ACCOMMODATIONS FOR HIDDEN
DISABILITIES
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Objectives:
1. Define and identify “hidden disabilities”.
2. Discuss current technologies and future trends of technologies.
3. Identify strategies and technologies that assist limitations associated with
“hidden disabilities”.
Presenter: Tony Gentry, PhD OTR/L
Assistant Professor and Director, Assistive Technology for
Cognition Laboratory
Department of Occupational Therapy
Virginia Commonwealth University
(804) 828-2219
logentry@vcu.edu
http://www.vcu.edu/partnership/pda
1
Linking Virginia’s Resources Together
Woodrow Wilson Rehabilitation Center (Fall 06)
Accommodations for “Hidden Disabilities”
INTRODUCTION AND OVERVIEW
WHAT ARE “HIDDEN DISABILITIES”
 Functional limitations caused by physical impairment not visible to the
naked eye.
 Impairments may affect:
o Thinking skills
o Respiration/Circulation
o Endurance/stamina
 Some Hidden Disability-related Conditions
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Attention Deficit Hyperactivity Disorder (ADHD)
Acquired Brain Injury
Cardiovascular Conditions
Asthma
Autism
Fibromyalgia
Multiple Sclerosis
Sleep disorders
Schizophrenia
 Difficulties in Addressing Hidden Disabilities
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Overlooked
Individuals seen as malingerers
Difficult to accommodate, because need may vary in complexity
Difficult to explain or convey functional issues
SERVICES
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Rehabilitation Physicians and Therapists (OT, PT, SLP, etc.)
DRS counselors and staff
Specialized clinics for various symptoms/disorders
Psychologists
Job Coaches/Case Managers
COMMON LIMITATIONS AND ACCOMMODATIONS
 Functional Cognition Deficits
o Remove clutter, simplify environment
o Teach pacing, doing one thing at a time
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Linking Virginia’s Resources Together
Woodrow Wilson Rehabilitation Center (Fall 06)
Accommodations for “Hidden Disabilities”
o Work in quiet setting, when possible
o Utilize low-tech and high-tech memory/organization aids
o Teach relaxation skills
 Decreased Stamina/Chronic Fatigue
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Flexible scheduled with regular down-times
Schedule in a daily nap, if possible
Use cooling jacket, if fatigue related to overheating
Work and shop from home (using Internet)
Delegate responsibilities
Keep fatigue diary, in order to pace oneself
Consider sleep clinic assessment
 Emotional Stress
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Relaxation and movement therapy
Conflict resolution training
Behavioral management training
Collaborate with co-workers on task delegation
Utilize Positive Behavioral Support strategies, as needed
 Reading/Writing/Speaking
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Use accommodations software on PC or Mac
Text-speech/Speech-text software, as needed
Know your strengths and work from them
Give yourself extra time for all tasks
Work with co-worker for proofreading, rehearsal
 Sensory Defensiveness/Sensitivity
o Occupational therapy assessment
o Utilize AT to compensate for problem, such as glare guards for
computers, ear plugs, etc.
 Pain
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Utilize pain diary/pain scale to pace oneself
Relaxation strategies
Avoid painful physical positions or postures
Allow for rest
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Linking Virginia’s Resources Together
Woodrow Wilson Rehabilitation Center (Fall 06)
Accommodations for “Hidden Disabilities”
CASE STUDIES
Case Study A:
Barbie, an individual with a severe traumatic brain injury, seeking her first job, but
facing difficulty due to difficulty in managing distractions, performing multi-step
tasks and remembering appointments.
Accommodation: Mentored workplace, quiet worksite, task-sequencing prompts
on handheld computer, reminder alarms for daily activities, rest breaks during the
day.
Case Study B:
Buck, an individual with heat-related fatigue due to multiple sclerosis, who is in
danger of losing his job as a heavy equipment operator for VDOT.
Accommodation: Cooling vest with exchangeable cool-paks, reorganize job to
include time off machinery (in A.C.-equipped trailer, if possible), frequent iced
drinks, awning over cab, fifteen minute nap at lunch-time in A.C.-equipped car,
cool shower before and after work.
Case Study C:
Jeremy, a high school graduate with Asperger’s Syndrome, who has difficulty
with non-routine tasks, social interactions and task organization.
Accommodation: PDA for activity reminder prompts, behavioral management
training to help in adjustment to changes in schedule, community theatre,
simplification of work setting.
Case Study D:
Mary, a nurse’s aide with fatigue and reduced endurance related to obesity,
diabetes and cardiovascular compromise.
Accommodation: Education re diet/diabetes control, supervised goal-focused
conditioning program (with P.T.), rest breaks during workday, strategies for
utilizing Hoyer lift and other devices for lifting/transfer of patients. Consider
rollator walker, when needed.
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Linking Virginia’s Resources Together
Woodrow Wilson Rehabilitation Center (Fall 06)
Accommodations for “Hidden Disabilities”
WEB RESOURCES
www.vcu.edu/partnership/pda. Informational site on use of assistive technology
for cognition.
www.biausa.org. Catalog of cognitive prosthetic devices.
www.enablemart.com. Online catalog of AT for individuals with visual, hearing,
cognitive challenges.
www.independentliving.com.
cognitive issues.
Online store with AT for visual, hearing and
www.e-pill.com. Online store that sells a wide variety of tools for individuals with
cognitive impairment.
www.ablelinktech.com. Task-sequencing and scheduling software for Pocket PC.
www.brainaid.com. Simplified reminder system (PEAT) for Pocket PC. In order
to purchase this device, you must agree to a training seminar provided by vendor.
www.nmss.org. National Multiple Sclerosis Society website, with information on
accommodations for chronic fatigue, heat-related fatigue, cognitive AT, etc.
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