RESNA Annual Conference - 2019

The Challenge And Strategy Of Disability  Infobases  

Cynthia Gauthier1, Hanna Paul1, Roger O. Smith1

University of Wisconsin-Milwaukee1, Rehabilitation Research Design & Disability Center 


With the normalization of day-to-day use of web-based applications in the daily life of all individuals, new interventions using innovative strategies are needed to assist people with disabilities to overcome environmental barriers regarding community accessibility. The creation of the Americans with Disabilities Act (ADA) in 1990 and update in 2010 (ADA-ABA) allowed thousands of people with disabilities to gain access to formerly inaccessible community buildings. However, after reading the literature or talking with people who have a disability, one finds that ADA Accessibility Guidelines (ADAAG) remain limited for several reasons: a) The ADA provides only minimal guidelines for building features; b) Older buildings are exempt from ADAAG; and, c) Accessibility is relative based on functional capabilities. The Access Ratings for Buildings (AR-B) suite of apps is designed to provide vital information to persons with disabilities (PWDs) with individualized accessibility information, allowing the user to anticipate and problem solve barriers when accessing their community.  Taking the project from design to implementation includes challenges that we are currently facing related to crowdsourcing populating the database.  


Chart comparing a type of assessment and their features.
Table 1. Assessment types and features
The AR-B suite includes a set of applications developed to assist in the accessibility assessment of buildings: the AccessTools suite and AccessPlace. Together, they form the NIDRR funded Access for Buildings Project. AccessTools is a suite of iOS mobile applications designed for use by trained raters to evaluate the accessibility of buildings. AccessPlace is a multi-platform mobile and web application designed for end-users to communicate and obtain Personalized Accessibility Information (PAI) tailored for the individual’s functional impairments.[1]   

To be confident in our proposed research and development plan, we assessed existing instruments to determine if any already met the design features of our proposed project. Analysis of these sources also informs our project about specific design features to avoid and ones that might be considered to improve our designs. Table 1 portrays a summary of assessment types and noted features of assessments reviewed. Most existing assessments were developed for specific purposes, different from our universal data collection and reporting system. Generally, existing assessments are limited in the following ways: 1) Data collection logistics: paper and pencil, too lengthy, time consuming; 2) Not easily portable in the field; 3) Limited measurement sensitivity: dichotomous compliance data only; 4) Too global results; 5) Too subjective and only individual results; 6) Computer-platform specific; 7) Costly to use; 8) Limited or targeted scope; 9) Does not recognize individual accessibility needs; 10) Limited functionality: uses ADAAG criteria only and fails to address preferred functional access of the environment.   


A screenshot of the AccessTools app. 
Figure 1. AccessTools taxonomy
Creating a series of questions that would effectively determine the accessibility of a building came with challenges. First, deciding how to display this information was challenging as a result of many potential options. Making sure the style (coloring, font, item placement) was accessible for users, was paramount given the mission of the application. Figure 1 displays the taxonomy that is currently being used, which shows stark contrast between background and font. Developing a proper flow of questions was another challenge within this project. While 28 main domains with subsequent subsets of questions were developed, the process of generating an appropriate taxonomy that would cover the necessary aspects of building accessibility was difficult. Focus groups were utilized to make sure that the questions on AccessPlace and resulting data generated by AccessPlace and AccessTools were useful and accessible. There were a total of nine focus groups that were comprised of 6 to 10 participants representing a wide range of disabilities. This range has been cited as being optimal to ensure a diversity of opinions, while still allowing each participant to be heard.[2,3] 

One focus group was held per year at each of the AR-B main sites - UW Milwaukee, Florida International University, and Texas Woman’s University. A modified Nominal Group Technique was utilized to allow individuals to generate ideas individually, then participate in a round robin discussion where all participants had equal opportunities to share their thoughts. This technique is used to avoid an overzealous participant dominating the procedures.[4,5] Focus group participants were asked the following three questions:   

1.     What changes or improvements would you like to see in the AccessPlace website/app?    

2.     What type of accessibility data would be most helpful for you to participate in the community?    

3.     What format(s) would you like to see the data in?   

These results helped the design team draft and revise the interface, information types included in AccessPlace, and the resulting reports generated by AccessPlace and AccessTools. Constructing a taxonomy that was holistic in its approach to building accessibility while also being meaningful and accessible for users continues to be a dynamic process.   


A table describing health conditions and functional impairments included in PAI feature 
Table 2. Health conditions and functional impairments included in PAI feature
The exact number of people with some sort of functional impairment is difficult to comprehend, as many people do not consider themselves “disabled”, such as many in the aging population.[6] We know that the accessibility of built environments affects many more people, including those with temporary impairments and people who are beneficiaries of universal design (such as mothers using strollers who need ramps or automatic doors for delivery people). Thus, the population benefitting from accessibility information is far greater than the 50-60 million people reported to have a disability. Our prior research has delineated 42 distinct types of relevant functional impairments.[7]    

In the creation of AccessPlace, it was important to create a way in which a user was not forced to scroll through numerous reviews related to accessibility and design for someone with a disability that was not related to their own. This difficulty was overcome with the creation of the Personal Accessibility Information (PAI) feature, which is based on a personal profile. The AccessPlace profile includes 9 health condition categories, with 29 functional impairments which a person can rate from easy or none (default) to unable or severe. Table 2 shows a sample of the 9 health conditions and functional impairments. Once the PAI profile has been created, AccessPlace automatically orders reviews so that reviews written by people with the same impairments will rise to the top of the list.    


We will collect accessibility data and populate the database for public buildings using three stages for expanding catchment areas. First, we will focus our development around the Milwaukee metropolitan area. Then will add our partners at University of Florida International University (FIU) and Texas Women’s University (TWU). We will then expand the assessments to include municipalities where other rehabilitation therapy professional training programs reside. Lastly, these deliberate steps lead to a public opening of data collection among rehabilitation training programs, and active invitations to community and civic organizations. Milwaukee will serve as the pilot city to begin this process. Because information goes viral in seemingly random ways, considering strategies for promoting AccessPlace is complex. We will first begin by networking with the Center for Community-Based Learning, Leadership and Research at UWM to formulate an action plan for disseminating information to our local community through various marketing materials including flyers, informational videos and informative presentations. We will contact our partners at Independence First, Vision Forward, Milwaukee Center for Independence, and the Milwaukee County Department on Aging with informational materials. We will collaborate with these groups to identify the best methods of making their clients aware of the AccessPlace app, and create promotional materials such as print and electronic flyers, to market AccessPlace. The next step is to extend our recruitment of PWDs to other communities, and advocate through 40 Occupational Therapy Professional Training programs (OTPs). One of our strategies will include the creation of a video that provides specific examples depicting how an individual with a disability must adapt their approach to engaging in their community due to the minimal standards of accessibility put forth by ADA.  


Crowdsourced website services are familiar to most, Yelp being perhaps the most well-known and relevant to this project. However, Yelp had the advantage of large influxes of investor money early in their development, and the CEO acknowledged to the New York Times that Yelp paid for reviews in the early days to “get the ball rolling in our otherwise empty site”.[8] This option is obviously not as available to us in an under-resourced disability community. Several people have attempted to create websites with some features like AccessPlace, however, they have not managed to achieve broadly useful information to the disability community due to limited area coverage, only covering mobility, and not appearing to be currently active. Finding a way to populate the AccessTools database without the use of paid reviews was, and still is, a major difficulty within the project.   

Currently, several websites and apps exist that present some accessibility information, but these are usually too general, are limited to specific disability types (usually mobility), are scarcely populated, or only populated in one region, and restricted in the information available (e.g., whether there is an accessible ramp or bathroom). While numerous accessibility measurement and reporting systems have been created, none address the full scope of disability while leveraging the potential of mobile device use, the cloud, and produce personalized reports.    


The true challenge in the creation of AccessPlace is not the creation of the application itself, it is the community engagement aspect that relies on interest and time of a diverse group of individuals. We must ask ourselves about the groups of people who have an interest in aiding in this project. Are they PWD? Are they family members of a PWD? Are they building and code inspectors who would benefit from the measurements taken within the application? Members of these stakeholder groups may have an interest in the advancement of this project. It is important that these groups of people are involved in the crowdsourcing process to come. Involving groups of people with a variety of connections to the project will result in a more widespread dissemination of AccessPlace. These are all pieces of the greater crowdsourcing challenge that is being framed as a strategy through our use of community partners and stakeholders. 


We have designed the app suite to be optimally accessible to all users, regardless of impairments by accessing the native accessibility features available on devices. AccessPlace’s user functional impairment profiles provide a means of filtering report data to customize matches to others with similar profiles. However, impairments may be highly individual in nature and even though two users may have identical general impairment profiles, their challenges and accessibility preferences can be quite different. Thus, we will extend the disability profile to allow for more detailed accessibility preferences that correspond more closely to specific AccessTools questions. The features being developed as a part of the AR-B NextGen will benefit not only PWD, but also building owners who would like to promote the accessibility of their buildings. The process of crowdsourcing and populating the database to be filled with information that will benefit our targeted population involves a variety of members of our immediate and extended communities, but this collaboration will result in the greatest benefit for all individuals who are seeking equality in accessing buildings.  


[1] Spaeth, N., Tomashek, D., Smith, R.O (2015). AccessPlace: Personalized accessibility information for buildings. Proceedings of RESNA Annual Conference-2015 Retrieved from   

[2] Johnson, B. & Christensen, L. (Eds.). (2004). Educational Research: Quantitative, Qualitative, and Mixed Approaches (2nd ed.). Needham Heights, MA: Allyn & Bacon.   

[3] Langford, B.E., Schoenfeld, G., & Izzo, G. (2002). Nominal grouping sessions vs. focus groups. Qualitative Market Research5, 58-70.   

[4] Onwuegbuzie, A.J., Dickinson, W.B., Leech, N.L. (2009). A qualitative framework for collecting and analyzing data in focus group research. International Journal of Qualitative Methods8(3), 1-21. doi: 10.1177/16094 0690900800301 

[5] Freeman, T. (2006). Best practices in focus group research: Making sense of different views. Journal of Advanced Nursing56(5), 491-497.   

[6] Kelley-Moore, J.A., Schumacher, J.G., Kahana, E., & Kahana, B. (2006). When do older adults become "disabled"? Social and health antecedents of perceived disability in a panel study of the oldest old. Journal of Health and Social Behavior47(2), 126-141.  doi: 10.1177/002214650604700203 

[7] Smith, R.O., Barnekow, K., Lemke, M. R., Mendonca, R., Winter, M., Schwanke, T., & Winter, J. M. (2007). Development of the medical equipment device accessibility and universal design information tool. In: J.M. Winters & M.F. Story (Eds.), Medical instrumentation: Accessibility and usability considerations (pp. 283-296).  Boca Raton, FL: C Press.   

[8] Hansell, S. (2008) Why yelp works. The New York Times. Retrieved from 


The work of the Access Rating for Buildings project was supported by a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research, NIDILRR grant number (NIDIRR) H133G100211. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this work do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government. 

The work of the Access Rating for Buildings – NextGen project was developed in part under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90IFDV0006).  NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS).  The content of this work does not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.