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How do disability and access laws vary across middle-income countries? Recent decades have seen a significant expansion of disability and access laws and practices in the developed world, including improved architecture, accommodations for limitations to vision and hearing, and other measures to permit fuller participation by persons with disabilities. Yet scholars have not studied the extent to which similar measures have been adopted in developing and middle-income countries. This project examines one middle-income region -- Latin America -- in order to understand (a) the particular measures that have been proposed and adopted across the 18 major countries and (b) the political factors that have played a role in the passage or defeat of these measures. It finds policy adoption has largely come at the initiative of reformist executives, responding to international agenda-setting efforts by intergovernmental organizations and issue-focused non-governmental organizations.