chair

David Lepofsky, CM, O. Ont.Chair, Accessibility for Ontarians with

Disabilities Act Alliance Visiting Professor, Osgoode Hall Law School

Co-Chair, Barrier-Free Canada

April 19, 2016

Enhancing Access to the Courts for People with Disabilities:

THE FINAL CHAPTER

*CLE16-0040600-d-weB*

DISCLAIMER: This work appears as part of The Law Society of Upper Canada’s initiatives in Continuing Professional Development (CPD). It provides information and various opinions to help legal professionals maintain and enhance their competence. It does not, however, represent or embody any official position of, or statement by, the Society, except where specifically indicated; nor does it attempt to set forth definitive practice standards or to provide legal advice. Precedents and other material contained herein should be used prudently, as nothing in the work relieves readers of their responsibility to assess the material in light of their own professional experience. No warranty is made with regards to this work. The Society can accept no responsibility for any errors or omissions, and expressly disclaims any such responsibility.

© 2016 All Rights Reserved

This compilation of collective works is copyrighted by The Law Society of Upper Canada. The individual documents remain the property of the original authors or their assignees.

The Law Society of Upper Canada 130 Queen Street West, Toronto, ON M5H 2N6Phone: 416-947-3315 or 1-800-668-7380 Ext. 3315Fax: 416-947-3991 E-mail: cpd@lsuc.on.ca www.lsuc.on.ca

Library and Archives Canada Cataloguing in Publication

Enhancing Access to the Courts for People with Disabilities: The Final Chapter

ISBN 978-1-77094-162-5 (PDF)

1

FINAL February 29, 2016

Chair: David Lepofsky, CM, O. Ont., Chair, Accessibility for Ontarians with Disabilities Act Alliance, Visiting Professor, Osgoode Hall Law School, Co-Chair, Barrier-Free Canada

April 19, 2016

4:00 p.m. to 6:00 p.m. Total CPD Hours = 2.0 Professionalism Hours

The Law Society of Upper Canada

130 Queen Street West Toronto, ON

CLE16-0040600-D-WEB

Agenda

4:00 p.m. – 4:05 p.m. Welcome and Opening Remarks

David Lepofsky, CM, O. Ont., Chair, Accessibility for

Ontarians with Disabilities Act Alliance, Visiting Professor, Osgoode Hall Law School, Co-Chair, Barrier-Free Canada

4:05 p.m. – 4:20 p.m. Accommodating Autism in the Courts

Stephanie Moeser, Social Worker/Therapist

ENHANCING ACCESS TO THE COURTS FOR

PEOPLE WITH DISABILITIES:

THE FINAL CHAPTER

2

4:20 p.m. – 4:40 p.m. Accommodating Traumatic Brain Injury in the Courts

Gail Simpson, Occupational Therapist

4:40 p.m. – 5:00 p.m. Accommodating Multiple Sclerosis in the Courts

Angela Covert, Manager, Education, Multiple Sclerosis Society of Canada 5:00 p.m. – 5:20 p.m. Court Accessibility Program: Accommodating Complex

Cases with Multiple Disabilities

Laurie McEvoy, Senior Accessibility Policy & Business Analyst, Ministry of the Attorney General Jill Sawchuk, Senior Accessibility Policy & Business Analyst, Ministry of the Attorney General

5:15 p.m. – 5:35 p.m. View From the Bench: What Can Judges Do to Improve Accessibility?

The Honourable Howard Borenstein, Ontario Court of Justice

The Honourable Anne Molloy, Ontario Superior Court David Wright, The Law Society of Upper Canada

5:35 p.m. – 5:50 p.m. Questions and Answers 5:50 p.m. – 6:00 p.m. Overview and Wrap-Up

David Lepofsky, CM, O. Ont., Chair, Accessibility for

Ontarians with Disabilities Act Alliance, Visiting Professor, Osgoode Hall Law School, Co-Chair, Barrier-Free Canada

6:00 p.m. Program Ends

ENHANCING ACCESS TO THE COURTS

FOR PEOPLE WITH DISABILITIES: THE

FINAL CHAPTER

April 19, 2016

SKU CLE16-00406

Table of Contents TAB 1 Accessibility for Ontarians with Disabilities Act Alliance.......... ..... .... ...1

TAB 2 Accommodating individuals with ASD within the justice system.........1 - 4

TAB 3 Accommodating Multiple Sclerosis in the Courts..............................1 – 12

TAB 4 Accessibility for People with Disabilities………………………………………………..1

Ministry of the Attorney General

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Accessibility for Ontarians with Disabilities Act Alliance LEARN ABOUT US! SPREAD THE WORD! Do you think Ontario should become fully accessible to over 1.8 million Ontarians with disabilities? The Accessibility for Ontarians with Disabilities Act Alliance is a non-partisan province-wide, volunteer community coalition. We advocate for a barrier-free Ontario for all persons with disabilities. We have no membership fees! We will not ask you for money. We will not give out our email list to anyone else. We advocate to the Government, the media and the public to promote the effective implementation of the Accessibility for Ontarians with Disabilities Act, 2005. We are concerned about all disabilities, whether a physical, sensory, mental, learning, communication or intellectual disability. We care about both visible and invisible disabilities. We are eager to include anyone--with or without a disability--who is interested in our cause. Perhaps you have a disability now. Perhaps a friend or family member has a disability. If not, you are bound to get a disability as you age. Sign up for our widely followed Email Updates. We give periodic updates on what’s new in the effort to promote a barrier-free Ontario -- news you cannot easily find elsewhere. This is not a heavy traffic list that clutters your inbox! You receive updates only from us. Replies to our Email Updates come only to us, not you! Each Update is easy to read or to skim. The subject line gives you the topic. Each Update then has a headline. If you just read that, you will get the gist of the whole document. Each Update then gives a summary of the news for those who want to read more than the headline. Finally, for those with more time, each Update includes more details beyond the summary. To receive our Updates, send a request to aodafeedback@gmail.com Encourage others to sign up for our Updates. Forward our Updates to your friends and family. Learn lots more about us by visiting: http://www.aodaalliance.org Follow us on Twitter. Get others to follow us. Please re-tweet our tweets. Our handle is @aodaalliance Subscribe to the AODA Alliance’s YouTube channel. Get immediate alerts when we post new videos. https://www.youtube.com/user/aodaalliance "Like" our Facebook page and share our updates: https://www.facebook.com/Accessibility-for-Ontarians-with-Disabilities-Act-Alliance-106232039438820/ Please also join the campaign for a strong and effective Canadians with Disabilities Act, spearheaded by Barrier-Free Canada. The AODA Alliance is its Ontario affiliate. Sign up for Barrier-Free Canada updates by emailing info@BarrierFreeCanada.org

1

Accommodating Individuals With ASD Within the Justice System

Stephanie Moeser, MSW, RSW (on behalf of Autism Ontario)

Stats

• 1 in 94 people have an autism spectrum disorder (Autism Ontario)

• 1 in 65 (Centre for Disease Control)

Social communication and Interaction

• Deficits in social emotional reciprocity

• Deficits in nonverbal communicative behaviours

• Deficits in developing, maintaining and understanding relationships

Social Communication

• Verbal or non-verbal does not necessarily correlate to understanding

• Misinterpretation or lack of understanding of non-verbal communication

• Concrete and literal thinkers

• Comprehension or expressive language may not match verbal ability

• Echolalia

2

Strategies to support communication

• Short sentences

• Concrete, literal words

• Neutral, quiet tone

• Time to process-at least 10 seconds

• Using written or visual instructions

• Rely on words rather than body language

• Don’t insist on eye contact

Behaviour

Restricted, repetitive patterns of behavior, interests, or activities

• Stereotyped or repetitive motor movements, use of objects of speech

• Insistence on sameness, inflexible adherence to routines or ritualized patterns or verbal

or nonverbal behaviour

• Highly restricted or fixated interests that are abnormal is intensity or focus

• Hyper or hypo sensitivity to sensory input or unusual interests in sensory aspects of the

environment

• Repetitive sounds or words

• Stereotyped “stimming” body movements

• Pacing

• Questions about routine

• Talking about a specific topic or subject

• Difficulty understanding Theory of Mind (other people’s perspectives)

• Lack of understanding of time or intense focus on time

3

Provide detailed information

• Provide detailed contextual information

• Steps of what will occur in the process

• Who will be present (judges, lawyers, etc) and their roles

• Expectations in the environment, level of formality etc.

• When there may be breaks, or how to request a break

• Ask about sign of when a break may be needed

• Information about expectations in the environment (level of formality, etc)

Sensory

• Hypo or hyper to environment: -tactile, visual, olfactory, taste, auditory, vestibular and

proprioceptive

• Vestibular- refers to structures within the inner ear (the semi-circular canals) that detect

movement and changes in the position of the head

• Proprioceptive-refers to components of muscles, joints, and tendons that provide a

person with a subconscious awareness of body position

4

Emotional Regulation

• Individuals with ASD have increased challenges with emotional regulation

• Have difficulty recognizing and labeling emotions

• Have difficulty understanding facial expressions

• Own facial expression sometimes will not match emotions

• Myth that individuals with ASD don’t feel emotions, often feel them more but lack the

language to identity and often need to be taught how to respond

• Can seem to go from 0-10

• More prone to meltdowns or shutdowns, especially when already experiencing a high

level of stress

1

Why is VLAP important?

In Ontario there are approximately 29,000 people living with MS.

Close to 80% of people with MS are eventually unable to work full-time, often in their prime of life

An MSSOC survey of client services personnel identified a significant need for legal assistance in the form of information, advice and support from legal experts on a variety of matters

Living with MS is costly–ie medication, medical equipment, attendant care etc and the access to legal support when required is often not within financial reach

VLAP is intended to engage volunteer legal professionals in providing

legal advocacy support to individuals with MS who do not qualify for assistance through existing community legal aid programs due to the amount of income they earn, yet have insufficient income to afford the cost of a lawyer.

The complexity and knowledge base required to effectively support

persons living with MS requires appropriate expertise.

2

Legal Challenges

Persons with MS often face increased legal challenges such as:

human rights issues associated with disability rights

access to disability insurance (CPP-D, LTD)

employment equity issues

power of attorney issues

family law issues

Wills and estate needs Specific Legal Examples

Dismissal from employment –E.g. Employee dismissed shortly after disclosing illness

Denied insurance benefits –E.g. Clients denied Long Term Disability Insurance

Drafting wills or power of attorney –E.g. Clients without many assets want to make sure what they have goes to the right person

–E.g. Concerned about health and need someone to making financial decisions

3

CPP-D Appeals

Human Rights/Accessibility support

–E.g. Client was denied right to use scooter in apartment hallway as it dragged in mud and dirt; a letter from lawyer resolved the issue

General Situations requiring support –E.g. Damage to property or personal injury

–E.g. Client falls into debt

–E.g. Canada Revenue Agency dispute on tax assessment

–E.g. Insurance claim support re house fire

What is MS?

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (brain and spinal cord).

inflammatory demyelinating condition –causes damage to myelin, the fatty material that insulates nerves and allows a nerve to transmit its impulses rapidly

inflammation and loss of myelin causes disruption to nerve transmission and affects many functions of the body.

areas where myelin is lost (lesions) appear as hardened areas, or scars

‘multiple sclerosis’ literally means, many scars

4

What causes MS?

exact cause of MS is not known

•current research increasingly points to a complex interplay of environmental and possibly genetic risk factors –together these two factors may influence a risk for developing MS given a prescribed set of conditions which are yet to be discovered

MS is NOT contagious, and is NOT inherited

Types of MS:

5

6

Some Facts About MS…

largest cause of neurological disability in young Canadians

100,000 Canadians are affected by MS

•typical onset is between the ages of 15 and 40

•three times as common in women than men

•more prevalent farther North and South from the equator –e.g. Canada, Northern USA, Northern & Central Europe, Australia, New Zealand

MS Symptoms: Invisible: •fatigue

•visual problems

•sensory dysfunction –numbness, tingling, ‘pins & needles’ •cognitive impairment

•bladder and bowel problems

•pain

•dizziness

•depression and mood alterations

•sexual dysfunction

7

Visible: •motor functions •walking •muscle weakness •spasticity •tremor •drop foot •speech problems •lack of balance and coordination Fatigue

most common symptom of MS, 90% of people will experience fatigue

•an overwhelming sense of tiredness, lack of energy, or feeling of exhaustion

•Someone can get a full night sleep and still feel tired Scheduling appointments –there may be time of day when individuals are too fatigued to process information or communicate effectively.

Visual Problems

Visual problems may result in painful eye movements, blurring or graying of vision, or blindness in one eye

uncontrolled eye movements

double vision, may increase with fatigue or straining the eyes

8

Individuals may require alternate format of print materials such as

audio, large print, etc.

Cognitive Impairment

occurs in about 50% of people with MS

•memory or recall problems

•abstract reasoning and problem-solving abilities

•hand-eye coordination

verbal fluency

•speed of information processing It is important to have your meeting free of outside distractions, speak slowly and don’t rush through information and ask frequently if the client understands what is being said or if they have questions.

Heat Intolerance

elevated body temperature can temporarily aggravate other MS symptoms such as fatigue, weakness, cognitive functions

•Be mindful of environmental factors like room temperature, outdoor temperature

Clients may have difficulty or be unable to travel to appointments in the summer months. Ensure meeting space is cool and water is available.

9

Bladder & Bowel Issues

•About 80-85% of people with MS has bowel and bladder issues Individuals may need to have meetings near an accessible washroom or may be uncomfortable leaving their homes.

10

You and Your Client with MS

What can you expect?

We provided her with some tips to foster a smooth process. Please notify us immediately

if you encounter problems such as missed appointments or lack of follow-through with

suggestions or requests. These behaviours may be the result of MS-related symptoms but

are nevertheless not acceptable. We will try to work with your client to remedy any such

problems.

Multiple sclerosis is a disease that attacks myelin, the insulating cover of the central

nervous system, causing inflammation and often destroying myelin in patches.

MS symptoms are unpredictable and vary greatly from person to person. Not all people

with MS will experience all symptoms and often the symptoms will improve during periods

of remission.

Below is a list of some MS symptoms that could have an effect on your relationship with

your client and may interfere with your ability to efficiently complete your work. We also

provide some suggestions as to how these symptoms could possibly be addressed.

Cognitive problems - These may include problems with short-term memory,

concentration, judgment or reasoning. They can influence the mind’s ability to store,

organize and recall information and the way the mind regulates moods and emotions.

There could be a shorter attention span and a slowing down in the time it takes to process

information. Some people will have problems analyzing a situation, identifying the salient

points, plan a course of action and carry it out. Verbal fluency - a problem that often

manifests itself as the “tip of the tongue” phenomenon – is also common.

Visual disturbances - These may include blurring of vision, double vision, optic

neuritis (inflammation of the optic nerve), involuntary rapid eye movement and very

rarely, total loss of sight.

Speech problems - These may include slowing of speech, slurring of words and changes

in rhythm of speech.

Extreme fatigue - This is a debilitating kind of fatigue that comes on suddenly or is out

of proportion to the activity. It is a feeling of an overwhelming sense of exhaustion and

11

lack of energy that can make simple tasks almost impossible. It severely limits energy

and endurance.

COPING TIPS;

1. Be very clear about what you will be doing for the client and what is not part of

your work.

2. More frequent and shorter appointment times may be beneficial for clients with

fatigue issues

3. Split information into manageable chunks or categories

4. Repetition or summary of key points at the end of an appointment is helpful to

increase retention. You also may want to ask the client to reiterate their understanding of your explanations.

5. Encourage the client to bring somebody with them to help remember and interpret information

6. Encourage the client to take notes or record the meetings with a small tape recorder;

7. You may want to provide written summaries or instructions if your client reports

memory problems

8. Call to reconfirm the appointment, that morning if possible, if your client has

memory problems

12

Online resources:

www.mssociety.ca MS Society of Canada

www.nationalmssociety.org National MS Society (USA)

www.msif.org MS International Federation – numerous languages available on this site

www.mscare.org Consortium of MS Centers

Videos:

• MS Society of Canada – MS Impacts: http://www.youtube.com/watch?v=ukU3fPseCMo

• National MS Society (US) – What is MS: http://www.youtube.com/watch?v=KGzsriXqg6U

– Heat’s Impact on MS: http://www.youtube.com/watch?v=kmlzp2otuXY

– Cognitive Issues in PPMS: https://www.youtube.com/watch?v=IpPbkE5dNzM

• MS International Federation – Fatigue: http://www.youtube.com/watch?v=6q44a6oxAAA

1

Accessibility for People with Disabilities Ministry of the Attorney General

This information is provided to participants of the Enhancing Access to the Courts session provided by the Law Society of Upper Canada. It provides links to information about accessibility at the Ministry of the Attorney General and services available for court users with disabilities.

Courthouse Accessibility Coordinator Service Accessibility Coordinator services are available for courthouses operated by the Ministry of the Attorney General. Coordinators provide information and accept requests about accessible services and respond to the needs of court users with disabilities. Coordinators are the primary point of contact at all court locations for members of the public and justice sector participants, partners and stakeholders on disability or accessibility-related issues. Accessibility Coordinator Contacts - search by court location (http://www.attorneygeneral.jus.gov.on.ca/english/courts/Court_Addresses/default.asp) More information about Accessibility at the Ministry of the Attorney General (http://www.attorneygeneral.jus.gov.on.ca/english/about/commitment_to_accessibility.asp)

Feedback about Accessibility The Ministry of the Attorney General welcomes feedback and suggestions to support our continuous efforts to improve the accessibility of our services and programs for people with disabilities. Feedback provided in any of the following ways will be directed to the appropriate department for response.

In person, by phone or mail where the service was received. Customer comment form available at some courthouses By phone, TTY, or in writing to the Ministry of the Attorney General:

Telephone: 416–326–2220 or 1–800–518–7901 TTY: 416–326–4012 or 1-877-425-0575 Fax: 416–326–4007 E-mail: attorneygeneral@ontario.ca Mailing address: Ministry of the Attorney General, McMurtry-Scott Building, 720 Bay Street, 11th Floor, Toronto, ON, M7A 2S9

On request, the ministry can provide accessible formats, communication supports and other disability-related assistance in all its services, including when needed by individuals to communicate feedback. If needed, the ministry can provide visual language interpreter at an in-person meeting or by video conference. April 12, 2016