Home Access Modifications: Effects on Community Visits by People with Physical Disabilities
An accessible environment is one that can be traveled through quickly and with minimal effort. Although public policy has addressed physical access and improvements continue to be made, accessible housing is not widely available.
Purpose and Anticipated Benefits
Building from a previous pilot study, this project entailed putting a ramp on the homes of six people with lower incomes to determine whether the ramps increased their visits into the community, an indicator of community integration.
Glen White, with the support of fellow Research and Training Center on Independent Living researchers Adrienne Paine, Mark Mathews, and Stephen Fawcett and with the advice of Michael Jones, conducted this study of six wheelchair users who were eligible for community block grant funds to have an exterior ramp constructed at their home. Participants were: Peg, 62, who had bone cancer in her hip that affected her walking ability; Hazel, 55, who had severe arthritis and a form of muscular dystrophy; Stan, 37, who had an incomplete high-level spinal injury; Pete, 46, who had complete spinal injury; Ellen, 82, who had a stroke; and Mick, 31, who had cerebral palsy. Four participants were black, and two white. Most lived by themselves. The Topeka Office of Community Development; Don Carr, Topeka Independent Living Resource Center; and Robert Mikesic, Independence, Inc., also provided support during the study.
Before the ramps were installed, each person rated satisfaction with their homes, frequency of social contacts, and other topics pertaining to community integration. They also completed the Arizona Social Support Network Inventory about social contacts. The accessibility of each residence was rated one to five weeks before and one to two weeks after ramp installation with American National Standards Institute guidelines. After the installation, the researchers did weekly telephone interviews to learn more about outings and visits. To verify the self-reports, participants were asked to save ticket stubs and other proof of outings. Contact was made, too, in some instances, with the person visited. A multiple baseline was used to analyze the effects of home access modifications on the frequency of participants’ trips into the community and visits into their homes by others.
The number of visits varied, which could have been to weather, demands from others, prearranged appointments, health, and other factors. The results showed that the ramps may have had some effect on outings by four of the six participants. One woman primarily had her husband to transport her into the community. Another had limited access to transportation and his volunteer job ended a week after the ramp was installed. Overall, there was a 60% increase in community trips, which did not count the number of sites visited on an outing.
Ramps, while a good start to accessibility, were not enough. People with mobility impairments need accessible transportation, buildings, and the broader environment to increase opportunities for community integration.
The costs of home access modifications should be considered when determining whether such accessible housing program should adopt them in their communities.
“Home access modifications may be a necessary condition for social integration, particularly among some low-income people with severe physical disabilities. However, ramps alone are not a complete solution. A ramp may enable the person to get across the threshold, but a lack of public transportation may limit access beyond the property line. Similarly, inaccessible public buildings may prohibit entry to the ultimate destination. Thus, modifications in the broader improvement are also necessary to increase opportunities for community integration.” (p. 463, see following citation for source publication)
White, G. W., Paine-Andrews, A., Mathews, R. M., & Fawcett, S. B. (1996). Home access modifications: Effects on community visits by people with physical disabilities. Journal of Applied Behavior Analysis 28(4), 457-463.