability-health advocates have called for improved education and training. Yet many residency programs continue to provide little or no structured training related to caring for people with disabilities, particularly people with intellectual and developmental disabilities. The result is a healthcare workforce in which many clinicians feel underprepared, uncomfortable, or uncertain when caring for this population.
Importantly, this is not simply an educational inconvenience. It is a healthcare equity issue with real-world consequences affecting diagnosis, communication, treatment, access to care, patient safety, and long-term health outcomes.
The Role of the American Academy of Neurology and Emerging Interdisciplinary Advocacy
Within organized medicine, the American Academy of Neurology (AAN) has increasingly become an important voice in advancing healthcare education and advocacy related to intellectual and developmental disabilities, neurodevelopmental conditions, aging, dementia, epilepsy, and lifespan neurological care.
The AAN Section on Adults with Intellectual Disabilities, which was developed to help elevate these issues within neurology and medical education, has increasingly collaborated with additional AAN sections and interdisciplinary partners to advance disability-inclusive healthcare education and awareness.
Importantly, emerging discussions within the AAN now involve not only clinicians with expertise in IDD and neurodevelopmental disabilities, but also leaders from areas including behavioral neurology, neurogenetics, child neurology, epilepsy, ethics, education, dementia care, and healthcare equity.
These collaborations are critically important because they demonstrate that disability competency is not a niche concern isolated to one subspecialty. Rather, disability-inclusive care intersects with virtually every aspect of neurology and healthcare.
Current efforts involving AAN leaders and collaborators are exploring how a formal statement related to disability-inclusive healthcare education and competency development may help support broader national discussions involving healthcare training, graduate medical education, accreditation standards, interdisciplinary collaboration, and healthcare equity.
Importantly, the intent of any forthcoming AAN-related statement is not merely symbolic.
Rather, the goal is to help establish a practical advocacy framework that:
Encourages healthcare organizations and specialty societies to participate in disability competency advocacy.
Supports coordinated engagement with ACGME review and revision processes.
Promotes disability-inclusive educational expectations across healthcare training.
Encourages interdisciplinary collaboration across specialties and professions.
Elevates the importance of intellectual and developmental disability education within neurology and beyond.
Provides a framework other organizations can adapt, endorse, expand, or operationalize.
Helps support coalition-building efforts involving disability organizations, self-advocates, families, educators, clinicians, and healthcare systems.
Importantly, this effort recognizes that sustainable educational reform requires broad interdisciplinary engagement rather than isolated advocacy by a single organization or specialty.
The involvement of organizations such as AADMD, Project D.I.M.E., NTG, and additional healthcare and disability partners will therefore be essential moving forward.
The Importance of Upcoming ACGME Revisions and Public Comment Opportunities
As conversations continue nationally regarding disability competency, healthcare equity, communication training, and inclusive care delivery, upcoming ACGME review and revision processes may represent one of the most important opportunities in decades to influence the future of disability-inclusive healthcare education.
The ACGME periodically reviews and revises both Common Program Requirements and specialty-specific requirements. During these revision processes, public comment opportunities are often opened, allowing professional organizations, educators, advocacy groups, clinicians, self-advocates, family members, and members of the public to provide formal feedback and recommendations.
Historically, organizations that successfully mobilize coordinated advocacy efforts during these public comment periods can substantially influence the direction of educational policy.
This is why the upcoming disability competency advocacy efforts are so important.
If disability-health organizations, professional societies, self-advocates, family organizations, healthcare educators, and clinicians speak with a coordinated and unified voice, there exists a meaningful opportunity to help shape future training expectations for physicians and other healthcare professionals.
Importantly, this effort should not be viewed narrowly as simply adding another curricular burden. Rather, disability competency should be understood as foundational clinical training relevant to communication, ethics, patient-centered care, healthcare equity, professionalism, lifespan medicine, and systems-based practice.
The stakes are especially high for people with intellectual and developmental disabilities, who frequently experience fragmented healthcare systems, inadequate transition-to-adult-care preparation, insufficient clinician expertise, and diagnostic overshadowing.
The healthcare experiences of people with IDD illustrate why disability competency cannot remain optional or dependent upon isolated individual interest.
Why Intellectual and Developmental Disabilities Require Specific Attention Within the Broader Disability Movement
As national conversations regarding disability-inclusive healthcare education continue to expand, it is critically important to recognize that intellectual and developmental disabilities (IDD) possess unique clinical, communication, educational, ethical, and systems-related complexities that require specific attention and expertise.
The broader disability-rights and disability-health movements have played an essential role in advancing healthcare equity, accessibility, inclusion, and civil rights for people with disabilities. However, within these broader discussions, the experiences, and needs of people with IDD are at times insufficiently understood, generalized, or inadvertently overshadowed.
People with IDD frequently encounter healthcare challenges that differ substantially from those experienced by many other disability populations. These include communication differences, diagnostic overshadowing, cognitive and adaptive-function considerations, reliance on caregivers and support systems, complex behavioral presentations, co-occurring neurological and psychiatric conditions, syndromic disorders, transition-to-adult-care difficulties, and significant aging-related concerns, including dementia and epilepsy.
Additionally, many healthcare professionals receive little or no formal training regarding how to effectively communicate with, assess, diagnose, and support individuals with IDD across the lifespan.
The field of IDD healthcare has therefore developed important expertise that should not be lost within broader disability-health initiatives.
At the same time, this is not an argument for separation from the larger disability-rights movement. Rather, it is an argument for ensuring that IDD perspectives remain visible, represented, and appropriately integrated within broader disability-health reforms.
A Forthcoming National Call to Action
A growing coalition of disability-health advocates, clinicians, educators, organizations, and self-advocates recognizes that the time for passive awareness has passed.
In the coming months, additional opportunities for collaboration, advocacy, organizational endorsement, public comment, educational implementation, and coalition building are expected to emerge.
Importantly, forthcoming advocacy efforts related to ACGME review and revision processes may require rapid mobilization and broad interdisciplinary participation.
Organizations and individuals must therefore begin preparing now.
Future actions may include:
Coordinated organizational sign-on letters.
Public comment submissions to ACGME review processes.
Advocacy campaigns involving specialty societies and healthcare organizations.
Educational toolkits and implementation frameworks.
Coalition-building efforts across disability, healthcare, and educational communities.
Webinars, Project ECHO initiatives, conference presentations, and educational forums.
Outreach to residency directors, medical schools, nursing programs, and healthcare systems.
Development of disability competency recommendations and educational benchmarks.
Engagement of self-advocates and family organizations as equal partners.
Importantly, organizations should not wait until formal comment periods are announced to begin planning.
Healthcare organizations, professional societies, advocacy groups, residency leaders, and educational institutions should begin now by:
Identifying leadership champions.
Reviewing current disability-health educational gaps.
Building interdisciplinary partnerships.
Preparing internal advocacy strategies.
Engaging self-advocates and family leaders.
Developing organizational statements and educational priorities.
Preparing to participate in future public comment opportunities.
This effort represents more than a curricular discussion.
It represents a national opportunity to redefine what competent, equitable, inclusive healthcare education should look like for future generations of clinicians.
Conclusion
The future of disability-inclusive healthcare will not be determined by a single report, a single organization, or a single profession.
It will be determined by whether healthcare systems, educational institutions, professional organizations, self-advocates, families, and policymakers are willing to work together to ensure that every healthcare professional is prepared to provide competent, respectful, and equitable care to people with disabilities.
For people with intellectual and developmental disabilities, the stakes are extraordinarily high.
The time for awareness has passed.
The time for coordinated action has arrived.
About the Author
Seth Keller, MD
Neurologist, Neurology Associates of South Jersey
Dr. Seth Keller 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. 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 IDD 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.
References
1. National Council on Disability. Framework to End Health Disparities of People with Disabilities. 2025.
2. National Council on Disability. Disability Competency Training Request for Information. 2025.
3. Rader R. Project D.I.M.E. (Disability Inspired Medical Education). HELEN Journal. 2025.
4. Krahn GL, Walker DK, Correa-De-Araujo R. Persons With Disabilities as an Unrecognized Health Disparity Population. American Journal of Public Health. 2015;105(S2):S198-S206.
5. American College of Physicians (ACP) disability equity and healthcare disparity educational resources.
6. Journal of Graduate Medical Education (JGME) discussions and recommendations related to disability competency and healthcare equity.
7. Keller SM, Rader R, Janicki MP, Correa D, et al. Disability-inclusive healthcare education advocacy initiatives. In development.
8. Project D.I.M.E., AADMD, NTG, and associated disability-health advocacy collaborations. Ongoing initiatives.
9. American Academy of Neurology Section on Adults with Intellectual Disabilities and related interdisciplinary educational and advocacy collaborations.
Prepared as an expanded strategic HELEN Journal discussion article regarding disability-inclusive healthcare education, ACGME advocacy efforts, Project D.I.M.E., AAN collaborations, and forthcoming national coalition-building initiatives.