Annex: Understanding disabilities

On this page

• Introduction
• General accessibility tips
• Vision or seeing disabilities
• Hearing disabilities
• Mobility, flexibility, and dexterity disabilities
• Pain-related disabilities
• Learning disabilities
• Developmental disabilities
• Mental health-related disabilities
• Memory disabilities

Introduction

The Accessible Canada Act (ACA) requires that you consult persons with disabilities in preparing your accessibility plans and progress reports. Approximately 6.2 million people in Canada have a disability. Understanding different types of disabilities and the barriers that persons with disabilities encounter is essential to planning and carrying out your consultations.

The ACA defines a disability as:

“any impairment, including a physical, mental, intellectual, cognitive, learning, communication or sensory impairment – or a functional limitation – whether permanent, temporary or episodic in nature, or evident or not, that, in interaction with a barrier, hinders a person’s full and equal participation in society.”

The ACA defines a barrier as:

“anything – including anything physical, architectural, technological or attitudinal, anything that is based on information or communications or anything that is the result of a policy or a practice – that hinders the full and equal participation in society of persons with an impairment, including a physical, mental, intellectual, cognitive, learning, communication or sensory impairment or a functional limitation.”

People experience their disabilities in different ways and encounter different kinds of barriers. Everyone with a disability is unique. Even people with the same type of disability may face different barriers.

Intersecting parts of a person’s identity, such as age, gender, race, and socio-economic status, can affect the way people interact with their environments and the barriers they face. As a result, what is accessible for one person may not be accessible for all. Read more about this in the annex on intersectional and cultural considerations.

People can have more than one disability. For example, a person with a mobility disability can also have learning and vison disabilities. Some accessibility factors and tips under each category of disability may overlap and apply to more than one category.

Disabilities can be permanent or temporary. They can also be episodic, which means they fluctuate over time. Some disabilities are visible, while others are invisible or hidden. Many disabilities have symptoms that range from very mild to very severe.

Disabilities can be congenital, which means people are born with them. People can also develop disabilities due to illnesses or injuries. Most people will have a disability at some point in their lives.

Society’s understanding of disability has evolved over time. Historically, disability has been viewed as a medical problem that needs to be cured. The medical model of disability focuses on labelling and treating people’s symptoms.

The ACA takes a different approach. It reflects a social model of disability by focusing instead on removing and preventing barriers that limit people’s participation in society.

When planning and carrying out your consultations, try to focus on the barriers people may face instead of on people’s medical diagnoses. If you are not sure about a person’s accessibility needs, the best thing to do is ask them.

The 2017 Canadian Survey on Disability identified ten types of disabilities:

• vision (or seeing)
• hearing
• mobility
• flexibility
• dexterity
• pain-related
• learning
• developmental
• mental health-related
• memory

This annex gives an overview of these categories. It includes tips, recommendations, best practices, and links to additional resources.

Disclaimer

This annex includes links to some Government of Canada and other resources that provide useful tips and information relating to different disabilities. By providing links, Employment and Social Development Canada (ESDC) is pointing to possibly helpful information, but not endorsing it. Consult the Canada.ca terms and conditions for more about links to non-Government of Canada resources.

Remember: These categories and tips are not exhaustive. This annex is only a starting point. You should always be open to learning from people’s lived experience and feedback.

General accessibility tips

This section gives an overview of general accessibility tips that are applicable to all or many persons with disabilities and their needs.

Interacting with people

• Be respectful and flexible, and adapt to people’s needs
• Do not make assumptions or judgments about people’s disabilities or accessibility needs
• If a person is wearing a lanyard or badge with a sunflower on it, this may indicate that they have a hidden or invisible disability
• Do not touch someone without their permission
• Do not touch or push someone’s wheelchair, walker, cane, or other mobility aid without asking
• When greeting someone, ask permission before trying to shake their hand
• Offer assistance, and wait for permission before acting
  • for example, ask “how can I help?” or “can I carry your bag?” rather than “do you need help?”
• When speaking with someone in a wheelchair or other mobility aid, consider sitting down to be at their eye level

Communicating with people

• Speak slowly enough that interpreters can understand you
• Speak clearly and in a loud voice, but do not shout
• Hire interpreters to provide information in sign language
  • These sign languages most commonly include American Sign Language (ASL), la langue des signes québécoise (LSQ) and Indigenous sign languages
    • The ACA recognizes these as the primary languages for communication by deaf persons in Canada
  • Make sure you book interpreters well in advance of any event (at least 4 to 8 weeks ahead of time)
    • Interpreters are in high demand, and their presence is required for some people to be able to participate in your consultations
  • Provide interpreters with information and other meeting materials in advance to help them prepare
  • You will likely have to hire at least two interpreters for each sign language
    • This allows the interpreters to take breaks and assist each other
• Look at the person to whom you are speaking
  • Address the person directly rather than their interpreter
• Do not look down, turn sideways, or turn your back to the person when you speak
• Hire a Communication Access Realtime Translation (CART) provider to produce captions
• If you are uncertain about what someone says or means, be patient and take the time to ask for clarifications

Managing events

• Ask participants how staff and presenters can be mindful of their needs
  • for example, by avoiding certain sights, sounds, or activities
  • ensure these questions are respectful; do not ask unnecessarily specific or invasive questions
  • respect participants’ privacy if they disclose personal information
• Ask staff and participants not to wear and perfumes or scented lotions to assist persons with multiple chemical sensitivities
• Ask speakers to say their names so that everyone knows who is speaking
• Ask people to introduce themselves when they enter a room, or when they join a table or discussion

Training

• Ensure that organizers and staff receive proper training on interacting with and assisting persons with diverse types of disabilities
• Consider organizers and staff receive training on sighted guide technique. Learning the basic technique will be useful to assist navigating persons with seeing disabilities

Wayfinding and navigation

• Let people tell you if they need assistance getting around
  • Some people prefer spoken directions, while others prefer being guided by putting their hand on someone’s arm or shoulder
• Do not touch someone without their permission
• Provide directions to areas in different ways
  • For example, directions given through signs, images or maps could be repeated out loud or in a video recording
• Make sure there are no objects (tables, chairs, etc.) blocking pathways
• Make sure pathways are wide enough for people with guide or service dogs, and people who use mobility aids like walkers and wheelchairs

Support persons, attendants, or companions

• Some people may attend your events with a support worker, attendant, intervener, or companion
• Ensure that tables, seating areas, and breakout room spaces will have enough room to accommodate them
• Provide a designated and private space for medical and personal care
• Ensure washrooms are large enough to enable private provision of care by a worker or support person
  • If possible, ensure washrooms include adult-sized changing tables
• Unless they instruct you otherwise, speak directly to the participant rather than to their companion

Guide and service dogs

• Do not interact with guide or service dogs unless the handler asks you to
  • Avoid eye contact with the dogs
  • Do not talk to, pet, or feed them
• Be ready to give the handler directions to nearby toilet areas or sources of water
• Clearly designate a lawn or relief area for dogs
• Clearly designate an area with water bowls and feeding space
• Leave space at tables for dogs to sit or lie comfortably next to their handlers
• Seat people with guide or service dogs away from high-traffic areas or loud speakers

Materials, documents, and information

• Alternate formats:
  • ask participants what types of alternate formats they require
  • provide consultation materials, documents and information in alternate formats like large print, braille, and audio
  • leave yourself extra time to produce documents in alternate formats
• Screen readers and assistive devices:
  • make sure materials can be read with screen readers and other assistive devices
  • test materials in advance to make sure they are accessible
• Colours:
  • use high contrasts between text and background colours (example: black text on a white background)
  • do not rely only on colours to highlight or emphasize information (example: highlighting an important detail in red)
• Fonts:
  • use fonts that do not have serifs, such as Arial or Calibri
    • serifs are decorative hooks, tips, and other features that are difficult to read for some people, screen readers, and assistive devises
• Images and tables:
  • ensure all images, tables, or other visual representations of information include alternative text (alt-text) or captions explaining their content and significance
  • ask presenters to describe images and other visual content they share on their screens or in their slides
• Submissions:
  • be flexible, when necessary, and adjust deadlines for when participants must submit comments, surveys, or other contributions
  • be flexible as well in allowing participants to contribute input in other formats than you have planned
    • for example: allow a participant to submit a recorded verbal response to a written survey, or a written response to a verbal discussion prompt
  • offer help or extra time for participants to complete forms, understand instructions, or make decisions

Emergency response plans

• Include people with different types of disabilities in developing your emergency response plans
• Read the guidance module on emergency planning for in-person consultations
• Creating an accessible emergency response plan: guidelines for federally regulated organizations (Accessibility Standards Canada)

Additional resources

• Government of Canada
  • Guide to planning inclusive meetings (ESDC)
  • Making communications accessible in the Government of Canada (Treasury Board Secretariat)
  • Accessible communication during COVID-19 and other emergencies: a guideline for persons with disabilities (Accessibility Standards Canada)
  • CART services and sign language interpreters (IT Accessibility Office)
  • Designing accessible documents and web pages (Digital Accessibility Toolkit)
  • How to create accessible documents in Office 365 (Digital Accessibility Toolkit)
  • How to create accessible documents in Office 2016 (Digital Accessibility Toolkit)
  • How to make accessible digital forms (Digital Accessibility Toolkit)
  • Designing accessible images (IT Accessibility Office)
  • A way with words and images: suggestions for the portrayal of people with disabilities (ESDC)
  • Best practices for interacting with persons with disabilities: a guide (Canadian Transportation Agency [CTA])
  • Traveling with a support person (CTA)
  • Traveling with service dogs (CTA)
  • Environmental sensitivities – How to determine and implement assessment accommodations (Public Service Commission)
• External
  • Guide to accessible public engagement (PDF file; Ontario Municipal Social Services Association)
  • Guide to conducting accessible meetings (PDF file; Ontario Municipal Social Services Association)
  • Guidelines for effective consultation with people with disabilities (National Disability Authority; Ireland)
  • A guide to community engagement with people with disabilities (NZ)
  • Checklist for accessible events (University of British Columbia Equity and Inclusion Office)
  • How to make your virtual meetings and events accessible to the disability community (Rooted in Rights; US)
  • What is universal design? (National Disability Authority Centre for Excellence in Universal Design; Ireland)
  • The Sunflower is for people with non-visible disabilities (Hidden Disabilities Sunflower Scheme; UK)
  • Disability considerations during the COVID-19 outbreak (World Health Organization)

Vision or seeing disabilities

More than 1.5 million people in Canada have a vision or seeing disability.

These disabilities affect how well a person sees, or whether they see at all. Some people with vision disabilities may also have difficulty in how they see things like light, colour, distance, or texture.

Common types of seeing disabilities include:

• blindness
  • blindness covers a spectrum of visual impairments that range from partially sighted or low vision to legal or total blindness
  • many people who are blind have some degree of vision
• low vision or partially sighted
  • people with a visual impairment but who have some degree of vision
  • they may be able to read print with accommodations like magnifiers, large print, or other adaptive technology
• legal blindness
  • a person who has 20/200 vision or less, or who has a visual field (peripheral vision) of 20 degrees or less, even when wearing glasses or contact lenses
  • they may have some vision, but it may be blurry, narrow, or have blind spots
  • limits some activities like driving and can determine eligibility for disability-related government programs and benefits
• deafblindness
  • a combination of hearing and vision loss
• other vision disabilities
  • people can have difficulty adapting to changes in light
  • people can have limited vision in one or both eyes, which can affect their depth perception or focus
  • colour-blindness affects the way a person sees color or differences in color

Here are some things to consider for your accessible consultations:

• in-person consultations
  • provide directions to areas in different ways other than printed signs, images, or maps
  • check if you can install guidance beacons at the venue
    • beacons are remote transmitting devices that can link to smartphones or other devices
    • you can program beacons to communicate environmental details like distances, directions, or nearby features
• virtual, digital, or other types of consultations
  • use fonts that are clear and do not have serifs, such as Arial or Calibri, for web pages and electronic documents
    • screen readers and other assistive devices can properly read these fonts
  • consider providing audio versions of web pages and electronic documents
  • whenever possible, limit the use of images, tables, or other visual representations of information
  • ensure any images, tables, or other visual representations of information include alternative text (alt-text) or captions explaining their contents and significance
  • ensure there is a strong colour contrast between the text and the backgrounds of your web pages and electronic documents, such as black text on a white background
  • adjust any deadlines for digital or mail submissions from participants
    • this will allow extra time for you to produce materials for participants in other accessible formats
  • try to find ways to make virtual consultations on platforms like Zoom or Microsoft Teams more accessible and welcoming to persons with seeing disabilities
    • presenters could provide brief descriptions of what appears on the screen in addition to speaking about the content

Additional resources

• Government of Canada
  • Designing documents and web pages for users with low vision (PDF) (Shared Services Canada)
  • Designing documents and web pages for users of screen readers (PDF) (Shared Services Canada)
  • Federal Identity Program Manual: Tactile Signage (Treasury Board Secretariat)
  • Bank note resources for the blind and partially sighted (Bank of Canada)
• External
  • What is blindness? (The Canadian National Institute for the Blind Foundation [CNIB])
  • Common eye conditions (CNIB)
  • Clearing our path: creating accessible environments for people with vision disabilities (CNIB)
  • Learn about braille (Braille Literacy Canada)
  • Accessible product and website design tips (Royal National Institute of Blind People; UK)
  • The DAISY Consortium
    • the Digital Access Information System is a common format for audio books and documents

Hearing disabilities

More than 1.3 million people in Canada have a hearing disability.

These disabilities affect how well a person hears, or whether they hear at all. Some people with hearing disabilities have difficulty hearing when there is background noise or multiple sources of sound or speech.

Common types of hearing disabilities include:

• deafness
  • deaf people typically cannot hear or have very limited hearing
  • capitalizing the letter “D” in Deaf recognizes that Deaf communities have their own cultures, languages, histories, and values
    • many persons who are Deaf use sign language as their first language
    • in Canada, the most common sign languages are American Sign Language (ASL) and la langue des signes québécoise (LSQ)
    • some Indigenous People use Plains Sign Language (PSL), Inuit Sign Language (IUR), or other Indigenous sign languages
• deafened
  • people who are deafened experience hearing loss after having been able to hear and speak
• hard of hearing
  • people who are hard of hearing have hearing loss that can range from mild to severe
• oral deaf
  • people who are deaf and whose method of communication is a mix of verbal, auditory, and lip-reading

Some things to consider as you plan your accessible consultations:

• in-person consultations
  • hire interpreters to provide information in ASL, LSQ, or other sign languages that participants use to communicate
    • review the general tips section on interpreters for more information
  • provide closed captioning for videos and slide shows
  • provide important information through multiple means, not only through spoken word
  • ensure that your venue has appropriately bright lighting for people who rely on lip-reading or sign language
  • consider offering participants assistive listening devices
    • this could include personal microphones that amplify sound or devices that use FM radio frequencies to broadcast directly to listeners
    • many of these devices can work with participants’ hearing aids, cochlear implants, or headsets
  • if your event includes small-group discussions or breakout sessions, remember that interpreters may have to be present at each session or discussion
  • eliminate distractions, such as:
    • background noise like music or equipment sounds
      • this may be a barrier to participants who have difficulty hearing or concentrating
    • animated displays, flashing or dimming lights, or bright windows behind speakers
      • these may be barriers to participants who need to focus on interpreters, captions, or speakers’ lips
• virtual, digital, or other types of consultations
  • hire interpreters to provide information in ASL, LSQ or other sign languages that participants use to communicate
    • conduct a test session with your video-conference platform in advance
      • this will help ensure that interpreters can log in correctly and organizers can pin or highlight interpreters’ video windows for participants
  • provide closed captioning for videos and slide shows
  • cameras should be on, and should focus on the presenter’s face to allow people to read lips
  • evaluate the potential limits of your video-conference platform’s accessibility
    • some software may not allow you to share documents on screen while you “pin” an interpreter’s screen
    • consider sending accessible files to participants in advance and asking them to view the documents on their own monitors rather than a shared screen
    • some video-conference software may provide real-time captions by default, but these captions may not always be accurate or accurate in all languages
    • ensure that you hire CART (Communication Access Real-time Translation) services to provide captions
  • during or after the presentation, ask an organizer to read aloud any questions and comments sent through the virtual platform’s chat feature
    • interpreters will then be able to sign them, allowing everyone to focus on the questions and comments at the same time

Additional resources

• Government of Canada
  • CART services and sign language interpreters (IT Accessibility Office)
  • Designing documents and web pages for users who are deaf or hard of hearing (PDF) (Shared Services Canada)
  • Learning about ASL, LSQ, and Indigenous sign languages (Translation Bureau)
  • Video Relay Service (VRS) (Canadian Radio-television and Telecommunications Commission [CRTC])
• External
  • Hearing disability terminology (Canadian Association of the Deaf)
  • Virtual meeting platform accessibility guide (Canadian Hard of Hearing Association)
  • Western Canadian Centre for Deaf Studies resources and toolkits (University of Alberta)
  • What is deaf culture? (Canadian Cultural Society of the Deaf)

Mobility, flexibility, and dexterity disabilities

Although people with mobility, flexibility, and dexterity disabilities may face different barriers, they can benefit from many of the same accessibility features. For example, ensuring that your meeting space has an automatic door can benefit people who:

• use wheelchairs, walkers, or other mobility aids
• do not have a full range of arm motion
• cannot grip or turn a door handle
• are accompanied by a guide or service dog

The recommendations below reflect this overlap. Remember to always ask each person about their needs and preferences.

Nearly 2.7 million people in Canada have a mobility disability. This type of disability affects people’s ability to move around, including walking or using stairs. Some people with mobility disabilities cannot walk at all, while others can only walk certain distances. Some people need to use aids like canes, crutches, wheelchairs, or scooters.

About 2.8 million people in Canada have a flexibility disability. This type of disability can affect people’s ability to bend over and pick things up, or reach out or upwards. Some flexibility disabilities can also affect how long a person can stand for.

Nearly 1.3 million people in Canada have a dexterity disability. This type of disability can affect people’s ability to use their fingers, wrists, or other extremities, and the way they use objects like pens and keyboards. Dexterity disabilities can also affect people’s ability to turn doorknobs, push buttons, and operate devices. They can also affect people’s sensitivity to temperatures and textures.

Remember that many mobility, flexibility, or dexterity disabilities are invisible or hidden. Some people may use assistive devices or mobility aids that are not immediately visible, such as back or leg braces. Other people may not use assistive devices or mobility aids at all. In some cases, functional limitations to movement will depend on how long someone must stand or how far they must walk.

Some common types of mobility, flexibility, and dexterity disabilities include:

• amputations and limb differences (arms, legs, fingers, toes)
  • people can be born without limbs or with differently formed limbs, or they can have limbs surgically removed
  • many people use prosthetics (artificial limbs) and devices to help them with daily activities
• cerebral palsy
  • affects a person’s ability to move and maintain their balance and posture
  • can cause stiff (spastic) muscles, uncontrollable movements, and poor balance and coordination
  • symptoms can range from mild to severe
• multiple sclerosis (MS)
  • affects a person’s central nervous system (brain and spinal cord)
  • often causes muscle weakness and difficulty with balance and coordination
• Parkinson’s disease
  • can affect a person’s ability to walk and talk, as well as their balance and coordination
  • people with Parkinson’s may experience shaking, stiffness, and rigid muscles
• spinal cord injuries
  • can affect a person’s ability to move, as well as their strength and sensation

When planning your accessible consultations, you should consider the following:

• in-person consultations
  • assessing the venue’s accessibility to determine whether or not:
    • it is accessible by public transport, including paratransit, and transit stops are near the event entrance
    • there are accessible, reserved parking spaces for persons with disabilities near the event entrance
    • there are curb cuts on sidewalks leading to the event entrance and ramps leading to external doors
    • there are elevators with interior handrails and seating available in waiting areas by their doors
    • external and internal doors are motion-activated or have electronic push-plates
    • non-automatic doors have lever doorknobs that people press
      • round doorknobs can be difficult for some people to turn
    • external and internal doors are at least one metre wide
      • this accommodates people who use mobility aids such as wheelchairs and walkers, and people with different gaits
    • hallways are wide and clear of obstacles, with corner mirrors to help prevent collisions
    • restrooms have accessible entrances and features, including:
      • motion-activated sinks and soap dispensers
      • bathroom stalls that can accommodate wheelchairs
      • handrails in accessible stalls
  • arranging tables and meeting spaces
    • leave enough space between tables, including wide pathways for people who use mobility aids or who have different gaits
    • participants with mobility aids should be able to join without having to move chairs or feel crowded
    • offer participants the option to stand or sit
    • ensure there are extra seats for participants’ attendants, companions, or personal support workers
    • provide seating options or rest areas along pathways or on stair landings, if feasible
  • avoid in-person tasks that some people may find difficult or impossible, such as tasks that require:
    • moving around the room
    • standing and sitting repeatedly
    • walking or standing for more than a few minutes at a time
    • raising or lowering hands
    • other bodily motions
  • take people’s needs into account when scheduling events
    • take regular 15-30-minute breaks
    • take lunch breaks of up to 90 minutes to allow more time to eat, rest, or use the restroom
    • avoid scheduling events early in the morning or in the evening
    • consider serving meals or snacks at tables, as buffets can create barriers
    • avoid scheduling events in locations that are far apart, or that will require participants to walk or take stairs without rest areas nearby
• virtual, digital, or other types of consultations
  • provide extra time for people to prepare and submit materials
  • ensure that web platforms allow participants to extend or cancel “time out” features (for example, webpages that log out after a period of inactivity)
  • give participants the option to speak rather than using the “raise hand” feature or typing in the chat box in video-conference platforms

Additional resources

• Government of Canada
  • Designing documents and web pages for users with physical or motor disabilities (PDF) (Shared Services Canada)
  • Multiple Sclerosis (Public Health Agency of Canada [PHAC])
  • Parkinsonism in Canada, including Parkinson’s disease (PHAC)
• External
  • What is cerebral palsy? (Cerebral Palsy Canada Network)
  • Living with amputation (The War Amputations of Canada [War Amps])
  • About multiple sclerosis (MS Society of Canada)
  • Understanding Parkinson’s (Parkinson Canada)
  • About spinal cord injury (Spinal Cord Injury Canada)
  • Hidden mobility disability challenges (Hidden Mobility Disabilities Alliance, Canada)

Pain-related disabilities

More than 4 million people in Canada have a pain-related disability. This represents nearly two-thirds of people with disabilities in Canada.

Some people experience pain all the time. Other people’s pain is episodic, which means it fluctuates over time, sometimes unpredictably. Pain can disrupt people’s daily activities. Some people manage their pain with medication or therapy, but this does not always make their pain disappear. Not all types of pain are treatable.

Many pain-related disabilities are invisible or hidden. Common types of pain-related disabilities include:

• arthritis
  • swelling of a person’s joints that causes pain and stiffness, and affects their ability to move
  • often affects people’s hips, knees, spines or fingers, but can affect almost any part of the body
  • symptoms can range from mild to severe
• dorsopathy (back pain)
  • diseases that affect the spine
  • can cause back and neck pain, and difficulty moving, standing, or resting comfortably
• sickle cell disease
  • a hereditary blood disorder that can impair blood flow, causing strokes, lung disease, and organ damage
  • symptoms include anemia, fatigue, pain, swelling, infections and vision problems
• traumatic injuries
  • sudden and severe injuries, including brain injuries and spinal cord injuries, occurring during incidents such as car accidents or falls
  • can cause long-lasting or permanent physical and psychological pain, as well as other impairments
• migraines
  • strong or intense headaches that often include nausea, vomiting and sensitivity to light

Here are some things to consider for your accessible consultations:

• in-person consultations
  • provide comfortable seating, and allow participants to sit or stand if they need to
  • schedule regular breaks of at least 15-30 minutes
  • adjust light and seating arrangements as necessary
  • limit loud noises
  • limit or prohibit smells such as perfumes or scented lotions
  • ask permission before shaking people’s hands, as this could cause pain
  • some participants may need to treat or deal with their pain during events
    • ask participants if they need any accessibility measures when they register for events
    • tell participants they can take breaks or skip certain activities if they need to
    • offer other ways for people to participate and allow people to submit comments or other materials later on, if necessary
    • ensure staff can offer respectful and empathetic assistance
  • consider setting aside a quiet, private room so that participants can:
    • take medication
    • stretch or do other therapeutic movements
    • sit quietly
    • have a break from sounds, lights, and movement
• virtual, digital, or other types of consultations
  • provide extra time for people to prepare and submit materials
  • ensure that web platforms allow participants to extend or cancel “time out” features (for example, webpages that log out after a period of inactivity)
  • offer participants the option of speaking rather than using the “raise hand” feature or typing in the chat box when using video-conference platforms

Additional tips:

• do not make assumptions or pass judgment about the nature or severity of someone’s pain, or about how they treat or cope with their pain
  • even severe pain or discomfort may not be visible or obvious
  • trust what participants tell you about how they are feeling

Additional resources

• Government of Canada
  • Arthritis (PHAC)
  • Stroke (PHAC)
  • Prevalence of migraine in the Canadian household population (Statistics Canada)
  • Chronic pain (PHAC)
• External
  • ABC of sickle cell disease (Sickle Cell Awareness Group of Ontario)
  • What is an acquired brain injury? (Brain Injury Canada)
  • Disability and migraine (Migraine Canada)
  • Managing chronic pain (Arthritis Society, Canada)

Learning disabilities

About 1.1 million people in Canada have a learning disability. Some learning disabilities make it difficult for people to learn, read, or process information. Some also involve difficulty with writing, organization and time management. Most learning disabilities are invisible or hidden.

Common types of learning disabilities include:

• attention deficit / hyperactivity disorder (ADHD)
  • affects a person’s concentration and behaviour
  • different types of ADHD can cause difficulty with:
    • staying focused and paying attention
    • controlling impulses
    • sitting or standing still
    • staying organized or sticking to schedules
  • common varieties of ADHD include:
    • inattentive type
      • note: while the name is less common now, some participants may refer to inattentive type ADHD as attention deficit disorder, or ADD
    • hyperactive / impulsive type
    • combined type
• dyscalculia
  • affects a person’s ability to understand numbers and do math calculations
• dyslexia
  • affects a person’s ability to read written language accurately and fluently
  • may cause difficulty with spelling, word order, and comprehension
• executive function disorders
  • can affect how a person plans, solves problems, or adapts their thinking
  • can sometimes overlap with anxiety, depression, or other conditions related to memory or mental health

Here are some things to consider for your accessible consultations:

• in-person consultations
  • reduce auditory distractions like background noise, music, or equipment sounds
  • reduce visual distractions like animated displays, flashing or dimming lights, or bright windows behind speakers
  • provide information in simple, clear, and concise language
  • provide information in alternate formats like large print, high colour contrast, or audio
  • allow participants to submit materials in different formats, such as:
    • providing comments verbally, in writing, or through a scribe or stenographer
    • typing answers to surveys, questionnaires, or other documents
  • provide a quiet and darker space for people to use if they need it
  • schedule regular breaks of at least 15-30 minutes throughout the event
  • reduce communication barriers by ensuring that organizers, staff, and presenters:
    • speak at a steady pace
    • speak in clear, short sentences
    • avoid using jargon or acronyms
• virtual, digital, or other types of consultations
  • organize web page content in a predictable and consistent way
  • avoid using acronyms
  • consider ways to make video conferences more welcoming to participants with learning disabilities
    • allow participants to keep their cameras off, if they prefer
    • do not draw attention to participants’ behaviour, or mistake certain actions as signs of disrespect, such as when participants:
      • look away
      • do things with their hands
      • perform other tasks during the event
  • participants’ comments, forum posts, or other written content may not always use proper grammar, spelling, or formatting
  • if web pages include lists or tables of numbers or data, include written or other alternate descriptions of their meaning

Additional tips:

• remember that learning disabilities do not necessarily affect people’s cognition or intelligence
• persons with learning disabilities may need to do things that could be misunderstood as signs of disrespect or disinterest, such as:
  • looking away from the speaker
  • moving, fidgeting, or occupying their hands
  • moving around the room rather than staying in their seat
  • speaking, moving, or leaving abruptly
  • arriving late for events or not bringing the necessary materials

Additional resources

• Government of Canada
  • Attention Deficit Hyperactivity Disorder – How to determine and implement assessment accommodations (Public Service Commission)
  • Learning disabilities – How to determine and implement assessment accommodations (Public Service Commission)
• External
  • ADHD symptoms, impairments and accommodations in a work environment (PDF file; Centre for ADHD Awareness, Canada)
  • Dyslexia basics (Dyslexia Canada)
  • What is dyscalculia? (The Dyslexia Association; UK)
  • Learning disabilities basics (Learning Disabilities Association of Canada)

Developmental disabilities

More than 315,000 people in Canada have a developmental disability. People with developmental disabilities may have difficulty communicating or understanding written or spoken language. Some people may have difficulties with learning, reasoning, decision-making, or problem-solving. Developmental disabilities sometimes overlap with learning disabilities. Some developmental disabilities are invisible or hidden.

Common types of developmental disabilities include:

• autism spectrum disorder (ASD)
  • can affect how a person interacts with others, communicates, behaves, and learns
  • covers a wide range of symptoms, skills, and levels of disability, including difficulties with things like processing sensory input (sounds, smells, touch, etc.), processing emotions, adapting to change, and making eye contact
• Down syndrome
  • can cause cognitive impairment (intellectual disability) and delays or differences in speech and motor skills
  • can also cause health issues such as heart and gastrointestinal disorders
• fetal alcohol spectrum disorders (FASD)
  • can cause cognitive impairment (intellectual disability) and difficulties with learning, memory, behaviour, reasoning, and judgment
  • can also cause physical issues such as joint pain and delays or differences in growth
• epilepsy
  • can cause sudden, recurrent episodes of sensory disturbance, loss of consciousness or convulsions (also known as seizures)
  • not all persons with epilepsy experience the same symptoms, including the types of seizures they may have

Here are some things to consider for your accessible consultations:

• in-person consultations
  • reduce auditory distractions like background noise, music, or equipment sounds
  • reduce visual distractions like animated displays, flashing or dimming lights, or bright windows behind speakers
  • some people with developmental disabilities may attend your event with a support person, assistant, intervener, or companion
    • ensure that rooms (including breakout rooms), tables, and seating areas have enough space to accommodate them
    • speak directly to participants rather than to their support persons, unless a participant requests otherwise
  • reduce communication barriers by ensuring that organizers, staff, and presenters:
    • speak at a steady pace
    • use clear, short sentences
    • avoid using words or phrases that have multiple meanings
    • avoid using sarcasm, irony, or figures of speech
    • avoid using jargon or acronyms
  • hire a Communication Access Realtime Translation (CART) provider to produce captions
  • schedule frequent breaks
• virtual, digital, or other types of consultations
  • if participants must register to use digital platforms, ask if they also need access for their assistants or companions
  • if participants request it, allow their assistants or companions to submit materials on their behalf
  • ensure that moderators and event supervisors keep track of and properly identify participants’ assistants and companions

Additional resources

• Government of Canada
  • Autism Spectrum Disorder (ASD) therapies and supports (PHAC)
  • Fetal alcohol spectrum disorder (PHAC)
  • Designing documents and web pages for users with cognitive disabilities (PDF) (Shared Services Canada)
  • Designing documents and web pages for users on the autism spectrum (PDF) (Shared Services Canada)
  • Epilepsy in Canada (PHAC)
  • Developmental disabilities in Canada (PHAC)
• External
  • About Down Syndrome (Canadian Down Syndrome Society)
  • Fetal Alcohol Spectrum Disorders (Centre for Addiction and Mental Health, Canada)
  • WHO information kit on epilepsy (World Health Organization)

Mental health-related disabilities

More than 2 million people in Canada have a mental health-related disability. These disabilities are sometimes called psychosocial disabilities.

People with mental health disabilities may experience and manage emotions, thoughts, and sensations in different ways. Many mental health disabilities are invisible or hidden. They can affect a person’s mood, energy levels, thinking, and physical health.

Common types of mental health-related disabilities include:

• anxiety disorders
  • examples include panic disorder (panic attacks), generalized anxiety disorder, and obsessive-compulsive disorder (OCD)
  • can be chronic or episodic, and can cause physical distress, including difficulty breathing or processing sensory information
  • certain sights, sounds, or experiences may trigger anxiety episodes or attacks
• bipolar disorder
  • causes intense mood swings that include emotional highs (mania) and lows (depression)
  • during manic episodes, people may experience racing thoughts, increased energy, and decreased desire for sleep
• depression
  • common symptoms include intense sadness, feelings of hopelessness or worthlessness, loss of interest or pleasure in activities, sleep disturbances or fatigue, and difficulty concentrating
• post-traumatic stress disorder (PTSD)
  • can occur after a person experiences or witnesses a traumatic event
  • can cause nightmares, distressing thoughts, or flashbacks, and cause people to avoid certain places or things
  • certain sights, sounds, or experiences may trigger anxiety attacks
• schizophrenia
  • can cause a person to experience and interpret reality differently
  • can cause psychotic symptoms such as:
    • hallucinations (hearing voices or seeing things that are not there)
    • delusions (strong beliefs that are not supported by facts, such as paranoia)
    • disorganized or unusual thinking, behaviour or speech

Here are some things to consider for your accessible consultations:

• in-person consultations
  • privately ask participants how staff and presenters can be mindful of their needs
  • avoid sudden noises, changes in lighting, or other things that could trigger anxiety
  • reduce auditory distractions like background noise, music, or equipment sounds
  • reduce visual distractions like animated displays, flashing or dimming lights, or bright windows behind speakers
  • consider setting aside a quiet, private room so that participants can:
    • take medication
    • stretch or move around
    • sit quietly
    • have a break from sound, light, and movement
  • avoid scheduling in-person events early in the morning or late in the evening
    • people may experience difficulties with sleep, energy, or mood
• virtual, digital, or other types of consultations
  • take the same accessibility factors into account as you would for participants who have learning or developmental disabilities
  • organize web page content in a predictable and consistent way
  • consider ways to make video conferences more welcoming to participants with mental health-related disabilities
    • allow participants to keep their cameras off, if they prefer
    • remember not to draw attention to participants’ behaviour, or to mistake certain actions for signs of disrespect; this might include when participants:
      • choose to look away
      • keep their hands occupied
      • perform other tasks while the event is in session

Additional resources

• Government of Canada
  • Mood and anxiety disorders in Canada (PHAC)
  • Anxiety disorders (PHAC)
  • Mental illness (PHAC)
  • Depression (PHAC)
  • Bipolar disorder (PHAC)
  • Schizophrenia (PHAC)
• External
  • Mental health first aid (Mental Health Commission of Canada)
  • Depression (Centre for Addiction and Mental Health, Canada)
  • Bipolar disorder (Centre for Addiction and Mental Health, Canada)
  • Post-traumatic stress disorder (PTSD) (Canadian Mental Health Association)
  • Schizophrenia (Centre for Addiction and Mental Health, Canada)
  • Trauma (Centre for Addiction and Mental Health, Canada)
  • Lesbian, gay, bisexual, trans and queer identified people and mental health (Canadian Mental Health Association)

Memory disabilities

More than 1 million persons in Canada had a memory disabilities. People with memory disabilities may have difficulty processing or holding on to information. They may also have difficulty with recognizing faces, emotional responses, and bodily movements.

Common types of memory disabilities include:

• dementia
  • can affect a person’s memory, thinking, reasoning, behaviour, and personality
  • can cause difficulty controlling emotions, navigating environments, speaking, and recognizing faces
  • there are many types of dementia, including Alzheimer’s disease
• encephalopathy
  • diseases or injuries that affect a person’s brain and mental state
  • can be caused by many things, such as infections, brain tumors, or environmental factors
  • can cause difficulties with cognition, memory, and concentration
• strokes
  • a lack of blood flowing to the brain that damages a person’s brain cells
  • can have various long-term effects, such as paralysis
  • rapid treatment can limit the amount of brain damage
  • signs of a stroke include: drooping or numbness on one side of a person’s face, weakness or numbness in one arm, and slurred speech

Here are some things to consider for your accessible consultations:

• in-person consultations
  • take the same accessibility factors into account as you would for participants with mobility, flexibility, or dexterity disabilities
  • ensure that staff and organizers repeat their names and roles whenever they address participants
  • ask participants to wear name tags, if they consent to it
  • present small bits of information at a time, when possible
  • reduce auditory distractions like background noise, music, or equipment sounds
  • reduce visual distractions like animated displays, flashing or dimming lights, or bright windows behind speakers
  • some people may attend your event with an assistant, intervener, or other companion
    • ensure that tables, seating areas, and breakout room spaces will have enough room to accommodate companions
    • unless they instruct you otherwise, speak directly to the participant rather than to their companion
  • reduce communication barriers by ensuring that organizers, staff, and presenters:
    • speak at a steady pace
    • speak in clear, short sentences
    • avoid using words or phrases that involve multiple meanings
    • avoid using sarcasm, irony, or figures of speech
    • avoid using jargon or acronyms
• virtual, digital, or other types of consultations
  • take the same accessibility factors into account as you would for participants who have learning or developmental disabilities
  • organize web page content in a predictable and consistent way
  • avoid using acronyms without defining each word
  • present small bits of information at a time, when possible
  • participants’ comments, forum posts, or other written content may not always use proper grammar, spelling, or formatting
  • if web pages include lists or tables of numbers or data, include written or other alternate descriptions of their meaning

Additional tip:

• when greeting someone you have met before, remind them of your previous meeting
  • for example: “Hello again, [their name]. My name is [your name]. We met yesterday at [location]”

Additional resources

• Government of Canada
  • Dementia in Canada, including Alzheimer’s disease (PHAC)
  • Dementia (PHAC)
  • Stroke (PHAC)
• External
  • Meaningful engagement of people living with dementia (Alzheimer Society of Canada)
  • Dementia-friendly Canada resources (Alzheimer Society of Canada)
  • Towards a dementia inclusive society (World Health Organization)