Title IV of the ADA amended the landmark Communications Act of 1934 primarily by adding section 47 U.S.C. § 225. This section requires that all telecommunications companies in the U.S. take steps to ensure functionally equivalent services for consumers with disabilities, notably those who are deaf or hard of hearing and those with speech impairments. When Title IV took effect in the early 1990s, it led to the installation of public teletypewriter (TTY) machines and other TDD (telecommunications devices for the deaf). Title IV also led to the creation, in all 50 states and the District of Columbia, of what was then called dual-party relay services and now are known as Telecommunications Relay Services (TRS), such as STS relay. Today, many TRS-mediated calls are made over the Internet by consumers who use broadband connections. Some are Video Relay Service (VRS) calls, while others are text calls. In either variation, communication assistants translate between the signed or typed words of a consumer and the spoken words of others. In 2006, according to the Federal Communications Commission (FCC), VRS calls averaged two million minutes a month.
Certain specific conditions that are widely considered anti-social, or tend to result in illegal activity, such as kleptomania, pedophilia, exhibitionism, voyeurism, etc. are excluded under the definition of "disability" in order to prevent abuse of the statute's purpose.[8][9] Additionally, gender identity or orientation is no longer considered a disorder and is also excluded under the definition of "disability".[9][10]
On September 25, 2008, President George W. Bush signed the ADA Amendments Act of 2008 (ADAAA) into law. The amendment broadened the definition of "disability", thereby extending the ADA's protections to a greater number of people.[43] The ADAAA also added to the ADA examples of "major life activities" including, but not limited to, "caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working" as well as the operation of several specified major bodily functions.[43] The act overturned a 1999 US Supreme Court case that held that an employee was not disabled if the impairment could be corrected by mitigating measures; it specifically provides that such impairment must be determined without considering such ameliorative measures. It also overturned the court restriction that an impairment which substantially limits one major life activity must also limit others to be considered a disability.[43] In 2008, the United States House Committee on Education and Labor stated that the amendment "makes it absolutely clear that the ADA is intended to provide broad coverage to protect anyone who faces discrimination on the basis of disability."[44] Thus the ADAAA led to broader coverage of impaired employees.
Technology is changing, and many website designers are using creative and innovative ways to present web-based materials. These changes may involve new and different access problems and solutions for people with disabilities. This Chapter discusses just a few of the most common ways in which websites can pose barriers to access for people with disabilities. By using the resources listed at the end of this Chapter, you can learn to identify and address other barriers.
While legal considerations might be your biggest worry, making your site more accessible is simply good customer service. More than 39 million Americans are blind and another 246 million have "low vision," Another one million are deaf in the U.S. Add to that people with mobility issues that prevent them from using their hands and that's a huge portion of the country's buying power.
As of 2015 the ADA had improved access to public services, the built environment (e.g., crosswalks with curb cuts and accessible pedestrian signals), understanding of the abilities of people with disabilities, established a right to equal access to public services and has demonstrated the contributions which people with disabilities can make to the economy. Disparities have remained in employment, earned income, Internet access, transportation, housing, and educational attainment and the disabled remain at a disadvantage with respect to health and health care.[45]
Most recently, however, pizza chain Domino's has been brought under suit for their website not being accessible for specialty ordering. The U.S. Supreme Court refused to review the case, instead upholding the decision of the 9th U.S. Circuit Court of Appeals who said the “alleged inaccessibility of Domino’s website and app impedes access to the goods and services of its physical pizza franchises—which are places of public accommodation.” 
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