Synapse - reconnecting lives

Accommodations in the workplace are simply adaptations that allow a person with a disability to work effectively.

In many countries, employers are required by legislation to make reasonable accommodations in the workplace for employees with a disability.

A brain injury can result in a combination of disabilities which may require accommodations, but these are typically low cost and easy to implement. 

The important questions 

• What are the limitations caused by the brain injury?
• How much do they affect the person and their performance?
• What specific tasks will be affected?
• Has the person been asked about their accommodation needs?
• What accommodations are available?
• Will the person be asked about their effectiveness?

Examples of accommodation
People who have brain injuries may develop some of the following limitations.

Physical limitations could result in using ramps, handrails, and providing disabled parking spaces. All pathways of travel can be cleared of any unnecessary equipment and furniture.

Visual problems  can be accommodated by written information in large print, powerful fluorescent lights, increased natural lighting and providing a glare guard for computer monitors. Consult a vision specialist particularly with someone who has lost part of or all of their vision.

 
Maintaining stamina during the workday is possible with flexible scheduling and allowing longer or more frequent work breaks. Provide additional time and a self-paced workload to learn new responsibilities. Provide backup coverage for when the employee needs to take breaks and allow time off for counselling. Make room for the use of supportive employment and job coaches if required. Allow the employee to work from home during part of the day and provide for job-sharing opportunities.

 
Maintaining concentration is easier if distractions in the work area are reduced. Typical accommodations include providing space enclosures, a private office or allowing use of white noise or environmental sound machines. Increase natural lighting and reduce clutter in the employee's work environment. Let the employee play soothing music using a headset. 

Plan for uninterrupted work time and divide large assignments into smaller tasks and steps. Try restructuring the job to include only essential functions.

 
Difficulty with organization & deadlines can be reduced by encouraging the use of daily 'to do' lists and checking items off as they are completed. Use several calendars to mark meetings and deadlines and remind the employee of important deadlines via memos, email or weekly supervision. Use a watch or pager with timer capability or an electronic organizer. Divide large assignments into smaller tasks and steps and assign a mentor to assist the employee in determining goals and providing daily guidance. Schedule weekly meetings with the supervisor, manager or mentor to determine if goals are being met.

 
Memory deficits can be managed by allowing the employee to tape record meetings or provide type written minutes of each meeting. Use notebooks, calendars, or sticky notes to record information for easy retrieval and provide written as well as verbal instructions. Allow additional training time and provide environmental cues to assist in memory for locations of items, such as labels, colour coding, or bulletin boards. Post instructions over all frequently used equipment.

Problem-solving deficits  are common after a brain injury but can be accommodated in various ways. Provide picture diagrams of problem solving techniques such as flow charts. Restructure the job to include only essential functions and assign a supervisor, manager or mentor to be available when the employee has questions.

Working effectively with supervisors can be accommodated by providing positive praise and reinforcement. Written job instructions and clear expectations of responsibilities and the consequences of not meeting them are very helpful. Allow for open communication to supervisors and establish written long term and short term goals. Develop strategies to deal with problems before they arise and develop a procedure to evaluate the strategies' effectiveness.

 
Difficulty handling stress and emotions can occur after a brain injury. Provide praise and positive reinforcement and refer to counselling and employee assistance programs if required. Allow telephone calls during work hours to doctors and others for needed support. Provide sensitivity training to co-workers and allow the employee to take a break to use stress management techniques to deal with frustration.

Attendance issues  might arise from regular medical appointments or due to managing fatigue. Provide flexible leave for health problems. Provide a self-paced work load and flexible hours. Allow employee to work from home or provide part-time work schedule.

 
Issues of change 

can arise after brain injury to due needing more time to adapt to changes. Keep open channels of communication between the employee and the new and old supervisor in order to ensure an effective transition. Provide weekly or monthly meetings with the employee to discuss workplace issues.

Examples of accommodation

A police officer returned to work following surgery for a brain aneurysm. He had partial paralysis to the left side and could no longer use both hands for word processing. He was transferred to a vacant position that involved computer research, and was provided a one-handed keyboard.

A professional returning to his job was unable to read past the midline when reading from left to right on the computer screen. Accommodation suggestions included: changing the margin settings of his word processing program for 80 to 40 to limit right side reading, or to purchase software that could split the computer screen left to right and black out the right side; redesign his workstation to place equipment on the left; and provide task lighting.

A therapist with short-term memory problems had difficulty writing case notes from counselling sessions. Accommodation suggestions included: allowing the therapist to tape record sessions and replay them before dictating notes, to schedule 15 minutes at the end of each session to write up hand written notes and to schedule fewer counselling session per day.

A labourer working in a noisy factory had difficulty concentrating on job tasks. Accommodation suggestions included: erecting sound absorbing barriers around his work station, moving unnecessary equipment from the area to reduce traffic, and allowing the employee to wear a headset or ear plugs.