The Plain Language Movement is supported by information makers and providers who want more people to read their content. Dense academic language meant for other academics is frustrating for others wanting to learn more. So, it is time for clear language now that more universities are producing open access articles.
“… the plain language movement is rooted in the ideal of an inclusive society… ” Language is not for those with social privilege.
Plain language summaries are a good start and sometimes a requirement of research funding. These summaries are often shown as four or five short bullet points before the academic abstract. And now we have a new acronym: Knowledge Mobilization (KMb). The requirement for plain language summaries has given rise to yet another area of research.
Sasha Gaylie at the University of British Columbia explains more about this in her article Clear Language Description. There is a little confusion whether plain language and clear language are the same things. Consequently, there is a move to create an international standard.
The International Plain Language Federation defines plain language as “wording, structure, and design are so clear that readers can easily find what they need”. Easy Read, Easy English or Easy Language, which is for a specific group of readers, is not the same thing. It’s good to see universal design in language as a relatively new frontier in inclusive practice.
Gaylie lists five focus areas for that offer a structure for grouping individual recommendations briefly listed here:
Audience: The benchmark is 8th grade reading level.
Structure: The most important information should appear first.
Design: White space and headers to break up text, and also helps screen readers.
Expression: Use an active voice and avoid jargon.
Evaluation: Peer review by a non-expert for best feedback.
Inclusive descriptions
This is a growing area of language. Words can hurt and harm. We already see how language has changed when we look at old texts. For example the use of “man” and “he” when meaning all humans.
“A term need not be intentionally harmful to cause harm; the act of description is not neutral, and even when using the “plainest” of language, inherent bias affects output.”
Sasha Gaylie’s article concludes with a practical guide based on the five focus pointed mentioned earlier.
From the Editor: Writing in plain language is a skill-set that challenges a writer to think really carefully about what they want the reader to know. It is not about what the writer wants to say. Doing plain language is a process. Writing complex ideas in a straightforward way takes time and effort. And it also makes me think about my relationship to the topic.
Many followers of universal design will have critiqued the entry to Museum M in Leuven, Belgium as dangerous. Unfortunately, a Google image search on “universal design” includes images of this entry as examples of universal design. While this design might be architecturally creative, it is not architecturally inclusive or safe for everyone.
The entry steps to Museum M are mistakenly taken as an example of universal design. Consulting people with disability after construction revealed many concerns for safety.
An article by three Belgian researchers gives both sides of the design story. The classic design ideas and objectives of the architects, and the user experience. The article first discusses disability and the built environment from a justice perspective. They emphasise how architect’s human senses are not the same as everyone else. Museum M is used as a case study to explore the differing values of architects and users with disability.
“The descent before entering Museum M is supposed to symbolise its accessibility and openness to all people. When we mention this openness to Philip, he understands the idea, but for him it does not make the museum more accessible.”
The architect thought it a good idea if visitors didn’t have to separate at the entrance. He could see no problems for wheelchair users by crossing the ramp through the stairs. This design is sometimes called “stramps” With no kerbing to the ramp, wheelchair users would need to be careful not to run off the grade into the steps. Although some wheelchair users might find this workable, it is not the case for people who are blind.
What Charlotte and Philip said
Charlotte is a wheelchair user and Philip has a vision impairment: their experiences are at odds with the grandiose ideas of the architect. Philip understands the idea of the stramps but it does not make the museum more accessible for him. The break in the handrail to accommodate the ramp section means he doesn’t know where the next handrail is.
The colour of the entrance is also causing an obstacle. The white colour when the sun is shining onto the floor it looks like one flat surface. Philip can’t make out the steps and combining it with ramp makes it more confusing. Charlotte isn’t comfortable about entering either because the ramp is not entirely visible for wheelchair users.
Australians are known for their love of beaches and water. Beach accessibility has improved greatly in recent years. Strip matting, specialist water wheelchairs and accessible change facilities have made a significant difference for wheelchair users. But beach access needs constant maintenance.
“…beach access has many more challenges due to the uncontrollable nature of the movement of sand, water and wind… storms [also] play havoc on accessible paths of travel.” Jane Bryce
The latest access consultants association magazine, Insight, is all about beaches, water and access. The lead article by Jane Bryce looks at the damage done by storms and the erosion of once accessible beach access
Derek Mah covers the accessibility of aquatic facilities from an architect’s perspective. Access for swimming pools was first introduced in 2011. But the standard for the public domain (AS1428.1) is inadequate for ramps and stairs in pools. Mah discusses the issues of design and certification of swimming pools and some of the assistive equipment.
Shane Hryhorec provides a wheelchair user perspective. Going to the beach is not just a fun thing, it also enables social inclusion for individuals and families. Shane is the founder of Accessible Beaches Australiawhich has a directory of accessible beaches.
“Going to the beach is a quintessential part of the Australian way of life”, says Accessible Beaches Australia chairperson and founder, Shane Hryhorec.
Italian beach fun
For those wanting to travel there’s an extra feature on the accessible beaches in Italy. Stefano Sghinolfi is an Italian accessible tourism operator. Lots of pictures show great beaches. “To make up for the shortcomings of national policies on accessibility, there are associations and private companies. Hard work has been done by these private groups to make part of the Italian coast accessible to wheelchair users.” It’s worth noting that all accessible beaches in Italy are private.
Technical insights
As usual, Howard Moutrie adds the technical insights and background information. The purpose of this feature is to promote thought and discussion and answer members’ questions. Swimming pools are covered in the National Construction Code when it is part of another building. But there are exceptions. Swimming pools can be part of an apartment complex, an hotel, and a regular back yard. This is where it all gets tricky. Howard works his way through these in the article.
The City of London Street Accessibility Tool is like an educational access audit report. It shows street designers how street features impact on the different needs of pedestrians. The focus is on people with mobility impairments and wheelchair users, which means everyone wins.The tool recognises that there are sometimes competing needs: what’s good for one group might not be good for another. Co-design is the best way to find the trade-offs to prevent unintended exclusion. The tool comes in three parts: two Excel spreadsheets and a PDF downloadable from the City of London website.
Two photos from the “Instructions for Use” PDF document.
Doing the analysis
The PDF document begins with a table of different pedestrian types with and without assistive mobility devices. They cover mobility, sensory and neurodiverse conditions. There are three steps for using the tool.The case study for the tool is London Wall, a street in London. A 500m long section is analysed for accessibility and is split into six sections. Each section has detailed access advice for improvements with photographs overlaid with dimensions and text to illustrate issues.
Down to the detail
The first spreadsheet has detailed dimensions, colours, and placements for elements such as tactiles, street furniture, and kerbs. All the necessary technical detail is here.
What pedestrians said
The second spreadsheet is a route analyser and has a column of photos with user feedback about the issues they see. The feedback sheet highlights the “why” of planning and design. It provides insights for planners and designers in a way that that is missed in 2D drawings.The direct quotes from people with disability provide the necessary insights for planners and designers. However, those responsible doing the actual construction should also have this information. All the access planning and designing goes awry if the “why” isn’t understood by all involved. Here are two quotes from the spreadsheet on route comments:
I feel quite wary. This is an unmarked crossing as far as I can see, I can’t see any wait signs. Somebody has stopped for me I can see a cyclist, I’m now onto some more tactile paving, this is the sort of crossing I am totally unfamiliar with. Person using a white cane
This is all fine but the paving stones are a little even so I’d be looking down and watching my speed so I don’t knock into one. Person using a wheelchair
A page from the London Street Accessibility Tool Ross Atkin Associates and Urban Movement for the City of London Corporation developed The City of London Street Accessibility Tool (CoLSAT).
London’s inclusive design standards
The London Legacy Development Corporation (LLDC) is similar to the Sydney Olympic Park Authority. Both focus on maintaining the benefits of hosting the Olympic and Paralympic Games. Sydney claimed the title of “most accessible games ever” and then the title went to London. Inclusive design is a priority in all developments related to the Olympic precinct, and these Standards are designed to assist.
“Venues excelled in their inclusive design and the story could have ended there. However, LLDC embraced this approach and made ‘Championing equalities and inclusion’ one of their four corporate priority themes.”
Baroness Grey-Thompson LLDC Board Member
Front cover of the Standards
Inclusive design is the favoured term in the UK while other countries and the United Nations use universal design. They mean the same thing – creating inclusive societies.
A Standard not a Guide
The Inclusive Design Standardsbegin with all the relevant legislation and standards followed by a page on how to use the document. The standards have four key parts: inclusive neighbourhoods, movement, residential, and public buildings. Each part has two sections – the design intent and the inclusive guidelines. The guidance is just that and design teams can create solutions that achieve the same outcomes.
This is clearly a standards document and not a guide. It has numbered clauses for designers to reference. As such, it is not an accessible document itself. The language and size of text makes for detailed reading. A summary document with the key points would be useful as a starter.
The “Go-Along” research method is a way of observing people in their local neighbourhood to see the streets from their perspective. It allows participants to tell their stories about the things they like and don’t like when getting out and about.
The “go-along walking” method has been used with people with dementia.The findings provided insights into how people get around and their need to feel safe.
A similar project was undertaken in Copenhagen focused on older people. The data was gathered using a Go-Pro camera and interviews. Social interaction turned out to be the overall reason for going outdoors. Footpaths, seating and sheltered places were the most important design elements. Of course, these are not limited to older people. A case of “necessary for some and good for others”.
Image from the article. A wide corner is a meeting place for neighbours.
Photographs tell the personal stories and illustrate some of the findings.
Neighbourhoods are extremely important to older people, as this is where a great deal of their everyday life is spent and where social interaction happens. This is particularly the case in deprived neighbourhoods, where people with limited economic resources or physical limitations find it challenging to venture outside the neighbourhood.
A growing body of research suggests studying age-friendly neighbourhoods from a bottom-up approach which takes the diversity of the age group into account. This paper aims to investigate how the go-along method can serve to co-construct knowledge about age-friendly neighbourhood design in a deprived neighbourhood of Copenhagen with a diverse group of older people.
Sixteen go-along interviews were carried out with older people aged 59–90. The participants took on an expert role in their own everyday life and guided the researcher through the physical and social environments of their neighbourhood.
The go-alongs were documented with a GoPro camera. The data were analysed using situational analysis and was grouped into thematic categories. Our findings conclude that social interaction is the overall motivator for going outdoors and that dimensions of pavements, the seating hierarchy, the purpose of lawns, sheltered spaces and ‘unauthorised’ places are all neighbourhood design elements that matter in this regard.
The findings suggest to consider age-friendly details as the starting point for social interaction, to target the appropriate kind of age-friendly programs and to enhance empowerment through physical spaces. The go-along interview as a research method holds the potential for empowering older people and appreciating their diversity.
Almost everyone finds themselves in hospital at some time whether as a patient or a visitor. Consequently, we are talking about the whole of our diverse population. But how well is diversity, equity and inclusion considered in healthcare practice? If the statistics are anything to go by, we are not doing well. Marginalised groups experience poorer health outcomes. The conditions in which people live – referred to as the “social determinants of health” – are the main reason for this.
Thirteen people were involved in devising 12 Tips for Inclusive Practice in Healthcare Settings.
Appropriate terminology is a major feature in the list of 12 tips. Non-judgmental factual terms are preferred. Labels such as “obese” or “schizophrenic” can imply blame or non-compliance. And some patients will want to use non-binary gender terms when referring to themselves. Using the person’s preferred terms is recommended in all situations as these can vary. For example some people say they are autistic and others will say they have autism. Then there are people with multiple identities (intersectionality).
The 12 Tips for Inclusive Practice
Here is a brief outline of the the 12 tips.
Tip 1: Beware of assumptions and stereotypes: An individual might have multiple diverse characteristics. In the absence of early information it is easy to assume some things by default. A wheelchair user might conjure up assumptions about the health and ability to make decisions. A person accompanying a patient may be assumed to be a partner or family member.
Tip 2: Replace labels with appropriate terminology: The main point here is to keep up to date with best-practice terminology. For example, guidelines for preferred language for First Nations people is shifting and evolving. Some terms considered derogatory are now embraced by some (queer, autistic).
Tip 3: Use inclusive language: words can exclude and “other” people when they deemed to be different to oneself.
Tip 4: Ensure inclusive physical spaces: Accommodating physical, sensory and cognitive needs improves patient experience. Inclusive design goes beyond legislated minimum access requirements for buildings. For example gowns, furniture, and blood pressure cuffs, should accommodate all sizes.
Tip 5: Inclusive signage and symbols: A rainbow flag or First Nations flag will make people feel welcome. However, the use of these signs needs to be accompanied by inclusive care to avoid disappointment.
Tip 6: Appropriate communication methods: This is where body language and auditory input come into play. Not everyone processes these cues well and sometimes information is better put in writing.
Tip 7: Adopt a Strengths-Based Approach: This approach avoids stereotyping and acknowledges patients’ capacity for resilience and builds on their strengths.
Tips 8 – 12 focus on the health system and healthcare delivery and encourages health workers to advocate for improvements.
This paper outlines practical tips for inclusive healthcare practice and service delivery, covering diversity aspects and intersectionality. A team with wide-ranging lived experiences from a national public health association’s diversity, equity, and inclusion group compiled the tips, which were reiteratively discussed and refined. The final twelve tips were selected for practical and broad applicability.
The twelve chosen tips are: (a) beware of assumptions and stereotypes, (b) replace labels with appropriate terminology, (c) use inclusive language, (d) ensure inclusivity in physical space, (e) use inclusive signage, (f) ensure appropriate communication methods, (g) adopt a strength-based approach, (h) ensure inclusivity in research, (i) expand the scope of inclusive healthcare delivery, (j) advocate for inclusivity, (k) self-educate on diversity in all its forms, and (l) build individual and institutional commitments.
The twelve tips are applicable across many aspects of diversity. They provide a practical guide for all healthcare workers and students to improve practices. These tips guide healthcare facilities and workers in improving patient-centered care, especially for those who are often overlooked in mainstream service provision.
Academics talk about “vulnerable groups” based on ethics approval language. But what they mean is, people who have difficulty participating because they have a disability, illness, or some other condition. Indeed, some ethics requirements are so protective of “vulnerable groups” that they make it difficult to include them from research projects. Consequently their voices are silenced. So how do we include them in co-design and when?
While co-design is the new buzz word, participatory design has been around in academia for many years. Involving communities in decision-making is now recognised as being responsive to community needs. That means going beyond a one-size-fits-all approach to design.
Participatory design
Participatory design, or co-design, is about genuine inclusion. That is, not just informing the design, but being participants in the design process. However, involving people with complex needs poses some challenges. It’s easy to make assumptions about their capacity to participate and collaborate. However, this comes down to the way the participation process is designed.
Participatory design and the inclusion of vulnerable groups is the topic of an article from Finland. They use three projects to compare how participatory design might work best. The first explored co-design activities with people with intellectual disabilities living in supported housing. The second focused on culturally diverse young people experiencing crisis situations. The third dealt with nursing students with learning disabilities adapting to work in the health sector.
Challenges and power dynamics
The article covers the challenges, the power dynamics and their methodology. Each of the three projects is documented in detail. The findings show some similarities between the projects, but when it came to users, there were different outcomes and processes. Participatory design became more challenging when there were more pronounced differences in power dynamics.
These three projects provide good information for involving vulnerable groups in participatory design processes. Questions of equality and genuine inclusion is about both the design activities and how the entire project is planned.
This article makes three contributions to participatory design (PD) research and practice with vulnerable groups:
A framework for understanding stakeholder engagement over the course of a PD project.
Approaches to making user engagement and PD activities more inclusive.
An analysis of how the design and power dynamics of PD projects affect vulnerable groups’ participation.
A map of engagement evaluates stakeholder involvement from initial problem definition to design outcome.
The first looks at codesign activities to support decision-making in the context of intellectual disabilities. The second looks at culturally diverse youth navigating crisis without adequate assistance from public services. The third examines nursing students adapting to work in the health sector without accommodations for learning disabilities.
Comparing the projects reveals patterns in project planning and execution, and in stakeholder relationships. The article analyses how users are defined, engaged and supported in PD; how proxies shape vulnerable groups’ involvement and PD projects as a whole; and opportunities for greater inclusion when the entire PD project is taken into account.
What does co-design mean? How does it work?
The term co-design is being used more frequently, but what does co-design mean and how does it work? Well, that depends on the context. It could mean a design group working together. Nothing difficult about that concept. Or it could mean involving end users in the design process. This is where it gets more tricky and more questions arise.
At what point do you involve users? Which users do you involve? Will the users have the required knowledge and experience to contribute constructively? Will designers have the skills to be inclusive and listen to users? Participatory action research incorporates both designer and user learning. But these projects are necessarily long and usually have research funding attached. However, they usually produce knowledge and results useful in other settings.
A related concept is co-design in quality improvement, for example, in a hospital setting. Both staff and patients have a role to play in advancing quality improvement. Differing levels of understanding between staff and patients can lead to tokenism. So how can we equalise knowledge so that everyone’s contribution is constructive?
A research team in a Brisbane hospital grappled with this issue. Their research reportis written in academic language and not easy to read. Nevertheless, they conclude that effective patient-staff partnerships require specific skills. Briefly, it means adapting to change, and generating new knowledge for continuous improvement.
A framework
The researches developed a framework that includes ten capabilities under three key headings.
Personal attributes:
Dedicated to improving healthcare
Self-aware and reflective
Confident and flexible
2. Relationships and communication attributes:
Working and learning as a team
Collaborating and communicating
Advocating for everyone
3. Philosophies/Models:
Organisational systems & policy
Patient and public involvement best practice
Quality improvement principles.
These nine points are connected with the overarching theme of sharing power and leadership.
Title of the article is, “Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review”.
This site has a web accessibility overlay or add-in widget. It’s the circle icon next to our logo on the website. If you click on it, it has a dropdown accessibility toolbar. That’s because the platform, WordPress, isn’t inherently accessible. So like the tacked on ramp to a building, it is an afterthought. But really, it advertises that the website platform isn’t really accessible and there are good reasons why.
Website add-ons for accessibility go back to the 1990s with products like Browsealoud and Readspeaker. They added text to speech capabilities on the website. More products arrived in the market with similar aims. To the layperson these features seem beneficial, but their practical value is overstated. That’s because the people who need these features will already have the software on their devices to access the web and other software. The Overlay Fact Sheet by Karl Groves explains more:
From the overlay fact sheet
“It is a mistake to believe that the features provided by the overlay widget will be of much use by end users because if those features were necessary to use the website, they’d be needed for all websites that the user interacts with. Instead, the widget is —at best—redundant functionality with what the user already has.”
Do overlays meet compliance?
While an overlay might improve compliance in some respects, full compliance cannot be achieved using this method. That’s because the products are unable to “repair” all possible issues. In some cases, the overlay can conflict with the users software and cause problems. And ironically, some overlays are inaccessible. So that means it’s back to the programmer and designer to get it right.
The video below gives examples of overlays and graphically shows how they don’t work. You only need to look at the first three minutes to get the idea.
We all have a responsibility to make our digital information accessible. Beware any web developer who says they’ve solved the accessibility problem with an overlay or widget. Indeed, you are showing your inaccessibility by having an “accessibility” overlay and icon on your site.
Web designers might think the international web standards are sufficient. But they are not – just like the standards for access and mobility in the public domain are not enough.
By the way, CUDA uses the WordPress platform’s free version and continues to do so because we do not receive financial support for the website and want to keep it open access. As with everything universal design – it is a work in progress. “Do the best you can with what you have at the time and strive to improve next time.”
Planning inclusive communities begins with asking the right questions. For example: What makes an inclusive community? What stops communities being inclusive? When we say community, what do we mean? And what does inclusive mean?
Lisa Stafford’s research project sought to answer those questions and more. Her research heard from 97 people aged from 9 to 92 years. Some had a disability or long term health condition, and others were their family members or allies. The findings are presented in a reader friendly format rather than an academic article.
Image from Planning Inclusive Communities website
Findings from Stage 1
The thoughts and experiences from participants with and without disability shared many aspects in common. Here are some of the points in brief.
An inclusive community is about people where everyone is valued and belongs. Everyone is valued and respected regardless of their culture or background. That means communities must be planned for all people – built for equity, fairness and accessibility. Inclusive communities are happy places where people have choices and safe spaces to have fun and socialise. So how do we make it happen?
The answer is planning together from the very beginning. People with disability, diverse groups, government and urban planning practitioners should all be involved.
Stage 2 of this research project will identify people who want to help make change and create a plan for inclusive communities.
https://youtu.be/s9LFt8LZ81k
Here is a quote from the website that has more information.
“I feel like it’s all about everyone being able to equally engage in the environment in the community. For people with disabilities there is a lot of restraint and they can’t engage as much as other people. It’s also like equality is not enough, it should be equity so everyone has what they need to be able to engage in that community. Because I feel like a community is about people and engagement, but also being able to access and work around a community.”
Planning Inclusively: Make Communities Just for All
Urban planning is a highly contested and politicised area to work in. The talk is that planning is about people, not roads and buildings. But when do users – people – get a say in planning? Only at the end when plans are put on exhibition. Then you need to be an expert to understand them. Planning inclusively is to make communities just for all.
Lisa Stafford, ina briefing paper, asks how well do we consider human diversity in planning cities and regions? Planners and bureaucrats would rarely even consider the concept of “Ableism” in their designs. That’s why we still have marginalisation by design. The lens of the average or the “normal” person is rarely put aside for a lens of diversity.
Social planning can drive inclusive communities because it operates from a justice framework. Participatory planning is one way to work towards inclusion.
Embed universal design as a core planning principle
Re-emphasise the social in planning
Editorial Introduction
“Disabled people continue to experience exclusion by design in our everyday spaces, infrastructure and services, which has been magnified through the COVID-19 pandemic. Now, more than ever, there is an opportunity for urban and regional planning practitioners, researchers and disabled people to come together to advocate for and create inclusive, sustainable communities for all. However, to make this transformative, we must first critically question how well do we really consider human diversity in planning cities, towns and regions? This question is examined in this briefing paper by contesting entrenched challenges like ‘ableism’ before providing fundamental starting points for planners in planning more inclusive and just communities for all.”
On one hand, new mobility technology increases opportunities to improve transport systems. But on the other, the technology is unevenly distributed in terms of access and inclusion. This means many will be left out, especially those with reduced mobility.
The new technology can create unintended barriers: physical, technological, economic and mental – each one a challenge to universal design. Public policy also has a role to play in reducing barriers to mobility.
Norway has a whole of government universal design policy and has done good work in making public transport accessible. However, many advancements require digital skills in using smartphone apps and electronic ticketing. And that’s just one universal design challenge.
Most technological advances in mobility result in better accessibility for many, yet the benefits remain unevenly distributed. New and improved mobility technologies typically result in increased mobility. However, most new technologies create both winners and losers. Who wins and who loses depends on how the mobility solution in question is introduced to the mobility system.
This study finds that many of the new mobility technologies that are introduced, though not directly relating to universal design, strongly affect the universality of access to mobility.
The chapter aims to give insight into how certain new mobility solutions affect different user groups, and to highlight how the outcome is a function of the interplay between technology and its implementation. The paper concludes by pointing to the need for regulation to align the objectives of the actors behind new technologies and an inclusive society.
Automated vehicles: mobility and accessibility
The transportation and mobility sector has a design history focused on infrastructure efficiencies. User perspectives are being introduced in other sectors and it is time for the mobility sector to catch up.
An article from Norway discusses the issues introducing universal design and co-creation. The author uses three vignettes to highlight some of the issues users encounter.
Many people in Europe still have limited access to transportation modes overall. Socio-economic constraints, and cognitive, sensory and physical impairments affect everyday life, posing challenges to accessing mobility services.
Technologies for vehicle automation have advanced in recent decades. Yet, the implementation and use of automated and autonomous vehicles (jointly referred to as AVs) entails chances but also hurdles regarding accessibility and inclusivity of vulnerable groups.
This concerns both the use of the vehicle by humans as well as the interaction between humans and vehicles as participants in road traffic.
In this chapter, we identify opportunities and risks narrow down the vulnerable social groups we are looking at. Subsequently, we present the benefits that co-creation and universal design can have in overcoming or, in the best case, avoiding these obstacles.
Detailed recommendations for action cannot be given within this framework, but suggestions for solutions are outlined.