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Environmental Barriers

What are Environmental Barriers?

The severity of a TBI is a key factor in determining how well someone does after his or her injury. That’s almost a “no-brainer.” Medical care and rehabilitation play a role too. So does the person’s motivation and attitude.

However, there are also things, separate from the person with the TBI, that make a difference. For example, there are things like:

  • Support from other people: What if family or co-workers are not supportive and don’t help?
  • Discrimination: What if people are prejudiced toward the person?
  • Physical barriers: What if buildings are not accessible? What if the environment prevents the person from doing things he or she needs to do?

Any of these things can make it harder for a person with a TBI. They can make life much more difficult and much less satisfying. When things like these create problems, they are called “Environmental Barriers.”

Five kinds of Environmental Barriers

People with disabilities can face many Environmental Barriers. These barriers depend on the person, the type of the disability, and many other things. There are five broad types of barriers:

  1. Physical barriers: Is your home accessible? Does it let you move around easily? How accessible is work or school, and the public places you go? Physical barriers can be caused by things like buildings, stairs or hills, doorways, or even the weather and climate.
  2. Attitude barriers: These have to do with prejudice and discrimination. Do negative attitudes and prejudice from people you come in contact with keep you from being as productive and successful as possible?
  3. Assistance barriers: Does lack of transportation keep you from going where you need to go? Does a lack of good information or medical care keep you from doing what you need to do? Are people in your home and community helpful enough?
  4. Policy barriers: Do government rules make road-blocks for you? Can you find the educational, employment, and service programs you need? Do rules and regulations stop you or get in your way?
  5. Work and School Barriers: Are people you interact with at school or work positive and helpful? Do they support you? Does how they act prevent you from doing the things you need to do?

What did we learn?

We developed a survey that covered all of these barriers. It included several specific examples of each of the five types -- 25 different barriers in all. Then, we asked more than 70 adults with TBI who had their injury about a year ago to complete the survey. Here is what we learned:

Most people with TBI aren’t very bothered a lot by barriers in the environment. Those who do have barriers often fall into certain groups.

  1. Women seem to say they face more barriers than men. However, men reported more barriers that had to do with work.
  2. People who were married when they were injured seemed to face more environmental barriers than people who were not married.
  3. People who are African-American or Hispanic reported more barriers than white people. In fact, people who were in other minority groups also reported more barriers. But, white people reported more of two particular types of barriers: those that had to do with bad attitudes, and those relating to lack of support from other people.
  4. Physical barriers, like stairs, hills, roads, and buildings were more of a problem for older people with TBI.
  5. People who were working or in school before they were injured reported that they had fewer barriers after injury.
  6. People whose TBI causes them to need actual help from others are more likely to report barriers. But, beyond this, the severity of the TBI didn’t seem to affect the number of environmental barriers that people reported.

These were the biggest and most common barriers that people did report:

  1. Not having the transportation they need
  2. Barriers in their surroundings – like poor lighting, too much noise, crowds. It also includes things in nature like cold temperatures, too much rain, steep hills, etc.
  3. The attitudes of people in their own homes or families

Barriers affected people with TBI in several ways

  1. People who said they had a lot of barriers were less satisfied with their lives.
  2. People had trouble getting out of their houses and moving around their communities also said they had more barriers in their environment.
  3. People who reported experiencing negative attitudes or prejudice were less indepndent and less active in outside activities.
  4. People who did not work or go to school reported more barriers. In other words, people who were not doing something “productive” also thought they had more barriers.

What does this mean to you?

Keep in mind that, in spite of the research we described here, the majority of people with TBI in our we study did not report that environmental barriers are a big problem for them. That means that it is very likely that you don’t have a lot of trouble with barriers either. If that is the case, then think of this brochure as just “food for thought.”

However, if you are dealing with barriers in the environment, you need to think about whether they are making a difference in your life. Here is a modified version of the survey we used in our research:

Check the barriers that are big problems for you: ones that you experience often, or ones that are severe problems:

  • The availability of transportation
  • Design and layout of your home
  • Design and layout of buildings and places you use at school or work
  • Design and layout of buildings and places in your community
  • The natural environment — temperature, terrain, and climate
  • Aspects of your surroundings — lighting, noise, crowds, etc.
  • The availability of information you want or need
  • The availability of education and training you want or need
  • The availability of health care services and medical care
  • Lack of personal equipment or special adapted devices
  • Lack of computer technology
  • The availability of someone else to help you in your home
  • The availability of someone else to help you at school or work
  • The availability of someone else to help you in your community
  • The attitudes of others in your home
  • The attitudes of others at school or work
  • The attitudes of others in your community
  • Lack of support and encouragement from others in your home
  • Lack of support and encouragement from others at school or work
  • Lack of support and encouragement from others in your community
  • Prejudice or discrimination
  • Lack of program or services in your community
  • Problems with rules and policies of businesses and organizations
  • Problems with education and employment programs and policies
  • Problems with government programs and policies

Now, go back and look at the ones you checked. Ask your self: What can you change to make these barriers be smaller or less frequent?

  • Do the people around you know what kind of support you need from them?
  • Could you move to a different place that is more accessible?
  • Could equipment like a cane or a wheelchair, or even a wheelchair lessen your barriers?
  • Could you find new people to be with -- ones who are more supportive and positive?
  • Can you change what you do so you are less bothered by your environment? For, example, if noise bothers, could you avoid noisy places?
  • Can you change things about yourself so other people perceive you differently? This could improve their attitudes. Check out our brochure on Communicating for ideas.

If you want still more information, the full Barriers Survey is on the Internet at www.craighospital.org Click “Research,” then “Disability Research.” Click on the link to CHIEF – Craig Hospital Inventory of Environmental Factors. Read the page, then click on the link at the end. The full survey is on pages 30-32.