XCEL Training

XCEL is designed to give quick tips in an entertaining way to reception/support staff who interact with people with developmental disabilities in healthcare settings. It comprises of a 7 minute animated video, a fact sheet, and highlights other resources that are helpful.

 

Source: Florida Center for Inclusive Communities (FCIC)

XCEL Training

Accessible Hospitals and Medical Care Facilities – A Refresher Webinar

Source: Accessible Hospitals and Medical Care Facilities – A Refresher

This session will provide a refresher on the requirements in the ADA and ABA Accessibility standard for Hospitals and Long-Term Care facilities. The presenters will provide an in-depth review of the standards and design challenges in long-term care settings, including highlights from recent research. Additionally, strategies for success in the field that both comply with the standard and meet the needs of older adults and their caregivers will be discussed. This is a joint session presented by the Access Board and the AIA Codes and Standards Committee. Session participants are encouraged to submit questions in advance.

Early Childhood Technical Assistance Center: Improving Systems, Practices and Outcomes for Young Children with Disabilities and their Families

Source: ECTACenter.org : The Early Childhood Technical Assistance Center : Improving Systems, Practices and Outcomes for Young Children with Disabilities and their Families

Most recent additions to this page:

 National Child Traumatic Stress Network (2017) – established to improve access to care, treatment, and services for traumatized children and adolescents exposed to traumatic events. This resource includes descriptions of each type of trauma and evidence-based treatments that work.

 Caring for Children in a Disaster (2017) – This collection of resources from the Centers for Disease Control and Prevention offers simple steps to protect children in emergency situations and help meet their needs during and after a disaster.

Related pages:

State Community Health Worker Models – NASHP

As states transform their health systems many are turning to Community Health Workers (CHWs) to tackle some of the most challenging aspects of health improvement, such as facilitating care coordination, enhancing access to community-based services, and addressing social determinants of health.

Source: State Community Health Worker Models – NASHP

While state definitions vary, CHWs are typically frontline workers who are trusted members of and/or have a unique and intimate understanding of the communities they serve. This map highlights state activity to integrate CHWs into evolving health care systems in key areas such as financing, education and training, certification, and state definitions, roles and scope of practice. The map includes enacted state CHW legislation and provides links to state CHW associations and other leading organizations working on CHW issues in states.

What Effect Does Transition Have on Health and Well-Being in Young People with Intellectual Disabilities? A Systematic Review

 Source: JARID

Background Transition to adulthood might be a risk period for poor health in people with intellectual disabilities. However, the present authors could find no synthesis of evidence on health and well-being outcomes during transition in this population. This review aimed to answer this question. MethodPRISMA/MOOSE guidelines were followed. Search terms were defined, electronic searches of six databases were conducted, reference lists and key journals were reviewed, and grey literature was searched. Papers were selected based on clear inclusion criteria. Data were extracted from the selected papers, and their quality was systematically reviewed. The review was prospectively registered on PROSPERO: CRD42015016905. Results A total of 15 985 articles were extracted; of these, 17 met the inclusion criteria. The results of these articles were mixed but suggested the presence of some health and well-being issues in this population during transition to adulthood, including obesity and sexual health issues. Conclusion This review reveals a gap in the literature on transition and health and points to the need for future work in this area.

How I bridge 2 worlds as a deaf medical student

Growing up as a deaf person has given me unique insights into patient care, which I hope to incorporate into my practice when I’m a physician.

Source: How I bridge 2 worlds as a deaf medical student

 

I was born profoundly deaf in both ears, which means I could only hear sound above 95 decibels. Without hearing aids, I could hear extremely loud sounds, such as a plane taking off or a train going by, only if I was near them. With hearing aids, I could hear sound at 40 decibels and up, so I could understand one-on-one conversations as long as there was no background noise, the person didn’t mumble and I could see his or her mouth clearly.

Before starting medical school, I got a cochlear implant, which helps me hear so much more than I could before. When I listen to music now, I can hear all the different sounds rather than one static sound, and it’s much easier to differentiate between the instruments. Understanding speech has also become much easier. I now communicate orally with hearing people and via sign language with deaf people. However, I am still deaf, and there are still times when I am unable to understand what people are saying, such as group settings where there’s a lot of ambient noise.

I chose osteopathic medicine because I heard from many patients who spoke highly of DOs, and the osteopathic philosophy resonated with me as well. I strongly believe in treating the person as a whole and that lifestyle factors can dramatically affect a person’s health. Ultimately, I hope to become an obstetrician-gynecologist. I’d like my practice to include caring for deaf patients—some deaf people have very little health literacy due to communication barriers growing up, which is something I hope to combat.

Culture and communication

Growing up as a deaf person has given me insights I hope to incorporate in my future practice as a physician. The first is the importance of maintaining eye contact during conversations. That’s not only because it helps me lip-read and understand what’s being said; eye contact shows that you are truly listening to the other person. It shows respect.

Secondly, because of growing up in the deaf culture, I’m very aware that all cultures are different. Physicians may not encounter deaf patients frequently, but they will definitely care for patients who have special needs when receiving medical care, such as a disability or an interpreter if English isn’t their primary language. As a patient, I’ve learned that I need to speak up about my needs, because sometimes people just are not aware. As a physician, I’ll know to ask patients what they need.

Victoria MacPherson, OMS II (center), attends the Philadelphia College of Osteopathic Medicine, as do Victoria Gordon, OMS II, (left) and Helen Lesser, OMS II (right). (Photo provided by Victoria MacPherson)

Tips for physicians

Physicians should keep in mind that American Sign Language is its own language, so written English doesn’t automatically translate to ASL. A deaf person who uses exclusively ASL and is not fluent in English might have trouble understanding written text, which is why some patients prefer to use an interpreter.

At the end of the visit, I appreciate being asked to repeat back my treatment plan so my physician can be sure I fully understand what was said. Receiving a written copy of my doctor’s recommendations is also very helpful—that’s probably true for any patient, not only those who are deaf.

If you’re unsure how to communicate with a patient who is deaf, or anyone with a disability, just ask! I suggest language such as, “I believe in offering top-notch accessible care. Do you need any special accommodations?” Then let the patients explain to you what they need, because they are the experts on themselves.

How to Make Healthcare Accessible for All

Source: University of Washington, Healthy Aging RRTC

Healthcare access is important for all individuals, especially for people with disabilities. However, people with disabilities don’t always receive the healthcare they need. Several barriers can make it harder for them to access critical healthcare services or build optimal working relationships with their providers. Fortunately, by being aware of these barriers, we can overcome them with changes in design, training, and policy.

Download How to Make Healthcare Accessible for All

Perspectives about support challenges facing health workers assisting older adults with and without intellectual disability in rural versus urban settings in Australia

Rafat Hussain , Matthew P. Janicki , Marie Knox, Stuart Wark & Trevor Parmenter (2017): Perspectives about support challenges facing health workers assisting older adults with and without intellectual disability in rural versus urban settings in Australia, Journal of Intellectual & Developmental Disability, DOI: 10.3109/13668250.2017.1326589

Source: Journal of Intellectual & Developmental Disability

ABSTRACT

Aims: Life expectancy for both sexes in Australia exceeds 80 years, with individuals with intellectual disability also increasingly living into older age. This research aimed to comparatively examine perceptions of staff supporting either older adults or age peers with lifelong intellectual disability.

Methods: This project asked 420 medical, health, and support workers about training adequacy, health services access, and trigger points for premature institutionalisation. This paper is based on a subsample of 196 respondents who provided quantitative and qualitative responses.

Results: There was considerable variation in confidence in supporting ageing individuals, while only 23.7% of doctors reported their training was adequate to support adults ageing with intellectual disability. A lack of services and poor carer health were identified as triggers for premature institutionalisation.

Conclusions: The study revealed key differences in staff perceptions of support provision and training adequacy when comparing ageing individuals with intellectual disability to the general ageing population.

Download Perspectives about support challenges-JIDD

Doctors With Disabilities: Why They’re Important – The New York Times

There’s good reason to believe a more diverse work force — one that includes doctors with disabilities — would be good for patients and doctors. Patients of various backgrounds tend to feel more comfortable with physicians like them, and that’s true for people with disabilities as well.

Source: Doctors With Disabilities: Why They’re Important – The New York Times

More than 20 percent of Americans — nearly 57 million people — live with a disability, including 8 percent of children and 10 percent of nonelderly adults. And while the medical profession is devoted to caring for the ill, often it doesn’t do enough to meet the needs of the disabled.

Read entire article… Doctors With Disabilities- Why They’re Important – NYTimes

 

Dr. Gregory Snyder, a physician at Brigham and Women’s Hospital in Boston, has paralysis in his legs after a spinal cord injury during medical school. He uses a wheelchair and says that he’s sometimes mistaken for a patient while working. But that’s not necessarily a bad thing.

“It reminds us that at some point we’ll all be patients,” he said. “And perhaps, when we least expect it.”

Over the course of our lives, most of us will acquire a disability: More than two thirds of Americans over the age of 80 have a motor, sensory or cognitive impairment.

Dr. Snyder remembers the difficulty of adjusting to life as a patient after his accident, and the long road to recovery. But he says his disability and rehabilitation have fundamentally changed the way he cares for patients — for the better.

“I would have been this six-foot-tall, blond-haired, blue-eyed Caucasian doctor standing at the foot of the bed in a white coat,” he said. “Now I’m a guy in a wheelchair sitting right next to my patients. They know I’ve been in that bed just like they have. And I think that means something.”

There’s good reason to believe a more diverse work force — one that includes doctors with disabilities — would be good for patients and doctors. Patients of various backgrounds tend to feel more comfortable with physicians like them, and that’s true for people with disabilities as well.

Increasing the number of doctors with disabilities would improve health care.

Increasing the number of doctors with disabilities would improve medical care, not weaken it

Source: Increasing the number of doctors with disabilities would improve health care.

We Need More Doctors With Disabilities

One-fifth of all Americans have a disability, but less than 1 percent of doctors do. That’s slowly starting to change—to the benefit of medicine and patients.

When Dr. Bliss Temple was in training, she remembers being in an elevator wearing her white coat and her stethoscope when a patient who was using a wheelchair got in. Temple is paraplegic; she also uses a wheelchair.

“We checked out each other’s chairs, and then he looked at me and said, ‘Oh! You’ve joined the enemy.’ ”

More than 56 million Americans have a disability of some kind—nearly a fifth of the country. Yet a vanishingly small percentage of doctors have a disability of any kind—estimates vary and data is scant, but the consensus suggests that the number is somewhere around 1 percent. The problem starts at the tip of the pipeline: People with disabilities make up somewhere between 0.3 and 2.7 percent of medical school classes—estimates vary, but even at the high end, this makes them one of the most underrepresented groups in American higher education.

The divide is stark, and the consequences can be severe. Americans with disabilities are more likely to be sick but less likely to get adequate health care. This is partially because having a disability increases the likelihood of being poor or being unable to access care. But it has also created a system in which vulnerable patients feel their doctors misunderstand their bodies and their lives.

Colleagues sometimes tell Temple that they don’t think of her as a person with a disability, even though she’s spent her career at San Francisco General Hospital working on health care access and social justice for people with disabilities, including stints at the World Health Organization and consulting for the Department of Health and Human Services. She’s no stranger to the stereotype that doctors don’t have disabilities. Doctors take care of us in our most critical moments, when their ability to do their jobs can make a mortal difference. We want doctors who look like they can rush us to the intensive care unit like it’s 45 minutes through an episode of a medical drama.

But in recent years, disability activists and policy experts have argued—persuasively, according to many court cases—that disability does not prevent medical students from learning how to provide excellent medical care, particularly when they can receive assistance from increasingly adept technical tools. Not only is denying their right to train as doctors illegal; it inadvertently denies the many Americans with disabilities the benefit of having more medical professionals who understand them.

Additional Resources for Technical Standards and Accommodations

The struggle for representation in medicine starts with who gets to go to medical school in the first place. For most aspiring doctors, medical school admission is merely a matter of excelling at coursework, research, volunteering, the Medical College Admission Test, personal essays, and interviews. Even then it’s tough going—most medical schools have admission rates in the low single digits. But students with disabilities have an additional obstacle after they’ve been admitted: They must prove to the school’s administrators that they can meet the physical requirements of medical education. These expectations, codified into “technical standards,” are often broken down into five essential functions: observation, communication, motor function, conceptual and quantitative analysis, and social skills. The exact standards vary by school and curriculum. For example, MD candidates at one school may have to personally deliver 10 babies to pass an obstetrics rotation while candidates at another only have to assist. This idiosyncrasy wouldn’t matter to most applicants, but it can disqualify someone with limited arm mobility, no matter how dazzling their application. After getting in on the strength of their grades, scores, and essays, students can find themselves caught between forfeiting their admission and signing a document pledging they can perform medical procedures with accommodations that they don’t know for sure that they’ll receive.

For years, medical schools have defended their technical standards by arguing that they protect patient safety and ensure academic consistency. Reformers argue that these policies violate federal law and promote a culture of prejudice. In 1973, the Rehabilitation Act prohibited universities, and other institutions receiving federal funding, from discriminating against applicants with disabilities who were “otherwise qualified.” But the law’s vague language left it open to evasion. In 1990, the Americans With Disabilities Act, or ADA, reinforced and expanded the scope of the Rehabilitation Act, affirming that in higher education and employment, people with disabilities could not be “excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services,” unless the university can show that accommodations would “fundamentally alter” the education they offer or result in “an undue burden.”

Perhaps unsurprisingly, this federal law compelled only a modest increase in the number of students with disabilities graduating from medical school. In 1979, six years after the Rehabilitation Act’s passage, the Association of American Medical Colleges, or AAMC, published a technical standards template to guide medical schools as they began to read applications they could have quickly rejected a few years earlier. After the ADA was passed, many medical schools complied with the law by simply copying the AAMC’s 1979 guide near-verbatim and haven’t changed them much since. At the time, the AAMC seemed more concerned about preventing lawsuits than inclusion. “In the admissions process, the burden of proof is on the applicant to demonstrate that he/she can meet the essential 5 functions of the program,” an AAMC memo from 1993 read. “How much accommodation may be too much is a matter which will be tested in the courts. The safety of patients involved in student education is of paramount importance.” To this day, many schools leave the burden on aspiring physicians with disabilities.