Resource Guide For Training Disability Competence

Resource Guide for Training
Disability Competence
A resource guide for PT and PTA faculty, clinicians , and students
December 2021
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Authors
Cara N. Whalen Smith, PT, DPT, MPH, CHES
2021 APTA Centennial Scholar, HPA The Catalyst
Co-Founder, Disability Justice and Anti-Ableism Catalyst Group, HPA The Catalyst
SME Mentor, Beyond Clinical Practice Catalyst Group, HPA The Catalyst
Project Evaluator, Ohio Disability and Health Partnership
Project Director, Ohio Colleges of Medicine Government Resource Center
Editors
HPA The Catalyst Board of Directors
President: Matthew Mesibov, PT, GCS

Vice President: Karen Hughes, PT
Secretary: Jeremy Bittel, PT, DPT
Treasurer: Lori Pearlmutter, PT, MPH
Director of Scholarship: Dawn Magnusson, PT, PhD
Director of Operations: Amit Mehta, PT, DPT, MBA
Director of Social Responsibility & Global Health: Jennifer Audette, PT, PhD
Director of Technology & Innovation: Bob Latz, PT, DPT, CHCIO, CIO
Director of LAMP: Susan M. Ropp, PT, MS
Disability Justice and Anti-Ableism Catalyst Group
Co-Founder: Winston Kennedy, PT, DPT, MPH

Co-Founder: Heather A. Feldner, PT, PhD, PCS
Co-Founder: Deana Herrman, PT, CWS
Co-Founder: Bethany M. Sloane, PT, DPT
Co-Founder: Faye H. Weinstein, PT, MMSc, MS
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Ohio Disability and Health Partnership
Program Director & PI: Susan Havercamp, PhD, FAAIDD, NADD -CC
Program Manager & PI: David Ellsworth, MPH, CHES
Clinical Research Assistant: Samantha Shetterly
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Table of Contents
Introduction .................................................................................................................................... 5
Core Competencies on Disability for Health Care Education Citations and Toolkit ....................... 7
Sources of Population-Level Data ................................................................................................... 8
Suggested Reading List ................................................................................................................... 9
Training Resources ........................................................................................................................ 25
Appendix I: Core Competencies on Disability for Health Care Education .................................... 32
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Introduction
People with disabilities comprise the largest underserved group in the United States (26% of
Americans)1,2 and intersect with all historically disadvantaged and underrepresented groups,
including Black, Indigenous, People of Color (BIPOC), the LGBTQ+ community, women, and
immigrants and refugees.3 The World Health Organization (WHO) defines disability as any
health condition resulting in impairments, activity limitations, and/or participation
restrictions.4 It is important to note that participation restrictions are often a result of
inaccessible environments or ableist attitudes and practices in our society, and not reflective of
an individual’s impairments or activity limitations. Disability is often excluded from discussions
of social determinants of health due to misinformation or misunderstanding surrounding
disability and health.5 Historically, disability has been mistakenly described as an adverse health
outcome, rather than acknowledged as a demographic characteristic for millions of Americans.6
More accurately, people with disabilities are a community of individuals who share a unique
culture and collective lived experiences, which often include instances of institutionalized
discrimination.6 People with disabilities are not destined for a life of poor health status by
virtue of their disability.6 In fact, the WHO makes the distinction between health and disability
in its definition of disability through the International Classification of Functioning (ICF) model.4
Often, it is the lack of institutional support and other barriers for people with disabilities that
contributes to poor health outcomes, which is a phenomenon seen among all historically
underserved populations.6
People with disabilities experience worse health outcomes and decreased access to competent
health care than people without disabilities.7,8 To address these health inequities stemming
from organizational, physical, communication, and attitudinal barriers, the Core Competencies
on Disability for Health Care Education (Core Competencies) were developed through a
rigorous national Delphi method consensus process to train a more prepared and competent
health care workforce.9 To date, the Core Competencies have been endorsed by 25 local and
national health professional and disability-related organizations indicating that the
competencies capture the essential standards to providing quality health care for people with
disabilities.
Purpose of this Guide

This guide was developed as part of the APTA Centennial Scholars Program to provide training
resources for faculty and clinicians to improve their own disability competence and to use in
the training of their students that address the Core Competencies. These materials specifically
highlight conceptual and contextual frameworks of disability, civil rights and independent living
history of people with disabilities and their access to services, how the social determinants of
health directly impact people with disabilities, and disability as an aspect of diversity/cultural
identity and not merely a negative health outcome. These resources also provide information
5
about ableism, how it functions in our society and within the physical therapy profession, and
how the profession can undertake a deeper examination of ways that ableism operates and can
be identified and mitigated.10 The intent of this resource guide is to promote cultural
competence within physical therapy practice, specifically as it relates to topics on disability and
the intersection between diversity, equity, and inclusion. This guide is not exhaustive or
comprehensive. Users are encouraged to use this as a starting point to build their competence
and to include more disability content into their training programs.
References
1. Okoro CA, Hollis ND, Cyrus AC, Griffin-Blake S. Prevalence of disabilities and health care access
by disability status and type among adults — United States, 2016. MMWR Morb Mortal Wkly
Rep, 2018;67(32):882–887. DOI: http://dx.doi.org/10.15585/mmwr.mm6732a3
2. Centers for Disease Control and Prevention. Disability and Health Data System (DHDS) [Internet].
[updated 2018 May 24; cited 2018 August 27]. Available from: http://dhds.cdc.gov
3. Drum C, McClain MR, Horner-Johnson W, Taitano G. Health disparities chart book on disability
and racial and ethnic status in the United States. Institute on Disability, University of New
Hampshire. https://iod.unh.edu/projects/health-disparities-project/health-disparities-chart-
book Published August 2011. Accessed October 5, 2015.
4. World Health Organization. Disabilities. http://www.who.int/topics/disabilities/en/. Published
2012. Accessed October 26, 2015.
5. McDonald KE, Raymaker DM. Paradigm shifts in disability and health: Toward more ethical
public health research. Am J Public Health, 2013;103 (12):2165-
2173. https://ajph.aphapublications.org/doi/10.2105/AJPH.2013.301286
6. Blick R, Franklin M, Ellsworth D, Havercamp S, Kornblau B. (2015). The Double Burden: Health
Disparities among People of Color Living with Disabilities. (Available from the Ohio Disability and
Health Program, https://nisonger.osu.edu/wp-
content/uploads/2016/11/The_Double_Burden_Health_Disparities_among_People_of_Color_Li
ving_with_Disabilities.pdf).
7. VanPuymbrouck L, Friedman C, Feldner H. Explicit and implicit disability attitudes of healthcare
providers. Rehabilitation Psychology, 2020;65(2):101-112. https://doi.org/10.1037/rep0000317
8. Feldner HA, VanPuymbrouck L, Friedman, C. Explicit and implicit disability attitudes of
occupational and physical therapy assistants. Disability and Health Journal, 2022;15(1):101217.
https://doi.org/10.1016/j.dhjo.2021.101217
9. Alliance for Disability in Health Care Education. (2019). Core Competencies on Disability for
Health Care Education. Peapack, NJ: Alliance for Disability in Health Care Education.
http://www.adhce.org/. Retrieved from, https://nisonger.osu.edu/education-training/ohio-
disability-health-program/corecompetenciesondisability/.
10. Feldner HA, Lent K, Lee S. Approaching disability studies in physical therapist education:
Tensions, successes, and lessons learned. Journal of Teaching Disability Studies, 2021;2:1-30.
https://jtds.commons.gc.cuny.edu/approaching-disability-studies-in-physical-therapist-
education-tensions-successes-and-future-directions/
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Core Competencies on Disability for Health Care Education Citations and
Toolkit
Citation for the Core Competencies
• Alliance for Disability in Health Care Education. (2019). Core Competencies on Disability
for Health Care Education. Peapack, NJ: Alliance for Disability in Health Care Education.
http://www.adhce.org/. Available at https://nisonger.osu.edu/wp-
content/uploads/2019/08/post-consensus-Core-Competencies-on-Disability_8.5.19.pdf
Information on the Development of the Core Competencies

• Havercamp SM, Barnhart WR, Robinson AC, Whalen Smith CN. What should we teach
about disability? National consensus on disability competencies for health care
education. Disabil Health J, 2021;14(2):100989.
Toolkit to Implement the Core Competencies

• Ohio Disability and Health Program (ODHP). Competency Resource Toolkit for Core
Competencies on Disability. (2019). Available at https://nisonger.osu.edu/education-
training/ohio-disability-health-program/core-competencies-disability-health-care-
education-toolkit/
7
Sources of Population-Level Data
National
• CDC Disability & Health Data System (DHDS)
o https://www.cdc.gov/ncbddd/disabilityandhealth/dhds/index.html
• Annual Disability Statistics Compendium (source American Community Survey)
o https://disabilitycompendium.org/
• National Core Indicators (NCI)
o https://www.nationalcoreindicators.org/
• Residential Information Systems Project (RISP)
o https://risp.umn.edu/
• Other Population Surveys that collect standard disability demographics:
https://www.cdc.gov/ncbddd/disabilityandhealth/datasets.html
o American Community Survey (ACS)
o American Housing Survey (AHS)
o Behavioral Risk Factor Surveillance System (BRFSS)
o Current Population Survey (CPS)
o Health Information National Trends Survey (HINTS)
o Medical Expenditure Panel Survey (MEPS)
o National Crime Victimization Survey (NCVS)
o National Health and Aging Trends Study (NHATS)
o National Health Interview Survey (NHIS)
o National HIV Behavioral Surveillance Survey (NHBS)
o National Postsecondary Student Aid Study (NPSAS)
o National Survey of Children’s Health (NSCH)
o National Survey of Drug Use and Health (NSDUH)
o National Survey of Family Growth (NSFG)
o National Survey of the Diagnosis and Treatment of ADHD and Tourette
Syndrome (NS-DATA)
o Survey of Income and Program Participation (SIPP)
o Youth Risk Behavior Surveillance System (YRBSS)
▪ https://www.cdc.gov/healthyyouth/data/yrbs/results.htm
International
• World Health Organization Model Disability Survey (MDS)
o https://www.who.int/activities/collection-of-data-on-disability
• Disability Evidence Portal
o https://www.disabilityevidence.org/
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Suggested Reading List
Reports
• World Report on Disability
o http://www.who.int/disabilities/world_report/2011/en
• The Missing Billion
o https://www.lshtm.ac.uk/media/38726
• WHO Global Disability Action Plan 2014-2021
o https://www.who.int/disabilities/actionplan/en/
• Towards a Common Language for Functioning, Disability and Health: ICF
o https://www.who.int/classifications/icf/icfbeginnersguide.pdf
• The Surgeon General’s Call to Action to Improve the Health and Wellness of Persons
with Disabilities 2005
o https://www.ncbi.nlm.nih.gov/books/NBK44667/pdf/Bookshelf_NBK44667.pdf
• Guide to Community Preventive Services and Disability Inclusion
o https://www.cdc.gov/ncbddd/disabilityandhealth/features/preventive-services-
and-disability-inclusion.html
• The Future of Disability in America
o https://www.ncbi.nlm.nih.gov/books/NBK11434/pdf/Bookshelf_NBK11434.pdf
• NACCHO Follow-up National Assessment of the Practices, Awareness, and Inclusion of
People with Disabilities in Local Health Departments' Public Health Practices
o https://www.naccho.org/uploads/downloadable-resources/Health-and-
Disability-Followup-Assessment-Report_June-2018_FINAL.pdf
• NACCHO and NCHPAD Mobilizing for Action through Planning and Partnerships (MAPP)
Resource Guide for Disability Inclusion"
o https://www.aucd.org/docs/phe/MAPP%20for%20Disability%20Inclusion%2020
19.pdf
• Quality-Adjusted Life Years and the Devaluation of Life with Disability
o https://ncd.gov/sites/default/files/NCD_Quality_Adjusted_Life_Report_508.pdf
Books
• A Disability History of the United States (Nielsen)
• Ableism: The Causes and Consequences of Disability Prejudice (Nario-Redmond)
• An Unquiet Mind: A Memoir of Moods and Madness (Redfield Jamison)
• Being Heumann: An Unrepentant Memoir of a Disability Rights Activist (Heumann)
• Blind Rage: Letters to Helen Keller (Kleege)
• Brilliant Imperfection: Grappling with Cure (Clare)
• Care Work: Dreaming Disability Justice (Piepzna-Samarasinha)
• Claiming Disability: Knowledge and Identity (Linton)
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• Crip Theory: Cultural Signs of Queerness and Disability (McRuer)
• Demystifying Disability: What to Know, What to Say, and How to be an Ally (Ladau)
• Disability Studies: An Interdisciplinary Introduction (Goodley)
• Dis/ability Studies: Theorising Disablism and Ableism (Goodley)
• Disability Theory (Siebers)
• Disability Visibility: First Person Stories from the Twenty-First Century (Wong)
• Don’t Call Me Inspirational: A Disabled Feminist Talks Back (Rousso)
• Extraordinary Bodies: Figuring Physical Disability in American Culture and Literature
(Garland Thomson)
• Feminist, Queer, Crip (Kafer)
• If at Birth You Don’t Succeed: My Adventures with Disaster and Destiny (Anner)
• I'm Only in It for the Parking: Life and Laughter from the Priority Seats (Ridley)
• Manipulating Practices: A Critical Physiotherapy Reader (Gibson, Nicholls, Setchell, &
Groven)
• Mapping Fate: A Memoir of Family, Risk, and Genetic Research (Wexler)
• More than Ramps (Iezzoni and O'Day)
• My Body Politic (Linton)
• My Lobotomy (Dully)
• No Pity: People with Disabilities Forging a New Civil Rights Movement (Shapiro)
• Nothing About Us Without Us: Disability Oppression and Empowerment (Charlton)
• Out of Joint: A Private and Public Story of Arthritis, (Felstiner)
• Physical Health of Adults with Intellectual and Developmental Disabilities (Prasher and
Janicki)
• Planet of the Blind (Kuusisto)
• Poster Child: A Memoir (Rapp)
• Public Health Perspectives on Disability: Science, Social Justice, Ethics, and Beyond
(Lollar, Horner-Johnson, Froehlich-Grobe)
• Rehabilitation: A Post-Critical Approach (Gibson)
• Rethinking Disability: A Disability Studies Approach to Inclusive Practices (Valle and
Connor)
• Riding the Bus with my Sister (Simons)
• Routledge Handbook of Disability Studies (Watson, Roulstone, and Thomas)
• Sitting Pretty: The View from my Ordinary Resilient Disabled Body (Taussig)
• Skin, Tooth, and Bone: The Basis of Movement is our People: A Disability Justice Primer
(Sins Invalid)
• The Disability Rights Movement: From Charity to Confrontation (Fleischer and Zames)
• The Disability Studies Reader (Davis)
• The New Disability History: American Perspectives (Longmore and Umansky)
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• The Pretty One: On Life, Pop Culture, Disability, and Other Reasons to Fall in Love with
Me (Brown)
• The Reason I Jump: The Inner Voice of a Thirteen-Year-Old Boy with Autism (Higashida)
• The Short Bus: A Journey Beyond Normal (Mooney)
• “This Unfortunate Young Girl…”: Rethinking a Necessary Relationship between Disability
Studies and Rehabilitation (Guenther-Mahipaul; chapter in Rethinking Rehabilitation:
Theory and Practice)
• Too Late to Die Young: Nearly True Tales from a Life (McBryde Johnson)
• Understanding Disability: From Theory to Practice (Oliver)
• Waist High in the World: A Life Among the Nondisabled (Mairs)
• What Can a Body Do?: How We Meet the Built World (Hendren)
• Why I Burned My Book and Other Essays on Disability (Longmore)
• The National Center for College Students with Disabilities (NCCSD) Clearinghouse and
Resource Library: List of Books about Disability and Higher Education
o https://www.nccsdclearinghouse.org/list-of-books-about-disability-and-higher-
education.html
Peer-Reviewed Journal Articles

Prevalence
• Havercamp SM, Scott HM. National health surveillance of adults with disabilities, adults
with intellectual and developmental disabilities, and adults with no disabilities. Disability
and Health Journal, 2015;8(2):165-172. https://doi.org/10.1016/j.dhjo.2014.11.002
• Okoro CA, Hollis ND, Cyrus AC, Griffin-Blake S. Prevalence of disabilities and health care
access by disability status and type among adults — United States, 2016. MMWR Morb
Mortal Wkly Rep, 2018;67(32):882–887. https://doi.org/10.15585/mmwr.mm6732a3
Models of Disability, Conceptual Frameworks, and Disability as an Aspect of Diversity/Cultural

Identity
• Abberley P. Disabling ideology in health and welfare-the case of occupational therapy.

Disability & Society, 1995;10(2):221- 232. https://doi.org/10.1080/09687599550023660
• Dunn DS, Andrews EE. Person-first and identity-first language: Developing psychologists'
cultural competence using disability language. American Psychologist, 2015;70(3):255-
64. https://doi.org/10.1037/a0038636
• Ferguson PM, Nusbaum E. Disability studies: What is it and what difference does it
make? Research & Practice for Persons with Severe Disabilities, 2018;37(2):70-80.
https://doi.org/10.1177/154079691203700202
11
• Garland-Thomson R. Feminist disability studies. Signs: Journal of Women in Culture and
Society, 2005;30(2):1557-1587. https://doi.org/10.1086/423352
• Gibson B, Nicholls D, Setchell J, Groven KS. (2018) Manipulating practices: A critical
physiotherapy reader. https://doi.org/10.23865/noasp.29
• Gibson B. (2016). Rehabilitation: A post-critical approach. Boca Raton, FL: CRC Press.
https://doi.org/10.1201/b19085
• Gill CJ. Four types of integration in disability identity development. Journal of Vocational
Rehabilitation, 1997;9(1):39-46. https://doi.org/10.1016/S1052-2263(97)00020-2
• Gilson SF, DePoy E. Theoretical approaches to disability content in social work
education. Journal of Social Work Education, 2002;38(1):153-165.
https://doi.org/10.1080/10437797.2002.10779088
• Goering S. Rethinking disability: the social model of disability and chronic disease. Curr
Rev Musculoskelet Med, 2015;8:134-8. https://doi.org/10.1007/s12178-015-9273-z
• Haegele JA, Hodge S. Disability discourse: Overview and critiques of the medical and
social models. Quest, 2016;68(2):193-206.
https://doi.org/10.1080/00336297.2016.1143849
• Heffron JL, Lee D, VanPuymbrouck L, Sheth AJ, Kish J. "The bigger picture": Occupational
therapy practitioners' perspectives on disability studies. Am J Occup Ther,
2019;73(2):7302205100p1-7302205100p10. https://doi.org/10.5014/ajot.2019.030163
• Kielhofner G. Rethinking disability and what to do about it: disability studies and its
implications for occupational therapy. Am J Occup Ther, 2005;59(5):487-496.
https://doi.org/10.5014/ajot.59.5.487
• Krahn GL, Robinson A, Murray AJ, Havercamp SM. It’s time to reconsider how we define
health: perspective from disability and chronic condition. Disability and Health Journal,
2021;14(4):101129. https://doi.org/10.1016/j.dhjo.2021.101129
• Krahn GL, Walker DK, Correa-De-Araujo R. Persons with disabilities as an unrecognized
health disparity population. American Journal of Public Health, 2015;105(S2):S198-S206.
https://ajph.aphapublications.org/doi/10.2105/AJPH.2014.302182
• Linton S. Disability studies/not disability studies. Disability & Society, 1998;13(4):525-
539. https://doi.org/10.1080/09687599826588
• Magasi S. Disability studies in practice: A work in progress. Topics in Stroke
Rehabilitation, 2008;15(6):611-617. https://doi.org/10.1310/tsr1506-611
• Magasi S. Infusing Disability Studies into the Rehabilitation Sciences. Topics in Stroke
Rehabilitation, 2008;15(3):283-287. https://doi.org/10.1310/tsr1503-283
• Meekosha H, Shuttleworth R. What's so ‘critical’ about critical disability
studies? Australian Journal of Human Rights, 2009;15(1):47-75.
https://doi.org/10.1080/1323238X.2009.11910861
• Mosleh D. Critical disability studies with rehabilitation: Re-thinking the human in
rehabilitation research and practice. J Human Rehab, 2019:1-12.
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https://www.jhrehab.org/2019/11/14/making-the-case-for-critical-disability-studies-
with-rehabilitation-sciences/
• Nario-Redmond MR, Noel JG, Fern E. Redefining disability, reimagining the self: disability
identification predicts self-esteem and strategic responses to stigma. Self and Identity,
2013;12(5):468-488. https://doi.org/10.1080/15298868.2012.681118
• Nario-Redmond MR, Oleson KC. Disability group identification, disability rights advocacy
and political attitudes: contingencies among emerging adults. Emerging Adulthood,
2016;4(3):207-218. https://doi.org/10.1177/2167696815579830
• Nicholls DA, Gibson, BE. The body and physiotherapy. Physiotherapy Theory and
Practice, 2010;26(8):497-509. https://doi.org/10.3109/09593981003710316
• Oliver M, Barnes C. Disability studies, disabled people and the struggle for inclusion.
British Journal of Sociology of Education, 2010;31(5):547-560.
https://doi.org/10.1080/01425692.2010.500088
• Roush SE, Sharby N. Disability reconsidered: the paradox of physical therapy. Phys Ther,
2011;91(12):1715-1727. https://doi.org/10.2522/ptj.20100389
• Seelman K. Disability studies in education of public health and health professionals: can
it work for all involved? Disability Studies Quarterly, 2004;24(4): https://dsq-
sds.org/article/view/888/1063
• Shildrick M. The disabled body, genealogy and undecidability. Cultural Studies,
2005;19(6):755-770. https://doi.org/10.1080/09502380500365754
• Yoshida KK, Self H, Willis H. Values and principles of teaching critical disability studies in
a physical therapy curriculum: Reflections from a 25-year journey - part 1: Critical
disability studies value framework. Physiotherapy Canada, 2016;68(4):315-318.
https://doi.org/10.3138/ptc.68.4.GEE2
• Yoshida KK, Self H, Willis H, Rose N. Values and principles of teaching critical disability
studies in a physical therapy curriculum – part 2: Pedagogical imperatives and teaching
innovations. Physiotherapy Canada, 2017;69(1):6-9.
https://doi.org/10.3138/ptc.69.1.GEE2
Civil Rights History of People with Disabilities
• Atherton HL, Steels SL. A hidden history: A survey of the teaching of eugenics in health,
social care and pedagogical education and training courses in Europe. Journal of
Intellectual Disabilities, 2015;20(4):371–385.
https://doi.org/10.1177/1744629515619253
• Minarik DM, Lintner TL. Disability history: Humanity worth defending. The Ohio Social
Studies Review, 2013;50(2):15-21. https://core.ac.uk/download/pdf/217664284.pdf
• Osgood RL. Education in the name of “improvement”: The influence of eugenic thought
and practice in Indiana’s public schools, 1900-1930.” Indiana Magazine of History,
2010;106(3). https://scholarworks.iu.edu/journals/index.php/imh/article/view/12560
13
• Phelps Coco A. Diseased, maimed, mutilated: Categorizations of disability and an ugly
law in late nineteenth-century Chicago. Journal of Social History, 2010;44(1):23-37.
https://doi.org/10.1353/jsh.2010.0025
• Samuels Himelhoch M, Shaffer AH. Elizabeth Packard: Nineteenth-century crusader for
the rights of mental patients. Journal of American Studies, 1979;13(3):343-375.
https://www.jstor.org/stable/27553740
• Selden S. Eugenics and the social construction of merit, race, and disability. Journal of
Curriculum Studies, 2000;32(2): 235-252. https://doi.org/10.1080/002202700182736
Health Disparities and Access to Care
• Agaronnik ND, Pendo E, Campbell EG, Ressalam J, Iezzoni LI. Knowledge of practicing
physicians about their legal obligations when caring for patients with disability. Health
Affairs, 2019;38(4):545-553. https://doi.org/10.1377/hlthaff.2018.05060
• Algood C, Davis AM. Inequities in family quality of life for African-American families
raising children with disabilities. Social Work in Public Health, 2019;34(1):102–112.
https://doi.org/10.1080/19371918.2018.1562399
• Bright T, Kuper H. A systematic review of access to general healthcare services for
people with disabilities in low- and middle- income countries. Int J Environ Res Public
Health, 2018;15(9):1879. https://doi.org/10.3390/ijerph15091879
• Bright T, Wallace S, Kuper H. A systematic review of access to rehabilitation for people
with disabilities in low- and middle-income countries. Int J Environ Res Public Health,
2018;15(10):2165. https://doi.org//10.3390/ijerph15102165
• Groce NE. Global disability: an emerging issue. Lancet Global Health, 2018;6(7):e724-
e725. https://doi.org/10.1016/S2214-109X(18)30265-1
• Hammel J, Magasi S, Heinemann A, Gray DB, Stark S, Kisala P, Carlozzi NE, Tulsky D,
Garcia SF, Hahn EA. Environmental barriers and supports to everyday participation: a
qualitative insider perspective from people with disabilities. Archives of Physical
Medicine & Rehabilitation, 2015;96(4):578-588.
https://doi.org/10.1016/j.apmr.2014.12.008
• Havercamp SM, Scandlin D, Roth M. Health disparities among adults with
developmental disabilities, adults with other disabilities, and adults not reporting
disability in North Carolina. Public Health Reports, 2004;119(4):418-426.
https://doi.org/10.1016/j.phr.2004.05.006
• Kirschner KL, Breslin ML, Iezzoni LI. Structural impairments that limit access to health
care for patients with disabilities. JAMA. 2007;297(10):1121–1125.
https://doi.org/10.1001/jama.297.10.1121
• Krahn GL, Fox MH. Health disparities of adults with intellectual disabilities: What do we
know? What do we do? Journal of Applied Research in Intellectual Disabilities,
2014;27(5):431-446. https://doi.org/10.1111/jar.12067
14
• Krahn GL, Havercamp SM. From invisible to visible to valued: improving population
health of people with intellectual and developmental disabilities. Intellect Dev Disaibil,
2019;57(5):476- 481. https://doi.org/10.1352/1934-9556-57.5.476
• Krahn GL, Walker DK, Correa-De-Araujo R. Persons with disabilities as an unrecognized
health disparity population. American Journal of Public Health, 2015;105(S2):S198-S206.
https://doi.org/10.2105/AJPH.2014.302182
• McDoom MM, Koppelman E, Drainoni M-L. Barriers to accessible health care for
Medicaid eligible people with disabilities: A comparative analysis. Journal of Disability
Policy Studies. 2014;25(3):154-163. https://doi.org/10.1177/1044207312469829
• Mudrick NR, Swager LC, Breslin ML. Presence of accessible equipment and interior
elements in primary care offices. Health Equity, 2019;3(1):275-279.
https://doi.org/10.1089/heq.2019.0006
• Ordway A, Garbaccio C, Richardson M, Matrone K, Johnson KL. Health care access and
the Americans with Disabilities Act: A mixed methods study. Disability and Health
Journal, 2021;14(1):100967. https://doi.org/10.1016/j.dhjo.2020.100967
• Ouellette‐Kuntz, H. Understanding health disparities and inequities faced by individuals
with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities,
2005;18(2):113-121. https://doi.org/10.1111/j.1468-3148.2005.00240.x
• Persad G. Disability law and the case for evidence-based triage in a pandemic. SSRN
Electronic Journal, 2020. https://doi.org/10.2139/ssrn.3571139
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Provider Attitudes around Disability
• Alahmari KA, Rengaramanujam K, Reddy RS, Silvian Samuel P, Ahmad I, Nagaraj

Kakaraparthi V, Tedla JS. Effect of disability-specific education on student attitudes
toward people with disabilities. Health Education & Behavior, 2021;48(4): 532-539.
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• Faulks D, Dougall A, Ting G, Ari T, Nunn J, Friedman C, John J, Daly B, Roger-Leroi V,
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behaviours of dental students towards people with disability or those in marginalised
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• Feldner HA, VanPuymbrouck L, Friedman C. Explicit and implicit disability attitudes of
occupational and physical therapy assistants. Disability and Health Journal,
• Hsiao CY, Lu HL, Tsai YF. Factors influencing mental health nurses' attitudes towards
people with mental illness. Int J Ment Health Nurs, 2015;24(3):272-80.
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• Iezzoni LI, Rao SR, Ressalam J, Bolcic-Jankovic D, Agaronnik ND, Donelan K, Lagu T,
Campbell EG. Physicians' perceptions of people with disability and their health care.
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• Lam WY, Gunukula SK, McGuigan D, Isaiah N, Symons AB, Akl EA. Validated instruments
used to measure attitudes of healthcare students and professionals towards patients
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• Lyon L, Houser R. Nurse educator attitudes toward people with disabilities. Nurs Educ
Perspect, 2018;39(3):151-155. https://doi.org/10.1097/01.NEP.0000000000000282
• Pelleboer-Gunnink HA, Van Oorsouw WJ, Van Weeghel J, Embregts, PJCM. Mainstream
health professionalsˈ stigmatising attitudes towards people with intellectual disabilities:
a systematic review. Journal of Intellectual Disability Research, 2017;(61)5:414-434.
https://doi.org/10.1111/jir.12353
• Perusini DJ, Llacuachaqui M, Sigal MJ, Dempster LJ. Dental students' clinical expectations
and experiences treating persons with disabilities. J Dent Educ, 2016;80(3):301-310.
https://doi.org/10.1002/j.0022-0337.2016.80.3.tb06085.x
• Seccombe JA. Attitudes towards disability in an undergraduate nursing curriculum: a
literature review. Nurse Educ Today, 2007;27(5):459-465.
https://doi.org/10.1016/j.nedt.2006.08.005
• Smeltzer SC, Mitra M, Long-Bellil L, Iezzoni LI, Smith LD. Obstetric clinicians' experiences
and educational preparation for caring for pregnant women with physical disabilities: A
qualitative study. Disability and Health Journal, 2018;11(1):8-13.
• VanPuymbrouck L, Friedman C, Feldner H. Explicit and implicit disability attitudes of
healthcare providers. Rehabilitation Psychology, 2020;65(2):101-112.
https://doi.org/10.1037/rep0000317
• Weil TN, Inglehart MR. Dental education and dentists' attitudes and behavior
concerning patients with autism. J Dent Educ, 2010;74(12):1294-307.
https://doi.org/10.1002/j.0022-0337.2010.74.12.tb05005.x
• Yorke AM, Ruediger T, Voltenburg N. Doctor of physical therapy students' attitudes
towards people with disabilities: a descriptive study. Disability and Rehabilitation,
2017;39(1):91-97. https://doi.org/10.3109/09638288.2016.1140830
Ableism
• Branco C, Ramos MR, Hewstone M. The association of group‐based discrimination with

health and well‐being: A comparison of ableism with other “isms”. Journal of Social
Issues, 2019;75(3):814–846. https://doi.org/10.1111/josi.12340
• Brown N, Leigh, J. Ableism in academia: where are the disabled and ill academics?
Disability & Society, 2018;33(6):985-989.
https://doi.org/10.1080/09687599.2018.1455627
• Burke L. Hostile environments? Down’s syndrome and genetic screening in
contemporary culture. Medical Humanities, 2021;47(2):193-200.
https://mh.bmj.com/content/47/2/193
• Calder-Dawe O, Witten K, Carroll P. Being the body in question: young people’s accounts
of everyday ableism, visibility and disability. Disability & Society, 2020;35(1):132-155.
https://doi.org/10.1080/09687599.2019.1621742
17
• Dirth T, Branscombe N. Recognizing ableism: A social identity analysis of disabled people
perceiving discrimination as illegitimate. Journal of Social Issues, 2019;75(3):786-813.
https://doi.org/10.1111/josi.12345
• Dunn D. Outsider privileges can lead to insider disadvantages: Some psychosocial
aspects of ableism. Journal of Social Issues, 2019;75(3): 665-682.
• Fine M. Critical disability studies: Looking back and forward. Journal of Social Issues,
2019;75(3): 972-984. https://doi.org/10.1111/josi.12344
• Harder JA, Keller VN, Chopik WJ. Demographic, experiential, and temporal variation in
ableism. Journal of Social Issues, 2019;75(3):683-706.
• Iezzoni LI. Explicit disability bias in peer review. Med Care, 2018;56(4):277-278.
https://doi.org/10.1097/MLR.0000000000000889
• Jain NR. Political disclosure: resisting ableism in medical education. Disability & Society,
2020;35(3):389-412. https://doi.org/10.1080/09687599.2019.1647149
• Janz HL. Ableism: the undiagnosed malady afflicting medicine. Canadian Medical
Association Journal, 2019;191(17):E478-E479. https://doi.org/10.1503/cmaj.180903
• Kattari SK, Olzman M, Hanna MD. “You Look Fine!” Ableist experiences by people with
invisible disabilities. Affilia, 2018;33(4):477-492.
https://doi.org/10.1177/0886109918778073
• Narasaki-Jara M, Encarnacion Carmona C, Stillwell B, Onofre R, Brolsma DJ, Lachica
Buenavista T. Exploring ableism in kinesiology curriculum through kinesiology students’
experience: A phenomenological study. International Journal of Kinesiology in Higher
Education, 2021;5(3):105-114. https://doi.org/10.1080/24711616.2020.1753602
• Nario-Redmond MR, Kemerling AA, Silverman A. Hostile, benevolent, and ambivalent
ableism: Contemporary manifestations. Journal of Social Issues, 2019;75(3):726-756.
• Olkin R, Hayward H, Schaff Abbene M, VanHeel G. The experiences of microaggressions
against women with visible and invisible disabilities. Journal of Social Issues,
2019;75(3):757-785. https://doi.org/10.1111/josi.12342
• Wolbring, G. The politics of ableism. Development, 2008;51:252-258.
https://doi.org/10.1057/dev.2008.17
Studies on Quality of Life
• Algood C, Davis AM. Inequities in family quality of life for African-American families
raising children with disabilities. Social Work in Public Health, 2019;34(1):102–112.
https://doi.org/10.1080/19371918.2018.1562399
18
• Bach JR, Tilton MC. Life satisfaction and well-being measures in ventilator assisted
individuals with traumatic tetraplegia. Arch Phys Med Rehabil, 1994;75(6):626-32.
https://doi.org/10.1016/0003-9993(94)90183-x
• Eisenberg MG, Saltz CC. Quality of life among aging spinal cord injured persons: long
term rehabilitation outcomes. Spinal Cord, 1991;29:514-520.
https://doi.org/10.1038/sc.1991.74
• Gerhart KA, Koziol-McLain J, Lowenstein SR, Whiteneck GG. Quality of life following
spinal cord injury: knowledge and attitudes of emergency care providers. Ann Emerg
Med, 1994;23(4):807-12. https://doi.org/10.1016/s0196-0644(94)70318-3
• Ray C, West J. Social, sexual and personal implications of paraplegia. Spinal Cord,
1984;22:75-86. https://doi.org/10.1038/sc.1984.15
• Stensman R. Severely mobility-disabled people assess the quality of their lives. Scand J
Rehabil Med, 1985;17(2):87-99. https://pubmed.ncbi.nlm.nih.gov/3161178/
Interventions to Reduce Health Disparities
• Andrews EE, Forber-Pratt AJ, Mona LR, Lund EM, Pilarski CR, Balter R. #SaytheWord: A
disability culture commentary on the erasure of "Disability". Rehabilitation Psychology,
2019;64(2):111-118. https://doi.org/10.1037/rep0000258
• Ankam NS, Bosques G, Sauter C, Stiens S, Therattil M, Williams FH, Atkins CC, Mayer RS.
Competency-based curriculum development to meet the needs of people with
disabilities: A call to action. Acad Med, 2019;94(6):781-788.
https://doi.org/10.1097/ACM.0000000000002686
• Block P, Vanner EA, Keys CB, Rimmer JH, Skeels SE. Project Shake-It-Up: Using health
promotion, capacity building and a disability studies framework to increase self-efficacy.
Disability and Rehabilitation, 2010;32(9):741-754.
https://doi.org/10.3109/09638280903295466
• Bowers A, Owen R, Heller T. Care coordination experiences of people with disabilities
enrolled in Medicaid managed care. Disability and Rehabilitation, 2017;39(21):2207-
2214. https://doi.org/10.1080/09638288.2016.1219773
• Boyle CA, Fox MH, Havercamp SM, Zubler J. The public health response to the COVID-19
pandemic for people with disabilities. Disability and Health Journal. 2020;13(3):100943.
• Drum CE, Peterson JJ, Culley C, Krahn G, Heller T, Kimpton T, McCubbin J, Rimmer J,
Seekins T, Suzuki R, White GW. Guidelines and criteria for the implementation of
community-based health promotion programs for individuals with disabilities. American
Journal of Health Promotion. 2016;24(2):93-101. https://doi.org/10.4278/ajhp.090303-
CIT-94
19
• Forber-Pratt AJ, Mueller CO, Andrews EE. Disability identity and allyship in rehabilitation
psychology: Sit, stand, sign, and show up. Rehabilitation Psychology, 2019;64(2):119-
129. https://doi.org/10.1037/rep0000256
• Hoffman M, Kasnitz D, Mankoff J, Bennet C. Living disability theory: Reflections on
access, research, and design. ASSETS ’20: The 22nd ACM SIGACCSS Conference on
Computers and Accessibility, 2020;4:1-13. https://doi.org/10.1145/3373625.3416996
• Hwang K, Johnston M, Tulsky D, Wood K, Dyson-Hudson T, Komaroff E. Access and
coordination of health care service for people with disabilities. Journal of Disability
Policy Studies, 2009;20(1):28-34. https://doi.org/10.1177/1044207308315564
• Joseph M, Nisker J. Need for prominent core curricula designed and taught by persons
with disabilities in all levels of medical education. Canadian Journal of Disability Studies,
2020;9(5):245-264. https://doi.org/10.15353/cjds.v9i5.697
• Kennedy W, Fruin R, Lue A, Logan SW. Using ecological models of health behavior to
promote health care access and physical activity engagement for persons with
disabilities. Journal of Patient Experience, 2021;8:1-3.
https://doi.org/10.1177/23743735211034031
• Ma JK, Martin Ginis KA. A meta-analysis of physical activity interventions in people with
physical disabilities: Content, characteristics, and effects on behaviour. Psychology of
Sport and Exercise, 2018;37:262-273. https://doi.org/10.1016/j.psychsport.2018.01.006
• Maldonado ME, Fried ED, DuBose TD, Nelson C, Breida M. The role that graduate
medical education must play in ensuring health equity and eliminating health care
disparities. Annals of the American Thoracic Society, 2014;11(4):603-607.
https://doi.org/10.1513/annalsats.201402-068ps
• Mastal M, Reardon ME, English M. Innovations in disability care coordination
organizations. Professional Case Management, 2007;12(1):27-36.
https://doi.org/10.1097/01269241-200701000-00007
• Masuda JR, Zupancic T, Crighton E, Muhajarine N, Phipps E. Equity-focused knowledge
translation: a framework for ‘‘reasonable action’’ on health inequities. International
Journal of Public Health, 2014;59:457-464. https://doi.org/10.1007/s00038-013-0520-z
• Palsbo SE, Mastal MF, O'Donnell LT. Disability care coordination organizations:
improving health and function in people with disabilities. Professional Case
Management, 2006;11(5):255-264. https://doi.org/10.1097/00129234-200609000-
00008
• Ruiz S, Giuriceo K, Caldwell J, Snyder LP, Putnam M. Care coordination models improve
quality of care for adults aging with intellectual and developmental disabilities. Journal
of Disability Policy Studies, 2020;30(4):191-201.
https://doi.org/10.1177/1044207319835195
• Sharby N, Martire K, Iversen MD. Decreasing health disparities for people with
disabilities through improved communication strategies and awareness. Int J Environ
Res Public Health, 2015;12(3):3301-3316. https://doi.org/10.3390/ijerph120303301
20
• Vanderbom KA, Eisenberg Y, Tubbs AH, Washington T, Martínez AX, Rauworth A.
Changing the paradigm in public health and disability through a knowledge translation
center. Int J Environ Res Public Health, 2018;15(2):328.
https://doi.org/10.3390/ijerph15020328
• White GW, Gonda C, Peterson JJ, Drum CE. Secondary analysis of a scoping review of
health promotion interventions for persons with disabilities: Do health promotion
interventions for people with mobility impairments address secondary condition
reduction and increased community participation? Disability and Health Journal,
2011;4(2):129-139. https://doi.org/10.1016/j.dhjo.2010.05.002
• Wilhite B, Biren G, Spencer L. Fitness intervention for adults with developmental
disabilities and their caregivers. Ther Recreation J, 2012;46(4):245-267.
https://js.sagamorepub.com/trj/article/view/2910
Universal Design
• Iwarsson S, Ståh, A. Accessibility, usability and universal design—positioning and

definition of concepts describing person-environment relationships. Disability and
Rehabilitation, 2003;25(2):57-66. https://doi.org/10.1080/dre.25.2.57.66
• Williams AS, Moore SM. Universal design of research: inclusion of persons with
disabilities in mainstream biomedical studies. Sci Transl Med, 2011;3(82):82cm12.
https://doi.org/10.1126/scitranslmed.3002133
Language Guides
• National Center on Disability and Journalism Language Style Guide
o https://ncdj.org/style-guide/
• Guidelines: How to Write about People with Disabilities 9th Edition (AUCD)
o https://www.aucd.org/docs/phe/9%20ed%20guidelines%20pamphlet%207.24.p
df
• Ableism/Language
o https://www.autistichoya.com/p/ableist-words-and-terms-to-avoid.html
• APA Style Guide
o https://apastyle.apa.org/style-grammar-guidelines/bias-free-language/disability
• Autistic Self Advocacy Network (ASAN) Identity-First Language
o https://autisticadvocacy.org/about-asan/identity-first-language/
• NPR ‘Disabled’: Just #SayTheWord
o https://www.npr.org/sections/13.7/2016/02/25/468073722/disabled-just-
saytheword
21
Accessible Online Resources and Materials
• Web Accessibility In Mind (WebAIM)
o https://webaim.org/
• WAVE Web Accessibility Evaluation Tool
o https://wave.webaim.org/
• Web Accessibility Checker
o https://achecker.us/checker/index.php
• The UDL Guidelines
o https://udlguidelines.cast.org/
• ABCs of Plain Language (AUCD)
o https://www.aucd.org/docs/ABCs%20of%20Plain%20Language_final.pdf
• One Idea Per Line: A Guide to Making Easy Read Resources (ASAN)
o https://autisticadvocacy.org/resources/accessibility/easyread/
• Universal Design of Projects, Conference Exhibits, Presentations, and Professional
Organizations
o https://www.washington.edu/doit/programs/center-universal-design-
education/universal-design-projects-conference-exhibits
Intersectionality
• Black, Disabled, and Proud: College Students with Disabilities
o https://www.blackdisabledandproud.org/
• Disability Rights Washington: Black Lives Matter
o https://www.disabilityrightswa.org/black-lives-matter/
• RespectAbility: LGBTQ+ People with Disabilities
o https://www.respectability.org/resources/lgbtq/
• Rooted in Rights: Navigating the Twists and Turns of Healthcare as a Trans Disabled
Person
o https://rootedinrights.org/navigating-the-twists-and-turns-of-healthcare-as-a-
trans-disabled-person/
Key Websites
• World Health Organization (WHO)
o https://www.who.int/health-topics/disability
• WHO Community-Based Rehabilitation
o https://www.who.int/publications/i/item/9789241548052
• Centers for Disease Control and Prevention (CDC)
o https://www.cdc.gov/ncbddd/disabilityandhealth/index.html
• CDC State Disability and Health Programs
22
o https://www.cdc.gov/ncbddd/disabilityandhealth/programs.html
• National Center on Health, Physical Activity, and Disability (NCHPAD)
o https://www.nchpad.org/
• Special Olympics
o https://www.specialolympics.org/
• National Council on Disability (NCD)
o https://ncd.gov/publications/2009/Sept302009
• National Council on Independent Living (NCIL)
o https://ncil.org/
• Center for Dignity in Healthcare for People with Disabilities
o https://centerfordignity.com/
• Association of University Centers on Disabilities (AUCD)
o https://www.aucd.org/template/index.cfm
o Leadership Education in Neurodevelopmental and Related Disabilities (LEND)
Training: https://www.aucd.org/template/page.cfm?id=473
• Americans with Disabilities Act Participatory Action Research Consortium (ADA-PARC)
o https://centerondisability.org/ada_parc/index.php
• ADA National Network: ADA Centers
o https://adata.org/find-your-region
• Healthy People 2030
o https://health.gov/healthypeople/objectives-and-data/browse-
objectives/people-disabilities
o https://health.gov/healthypeople/objectives-and-data/browse-
objectives/health-care-access-and-quality
• American Physical Therapy Association
o https://www.apta.org/apta-and-you/leadership-and-
governance/policies/americans-with-disabilities-role-of-the-american-physical-
therapy-association-in-advocacy-promotion-and-accommodation
• World Physiotherapy: Network for Intellectual and Developmental Disability
o https://world.physio/networks/intellectual-developmental-disability
• American Public Health Association Disability Section
o https://www.apha.org/apha-communities/member-sections/disability-section
• Disability in Public Health
o https://disabilityinpublichealth.org/
• American Association on Health and Disability
o https://aahd.us/
• American Association on Intellectual and Developmental Disabilities
o https://www.aaidd.org/
• Coalition for Disability Health Equity
o http://disabilityequity.org/
23
• Coalition for Disability Access in Health Science Education
o https://www.hsmcoalition.org/
• The Alliance for Disability in Health Care Education
o https://www.adhce.org/
• National Association for the Dually Diagnosed
o http://thenadd.org/
• Autistic Self Advocacy Network
o https://autisticadvocacy.org/
• RespectAbility
o https://www.respectability.org/
• Disability Social History Project
o http://www.disabilityhistory.org/
• Disability History Association
o http://www.dishist.org/
• Paul K. Longmore Institute on Disability
o http://longmoreinstitute.sfsu.edu/
• Disability History Museum
o http://www.disabilitymuseum.org/dhm/index.html
24
Training Resources
Free Online Trainings/Resources
• Disability Competent Care (Resources for Integrated Care)
o https://www.resourcesforintegratedcare.com/concepts/disability-competent-
care
• Global Disability: Research and Evidence (London School of Hygiene and Tropical
Medicine)
o https://www.futurelearn.com/courses/global-disability-research-and-evidence
• Global Health and Disability (London School of Hygiene & Tropical Medicine and
International Centre for Evidence in Disability)
o https://www.futurelearn.com/courses/global-disability
• Healthcare Access for People with Disabilities: Part I: People with Physical and Sensory
Disabilities (Ohio Disability and Health Program)
o https://nisonger.osu.edu/education-training/ohio-disability-health-
program/disability-healthcare-training/
• Healthcare Access for People with Disabilities: Part II: People with Developmental
Disabilities (Ohio Disability and Health Program)
program/disability-healthcare-training/
• Health Care for Adults with Intellectual and Developmental Disabilities: Toolkit for
Primary Care Providers (Vanderbilt Kennedy Center)
o https://iddtoolkit.vkcsites.org/
• Ohio Disability and Health Program Health Trainings and Continuing Education
program/odhp-training/
• NACCHO Health and Disability Program Resources
o https://www.naccho.org/programs/community-health/disability
o https://www.naccho.org/blog/articles/updated-health-and-disability-toolkit-in-
nacchos-new-toolbox
• Practical Recommendations for Enhancing the Care of Patients with Disabilities (Upstate
Medical University)
o https://www.upstate.edu/pmr/education/disability/
• Responsive Practice Trainings (New Hampshire Disability and Health Program)
o https://iod.unh.edu/projects/new-hampshire-disability-public-health-
project/responsive-practice-healthcare-providers
• Your Patient and Disability: How Context and Attitudes about Disability Affects Physical
Therapy Outcomes (APTA Oregon)
o https://opta.mclms.net/en/package/7026/course/12460/view
25
Free Recorded Webinars
• Human Development Institute Seminar Series on Disability (University of Kentucky)
o https://hdi.uky.edu/training/hdi-seminar-series
• RespectAbility Including People with Disabilities in Non-Profits and Foundations:
Accessibility & Equity Webinar Series
o https://www.respectability.org/inclusive-philanthropy/#webinarseries
HPA The Catalyst Webinars

• Engaging Anti-Ableist Strategies to Reduce Healthcare Inequities Experienced by People
with Disabilities
o https://www.aptahpa.org/store/viewproduct.aspx?ID=19249092
Training Videos
• Health and Disability 101 Training for Health Department Employees (NACCHO)
o https://www.pathlms.com/naccho/courses/5037
• Disability Sensitivity Training Video (DC Office of Disability Rights)
o https://www.youtube.com/watch?v=Gv1aDEFlXq8&list=PLbFKGFkIKL21ureNznAl
zeQmeB4zECsOc
• Social Justice Project - Ableism
o https://www.youtube.com/watch?v=P7_cMziG1Fc
TED Talks
• Adrian M. What I learned designing a school for the deaf. TEDxGatewayArch. October
2017.
https://www.ted.com/talks/marcus_adrian_what_i_learned_designing_a_school_for_t
he_deaf.
• Austin S. Deep sea diving...in a wheelchair. TEDxWomen 2012. December 2012.
https://www.ted.com/talks/sue_austin_deep_sea_diving_in_a_wheelchair#t-549679 .
• Campbell B. Confronting ableism. TEDx Yale. April 2019.
https://www.ted.com/talks/brendan_campbell_confronting_ableism
• DiMarco N. Why we need to make education more accessible to the deaf.
TEDxKlagenfurt. June 2018.
https://www.ted.com/talks/nyle_dimarco_why_we_need_to_make_education_more_a
ccessible_to_the_deaf.
• Floyd K. The cost of failing to design accessibly. TEDxDirigo. November 2019.
https://www.ted.com/talks/kings_floyd_the_cost_of_failing_to_design_accessibly.
26
• Heumann J. Our fight for disability rights—and why we’re not done yet.
TEDxMidAtlantic. October 2016.
https://www.ted.com/talks/judith_heumann_our_fight_for_disability_rights_and_why_
we_re_not_done_yet.
• King R. How autism freed me to be myself. TEDMED. September 2014.
https://www.ted.com/talks/rosie_king_how_autism_freed_me_to_be_myself
• Kish D. How I use sonar to navigate the world. TED2015. March 2015.
https://www.ted.com/talks/daniel_kish_how_i_use_sonar_to_navigate_the_world.
• Knill R. How technology has changed what it’s like to be deaf. TED@WellsFargo.
February 2020.
https://www.ted.com/talks/rebecca_knill_how_technology_has_changed_what_it_s_lik
e_to_be_deaf.
• Kunc N. The Right to be Disabled. August 2016.
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• Lanier H. “Good” and “bad” are incomplete stories we tell ourselves. TED@BCG Milan.
October 2017.
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e_tell_ourselves#t-797500.
• Mahamane S. ADHD sucks, but not really. TEDxUSU. December 2015.
https://www.youtube.com/watch?v=fWCocjh5aK0
• McCabe J. Failing at normal: an ADHD success story. TEDxBratislava. October 2017.
https://www.youtube.com/watch?v=JiwZQNYlGQI
• Nash T. The perks of being a pirate. TEDxSydney. May 2019.
https://www.ted.com/talks/tom_nash_the_perks_of_being_a_pirate_apr_2019.
• Rico N. Overcoming ableism: what you don’t know as an able-bodied person. TEDx Talks.
July 2015. https://www.youtube.com/watch?v=X1xnyVCBYNQ
• Roundtree PJ. Black mental health matters. TEDxWilmington. September 2018.
https://www.ted.com/talks/phillip_j_roundtree_black_mental_health_matters
• Roy E. When we design for disability we all benefit. TEDxMidAtlantic. September 2015.
https://www.ted.com/talks/elise_roy_when_we_design_for_disability_we_all_benefit#
t-56508.
• Shifrin M. How I made Lego accessible to the blind. TEDxSuffolkUniversity. April 2019.
https://www.ted.com/talks/matthew_shifrin_how_i_helped_make_lego_accessible_to_
the_blind.
• Tonti S. ADHD as a difference in cognition, not a disorder. TEDxCMU. April 2013.
https://www.youtube.com/watch?v=uU6o2_UFSEY
• Weight E. 3 things I learned from my intellectually disabled son. TED@Merck KGaA,
Darmstadt, Germany.
https://www.ted.com/talks/emilie_weight_3_things_i_learned_from_my_intellectually
_disabled_son.
27
• Young S. I’m not your inspiration, thank you very much. TEDxSydney. April 2014.
https://www.ted.com/talks/stella_young_i_m_not_your_inspiration_thank_you_very_
much?language=en.
Documentaries
• Crip Camp: A Disability Revolution (2020)
• The Reason I Jump (2020)
• Becoming Bulletproof (2014)
• Fixed: The Science/Fiction of Human Enhancement (2014)
• Invitation to Dance (2014)
• Sins Invalid: An Unshamed Claim to Beauty (2013)
• The Last Taboo (2013)
• One Question (2012): https://sproutflix.org/programs/one-question
• Brain Injury Dialogues (2011)
• Deaf Jam (2010)
• Monica & David (2009)
• Shameless: The Art of Disability (2006)
• Murderball (2005)
• Kiss My Wheels (2003)
• A World Without Bodies (2001)
• Sound and Fury (2000)
• Breathing Lessons: The Life and Work of Mark O’Brien (1996)
• Unforgotten: Twenty-Five Years After Willowbrook (1996)
• Vital Signs: Crip Culture Talks Back (1995)
• When Billy Broke His Head…and Other Tales of Wonder (1995)
• Rolling https://www.thirteen.org/rolling/thefilm/
• ReelAbilities Film Festival: https://reelabilities.org/about-us/
Peer-Reviewed Journal Articles on Training Disability Competence

• Crane JM, Strickler JG, Lash AT, Macerollo A, Prokup JA, Rich KA, Robinson AC, Whalen
Smith CN, Havercamp SM. Getting comfortable with disability: The short- and long-term
effects of a clinical encounter. Disability and Health Journal, 2021;14(2):100993.
https://doi.org/10.1016/j.dhjo.2020.100993.
• Feldner HA, Lent KD, Lee S. Approaching disability studies in physical therapist
education: tensions, successes, and future directions. Journal of Teaching Disability
Studies. https://jtds.commons.gc.cuny.edu/approaching-disability-studies-in-physical-
therapist-education-tensions-successes-and-future-directions/
28
• Flower A, Burns MK, Bottsford-Miller NA. Meta-analysis of disability simulations
research. Remedial and Special Education, 2007;28(2):72–79.
http://dx.doi.org/10.1177/07419325070280020601
• French S. Simulation exercises in disability awareness training: A critique. Disability,
Handicap & Society, 1992;7(3):257-266. https://doi.org/10.1080/02674649266780261
• Garavatti E, Tucker J, Pabian PS. Utilization of an interprofessional integrated clinical
education experience to improve medical and physical therapy student comfort in
treating patients with disabilities. Education for Health, 2018;31(3):155-162.
https://pubmed.ncbi.nlm.nih.gov/31134946/
• Garrand K, Pechak C, Jimenez L, Gell N. Survey of disability competence teaching and
assessment strategies in physical therapist education. Journal of Physical Therapy
Education, 2018;32(1):55-64. https://doi.org/10.1097/JTE.0000000000000026
• Gill CJ, Mukherjee SS, Garland-Thomson R, Mukherjee D. Disability stigma in
rehabilitation. PM&R, 2016;8(10):997-1003. https://doi.org/10.1016/j.pmrj.2016.08.028
• Giuffre S, Domholdt E, Keehan J. Beyond the individual: population health and physical
therapy. Physiotherapy Theory and Practice, 2020;36(5):564-571.
https://doi.org/10.1080/09593985.2018.1490364
• Herbert JT. Simulation as a learning method to facilitate disability awareness. Journal of
Experiential Education, 2000;23(1):5-11.
http://dx.doi.org/10.1177/105382590002300102
• Iezzoni LI, Long-Bellil LM. Training physicians about caring for persons with disabilities:
“Nothing about us without us!”. Disability and Health Journal, 2012;5(3):136-139.
• Jimenez L, Pechak C, Garrand K. Improvements in students’ attitudes towards people
with disabilities with or without semi-structured community-based interactions. Journal
of Physical Therapy Education, 2019;33(3):185-190.
https://doi.org/10.1097/JTE.0000000000000102
• Lim SM, Tan BL, Lim HB, Goh ZAG. Engaging persons with disabilities as community
teachers for experiential learning in occupational therapy education. Hong Kong Journal
of Occupational Therapy, 2018;31(1):36-45.
https://doi.org/10.1177/1569186118783877
• Lindsay S, Edwards A. A systematic review of disability awareness interventions for
children and youth. Disability and Rehabilitation, 2013;35(8):623-646.
http://dx.doi.org/10.3109/09638288.2012.702850
• Lynch S, Simon M, Maher A. Critical pedagogies for community building: challenging
ableism in higher education physical education in the United States. Teaching in Higher
Education, 2020. https://doi.org/10.1080/13562517.2020.1789858
• Magnusson DM, Eisenhart M, Gorman I, Kennedy VK, Davenport TE. Adopting
population health frameworks in physical therapist practice, research, and education:
29
The urgency of now. Physical Therapy, 2019;99(8):1039-1047.
https://doi.org/10.1093/ptj/pzz048
• McGoldrick K, Zelizer D, Ray SA. Shifting perspectives: Enhancing healthcare
professionals' awareness through a disability studies undergraduate curriculum.
Canadian Journal of Disability Studies, 2018;7(1):26-51.
https://doi.org/10.15353/cjds.v7i1.401
• Nario-Redmond MR, Gospodinov D, Cobb A. Crip for a day: The unintended negative
consequences of disability simulations. Rehabilitation psychology, 2017;62(3):324-333.
https://doi.org/10.1037/rep0000127
• National Academies of Sciences, Engineering, and Medicine. A framework for educating
health professionals to address the social determinants of health. Washington, DC: The
National Academies Press, 2016. https://doi.org/10.17226/21923
• Phillips KG, England E, Wishengrad JS. Disability-competence training influences health
care providers’ conceptualizations of disability: An evaluation study. Disability and
Health Journal, 2021;14(4):101124. https://doi.org/10.1016/j.dhjo.2021.101124
• Roush SE, Sharby N. Disability reconsidered: the paradox of physical therapy. Advances
in Disability Research, 2011;91(12):1715-1727. https://doi.org/10.2522/ptj.20100389
• Shakespeare T, Iezzoni LI, Groce NE. Disability and the training of health professionals.
The Lancet, 2009;374(9704):1815-1816. https://doi.org/10.1016/s0140-6736(09)62050-
x
• Shakespeare T, Kleine I. Educating health professionals about disability: A review of
interventions. Health and Social Care Education, 2013;2(2):20-37.
https://www.tandfonline.com/doi/full/10.11120/hsce.2013.00026
• Silverman AM, Gwinn JD, Van Boven L. Stumbling in their shoes: disability simulations
reduce judged capabilities of disabled people. Social Psychological and Personality
Science. 2015;6(4):464-471. https://doi.org/10.1177/1948550614559650
• Silverman AM, Pitonyak JS, Nelson IK, Marsuda PN, Kartin D, Molton IR. Instilling positive
beliefs about disabilities: pilot testing a novel experiential learning activities for
rehabilitation students. Disabil Rehabil. 2018;40(9):1108-1113.
https://doi.org/10.1080/09638288.2017.1292321
• Vanderbom KA, Eisenberg Y, Tubbs AH, Washington T, Martinez AX, Rauworth A.
Changing the paradigm in public health and disability through a knowledge translation
center. International Journal of Environmental Research and Public Health,
2018;15(2):328. https://doi.org/10.3390/ijerph15020328
• VanPuymbrouck L, Heffron JL, Sheth AJ, Lee D. Experiential learning: critical analysis of
standardized patient and disability simulation. Journal of Occupational Therapy
Education, 2017;1(3):5.
https://encompass.eku.edu/cgi/viewcontent.cgi?article=1038&context=jote
30
Books and Articles on Training Health Professional Students with Disabilities
• Disability as Diversity: A Guidebook for Inclusion in Medicine, Nursing, and the Allied
Health Professions (Meeks, Neal-Boylan)
• Equal Access for Students with Disabilities: The Guide for Health Science and
Professional Education (Meeks, Jain, and Laird)
• Francis N, Salzman A, Polomsky D, Huffman E. Accommodations for a student with a
physical disability in a professional physical therapist education program. Journal of
Physical Therapy Education, 2007;21(2):60-65. https://doi.org/10.1097/00001416-
200707000-00010
• Hinman MR, Peterson CA, Gibbs KA. Educating students with disabilities: Are we doing
enough? J Phys Ther Educ, 2015;29(4):37-41. https://doi.org/10.1097/00001416-
201529040-00006
• Hinman MR, Peterson CA, Gibbs KA. Prevalence of physical disability and
accommodation needs among students in physical therapy education programs. Journal
of Postsec Educ Disabil, 2015;28(3):309-328. https://eric.ed.gov/?id=EJ1083842
31
Core Competencies on
Disability for
Health Care
Education
June 2019
© Alliance for Disability in Health Care Education
June 2019
Please use the following citation when referring to this document:
Alliance for Disability in Health Care Education. (2019). Core Competencies on Disability for Health Care
Education. Peapack, NJ: Alliance for Disability in Health Care Education. http://www.adhce.org/
This document was supported by the Cooperative Agreement Number, NU27DD000015-02, funded by the
Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not
necessarily represent the official views of the Centers of Disease Control and Prevention or the Department of
Health and Human Services.
1
About this Document
The Core Competencies on Disability for Health Care Education establish the baseline expertise
required to provide quality care to patients with disabilities. The Alliance for Disability in Health Care
Education partnered with Ohio Disability and Health Program at the Ohio State University Nisonger
Center to establish a consensus on the core competencies through an iterative structured feedback
process that included 152 people with disabilities, disability experts, health educators, and health
care providers. The intent of this document is to provide broad disability standards for health care
education. Following the principles of patient centered care, patients with disabilities should be
included as central members of the care team as early and completely as possible. We anticipate
that as these competencies are integrated into existing curricula, faculty will implement
corresponding lectures, readings, and patient experiences to provide greater detail to students.
Competency Vision
We envision a society where disability does not limit access to quality health care. We believe that
including disability in healthcare training programs is an essential step towards achieving this vision.
Our goal is to incorporate disability competencies in accreditation and licensure standards for health
care providers.
The Alliance for Disability in Health Care

Education
The Alliance for Disability in Health Care Education, Inc., (the Alliance)is a not-for-profit organization
of health care educators representing medicine, nursing, and other disciplines who are working to
integrate disability-related content and experiences into health care education and training
programs. The Alliance for Disability in Health Care Education identified the need for a consensus
around the skills and competencies essential to providing quality interprofessional health care to
patients with disabilities. The Alliance then developed a core set of disability competencies to
facilitate the integration of disability content into health care education and training programs.
Ohio Disability and Health Program

The Ohio Disability and Health Program is one of 23 State Disability and Health Programs funded by the
Centers for Disease Control and Prevention to improve the health and quality of life for people with
disabilities through adaptation and implementation of evidence-based strategies in their communities.
2
Preface
Health education programs strive to prepare future health professionals to deliver safe, high-quality,
accessible, person-centered care that improves population health outcomes and reduces the cost of
health care. Although overall health care quality is improving in the United States, health care
disparities persist, reflecting a lower quality of health care and worse health outcomes for socially
disadvantaged groups. Evidence suggests that bias, prejudice, and stereotypes on the part of
healthcare providers contribute to differences in care. Health care training programs have responded
by prioritizing the reduction of health disparities in their training. We now see meaningful curricula on
cultural competency, health disparities, and patient-centered care and efforts to create a diverse
health care workforce. These programs will prepare the next generation of health care providers to
meet the needs of a culturally, racially, and socioeconomically diverse patient population. People with
disabilities represent one socially disadvantaged population that has been overlooked in these efforts.
Americans with disabilities still experience barriers to routine clinical and preventive services and
public health and wellness initiatives. Inadequate knowledge and limited skills in diagnosing, treating,
and providing ongoing care to people with disabilities play a role in perpetuating health care
inequalities for this population. The Core Competencies on Disability for Health Care Education defines
standards for disability training to improve health care for people with disabilities.
Many health care professionals underestimate the capabilities, health, and quality of life experienced
by people with disabilities. They may hold erroneous assumptions about the current and future
functional status of people with disabilities. Because health care professionals provide information
about the functional status of patients that often determines their eligibility for essential social and
health benefits, these erroneous assumptions can have a detrimental effect on access to services for
people with disabilities. This type of judgment can also influence the health care professionals’ view
of the quality of life for people with disabilities, and therefore their proclivity to promote healthy
behaviors and their approach to end-of-life issues and palliative care. These Core Competencies on
Disability present standards on social, environmental, and physical aspects of disability that will
inform future health professionals on how to provide effective, interprofessional team-based health
care to patients with disabilities across the lifespan.
The importance of interprofessional collaborative practice has been recognized and embraced by
the WHO, federal agencies (CDC, Dept. of Education, NIH, MCHB/LEND, Dept. of Veteran’s Affairs,
National Academies of Practice, AUCD), managed care organizations, and a broad range of
professional associations. Adopting interprofessional collaborative practice competencies in health
education programs will prepare students to work effectively as part of an interprofessional team
and improve care. In addition to being interprofessional, the competencies are cross-disability,
applicable to the care of patients with any type and severity of disability.
3
Guiding Principles and Values
Rationale: As a demographic group, people with disabilities are likely to be very-well represented in
primary and specialty healthcare settings. The World Health Organization defines disability as an
umbrella term covering impairments, activity limitations, and participation restrictions. An impairment
is a problem in body function or structure; an activity limitation is a difficulty encountered by an
individual in executing a task or action; while a participation restriction is a problem experienced by an
individual in involvement in life situations. People may experience one or more disabilities that impact
physical, mental and/or behavioral health. High quality healthcare for people with disabilities depends,
in part, on the values held by healthcare providers. These guiding principles and shared values,
deemed essential to providing quality care to people with disabilities, establish the basis of these core
competencies on disability.
1. Culturally and linguistically competent care for patients with disabilities means recognizing that
patients have diverse backgrounds and are influenced by multiple social, economic, and cultural
factors, all of which should be included in a comprehensive view of a patient’s health status and
treatment.
2. People with disabilities should have equitable access to appropriate, accessible, and high-quality
health care.
3. People with disabilities face barriers in accessing effective health care that may or may not be
associated with their disabilities.
4. Training should be provided to all health care providers so that they are able to provide high-quality
care to patients with disabilities.
5. Healthcare providers can maximize the quality of life of their patients with disabilities by preventing
and treating health conditions.
6. People with disabilities are typically knowledgeable of their condition, and this expertise should be
respected and used to improve healthcare decisions and care.
7. Quality of life and treatment goals should incorporate and reflect the patient’s point of view.
8. Healthcare providers should communicate directly and respectfully with patients with disabilities,
including them in the decision-making process.
9. Healthcare providers should know under what circumstances caregivers should be included in
healthcare encounter and decision-making.
10. Provide the optimal patient experience by creating a respectful, accessible, and welcoming office
environment using universal design principles. Accessible diagnostic/screening equipment and
techniques are essential to quality health care for patients with disabilities.
4
Competency 1: Contextual and Conceptual Frameworks on Disability
Rationale: Disability can be considered in multiple contexts beyond the medical cause and its
implications, and these contexts may be relevant to patients with disabilities. Learners should recognize
multiple conceptual frameworks of disability and understand that disability exists within a socio-
historical context.
Acquire a conceptual framework of disability in the context of human diversity, the lifespan,
wellness, injury and social and cultural environments.
1.1 Define disability as a functional limitation and identify disability prevalence. Discuss the diversity
and range of disabilities in terms of disability types (e.g. mobility, sensory, cognitive, and behavioral).
1.2 Describe the conceptual and contextual framework of disability.
1.3 Compare and contrast the Medical, Social, and World Health Organization International
Classification of Functioning models and recognize their application to health care of people with
disabilities. Compare and contrast disability and disease.
1.4 Describe the civil rights and independent living history of people with disabilities and their
access to services. Understand how such history has both informed current thinking and improved
access to care and equal rights for people with disabilities.
1.5 Describe how social determinants of health directly impact people with disabilities (e.g.,
discrimination, employment, education, transportation, housing, poverty, access to healthcare).
1.6 Describe disability as an aspect of diversity/cultural identity and contrast this with historical
views of disability as merely a negative health outcome.
5
Competency 2: Professionalism and Patient-Centered Care
Rationale: Adherence to principles of professionalism, communication, and respect during interactions
with people with disabilities, as well as building an understanding of the patient’s perspective, is
essential for effective health care for patients with disabilities.
Demonstrate mastery of general principles of professionalism, communication, respect for patients,

and recognizes optimal health and quality of life from the patient’s perspective.
2.1 Explore and mitigate one’s own implicit biases and avoid making assumptions about a person’s
abilities or lack of abilities and lifestyle.
2.2 Treat all patients, regardless of disability and functional status, with respect and humility.
2.3 Demonstrate communication strategies to best meet the needs/abilities of the patient. Seek out
and implement appropriate resources, including interpreter services, to communicate effectively using
clear language at an appropriate level of health literacy. Adjust schedule to allow extra time as needed.
2.4 Demonstrate patient-centered care in terms of building a trusting partnership between patient
and health care providers.
2.5 Discuss issues of trust, confidence, and confidentiality with patients who receive support with
personal care during health care encounters related to their disability.
2.6 Recognize that some patients with disabilities may benefit from supported decision-making.
Demonstrate skill in engaging the patient and caregivers in the supported decision-making process.
2.7 People with disabilities have many cultural identities including race, ethnicity, primary language,
sexual orientation, gender identity, geographic residence (urban versus rural), and values and beliefs
about health, well-being, and function. Describe healthcare practices that demonstrate sensitivity and
respect for diverse cultural backgrounds.
2.8 Consider and discuss social determinants of health (including socioeconomic factors, cultural
background, finances, insurance coverage, availability/access to personal support systems) in clinical
decision making and the provision of care.
2.9 Understand that people with disabilities may consider their devices and equipment to be an
extension of their person. Consult patients before interacting with such equipment (e.g., wheelchair,
assistive communication device, crutches, service animal, etc.).
6
Competency 3: Legal Obligations and Responsibilities for Caring for Patients with
Disabilities
Rationale: Federal laws are in place to protect the civil rights of patients with disabilities and prevent
discrimination in health care settings. Health care professionals must meet the physical,
communication, and programmatic access requirements of the Americans with Disabilities Act,
Rehabilitation Act, Civil Rights Act of 1964, and related laws and policies by using the best practices
associated with universal design.
Understand and identify legal requirements for providing health care in a manner that is, at
minimum, consistent with federal laws such as the Americans with Disabilities Act (ADA),
Rehabilitation Act, and Social Security Act to meet the individual needs of people with disabilities.
3.1 Describe the concept and application of universal design in a health care system, including costs
and benefits.
3.2 Identify the physical access requirements (e.g., accessible exam table, mammography
equipment, etc.) of the ADA, Rehabilitation Act, and related laws and policies that apply to health and
the provision of health care.
3.3 Plan for accessible communication in all aspects of the healthcare encounter including
scheduling, intake, responding to and asking questions, and follow-up care. Avoid technical jargon.
3.4 Provide documents in alternate formats to be accessible for patients with disabilities (e.g. large
print, Braille, audio versioning, accessible color text).
3.5 Discuss strategies for meeting access requirements (e.g., needed accommodations) of the ADA,
Rehabilitation Act, and related laws and policies.
3.6 Ensure that healthcare providers and support staff members are trained to provide services that
meet the needs of the patient with a disability (e.g., knowing how to appropriately transfer a patient
with a mobility limitation to an exam table).
3.7 Providers recognize their own need for further training and/or skill development in
caring for patients with disabilities and take action to address those needs based on current best
practices.
3.8 Recognize issues related to legal guardianship (e.g., consent to treatment, HIPAA,
privacy) in the health care system.
7
Competency 4: Teams and Systems-based Practice
Rationale: The input of professionals from multiple disciplines is often required to address the complex
health needs of patients with disabilities in various health and community support systems.
Engage and collaborate with team members within and outside their own discipline to provide high-
quality, interprofessional team-based health care to people with disabilities.
4.1 Describe various models of team approaches when supporting people with disabilities in health
care systems (e.g., interdisciplinary, multidisciplinary, inter-professional).
4.2 Describe impact of teams and the unique and the discipline-specific responsibilities of team
members in addressing health needs of patients with disabilities and in partnering with the patient as a
central member of the team.
4.3 Describe challenges in creating a person-centered or family-centered system of care. Identify

services and providers that could play a role in the health of the patient. Discuss strategies to build an
effective healthcare team.
4.4 Demonstrate skills in teamwork including flexibility, adaptability, open communication,

assertiveness, conflict management, referral, use of evidence-based practice to support decision-making
and mutual goal-setting with patients with disabilities and other team members.
4.5 List systems of community-based services and supports that may be useful for patients with
disabilities outside of the clinical care system. Be prepared to consider cultural factors and interact with
these systems and make relevant referrals to ensure comprehensive care coordination, particularly during
times of transition.
8
Competency 5: Clinical Assessment
Rationale: Good clinical management requires that accurate and relevant information about the health
and function of patients with disabilities is viewed in the context of the person’s life activities, goals, and
interests. It is essential to consider a patient’s disability as well and their language, race, ethnicity, sexual
orientation, gender, gender identity and expression, health literacy and other cultural factors in clinical
assessment.
Collect and interpret relevant information about the health and function of patients with disabilities
to engage patients in creating a plan of care that includes essential and optimal services and supports.
5.1 Understand that the patient with disabilities should be the primary source of information
regarding their care.
5.2 Discuss situations where the caregiver(s) can be helpful to inform or enhance assessments and
interventions and the importance of securing patient permission before engaging caregivers.
5.3 Integrate information on functional status of people with disabilities, including both functional
strengths and limitations, in clinical decision making.
5.4 The capacity to respond competently to a patient’s language, race, ethnicity, sexual orientation,
gender, gender identify and expression, health literacy, and other cultural factors is essential to clinical
assessment. Demonstrate awareness of the impact of intersecting marginalized social identities, such as
race, ethnicity, and disability, in the context of healthcare.
5.5 Apply strategies or supports that could be used in a healthcare setting to accommodate patients
with functional limitations (mobility, sensory, cognitive, behavioral) associated with disabilities.
5.6 Recognize that people with disabilities experience the same common health conditions as people
without disabilities, and that a disability may impact the presenting signs and symptoms.
5.7 Identify health issues that are often associated with primary disability diagnoses (e.g., congenital
heart defect, urinary tract infections in patients with spinal cord injuries, etc.).
5.8 Describe the nature and etiology of different types of disabilities and determine if they are static,
progressive, or variable in course.
5.9 When applicable to the scope of practice of the learner’s profession, demonstrate skill in
performing a history and physical exam (PE), modifying it as needed to provide equally effective care
while accommodating for mobility, sensory, cognitive, and/or behavioral issues.
5.10 Recognize that mental health conditions can be the primary disabling condition. People with
disabilities are also at increased risk for co-occurring mental health conditions. Recognize the risk of
misdiagnosing mental health concerns in patients with disabilities.
10
5.11 Assess the social environment of patients with disabilities to understand the impact of significant
relationships and social networks on health outcomes.
5.12 Recognize that children and adults with disabilities are vulnerable to abuse. The nature of abuse
may be verbal, financial, physical and/or sexual. Abuse often goes unreported because the person with a
disability may depend on the abuser for activities of daily living or social support.
5.13 Assess the physical environment of people with disabilities, recognizing that the patient’s
socioeconomic status is a determinant of his/her functioning and independence and also affects health
and safety.
10
Competency 6: Clinical Care over the Lifespan and during Transitions
Rationale: Patients with disabilities may require supports and accommodations to benefit fully from
clinical intervention. Transitions across the lifespan may be similar yet differ in terms of opportunities,
needed supports, or services for people with disabilities. Providers should be sensitive to supports
needed across the lifespan of patients with disabilities with consideration given to unique and/or
specific challenges that patients with disabilities may face, especially during transitional periods.
Particularly relevant transitions in the life of people with disabilities include transitioning from preschool
or early intervention to kindergarten, graduating from high school, transitioning from the pediatric to
adult care system, moving from parents’ home, marriage, birth of a child, changing job, home, or
housemate, coping with the death of parent, retirement, health in aging, and end of life. Health care
providers must plan adequate time to address related care issues during the clinical visit.
Knowledgeable about effective strategies to engage patients with disabilities in creating a coordinated
plan of care with needed services and supports.
6.1 Demonstrate sensitivity and support for the health care needs of the patients with disabilities
across the lifespan and during transitions.
6.2 Integrate assessment information from individuals with disabilities, multiple disciplines, and
ancillary informants in order to develop a collaborative health care plan that includes health promotion
strategies and preventative care.
6.3 Recognize that people with disabilities need access to age-appropriate preventative screenings,
assessments, and health education including reproductive health, family planning, and sexuality.
6.4 Tailor recommended supports and interventions to the patient’s cultural beliefs and values, time,
resources, and preferences. Be prepared to propose constructive solutions to possible conflicts between
patient, caregivers, and other professionals about goals and treatments.
6.5 Demonstrate skill in identifying, coordinating, referring, and advocating for access to community
and health care resources needed to support treatment plan objectives.
6.6 Identify policy, practice, and systems changes essential to providing optimal health supports and
services for people with disabilities.
6.7 Recognize the role of interprofessional healthcare providers in encouraging healthy behaviors
(e.g., weight management, exercise, diet, smoking cessation, etc.) to promote the health and function of
patients with disabilities.
6.8 Recognize that disability should not limit self-determination in end-of-life care for people with
disabilities, regardless of disability type and severity. Offer treatment options in the same way options
would be presented to similar-aged peers without disabilities.
11
The Alliance for Disability in Health Care Education is made up of interprofessional health educators
committed to improving health care for people with disabilities. The Alliance recognized the need for
disability standards in health care education and drafted core disability competencies. The Alliance
then partnered with Ohio Disability and Health Program at the Ohio State University Nisonger Center
to establish a national consensus on these core competencies. Ohio Disability and Health Program
enlisted people with disabilities and health professionals to form the Core Competencies Development
Committee. National consensus on the core competencies was achieved through an iterative Delphi
process.
Alliance Members Responsible for Drafting Competencies

Ellen Bannister, MA Paula Minihan, PhD
University of Oklahoma Health Sciences Center Tufts University
Kathryn Cappella, BA LeRoy William Nattress, Jr., PhD
NYS Disabilities Advocacy Association and Network The Services Center for Independent Life
Carrie Coffield, PhD Ken Robey, PhD
Rutgers Robert Wood Johnson Medical School Matheny Medical and Educational Center
Alicia Conill, MD Suzanne Smeltzer, RN, EdD, ANEF, FAAN
Conill Institute for Chronic Illness Villanova University
Julie Davidson, MSN, Ed. Deborah Spitalnick, PhD
Davidson Residential Homes Rutgers Robert Wood Johnson Medical School
Deborah Dreyfus, MD Andrew Symons, MD
UMass Memorial Health Care University of Buffalo
Joan Earle Hahn, PhD, APRN, GCNS/GNP-BC, CDDN, Carl Tyler, MD
CNL Case Western University
Walden University
Sheryl White-Scott, MD
Gary Eddy, MD Metro Developmental Services, NYSOPWDD (New York
Rutgers New Jersey Medical School State Office of Persons with Developmental Disabilities)
Alina Engleman, DrPH, MPH Laurie Woodard, MD
California State University University of South Florida
Catherine Graham, MEBME Bethany Ziss, MD
University of South Carolina The Children’s Institute of Pittsburgh
Susan M. Havercamp, PhD
The Ohio State University Nisonger Center
Linda Long-Bellil, PhD
University of Massachusetts Medical School
Ohio Disability and Health Program Responsible for Establishing Consensus

Susan M. Havercamp, PhD
Wesley R. Barnhart, BA
Ann C. Robinson, BS
Core Competencies Development Committee
Sarah Ailey Adriane Griffen Renee Navarro
Carol Akers Joan Earle Hahn Christina Neill Bowen
Cindy Anderson Jean Hall Nassira Nicola
Kathy Auberry Sarah Hall Libby Oseguera
Jamie Axelrod Lisa Hamlin Theresa Paeglow
Jeffrey Baker Christopher Hanks Wendy Parent-Johnson
Julia Bascom Angela Hassiotis Georgina Peacock
Molly Bathje Sarah Hein Elizabeth Perkins
Freida Becoat Nancy A. Hodgson Sidney Pickern
Helena Berger Matthew Holder Tracy Plouck
Mary Lou Breslin Willi Horner-Johnson Thomas Quade
Marisa Brown Amy Houtrow Amy Rauworth
Kathleen Brown Kelly Hsieh Sharaine Rawlinson Roberts
Jane Brown Michael Ioerger Sara Reiner
Lisa Bruce June Isaacson-Kailes Tom Rickels
Susan Buchino Charron Johnson Ilka Riddle
Kelly Buckland Teresa Kobelt Candy Rinehart
Kim Bullock Barbara Kornblau Kenneth Robey
Agnes Burkhard Brenda Koverman Will Ross
Maggie Butler Emma Kowal Charlotte Royeen
Kathryn Cappella Rebecca Kronk Bryan Russell
Roberta Carlin Boo Krucky Elizabeth Sammons
Kathy Carter Steve Larew Barbara Sapharas
Priya Chandan Sarah Liss Laura Sardinia-Prager
Nanya Chiejine Barb Locker Donna Schultz
Rosemary Ciotti Linda Long-Bellil Barbara Shaw
Diane Coleman Nora Lowy Maggie Shreve
Sheila Crow Yona Lunsky Michael Sigelman
Christina Curry Allison Macerollo Reina Sims
Julie Davidson Elizabeth Madigan Lisa Sinclair
Caroline Dejean Christiansen Susan Magasi Satendra Singh
Colleen Dempsey Donna Maheady Suzanne Smeltzer
Barbara Devore Wanda Mahoney Patrick O. Smith

Linda Dezenski Catherine Mann Chloe Spring Slocum
Icilda Dickerson Barry Martin Cynthia Stevens
Susan Dooha Regina Martinez-Estela Andrew Symons
Nienke Dosa Matt Mason Elaine Tagliareni
Charles Drum Mat McCollough Rachel Tanenhaus
Karen Edwards Karen McCulloh Robyn Taylor
Allison P. Edwards Suzanne McDermott Erica Thomas
Kathleen Eggleson Leon McDougle Kay Treanor
Brett Eisenberg Michael McKee Margaret Turk
Laurie Eldridge Donna McNelis Mindy Vance
Alina Engelman Prerak Mehta Tamara Veppert
David Ervin Rebecca Monteleone Cara Whalen
Gloria Findley Timothy Montgomery Sheryl White-Scott
Donna Foster Diane Moore Tom Wilson
Debra Frankel John L. Moore Janet Winterstein
David Fray Teresa Moro Gerald Yutrzenka
Katie Frederick Shubhra Mukherjee Christine Zammit
Merrill Friedman Jacqleen Musana Bethany Ziss
Ginny Furshong Gina Maria Musolino
Andrés Gallegos Marcia Nahikian-Nelms
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Resource Guide For Training Disability Competence

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Resource Guide For Training Disability Competence

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Resource Guide for Training

President: Matthew Mesibov, PT, GCS

Disability Justice and Anti-Ableism Catalyst Group

Co-Founder: Winston Kennedy, PT, DPT, MPH

Purpose of this Guide

Information on the Development of the Core Competencies

Toolkit to Implement the Core Competencies

Peer-Reviewed Journal Articles

Models of Disability, Conceptual Frameworks, and Disability as an Aspect of Diversity/Cultural

• Abberley P. Disabling ideology in health and welfare-the case of occupational therapy.

Civil Rights History of People with Disabilities

Health Disparities and Access to Care

Provider Attitudes around Disability

• Alahmari KA, Rengaramanujam K, Reddy RS, Silvian Samuel P, Ahmad I, Nagaraj

• Branco C, Ramos MR, Hewstone M. The association of group‐based discrimination with

Studies on Quality of Life

Interventions to Reduce Health Disparities

• Iwarsson S, Ståh, A. Accessibility, usability and universal design—positioning and

HPA The Catalyst Webinars

Peer-Reviewed Journal Articles on Training Disability Competence

Please use the following citation when referring to this document:

The Alliance for Disability in Health Care

Ohio Disability and Health Program

1.2 Describe the conceptual and contextual framework of disability.

Demonstrate mastery of general principles of professionalism, communication, respect for patients,

4.3 Describe challenges in creating a person-centered or family-centered system of care. Identify

4.4 Demonstrate skills in teamwork including flexibility, adaptability, open communication,

Alliance Members Responsible for Drafting Competencies

Ohio Disability and Health Program Responsible for Establishing Consensus

Barbara Devore Wanda Mahoney Patrick O. Smith

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