Blog Series – Covid-19: Stories, Insights and Perspectives Hannah Anderson

By Corrinne Fahl

The COVID-19 pandemic has required major changes to where we work and how we communicate at work. Many of us are adapting to challenging online meeting environments: poor-quality calls with background noise, video chats with colleagues required to wear facemasks, and pre-recorded lectures with limited interaction. For those of us who are d/Deaf or hard-of-hearing, however, those types of virtual interactions are not just challenging – they can make our equal participation impossible.

Under typical circumstances, my colleagues rarely notice my hearing aids, my remote FM system, or the real-time captioning I keep open on my phone or laptop during meetings. These technologies are unobtrusive tools that allow me to connect and contribute. Recently, that connection has been harder to maintain. Meetings with glitches and overlapping voices erase essential communication cues from eye contact and lip-reading. Interpreting, captioning, and assistive listening rely on high-quality audio – a rare phenomenon in most online meetings.1 In every call and telehealth encounter, my mind races with questions: “Who’s speaking?” “What’s going on?” and “Have I missed anything?” I have repeatedly misspoke, misunderstood, and made humbling mistakes. As these types of snafus accumulate, I find myself hesitant to speak at all. Most days, I spend hours scheduling services for upcoming calls, finding workarounds for technology issues, and nursing a profound case of what hearing aid users know as “listening fatigue.”2 The communication strategies I depend on are suddenly inaccessible and many of the spaces where I normally feel most included are oftentimes where I feel most invisible.

In talking with fellow colleagues and trainees with disabilities, I know I am not alone in struggling to maintain access to my life activities during COVID-19. As a community, we are finding creative ways to adapt, like designing our own disability-friendly facemasks and accessible educational tools, but we worry about our careers and futures and about our community’s ever-limited access to healthcare, basic necessities, and human connection.3 As we witness new barriers emerge and old barriers resurface, many of us worry that this crisis may move the needle backwards in accessibility and civil rights protections for all of us 61 million Americans with disabilities.4,5

There is no magic solution for those many barriers, but those of us who work in healthcare might benefit from thinking about them differently. First, disability accommodations are often viewed as federally-mandated, resource-intensive amenities that are only useful for small groups of individuals with disabilities. Yet making the world accessible for people with disabilities often makes it a better place for everyone. Many of the features that make online meeting and telehealth platforms more accessible – high-quality audio, ‘raise hand’ and chat box options, turn-taking notifications, screen reader access, easy-to-follow navigation buttons, automatic transcripts – are low-cost features that make platforms easier to use for able-bodied people too.6,7 This is just one small illustration of a principle called Universal Design. When we design systems with the goal of maximizing accessibility, everyone in the system can benefit.8 Second, people with disabilities are the largest minority group in the country and represent the largest pool of untapped talent in every sector.9 Organizations that utilize their existing disability talent are more productive and profitable than peer organizations, in part because people with disabilities have unique perspectives on common challenges.10 In many cases, we are adept at finding solutions when the ‘usual way of doing things’ doesn’t work.11

The current state of remote work and telehealth does not optimally serve everyone. As we rapidly re-design our workplaces, we are presented with opportunities to prioritize accessibility, improve platforms for everyone, and discover new ways of navigating the challenging environments we face.

For questions and resources, please email: andersonhl@email.chop.edu.

Hannah Anderson, MBA

Leadership in Neurodevelopmental Disabilities (LEND) Fellow

Clinical Research Associate in Medical Education

Children’s Hospital of Philadelphia

References:

1. COVID-19 Response: Digital Accessibility and Other Best Practices for Remote Work - Disability:IN. (2020, May 5). Retrieved from https://disabilityin.org/resource/covid-19-response-accessible-tools-and-content/

2. Alhanbali, Sara; Dawes, Piers; Lloyd, Simon; Munro, Kevin J.  Listening-Related Effort and Fatigue in Hearing-Impaired Adults. Ear and Hearing: January/February 2017 - Volume 38 - Issue 1 - p e39-e48 doi: 10.1097/AUD.0000000000000361

3. The American Association of People with Disabilities. (2020, March 21). Retrieved from https://www.aapd.com/press-releases/civil-rights-letter-covid-19/

4. UNICEF. (2020, March 19). COVID-19 response: Considerations for Children and Adults with Disabilities. Retrieved from https://www.unicef.org/disabilities/files/COVID-19_response_considerations_for_people_with_disabilities_190320.pdf

5. Centers for Disease Control and Prevention. Disability and Health Data System (DHDS). Available from: http://dhds.cdc.gov

6. Pramuka, M., & Roosmalen, L. V. (2015). Telerehabilitation Technologies: Accessibility and Usability. International Journal of Telerehabilitation, 25–36. doi: 10.5195/ijt.2008.702

7. Ruukel, R. (2019, January 17). A Case for Accessible, Usable and Universal Design for Learning. Retrieved from https://open.edx.org/blog/case-accessible-usable-and-universal-design-learning/

8. Rogers-Shaw, C., Carr-Chellman, D. J., & Choi, J. (2017). Universal Design for Learning: Guidelines for Accessible Online Instruction. Adult Learning, 29(1), 20–31. doi: 10.1177/1045159517735530

9. Accenture Research. (2018). Getting to Equal: the Disability Inclusion Advantage. Retrieved from https://www.accenture.com/t20181108t081959z__w__/us-en/_acnmedia/pdf-89/accenture-disability-inclusion-research-report.pdf

10. Hewlett, S. A. (2017, November 17). Millennials with Disabilities: A Large, Invisible Talent Cohort with Innovative Potential. Retrieved from https://www.inc.com/sylvia-ann-hewlett/millennials-with-disabilities-a-large-invisible-talent-cohort-with-innovative-potential.html

11. Girma, H. People with Disabilities Drive Innovation. Financial Times (2017, September 13). Retrieved from https://habengirma.com/2017/09/13/people-with-disabilities-drive-innovation/