Decades of Progress Since the ADA
But Challenges Remain for People with Disabilities
By Jim Brett
Summary: 36 years after the Americans with Disabilities Act became law, Jim Brett reflects on the progress it helped drive in accessibility, nondiscrimination, technology, and inclusion. Innovations such as captions, screen readers, ramps, hands-free access, and emerging AI tools demonstrate how accessibility can benefit everyone.
But significant gaps remain, particularly in healthcare. Brett points to Project DIME as one effort to improve disability competency among future medical professionals and argues that continued progress depends on listening to people with disabilities, families, caregivers, and advocates as policies and technologies evolve.
It’s been 36 years since the landmark Americans with Disabilities Act (ADA) was signed into law by President George H.W. Bush on July 26, 1990.
The ADA requires that public spaces like buildings, schools and parks are made accessible for people with disabilities. The law also prohibits discrimination against people with disabilities in all aspects of living, including employment and housing.
Since its passage, we have seen significant advances.
Achieving equity via legislation was hard fought. And the work is not over. As new pressures emerge, in the areas of community support and healthcare, for example, it is more important than ever that the voices of people with disabilities be heard.
Innovation benefits all
Access requirements spark design innovation that benefits all people, including those without disabilities. Think about buildings with elevators, hands-free door opening, ramps, building alerts with lights and digital displays, to name a few.
Information is power
Information and education can be transformative, but only if you have access.
Digital access may require special software or coding solutions to help users access websites. Alternative-text makes websites ADA accessible for readers for people with visual disabilities.
Some of the technologies we use every day were initially created as tools to increase accessibility for people with disabilities.
Consider these innovations that can help all people, those with or without a disability, learn and work more efficiently: voice assistants, speech-to-text software, captions and live transcription in videoconferencing, and screen readers and high-contrast display options.
AI is part of the next generation of solutions
New multi-modal apps can use computer vision to describe surroundings and read text. The apps can also recognize facial expressions for blind individuals. We’ve also seen the development of wearables, such as AI-powered smart glasses to read or navigate signs. AI can be used to condense a complex page of online information into an audio summary. (see endnote for sources).
Stakeholders play a role in innovation
Trends in research have resulted in a significant increase in stakeholder involvement in project design. Researchers want to learn from potential users and their caregivers: Is this practical? Will you use it? How can we make this solution user friendly?
Stakeholders’ voices at work in new curriculum
About 44 million Americans are living with a disability. Yet many do not receive regular preventative healthcare or adequate attention to chronic illnesses.
Each year, more than 50,000 medical, physician assistant, and nurse practitioner students graduate in the United States. In a survey of physicians (Journal of Health Affairs, "I Am Not the Doctor for You': Physicians' Attitudes About Caring for People with Disabilities, T. Lagu et al., October 3, 2022), the majority reported they do not feel competent to care for patients with disabilities.
In fact, the 30,000 medical school students who graduate every year have typically received less than 11 minutes of clinical training in treating patients with disabilities.
Additional training may help.
Project DIME (Disability Inspired Medical Education), operating under the guidance of its director, Dr. Rick Rader, and with funding by the board of directors at the Orange Grove Center in Chattanooga, Tennessee, has a goal of mandating that all of the nation’s 200 medical schools, 500 nurse practitioner programs, and 300 physician assistant programs include clinical disability competency training in their curriculum. A crucial element is "mandating" the curriculum.
In Massachusetts, DIME’s curriculum has been implemented across all of our medical schools, and it was codified into state law in 2023. Each year, more than 1,200 medical, dental and nursing students take the six-hour course.
The curriculum is provided through The Arc’s Operation House Call and includes classroom lessons taught by parent caregivers and individuals with autism or other disabilities and a home visit where families and individuals share their experiences.
Conclusion
Being free to enjoy a high quality of life is a right of all people.
The ADA became law with broad bipartisan support. The promise of the ADA is solid. Its implementation continues to evolve in variety of programs, new ideas and technologies not even imagined in 1990.
One may be optimistic that positive change will continue.
But the spark of innovation doesn’t ignite in a silo. The work continues for advocates, family, caregivers, providers and people with disabilities who are also advocates. Service providers, stakeholders and policymakers need to understand your needs and hear your voices to do their jobs better and support improvement.
About the Author
Jim Brett is the president and CEO of The New England Council, a regional business organization. He is the former chair of the President’s Committee on People with Intellectual Disabilities and the former vice-chair of the National Council on Disability. Jim is the chair of the Massachusetts Governor’s Commission on Intellectual Disability, and also the chair of the Commission for the Protection of Persons with Disabilities. Jim’s late brother Jack was the inspiration for Jim’s work as an advocate for people with disabilities.
Sources: Texas Tech University resource library, Disability-IN, Marketing with a Conscience, Connor Bulmer, on LinkedIn.