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AT Works: Accessible Technology's Impact on the Employment of People with Cognitive and Developmental Disabilities Webinar

August 2, 2012

2:00pm to 3:00pm EST

Moderator:

Kathleen Martinez,
Assistant Secretary of Labor for Disability Employment Policy,
U.S. Department of Labor

Speakers:

Ari Ne'eman,
President and Co-founder,
Autistic Self Advocacy Network;
Adam Anicich,
Acting Director,
Office of Congressional and Legislative Affairs' Liaison Service,
U.S. Department of Veterans Affairs

KATHLEEN MARTINEZ: Good afternoon, everyone, and welcome to today's AT Works webinar. I'm Kathy Martinez, assistant secretary of labor for disability and -- disability employment policy. And I'm delighted you've all joined us today.

For those of you who don't know me, I have the pleasure of leading ODEP's Office of Disability Employment Policy at the U.S. Department of Labor. We're the federal government's center on employment -- on employment of people with disabilities.

As part of the Labor Department's focus on expanding opportunities for all Americans, we work to influence national policy and promote effective workplace practices that ensure today's workforce is inclusive of the skills and talents of all people, including those of us with disabilities. We in the disability arena view technology as a game-changer, especially with regard to independent living and employment. But it's also a great equalizer in the workplace and a vital means to increasing the hiring, retention and advancement of people with disabilities in the public and private sectors. Why? Because so much of the information and communications technology that is so pervasive in our everyday lives is used daily in the workplace -- from smartphones to desktop software.

But these innovations have to be accessible to all employees. After all, if the technology in one's work environment is inaccessible, that workplace is not inclusive and not functional. Eliminating such barriers and ensuring the accessibility of future emerging technologies is what ODEP's Accessible Technology in the Workplace Initiative is all about.

This summer, we launched the AT Works series, a sequence of free webcasts and webinars that explore the connection between emerging technologies and the employment of people with disabilities. Today's event is our second AT Works series, and I'm very energized by the topic: "Accessible Technologies that Impact on the Employment of People with Cognitive and Developmental Disabilities." We believe this is a facet of accessible technology that you don't always hear about.

I'm sure many of us are familiar with the technologies designed for people with visual impairments like myself or folks with hearing impairment, such as screen-readers or closed captioning. And as someone who's blind, I myself benefit from many of these innovations. But today's technology developments are expanding and benefiting many more folks, including those with other types of disabilities.

So that's what we want to discuss today. Our panel presenters will be addressing the current state of accessible technology for those with cognitive and developmental disabilities -- whether congenital, such as autism, or acquired, such as traumatic brain injury. And they'll be providing examples of the current and future use of these technologies in the workplace.

Before I introduce our esteemed panelists, I'd like to go over a bit of housekeeping. If you're not already logged on to the WebEx interface, you can access this through the ODP website. Just go to www.dol.gov/odp/topics/technology.htm. Our event is being live audio captioned, and features a real-time Twitter feed. So if you're on Twitter, please consider tweeting about this event using #atworks.

Now let's get down to business. It's my pleasure to introduce our first presenters. Ari Ne'eman, president and co-founder of the Autistic Self Advocacy Network. Ari's advocacy organization is run by and for autistic adults seeking to increase the representation of autism across society. He is an autistic adult himself, and a leading advocate in the neurodiversity and self-advocacy movements. In 2009, President Obama nominated Ari to the National Council on Disability, and he currently chairs the council's Committee on Entitlements. In his policy work, Ari has worked on a wide variety of disability-rights-related legislation with regard to education, transition, employment rights and protection in other areas. Please welcome, ladies and gentlemen, Ari Ne'eman.

ARI NE'EMAN: Thank you so much for having me on the webcast and for raising these critical issues.

As you mentioned, people with intellectual and developmental disabilities have not always been included in broader conversations with respect to disability employment and accessible technology. In fact, our country's disability employment infrastructure with respect to intellectual and developmental disabilities is only now starting to move away from outdated and obsolete models of service provision and towards more integrated forms of providing for employment supports for our community. And as we move away from segregated and paternalistic models and towards service provision that recognizes the inherent potential of all people with disabilities, technology plays an absolutely critical role.

One of the things that we have to understand when talking about accessible technology for people with intellectual and developmental disabilities, including autistic adults, is that the benefits and barriers that we need to address are multifaceted. And they relate both to traditional issues of access -- which we may be familiar with from conversations in the sensory disability community; for example, many of us on the autism spectrum have auditory processing issues, which make some of the same accommodations with respect to captioning and other needs relevant for our community -- but also issues of relevancy of technology, and the ability for technology to address specific needs.

And we're seeing a growing use of accessible technology, particularly in the fields of mobile and tablet computing serving the role of assistive technology. And not always simply through the mechanism of durable medical equipment designed specifically for that purpose but very frequently through the use of technology designed for the general public that has a particularly positive impact on the quality of life and employment prospects of people with intellectual and developmental disabilities.

Next slide. We've seen four key areas of benefit for the IDD community with respect to accessible technology and employment.

The first, which is in some regards the most straightforward -- although the policy issues that surround it remain just as challenging as many others -- is that of access to augmentative and alternative communication technology.

Next slide. One of the key barriers for many people in the intellectual and developmental disability community is communication. For people who struggle to use traditional, oral speech, the ability to communicate plays a central role in addressing barriers not only to employment but community integration, housing, behavior and quality of life more generally. Traditional augmentative communicative devices which might enable someone to either type rather than speak or to point to an image to represent an idea are often highly expensive -- and in part because they're designed specifically for the disability market, lack any type of general applicability -- and we do not tend to see prices on these drop to amounts that are feasible for the average person with a disability or a family to purchase without a third-party purchaser like a Medicaid agency or a school district.

In part because of these high-cost barriers, we've seen the growing use of augmentative communication aps for smartphones and tablets. And not only do these offer a very significant cost advantage, there's also a significant functionality advantage, namely that not only are you purchasing a device which can help someone communicate, but in recognition of the fact that this is technology that's used in the general population as well, there are all kinds of other things that it can be used for.

It's also a phone. It's also a tablet computer. Unfortunately, third-party payors, in part because they fear the emergence of some kind of woodwork effect in which, if people with disabilities are given the opportunity to have access to technology that the general public wants, that there are going to be more people with disabilities trying to claim access to that benefit, have been very reluctant to allow the purchase of dual-use augmentative communication devices.

And we've generally seen this as very unfortunate, and often, you know, just patently illogical because the reality is, is that paying 20,000 (dollars) or $15,000 for a dedicated device that only use -- only can do augmentative communication not only provides a less functional piece of equipment, but it's really going to drive up costs in the way that purchasing a $500 device and the accompanying software for it that's of use in the general population will not. The cost disparities that we see between dedicated AAC devices and apps that are on hardware that's available to the general public are such that the woodwork effect would have to be truly enormous before cost increases would emerge.

We have next slide.

We've also seen particular use of assistive technology for executive functioning support. Executive functioning, which is a common challenge for people with developmental disabilities and people with learning disabilities, relates to organizational skills, time management, the ability to navigate complex infrastructure and it represents a significant barrier in employment, in access to education, particularly higher education and transportation for people with intellectual and developmental disabilities.

Increasingly, we're seeing -- and sometimes this is through the emergence and use of general use software such as time management software or calendar software, and sometimes, this is through the emergence of disability-specific software, such as apps that have been developed to assist people with intellectual disabilities to navigate public transit. The use of these types of cognitive prosthetics, particularly with respect to tablet and mobile computing, to open up opportunities to compensate for challenges in executive functioning.

They are the same types of issues that we see with regards to financing dual-use technologies and devices and software here as in the augmentative communication market, and one of the challenges that really emerges is how do we make the case to policymakers and funders, particularly school districts, that software and devices that, in fact, could benefit any member of the general public or any student or any worker are often particularly necessary for employees or students with intellectual and developmental disabilities. And, you know, one way of responding to that is making a case around particular need, which is often necessary. Another case is to talk about this in a universal design context and point out the ways in which making this available to all employees or all students in a particular setting can not only move the ball forward with regards to executive functioning challenges, but also help address some of the stigma that's often attached to disability supports.

Next slide.

We've also noted a number of community and cultural connections associated with accessible technology, and this has been the case particularly within the autistic community. Social communications are a very significant barrier for our community, and in a lot of ways, online technologies and the opportunity to access very broad geographically dispersed communities for people who have things in common but are nowhere near each other and in previous generations would never have met, has been a really powerful tool to see the emergence of a sense of disability culture, community pride. And there are a lot of qualitative advantages to the use of online technologies for community building, particularly for the autistic community.

Online, there are very few non-verbal cues. You can have the aggregation, the easy aggregation of people with very particular and specialized interests, which is a big issue for our community. And more generally, the internet has been utilized more broadly to open up cultural opportunities for many stigmatized minorities.

Now one of the issues that comes up here, particularly for people with intellectual and developmental disabilities who may be under guardianship or are in residential service provision settings where there are a great deal of paternalistic attitudes that often restrict access to technology is that, very often, family members or support providers will have safety concerns with respect to accessible technology, and we've, you know, heard of efforts to try and restrict social media usage for people with intellectual disabilities or a feeling that access to digital literacy training that's accessible for people with intellectual disabilities shouldn't be considered a priority, either because of a perception that people with intellectual disabilities won't benefit or that it's unsafe.

And I think in this, we have to recognize the same kind of paternalistic attitudes that have dominated previous conversations of balancing safety versus self-determination. We saw these same objections to the deinstitutionalization movement, to broader efforts of choice and control for people with disabilities throughout society.

And the thing that we really have to reinforce and that our community feels at a very personal level is that people's quality of life and also, quite honestly, people's safety increases when they form more meaningful connections to a broader community that has to go beyond people who are paid to provide services to someone. That helps employability, provides networking opportunities. It helps quality of life. It also helps safety because it -- people are going to be more safe when there are people in their lives who care about them and who notice if they go missing or are under distress. And that holds true for both offline and online interactions. Next slide.

And then, finally, there have been tremendous opportunities opened up by the telecommunications revolution. And, you know, as we know from previous discussions, transportation remains one of the most frequently cited barriers to employment for people with disabilities of all kinds. Many people with intellectual and developmental disabilities don't drive and have difficulty navigating public transit. So access to telecommunication technology, particularly if we can help support supported employment providers and customized employment providers to actually understand what this technology is and incorporate it within their work, is going to necessitate tremendous steps forward in the broader disability employment discussion.

Obviously, there are certain challenges which I think are common to the general telecommunications and employment discussion. Issues of flexible work schedules and the need for accommodating employers and relationships based on trust to build accountability for people who may not be going into the office on a regular basis. But at the same time, for a community that may not be working traditional hours and a community that faces significant access issues to the traditional national transportation infrastructure, this is really significant step forward with regards to employment.

MS. MARTINEZ: Thank you so much, Ari. We learn so much from you always. And from universal design to culture to safety, ultimately to employment, this technology is so critical in the lives of folks with intellectual disabilities.

Our next presenter is Adam Anicich, acting director of the Congressional Liaison Service for the U.S. Department of Veterans Affairs. In this role, he is responsible for the Senate Liaison Office. And as a disabled combat veteran and former Army sergeant, Adam is uniquely qualified to identify and communicate the needs of the Department and veterans to Congress.

Prior to his appointment to the VA, Adam worked in leadership positions for the Department of Commerce, Missile Defense Agency, and spent six years in the private sector at a number of southern California banks. Adam received a B.A. and an MBA from St. Leo University and is currently finishing a doctorate in management at the University of Maryland.

Please welcome Adam Anicich.

ADAM ANICICH: Hello and good afternoon, everyone, and good morning to our West Coast viewers. Thank you all for allowing me to be here and share some of my experiences with adaptive technology in the workplace. A special thanks to Assistant Secretary Martinez for her long-time work on developing support for individuals and veterans with disabilities and to Ari and his team at the Autistic Self-Advocacy Network for their outstanding work as well. I look forward to collaborating together with you both in the future.

My name is Adam Anicich, and I'm here today to speak a little about acquired cognitive disabilities and some of the ways in which technology and employer support can help mitigate symptoms and improve functioning in employees with disabilities.

There is two really, you know, kind of top-line conditions that I want to talk about today. The first is traumatic brain injury. It's a form of acquired brain injury and occurs where there is a sudden trauma to the brain that causes damage. To put this in context, there is an estimated 1.7 million traumatic brain injuries each year in the general United States population. Of Iraq and Afghanistan war veterans seen at the Veterans Health Administration over a two-year period from 2009 to 2010, 8.6 percent of them had a diagnosis of traumatic brain injury.

Additionally, most veterans with a traumatic brain injury diagnosis also carry a mental health diagnosis, with post-traumatic stress disorder, or PTSD, being the most common. PTSD is a mental health disorder that can occur after someone goes through a traumatic event, like war, assault or disaster.

Next slide, please.

Some of the symptoms of traumatic brain injury can be categorized into three main areas. First is the physical. Headaches, difficulties speaking or hearing, loss of energy, dizziness and/or blurry eyesight are very common. Some of the cognitive disabilities include difficulties in concentrating, forgetfulness and problems with memory, trouble with concentration and decision-making. And then some of the behavioral effects are that individual can at times become easily angered or frustrated or act without fully thinking something through.

On the post-traumatic stress disorder arena, many times symptoms are feeling upset or avoiding remembrances of a traumatic or life-threatening event. This includes feeling emotionally cut off from others, depressed, anxious or easily irritated. There is also difficulty sleeping or concentrating.

Next slide, please.

So what are we really here to talk about today? One of the things is the various technology initiatives that are available to individuals with these types of disabilities or symptoms.  And there is really a couple of different categories.

The hardware and the software have been around, and they're only getting better. That includes things like smartphones. You know, you can manage your calendars on the go, create alert reminders for medication or important events -- nonrecurring events, for example. There is also management of electronic contacts. So if you need a contact information for somebody, you don't have to remember the phone number -- maybe their address, directions to their house. There is also the GPS functionality, which, for individuals with traumatic brain injury, can be very beneficial because it'll allow, either by driving or by walking, the ability to navigate directly to where you're going without getting lost.

Other things involve voice recorders and speech-to-text software. You know, it's -- it really makes remembering discussions and verbal notes super easy. And it also transitions well to the various Word documents or email or some kind of electronic capturing mechanism.

Finally, the regular use of electronic calendars provide a real consistency and helps individuals with cognitive impairments -- remember, the routine and the important tasks. So it's very helpful for me, for example, as somebody with a mild traumatic brain injury, to use my calendar on a regular basis so I can plan out my day, I can know when travel occurs, things like that. And that's something that, speaking with other veterans and other individuals with traumatic brain injury, has been something that's been almost critical to their daily lives.

Some other mobile apps is really kind of the second aspect. And some of the current apps that are available for free are the Life Armor. And it's a comprehensive learning and self-management tool that assists member mainly of the military community with common mental health concerns. Users can borrow information and browse information, I should say, on about 17 different topics. That includes sleep, depression, relationship issues and post-traumatic stress. There is also some brief self-assessments that help the user measure and track their symptoms over time, and the tools are available to assist in managing specific concerns.

The mTBI, which stands for mild traumatic brain injury pocket app, gives instant access to a comprehensive quick reference guide on improving the care for mTBI patients, which really can help improve the quality of the care and the clinical outcomes for the patients.

Finally, the third one is the T2 Mood Tracker. And essentially, what it is, it's a mobile app that allows users to self-monitor and report, track and reference their emotional experiences over a period of days, weeks and months using a visual analog rating scale. Users can self-monitor emotional experiences associated with common deployment-related behavioral health issues, like post-traumatic stress, traumatic brain injury, different life stressors and/or depression and anxiety, which also go along, you know, as a symptom of both traumatic brain injury and post-traumatic stress disorder.

Next slide, please.

So the big question is how can employers help? If you're an employer out there listening in, first, thank you for joining us, but second, one of the -- one of the real -- the crux of the issues of why we're here today is how we -- how we can engage together and kind of embrace different adaptive technologies and support of environments in a way that's going to be most beneficial for individuals with disabilities in all ranges. That includes the mild traumatic brain injury all the way up, you know, severe PTSD and even moderate traumatic brain injury.

There are some -- you know, support is really kind of the key word here, but some of the things are support for adaptive technology in the workplace. This involves really a cultural change. And some of the actions associated with that are encouraging the use of smartphones and electronic contacts. This keeps everything in a easily referenceable electronic format that can be used by individuals with cognitive impairments on the go.

Also, allowing voice recorders to be used in meeting, that's really something that's kind of crucial. Installing speech detect software on computers and making group licenses available to individuals, both working in the office and working from their home computers.

Finally, encouraging a climate of officewide use of online calendars for meetings. And, you know, really what this -- what this is doing is creating a situation where the calendars are the primary go-to for individuals with disabilities or possibly memory functioning concerns where they can access where they're supposed to be, what time they're supposed to be there, and we can also include additional information inside of those calendar appointments, which are updated essentially instantaneously to the larger group. Really, it improves attendance at meetings, and it also gives people the ability to plan their day, which makes individuals more productive, you know, and efficient during their workdays.

You know, the next -- the next thing is really a supportive environment. And this is the largest cultural change. There are -- there are some action items that we can talk about, and that includes -- actually, one of the areas where Ari and I overlapped was telecommuting resources for individuals with disabilities. That's really a key aspect of kind of promoting individuals with disabilities because it allows them to work from a location that they find familiar. And specifically relating to post-traumatic stress disorder and traumatic brain injury, having a familiar place truly reduces the anxiety on those individuals while improving productivity. It allows them to operate in an environment that they're familiar with, and it allows them to concentrate in their at-home environment.

Again, we're talking about a quiet workplace that allows the employees to concentrate. That may be in a physical work location like an office setting, or it may be at home. Alternatively, there's many jobs outside or there's jobs in retail establishments that individuals may not necessarily have the opportunity to have a perfectly quiet environment, but they would have the opportunity to have a minimized -- minimal noise environment.

Again, one of the things that I think is really critical is providing a flexible scheduling for individuals with traumatic brain injury and post-traumatic stress disorder to avoid common stressors like traffic and/or congested public transit systems. One of the things that really is a barrier for individuals with post-traumatic stress disorder is being in highly populated areas, especially from the wars in Iraq and Afghanistan. Many veterans and other individuals just don't feel comfortable in the open spaces. And having the opportunity to -- if they're forced to ride the public transit system or drive in a congested area, having the opportunity to do that at an off-peak hour is something that will resonate with them and will ultimately leave your organization as a more valuable place to work for these individuals.

Finally, we discussed individual task assignment and personal responsibility. Really, what I'm focusing on here is the ability for an organization to assign a task and the responsibility for completing that task to an individual. So let's say if it's a construction site, you know, many times people with traumatic brain injury or post-traumatic stress disorder may, you know, have complications when they're trying to communicate, may get nervous when other people are using power tools or loud noises around them. Giving them an individual assignment where they can be responsible from end to end really is an opportunity for them to be as efficient and effective as possible while mitigating any kind of risk factors associated with them feeling nervous and anxious.

One really great question is for the employer to ask the employee, engage them, change that culture, change that stigma and ask, how can I better help you do your job or how can you get the most satisfaction from working here?  You know, having that dialogue with the employees, who may or may not have these stated disabilities, is a great way to gain new ideas and really gain target-centered resolution techniques for your individual organization. We're kind of talking about broad, high-end things here, but really if you want to know how this applies to your organization, engage your employees. Find out -- find out what can make it easier. Some of the creativity and ingenuity that they're going to come up with, I think, will definitely impress you. As I always say, a supported employee is a productive employee.

Next slide, please. Some of the resources for support are online, in person and over the phone. And with those three different methods, you also gain a little bit of confidentiality based on your level of comfort in the interaction. So if you're an employer, you can go -- a lot of these websites might allow you to browse some of the common concerns and become involved with the topics on traumatic brain injury and PTSD. Those are maketheconnection.net, brainlinemilitary.org and brainline.org and then the nationalresourcedirectory.gov. The websites are listed on the screen. But those three locations are really a great source of information to find out what some of the new techniques are, find out what some of the innovative accommodations are that are minimally invasive to organizational operations but hugely beneficial to the veterans and the individuals with disabilities who are on the receiving end of those.

And quite honestly, it makes people very, very engaged and the employees become very productive when they feel like this is a place for them, that their organization is a place where they feel supported. And alternatively, for maybe some of the individuals on the line who are seeking to get help maybe in person, which obviously is the most personal, va.gov/health for our veterans out there and the Department of Veterans Affairs Veterans Health Administration runs a national medical center of more than 150 medical centers nationwide. And so there's definitely help for individuals who feel they may be suffering from TBI or PTSD as a result of service in the military.

Finally, for individuals who are looking for some information over the phone, there's the National Veterans Crisis Line at 1-800-273-8255, and then there's the Military OneSource and Wounded Warrior Resource Center at 1-800-342-9647.

So why am I here talking to you about this if I don't -- if I'm not active in the community and I'm working in congressional affairs? Well, I joined the Army in 2002 and served until 2007. And during that time I actually sustained a mild traumatic brain injury in 2006 in Tikrit, Iraq. So although currently I'm working in congressional affairs, I also serve on the executive committee for polytrauma and blast-related injuries at the Veterans Health Administration. So this polytrauma and -- which is VA's term for blast-related and multiple-injured individuals -- and this is really a passion of mine.

And getting the word out to organizations to let them know that engaging employees on accommodations and finding the right mix of -- the right kind of tenacity of the employees -- when you find an individual with a disability, they've already overcome a lot. And to get just to where they are at any given point when you meet them, they've been through myriad of issues, and they've overcome so much, which makes them really resilient. So the benefit of this for an organization that's hiring is multifold, but specifically, they're going to be very resilient once they do get engaged, once they do get connected, which is really a topical aspect. Their productivity level and their dedication to the organization is really -- is bar none, and they're going to become one of your best assets.

Specifically on the recovery side, for me personally, I've gone through the physical, the occupational speech therapy, and then I'm an ongoing polytrauma patient. But some of the pieces of success in terms of adaptive technology and technological initiatives -- the smartphone was a very, very big one for me. Using the calendar, using the electronic contacts and then on the go using notes is something that basically helps me organize my life. So even if there's physical symptoms, a headache, dizziness, I can always resort back to my smartphone to identify exactly where I left off or reconnect with a certain individual. Maybe for veterans or for individuals out there with disabilities, it's a doctor or a clinic or a family member or friend. And having that contact list available is really a great resource.

Finally, the occupational therapy was something that I had great success with, and that's using kind of the cognitive strategies for memory improvement. One of the things that I like to talk about real quick before I let everyone go is I use a "one, two, three, four" system to make sure I remember everything. And so you can outline your wallet, your keys, sunglasses, cellphone and you can count off one, two, three, four. So if an individual is out there that might be helpful for them, please feel free to use that. But you can always count one, two, three, four before you leave and be -- make sure you have all of your gear secured.

That concludes my section of today's briefing. And appreciate everyone's time.

MS. MARTINEZ:  Thank you so much, Adam, for your passionate and provocative presentation. Thank you for your leadership and also for your service to our country.

I'd like to begin with a few questions of my own for the panelists. We'll start with Ari, but the question is for both of you, actually. Where do you think accessible technology is headed, and what related policies and practices do you have hope will evolve in your lifetime?

MR. NE'EMAN: Thank you very much. And before I answer that, let me just join you in thanking Adam for his service. It's an honor to be here presenting with you and your team today.

As far as the future of accessible technologies, I know that as far as the intellectual and developmental disability world is concerned, one growing area of priority is going to be ensuring that digital literacy is accessible to the broad scope of the disability community.

MS. MARTINEZ: Could you explain what that means?

MR. NE'EMAN: Well, we have an ongoing conversation, particularly for older Americans about building digital literacy skills, and we recognize that for generations of people who grew up before the advent of the Internet, that there's a need to provide training, and quite frankly that today online technologies are as central to day-to-day existence as the telephone or any number of other things.

But when we talk about a younger generation of people with intellectual and developmental disabilities, or even an older generation that may not have had access to the same opportunities to learn these things, we don't really recognize the need for accessible educational (modules/models ?) around digital literacy. And it's not a new problem. We have the same issue with regards to sex education and accessible sex education for people with intellectual disabilities. But we really need to be driving forward the discussion that recognizes that in much the same way that we recognize telephone usage as an instrumental activity of daily living and Medicaid will pay for support for someone to learn how to make use of a telephone because that's a key aspect of being integrated in one's community and being as independent and self-determined as possible, online technologies and digital literacy should also be viewed within that IADL framework. And for the ID/DD community, that's going to be absolutely critical in ensuring the technology is not only accessible but also relevant and usable.

MS. MARTINEZ: Very good.

Adam?

MR. ANICICH: Thank you, Madam Secretary. It's kind of two questions. One is, where do I think accessible technologies are heading? And really for me and what -- I speak, you know, for myself, but I project on the veteran community as well. I think it's really a fusion between mobile apps, the care providers and service providers, government and community agencies and the individuals themselves.

People are obviously becoming very much more technologically savvy. You know, obviously there are also some concerns that people as a whole in the United States aren't as savvy in different age generations. But overall, I think in the future moving forward, it's going to be really a triad approach, where technology and mobile applications and the software or the network, the cloud, is working together with the providers, with the individuals who are involved in -- when I say providers, it really may be the individuals who are involved in their own kind of I don't want to say "care" -- that's really more of a, you know, TBI-focused -- but in the daily maintenance, in the daily operations of an individual's life, it may be themselves. And so kind of the fusion between technology, applications, providers, individuals is something that I think we'll see a lot of development on, and I think we'll see a lot more usefulness. We talked earlier about applicability before the webinar started. And that's really something -- you know, is the technology relevant? Are these mobile apps and things -- are they actually useful to people other than just being very cool? And for me the answer is: Yes, they are. I know that because I use them personally, but I also know that because I can see in the future, you know, where this might be headed and kind of some of the gaps that are out there right now where this could pick up and this kind of technology could improve.

And the second aspect of the question is really about what policies do we see changing in the future and what kind of cultural shifts might I envision. And really it -- individuals are becoming a lot more self-sufficient in their own development. These are individuals with disabilities are becoming much more self-sufficient as the stigmas are reduced and as the media, social media, the commercialization of the Internet -- everything like that is really creating an awareness and a cultural revival or renaissance, if you will, of how people, especially with the veterans of Iraq and Afghanistan, you know, and any kind of current wars are coming home. And that stigma of traumatic brain injury, of PTSD, is slowly being eroded into a more palatable understanding in the general public. And I think as we move forward and the individuals', veterans' media is becoming more engaged with the, let's say, awareness campaigns and the traumatic brain injury and PTSD culture and kind of penetration of society's cultural norms, I think we're going to start seeing a much more robust and understanding dialogue on the subject, which is really going to be helpful to individuals who may have been socially isolated or culturally felt that there were some deficiencies in themselves that kept them out of the limelight. And so I think you'll see an individual -- individualized progression of people's skills. You'll find people entering the workplace that otherwise weren't able to. And then finally, which is I think really applicable here to this group, is you're going to find individuals with disabilities entering the workplace and producing at a level that no employer thought they would be able to produce at just by the fact that they were termed to have a "disability." And so I think kind of the -- in my mind, that's just going to blow the stigma out of the water. It's going to be a very dynamic event. I'm looking forward to seeing that evolve over the next five, 10, 20 years.

MS. MARTINEZ: Well, both of you give very interesting answers to me. You both mentioned flexible work hours, you both mentioned telework and you both mentioned the topic of stigma with regard to the fact that technology will change that. And I'm certainly looking forward to that.

My next question is, what advice do you have for agencies -- federal agencies or private sector employers interested in hiring people with disabilities -- people with disabilities and veterans, people who are -- who've also acquired disabilities? Go ahead. Ari, go ahead.

MR. ANICICH: Well, this is an issue that we care quite a bit about. Actually, we're currently running a program with Freddie Mac, a leading housing finance company, to provide internship opportunities for autistic college students and recent college graduates on the autism spectrum. It's our hope that we'll see similar programs as the disability employment conversation continues to develop.

One thing we feel very, very strongly about here is that the future of disability employment is an integrated future, and we're seeing a broad-based recognition of this on the part of many state governments, the employment-first movement, which I know ODEP has supported and a lot of ways has been really helping to move the ball forward, and innovations like customized employment services and other innovations in the field of supported employment mean that it's now possible to serve people with a broad range of levels of impairment in integrated employment settings.

So you know, I would really urge private employers in particular whom in the past may have been encouraged to meet their obligations to people with disabilities by, say, sending a contract to a sheltered workshop or some other type of employer that is really geared only around employing people with disabilities, to instead make the investment in helping to educate or hiring managers, their HR department and their workforce on the need to include people with disabilities across the board. If we're going to be achieving one of the main goals of employment -- and you know, employment has many goals; obviously, economic goals are one of them but there are also broad social inclusion goals of employment and building more diverse workforces -- then that needs to occur in integrated rather than segregated settings.

I would also add that we need to be building a more meaningful pipeline from school to work. And a lot of the challenges that people with disabilities face in entering the workforce relate to the expectations facing our community in school settings or a community that is disproportionally segregated or a community that experiences very low expectations. And if we want to be seeing a meaningful dialogue and to really fulfill the vision that we've seen undertaken in recent years with President Obama's 2010 executive order on disability employment and the broad scope of other activities that have been taken to try and address this issue, we need to start recognizing that the time to think about employment, the time to think about transition, the time to think about inclusion is with school-age youth. We need to bring agencies like VR and state developmental disabilities agencies and others to the table with school systems so that we have meaningful collaboration. And we expect employment for all people with disabilities from a very young age.

MR. ANICICH: Well, essentially, there's a few things. But you know, one is really engaging employees and asking how to best provide a supportive working environment. Organizations today I don't think do a very good job of, you know, reaching out to the different populations and segments of employees, and in finding from both individuals with documented disabilities and individuals with no self-described disabilities -- you know, reaching out to them, find out how you can make a better working environment. And that includes everything from the accommodations that we've talked about today, different technology initiatives that can be included, as well as just organizational structures and workflow processes. By engaging the employees, I think any organization is going to find that there are a lot of good ideas out there that are just waiting to be implemented.

The second really critical piece is, for any organization, you have to be flexible. You know, and that includes both the policies and the culture. So be flexible in the scheduling. We both talked about the obstacles with transportation for individuals with disabilities; there's a lot more than just getting from point A to point B. There's crossing the street, there's finding the touch button pad to cross the street; there's finding the right accessible bus route or public transportation route, or individual vehicle -- privately-owned vehicle route that will get an individual from point A to point B. And as a result of that, that's a pretty large logistical challenge.

So being flexible -- an employer being flexible means they're being flexible in the time individuals can come to work. It's being flexible with where they work from. It's being flexible on how they do their job. In a -- you know, there's a lot of good work being done on the policies, but there's still a lot more visible work to be done on the culture of organizations. Federal agencies and others -- you know, having a culture that is flexible and is accommodating, in the truest sense of the word, I think is really where there's a lot of opportunity and would be the advice that I would give.

And finally, the last comment that I wanted to leave you with is that individuals and veterans with a disability have real vast and diversified experiences, and they have the proven ability to overcome obstacles. So with a little support from the employer, they can really, truly be the organization's greatest asset. You know, there's a long history of overcoming challenges and getting to success, and I think that's something that employers who leverage these employees with that ability and determination are setting themselves up for a very successful, professional relationship in the future. And -- I mean, I think this is something that we'll see evolve and develop more in the coming years as well.

So thank you.

MS. MARTINEZ: Yeah; I think you're right. I think we tend to -- both veterans and civilians with disabilities tend to have to strategize just to exist and to, you know, just to get through their lives. So when the other -- when employers and other employees both with and without disabilities see that, I think it adds to the, you know, to the fabric of the workplace. And also, I think just -- what we say when people ask us, what's your best training? What is the best training ODEP can offer us? When employers ask that question, we say: Hire a person with a disability, because there's nothing like the real experience.

Anyway, I'd like to pass the mic over to my colleague Katia Albanese, to see if we have any questions from our viewers.

KATIA ALBANESE: Thank you, Kathy.

We do have several questions -- or we have lots of questions from our viewers coming in through the chat.

MR.: (Off mic.)

MS. ALBANESE: -- coming in through the chat as well as through our Twitter feed and our odep@dol.gov email box. Unfortunately, we don't have too much time, so we're going to answer just one or two. And then the remaining responses we will post to the ODEP website; so please visit www.dol.gov/odep for those responses.

So we did talk a little bit, and we hear our presenters talk about mobile apps. So one of the questions that we received was: "How can we encourage the development of new apps that are accessible, that incorporate universal design?" We heard Ari talk a little bit about universal design.

So I will let you -- Adam, if you would like to take that first; and Ari second. And Kathy, if you like to add to that as well.

MS. MARTINEZ: OK. Again, the question is how can we encourage the development of new apps that are accessible?

MR. ANICICH: Well, thank you, Katia, for the question.

Developing new apps, I think, is really a long process that is driven really by need. And I think the more vocal individuals become and organizations and advocacy groups become, the more targeted the different apps are going to occur. So, you know, how do we develop these apps? You know, there's a number of competitions that federal agencies offer and promote; you know, they just put it out publicly. And many times, universities or private sector nonprofits and others compete to develop these apps within the parameters that the agency or organization is asking for, but at the same time in a(n) innovative way that really captures what their reality on the ground is. And I think that differs not only regionally but within the different population segments, as well.

Obviously, the PTSD world is going to be different than the visually-impaired world, and is also going to be different from the TBI world. And so develop -- depending on which organization is really pushing the development of these apps, we're going to see a lot of differentiation and specialization within each app that's developed.

MS. ALBANESE: Great; thank you. Ari?

MR. NE'EMAN: I think key to any discussion with regards to universal design is trying to jumpstart a dialogue in the general technology community about how they can develop things which are useful to people with and without disabilities. And you know, core to that concept is being willing to pay for things that are useful for people with and without disabilities. And right now, quite frankly, we have a real disconnect on the part of many public funders as to what people are and are not willing to pay for. And then we talked earlier about the issues with regards to dual-use technologies and fear of the woodwork effect.

But there's also very often -- and I think this is often the case particularly with programs that integrate both federal and state funding, or federal funding and state administration, like Medicaid, IDEA, and Vocational Rehabilitation -- there is a fear that to purchase technologies which are more functional but are not specifically designed for people with disabilities will run afoul of regulation. And very often that's not the case; we've had conversations for example with state Medicaid agencies who are of the belief that CMS will prevent them from purchasing tablet computers for AAC use. In conversations at the federal level, we've generally heard that this is something to which there is substantial state flexibility.

So part of this is building a level of communication so that the financing matches up.

MS. MARTINEZ: Thank you very much. And here at ODEP, we are working tirelessly with our technology comrades, collaborators in the development world to try to make that dual-use technology more common.

And I'm afraid we're nearly out of time. I'd like to thank our two presenters for sharing their insights and expertise today, and I'd like to thank all of you out there for listening.

An archived version of this webinar will be posted shortly on the ODEP website: www.dol.gov/odep. Just select "technology;" "topic area." And ladies and gentlemen, just for your information ODEP is hosting an app challenge, and you can find information about that at the dol.gov/odep website, too.

In the meantime, I'd like to promote our next AT Works event, which is scheduled for August 16th, at 2 p.m. Eastern Daylight Time. It's a webcast and panel discussion titled "Accessibility and Emerging Technology -- Keys to Improving the Employment of People with Disabilities." Panelists will include Jim Tobias, president of Inclusive Technologies, and Vint Cerf, vice president and chief Internet evangelist at Google Inc. Please mark your calendars for this exciting event.

Thank you again for joining us today. Until next time, I'm Kathy Martinez, assistant secretary of the Office of Disability Employment Policy for the Department of Labor.

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