Category: Policy and Policy Development

Socioeconomic benefits and costs of universal design

Access and inclusion are considered a “good thing” until someone asks, “what will it cost?” Rarely does anyone ask “what does doing nothing cost?”. Many of the benefits are on the social scale, but are difficult for orthodox economists to measure with their current tools. So what to do about it? A report from Norway looks at studies of the socioeconomic benefits and costs of universal design and accessibility.

There is a risk that a disproportionate emphasis is put on the costs and benefits of universal design rather than its broader societal benefits.

Part of the front cover of the universal design and socioeconomic analyses report. It shows a blue city tram with a person about to board.

The Nordic nations are really keen to implement universal design policies. The high priority that Norway gives universal design makes it an international leader. Other Nordic countries are yet to show the same commitment. The report maps international socioeconomic analyses and related analyses. Although using different methods, the studies emphasise cost-benefit analysis.

Why do an analysis?

Cost-benefit analyses are commissioned for different reasons. There are four main types:

1. regulatory impact assessments to analyse the potential socioeconomic consequences of new legislation and regulation related to universal design or accessibility;
2. business case studies of the profitability of investing in universal design and accessibility;
3. cost-benefit analyses as part of an assessment of reasonable accommodation, primarily with regard to discrimination legislation; and
4. research projects examining the effects of accessibility measures in general, or of specific measures, or their benefit to different target groups.

What do they look at?

Most of the analyses are about housing and the built environment with a focus on legal access requirements. The studies mainly focus on the consequences in terms of participation, employment, risk of falls, and health benefits for people with disability.

Street scene of Oslo showing footpath dining and 2 cyclists.

In the transport sector, studies mainly looked at travel time and willingness to pay more to improve accessibility. Business case studies dominate the field of information and communication technology.

Costs are usually easier to measure in monetary terms than benefits. Assumptions based on hypothetical reasoning, such as accessibility results in increased employment, lacks evidence.

From the conclusions

Many studies indicate there are significant benefits for people with and without disabilities. However, evaluating these benefits against quantifiable costs entails other variables.

Regulatory impact assessments of new legislation lacks data for calculating different effects. Specialist consultancy firms often carry out these assessments as government staff lack expertise.

In other studies, new knowledge emerges but with different methods. Designing these studies and collecting data is a constant challenge. Measuring the benefits of universal design in its broadest sense is even more difficult than measuring statutory access requirements.

It is at least as important to study why people choose not to use, say public transport, as it is to study the benefits for those who do. Any cost-benefit analysis of universal design and accessibility must be accompanied by what constitutes a cost and for whom.

The report presents areas for improvement and development including the ongoing exchange of experience and knowledge.

The title of the report is Universal design and socioeconomic analysis: A survey of analyses and literature. The main part of the report is in Swedish, but the English language summary begins on page 105. Included in the list of documents at the end is the Australian Building Codes Board Regulatory Impact Statement on accessible housing.

Abstract

What do measures for increased accessibility for people with disabilities cost? And what benefit do the measures provide? What analysis methods are there to evaluate the effects of increased accessibility? This report presents a survey of socio-economic analyses carried out in the Nordic countries and internationally.

An accessible society is a priority goal for the Nordic countries’ disability policy. The concept of universal design has become increasingly central to the Nordic countries’ work.

Calculations of the costs and benefits of measures for increased accessibility are requested by authorities and companies as well as organizations. The report presents studies, methods and analyses to evaluate the benefits and costs of various measures within universal design and accessibility. 

The focus is on cost-benefit analyzes and impact studies. The mapping has been carried out via a literature search, surveys to experts and two workshops. A total of 45 studies and seven literature reviews are presented in an English-language appendix. 

Dementia + Urban Planning

Dementia is a medical diagnosis that needs consideration beyond that of health care. Living with dementia is just that – living. Urban planning has a significant role to play in supporting people with dementia to maintain an active life in their neighbourhood. Samantha Biglieri’s magazine article on dementia and planning provides some useful advice.

Around two thirds of the population with dementia live in the community not a residential care setting. How can planners understand and meet the needs of this group?

A row of blue and white apartment units that all look the same.

Dementia is diverse

Dementia is an umbrella term to describe a set of symptoms that affect memory, visual perception, judgement and ability to sequence tasks. People who are neurodiverse or have an intellectual disability, also have similar experiences. When added together this becomes a significant portion of the population needing consideration in urban planning and design.

Designing urban settings for people with dementia provides benefits for others as well. For example, we all appreciate good wayfinding design with the use of landmarks and signage.

The importance of wayfinding

Getting lost and not knowing your way home is a common fear for people with dementia. When intersections and suburban houses look the same it becomes easier to get lost. Based on a UK study, briefly Biglieri suggests the following:

  • A short, irregular grid pattern of streets to create identifiable intersections and allow residents to visualize their travel path.
  • Streets with ample space for pedestrians with wide buffer zones between pedestrian paths, cycling paths and roads;
  • Variated architectural styles within the same development, mixed land-use, designs incorporating diverse styles of street furniture, public art, and vegetation to provide unique landmarks for improved navigation;
  • Signage that uses textual information (‘5 minute walk to the library’) and realistic photos (instead of icons, which can create confusion).
  • Development of memorable landscape features, open public squares, and community facilities.

The title of the article is, Dementia + Planning: Expanding accessibility through design and the planning process.

Who gets heard in research methods?

Many studies use research methods that are not designed to enable everyone to participate. This means only some people get heard and for others, researchers aren’t hearing them. Whether it’s academic research or a workplace survey researchers could be missing out on valuable information. Cathy Basterfield makes this point in her short article on who gets heard in research methods .

Co-design processes are another form of research – action research. But will that process include people with intellectual, physical and sensory conditions? If there is a reading component, will everyone be able to read and interpret written information?

An international group of adults stand with a big board in front of them. It says, Make Things Happen. There are lots of coloured post it notes on the board. Who gets heard in research methods?

Basterfield lists some common problems with surveys: use of difficult vocabulary, imprecise response options, and ableist language or concepts.

People who need Easy English find it confusing to be asked to read a statement and rate their agreement on a scale. They prefer to be asked a direct question.

Picture of a hand holding a pen and filling in boxes on a survey form

Expecting every person to have the ability to access websites is another barrier. 25% of Australian adults are digitally excluded according to Basterfield. Some only have a phone and completing surveys requiring text is difficult at the best of times. Basterfield’s tips to help make sure everyone can understand your information:

  • add prefaces to increase precision or explain context
  • simplify sentence structure for questions
  • replace difficult words with straitforward terms
  • drop the jargon
A boy sits at a desk, pen in hand ready to write on the paper.

There is more information in Cathy Basterfield’s article Inclusive research and surveys.

Engaging people with intellectual disability in research

People with intellectual disability continue to be excluded from research practices. This is often due to social and economic factors such as limited education opportunities and access to services. Exclusion is easily perpetuated when you add systemic bias to the list.

Ethics approval processes often view people with intellectual disability as “vulnerable”. This makes their inclusion more difficult for researchers.

Four people are seated at a table but their faces are obscured. One is writing on a notepad. A coffee mug and laptop are on the table. Including people with intellectual disability.

The design of research methods systemically excludes people with disability and other marginalised groups. Consequently, their voices are unheard in health, employment, education and independent living research.

According to an article from the US, approximately 75% of clinical trials have directly or indirectly excluded adults with intellectual disabilities. Just over 33% of the studies have excluded people based on cognitive impairment or diagnosis of intellectual disability.

New methods needed

In response to the ethics and research design challenges, researchers are finding new ways to adapt their methods. The article discusses three approaches:

1. Adapting research materials and processes into individualised and accessible formats.

2. Adopting inclusive research participation methods.

3. Community participation and co-researcher engagement.

Although inclusion strategies are making progress, researchers are lacking helpful guidance. Consequently, including people with intellectual disability in research in a meaningful way requires more work.

The title of the paper is, Inclusive Methods for Engaging People With Intellectual and Developmental Disabilities in Research Practices. This is a short paper and easy to read.

Technology and wellbeing

A related article on co-designing with people with intellectual disabilities looks at developing technologies. Here is an excerpt from the abstract:

Involving people with intellectual disabilities on issues relating to their mental wellbeing is essential for developing relevant tools. This research explores the use of inclusive and participatory co-design techniques and principles.

Individuals with intellectual disabilities participated in a co-design process via a series of
workshops and focus groups. The workshops helped participants explore new technologies, including sensors and feedback mechanisms that can help monitor and potentially improve mental wellbeing. The co-design approach developed various interfaces suited to varying ages.

The title of the article is, In the hands of users with Intellectual Disabilities: Co-Designing Tangible User Interfaces for Mental Wellbeing.

People with intellectual disability and support workers

Abuse of people with intellectual disability focuses on extreme forms of violence at the expense of everyday indignities. Humiliation, degradation, and hurt have a negative effect on identity and makes it more difficult to recruit research participants.

An article by a group of Australian researchers recommends taking action to support both workers and people with disability for improved wellbeing. Here are the key points from their article:

  • Everyday harms are the little things that upset people, such as making unkind jokes about you, being ignored, or disrespected, are not treated as abuse
  • In our project, we called this misrecognition.
  • We looked at when misrecognition happened between young people with disability and their paid support workers.
  • Much of the time, people did not intend to cause harm, but the other person was still hurt by the things they did or said.
  • We can improve the way that people with disability and support workers work together if people understand how their actions affect other people.

The article is titled, Recasting ‘harm’ in support: Misrecognition between people with intellectual disability and paid workers.

Theatre, research and intellectual disability

This study aims to demonstrate how disability theatre contributes to inclusive research practice with people with intellectual disability. The title of the article is Disability Theatre as Critical Participatory Action Research (CPAR). Here is an excerpt from the abstract:

This article describes how self-advocates (individuals with intellectual disability), theatre artists, researchers, and a community living society create social justice disability theatre as critical participatory research. It demonstrates how disability theatre can contribute
to and advance inclusive research practice.

Disability justice-informed theatre as CPAR has direct relevance to people with intellectual disabilities. It also offers a platform where self-advocates’ diverse ways to communicate and be in the world are honoured. Mentorship generates opportunities for self-advocates to learn, practice, and develop research skills.

The theatre creation process (devising, developing, and refining scenes) is research in itself where tensions are recognized as sites of possibility. Future research should explore strategies, and protocols for power sharing and problem solving within disability theatre.

Robotics, ethics and inclusive design

This post features abstracts from a conference panel session about robotics and ethics, and inclusive design. There’s more awareness of the need for diversity and representation in the development of ethical robots. The decision-making processes that go into these robots must be inclusive and considerate of the diverse communities that will interact with them. The discussion papers focus on two things: ethical implications of diversity in robotic research, and fostering a deeper understanding of diverse perspectives on design.

Key concepts considered in the abstracts are:

  • Privacy and surveillance, bias in decision systems and automation and employment.
  • Diversity, equity and inclusion and autonomous machines.
A white human shaped robot is standing in a technology store. It has a touch screen attached to the chest area. What are the ethics and inclusion?

The title of the session is, Robotics at the Crossroads: A Discussion of Ethical Considerations, Moral Implications, and Inclusive Design. Here is a brief overview of the five abstracts.

Revisiting the use and misuse of autonomous

The application of technologies like generative AI is outpacing our ability to understand the implications for users. So who is really being serviced by these technologies?

Autonomous vehicles and ethical decision making

One of the motivations behind autonomous vehicles (AVs) is the potential to reduce vehicle crashes due to driver factors such as inattention. However, there are social concerns about how AVs should behave ethically in unavoidable crashes.

Opportunities for inclusive and ethical design in the U.S. army

The male body as a standard the the design of military equipment changed in the 1980s. However, aviation remains male-dominated and, for example, airplane cockpits are still designed with men in mind. This where Human Factors design is needed to ensure military equipment is operated at optimum levels regardless of the body size of the user.

Ethics and inclusion in product design and development

Product experience researchers have a unique role to play in the development of creating new products. While they don’t write code or build algorithms, they look at the use and impacts of these technologies when they become products.

Design Equity

Human-robot interaction as a discipline likely has more questions than answers when it comes to equitable design. Is technology value-free? If technology is not value-free, what values, or who’s values are highlighted, and who’s are downgraded? Experts in diversity, equity and inclusion should collaborate with robotic engineers and designers.

Autism: What we have heard

The Olga Tennison Autism Research Centre has responded to the NDIS Review Committee’s interim report, What we have heard. In responding they draw on evidence from their research and from autistic people.

The report has 29 recommendations that go beyond the NDIS review to all sections of society. The focus is on children – one in ten Australian children are participants in the NDIS. The recommendations are based on providing supports in everyday early childhood settings and with collaboration across governments and community services.

Longer term support needs are minimised if neurodevelopment vulnerability is detected early and community-based supports are put in place.

Front cover in red and white of the What we Have Heard Report.

When setting up the NDIS the Productivity Commission’s assumption was that about 1 in 150 children would need support. Research at that time showed it was closer to 1 in 69. Currently the estimation is 1 in 31 children are autistic. This figure is similar to those in other countries and indicates diagnoses not prevalence. In addition, autistic people are just as likely to have some of the same challenges neurotypical people face. Intersectionality applies here too.

Community supports in everyday settings

With the right community supports, children can make significant developmental gains and increase their chances of participating in mainstream settings. State and local governments should be key players in the quest to include autistic people in community activities, education and employment.

The title of the report is, Olga Tennison Autism Research Centre: Response to ‘What we have heard’ report. The research centre is based at La Trobe University. They aim to support autistic people to realise their full potential, and to actively participate in the community.

La Trobe University pioneered an autism screening tool which is used on children as young as 11 months. The SACS-R tool, or Social Attention Communication Surveillance Tool, is based on 15 years of research. Key points are infrequent or inconsistent use of:

  • gestures (waving, pointing)
  • response to name being called
  • eye contact
  • imitaton or copying others
  • sharing interest with others
  • pretend play
A young boy in a white T shirt is pointing at something in the distance. The background shows he is at the coast.

La Trobe University has devised a free app, called ASDetect to help parents detect autism in their child. the App is 83% accurate and is for children from 11 to 30 months.

This research paves the way for more autistic people to participate in everyday life and feel included. The Victorian Government has a state-based autism plan in recognition of the need for community support.

Assistive technology and universal design

All the universally designed places, spaces, and services are of no use if a person cannot access them due to lack of the assistive technology they need. On the other hand, a wheelchair, for example, is of little use without level access in the built environment. Together, assistive technology and universal design form the disability inclusion continuum. Both are needed but are rarely discussed together.

The assistive technology and universal design continuum showing AT at one end an universal design at the other. In between the two meet for inclusion.
Assistive technology and universal design work together for disability inclusion

Together, assistive technology (AT) and home modifications are essential for independent living. But access to the funding schemes is somewhat haphazard, especially for the majority of people who are not NDIS participants. The cost of AT and home modifications is the cited as the reason for letting the status quo remain. But who is really paying for NOT funding AT for the people who need these devices? Until now, there has been little research on this issue.

A team at Monash University set up a study to identify the many AT and home modification schemes in Australia. They also conducted an economic analysis of the data they collected to form policy recommendations. The fact that there are 88 government funders administering 109 schemes tells us there is a problem here. Difficulties obtaining data from these schemes confounds the issues further.

Recommendations

The NDIS, and the misplaced assumption that it will cover everyone with a disability, has caused greater inequity in the provision of AT. It now makes the matter more urgent.

The most obvious recommendation is to take a whole of government approach to tackle the inequity of access to AT and home modifications. The second, is to devise a way of capturing data for more informed decision making. Data are essential for measuring needs and outcomes. The third recommendation is to co-design – a universal design concept – with stakeholders.

Governments cannot expect to achieve significant change within Australia’s new Disability Strategy unless people with disability have access to AT and HM they need. The current study offers new evidence to inform government responses to realise the potential of AT and HM through public policy reform.

Assistive technology was peviously known as “aids and equipment for people with disability”. That’s because it is not mainstream equipment such as a pair of scissors, or a bicycle. Anyone requiring assistive technology requires a prescription by a health professional to access a funding scheme. The same goes for anyone requiring a home modification so they can live safely at home.

The title of the paper is, It is time for nationally equitable access to assistive technology and home modifications in Australia: An equity benchmarking study. It is open access.

From the abstract

Australians with disability have inequitable access to assistive technology (AT) and home modifications (HM). This is inconsistent with human rights obligations and fails to capitalise on internationally recognised potential return on investment.

This study quantifies the public provision of AT and HM in Australia by identifying all publicly funded schemes and comparing data on the spend per person.

An environmental scan and data survey identified 88 government funders administering 109 schemes. Data were available for 1/3 of schemes. Economic evaluation of available cost and participant data estimated the annual AT/HM spend per person per scheme.

Data demonstrated significant AT/HM spend variability across schemes. Modelled costs are presented for a $16 billion national scheme where all Australians with disability are funded NDIS-equivalent. There are substantial service provision gaps and an urgent need for change in disability policy. A cost model and policy principles are proposed to achieve economies of scale and equity in the provision of AT and HM.

Victoria’s Autism Plan

The Victoria’s Autism Plan builds on their Absolutely everyone: state disability plan. It incorporates commitments to remove specific barriers faced by people in the autistic community. The plan is based on feedback from a parliamentary inquiry into the needs of autistic people and their families. Building helpful attitudes toward autistic people is a key element of Victoria’s Autism Plan.

The document begins with personal stories, which is pleasing to see because they are more revealing than statistics or diagnoses. It sets the tone for the rest of the document and acknowledges additional barriers faced by the autistic community.

Front cover of Victorian Autism plan showing a child in a blue track suit on a swing. A woman stands behind him.

A note on language

The term Autism Spectrum Disorder (ASD) is no longer the preferred term. Language is influential in changing community attitudes so choosing the right terms is important. Individuals and advocacy bodies were asked which term they thought should be used in the plan. There was general agreement that the term “autistic people” should be used. An important point – ask people what terms they prefer.

Key points in the plan

The parliamentary inquiry found that autistic people experience social isolation, and difficulty accessing health and other public services. Specific barriers included:

  • lack of community understanding
  • accessing education that meets their needs
  • exclusion from employment opportunities
  • limited access to supports and services
  • additional barriers to inclusion for autistic people with intersecting identities
A boy and a woman lay on the grass together looking up at the sky.

The commitments in this plan relate to the key areas in the state disability plan: inclusive communities; health housing and wellbeing; fairness and safety; and contributing lives. The plan has more detail on each commitment and useful case studies illustrate success stories.

Although there is greater community awareness of autism, community attitudes remain the biggest barrier to inclusion in social and economic life. Many autistic people avoid environmental barriers such as crowds, noise and light levels. Worrying how people will treat them or respond to them adds to social isolation.

There are four ways to access the plan on the website: Full version in PDF, Easy English Version in PDF, a text version in Word, and an Auslan summary. Or you can download the full PDF version, Victorian Autism Plan.

Inclusive and accessible libraries

We know public libraries have books and magazines, but they are often a major focal point in a community as well. But not everyone can take advantage of the many and varied library resources, and it’s not just about being able to read. Getting to and around a library and being made welcome will encourage more people to take advantage of their local library. So what actions can library staff take to make inclusive and accessible libraries?

Malmo City libraries in Sweden developed a guide to accessibility for their staff. It’s titled, A Library Without Obstacles: A Guide to Accessibility. The guide is easy to read and follow and is useful for any information service, not just libraries. It’s translated to English and consequently, some terms are specifically Swedish.

Libraries in Sweden must be accessible to all and provide an equal opportunity to enjoy literature and knowledge. Their basic premise is whatever is necessary for some is good for everyone. This premise holds for all information services. Image is the front cover of the guide.

Front cover of A Library Without Obstacles with a photo of a girl with a tablet close to her face. She is smiling. Inclusive and Accessible Libraries.

What do libraries offer besides books?

Libraries across the globe arrange events throughout the year including school holidays. Many offer community information services, and librarians have skills in finding information when looking for something in particular. Events must be as accessible as possible and visitors like to know the level of access they can expect. The guide lists some minimum requirements. The way information is presented is also important.

“We write so everyone can understand. Plain language means using words that are easy to understand in a clear and simple structure. Use everyday language, write short sentences, and begin with the most important information.” Image is from the guide.

A photo from the Guide showing a young man in a blue shirt working on his laptop. The text says, Accessible information and communication.

Reading without obstacles

Most libraries offer adapted media such as talking books, large print and easy to read books. Getting to the library and finding your way around is key for people with physical disabilities. The aim of an inclusive and accessible library is that everyone should be able to reach their next book.

While this guide is for public library staff, the content is applicable to other institutions and services that provide public information. An excellent resource with many of the actions easy to achieve.

Occupational therapy & universal design

Is it enough for the occupational therapy profession to just focus on clients and their occupation goals? Barriers faced by people with disability, are complex and multi-faceted and go beyond specific individual solutions. So, at what point should occupational therapists engage in issues of social justice? And can universal design thinking help?

Disability studies emphasise the dignity, worth and equal rights of all people and draws attention to the discrimination faced by people with disability.

A man in a wheelchair is separated from the crowd by a low concrete barrier. Occupational therapy & universal design.

Two researchers, one from social science and one from occupational therapy, offer an interesting discussion on this topic. They argue that occupational therapy practice and research should incorporate social justice and universal design perspectives. They add that they should join with the disability community to call for a more just society. One way to do this is to also promote the principles of universal design.

Incorporating social justice and universal design perspectives more effectively requires a change of mindset and ways of working. Expanding Person-Centred and Person-Environment theories to understand social and structural barriers is one solution. The occupational therapy profession has the potential to pave the way for more equitable services and policies.

The title of the discussion paper is, Drawing on critical disability and universal design perspectives within occupational therapy and is open access.

From the abstract

Socio-political influences have gained increased attention within the occupational therapy profession. Critical disability studies question prevailing assumptions about disability and how disabling ideologies and practices are perpetuated in society. A universal design approach aims to address issues of inclusion and justice.

This paper discusses how the tenets of critical disability studies and universal design can contribute to occupational therapy practice and research.

We provide ideas on how practice can be guided by the tenets of disability studies and universal design to promote social equity.

Incorporating both perspectives in occupational therapy practice and research requires a change in mindset and ways of working. Occupational therapy knowledge needs to be expanded to scrutinise disabling hindrances hidden within social and structural spaces, and implemented in services.

We recommend working with disability communities to raise awareness and combat disabling barriers at various level of society.

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