This publication is funded under a contract supported by the Office of Disability Employment Policy of the U.S. Department of Labor, contract #J-9-M-2-0022. The opinions contained in this publication are those of the contractor and do not necessarily reflect those of the U.S. Department of Labor.

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ACCOMMODATIONS FOR PEOPLE WITH MENTAL RETARDATION OR OTHER DEVELOPMENTAL DISABILITIES
By Suzanne R. Gosden, MA

Preface

Terminology

Asperger Syndrome is a social and communication disorder. Individuals with Asperger Syndrome may have problems with social interaction, nonverbal communication, or managing change. They appear to lack common sense. Other difficulties include motor skills, writing, math, abstract reasoning, or concept formation. People with Asperger Syndrome may have anxiety, depression, or behavioral problems. http://www.asperger.org

Autism is a complex developmental disorder. Symptoms of autism include impaired social interaction, problems with verbal and nonverbal communication and imagination, and unusual or severely limited activities and interests. The most severe cases of autism are marked by extremely repetitive, unusual, self-injurious, and aggressive behavior. The mildest forms of autism resemble a personality disorder associated with a perceived learning disability. http://www.autism-society.org

Cerebral Palsy is a disorder caused by brain damage, affecting ability to control movement and posture. People with Cerebral Palsy exhibit muscle weakness (paresis), inability to make voluntary movements and suppress involuntary ones. It can be associated with other problems such as seizures, mental retardation, ear/hearing problems, eye/vision problems, or verbal communication problems. http://www.ucpa.org

Developmental Disabilities are severe, chronic disabilities which are attributable to a mental or physical impairment or combination of mental and physical impairments; are manifested before the person attains the age twenty-two; is likely to continue indefinitely; and results in substantial functional limitations in three or more of the following areas of major life activities:

Large Blue Triangle Bullet self-care
Large Blue Triangle Bullet receptive and expressive language
Large Blue Triangle Bullet learning
Large Blue Triangle Bullet mobility
Large Blue Triangle Bullet self-direction
Large Blue Triangle Bullet capacity of independent living
Large Blue Triangle Bullet economic self-sufficiency

http://www.arch.gatech.edu

Down Syndrome is a genetic condition caused by extra genetic material (genes) from the 21st chromosome. Individuals with Down Syndrome also have some degree of mental retardation, or cognitive disability and other developmental delays. Sixty to eighty percent of people with Down syndrome have hearing deficits. Fourty to fourty-five percent of people with Down syndrome have congenital heart disease. Other important medical aspects in Down syndrome, including immunologic concerns, leukemia, Alzheimer disease, seizure disorders, sleep apnea and skin disorders. http://TheArc.org/faqs/down.html

Fetal Alcohol Syndrome is a series of mental and physical birth defects that include mental retardation, growth deficits, central nervous system dysfunction, craniofacial abnormalities and behavioral maladjustments. Fetal Alcohol Effect is a less severe set of the same symptoms. http://www.nofas.org

Fragile X Syndrome is a hereditary condition which can cause learning problems ranging from subtle learning disabilities and a normal IQ, to severe mental retardation and autism. Individuals with Fragile X syndrome may also have physical and behavioral disorders, and speech and language delay. http://nfxf.org

Mental Retardation begins in childhood and is characterized by limitations in both intelligence and adaptive skills. An individual is considered to have mental retardation based on three criteria: intellectual functioning level (IQ) is below 70-75; significant limitations exist in two or more adaptive skill areas; and the condition is present from childhood (defined as age 18 or less) (AAMR, 1992). The three major known causes of mental retardation are Fetal Alcohol Syndrome, Down syndrome, and Fragile X syndrome. http://thearc.org

Prater-Willi Syndrome is a complex genetic disorder that includes short stature, mental retardation or learning disabilities, incomplete sexual development, characteristic behavior problems, low muscle tone, and an involuntary urge to eat constantly, which leads to obesity. http://www.pwsausa.org

Spina Bifida is a congenital deformity that begins early in pregnancy. It is characterized by a defective closure in the vertebral column. The most common impairment is partial or total paralysis of affected muscle groups. People with spina bifida may also have bowel and bladder dysfunction. Individuals may develop hydrocephalus at birth, which can create learning disabilities and other cognitive impairments. http://www.arch.gatech.edu

Other related conditions or symptoms of MR/DD can include:

Large Blue Triangle Bullet Pervasive developmental disorder-not otherwise specified
Large Blue Triangle Bullet Semantic-pragmatic disorder
Large Blue Triangle Bullet Hyperlexia
Large Blue Triangle Bullet Developmental language disorder
Large Blue Triangle Bullet Mixed expressive-receptive language disorder
Large Blue Triangle Bullet Speech disorders-not otherwise specified
Large Blue Triangle Bullet Hearing impairments
Large Blue Triangle Bullet Vision impairments
Large Blue Triangle Bullet Gross motor impairments
Large Blue Triangle Bullet Fine motor impairments

Accommodation Ideas for People with MR/DD

Note: People with MR/DD may experience limitations in cognitive abilities, motor abilities, and social abilities that can affect workplace performance. People who have MR/DD may have some of these limitations, and possibly all of these limitations. The degree of limitation will vary from individual to individual, and therefore, the accommodation provided will also vary.

Limitations in Cognitive Abilities

Reading: Depending on IQ and other cognitive abilities, people with MR/DD may not be able to read information in the work environment.

Large Blue Triangle Bullet Provide pictures, symbols, or diagrams instead of words
Large Blue Triangle Bullet Read written information to employee
Large Blue Triangle Bullet Provide written information on audiotape
Large Blue Triangle Bullet Use voice output on computer
Large Blue Triangle Bullet Use Reading Pen on single words
Large Blue Triangle Bullet Use line guide to identify or hi-light one line of text at a time

Writing: Depending on IQ and other cognitive abilities, people with MR/DD may not be able to write, spell, sign documents, or otherwise communicate through written word.

Large Blue Triangle Bullet Provide templates or forms to prompt information requested
Large Blue Triangle Bullet Allow verbal response instead of written response
Large Blue Triangle Bullet Allow typed response instead of written response
Large Blue Triangle Bullet Use voice input on computer
Large Blue Triangle Bullet Use spell-check on computer
Large Blue Triangle Bullet Use a scribe to write the employee's response
Large Blue Triangle Bullet Provide ample space on forms requiring written response

Memory: People with MR/DD might have memory deficits due to auditory processing problems, cognitive inability to retain information, or congenital hearing impairment.

Large Blue Triangle Bullet Use voice activated recorder to record verbal instructions
Large Blue Triangle Bullet Provide written information
Large Blue Triangle Bullet Provide checklists
Large Blue Triangle Bullet Prompt employee with verbal cues (reminders)
Large Blue Triangle Bullet Post written or pictorial instructions on frequently-used machines

Performing Calculations: Depending on IQ and other cognitive abilities, people with MR/DD may not be able to count, tally, measure, or track due to an inability to "do math" or perform calculations involving numbers.

Large Blue Triangle Bullet Allow use of calculator

Small Triangle Blue Bullet Large-display calculator
Small Triangle Blue Bullet Talking calculator

Large Blue Triangle Bullet Use counter or ticker
Large Blue Triangle Bullet Make pre-counted or pre-measured poster or jig
Large Blue Triangle Bullet Provide talking tape measure
Large Blue Triangle Bullet Use liquid level indicators
Large Blue Triangle Bullet Mark the measuring cup with a "fill to here" line

Organization: People with MR/DD may be disorganized due to an inability to retain information and/or an inability to transfer or apply skills in different work environments.

Large Blue Triangle Bullet Minimize clutter
Large Blue Triangle Bullet Color-code items or resources
Large Blue Triangle Bullet Provide A-B-C chart
Large Blue Triangle Bullet Provide 1-2-3 chart
Large Blue Triangle Bullet Divide large tasks into multiple smaller tasks
Large Blue Triangle Bullet Avoid re-organization of workspace
Large Blue Triangle Bullet Label items or resources

Small Triangle Blue Bullet Use symbols instead of words
Small Triangle Blue Bullet Use print labels instead of hand-written labels

Time Management/Performing or Completing Tasks: People with MR/DD may have limitations in adaptive skills, such as self-initiating tasks.

Large Blue Triangle Bullet Provide verbal prompts (reminders)
Large Blue Triangle Bullet Provide written or symbolic reminders
Large Blue Triangle Bullet Use alarm watch or beeper
Large Blue Triangle Bullet Use jig for assembly to increase productivity
Large Blue Triangle Bullet Arrange materials in order of use
Large Blue Triangle Bullet Use task list with numbers or symbols
Large Blue Triangle Bullet Avoid isolated workstations
Large Blue Triangle Bullet Provide space for job coach
Large Blue Triangle Bullet Provide additional training or retraining as needed

Limitations in Motor Abilities

Using Computer: People with MR/DD might have difficulty using the computer due to motor problems, such as manual dexterity deficits, spasticity or rigidity, paralysis, or birth defects involving the fingers, hands, or arms.

Large Blue Triangle Bullet Use key guard
Large Blue Triangle Bullet Use alternative input devices

Small Triangle Blue Bullet speech recognition
Small Triangle Blue Bullet speech output
Small Triangle Blue Bullet trackball
Small Triangle Blue Bullet joystick
Small Triangle Blue Bullet touchscreen

Using Telephone: People with MR/DD might have difficulty using the telephone due to motor problems, such as manual dexterity deficits, spasticity or rigidity, paralysis, or birth defects involving the fingers, hands, or arms.

Large Blue Triangle Bullet Use large-button phone
Large Blue Triangle Bullet Use phone with universal symbols (fire, police, doctor)
Large Blue Triangle Bullet Use phone with speed-dial, clearly labeled
Large Blue Triangle Bullet Use receiver holder
Large Blue Triangle Bullet Use headset

Accessing Workspace: People with MR/DD may have difficulty accessing the workspace due to gross motor problems, such as muscle weakness or fatigue, an inability to stand for long periods of time, inability to walk long distances, inability to reach items, or an inability to carry/move heavy objects.

Large Blue Triangle Bullet Place anti-fatigue mats at workstation
Large Blue Triangle Bullet Use motorized scooter
Large Blue Triangle Bullet Use stools at workstations
Large Blue Triangle Bullet Move items within reach
Large Blue Triangle Bullet Provide frequent rest breaks

Handling or Grasping Objects: People with MR/DD might have difficulty handling or grasping objects due to fine motor problems, such as an inability to pinch or grip, inability to maintain a steady hand, muscle weakness, or joint pain.

Large Blue Triangle Bullet Use ergonomic tools, handle build-ups, or other tool adaptations
Large Blue Triangle Bullet Use orthopedic writing aids
Large Blue Triangle Bullet Use grip aids
Large Blue Triangle Bullet Use jig or brace

Limitations in Social Abilities

Emotional Support: People with MR/DD may need more or different emotional support in the workplace.

Large Blue Triangle Bullet Give positive feedback
Large Blue Triangle Bullet Use visual performance charts
Large Blue Triangle Bullet Provide tangible rewards
Large Blue Triangle Bullet Use co-workers as mentors
Large Blue Triangle Bullet Use Employee Assistance Program (EAP)
Large Blue Triangle Bullet Provide job coach

Interacting with Co-Workers: People with MR/DD may have limitations in adaptive skills, such as communicating with others, or exhibiting appropriate social skills.

Large Blue Triangle Bullet Provide sensitivity training (disability awareness) to all employees
Large Blue Triangle Bullet Use role-play scenarios to demonstrate appropriate behavior in workplace
Large Blue Triangle Bullet Use training videos to demonstrate appropriate behavior in workplace
Large Blue Triangle Bullet Model appropriate social skills

Small Triangle Blue Bullet Where to eat at work
Small Triangle Blue Bullet When to eat at work
Small Triangle Blue Bullet When to hug other co-workers
Small Triangle Blue Bullet How to pay for coffee
Small Triangle Blue Bullet What to do if you are mad
Small Triangle Blue Bullet Who to ask for help
Small Triangle Blue Bullet When to leave your workstation

Working Effectively with Supervisors: People with MR/DD may have limitations in adaptive skills, such as communicating with others and exhibiting appropriate social skills.

Large Blue Triangle Bullet Communicate one-to-one with employee
Large Blue Triangle Bullet Deal with problems as they arise
Large Blue Triangle Bullet Keep job coach informed
Large Blue Triangle Bullet Train supervisors on communication etiquette
Large Blue Triangle Bullet Discuss disciplinary procedures
Large Blue Triangle Bullet Monitor effectiveness of accommodations currently provided

To discuss further accommodations for people with mental retardation or developmental disabilities, contact JAN.

Accommodation Scenarios

RESOURCES

If you have a question about accommodations and/or the employment provisions of the Americans with Disabilities Act (ADA), click here:
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