Developmental, Cognitive, and Intellectual Disabilities

The Developmental, Cognitive, and Intellectual Disabilities Toolkit guides library professionals in supporting patrons with a wide range of abilities by promoting inclusive, respectful services and programs that are both cognitively and age appropriate, while recognizing the diverse experiences and strengths of individuals with developmental disabilities.

Toolkit Table of Contents

Definitions 

  • Developmental disabilities is a “broad category of often lifelong disability that can be intellectual, physical, or both. Intellectual developmental disabilities (IDD) is the term often used to describe situations in which intellectual disability and other disabilities are present. Examples of developmental disabilities include autism, behavior disorders, brain injury, cerebral palsy, Down syndrome, fetal alcohol syndrome, intellectual disability, and spina bifida.”1

  • A cognitive disability refers to a condition that affects a person’s ability to think, learn, remember, or make decisions. These disabilities can impact intellectual functioning, problem-solving, attention, language, and comprehension. Cognitive disabilities may be present from birth, develop over time, or result from injury or illness.2

  • An intellectual disability is a type of developmental disability characterized by significant limitations in both intellectual functioning (such as reasoning, learning, and problem-solving) and adaptive behavior (which includes everyday social and practical skills). These limitations originate before the age of 18.3

Quick Tips 

1. Respect and Communication

  • Do not underestimate people with developmental disabilities.
  • Talk directly to the patron, rather than to any caregiver who may be with them.
  • Ask people what they want to do and read in the library.
  • Listen attentively and don’t interrupt—be patient.
  • Provide positive reinforcement to employees, and answer questions quickly.

2. Clear and Supportive Instruction

  • Give concrete directions in plain English.
  • Do not combine excessive instructions into a wordy command—break instructions into steps and relay them individually.
  • Demonstrate as well as tell.
  • Provide opportunities to try things rather than simply explaining a task.

3. Inclusive Environment and Accessibility

  • Maintain a barrier-free facility with easily manipulated door handles, restroom fixtures, and water fountains.
  • Use universal or easily recognizable graphic representations on signage.
  • Provide sensory supports such as quiet or private spaces, noise-canceling headphones, or fidgets to support self-regulation.

4. Resources and Materials

  • Have a variety of tools available.
  • Provide appropriate materials immediately. For example, a painting program should offer different types of brushes, and coloring sheets should include a mix of complexity levels.

5. Community Engagement and Support

  • Involve patrons in clubs or group activities that are age- and interest-appropriate.
  • Know about your state’s developmental disabilities services and make this information available to patrons.

Overview 

Developmental disabilities (DD) begin before the age of 22 and continue through adulthood. Some of the disabilities have physical manifestations, some have cognitive or intellectual manifestations, and some have both. For example, people with cerebral palsy, spina bifida, and hydrocephalus are all considered to have a developmental disability, but they may or may not have a cognitive disability. In general, people with an intellectual disability, such as Down syndrome, fragile X syndrome, or Fetal Alcohol Syndrome, learn more slowly than their peers. This can affect communication, reasoning, and social skills. People with intellectual and cognitive disabilities may require more time to perform tasks and process information.  They may read at a beginning level  or not read at all.   

Autism Spectrum Disorder is also considered a developmental disability and is covered in a separate toolkit, so you may want to refer to specific information for patrons that may have difficulty with communication and socialization. Many people with developmental disabilities do not have any distinguishable physical characteristics. People with intellectual and cognitive disabilities may live independently, with family or in supported housing.  They may attend mainstream colleges, work, or attend day habilitation programs.  It is important to keep in mind that most people with developmental disabilities can vote, testify in court, marry, and have children.   

Patrons with developmental disabilities have many of the same recreational and information needs as do all patrons. When designing programs and services for these patrons, the most important thing is involving them in the process.  Make sure that things are both cognitively and age appropriate.  Consider books in a wide variety of formats.

Action Items

1. Communication and Respect

  • Speak directly to patrons with developmental disabilities, not just to caregivers.
  • Use plain language and avoid jargon or overly complex instructions.
  • Break down tasks into manageable steps and provide instructions one at a time.
  • Demonstrate tasks visually in addition to verbal explanations.
  • Be patient, listen actively, and allow extra time for processing and response.
  • Avoid assumptions—ask patrons about their interests and preferences.

2. Inclusive Programming and Services

  • Involve patrons with developmental disabilities in planning programs to ensure relevance and accessibility.
  • Offer programs that are both cognitively and age-appropriate.
  • Include multisensory activities and hands-on learning opportunities.
  • Provide sensory-friendly programming options (e.g., quiet storytimes, low-stimulation environments).
  • Incorporate hi-lo books, audiobooks, and book/audio sets into programming.

3. Accessible Facilities and Environments

  • Ensure the library is physically accessible: barrier-free entrances, accessible restrooms, and easy-to-use fixtures.
  • Use clear, universally recognizable signage with graphic symbols.
  • Provide sensory supports such as quiet rooms, noise-canceling headphones, and fidgets.
  • Maintain a welcoming, inclusive atmosphere for all patrons.

4. Assistive Technology and Materials

  • Offer assistive technologies such as:
    • Screen readers
    • Speech-to-text and text-to-speech software
    • Touch screens and alternative input devices (e.g., Intellikeys, Jelly Bean switches)
    • Augmentative and alternative communication (AAC) tools
  • Provide materials in multiple formats: large print, plain language, graphic novels, and accessible digital content.
  • Ensure digital collections are compatible with screen readers and other assistive tools.

5. Staff Training and Support

  • Train staff on disability awareness, inclusive communication, and assistive technology.
  • Encourage staff to use positive reinforcement and to respond to questions with patience and clarity.
  • Promote a culture of respect, inclusion, and continuous learning.

6. Community Engagement and Partnerships

  • Curate and share information about local and state developmental disability services.
  • Partner with organizations like The Arc, local DD councils, or self-advocacy groups.
  • Host or support inclusive book clubs (e.g., Next Chapter Book Club) and social groups.
  • Provide space for community service providers to meet with patrons or offer workshops.

Data 

In 2019, there were 7.39 million people with DD in the United States.  People with DD are as diverse as their communities and in every state, commonwealth and territory of the US.

  • Only 22% or 1.58 million are known to their respective developmental disability agencies.
  • 19% or 1.4 million receive long-term DD services.2

Resources for Librarians 

Resources for Patrons

  • Materials:
    • Hi-lo books, including new adult reader material and books for adult language learners.
    • Books written for children are generally not appropriate for teens and adults.
    • Book and audio sets.
    • Audio books.
    • Rember, books written for children are generally not appropriate for teens and adults.
  • Assistive Technology
    • Software programs, such as vocabulary- and communication-building skills, for example, those designed by Laureate Learning and by the Attainment Company.
    • Touch screens that enable the user to respond by simply touching the screen.
    • Screen readers.
    • A variety of input devices such as Intellikeys, an alternative keyboard that is easy to see, touch, and understand, or the Jelly Bean switch, a large, durable, single switch that activates regardless of where the user presses and provides audible feedback or touch screens that enable the user to respond by simply touching the screen.
    • Voice input and output devices.
    • Augmentative and alternative communication (AAC).
  • Web resources:

References 

  1. Institute on Community Integration.  2023.  “What Are Intellectual and Developmental Disabilities?”  https://ici.umn.edu/welcome/definition.
  2. WebAIM. (n.d.). Cognitive disabilities. Center for Persons with Disabilities, Utah State University. https://webaim.org/articles/cognitive/
  3. American Psychiatric Association. (n.d.). What is intellectual disability? https://www.psychiatry.org/patients-families/intellectual-disability/what-is-intellectual-disability
  4. Residential Information Systems Project 2023.. People with ID in the United States.  Minneapolis: University of Minnesota, RISP, Research and Training Center on Community Living, Institute on Community Integration. Retrieved from: https://risp.umn.edu. 

Toolkit updated by Lauren Kehoe from the Accessibility Assembly, June 2025.