Chapter 15: Architectural Adaptations

Chapter 15 presents information on wheelchair-accessible design relevant to rehabilitation after spinal cord injury.

INTRODUCTION

Much of rehabilitation focuses on maximizing a person's potential to participate in home and community life after discharge. However, this participation may be impeded when people leave rehabilitation centers and encounter barriers in the physical environment. Features such as curbs, stairs, narrow doorways, and appliances or controls positioned out of reach can prevent people from functioning independently at home and in the community. Thus, inaccessible architecture can disable people as profoundly as can physical impairments themselves.

Because architectural accessibility can strongly impact participation, this area should be addressed during rehabilitation. The team's involvement can include home evaluations, education and advocacy on architectural barriers and adaptations, problem-solving and recommendations regarding home modification, and education about legal rights. The rehabilitation team can also consult with employers, school systems, and community members regarding architectural accessibility.

This chapter presents typical design features that make homes accessible to people who use wheelchairs and those whose ability to grasp is impaired. These same features are generally required to make a nonresidential environment accessible. Rehabilitation professionals who are involved in architectural adaptations in work sites, school environments, or in the community at large should become familiar with additional guidelines that apply to certain features (stadium seating, food service lines, etc.) that are unique to nonresidential environments.^1-3

It is important to remember that no single design will be perfectly suited to all people with spinal cord injuries (SCIs). The ideal physical environment for a given individual will depend on their functional abilities. Such features as the optimal height of controls, appliances, and plumbing fixtures and the required width of doorways will depend on whether the person is ambulatory, uses a wheelchair for all activities, or uses a wheelchair only for certain activities. If a wheelchair is used, both the person's skill in its use and the wheelchair's overall length and width will dictate the minimal doorway widths and turning spaces that must be present. The individual's reaching capacity will depend on whether they walk or use a wheelchair and will also be influenced by their body build, range of motion, and motor abilities. Motor function will also determine the capacity for grasping and manipulating controls and doorknobs.

Because people with spinal cord injuries vary in body build, ambulatory status, equipment use, reach capacity, and ability to grasp and manipulate, an adapted home that is ideal for one individual may be unsuitable for another. When a home is designed or modified for a particular person, the environment should be tailored to suit their needs and preferences. Rather than providing “standard” accessible features, the home's design should reflect the specific individual's requirements.⁴

U.S. LAWS REGARDING ARCHITECTURAL ACCESSIBILITY

The Architectural Barriers Act (ABA)⁵ mandates that virtually any^a newly ...