and critiqued. Second, the evidence on the environment-disability link among adults with mobility limitations is examined. Third, challenges to this area of research are discussed. A thorough review covering all areas of disability is beyond the scope of this paper. Instead, the focus is on the environment-disability link in adults with mobility limitations. Other important areas of the environment-disability link among children and individuals with hearing, visual, or learning impairments are not discussed here.
Researchers face several formidable challenges when they pursue environmental assessments. The first challenge is conceptual. To study the complex interplay between environmental factors and disability, researchers need to know how to identify and measure the environmental factors that are relevant to individuals. Fougeyrollas (1995) suggests that the organization and context of society contain social, cultural, and physical dimensions. Factors in these dimensions can become obstacles or supports to individual functioning. The taxonomy of environmental factors of Fougeyrollas and colleagues (1991) includes socioeconomic organization (e.g., family structure, political systems, and economic systems), social roles (e.g., law, values, and attitudes), nature (e.g., geography, climate, and time), and development (e.g., architecture, land development, and technology).
The International Classification of Functioning, Disability and Health (ICF), on the other hand, specifies five environmental domains: products and technology; natural environment and human-made changes; support and relationships; attitudes; and services, systems, and policies (WHO, 2000). The Craig Hospital Inventory of Environmental Factors (CHIEF) assesses five domains that are similar to those used in the ICF taxonomy: (1) attitudes and support, (2) services and assistance, (3) physical and architectural, (4) policies, and (5) work and school (Whiteneck et al., 2004c). Shumway-Cook and colleagues (2002, 2003), in contrast, focus on the physical domain of the environment and identify eight dimensions: (1) temporal, (2) physical load, (3) terrain, (4) postural transitions, (5) distance, (6) density, (7) attentional demands, and (8) ambient conditions. To date there is no consensus on which environmental domains or which elements of the domains should be measured to study the importance of the environment in the lives of people with disabilities.
The second challenge is one of measurement, with three general approaches currently being used. The first approach assesses an individual’s perceptions of the degree to which environmental factors influence his or her participation in daily life. Four instruments assess the environment in this manner: (1) CHIEF (Whiteneck et al., 2004c); (2) the Measure of the Quality of the Environment (Fougeyrollas et al., 1997); (3) the Facilitators