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Aphasia and Voting: Accommodation Requires Communications Ramps

National Disability Voting Rights Week - Guest Blog - Issue 4.

The fourth guest blog post in U.S. Vote Foundation’s Disability Rights Voting Week series comes from Marion Leaman and Troy Van Horn. Dr. Leaman is a speech-language pathologist and Assistant Professor at the University of Kansas Medical Center. She is the Director of the ALL-CAN-Converse Aphasia Lab, where she conducts clinical aphasia research focused on improving communication, quality of life, advocacy and agency for people with aphasia. Co-author Troy Van Horn is a videographer, writer, guitarist, and an artist. He has had aphasia for 3 years.

In honor of Disability Rights Voting Week, we are proud to be launching our new Resources for Voters with Disabilities initiative. As part of this initiative, U.S. Vote Foundation (US Vote) has created a state-by-state guide to empower voters with disabilities to realize US Vote’s mission: Every Citizen is a Voter. Our new initiative for voters with disabilities will help new and experienced voters navigate the continuous changes in accessibility that have resulted from the recent revisions to election law across the country.

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Aphasia: The ancient Greek goddess of beauty ... no, that's Aphrodite ... they are very common health of plants ... hold on, those are aphids ... how about pithy observation ... ahh, this is aphorism ...

What the heck is going on here?

Knowing just what you want to say, but getting wrong words. Lots of wrong words or no words at all. THAT’S aphasia.

We all experience getting stuck for words once in a while. When it happens, our sentences may sound funny or be filled with hesitations. We may laugh, we may get frustrated. We may ask for help. We may Google the word. Sometimes we give up. This is what people with aphasia do, too.

For most of us, these momentary glitches are just that, glitches. When we can’t think of a word, it doesn’t mean our intellects are impaired. Rather, the brain has a momentary short circuit connecting ideas to words. Even though it’s happening, we are still competent. We have the same decision-making capacity as we always do.

However, for the 2.5 million Americans who have the language disorder aphasia following a stroke or other brain injury, the experience of getting words wrong happens in nearly every conversation. It can happen so often that the person’s speech sounds confusing, but this does not mean the person is confused.

Because the language centers of the brain are impacted, people with aphasia also have difficulty with reading comprehension and understanding what others are saying. It’s kind of like traveling to a country where you don’t know the language, or only know the language a little. You can’t understand everything that you hear or read, but the problem is using language, not your thinking, memory, or reasoning abilities.

In this situation, you would need extra time to understand information. Other people could help by slowing down when speaking, adding gestures, writing things down, and using simple language and short sentences.

This experience is what life is like for people with aphasia. Except it’s happening in their native language.

So, what does aphasia have to do with voting?

The way people with aphasia communicate can seem pretty strange if you’ve never heard of aphasia. And most people have never heard of aphasia. And there’s the whole problem of “competence.”

Poll workers may mistakenly believe a person with aphasia is incompetent because of the way they sound. This perception simply isn’t true. People with aphasia have a communication disability and may need accommodations to exercise their right to vote. In contrast, incompetence can only be declared through a legal process. If a person is on the voting roll, competence cannot be questioned.

Voting accessibility for people with disabilities is a right protected by multiple federal laws. Accessibility is often thought of in relation to people with physical disabilities, such as the requirement for polling places to have ramps for wheelchair users. But not all disabilities are physical, so we also need communication ramps.

So, what is a communication ramp?

Just like physical ramps create an accessible environment for people with physical disabilities to exercise their right to vote, communication ramps create an accessible environment for people with communication disabilities to exercise their right to vote. They are no less necessary or less legally mandated than physical ramps. In practice, however, communication ramps are rarely present.

A communication ramp is a modification that provides equitable access for people with communication disorders. These communication ramps are often very simple to employ, but require awareness and some basic knowledge about aphasia and strategies that can be used to help people express themselves.

Examples of communication ramps that would improve access to voting include how poll workers can support voters with aphasia, how polling places can accommodate their needs, and how ballot design can be improved as well.

Poll workers can:

    • Use simple, straightforward language (for verbal and written information)
    • Provide extra, unpressured time to process information
    • Not rush the person with aphasia
    • Use patience and respect if information must be repeated to help with comprehension
    • Include gestures when giving instructions or making requests
    • Don’t require the person to wait extra time to meet their needs; once it’s their turn, accessibility laws guarantee the right to the time required to communicate effectively
    • Know the state law about whether the person can have a family, friend, or poll worker assist with completing the ballot

Polling places can:

  • Have instructions available in writing
  • Have instructions available in pictures (pictographs)
  • Provide signage that uses simple, clear signage about where to go and what to do

Ballots must:

  • Be written in simple language
  • Clearly state party affiliations of candidates, without using abbreviations (i.e., write out “Democrat”, “Republican”, “Unaffiliated”)
  • Consider use of symbols and/or colors associated with each party on the ballot to signify affiliations

Communication ramps can really make a difference!

  • They help everyone vote by making the communication involved with voting, simple, straightforward and clear.
  • Communication accessibility for people with aphasia = communication accessibility for us all!