The Americans with Disabilities Act (ADA, 1990) is the cornerstone of civil rights policy for people with disabilities. Although enforced through the justice system, the legacy of the ADA transcends well beyond its legal ramifications. The policy's framework and the rhetoric of Disability Rights suggest both an embrace of the spirit and the letter of the law, or promulgating both legislative and cultural change to ensure that the rights of people with disabilities are met. In attempting to understand how and if such change has happened, researchers have gathered extensive evidence since 1990. Much of this research evidence, however, remains fragmented, under-utilized, and at times inconclusive. This article presents the results of a rapid evidence review of a sample of such research that is crucial to understand the ADA's progress. The study examines evidence about the ADA's influence on knowledge, attitudes and perceptions about employment of people with disabilities. The research illustrates the importance of moving beyond the law to incorporate changes in knowledge about the law, perceptions of employability, and workplace culture.

The existing research about the Americans with Disabilities Act (ADA) provides considerable evidence about the law's impact, yet also yields disparate findings that span across a range of resources. On the ADA's 25th anniversary there is a need to consolidate this evidence to improve our understanding about the existing research, and to assess the progress made in achieving the ADA's intended goals.

To address this need, the University of Illinois, Chicago is conducting a five-year multi-stage systematic review of the ADA as part of the NIDRR-funded ADA Knowledge Translation Center based at the University of Washington. This article details the second stage of the project — the rapid evidence review. The purpose of the rapid evidence review is to preliminarily assess the existing ADA research and to pilot a review process that can be used for subsequent full systematic reviews. Initial results respond to a research question that developed iteratively from the evidence and stakeholder feedback generated during the first stage of the project (Parker Harris, S., Gould, R., Ojok, P., Fujiura, G., Jones, R., & Olmstead IV, 2013): What evidence exists that the ADA has influenced knowledge, attitudes and perceptions about the employment of people with disabilities?

This article first considers the broader goals of the ADA's employment provisions as it relates to attitudinal change. It then examines ongoing debates within the current state of evidence. Lastly, it presents the process and findings of the review.

Background: The ADA and its social goals

The ADA provides a legal framework for individuals with disabilities to challenge discriminatory practices. In the employment context, the primary legal basis for claiming discrimination in the workplace is twofold. The ADA considers it discrimination in employment (1) when an individual is denied a position based on disability for which he or she is qualified (Section 101-8), and (2) when a qualified individual with a disability is prevented from reasonable accommodation (Section 101-9). By preventing unequal treatment and facilitating reasonable accommodations, the law provides a clear legal definition of how to prevent discriminatory practice.

The process of preventing discriminatory attitudes that may accompany or predicate such practice is a more complex task that requires inquiry beyond the legal framework. In addition to facilitating civil protections, policymakers and activists alike imagined that a cultural embrace of the law (what George Bush referred to as the "spirit" of the law during the ADA signing ceremony in 1990), would further enhance the implementation process. While the federal government would oversee the protection of rights through the legal system, policy players imagined that various entities within the public and private sector would stimulate and support change by increasing a culture of compliance and accessibility (NCD, 1986). Together, the cultural embrace of compliance is commonly referred to as the 'spirit goal' of the ADA- or the process of informing stakeholders about disability rights and changing prejudicial attitudes that often precede discriminatory practice (see Mayerson, 1991).

The process of attending to the ADA's spirit goals in the area of employment has proven to be a challenge, as indicative of ongoing reports of disability discrimination in all aspects of the employment process (e.g. Robert & Harlan, 2006; NOD, 2010); and the low employment participation rate of people with disabilities (about 33%) that has remained relatively stagnant since an initial decline following the ADA's implementation (Erickson, Lee, & Von Schrader, 2014). Although there is general scholarly consensus that the ADA's legal framework is meeting its intent following the 2008 ADA Amendments (Feldblum, Barry & Benfer, 2008), a wide range of stakeholders claim that the ADA's social and attitudinal goals - both as outlined in the law's preamble and as more broadly imagined as encompassing the spirit of the ADA- have not been fully achieved.

The passage of the ADA-Amendments was both imagined to reverse the trend of an increasingly narrowed legal definition of disability and to also re-embrace the goal of broadening social and attitudinal change (NCD, 2007). With this reinvigorated focus on the ADA's spirit, questions still remain on how to bring the policy goals into practice. Implementation gaps continue to mire the ADA's impact 25 years after its initial passage.

ADA research on knowledge, attitudes and perceptions

A broad body of social science research on the ADA's impact highlights the gaps that continue to exist in attending to the ADA's spirit goals. This research, from 1990 onward, assesses the attitudes and perceptions about and by people with disabilities in relation to the changing policy context. Much of this research also analyzes how knowledge about the law by people with disabilities and other stakeholders impacts perceptions and practice (e.g. Carpenter & Paetzold, 2013; O'Day, 1998; Rumrill, 1999). This broad body of research is useful to document how attitudes have evolved with the ADA's implementation.

Although there is ample research exploring changes in attitudes, perceptions, and knowledge since the ADA's passage, there is considerable difficulty in drawing an answer as to the impact of the law's employment provisions. Even though many of these studies are commonly referred to when describing the continued prevalence of discriminatory attitudes, it is not always clear how study data relates to the ADA's implementation. Much of the research is based on single use surveys about attitudes or derived from one-on-one interviews and not always directly in relation to assessing the ADA's impact (Hernandez, Keys, & Balcazar, 2004). Similar to much of the research on the ADA, evidence on the impact of the law on attitudes, perception, and knowledge is fragmented across a wide volume of resources that presents an array of often-debated evidence without summative conclusions (Parker Harris et al., 2013)

One of the primary factors contributing to ongoing knowledge gaps about the ADA's impact is the lack of longitudinal record keeping (NCD, 2007). Resources from various national disability rights, such as the National Council on Disability (NCD), Disability Rights Education and Defense Fund (DREDF) and others have provided summative evidence to suggest gaps in monitoring and implementation. The NCD (2007, 2010) for example, has gathered and synthesized information on the impact of the ADA, which includes attitudes and employment as a subcategory. In regards to studying the ADA's impact on attitudes in employment, the NCD primarily uses data from a National Organization on Disability (2010) report, which finds that more than 60 percent of people with disabilities perceived significant improvements in public attitudes. At the same time, the NOD (2010) also finds that nearly half of survey respondents believe employers had discriminated against them, in particular at the hiring stage. This evidence is primarily used to suggest need for further analysis of why continued accounts of discrimination exist. NCD acknowledges that their findings are "far from complete" and that there is "significant knowledge gaps about the impact of the ADA" (NCD, 2007). Instead of reconciling those gaps, NCD recommends further research. As such, our study begins to respond to this gap.

The ADA KT systematic review process.

In response to results from such national reports, ongoing stakeholder feedback, and the purported evidence gaps on the ADA's influence, this research begins to consolidate the broad range of fragmented evidence on the ADA's impact. The systematic review project seeks to increase the utility of research on the ADA and thereby generate summative conclusions from the existing research evidence across three stages. The remainder of this article contains the results of the second stage of the process: the rapid evidence review.

Rapid evidence assessments examine what is known about a policy issue, and use systematic methods to search and critically appraise the available research evidence in a strategic and timely way. These reviews limit particular aspects of the full systematic review process (i.e. by using broader search strategies, extracting only key variables, and performing a simplified quality appraisal) (Grant & Booth, 2009). They are undertaken with the potential to be developed into full systematic reviews or use as protocols for future reviews.

This project does not seek to replace or refute evidence in such broad scale reporting. The consolidation of existing resources complements policymakers' and researchers' ongoing efforts by providing summative conclusions about often debated areas that have resulted in repeated and decisive evidence-based claims.

Overview of research to date

Before the rapid evidence review, this project conducted a scoping review of the full body of ADA research. The scoping review explored: What English-language studies have been conducted and/or published from 1990 onwards that empirically study the Americans with Disabilities Act? This question was answered via a literature search using the following parameters: (a) published or dated from 1990; (b) written in English; (c) carried out in the United States; (d) relate to the ADA and (e) based on published studies reporting the gathering of primary or secondary data or the collating and synthesis of existing information to answer ADA-related research questions. Items that were not included were established facts about the ADA (i.e. court-case decisions, technical materials on compliance, general fact sheets), opinion pieces (i.e. by various stakeholders, lawyers or academics), and anecdotal evidence research (see Parker Harris, S. Gould, R. , & Fujiura, 2014 for full description of methods and findings from the scoping review).

The search yielded 34,995 records, of which 980 relevant records that met the inclusion criteria were included in the scoping review. Approximately 51 per cent (499 records) of these were related to employment. Within the employment literature, the most prevalent types of records pertained to attitudes and knowledge, barriers and facilitators to implementation, assessments of compliance rate, and costs associated with the ADA. The research team combined these results with feedback from an expert panel of ADA stakeholders to identify research priorities for the rapid evidence review. The research team continuously collaborates with the key ADA stakeholders who have been instrumental in the drafting of policy, dissemination of research, and implementation of the ADA so that the research generated through this project is relevant and topical.

Methodological Overview

Following the scoping review, the research team refined the employment research to conduct the rapid evidence review using a methodology novel to this research project. A full overview of the methods is available in the ADA Knowledge Translation Center Rapid Evidence Review Technical Report , which is available at http://adata.org/research.

Data Collection

Data collection for the rapid evidence review crosscuts three steps of the rapid evidence process: refining the protocol, coding and appraising the data; and extracting relevant records and evidence. Appendix 1 provides a visual representation of the data collection process.

First, changes related to the inclusion criteria were made in response to stakeholder feedback about the scoping review. These changes helped distinguish ADA research from ADA-related research and only the most pertinent research was included. Articles included in the rapid evidence review:

  • Were included in the scoping review.
  • Specify the ADA, an ADA case decision, or one of the principal titles or guidelines within the law.
  • Contain an explicit statement of the critical or theoretical framework and/or the method of analysis.
  • Do not present duplicative reporting of a study that is already in the review.

The revised criteria yielded a total of 451 potentially relevant records that were identified for inclusion in the rapid evidence review. These records were categorically sorted according to various disability policy domains identified by the expert panel. During the second stage of data collection, 203 records relevant to employment were identified and met the inclusion criteria.

At this point, additional employment-specific records were identified by searching for organizational reports and books previously excluded and conducting an updated search of NARIC's (NIDRR's online library resource) database for records published since the completion of the scoping review. Ten additional records pertinent to employment were identified and included in the rapid evidence review.

Following the location of employment-related records, an abbreviated quality appraisal based on Dixon-Woods et al.'s (2006) tool was conducted to assess that included records adhered to a minimum standard of research reporting (see Appendix 1). As there is considerable debate and ambiguity when assessing rigor in theory/policy records (Kissam, 1988), the research team excluded this type of research from the rapid evidence assessment for future inclusion in the systematic reviews. Consequently, 85 records were excluded at this stage, which also included a number of organizational reports and dissertations. An additional ten records were excluded because they did not meet the minimum criteria for quality reporting.

The research team reviewed included articles, extracting key information. Data extraction occurred in two stages, initial data extraction (commonly called 'keywording') followed by a more detailed extraction of findings specific to the research question. After obtaining the appraisal score, full-text records were reviewed and key information was extracted into a database file (using EPPI Review 4.0 systematic review software). Extracted information included descriptive data (e.g. bibliographic information) and content variables (e.g. study demographics, study design, research design).

Following this initial extraction phase, the research question was iteratively generated, as outlined in the following section, and a more detailed data extraction process occurred. The research team extracted evidence addressing the key research question using an open-coding procedure. This procedure extracts key concepts and findings from the data using a synthesis guide created in EPPI Review 4.0 to capture first-order (participant quotes/ direct data points) and second order (author analysis) constructs.

Creation of Research Questions

Following the thematic coding during the initial data extraction stage, a specific sub-topic was selected for the rapid evidence review using a three-step process: (1) identifying a sufficient body of evidence to generate a configurative assessment; (2) reviewing relevant research (i.e. NCD, 2007) to pinpoint existing knowledge gaps; and (3), assessing stakeholder needs by consulting with the ADA Expert Panel and representatives from the ADA National Network to refine the research topic. Soliciting stakeholder feedback is a knowledge translation process that enhances the utility and relevance of systematic reviews (Graham et. al, 2006).

Following this process, the research team focused on knowledge, attitudes, and perceptions in relation to employment and the ADA for the rapid evidence review. This iterative process led to the development of the research question: What evidence exists that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities?

Study Demographics

The database of records reporting on knowledge, attitudes, and perceptions within employment literature on the ADA included thirteen mixed methods, seven qualitative, and forty quantitative studies. The records reflect data collected between 1990 and 2007, and published between 1990 and 2013. There are nine records that have been published since 2007, but none report collecting data after 2007 (5 of the 9 records do not report when data was collected). The findings therefore exclude research on the ADA Amendments of 2008. Additionally, two records include data collected before the ADA that were used to compare to data collected after the ADA went into effect (Gerber, Batalo & Achola, 2011; Hazer & Bedell, 2000).

Data Synthesis & Analysis

The synthesis techniques for the rapid evidence review involved qualitative content analysis (generated from the data extraction) in addition to more advanced analysis techniques to explore the relationships and thematic components of the research literature. The process involved providing a descriptive numerical summary (e.g. overall number of studies included, types of study design, topics and/or titles studied, characteristics of disability sub-groups and/or stakeholders, years of publication); and thematic analysis using EPPI Reviewer 4.0 systematic review software.

Analysis was then conducted using an adapted mixed methods meta-synthesis technique (see Jesson, Matheson & Lacey, 2011 or Dixon-woods et al.'s 2006 critical interpretive synthesis for similar procedures). Defining relationships between and across studies is a key component of analysis and is commonly referred to as 'third order interpretation' in review-based research. To do this, the research team first noted trends, related findings, and discordant evidence across the research studies. Specific to the research question, this included findings directly relevant to knowledge, attitudes, and perceptions. Once the research team established the third order interpretation (i.e. by noting key arguments repeated across studies), the next step was to develop higher-order themes.

The thematic findings were reviewed and critiqued by the ADA expert panel to improve the credibility of findings and to ensure rigor in analyzing the codes. One of the primary means to ensure credibility when conducting this type of review is to utilize feedback from outside experts or stakeholders that closely engage with and/or will closely be impacted by the research findings (Keown, Van Eerd, & Ervin, 2008). A strength of this approach is that the inherent biases of the review authors are addressed through open dialogue, member checking of findings, and inter-scholastic collaboration. The ADA expert panel was consulted to assess if any findings seemed inconsistent with their experience with the ADA in research and/or in practice. Respondents from the panel agreed or strongly agreed that all of the findings presented in this article were representative of the ADA's influence on knowledge, attitudes, and perceptions in employment.

The identification of higher order themes is a collaborative process, where members of the research team combine individual assessments of the synthesized data to generate a configurative analysis. Gough, Oliver, & Thomas's (2011) description of open-thematic coding for systematic review informed this process. Findings were divided across two higher-order themes of synthesis arguments (or thematic categories) related to how the evidence's about ADA's influence on knowledge, attitudes, and perceptions about the employment of people with disabilities has been studied, through (1) Individual Perspectives; and (2) Employer Perspectives. A number of subthemes of related syntheses also emerged within each of these higher order themes.

The primary purpose of identifying the two thematic categories is to present research syntheses in a way that portrays how individual results are related to each other. These themes are not mutually exclusive, as the records may contribute to synthesis arguments found in multiple subthemes. The process of identifying subthemes allows for the grouping of similar findings across study contexts for analytical purposes.


Individual Perspectives

The first thematic category of evidence relates to individual perspectives. Evidence exists that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities from the individual perspective across four synthesized subthemes of findings. The first two subthemes (rights/processes and services/service providers) pertain to individual knowledge about the ADA. The second two subthemes (accommodation requests and dispute resolutions) relate to individual perspectives about employment experiences.

Rights & Processes

The subtheme of rights and processes refers to an individual's knowledge about their rights under the ADA and how to apply the ADA. In this area, the synthesized findings of the research evidence show that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities in relation to:

Self-Advocacy: People with disabilities' self-advocacy skills have developed in relation to knowledge about their rights under the ADA. There is evidence that individual knowledge has grown in relation to increased choice and access. There is also evidence that the growth of self-advocacy skills has come out of necessity due to limited knowledge of the ADA by employers (Blanck, 1996; Gerber, Batalo, & Acaolo, 2011; Thompson & Dickey, 1994).

Disclosure decisions: Knowledge of the ADA facilitates the decision to disclose one's disability status. The evidence shows that a person is more willing to disclose when they are aware of their legal rights. Conversely, people who are less aware of their ADA rights are less likely to disclose (Goldberg, Killeen, & O'Day, 2005; Madaus, 2006 & 2008).

Impairment Type & Complaint Process: People with cognitive impairments experience barriers while filing formal ADA complaints to the EEOC due to lack of knowledge about the complaint process. This evidence is derived from the notion that people with cognitive impairments are most likely (compared to other types of disability) to have formal ADA complaints dismissed due to improper filing before they have a chance to be reviewed in full (Unger, Campbell, & McMahon, 2005; Van Wieren, Armstrong, & McMahon, 2012).

Knowledge Barriers: People with stigmatized disabilities and/or more complex accommodation requirements have increased knowledge barriers to applying their rights under the ADA during the job search process. This evidence comes from people with disabilities expressing difficulties or insufficient knowledge about how to apply the ADA to their individual job searches (Gioia & Brekker, 2003; Goldberg, Killeen, & O'Day 2005; O'Day, 1998; Price, Gerber & Mulligan, 2003; Thompson & Dickey, 1994).

Services & Service Providers

The subtheme pertains to the role of the ADA on services and service providers primarily as it relates to rehabilitation counselors. In this area, the synthesized findings of the research evidence show that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities in relation to: Increased Role of Service Providers: Rehabilitation counselors and other professionals can and should have an increased role in providing information/knowledge to people with disabilities on how to apply and use the ADA. The evidence is primarily derived from research in rehabilitation counseling that interrogates the changing roles of service providers since the ADA (Gordon, Feldman, Shipley & Weiss, 1997; Neath, Roessler, McMahon & Rumrill, 2007; Rumrill , 1999; Rumrill, Roessler, Battersby-Longden & Schuyler, 1998).

Dispute Resolution: When rehabilitation counselors inform people with disabilities about ADA processes prior to job placement they are more likely to prevent disputes that end in discharge. Evidence demonstrates that when training or information is provided early in employment processes, formal disputes are often avoided (Neath, Roessler, McMahon & Rumrill, 2007; Rumrill , 1999; Rumrill, Roessler, Battersby-Longden & Schuyler, 1998).

Accommodation Requests: This subtheme is in regards to the ADA's influence on accommodations requests. In this area, the synthesized findings of the research evidence show that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities in relation to:

Workplace Culture: Workplace culture impacts decisions to disclose and to request accommodation. The evidence is underpinned by the notion that anticipated disruption to routine workplaces continues to influence accommodation requests by individuals (Baldridge & Veiga, 2001 & 2006; Gioia & Brekker, 2003; Madaus 2006 & 2008; Matt, 2008; Nachreiner, Dagher, McGovern, Baker, Alexander & Gerberich, 2007).

Stigma: Perceived stigma influences the decision to disclose disability for accommodation requests. There is evidence that fear of both explicit and implicit discriminatory attitudes prevent decisions to request accommodations (Gioia & Brekker, 2003; Goldberg, Killeen, & O'Day, 2005; Price, Gerber & Mulligan, 2003).

Dispute Resolutions

The final subtheme is in regards to formal and informal dispute resolution processes. In this area, the synthesized findings of the research evidence show that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities in relation to:

Impairment Type: Outcomes of formal dispute resolution are affected by different types of impairment. Evidence for this finding is derived from secondary analyses of data generated from the EEOC IMS. While secondary data does not provide direct evidence about knowledge, attitudes and perceptions in relation to the employment of people with disabilities, it does provide suggestions about potential relationships between individual knowledge and characteristics of plaintiffs (for example descriptions about the industry types of businesses involved in the ADA disputes) (Conyers, Boomer, & McMahon, 2005; Lewis, McMahon, West, Armstrong, & Belongia, 2005; McMahon, Shaw, West & Waid-Ebbs, 2005; Moss, Swanson, Ullman & Burris, 2002; Neath, Roessler, McMahon & Rumrill, 2007; Snyder, Carmichael, Blackwell, Cleveland, & Thornton III, 2010; Tartaglia, McMahon, West, & Belongia, 2005; Unger, Campbell, & McMahon, 2005; Unger, Rumrill & Hennessey, 2005; Van Wieren, Armstrong, & McMahon , 2012).

Employer Size & Knowledge: The number of disputes filed is jointly influenced by employer size and individual knowledge of the formal complaint process. There is evidence to suggest that the size of the business and the knowledge of its employees are interrelated factors that impact the frequency of disputes (McMahon, Rumrill, Roessler, Hurley, West, Chan, & Carlson, 2008; Tartaglia, McMahon, West, & Belongia, 2005; Van Wieren, Armstrong, & McMahon, 2012).

Employer Perspectives

The second thematic category of evidence relates to employer perspectives. Evidence exists that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities from an employer's perspective across four synthesized subthemes of findings. The first two subthemes (hiring/advancement and accommodation) relate to employers' perspectives about employing people with disabilities. The second two subthemes (knowledge about the ADA and employer concerns) relate to employers' responsibilities under the ADA. Table 4 provides a visual relationship of the themes, subthemes, and synthesis arguments pertaining to the ADA and employer perspectives about the employment of people with disabilities.

Hiring & Advancement

This subtheme manifested in regards to perceptions of disability in hiring or advancement decisions. In this area, the synthesized findings of the research evidence show that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities in relation to:

Perception of support needs: Hiring and advancement decisions are impacted by anticipated need for accommodation and on the job supports. The evidence demonstrates that employers take into account the potential complexity of an accommodation when making hiring decisions (Dowler & Walls; 1996, Hazer, & Bedell, 2000).

Role of Disability: Employers report concerns about the abilities of people with disabilities while concurrently reporting that disability does not factor into hiring and advancement decisions. The evidence indicating that disability does not factor into employment decisions is explained as a potential indication of public perception bias, meaning that individuals may report what they anticipate should be the appropriate answer as respondents are unlikely to report non-compliance (Bruyère, 1999; Houtenville & Kalargyrou 2012; Kaye, Jans & Jones, 2011; McMahon, Shaw, West & Waid-Ebbs, 2005).

Reasonable Accommodations

The subtheme is in regards to the provision of reasonable accommodations. In this area, the synthesized findings of the research evidence show that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities in relation to one finding:

Prior Experience with Disability: Willingness to provide accommodation is influenced by previous experience with disability. The evidence shows that the more exposure that employers have/have had in the past to working with people with disabilities, the greater the willingness is to provide reasonable accommodations (Hernandez et al. 2004; MacDonald-Wilson, Rogers, & Massaro, 2003; Popovich, Scherbaum, Sherbaum, & Polinko, 2003).

The findings related hiring and advancement and reasonable accommodations together provide evidence about how the ADA has not been able to positively influence knowledge, attitudes and perceptions about the employment of people with disabilities. This evidence exemplifies how extralegal factors continue to impact decisions regarding implementation and compliance for some businesses.

Knowledge About the ADA

Employer knowledge of the ADA was also found to be a subtheme. In this area, the synthesized findings of the research evidence show that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities in relation to: The Role of Technical Assistance: Lack of knowledge about the availability of technical assistance affects responsiveness to and compliance of reasonable accommodations. The evidence demonstrates how companies that have difficulties in providing accommodations often have limited knowledge of outside resources for assistance (Bruyère 1999; Slack, 1996; Unger & Kregel, 2003; Wooten & Hayes, 2005).

Employer Size: The size of the employer impacts knowledge of and compliance with the ADA. There is no consensus in the research as to the direct relationship between company size and knowledge. Rather, the evidence shows that there is a relationship between business size and the way knowledge/compliance is achieved (Waters & Johanson, 2001; Conyers, Boomer, & McMahon, 2005; Lewis, McMahon, West, Armstrong, & Belongia, 2005; McMahon, Rumrill, Roessler, Hurley, West, Chan, & Carlson, 2008; McMahon, Rumrill, Roessler, Hurley, West, Chan, & Carlson, 2008; Popovich, Scherbaum, Sherbaum, & Polinko, 2003).

Perception of Disability: Knowledge of the ADA does not translate into changing attitudes about hiring people with disabilities. The evidence shows that there is no direct relationship between knowledge of the ADA and hiring decisions, nor is there any evidence that the way an employer gains knowledge about the ADA changes attitudes towards people with disabilities. There is only a minimal amount of evidence showing that there are overtly negative perceptions about people with disabilities in relation to the ADA (Hazer, & Bedell, 2000; McMahon, Rumrill Roessler, Hurley, West, Chan, & Carlson, 2008; Robert & Harlan, 2006 ; Scheid 1998; Slack, 1996; Thakker & Solomon, 1999).

Employer Concerns

The final subtheme is regarding employer concerns of applying the ADA in the workplace. In this area, the synthesized findings of the research evidence show that the ADA has influenced knowledge, attitudes, and perceptions about the employment of people with disabilities in relation to:

Indirect Costs: Employers are concerned about decisions to hire and/or provide accommodations in relation to anticipated disruptions to workplace culture. The evidence shows that people in charge of hiring and accommodating workers weigh decisions about compliance against the potential for disrupting existing workplace practices (Florey & Harrison, 2000; Roessler & Sumner, 1997).

Perceived Direct Costs: Employers are concerned about disability and/or people with disabilities in relation to the perceived costs of job restructuring and modification, accommodations, and workers compensation claims. This body of research is used to explain employers' hesitancy in employing people with disabilities (Florey & Harrison, 2000; Roessler & Sumner, 1997; Gilbride, Stensrud & Connolly, 1992; Hernandez, Keys, & Balcazar, 2000; Houtenville & Kalargyrou, 2012; Kaye, Jans & Jones, 2011; Roessler & Sumner, 1997; Soffer & Rimmerman, 2012).

Fear of Litigation: Employers are concerned about hiring people with disabilities due to the fear of potential litigation and the perceived cost of that litigation. In early ADA research, there were anecdotal claims about how employers' fear of litigation impacted the labor market participation of people with disabilities. (Kaye, Jans & Jones, 2011; Moore, Moore, & Moore 2007; Satcher & Hendren, 1992; Schartz, Hendricks, & Blanck, 2006).

The above findings jointly demonstrate that employers' initial fears of the ADA relate to concerns about job restructuring, modifying workplace culture and processes, and accommodations. Moreover, that this has changed very little in the past 25 years.


The consolidated body of research evidence on ADA supports three key claims. These claims reflect how the findings configuratively relate to each other and to the broader research question. Configurative analysis in systematic reviews is used to translate the meaning of findings between and across studies (Gough, Oliver, & Thomas, 2012). From this process, there is substantial evidence to suggest that the ADA has influenced knowledge, attitudes, and perceptions in the area of employment with regards to: (1) knowledge of the law; (2) perception of employability; and (3) workplace culture.

Knowledge About the Law

The ADA research evidence demonstrates that employers maintain baseline knowledge of compliance while leveraging this knowledge to avoid the spirit of the law. Concurrently, people with disabilities experience barriers to knowledge that affect development of their rights and processes under the ADA. For example, employers have widespread concern about people with disabilities' skill levels while also reporting that disability does not factor into their hiring and advancement decisions. For people with disabilities, increased knowledge of the ADA facilitates their ability to advocate for themselves with enhanced legal protections. Together, this evidence suggests the need for a different type of knowledge translation that better fits the spirit of the ADA.

Perception of Employability

The ADA research evidence confirms that stigmatized perceptions of disability impact a variety of employment decisions, including hiring, advancement, and providing reasonable accommodation. For example, perceived origin of disability or type of disability has been used in determining the 'reasonableness' or perceived 'fairness' of accommodations. Correspondingly, people with disabilities who perceive stigma are less likely to disclose for the purpose of requesting accommodations. Together, this evidence suggests that although the ADA has made acting upon overtly prejudicial attitudes illegal, more implicit forms of discrimination continue to influence perceptions of employability.

Workplace Culture

The ADA research evidence illustrates that fear of disrupting workplace culture prevents people with disabilities from exercising their rights and responsibilities under the ADA. For example, disclosure and requests for accommodation may affect workplace practices. Correspondingly, evidence exists that fear of disrupting workplace culture also impacts employer decisions about the perceived reasonableness of accommodations and making hiring decisions. Together, this evidence suggests that adherence to universal design and flexibility in employment practices — rather than meeting only the legal minimum of the law — can be conducive to both individual requests and employer responsiveness.

Limitations and Next Directions

The primary limitation involved the abridged search strategies used to identify research. A number of records (i.e. dissertations, theoretical articles and organizational reports) were excluded due to time and resource constraints associated with conducting a rapid review. The search process for rapid evidence reviews is intentionally abbreviated to establish a rigorous process that can be expanded upon for future systematic reviews. It is not meant to detail the exhaustive body of literature on the subject. Supplementary topic-specific searches will be conducted in later stages of this project to provide a more complete overview of available research, which will span a smaller group of studies.

The rapid evidence review discussed here adds an important new component to the field, as it identifies and consolidates a sample of existing ADA research on knowledge, attitudes and perceptions in the area of employment. However, after twenty-five years of research on the ADA in general, we do not yet fully understand the legislative and cultural impact of this law. To help direct future systematic reviews of ADA research in subsequent stages of this project, and to ensure the utility of the findings of these reviews, the research team will continue to collaborate with the ADA expert panel and other key national ADA stakeholders. This collaboration is an essential component of increasing knowledge translation of research, deepening our understanding of the impact of the ADA, and ultimately enhancing the protection of rights for people with disabilities.

There are a multitude of stakeholders and resources that are necessary to consult when considering the ADA's impact in regards to both the Spirit and the Letter of the law. It is also necessary to look beyond the existing research to understand the full impact of the law. Conducting a review of this type leaves a number of questions unanswered- as systematic reviews are less useful to identify the evidence that still needs to be collected. Many people with disabilities have experienced improved access to various domains of employment in way that have not been quantified and analyzed but are reflected in the improved transportation systems, public accommodations, and the overall visibility of many people with disabilities that was much smaller before the emergence of disability rights. Other anecdotal evidence in relation to the ADA's spirit goals in employment indicates that the ADA has made monumental stride in challenging damaging perceptions of disability (Yee & Golden, 2011). Simply because there has not fully documentation or evidence about changes in the social fabric of society does not necessary connote that the policy has failed to do so. Moving forward we can only hope the research grows to reflect the full progress of people with disabilities in pursing civil rights under the ADA.

This project is funded by a NIDRR Grant.


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Appendix A: Rapid Evidence Review Decision Tree

Rapid evidence review decision tree. See text description.

[Click figure to enlarge]

Text description

Year 1: 980 records included in initial scoping review (Total n = 980). The Steps for the rapid evidence review include (in order):

  1. Abridged inclusion/exclusion applied and duplicate reports are linked. Excluded records: Do not specify the ADA, an ADA case decision, or ADA guidelines or regulations in relation to the purpose of study; do not have a clear method for inquiry. 461 records included after abridged inclusion/exclusion.
  2. Rapid evidence screening begins and policy (categorical) codes applied. Potentially relevant studies are identified. Excluded records do not pertain to employment. 203 records included after rapid evidence screening pertinent to employment. 258 records excluded after rapid evidence screening not pertinent to employment.
  3. 10 Additional records are identified by hand picking articles from expert suggestions. 213 total records are included in appraisal screening including both the scoping review and handpicked records pertinent to employment.
  4. Appraisal screening applied. Excluded records: Do not meet the minimum level of reporting for this study; are unpublished dissertations; or present theoretical/policy analysis without a quantitative or qualitative analytical technique. 118 records are included after the appraisal screening that meet all appraisal criteria. 95 records excluded after appraisal screening do not meet appraisal criteria. Of the 95 records, 85 are saved for systematic review including 59 dissertations, 23 theoretical/policy records, and 3 records where we were unable to obtain full text. 10 records do not meet inclusion criteria.
  5. Data extraction occurs and employment records are thematically coded. Excluded records: do not contain data relative to knowledge, attitudes, and perception about disability and employment. 60 records included after extraction contain data about knowledge, attitude, and perception. 58 records excluded after extraction do not contain data about knowledge, attitude, or perception. 60 total records included in rapid evidence analysis.

This article was originally published with an incorrect version of Ms. Enriquez' name. It was updated on 10/9/15.

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