Guide

Effective Communication

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Plain language + legal text

What Is Effective Communication?

Under the ADA, both government agencies and businesses must communicate effectively with people who have hearing, vision, or speech disabilities. This doesn't mean identical communication — it means the person must be able to understand and participate equally.

For example, a deaf patient at a hospital must be able to understand their diagnosis and treatment plan just as well as a hearing patient. A blind person at a government office must be able to access the same forms and documents as a sighted person.

Official Standard

28 CFR §35.160(a)(1) — Title II

"A public entity shall take appropriate steps to ensure that communications with applicants, participants, members of the public, and companions with disabilities are as effective as communications with others."

28 CFR §36.303(c) — Title III

"A public accommodation shall furnish appropriate auxiliary aids and services where necessary to ensure effective communication with individuals with disabilities."

Auxiliary Aids and Services

Auxiliary aids and services are the tools and methods used to make communication effective. The right aid depends on the person's disability and the situation. Common examples include:

Hearing disabilities

Sign language interpreters, real-time captioning (CART), assistive listening devices, written notes, video relay

Vision disabilities

Braille materials, large print, screen readers, audio recordings, qualified readers, accessible PDFs

Speech disabilities

Writing materials, communication boards, text-based communication, speech-to-text software

Official Standard

28 CFR §35.104 — Definitions

"Auxiliary aids and services" includes:

(1) Qualified interpreters on-site or through video remote interpreting (VRI) services; notetakers; real-time computer-aided transcription services; written materials; exchange of written notes; telephone handset amplifiers; assistive listening devices; telephones compatible with hearing aids; closed caption decoders; open and closed captioning, including real-time captioning; voice, text, and video-based telecommunications products and systems…

(2) Qualified readers; taped texts; audio recordings; Braille materials and displays; screen reader software; magnification software; optical readers; secondary auditory programs (SAP); large print materials; accessible electronic and information technology; or other effective methods of making visually delivered materials available to individuals who are blind or have low vision.

Primary Consideration

The ADA requires that the person with a disability gets primary consideration in choosing which auxiliary aid or service to use. In practice, this means:

The business or agency must consult with the person about what they need
The person's preference should be honored unless the entity can show that another equally effective method exists, or that providing the requested aid would be an undue burden
You cannot force a person to use a family member or friend as an interpreter — they have the right to a qualified interpreter

Official Standard

28 CFR §35.160(b)(2)

"The type of auxiliary aid or service necessary to ensure effective communication will vary… A public entity shall give primary consideration to the requests of individuals with disabilities. In order to be effective, auxiliary aids and services must be provided in accessible formats, in a timely manner, and in such a way as to protect the privacy and independence of the individual with a disability."

Communication with Companions

The ADA doesn't only protect the person directly receiving services — it also covers companions. A companion is someone with a disability who accompanies another person to a business or government agency.

For example, if a deaf parent accompanies their child to a doctor's appointment, the doctor's office must provide effective communication for the parent — not just the patient. Similarly, if a blind spouse accompanies someone to a bank, the bank must communicate effectively with the spouse about relevant account matters.

Official Standard

28 CFR §35.160(a)(2)

"A public entity shall ensure that interested persons, including persons with impaired vision or hearing, can obtain information as to the existence and location of accessible services, activities, and facilities."

When Is an Interpreter Required?

Not every interaction requires a sign language interpreter. The appropriate aid depends on the complexity, length, and importance of the communication:

Simple transaction (ordering food, buying a ticket)

Written notes, pointing, gestures — usually sufficient

Medical appointment, legal proceeding, financial consultation

Qualified interpreter likely required — complex information, serious consequences

Emergency room or urgent care

Interpreter required as soon as possible; written notes as interim measure

Lecture, class, or group meeting

Interpreter, real-time captioning (CART), or assistive listening device

Video Remote Interpreting (VRI)

Video Remote Interpreting (VRI) uses video conferencing to connect a sign language interpreter remotely. It can be a practical alternative when an on-site interpreter is not immediately available.

However, VRI has strict quality requirements — it's not enough to just set up a video call. The connection must be reliable, the image must be clear and large enough to see the interpreter's hands and face, and staff must be trained to use it properly.

VRI is not always appropriate. For long or complex communications (like a surgery consultation), or when the person requests an on-site interpreter, VRI may not meet the effective communication standard.

Official Standard

28 CFR §35.160(d) — VRI Performance Standards

When VRI is used, it must provide:

(1) Real-time, full-motion video and audio over a dedicated high-speed, wide-bandwidth video connection;

(2) A sharply delineated image large enough to display the interpreter's face, arms, hands, and fingers, and the participating individual's face, arms, hands, and fingers;

(3) A clear, audible transmission of voices; and

(4) Adequate staff training to ensure quick set-up and proper operation.

Undue Burden and Fundamental Alteration

A business or government agency does not have to provide a specific aid if it would result in an undue burden (significant difficulty or expense) or a fundamental alteration of the service or program.

However, this is a high bar. The entity must still provide an alternative auxiliary aid that ensures effective communication to the maximum extent possible. They cannot simply do nothing.

28 CFR §35.164

"When a public entity determines that an action would result in a fundamental alteration in the nature of a service, program, or activity or in undue financial and administrative burdens, the head of the public entity or his or her designee shall… take any other action that would not result in such an alteration or such burdens but would nevertheless ensure that, to the maximum extent possible, individuals with disabilities receive the benefits or services provided by the public entity."

Telecommunications Relay Services

Title IV of the ADA requires telephone companies to provide telecommunications relay services (TRS) so that people who are deaf, hard of hearing, or have speech disabilities can communicate by phone.

Relay services include:

TTY relay: An operator relays typed messages to the hearing person and types back their response.
Video Relay Service (VRS): A sign language interpreter relays between ASL and spoken English via video.
IP Relay: Similar to TTY relay, but uses the internet instead of a TTY device.

All relay services are free to the user and available 24 hours a day, 7 days a week, by dialing 711.

Important Note

This guide provides general information about ADA effective communication requirements. The right auxiliary aid depends on the specific situation. For guidance about your situation, connect with an experienced ADA attorney.

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What Counts As An Interpreter Requirement

The ADA generally requires a qualified sign language interpreter when a written note or gesture won't let a deaf person follow something complex, like a medical diagnosis, a legal proceeding, or a long meeting. For a quick, simple exchange, like asking a question at a counter, writing back and forth may be enough. It depends on the length, complexity, and importance of the communication. See 28 CFR §36.303(c) on the Standards Guide.

Primary Consideration Means The Person Chooses

Under the ADA, the person with a disability generally gets primary consideration when an auxiliary aid or service is chosen. A business or agency can offer an alternative, but it should give the requested aid or service primary weight unless it can show another option works just as well, or that the request would cause an undue burden or a fundamental change to what it offers. This isn't automatic agreement to every request, but the person's choice generally carries the most weight.

Companions Have Rights Too

Effective communication requirements generally extend to companions, not just the person receiving a service. A hearing parent of a deaf child, or a sighted spouse accompanying a blind patient, may still need an aid or service to participate in a conversation about care or decisions. Title II and Title III both name companions with disabilities specifically. See 28 CFR §35.160(a)(1).

When A Business Can Use A Different Aid

A business or agency doesn't have to provide the exact aid requested in every case. It generally can choose an effective alternative, especially where the requested aid would be an undue burden or isn't readily available on short notice. What matters is whether the alternative still lets the person understand and take part on equal footing, not just whether some aid was offered.

Who This Applies To

These rules generally apply to government agencies under Title II and to businesses open to the public under Title III, including hospitals, clinics, stores, hotels, and government offices. It depends on the type of entity and the situation, so check the specific section that applies to you.

If you're a small business owner trying to understand your obligations in plain terms, the small business primer walks through this without the legal language.

If you hit a communication barrier yourself and want to understand what happened, read the rest of the Standards Guide.