barrier free guidlines
-
Upload
abhinav-saini -
Category
Documents
-
view
234 -
download
0
Transcript of barrier free guidlines
-
8/9/2019 barrier free guidlines
1/7
Barrier Free Design: A
Review and Critique of
th
Occupational
Therapy Perspective
Barbara Acheson Cooper, Uriel Cohen,
Betty Risreen Hasselkus
Key
Words: architectural accessibility.
environmental
design
literature review
This review of the occupational therapy literature on
barrier-free design identifies both a p u c i ~ v of related
occupational therapy research on the topic
and
a
lack of a common conceptual base with which to
gUide the development and use of environmental as
sessments. Nonetheless, two fledgling themes can be ex
trapolated: tbe consistent reference to the concepts
of
a c c e s s i b i l i ~ v mobility, function
and
safety and
an
in
creased awareness among occupational therapists re-
garding the accessibility
standards
developed by the
American National Standards Institute (ANSI)
ANSI,
1971,
1980). A problem-solving model suggested by de
signersfor the 1979 revision of ANSI standards that in
corporates these
conceptual
themes is described
and
discussed.
Barbara Acheson Cooper, MHSC, Oil POT,
is ~ s i s t a n t
Professor,
~ s o c i t e Dean and
Director
of
the School
of
Occupational
Therapy and Physiotherapy, IJ 11 Health
Sciences
Centre,
McMaster University, 1200 Main Street West Hamilton, Ontar
io, Canada IBN
3Z5 She is
currently enrolled in the doctoral
program for environment behavior studies, School of Archi
tecture
and
Urban Planning, University
of
Wisconsin-Milwau
kee
Milwaukee, Wisconsin.
Uriel Cohen, DArch.
is
Associate Professor, School of Architec
ture and Urban Planning, University of Wisconsin-Milwaukee,
Milwaukee, Wisconsin.
Berry
Risteen
Hasselkus, PhI), OTK,
is
Assistant Professor,
De-
partment of Therapeutic Science and Chair, School of Occu-
pational Therapy, University of Wisconsin-Milwaukee, Milwau
kee Wisconsin.
Tbis article was Clccepted or publi catio n August 30 1990.
C
onsumers, families, and health care professionals
agree
that a physical setting that fosters inde
pendent living
is
often
the critical factor that al
lows persons
who
are frail and disabled
to
live in the
cominunity
instead of n
an institution
Although thig
statement
may seem self-evident, policymakers have
heen slow to acknowledge it (Liston, 1971; Shaw, 1971;
Taira, 1984). Changes made over the past 20 years in the
form of
new
regulatory
legislation and
the
adoption
of
more stringent bUilding standards, however, are gradual
ly
beginning to
have an impact
on the
problem
Martin,
1987; Steinfeld et aI., 1979; Taira, 1984). Low-cost units
specially designed to
accommodate
the needs of specific
groups
have been and are
being
erected;
c o m m u n i t i e ~
are
hecoming
increasingly aware
of
the need to
provide
access to public
buildings,
services, and the neighbor
hood at large; and
heightened
multidisciplinaly concern
is evident
(Taira, 1984).
The
occupational
therapy
profession has a declared
interest in
barrier-free design.
According to
Mosey
(1986), a fundamental aspect
of
the practice
of
occupational therapy
is
concern for and use
of thc
nonhuman cnvironment. The nonhuman
cnvironment
is viewed
as
an entity to be mastcred, an aid
10
facilitate the pcrform ance of
life tasks. and a vehicle for assisting in the
development of
senso
ry, perceptual, cognitive, and motor skills and need- fulfilling intra
personal ancl interpersonal relationships. (I'. 3)
Mosey's (1986) views are supported hy
the
profes
sion
as
a
whole, as
evidenced
by
educational
curricula
that include
as a basic component the teaching of
meth
ods used
to conduct
home assessments and modifica
tions
for both architectural
and
functional
features. Fur
ther
endorsement
comes from
the American
Occupational Therapy ~ s o c i t i o n
(AOTA),
which identi
fies and lists the
ability
to conduct home evaluations as
essential
for
various specialized roles (e.g., AOTA, 1981a,
1981b, 1983).
A conservative estimate of between 1.7 and 2.2
of
the
population
are
directly
affected by
barrier-free
design.
A more liberal view states
that
up
to
11.6 would
benefit
from
the
implementation of more stringent
standards
of
accessibility (Steinfeld
et
al., 1979). Persons who are el
derly and those
who
are physically disabled have been
identified as the two major groups requiring assistance
with environmental modification.
Barrier-free environ
ments, both in the
home
and the wider
community,
are
essential
to
successful independent living for these at-risk
populations.
Both the disabled and
elderly populations
are increasing in
number, primarily as
a result
of im
proved health care. This factor, the growing awareness
of
the expense and negative effects of
institutionalization,
and the profound desire
of
these persons
to remain in
the
community
are increasing the demand for appropriate
community-based,
barrier-free
housing, both new and
modified. Because of their training and skills in functional
assessment and environmental adaptation, occupational
April 1991
otume 45 umber
4
44
wnloaded From: http://ajot.aota.org/ on 01/20/2015 Terms of Use: http://AOTA.org/terms
-
8/9/2019 barrier free guidlines
2/7
therapists are well suited to function as facilitators
for
the
independent-living
movement
(Hasselkus Kiernat,
1973). Thus, we can reasonably
predict
that the volume of
requests
for our
input
will
increase in the immediate
future.
The framework
within which
occupational therapy
organizes its therapeutic approach to assessing the phys
ical
environment
thus becomes particularly
important.
The independent-living
thrust
defines the term environ-
ment
broadly and clearly considers
community
accessibil
ity to be as
important as
residential accessibility
for
those
whom it
serves.
The
conceptualization used in the future
by therapists, therefore, needs to be broad enough
to
include all possible bUilding types and settings. It must,
however, also allow the profession's focus on individual
function
to be maintained as the
unit of
analysis. Ideally,
this framework must be equally acceptable and useful to
all occupational therapists, regardless
of their
area
of
practice. Given that
no
one clinical strategy
is currently
agreed on, such a
framework for
environmental
assess-
ment would
also need
to
be flexible enough
to
accommo
date diverse formats. Professional consensus regarding
the conceptualization
of
barrier-free design and assess-
ments
would provide
a consistent
method for
data collec
tion
without restricting its subsequent clinical use. An
additional benefit
would
be the provision
of
a collective,
uniform
base from which issues related
t
occupational
therapy and environmental
access
could
be
researched.
The present paper reviews and critiques the occupa
tional therapy literature
on
barrier-free design, particular
ly concerning the conceptual approach
now
used in edu
cation, research, and practice.
It
suggests a model by
Steinfeld et
al
(1979) as
one
that
might
provide the pro
fession
with an appropriate but more
comprehensive
al-
ternative to
our
present situation-specific approach and
yet allow the focus on individual function
t
be
maintained.
Lllcramrc R \ ' jew
Education and ractice
The major instructional texts in occupational therapy usu
ally include sections
on
the
topic
of barrier-free design in
the sections that deal
with
physical disahilities
or
home
care. The classic general text, Willard and Spackman s
Occupational Therapy (Hopkins
Smith, 1988), ad
dresses the need
for
architectural modifications
but
pro
vides
only brief
general gUidelines
for making
these
changes. Additional
information
in chapters by Malik
(1988) and Levine (1988) discuss activities
of
daily living
and
independent community
living, respectively. Malik
(1988) listed broad areas
to
be considered when
maklllg
home
modifications, which can be restated
as
issues of
acceSSibility,
mohility,
function, and safety. Levine (1988)
stated that the best approach for the therapist to use
cannot be precisely
outlined
(p. 773). She cited cultural,
economic, and personal preference variables as barriers
to a universal approach. Nonetheless, she suggested
two
ways
of
conceptualizing the
environment for
treatment
purposes. First, she
built
on
ideas from Barris, Kiel
hofner, Levine, and Neville (1985) to propose a
model of
four
concent ric circles.
From inner
to outer, these circles
represent the
nonhuman environment,
required func
tional tasks, roles, and culture. Second, she suggested
Kielhofner
and Burke's (1985) Model of
Human
Occupa
tion as
a broad organizational base that could provide a
theoretical umbrella
for
specific treatments and theories
used
in community
health care.
Trombly
and Versluys (1989) discussed the evalua
tion
of
architectural features
within
the
home
and com
munity for
clients
with
physical disabilities
Although
a
sample questionnaire
is
provided,
no
overall conceptual
framework
is
suggested. The authors stressed the
impor-
tance
of
site visits and the inclusion
of
the client and
family in the assessment process,
which is
organized to
address function, safety,
mobility,
and accessibility in var
ious architectural zones
or
rooms.
Information
relevant to barrier-free design is some
times
buried in
texts
on other
topics.
For
example, in a
text on mental health assessments, a chapter by Hassel
kus and Maguire (1988),
which
may be a useful source
of
knowledge for barrier-free design, may be missed by
therapists
working
in specialty areas
other
than gerontol
ogy. Environmental assessments such as Maguire's
(198'5) 'l'ri-Level ADL Assessment organizes and rates six
c,negories of activities of daily living by environmental
level: personal, home or sheltered, and community.
Two
other sources
of
environmental assessments for
occupational therapy are provided by home-evaluation
and home-safety checklists.
The former
are often devel
oped
y
health care units and
institutions
to
meet their
own needs and vary great ly in length and breadth. Similar
organiZing constructs, however, such as safety and per
formance, arc usually used. These checklists
rerresent
an
i l
iosyncratic approach that has been
common in
occupa
tional therapy in the past. Home-safety checklists are spe
cific examples
of
the organiZing construct
of
safety and,
like
the
home
assessments, are varied and idiosyncratic
(cf. Tideiksaar, 1986)
In
summary,
major
occupational therapy texts and
practice sources illustrate that environmental
assess-
ments are viewed by the profession primarily as situation
specific and centered
on
the home. These are often struc
tured as room-by-room checklists to be completed by the
therapist
on
site in collaboration
with
the client and fam
ily. None of the checklists appear to have been tested for
reliability
or
validity.
Although no overriding
conceptual
framework can be identified, there is the suggestion that
two different
approaches
guide
the gathering
of
informa
tion: a consistent cluster of concepts (safety, mobility,
accessibility, and performance) and the relatively new
The American journal of
Occupational
Therapy
45
wnloaded From: http://ajot.aota.org/ on 01/20/2015 Terms of Use: http://AOTA.org/terms
-
8/9/2019 barrier free guidlines
3/7
application
of
theoretical frameworks such
as
the Model
of
Human Occupation.
journal
Articles
A computer search
of
the major occupational therapy
journals (i.e., American journal
o Occupational
Ther-
apy, Australian Journal
0/
Occupational Therapy,
Canadian Journal
0/
Occupational Therapy, Occupa-
tional Therapy
in
Health Care, Occupational Therapy
in Mental Health, Occupational Therapy journal o/Re-
search, Physical/Occupational Therapy in Ceriatrics,
and Physical/Occupational Therapy in Pediatrics re
vealed that in spite of the emphasis placed by the profes
sion on the importance
of
barrier-free design, few articles
of relevance have been published over the past
20
years.
Those identified can be categorized
as
pOSition papers,
surveys, and clinical intervention strategies.
The earliest
of
all the articles found was a position
paper
by
Shaw (1971), which presented a historical per
spective on the issue of architectural barriers and the
problems faced by persons
with
physical disabilities.
Ac-
cessibility needs were categorized and discussed under
the headings
of
housing, education, employment, trans
portation, and recreation. Shaw ended with an emotional
appeal to the health care community to take up the cause
of promoting
barrier-free design. A
more
recent paper by
Taira (1984) also presented a historical overview but fo
cused
more
on the needs of
older
people. She Cited,
as
particularly useful to occupational therapy, a series of
publications from the
U.S.
Department
of
Housing and
Urban Development (HUD). Taira commented on the
importance of considering consumer preferences and
weighed the merits
of architectural modifications versus
new construction. She also issued a challenge to the pro
fession to recognize the need to become more involved,
both as practitioners and as consultants.
Four surveys are reported in the literature. Two
of
these (I
-
8/9/2019 barrier free guidlines
4/7
of the modifica tions. The assessment form used
was
de
veloped with the use of AJ'JSI standards and a concern
for
safety
United
Cerebral
Palsy of
New York City, 1984).
The
authors stated that evaluations of the program suPPOrt
this as a cost-effective way of
improving
the quality of life
for
these persons and enabling
them t
remain
in
the
community, The
effectiveness
of
the
intervention
itself,
however, cannot be
determined
from the data
reported
in
the article,
The present review indicates that occupational ther
apy research
on
barrier-free design is
in an
early phase of
development and cannot be said to demonstra te any well
defined thrusts,
Although
elderly people have been iden
tified as a target
group in
need of barrier-free design,
no
studies specific t this group were found, The home
based checklist
orientation
espoused by education and
practice is strongly evident but, again,
no common
con
ceptual
framework could be identified, As
with
the educa
tion and practice literature, conceptual trends were noted
or
could be infer red, Primarily, these were the use
of
ANSI
standards, followed by the use of clusters
of
constructs,
either Shaw s (1971) or those of accessibility, mobility,
safety, and function,
The lack of a clearly defined conceptual base pre
sents a
primary
obstacle to further professional develop
ment,
lending
itself to idiosyncratic interpretations and
variations
of
architectural assessments that cannot be
compared, Fledgling conceptual frameworks can be ex
trapolated, the
most
distinct being the
use of
ANSI stan
dards as well as the focus
on
individual needs
as
catego
rized by a
number of different
constructs, The strongest
and most pervasive of these thrusts, the use of ANSI
standards,
is
discussed below,
wndard
The
use
of
ANSI standards
in
construction
is
currently
voluntary,
but
they have been adopted by federal agen
cies and 50 states
t
form the basis for most
of
the cur
rently used gUidelines
on
barrier-free design (Martin,
1987; Steinfeld et
aI.,
1979), These standards were revised
in
1980
(AJ'JSI,
1980)
with input
commissioned by
HUD
from the University of Syracuse
in
New York. Phase 1 of
the research contract, supervised by Steinfeld et al.
(1979), addressed six factors:
1. The
history
of
the barrier-free
movement
2,
The
extent of the
problem
3, Existing legislation
4. The
scope of barrier-free design problems
5, Relevant research
6. The
effects of barriers
on
the life-styles of persons
with
disabilities and ways
of mitigating
these
effects.
The
second phase built on these findings to focus on the
foJJowing:
1.
The
identification
of particularly
difficult
design
problems and their
solutions
2,
Laboratory testing of design criteria
3
The
collaborative development of design criteria
4, A study of the cost of erecting accessible buildings
5,
An analysis of economic costs and benefits,
Six reports were published by Steinfeld et
a!.
(1979)
as
a result of the contract (these
would
appear to be the
same series cited by Taira [1984]),
One report is
of par
ticular interest
t
occupational therapists. Two
sections-
the scope of barrier-free design and
human
factors re
search - contain ideas that
might
provide the
common
conceptual base that
is
needed by occupational therapy,
Ban ier Free Design
Most gUidelines and architectural assessments have fo
cused
on
accessibility
for
persons
in
wheelchairs
on
the
assumption that
an
environment that is suitable
for
such
persons will be equally suitable for persons
with other
disabilities, This, however,
is not
always the case; for
example, the installation
of
curb cuts, so useful to those in
wheelchairs, is hazardous
for
persons
who
are blind,
For
the latter, the lack of a clear-cut
boundary
eliminates the
warning of the immediate presence of the street and the
dangers
of
traffic: supplementary cuing methods, such as
varying the texture of the pavement, are then reqUired,
Issues of
this type pose a problem
for
the making
of
environmental
changes to
improve
accessibility in
public
areas, In the absence of a universal soluti on, whose needs
should take precedence?
RecogniZing that much of
the
literature
on
barrier
free design presented a reductionistic view, Steinfeld
et
al. (1979) proposed an ideogram called the nabler (see
Figure 1),
which
would
allow a
broader
and
simpler
con
ceptualization of disabilit y and, by
providing
a
method for
identifying
problems, facilitate design decision making,
The Enabler model represents
four
general areas
of
hu
man disability that should
be
considered in the designing
of environments: (a) mental functioning,
b)
the senses,
(c) internal body regulation, and (d) motor
impairment,
These subsume 15 specific areas of disability,
Steinfeld et al. (1979), using expert
opinion
and re
search findings, then developed 13
problem
identifica
tion matrices, These matrices represent
aJl
the
movement
and functional patterns possible in the
environment
With
out being specific to area,
room,
or building type (see
Figure 2), Table 1 depicts
an
exhaustive list of
movement
and functional patterns. Each
matrix
sets the enabler
on
the abscissa and places the design factors on the ordinal.
This scheme allows
problem
areas to be mapped and
graded according to severity
for
each design concern
generated.
Advantages and
limitations
of
this approach are dis
cussed
in
some detail by Steinfeld et
al.
(1979). The
ad-
vantages include the ability
t
present the pervasive di-
The merican Journal 1 Occupational Therapy
347
wnloaded From: http://ajot.aota.org/ on 01/20/2015 Terms of Use: http://AOTA.org/terms
-
8/9/2019 barrier free guidlines
5/7
DIFFICULTY INTERPRETING INFORMATION
SEVERE LOSS OF SIGHT
COMPlETE LOSS OF SIGHT
SEVERE
LOSS OF HEARING
PREVALENCE OF POOR BALANCE
INCOORDINATION
LIMITATIONS OF STAMINA
DIFFICULTY MOVING HEAD
DIFFICULTY REACHING WITH ARMS
DIFRCULTY
IN
HANDLING AND FINGERING
LOSS
OF UPPER
EXTREMITY SKILLS
J
~ : _ _ i i _ _ _ : _ ~
DIFFICULTY BENDING, KNEELING, ETC.
K
----;,...;--..;
RELIANCE ON WALKING AIDS
L ~
INABILITY
10
USE LOWER EXTREMInES
M . ~ ~
EXTREMES OF SIZE AND WEIGHT
N
--E:
Figure
1.
The Enabler model.
Note
From
Access t the
Built Environment:
A
Review
of
the Literature
p. 75) by E.
Steinfeld,
S.
Schroeder, J. Duncan, R. Faste, D. Chollet, M.
Bishop, P. Wirth, and
P.
Cardell, 1979, Washington, DC:
U.S. Government Printing Office.
mensions of disabilities in a manner that can be easily
understood and addressed by a multidisciplinary
group.
The limitations include
the
inability of
the
matrix
to
iden
tify
that
sometimes more
practical, alternate ways
to
ac
cess and use
the
building may exist.
uman
Factors Research
Most of the research reviewed by Steinfeld et al. (1979)
for their
report
was found in
the human
factors (ergo
nomics) literature. This body of work explores the fit
between
human
performance
and
the
physical environ
ment. Steinfeld et
al.
were critical of the mechanistic ori
entation of this literature, but found that
it
produced a
unifying concept for barrier-free design: buildings con
ceived
of
as task environments This conceptualization
of
barrier-free design places acceSSibility into an integrated
framework of human performance and allows for the gen
eration
of
a complete list
of
information needs for design
based
on
the task requirements
of
the inhabitants. As a
concept, access can be broken down into 10 basic re
quirements (e.g., passing through openings [see Table
1]). Each of these
requirements
in turn has
been
subdi
vided; the result is an exhaustive list
of
possibilities.
Steinfeld
et
al. (1979) reviewed and critiqued this
literature, organized by
the
headings of (a) functional
anthropometry,
(b)
biomechanics, (c) information dis
play, and (d) specific task environments On the basis
of
.
I
,
potential problem
problem
o
severe problem
r ~
impossibility
~ l i
n trances. [xi ts and OooT'flays
AB B2C
DE
FGH I
J
K
LMN
1. Extremely narrow door openin
gs
2. High thresholds
or
stairs at
entrance/exit
3. Not enough maneuvering
space
in
front of doors
4. Door
swings that
partially 0
bstruct
use
5. No
level
space in front
of
e
"try
doors
6.
Directions unclear
or poorly
marked
7.
Illogical opening procedure
8.
Great
force
needed to open d
oors
9.
Stairs
in
path
of travel to
an
emergency exit or place of r
e fuge
10. Revolving doors on turnstile
s
Figure 2. An example of an Enabler problem matrix. Note
From
Access t the Built Environment:
A
Review of the Lit-
erature
p. 91) by
E.
Steinfeld, S. Schroeder, J. Duncan, R.
Faste, D. Chollet, M. Bishop, P. Wirth, and
P.
Cardell,
1979, Washington, DC: U.S. Government Printing Office.
this, they presented a useful summary of
the
information
available at
the
time and identified the existing gaps in
each of these areas of barrier-free design. Issues such as
the
influence
of
speed,
range
of
motion, accuracy,
strength, and endurance on function were also discussed.
Discussion
The
reports issued for HUD by Steinfeld et al. (1979)
represent a thoughtful and
comprehensive
state-of-the
art statement on barrier-free design
and one
that is con
siderably more developed than any found in
the
occupa
tional therapy literature. Although Steinfeld et
al.
's report
is directed toward
the
design community, the ideas pre
sented embrace those identified in our review as impor
tant to occupational therapy. That
is,
they subsume the
concepts
of
safety, acceSSibility, mobility, and perform
ance and address these from the perspective
of
the
per
son
and disability, and they allow for home assessments
and for compliance with building standards. The Enabler
model acts as a problem-solVing device that permits
the
lack of ability to perform activities in task environments to
be identified and rated. This method
of
analysis is system
atic, exhaustive, and congruent with
the occupational-
functional orientation of our profession.
Steinfeld et al.'s (1979) conceptualization is broader
and
more
developed than
the
present occupational ther
apy site-specific
mode
of home assessment, because it
Apn l 1991 Volume 45
Number 4
48
wnloaded From: http://ajot.aota.org/ on 01/20/2015 Terms of Use: http://AOTA.org/terms
-
8/9/2019 barrier free guidlines
6/7
Table
Information Needs n Designing Accessible
Environments
Task Information Needs
1. Passing
through openings
Height of openings
Width of openings
Shape of openings
Maneuvering clearances
2. Operating electronic and
Configuration of control
mechanical controls
Location
vis-a-vis
reach
Force of activation
Activation motion
Speed of activation
Relationship
to
other control
Type of feedback
3.
Moving
along route of travel
Characteristics of surface
Friction between user and surface
Length of routes
Width of path
Exposure along route (to climate)
Overall paltern of circulation
4.
NegOtiating changes
in level
Degree of slope
for
ramp incline
Configuration of stair nosing
Stair shape and size
Length of run fm incline of stairs
Location and configuration of
assistS
Configuration and size of landings
5. Transferring from one body
Number and type of assists
posture
to
another
needed for transfer
Location
and configuration of
assists
Strength of assists
Size and configuration of transfer
clearances
Size and configuration of built-in
elements that are transfer
points (e.g, toilet)
6.
Searching
for
and
Information needs
interpreting direction-finding
Type of coding method
information
Location of display
Exposure of display
Content of information needed
Number of displays needed
Complexity of information
transmitted
Symbolic
content of information
7.
Negotiating a series of
Size
and configuration of
movements
in
a confined
clearances
space
Layout of elements in a space
Proximity of elements to each
Other
8.
Negotiating human and
Constraints
on traffIc
flow
vehicular traffic
Controls
on now
rate and
direction
Separation of human and
vehicular traffIc
9. Using flXtures,
storage, and
Height
work surfaces
Approach clearances
Configuration of fixtures
Size
10.
Avoiding hazards
in
the path
Definition of hazards thaI
should
of access
be avoided
Configuration of hazard-free zone
Size
of hazard-free zone
Guards against exposure to
hazards
Size
and configuration of warning
signals
allows
both
individual
and group needs to be addressed
by the same model
and
permits
homes, institutions, and
community areas to be
similarly
assessed. This represents
an improvement
over our
more
limited approach.
Al
though they represent very different disciplinary bases,
both the occupational
therapist
and
the designer
gather
information
on
accessibility for the same purpose: to con
struct an environment that
is
responSive to functional
needs and that facilitates performance.
It
is
particularly
important
to
note
that
the adoption
of
the
Enabler
matrix
would
permit
a
consistent format for
data
collection by
any discipline
on
aJl settings,
persons,
and
disabilities.
The advantages of the
establishment
of such
a
common
data pool are obvious and enormous. For example, the
development of a
large or
representative
database
of in
formation would allow for
the
generalization of
findings
and the
meaningful
application of
results
from disparate
studies. Finally,
Steinfeld et al.'s ideas have
formed
the
basis
for the Jast ANSI
revision
and
as
such, serve
to
include various
levels
of government on
the multidisci
plinary barrier-free design
team
and to proVide
a
gold
standard for
prOViding
accessible
environments.
Conclusion
The profession
of
occupational
therapy has traditionally
been
concerned with accessibility and barrier-free design.
This
concern
has
tended to be
case-
and
home-specific.
A
review of
the
literature indicates that both
a conceptual
base and
research on the topic
are
needed. Because the
demands
for accessible environments are increasing, par
ticularly to enable
elderly
and disabled persons to remain
in
the
community, increased occupational
therapy
input
will
be
required in the
future. The
literature
reviewed
raises our
awareness of three important issues:
the
need
to
develop
the occupational
therapy base
of research and
practice; the
growing
acceptance of
ANSI standards; and
the
existence
of
a
cadre of concerned and welt-informed
designers
and an architectural literature
base. Steinfeld et
al.'s (1979) Enabler model may provide a viable person/
disability/function model for
the extension and
unifica
tion of the present
occupational
therapy concepts relat
ing to barrier-free
designs
as
well
as
a
link
to
the
multidisciplinary
design team
In
return, we can
offer
the
health care
perspectives
and skills unique to
the
profes
sion
of
occupational therapy, that is,
our
knowledge
of
specific
diseases
and disability, of
life-span
development,
and of how these various processes may influence func
tion.
Together we
can enhance and
strengthen design
decisions
and the
provision of barrier-free environments
for
elderly and disabled persons ....
Acknowledgments
Note From Access to tbe Built Envimnmenl A Review
oftbe
Literature
(p
103) by
E Steinfeld, S Schroeder,]. Duncan, R Faste, D. Chollet,
M.
We are gratefUl for the
support of
the Canadian Occupational
Bishop,
P
Wirth, and
P Cal"dell, 1979,
Washington, DC: US. Govern
Therapy Foundation
and
the
Social Sciences
and
Humanities
ment Printing
OffIce.
Research Council of Canada.
be American
journ l
of
Occupational Therapy
349
wnloaded From: http://ajot.aota.org/ on 01/20/2015 Terms of Use: http://AOTA.org/terms
-
8/9/2019 barrier free guidlines
7/7
Refl:renct:s
American Na tional Standards
Institute,
Inc. (1971). Ameri-
can National Standards specifications
for
making buildings
and facilities accessible
to
and usable by Ihe phvsically
handicapped.
New
York: Author.
American Nat ional Standards Institute, Inc. (1980). Ameri-
can National
5Landards
specifications for making hUildings
and
facilities accessible
to
and usable by the physically
handicapped.
New
York:
Author.
American Occupational Therapy Association. (1981a). The
Association - Official position
paper-
Occupational therapy's
role
in
independent or alternative
living
situations. American
journal
of Occupational Therapy,
35
812-814.
American Occupational Therapy Association. (1981b). The
~ s o c i t i o n - Off ic ial position
paper- The
role
of
the occupa
tional therapist in home health care. mericanJournal ofOc-
cupational Therapy, 35 809-810.
American Occupational Therapy Association, Commission
on Practice. (1983). The roles and functions of occupational
therapy selvices for the severely disabled. mericanjournalof
Occupational Therapy,
37
811-814.
Barris, R. Kielhofner, G., Levine, R. Neville, A. (1985).
Occupation
as interaction with
the environment.
In
G. Kiel
hofner
(Ed.),
A Model
of
Human
Occupation: Theory
and
application pp. 42-62). Baltimore: Williams Wilkins.
Colvin, M. E. Korn, T. L. (1984). Eliminating barriers to
the disahled.
American journal
qfOccupational
Therapy,
38
748-753
Hasselkus, B. R. Kiernat,J.
M.
(1973). Independent living
for the elderly. American Journal of Occupational Tberapy,
27
181-188.
Hasselkus, B.
R.
Maguire, G. H. (1988). Functional as-
sessments used with
older
adults.
In
B.
Hemphill
(Ed.), Mental
health assessment
in occupational
therapy: An integrative ap-
proach to the evaluative process. Thorofare, NJ: Slack.
Hopkins,
H., Smith, H. (1988). (Eds.). Willard and
Spackman s occupational therapy (17th ed.). New York:
Lippincott.
Kielhofner,
G.,
Burke,
J
P.
(1985).
Components ;mcl
determinants of
human
occupation.
In
G. Kielhofner (Ed.), A
Model of Human Occupation. Theory and applicalion pp.
12-36). Baltimore: Williams Wilkins.
Kiernat, J M. (1972). Promoting community awareness
of
architectural barriers. American jow77al of Occupalional
Tberapy.
26,
10-12.
Levine. R. E. (1988). Community home health care. In H.
Hopkins I-I.
Smith (Eds.), Willard and Spackman s occupa-
tional
therapy (7th ed., pp. 756-780).
New
York: Lippincott.
Liston, R. (1971). Learning experience: Architectural har
riers survey. Ccmadianjournal of Occupational Therapy, 38
71-711.
Maguire, G. H. (1985). Acitivites of daily living.
In
C. Lewis
(Ed.),
ging
The health care cballenge.
Philadelphia:
F. A.
Davis.
Malik, M. (1988). Activities of daily living and homemaking.
In H.
Hopkins
H. Smith (Eds.), Willard
and
Spackman s
occupational therapy Oth ed., pp. 258-271). New York:
Lippincott.
Martin, L. M. (1987). Wheelchair accessibility
of
public
huildings in Utica, New York. mericanJournal ofOccupation-
al
Tberapy,
41 217-221.
McClain, L., Todd,
C.
(1990). Food store accessibility.
American
journal of
Occupational Therapy, 44 487--491.
Mosey, A. C. (1986). Psychosocial components
ofoccupa-
tional therapy. New York: Raven.
Shaw, J. A. (1971). Architectural barriers: A medical prob
lem. American Journal
of
Occupational Therapy, 25, 13-15.
Steinfeld, E. Schroeder,
S.
Duncan,
j.
Faste,
R.
Chollet,
D., Bishop, M., Wirth,
P.
Cardell, P. (1979).
Access to tbe buil t
environments: A review qfthe literature. Washington, DC: U.S.
Government Printing Office.
Taira, E. D. (1984). An occupational therapist's perspective
on environmental adaptations for the disabled elderly. Occupa-
tional Therapy in Health Care, 1(4), 25-33.
Tideiksaar, R. (1986). Preventing falls: Home hazard check
lists to help older patients
protect
themselves. Geriatrics, 41 (5),
26-28.
Trombly, C. A, Versluys, H. P. (1989).
Environmental
evaluation and community reintegration. In
C.
A Trombly (Ed.),
Occupational therapy for physical dysfunction pp. 427--440).
Baltimore:
Williams Wilkins.
United Cerebral Palsy
of
New York City, Inc. (1984). Occu-
pational therapy initial evaluation: Project open house.
(Availahle from United Cerebral Palsy 105 Madison Avenue,
New York, NY 10016)
Wittmeyer, M. B., Stolov, W. C. (1978). Educating wheel
chair patients
on
home architectural barriers.
American jour-
nal of Occupational Therapy, 32 557-564.