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COVID-19 presented a public health emergency in the U.S., resulting in severe illness, hospitalizations, high mortality rates, and long-term adverse health care conditions. Several studies examined the disparities in transmission rates, barriers to care, and negative health outcomes for persons with disabilities, particularly people with intellectual and developmental disabilities (I/DD). While data revealed similar trends among Black, Hispanic or Latino/a/x/e, Native, Indigenous, and Asian people, outcomes are compounded for people of color with I/DD. Several historical, pervasive, systemic, structural, and attitudinal barriers have constrained healthcare access and adequate treatment, instigating feelings of distrust among those in systems of care. Although vaccination is effective in minimizing adverse outcomes, COVID-19 vaccine policies and rollouts have also followed inequitable patterns in distribution and accessibility. To better address the concerns and needs of communities, a multidisciplinary team at a University Center of Excellence in Developmental Disabilities (UCEDD) engaged in a generative, multistep, systematic process to explore factors that influence vaccine confidence among people with I/DD, their families, and support circles, particularly people of color with IDD. Garnering data and input from multiple sources, we uncovered several complexities around vaccination, which include (a) accessibility; (b) context, history, and sociocultural concerns; (c) policies; (d) communication and media; and (e) a continuum of vaccine confidence and supported decision-making. Findings from these efforts underscore the centrality of equity and trust, with implications for practitioners, institutions, policymakers, and public health strategists. Furthermore, our model can serve as a useful framework for people invested in promoting healthcare equity in vaccination for people with I/DD and with multiple marginalized identities.

The COVID-19 global pandemic has affected the disability network across the world. In the United States, there are millions of people who cannot use their natural speech to communicate. Augmentative and alternative communication (AAC), a form of assistive technology (AT), helps people with complex communication needs (CCNs) to communicate with others. Examples of AAC include printed pictures and speech-generating devices. A team of professionals work together with the person with CCNs and their caregivers to choose the right type of AAC. Often, people with CCNs need face-to-face and ongoing AAC support. Prior to the COVID-19 pandemic, this population already faced multiple challenges to receive on-going support and services due to multiple factors, including limited access to AAC specialists and travel constraints. As a result of the COVID-19 pandemic, many services for people with CCNs stopped to abide by stay-at-home orders and ensure the safety of the person with CCNs and their caregivers. This paper describes how one AT Program at a University Center for Excellence in Developmental Disabilities (UCEDD) adapted AAC services and increased access to support using (a) tele-AAC assessment practices, (b) services through a partnership with our state AT Act program, and (c) tele-coaching strategies to help providers and caregivers in their facilitation and implementation of AAC services. We also discuss key considerations in tele-AAC practices to help people with CCNs and their caregivers during COVID-19 and beyond.