Universal design and occupational therapy

by Laurie Ringaert

Universal design is an emerging field for occupational therapists. Historically, most therapists practised in the home modification area, addressing individual needs. Whereas in the case of universal design, occupational therapists now work with a developer to design new homes to meet universal design principles. In Canada this would also incorporate Canada Mortgage and Housing Corporation’s (CMHC) FlexHousing concepts of adaptability, accessibility, affordability and healthy housing.¹

Universal design encompasses a large range of abilities and ages in broader contexts such as housing, public buildings, parks and public rights of way in urban areas. The needs of all user groups are considered; for instance, the maintenance personnel with large floor cleaning or snow cleaning machines. To provide consultation in universal design, one needs to have extensive knowledge of the theories and principles of universal design, human rights laws, standards and codes, and the functional requirements of a variety of users. It is also very important to involve all user groups in the process.

Occupational therapists have a great deal to contribute to the field and particularly to designers and architects due to their knowledge of human functioning, disability and the person-environment connection.

What is universal design?

Universal design is a way to create products and environments that are more usable by everyone, regardless of age or ability.³ Universal design can be defined as the design of products and environments to be usable by all people, to the greatest extent possible without the need for adaptation or specialized design.² In this definition the needs of persons with wide ranges of cognitive, visual, hearing, mobility and agility functions are taken into account as well as the needs of persons of various heights, widths and ages. Universal design is important to the design of environments such as houses, office buildings, hotels, restaurants, parks, streetscapes, urban planning, swimming pools, trails, historic attractions, museums, exhibits, auditoria, web sites, communication, product design, services and policies.

By thinking of the environmental needs of a range of human functioning, a better environment is created for everyone. For example:

• A level entrance is easier to use for a person pushing a baby carriage or someone moving boxes or furniture into a building.
• Wider hallways, doors and washrooms make it easier for cleaning and moving personnel to do their work.

These same features provide a more aesthetically pleasing environment than a cramped design.

• Colour contrasts between walls and floors and at stairways and entrances provide visual interest and also make wayfinding easier.
• Wayfinding is also improved through the use of easily read (including tactile and braille) and understood signs at appropriate heights located at decision-making points.
• Lever door handles on doors are easier to use by people with wet or cold hands or whose hands and arms are filled with packages.

Why are occupational therapists involved in universal design?

If people with disabilities and seniors are unable to use products, services or environments their occupational performance is affected in any of their interactions with society. For instance, a child is unable to get into a school because it is inaccessible. This will affect his occupational performance. If a person who is blind is unable to obtain documents from the local government on disk, then their ability to participate equally in society is affected. An 18-year-old man with a spinal cord injury is rehabilitated at the rehab centre but finds that there are no accessible arenas to view hockey and very few accessible restaurants in his town. He cannot visit the homes of friends because none of their homes have an accessible entrance or bathroom. Even though the rehabilitation has been “successful,” the individual now has to live in an inaccessible environment in society.

Occupational therapists often prescribe powered mobility devices as part of the rehabilitation process for an individual only to discover that the built environment is actually designed by law to be inaccessible to persons using scooters and power wheelchairs since the codes and standards were designed with manual wheelchair users’ requirements in mind. Thus the client may be unable to enter public restrooms or use public ramps with his power mobility device. Rather than just focusing at the individual level, occupational therapists apply their knowledge in a larger contextual approach. They can provide consultation to groups such as designers, architects, planners, contractors, service providers and to codes and standards committees.

Universal design relates to factors of participation and environmental in the World Health Organization’s International Classification of Functioning, Disability and Health. Occupational therapists practising universal design tend to operate more at the societal and policy development level rather than at the individual level of functioning.

Seven principles for universal design*

Equitable use
Flexibility in use
Simple and intuitive use
Perceptible information
Tolerance for error
Low physical effort
Size and space for approach and use

* These principles can be used to assess or design a product, service or an environment.
For a full explanation of these principles, visit the Center for Universal Design web site at http://www.design.ncsu.edu/cud/.

Footnotes

¹ For more information on CMHC’s FlexHousing,  visit their web site at : www.chmc-shl.gc.ca

² Connell, B. R., Jones, M., Mace R., Mueller J., Mullick A., Ostroff, E., Sanford, J., Steinfeld E., Story M., & Vanderheiden, G. (1996). Development and validation of principles of universal design. Paper presented at the RESNA Conference: June 7-12, 1996.

³ Mace, R. (1985). Universal design: Barrier-free environments for everyone. Designer West, 33 (1).

This article first appeared in the September/ October 2002 issue of Occupational Therapy Now magazine published by the Canadian Association of Occupational Therapists.