The Americans with Disabilities Act Turns 25

This summer is the 25th anniversary of the Americans with Disabilities Act

Stroke is a leading cause of disability in our country. The effects of stroke are wide ranging, from one-side paralysis to the tragedy of locked-in syndrome, as well as invisible difficulties, such as struggling to find the right word, or vision impairments. Part of the disability is facing the ignorance of others when aphasia is interpreted as mental impairment or a wheelchair is seen as lack of ability.

Stroke survivors know about disability.

In colonial times, fear, shame and lack of understanding led some families to hide or disown their disabled members or allow them to die. In the 19th century, people with disabilities were institutionalized and given custodial care, which resulted from the view that they were defective, incompetent and needed to be isolated from society.

In the 1920s, the return of WWI veterans and an increase in industrial accidents produced a large number of people with disabilities. Rehabilitation and a return to work were considered appropriate goals. WWII and the Korean War spawned more disabled veterans and an increase in the range of available rehabilitation services. The assumption behind these programs was that people with disabilities needed to be segregated and protected.

Starting in the ’70s, the disability rights movement learned an important lesson from the civil rights movement and got organized. Disability activists rejected the assumption that they should be segregated as well as the "medical model" that disability is a deficiency or abnormality. As they got organized, they stood on the principle that people with disabilities are competent and have the right to govern their lives. The activists’ policy standard was the creation of meaningful equal opportunity. Their goals were the elimination of attitudinal, communication, transportation, policy and physical barriers so as to integrate people with disabilities into society.

In 1986, the National Council on Disability, an independent federal agency, proposed the bill that became the Americans with Disabilities Act. First introduced in the 100th Congress, the ADA bans discrimination on the basis of disability in the areas of employment, public accommodation, public services, transportation and telecommunications. President George H.W. Bush signed the ADA into law on July 26, 1990. Final regulations for the employment provisions of ADA (Title I) were issued on July 26, 1991, by the Equal Employment Opportunity Commission. The Department of Justice issued final regulations for public services and public accommodations (Titles II &III) the same day.

The world is still not a perfect place for people with disabilities, but because of the ADA, it is a lot friendlier than it was. And the ADA provides the legal framework for society to continue improving.

How the ADA Changed One Man's Life

Survivor Steve Park with wife Charlene

Steve Park is a survivor who has worked as a vocational rehab counselor. He shared his experience with the ADA

I had my stroke in the winter of 1992 at age 32. When I started rehab that spring, my goal was to return to my job as facilities manager at a country club. I did specialized work in heating, ventilation and air conditioning (HVAC) that required working with ladders in high places, doing tasks and using tools that required two hands, balance and stamina. As I could no longer do those things, the company allowed me to go back to work part time, but in a greatly modified position and at greatly reduced pay. Country clubs were exempt from the ADA, so they were not required to make accommodation.

My quest for full-time employment led me to college, where I could learn skills that did not require as much movement, strength, stamina or balance as HVAC. I attended Southern Methodist University in Dallas for my undergraduate degree. The accommodations they provided me included a tape recorder for lectures (it was the ‘90s), notes provided by the class, time-and-a-half on tests, a quiet area for tests, the use of a laptop for notes and tests, plus extra time for travel between classes. They also waived the foreign language requirement because of my aphasia.

Eventually, I earned a master’s degree in Rehabilitation Counseling from the University of North Texas and worked as a vocational rehabilitation counselor (VRC) at the Texas Rehabilitation Commission. However, the pace there was too much and I took a less stressful job as a VRC and employment specialist for the Epilepsy Foundation of Greater North Texas.

As a VRC there, I concentrated on the part of the ADA that covers barriers to employment and accommodations. The ADA levels the playing field for applicants, so they can participate in a competitive environment. The ADA does not require companies to give preferential treatment to people with disabilities. Individuals must be able to do the job within the set standards of all employees. There is a common misconception that the ADA demands companies maintain a certain quota of its workforce for people with disabilities, but that is not the case.

I believe that anyone with the desire and ability to work should be allowed to work. "Supportive employment" is an area that the ADA does not address that I believe it should.

Supportive employment is customized, non-competitive employment that pays, at least, minimum wage in a regular employment setting.

Unfortunately, the ADA has not fixed all workplace discrimination. In many ways the past is still with us. For instance, there are still workplaces where people with disabilities are segregated to do piecework jobs that pay well below minimum wage.

I think of the ADA as a correction to society that is following the course set by the civil and women’s rights movements.

From the moment I was aware of my condition after the brain surgery and subsequent stroke, I knew the feeling of being in the minority. With or without the ADA, I would have fought just as hard to return to work, but without the ADA the result probably would have been the part-time job I had at the country club. The ADA removed barriers that allowed me to go to college for the training that allowed me to find fulltime employment. It was important for me to try to work full time, even though ultimately I scaled back. That experience allowed me to accept being limited by my disability without the overwhelming bitterness that comes with loss.

One of Our Own

Survivor Carolyn Cleveland

Longtime readers of Stroke Connection may remember reading several stories about stroke survivor Carolyn Cleveland. She began working as a call representative on our organization’s Stroke Family Warmline in 1997, after being fired from her previous job. There she had had a stroke on a Friday after work; she refused to go to the ER because she feared her insurance wouldn’t pay for it. Finally on Monday, her family convinced her to see a doctor, who diagnosed the stroke. Her main deficit was aphasia.

Cleveland moved in with her daughter, who assumed that she was permanently impaired and filed for Social Security Disability Insurance (SSDI). She began speech therapy and returned to work three months later and canceled the request for SSDI.

Cleveland’s aphasia was a problem at work, and her employers were reluctant to make accommodation despite the Texas Rehabilitation Commission’s offer to pay for a counselor to help her until she could do the job on her own. Her supervisor and co-workers ridiculed her speech and did other hurtful things. After a few months, she was fired.

Cleveland filed suit against her employer under Title I (workplace accommodation) of the ADA. They responded that the suit should be dismissed because she had previously filed for SSDI, which meant she was too disabled to work. If she could not work, there was no need to accommodate her. This was the state of the law at the time, but it created a kind of Catch-22 — if a worker filed for SSDI, then they couldn’t ask for accommodation in order to return to work.

At the time, Stroke Connection talked with Bobby Silversteen, a disability policy expert, who explained, "The standards of the ADA and SSDI are different. SSDI exists to provide cash assistance to people with a disability.

The ADA serves to foster economic self-sufficiency and productivity among people with disabilities." The case, Cleveland v. Policy Management Systems Corp., wound its way through the courts until it was finally heard by the Supreme Court in February 1999. It ruled unanimously that Cleveland’s lawsuit could go forward. According to the Center for an Accessible Society, the Cleveland v. PMS Corp. decision affected 22 million unemployed working-age Americans who were disabled in ways that limit, but do not prevent, their ability to work.

This information is provided as a resource to our readers. The tips, products or resources listed have not been reviewed or endorsed by the American Stroke Association.

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Stroke Rehabilitation

Making the Best Decisions at Discharge After Stroke

The type of rehabilitation and support systems a survivor receives at discharge can strongly influence health outcomes and recovery. In this, the first part of a two-part series on stroke rehab, we offer guidance for the decision-making process required when it’s time to leave the hospital.

What to Expect from Outpatient Rehab

After stroke, about two-thirds of survivors receive some type of rehabilitation. Outpatient therapy may consist of Several types of therapy. Whether a patient is referred to inpatient or outpatient therapy depends on the level of medical care required.

What to Expect in Stroke Rehab

Following a stroke, about two-thirds of survivors receive some type rehabilitation. In this second of our two-part series, we want to alleviate some of the mystery, fear and anxiety around the inpatient rehab part of the stroke recovery journey.
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AHA-ASA Resources

The Support Network

When faced with challenges recovering from heart disease or stroke, it’s important to have emotional support. That is why we created a network to connect patients and loved ones with others during their journey.

Caregiver Guide to Stroke

The Caregiver Guide to Stroke is meant to help caregivers better navigate the recovery process and the financial and social implications of a stroke.

Stroke Support Group Finder

To find a group near you, simply enter your ZIP code and a mile radius. If your initial search does not pull up any groups, try

Tips for Daily Living Library

This volunteer-powered library gathers tips and ideas from stroke survivors, caregivers and healthcare professionals all over the country who’ve created or discovered adaptive and often innovative ways to get things done!

Stroke Family Warmline

The Warmline connects stroke survivors and their families with an ASA team member who can provide support, helpful information or just a listening ear.

Let's Talk About Stroke Patient Information Sheets

Let's Talk About Stroke is a series of downloadable patient information sheets, created by the American Stroke Association, that presents information in a question-and-answer format that's brief, easy to follow and easy to read.

Request Free Stroke Information Packets

Fill out this online form to request free information about a variety of post-stroke topics.
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Stroke & Parts of the Brain

When Stroke Affects the Occipital Lobe

Our occipital lobe, the smallest of the four lobes of the cerebral cortex, controls how we visually interpret our world.

When Stroke Affects the Cerebellum

The cerebellum contains 80 percent of our neurons. Its job seems to be to make things better. We talked with neuroscientist Jeremy Schmahmann about how stroke affects the “little brain.”

When Stroke Affects the Parietal Lobe

The parietal lobe helps us make sense of sensory information, like where our bodies and body parts are in space, our sense of touch, and the part of our vision that deals with the location of objects.

When Stroke Affects the Frontal Lobe

Of the four lobes that make up the cerebral cortex, the frontal lobe is the largest. It plays a huge role in many of the functions that make us human — memory, language, movement, judgment, abstract thinking.

When Stroke Affects the Temporal Lobe

The temporal lobe has several functions, mainly involved with memory, perception and language.

When Stroke Affects the Brain Stem

The brain stem serves as a bridge in the nervous system. It sits at the top of the spinal column in the center of the brain. When a stroke happens there, it can cause a few different deficits and, in the most severe cases, can lead to locked-in syndrome.

When Stroke Affects the Thalamus

The thalamus can be thought of as a "relay station," receiving signals from the brain’s outer regions (cerebral cortex), interpreting them, then sending them to other areas of the brain to complete their job.
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Stroke Notes

Stroke-related news you can use about new scientific findings, public policy, programs and resources.

Readers Room

Articles, poems and art submitted by stroke survivors and their loved ones.

Life Is Why

Everyone has a reason to live a longer, healthier life. These stroke survivors, caregivers and others share their 'whys'. We'd love for you to share yours, too!

Everyday Survival

Practical tips and advice for day-to day living after stroke.

Life At The Curb

A unique perspective on survival by comedian and stroke survivor John Kawie.

Simple Cooking

Cooking at home can be a daunting task, but a rewarding one for your diet and lifestyle (and your wallet). Making small changes in your diet is important to your heart health. Here are simple, healthy and affordable recipes and cooking tips.

Helping Others Understand

Stroke affects people differently and many of the effects of stroke can be complicated. Helping friends and family understand how a stroke is affecting a survivor can help everyone involved.

Support Showcase

Our new department highlighting the good work being done by stroke support groups from around the nation. If you are part of a successful support group we should consider featuring, let us know!