Everyone in Israel has heard of the term accessible, but most of us are only aware of the physical aspect: ramps for wheelchair-users, sign-language translation for the hard of hearing and traffic lights that talk or beep to help blind people cross the street safely. But there is one field which few are aware of, despite the fact that it affects hundreds of thousands of Israelis – cognitive accessibility.
Our world is centered on information, and in many cases this information is not accessible to people whose ability to understand it is limited or different, explains Dr. Shira Yalon-Chamovitz, Director of the Occupational Therapy Department at the Ono Academic College. Cognitive accessibility is the way to make this information clear and comprehensible to the entire population.
This last paragraph is an excellent example: many people wouldn't understand it. Cognitive accessibility makes it possible to help these people cope with such complex situations. Another example is large hospitals, where it is often difficult for anyone to find their way around. Clearer and simpler signs – accessible signs – would make it much easier to avoid getting lost. At Ichilov Hospital in Tel Aviv, for example, there is a lovely project run by volunteers who themselves are disabled. They provide assistance to whoever needs help reaching their destination in the hospital.
Another example has to do with telephone answering systems. Everyone knows how it feels: you call customer support and an automatic system spews out a series of commands at the speed of light: press 1, press 2, press 1 again, etc Tens of thousands of Israelis simply despair and hang up. Exactly for this reason, the accessible service regulations were recently enacted, requiring service providers to enable people to speak with a live operator or a clear, slow-paced recording. These are classic examples of cognitive accessibility which improves quality of life, notes Yalon-Chamovitz, just as a ramp improve the quality of life for people who use wheelchairs.
Licensed accessibility experts
In addition to being the Director of the Occupational Therapy Department at the Ono Academic College and a consultant to the Ministry of Justice's Commission for Equal Rights of Persons with Disabilities, Dr. Yalon-Chamovitz is also licensed as an accessible service expert and is currently the head of an innovative institute for cognitive accessibility founded by the Ono Academic College and Nagish.
As a result of the Equal Rights Law for Persons with Disabilities, two new professions were born: the first is licensed accessibility experts for buildings, infrastructure and the environment; the second is licensed accessibility experts for service. These are the people who are supposed to implement the solutions and provide answers to the general public on the subject of service accessibility.
These licensed service accessibility experts include numerous occupational therapists, and for a good reason. As a profession, occupational therapy touches on the interface between people, their occupation and their environment, claims Yalon-Chamovitz. Actually, when we talk about service accessibility, we are referring to the creation of an accessible environment – an environment in which people can receive ideal service in order to perform the jobs and occupations that are important to them. As occupational therapists, we have the tools from the perspective of knowing the environment as well as from the perspective of knowing the person, including of course people with disabilities."
The Occupational Therapy Department at the Ono Academic College places a very strong emphasis on the environment – adapting a person's closest environment – but also in the larger sense of accessibility in Israel. Thus, for example, in the course of their studies, the Occupational Therapy students learn about the subject of accessibility and carry out accessibility surveys. What is unique is the emphasis placed on the field of cognitive accessibility.
As part of Ono Academic College's belief in social responsibility and applied academics, the students conducted surveys in a range of locations, evaluating the extent to which they are accessible. Now that the accessible service regulations have gone into effect, all service providers – both public and private – are required to assess themselves and their accessibility to the whole population.
The students evaluated the places where they are undergoing professional and clinical training: hospitals, clinics, schools, kindergartens, occupational frameworks, hostels, community housing, etc After completing their review, they shared their findings with the institutions in question, and in several cases the students' studies were used in order to improve actual accessibility.
The accessible service regulations in the area of cognitive accessibility in Israel are among the most advanced in the world. Although the actual situation in Israel today is not good, the regulations are stringent and progressive even when compared with the most advanced countries. Ironically, the reason for this has to do with the fact that Israel is so far behind in this field. In other countries laws were legislated and regulations were passed many years ago, while in Israel the legislation process is only now taking place. For example, the accessible service regulations were only passed two months ago, so that we had an opportunity to learn from the rest of the world, notes Yalon-Chamovitz, and at the same time we are able to include subjects such as cognitive accessibility that haven't yet been considered by other countries.
Occupational therapy studies at the Ono Academic College are interdisciplinary. The students receive knowledge from the medical fields – orthopedics, anatomy and more – as well as from the social sciences – psychology, sociology, etc Moreover, they are presented the unique approach to occupational therapy which focuses on human functioning and occupation, understanding how to take people who are coping with a disability or difficulty and bringing them to a state where they can function.
The occupational therapy students absorb this body of knowledge and implement it in real-life situations. They don't just study; they provide hands-on assistance to various sectors of society and help them focus on what is most important in their lives.
We train our students to work with a very wide range of populations – from preterm babies to the elderly, and everyone in between, clarifies Yalon-Chamovitz. Furthermore, we train them to work with every type of challenge: physical disabilities, emotional disabilities, mental disabilities, sensual and cognitive disabilities. We do this by giving the students the tools that enable them to first of all understand human functioning.
One of the most powerful tools in occupational therapy is activity analysis, which enables the occupational therapist to evaluate everything a person does or considers important in his life, understand the components of the activity and be able to provide a response – improving the person's abilities or changing his environment in a manner that allows him to function better. Usually, a combination of both is necessary.
Students at the Ono Academic College study the most up-to-date evidence-based professional know-how. But this is not enough. Another unique focus of the Ono Academic College occupational therapy program is the emphasis placed on combining this know-how with concepts from disability studies as a foundation for training the students. In simple language, people with disabilities are considered a minority group and the attitude towards people with disabilities is that they are full partners in society.
In the treatment process, I don't approach the patient with the attitude that I know a priori what is right for him. Rather, we are partners in the process, says the department head. It is a dialogue with the service recipient, to understand what is important to him and how I can put my professional tools at his disposal.
Partners in the process
The faculty of the Occupational Therapy Department at the Ono Academic College includes lecturers who themselves have disabilities. For example, Dr. Yalon-Chamovitz teaches a series of classes together with Mr. Yoav Kreim, who is well-known as an activist in the field of rights for people with disabilities. These classes take the professional know-how and the expertise culled from life experience, and, in a dialogue with the students, create a new foundation for an inclusive and non-patronizing treatment process.
The program includes a large number of meetings with people with disabilities who are active in promoting the rights of people with disabilities in Israel. The students are exposed to this subject first-hand through guest lecturers who are contending with disabilities themselves.
To my delight, points out Dr. Yalon-Chamovitz, we have been accepted as partners in JDC's Friending project, where occupational therapy students and students with cognitive disabilities study together in the same class about the subject of communications in the treatment process. This class is a requirement for all our students and it is in cooperation with Beit Issie Shapiro. As a result, our students take part in creating social change as a part of their academic curriculum.
For us, as an academic institution, it is almost taken for granted. Our approach is that we are part of a society, and therefore we will not confine ourselves to theoretical knowledge but, rather, we will try to implement it in real life to promote change in Israeli society. The interaction with different people and the joint studying are part of our belief and hope that in the future our students will become occupational therapists who will be able to provide a more egalitarian and cooperative treatment, while paying close attention to the patients' real needs. This is in contrast to the traditional approach that asserts that the therapist knows what is best for the patient, Yalon-Chamovitz concludes.
What is cognitive accessibility?
Cognitive accessibility facilitates the ability to comprehend information and the environment where we live, explains Dr. Shira Yalon-Chamovitz, Director of the Occupational Therapy Department at the Ono Academic College.
Cognitive accessibility's target population consists first of all of people with intellectual disabilities. According to data from the Ministry of Social Affairs and Social Services, approximately 35,000 Israelis fall in this category. However, this data isn't complete and many people in the community at large are not known to the welfare authorities and do not receive treatment.
Aside from people with intellectual disabilities, several hundred thousand other people benefit from cognitive accessibility, such as those with learning disabilities or any person who has difficulty with reading, or those with attention deficit disorder, as well as the elderly, stroke patients and head injury victims.
At the end of the day, accessibility is good for everybody, declares Yalon-Chamovitz. Just as most people will prefer to use a ramp rather than steps, the same is true for cognitive accessibility. Most of us prefer that the information we receive, for example from cellular phone companies or insurance agencies, will be presented in a clear language.
For more information about the Occupational Therapy Department at the Ono Academic College, visit www.ono.ac.il.