FARGO, N.D. - People with Down syndrome are having a bigger impact on society, and their advocates in the Dakota region say it's time for the public to take notice.

October is Down Syndrome Awareness Month. It's widely known that people born with this condition have an extra chromosome that affects their development, but some say there's more to it.

The New Directions Down Syndrome Association connects parents in a four-state region, including parts of North Dakota. Brandon Tilus, president of its board of directors, said he feels public perception is being outdated by the lives many with Down syndrome are carving out for themselves.

"People with Down syndrome born today have a really good chance of living a life where they're independent, that they get married, that they do all of these things that we expect all individuals to do," he said.

He credited early-intervention programs and advancements in therapy for establishing better outcomes. However, he said strong government funding still is needed to ensure more families have access to these services. According to the Centers for Disease Control and Prevention, Down syndrome occurs in about one in every 700 births.

Tilus said another way to overcome any stigma is for people to make others with Down syndrome feel more at ease in their interactions. He also advises that some ways of communicating should be avoided.

"'I use my hands more to talk to them, because I'm not sure they're going to understand me.' And, those types of things - sort of, coming into an interaction with those individuals with those preconceived notions - I think can make it a little bit more difficult," he said.

Tilus, whose 6-year-old daughter was born with the condition, said the best thing to do is treat a person with Down syndrome like anybody else. All they may need is a little extra time to respond, and be given the opportunity to take the lead in a conversation, to feel comfortable.

WATERLOO, Iowa -- Advocates for Iowans with disabilities are sounding the alarm over what they describe as a caregiver crisis, pleading with lawmakers to give the issue more priority, so these individuals are not pushed from their homes because of the scarcity of providers.

Tucker Cassidy, a person with quadriplegia from Waterloo, said the workforce shortage has been building for years, but in the past month and a half, it has become much worse.

He noted it is difficult for the agency he works with to send over enough caregivers to help with his daily routine. Stuck in bed more than he is used to, Cassidy admitted the shortage leaves him worried about his future.

"Is this going to be the week that they kick me off?" Cassidy questioned. "And then, where am I supposed to go? You know, I own my own house."

Advocates say the crisis is largely driven by low wages for caregivers. According to Indeed, the average starting pay for in-home caregivers in Iowa is around $13 an hour.

Lutheran Services in Iowa estimates it has been forced to reduce its client base by 350 in recent years. The shortage comes as Iowa touts a budget surplus of $1.24 billion.

Matt Grillot of DeWitt has used a wheelchair most of his life due to a spinal injury. He has been in his own house for the past 18 years, but he has struggled to hire a caregiver in recent months, forcing him to consider alternatives he would rather avoid.

"I have broken down within the last month and started looking at nursing homes and group homes," Grillot acknowledged.

But he said he faces barriers in moving to those places, adding to his stress in planning his care.

Cody Lewton, director of services for people with disabilities at Lutheran Services in Iowa, said they are down roughly 250 caregivers, citing the struggle to pay them enough money.

"It's less than a living wage, and it's only become worse," Lewton observed. "The funding has, over the last 20 years really, has not kept up with the cost of living."

The Iowa Developmental Disabilities Council said it is also concerned about the crisis, adding it will be the group's number one legislative priority next session.

SPRINGFIELD, Ill. -- As businesses across Illinois and the nation work to fill open positions, advocates for people with disabilities say they should take a more inclusive approach.

According to federal data, the jobless rate for people with disabilities is 11.5%, compared with slightly more than 5% for the rest of the population.

Kim Mercer-Schleider, director of the Illinois Developmental Disabilities Council, said with workforce shortages across many industries, there is no reason for people with disabilities to be underemployed.

"I would ask for employers to be open to taking a look at, what positions do you need to have filled?" Mercer-Schleider suggested. "How can they be broken up or looked at differently, that capitalizes on somebody's skill set?"

She noted it is important to acknowledge some people might need accommodations in some areas, but can really thrive in others. October is National Disability Employment Awareness Month, and she pointed out it is the perfect time to reflect on how to make hiring practices more inclusive.

Mercer-Schleider added it is also important to make sure the hiring process itself is accessible. She observed some online applications are not compatible with screen readers, for instance.

"Are your materials accessible? Can they be accessed with assistive technology, etc.? Are you opening up the door wide enough?" Mercer-Schleider outlined.

She emphasized the pandemic also has shown more flexible work is possible, for instance, working from home is a viable option for people who may have mobility issues or lack transportation. She hopes employers will embrace it as an option for accessibility beyond the COVID crisis.

NEW YORK -- Disability advocates and other groups are suing the federal government over the Social Security Administration's practices during the pandemic, including shuttering its local offices.

The challenge was filed on behalf of five New Yorkers who utilize Supplemental Security Income (SSI), which helps low-income older adults and people with disabilities.

In March 2020, Social Security, which administers SSI, closed all of its offices, making it difficult for recipients to report any financial changes. Six months later, the agency started to send notices to thousands of people telling them their benefits were going to be reduced due to overpayment, without giving them a meaningful chance to contest it.

Kate Lang, senior staff attorney for Justice in Aging, which represents the plaintiffs, said the office closure left many vulnerable people in the dark.

"People have difficulty communicating with Social Security and saying, 'This is a mistake. I'm still eligible for these benefits. I shouldn't be cut off,'" Lang explained. "We think that Social Security needs to recognize that the pandemic continues."

The federal government has 60 days from filing to respond to the lawsuit. Other organizations involved in the case include New York Legal Assistance Group and Arnold & Porter.

The suit also raised concerns over Social Security's streamlined waiver process, implemented in August 2020, which was meant to forgive financial penalties for overpayment during the first few months of the pandemic.

Danielle Tarantolo, director of the special litigation unit at New York Legal Assistance Group, said the waiver failed to address the pandemic-related SSI issues.

"Our clients tried repeatedly to take advantage of this streamlined process and get a quick waiver so that they could maintain their full benefits and over and over again, they were unsuccessful," Tarantolo recounted.

Representatives for the New York SSI recipients said they hope the lawsuit leads to Social Security revamping the waiver process to make sure that everyone who deserves one can get it. Social Security offices around the country remain closed to the public, except for emergency situations.