ADA Title II Action Guide for State and Local Governments

Effective Communication

Many people with disabilities are prevented from participating fully in programs, activities and services because of communication difficulties. To address this, the ADA requires that communication with people with disabilities must be “as effective” as communication with others. Generally this part of the regulations applies to people who are deaf, people who are hard of hearing, people who are blind, people with low vision and people with speech disabilities. 

Auxiliary Aids and Services

Often ensuring effective communication requires public entities to provide “auxiliary aids and services” which may include the following:

For people who are deaf or have hearing loss:

• qualified interpreters on-site or through video remote interpreting (VRI) services

• real-time computer-aided transcription services  (CART)

• written materials

• exchange of written notes

• typing on a tablet or computer

• assistive listening devices

• open and closed captioning, including real-time captioning

• videophones

• videotext displays

For people who are blind or have vision loss:

• large print materials

• audio recordings

• Brailled materials

• screen reader software

• magnification software

• notetakers

• qualified readers

• optical readers

• secondary auditory programs (SAP)

For people who have speech disabilities:

• exchange of written notes or typed communication

• qualified speech-to-speech transliterators (a person trained to recognize unclear speech and repeat it clearly)

The type of auxiliary aid or service will vary in accordance with the method of communication used by the person; the nature, length, and complexity of the communication and the context in which the communication occurs. What is required to communicate effectively when a person is registering for classes at a public university is very different from what is required to communicate effectively in a court proceeding.

Primary Consideration

Public entities are required to give primary consideration to the type of auxiliary aid or service requested by the person with the disability unless they can demonstrate that another equally effective means of communication is available or that the aid or service requested would fundamentally alter the nature of the program, service, or activity or would result in undue financial and administrative burdens. 

The auxiliary aid or service must be effective. If a public entity chooses Video Remote Interpreting (VRI – where the interpreteris [sic] off-site and communication occurs with computer equipment) rather than face-to-face, the public entity must make sure the quality is comparable. The regulations include specific performance standards for VRI.

Companions

In many situations, covered entities communicate with someone other than the person who is participating in the program, service or activity. The ADA refers to such people as “companions” and requires public entities to provide effective communication for companions who have disabilities

Effective communication with companions is particularly critical in health care settings where miscommunication may lead to misdiagnosis and improper or delayed medical treatment. A companion may be legally authorized to make health care decisions on behalf of the patient or may need to help the patient with information or instructions given by hospital personnel. A companion could be designated by the patient to communicate with hospital personnel about the patient's symptoms, needs, condition, or medical history.

In the past (and currently), some public entities have expected a person who uses sign language to bring a family member or friend to interpret. Often people with disabilities have to rely on their children to interpret. Providing sign language interpreters is the public entity’s obligation. The interpreter must be qualified and impartial; specialized vocabulary may be needed to interpret effectively and accurately. A public entity can rely on another person to interpret in two situations.

1. In an emergency involving an imminent threat to the safety or welfare, an adult or minor child may be relied upon to interpret when a qualified interpreter is not available.

2. In situations not involving an imminent threat, an adult accompanying someone who uses sign language may be relied upon to interpret when a) the person requests this, b) the accompanying adult agrees, and c) reliance on the accompanying adult is appropriate under the circumstances. This exception does not apply to minor children.

Undue Burden

Public entities are not required to provide an auxiliary aid or service that would fundamentally alter the program, service, or activity or would result in undue financial and administrative burdens. If the choice expressed by the person with a disability would result in an undue burden or a fundamental alteration, the public entity still has an obligation to provide another aid or service that provides effective communication, if possible.

If the requested auxiliary aid or service would result in an undue burden or a fundamental alteration, the public entity still has an obligation to provide another aid or service that provides effective communication, if possible. The decision that a particular aid or service would result in an undue burden or fundamental alteration must be made by a high level official, no lower than a Department head, and must be accompanied by a written statement of the reasons for reaching that conclusion. All resources available for use in the funding and operation of the service, program, or activity must be considered.

Telecommunication Relay Services (TRS)

Telecommunications Relay Services allows people with hearing or speech disabilities to place and receive telephone calls. Public entities’ staff who answer the telephone must treat relay calls like other calls. TRS calls usually take more time than “regular” calls. If you get a call from a relay service don’t hang up! They are not telemarketers.

Here are the two most common Telecommunication Relay Services:

Video Relay Service (VRS) is used by people who prefer sign language communication rather than typing.  The person who is deaf signs to the communication assistant who then voices to the hearing telephone user what the person is signing. The communication assistant listens to the voice telephone user and signs to the person who is deaf what a voice telephone user says.

Text-to-Voice TTY-based is a "traditional" TRS service. The person with a disability uses a TTY or other text input device to contact a communication assistant at the telephone relay center. TTYs allow people to type their telephone conversations. The communication assistant contacts the hearing telephone user and reads the text that the caller typed. The callee voices to the communication assistant. The communication assistant relays the call back and forth between the parties by speaking what a text user types, and typing what a voice telephone user says.

For both services, the communication assistant will explain to the voice telephone user how the system works.

TRS works in both directions. If a public entity wants to contact a person who can’t use a phone system the “regular” way, the TRS can be used. The public entity contacts the TRS, provides the individuals phone number, the TRS communication contacts the individual being called and communication occurs. Again, this could be by video relay service or TTY relay.

For most public entities the telecommunication relay service provides “effective communication” for people with disabilities communicating by telephone. 

Emergency Services

However, public entities that provide direct access to emergency services such as police, fire and ambulance, which often includes 911, must provide direct access for people with disabilities who use TTYs and computer modems. The relay system may not be relied on for emergency situations. Public entities may determine the appropriate technology for their emergency telephone systems.