Physical Disabilities: General Information
Source: Handycaps Welfare Association (HWA)
Introduction
A person with a physical disability is constrained by his physical ability to perform an activity independently such as walking, bathing, toiletting, etc.
A person can be physically disabled due to two reasons: Congenital/Hereditary – the person has physical disability since birth or the disability developed at a later stage due to genetic problems, problems with muscle cells or injury during birth.
Acquired – the person acquired the physical disability through road or industrial accidents, infections such as polio or diseases and disorders such as stroke or cancer.
Types of Physical Disabilities
There are two major categories under the Physical Disability Group, they are:
1.
Musculo Skeletal Disability
It is defined as the inability to carry out distinctive activities associated with movements of the body parts due to muscular or bony deformities, diseases or degeneration.
The disabilities grouped under musculo skeletal disability are:
- Loss or Deformity of Limbs
- Osteogensis Imperfecta
- Muscular Dystrophy
2.
Neuro Musculo Disability
It is defined as the inability to perform controlled movements of affected body parts due to diseases, degeneration or disorder of the nervous system.
The categories are:
- Cerebral Palsy
- Spina Bifida
- Poliomyelitis
- Stroke
- Head Injury
- Spinal Cord Injury
Details of Musculo Skeletal Disability
- Loss or Deformity of Limbs
This may be due to birth defect or may occur due to diseases or accidents. The person may require an artificial limb to compensate the functional loss of activities.
- Osteogensis Imperfecta
A defective development of the connective tissues at the growing age that leads to softening of bones and the affected person experiences deformed posture.
The person is usually small built with brittle bones. The cause of this condition is unknown but there is a strong hereditary link to it. Such persons are usually active though may require a wheelchair or crutches for mobility.
- Muscular Dystrophy
Progressive loss of muscle strength due to a group of hereditary disorders. Muscles around the neck, shoulders and hips are usually more affected than the other muscle groups.
Muscles of the respiratory system are also affected at a later stage. With time the affected person’s functional and mobility status deteriorates and may require a wheelchair for mobility.
Details of Neuro Musculo Disability
- Cerebral Palsy
A group of non-progressive disorders occurring in young children in which damage of the brain causes impairment of motor function. It is caused by birth injury, jaundice and infection.
A person with Cerebral Palsy usually has movement and co-ordination problems. The person may have other associated disabilities such as intellectual, behavioral, visual, speech etc.
He may need different adaptive equipment and external support for the day to day activities.
- Spina Bifida
It is due to development defect of the spinal canal, characterised by incomplete closure of the bony encasement of the spinal cord. It may cause paralysis of the lower part of the body depending on the level and extent of the lesion.
The person may loose bowel and bladder control and may have sensory loss at the affected side. This person may require a pair of crutches or wheelchair to move around.
- Poliomyelitis
It is an infectious virus disease affecting the lower motor-neuron system. It is caused by the poliovirus and can affect children and adults.
It causes weakness in the body and both legs. The person may require mobility aids and external limb supports for the day to day activities.
Recently it has been found that many victims of poliomyelitis experience a second decline of their physical and functional status when they reach around the age of forty.
- Stroke
It is caused by the interruption of blood supply of the central nervous system or due to hemorrhage inside the brain. The affected person experiences a sudden impairment of the sensory motor functioning of one side of his body.
This condition may also associate with other disorders like loss of vision, hearing, speech or intellectual functioning. The person may require a walking stick or wheelchair for mobility.
- Head Injury
The extend of this disability depends on the part of the brain involved and the severity of the injury. In most cases it leads to a condition called hemiplegia where the sensory and the motor functions of one side of the body are impaired.
It may also be associated with other disabling conditions like impairment of vision, hearing, speech or intellectual functioning.
Spinal Cord Injury – two types of disabilities:
- Paraplegia:
Total or partial impairment of the sensory and motor functions in the lower part of the body and lower limbs. In most cases the affected person looses bowel and bladder control and in some occasions experience poor postural control.
Depending on the level of injury the affected person may require a crutch, external limb supports or wheelchair
for mobility.
- Tetraplegia:
Total or partial impairment of the sensory and motor functions of the body including all four limbs. The person looses control over bowel and bladder functions, posture and even in few cases respiratory functioning.
The affected person may require different assistive devices to perform daily activities independently.
Treatment For Physical Disabilities
Improvement of the disabling condition depends on the cause, type, extend of the disease, disorder or injury. However, in most cases the physical improvement is seen only in the initial few years of disability.
There are few conditions that are progressive type and the treatment goal is to maintain their condition. Rehabilitation programmes are planned to help individuals to overcome initial unstable conditions and prevent deterioration of the medical condition.
The person should also be more conscious with his diet to avoid further deterioration of his medical condition and recurrent of diseases.
More importantly, people with disabilities will learn, through rehabilitation programme, to manage their disabilities confidently.
Some of the programmes include:
- Occupational Therapy is a specialised treatment programme that prepares the clients to live successfully in his/her own family and society.
Through the practice and training of purposeful and goal directed activities and exercises, this treatment programme tries to improve client’s functional abilities and independent living skills.
- Physiotherapy is a rehabilitative treatment programme, through the use of physical means such as exercises and electrotherapy that are planned and customised according to the individual client’s need.
Examples of the treatment are maintaining and improving the power of the target muscle group, preventing occurrence and progression of contractures and deformities.
- Speech Therapy is a specialised treatment and training programme that treats and trains clients to communicate effectively.
Medication/Vaccination may be prescribed by doctor to avoid further deterioration of the physical condition and structural deformities.
Vaccination against common virus is an effective way to prevent disabling diseases.
Life of a Disabled
Having a physical impairment is not the end of the world. Many people with disabilities live their lives just like any other able-bodied.
They enjoy sports, movies, shopping and do a lot of other activities as well. They work as hard as the able-bodied and earn a decent income to support themselves and their families. Some do get married and have children of their own.
However, they do need support from their families, friends, members of the public, the community to help them to integrate into the mainstream society by accepting who they are.
Giving them opportunities at work and treating them like any able-bodied are some of the ways that can help them to live life to the fullest.
Physical & Mobility Impairments: Information & News
Source: Disabled World
Mobility Impairment
Mobility impairment is defined as a category of disability that includes people with varying types of physical disabilities. This type of disability includes upper or lower limb loss or disability, manual dexterity and disability in co-ordination with different organs of the body.
Disability in mobility can either be a congenital or acquired with age problem. This problem could also be the consequence of disease.
People who have a broken skeletal structure also fall into this category of disability.
Main Document
Physical and Mobility Impairments
A physical impairment might be defined as a disabling condition or other health impairment that requires adaptation.
Persons with physical impairment disabilities often use assertive devices or
mobility aids such as crutches, canes, wheelchairs and artificial limbs to obtain mobility.
The physical disability the person experiences may be either congenital, or a result of injury, muscular dystrophy, cerebral palsy, amputation, multiple sclerosis, pulmonary disease, heart disease or other reasons.
Some persons may experience non-visible disabilities that may include respiratory disorders, epilepsy, or other conditions.
NANDA defines physical and mobility impairment as a limitation in independent, purposeful physical movement of the body or of one or more extremities.
According to them, the alteration in the person's mobility may be either temporary, or more permanent. Most of the diseases and rehabilitative states involved in physical and mobility impairments do involve a degree of immobility.
These are often associated with things such as leg fractures, strokes, morbid obesity, trauma, and Multiple Sclerosis, for example. NANDA states that longer life
expectancy among Americans will increase the incidence of disease and disability in America.
Shorter hospital stays are finding more people being transferred to rehabilitation facilities, or simply sent to their homes for physical therapy.
Mobility is related to changes in a person's body as they age as well. Loss in muscle strength and mass, less mobile and stiffer joints, as well as gait changes affect a person's balance and may significantly comprise their mobility.
Mobility is crucial to the maintenance of independent living among Seniors.
If a person's mobility is restricted, it may affect their activities of daily living.
Mobility Impairments Include:
Cerebral Palsy
The term, '
Cerebral Palsy,' is used to describe a group of chronic conditions which affect body movements and muscle coordination in persons affected with the disorder.
Cerebral Palsy causes damage to one or more particular areas of the person's brain, and usually occurs during fetal development or before, during, or shortly after birth; although the damage may be done during infancy.
Cerebral Palsy disorders are not caused by problems in the person's nerves or muscles. Faults in the development or damage to motor areas in the person's brain disrupt their brain's ability to control posture and movement.
Cerebral Palsy is not progressive, although secondary conditions like muscle spasticity may develop that can worsen or improve over time, or may remain the same.
Cerebral Palsy is not a communicable disease. Cerebral Palsy is not curable, but therapy and training may help to improve function.
Spina Bifida
Spina Bifida is a form of neural tube defect. Neural tube defects involve incomplete development of the brain, spinal cord, and/or their protective coverings, which are caused by the failure of the fetus' spine to close properly during the first month of pregnancy.
Children who are born with Spina Bifida may have an open lesion on their spine where notable damage to their nerves and spinal cord has happened. The nerve damage is permanent, although the opening in the spine can be surgically repaired.
The damage to the child's nerves may result in various degrees of paralysis in their lower limbs. In cases where there is no lesion present there is still the potential for the presence of improperly formed or missing vertebrae, as well as nerve damage.
Persons with Spina Bifida often experience a form of learning disability in conjunction with physical and mobility disability. There is currently no cure for Spina Bifida; the nerve tissue can neither be repaired nor replaced.
Treatment for Spina Bifida may involve surgery, physiotherapy, and medication. Many persons with Spina Bifida use assistive devices including braces, crutches, or wheelchairs.
Muscular Dystrophy
'
Muscular Dystrophy,' describes a group of genetic diseases which are characterized by progressive weakness and degeneration of the person's skeletal or voluntary muscles used to control movement. Heart muscles, as well as some additional, involuntary muscles, are affected by some forms of Muscular Dystrophy.
Some forms of Muscular Dystrophy affect a person's organs as well. Duchenne is the form of Muscular Dystrophy that affects children most commonly; Myotonic Muscular Dystrophy is the most common form of the disease affecting adult populations.
There are some forms of Muscular Dystrophy that appear in infancy or childhood, while other forms may not appear until a person reaches middle age or older. Muscular Dystrophy has the potential to affect persons of any age group.
There is no specific treatment for any form of Muscular Dystrophy. Both Physical therapy and corrective orthopedic surgery may improve a person's quality of life.
Heart Defects
During early pregnancy, as the heart begins to form, a heart defect may develop as well. These defects might affect the function and mechanics of a person's heart.M
Some of the children who develop heart defects show symptoms of them promptly after being born. Others do not show any symptoms until early childhood.
Some heart defects prevent the person's heart from pumping adequate amounts of blood to their lungs or additional parts of their body, potentially leading to heart failure.
Other heart defects may cause the person's skin to turn a pale gray or blue in color soon after they are born, or during their infancy; a condition referred to as, 'Cyanosis.'
The cause of congenital heart defects is not clear.
There are some environmental factors that are known to contribute to the formation of congenital heart defects, such as viral infections that are contracted by the mother during the early stages of pregnancy.
Some medications, taken by the mother during pregnancy, may also cause congenital heart defects in children.
Some of the medications that are associated with congenital heart defects in children include Accutane, certain anti-seizure medications, Lithium, Trimethoprim, and Folic Acid.
The characteristics of physical and mobility impairments involve many different things.
Persons with physical and mobility impairments may experience deficits in motor and/or fine motor functioning, locomotor and non-locomotor functioning.
There is the potential for deficits in cognitive, social, and adaptive behavior skills, as well as impairments in language, vision, hearing or other sensory areas.
Persons with physical and mobility impairments may experience stiffness and/or spasticity, as well as loss of muscle strength.
They may need help with learning, or activities of daily living.
Persons with physical and mobility impairments may need assistance with mobility, transfers, and ambulation.
They may have a limited range of motion, and be reluctant to attempt movement, or experience a perceptual or cognitive impairment. They may experience pain, discomfort; depression or anxiety.
Persons with these impairments may require prolonged bed rest, and have medical restrictions.
They may have musculoskeletal or neuromuscular impairments as well.
Quick Facts: Mobility Impairments & Students
Mobility impairments can impact students in several ways. Some students may take longer to get from one class to another, enter buildings, or maneuver in small spaces. In some cases physical barriers may inhibit entry into a building or room.
Accessible transportation may also be required for students to get to fieldwork sites. Mobility impairments can be permanent or temporary.
A broken bone or surgical procedure can temporarily impact a student's ability to walk independently and travel between classroom buildings in a timely manner.
Likewise, some students may be ambulatory with a walker for short distances within a classroom, but may need a wheelchair or scooter for longer distances.
Statistics: U.S. Physical Impairment
Non-institutionalized adults 18 years and older: Difficulties in physical functioning:
- Number of adults unable (or very difficult) to walk a quarter mile: 17.2 million
- Percent of adults unable (or very difficult) to walk a quarter mile: 7.3%
- Number of adults with any physical functioning difficulty: 35.2 million
- Percent of adults with any physical functioning difficulty: 15.0%
Non-institutionalized adults 18 years and older: Basic or complex activity limitations:
- Number of adults with at least one basic actions difficulty or complex activity limitation: 73.5 million (2012)
- Percent of adults with at least one basic actions difficulty or complex activity limitation: 31.9% (2012)
Non-institutionalized adults 65 years and older: Need help with personal care:
- Percent of adults 65-74 years who need help with personal care from other persons: 3.3%
- Percent of adults 75 years and over who need help with personal care from other persons: 10.5%
Mental Disability: What is the difference between Mental Illness & Mental Disability?
Source: Quora.com
By:
Cindy Ludwig, Experienced RN with previous clinical specialty & certification in critical care.
Good question! This is something I am continually educating people about. Any condition or illness, regardless of whether it is physical or mental is not a disability unless it interferes with an individual's ability to function so much so that the individual is not able to carry on very well without some sort of accommodation.
I worked as an RN in a vocational rehabilitation center clinic where we cared for individuals with intellectual and developmental disabilities, such as Down's syndrome.
Though many, if not most of the individuals we served were non-verbal, they were capable of some type of simple work under close supervision.
They also lived in group homes, and hence were unable to function independently. The people we served had disabilities because they were not able to function independently without accommodation.
Schizophrenia is also a disability because people with this mental illness are not usually able to easily live independently without some assistance.
Other types of mental illness may have an impact on an individual's life and work, but not so much that the person is not able to take care of him or herself and engage in work that earns a wage sufficient to pay the bills.
It is debatable whether something like depression or anxiety would be considered a disability, but it can also be debatable whether a physical condition such as amputation or diabetes is a disability.
The way I think of it, knowing the various definitions, is that the disability is oftentimes contextual, depends on the severity of the condition (as in anxiety or depression) and is subject to interpretation.
An amputation poses a limitation, but it doesn't prevent some people from finding a workaround and excelling despite their limitation.
Does the person with the amputation have a disability? I would say so. But does it prevent them from doing the things they want to do or even used to do?
Not always. So someone can have a disability and find ways to do what they want, despite their disability.
It gets complicated because other people with mental or physical illness do not have this ability, or the motivation to find a way to close the gap between what they want or need to do and the limitations posed by their disability.
Then again, part of the disability of someone with mental illness is the lack of motivation that comes with a mood or anxiety disorder.
It gets complicated to sort out.
What Is Considered A Visual Disability
Source: American Council of the Blind
Lack of Usable Sight
This is a very emotionally charged question which invariably leads to extremely emotional and irrational answers. In our society to be blind is considered to be inferior. To lack usable sight means that you are one sense short of the basic five senses. Therefore, the reasoning goes, you have less to work with and so you are, obviously, less capable. Regrettably, these days, less capable means less valuable, indeed, inferior; in the same way that a 4 speed car is considered inferior to a 5 speed car. Nobody wants to be inferior so, naturally, almost nobody wants to admit to being blind! Of course, this way of thinking completely misses the vital point that humans can adapt and compensate whereas machines cannot.
But we shall discuss this point in more detail later.
Fear and Fallacy
Despite progress in so many areas of human thinking, beliefs about and attitudes toward people with little or no vision have not changed much since ancient times. Humans fear the dark today, just as they have always feared it, and they also think that to be blind is to live in darkness so they equate the two and fear them both equally. They reason, wrongly, that being "blind" is the same as the experience of the sighted when they are blind-folded or in the dark. Thinking that they are simulating blindness, sighted people turn out the lights at night or put on blind-folds and then try and fail at doing the most basic tasks of life such as finding a door, buttoning a shirt or pouring a glass of milk. Having tried this experiment they confirm the fallacy which they already believed and are quite sure that they now know what it's like to be blind. Because they failed, when they tried to do even the simplest tasks without using their vision, sighted people decide that being blind means being totally incompetent, just as they were themselves with the lights out or wearing a blind-fold.
This ridiculous fallacy and resulting fear lives on, despite the fact that there are innumerable examples throughout history up to the present day, of successful and happy blind people, living and working in their communities and achieving in all walks of life.
Reality and Renaming
Truth and reality appear to have had little effect in dispelling the ancient fear of blindness. This is because facts and logic can only impact what people believe if they are prepared to acknowledge the truth, and confront and challenge their fears with reality. Such confronting of cherished beliefs with hard reality is usually very difficult for most people. Unfortunately, it is much easier to change our reality by renaming something than it is to work on bringing our thinking and feelings into line with what is real, because we then have to deal with that truth. Some examples of this renaming behavior are when people call small lies "white lies" instead of admitting that they are telling a lie no matter how small; or they describe themselves as "shy" instead of admitting that they are afraid of people and the disapproval of others. Or, they say that they are "visually challenged" or have "low vision" instead of accepting that they are blind. These blind people usually avoid certain tasks or experiences because they can't use their vision to do what's required. To do things non visually would shatter their created reality that they aren't blind.
So, they choose to miss out, pretending to be a "sighted" person, rather than joining in as a blind person.
Legal Definition of Blindness
According to U.S. law, if a person's best eye has an acuity of 20/200 or worse and/or if their peripheral vision is less than 20 degrees, then that person is LEGALLY BLIND.
This criteria is used to determine eligibility for driver's licenses, disability requirements, and eligibility for special services.
So, legally, those whose best eye, with correction, can see at twenty feet what those with normal vision can see at 200 feet, or whose peripheral vision is less than 20 degrees, are legally blind.
Social Impact
As we have already said, what makes the term "blind" difficult for legally blind people to accept is the widespread misunderstanding of the meaning of the word blind. The problem is not blindness but the perception of it. The public perception of "blind" is the same as helpless, dependent and inferior. Understandably, legally blind people want to avoid being thought of in that way so, they continue to reclassify themselves into subcategories such as partially sighted, high partial, sight impaired, low vision, visually challenged, vision impaired, visually disabled - anything to avoid being called blind. While this array of choices for renaming is comforting to those who do not want to be called "blind", for the general public all these names serve only to confuse the matter. These terms give no indication as to how much a person can use their vision in their daily life so, To say that one is "partially sighted" is to make a statement that says no more than "I have some sight so don't treat me like I'm blind." This statement is meaningless to all but a handful of professionals, such as mobility instructors and teachers, (and even they usually have their own arbitrary notions of how much vision a "partially sighted" person has). If one is "functionally blind" in many situations calling one's self "vision impaired" or "partially sighted" does not clarify anything it confuses the issue. As we've discussed, the fact that someone has a certain amount of vision does not automatically mean that they are more capable than those with less. Further, just how "functional" a person's vision will be in a given situation depends on many factors and the mere possession of some sight is no guarantee that a person will be able to rely on visual methods to get life's jobs done! So, what is the point of insisting that one's possession of some vision, no matter how unusable, is acknowledged? The only point is to prevent people from calling one "blind"! the overall social impact of this approach to dealing with vision loss has been to encourage legally blind people in their reliance on poor vision and to seek refuge from false public perceptions of blindness in vague terminology.
Even worse the proliferation of such "anything but blind" terms has reinforced the idea that to be blind is somehow not respectable and that to see, however poorly, is to be more normal and competent than those who are blind. In short it has done far more harm than good.
Seeing and Not Doing
The practical reality of the wide variation in types and degrees of legal blindness, and the insistence that to use vision - even extremely poor vision - is always a superior approach to doing things, means that many who can still "see" cannot "do" or, at best, "do" very poorly. For example, many people with quite a bit of usable vision are seriously affected by the amount of glare around them and some cannot see at all at night or in bright sun light. Yet, they continue to rely on their vision as their means of getting information and moving safely from one place to another. It isn't surprising then that many people with some vision are much worse at independent travel than many totally blind travelers. They neither see well enough to travel as sighted people nor use the alternative non visual techniques that blind people use. So, they have no viable means of traveling independently and safely.
Similarly, many braille readers read much faster, for much longer and in many more situations than a large number of print readers who have some sight but for whom reading print is a constant strain, even when using magnification devices.
These print readers cannot see the print in many circumstances, such as the index cards in a file drawer, a menu with small print and lots of text, documents with poor contrast between print and page color or even when there is simply too much glare in a room.
However, for the braille reader, if there is braille they can read it. If no braille is available then the braille reader has developed the alternative techniques of asking someone to read it to them, listening with careful attention and memorizing what they hear. They will get the information using non visual methods whereas, the person with some vision will struggle on, believing that no sacrifice of quality of life is too much to pay in order to conceal one's functional blindness.
They may get some of the information or they may get none at all.
Thus, it is clear that to see does not equal ability to "do" and not to see does not equal inability to "do"!
The Power of The False Assumption
Unfortunately, the misconception that "more vision equals more competence and no vision equals incompetence" perpetuates the false assumption that people who can see can also "do", and people who cannot see cannot do. Because it is an assumption based on false logic it seems perfectly reasonable and people, including blind people, don't question it, they accept it as truth! Regrettably, the falseness of an assumption does not reduce its power to influence thinking, decisions and lives and so this insidious assumption continues, largely unchallenged, to affect individuals and society alike. This terrible, ancient falsehood fosters fear, hopelessness, frustration and resignation. The horrible fact that people resign themselves to a total untruth, based on a totally false assumption about the correlation between amount of vision and one's competence in life, is the real tragedy of blindness.
The power of this false assumption can only be vanquished by the truth, as blind people assume that they are competent and then live it out in the hope that the sighted will see.
Acceptance and Alternative Techniques
While it is tempting to pretend that one is not blind, to rename one's condition, and hide in denial and fear of blindness, it is much more useful to accept the term "blind", if one's vision fits the legal definition, and move on. As the old saying goes, if the shoe fits wear it. Having moved passed denial the wonderful experience of finding the best adaptive, non-visual techniques for minimizing the effects of blindness will begin and the age old fears, fallacies and false assumptions will give place to the joy of success, independence and self-determination. With proper training and opportunity blindness is reduced to nothing more than a physical nuisance; not a tragedy, an inconvenience.
Literally hundreds of thousands of blind people are living out this truth every day, all over the world.
The members of the American Council of the Blind are ready, willing and able to assist anyone who is blind to leave the trap of tragedy behind them and joyfully embrace the truth of what it means to be blind.
To be blind means no more and no less than to be sighted. It means that we each have a life to live and what we make of that life is up to us.
Let us not make the mistake of allowing others to decide what it means to be blind or to tell us who is blind and who is not.
Hearing Loss, The Forgotten Disability
Source: Huffington Post
By:
Janice S. Lintz
The Americans with Disabilities Act (ADA) was enacted 25 years ago, yet we are still discussing the same issues for people with hearing loss. The terms “disability” and “access” have morphed into just meaning physical disability and physical access. The ADA symbol for people with disabilities is a person using a wheelchair rather than a symbol showing multiple disabilities, but a wheelchair can’t visibly represent all disabilities.
The LGBT community uses initials for all the individual groups to form the name and a rainbow to reflect the diversity of the group. They didn’t select one segment to represent the entire community. Likewise, the Hispanic or Latino community didn’t choose one country to represent all the nationalities. Why is the wheelchair symbol used to represent people with hearing loss, visual impairments, and cognitive disabilities? It reinforces the misconception that the only disability of consequence is the one requiring physical access.
Part of the problem is that hearing loss isn’t perceived as a “real” disability. Hearing aids, unlike wheelchairs, are mostly inconspicuous, so hearing loss is an invisible disability. Even the means of access are seldom seen—they are a bunch of wires or a small captioning device, whereas ramps are highly visible. As a result, hearing loss access needs are often overlooked.
There is also confusion about the forms of access that people with hearing loss need. A recent Disability Pride Parade chose at first to use only a wheelchair symbol and then added the American Sign Language (ASL) symbol to represent hearing loss, even though the vast majority of people with hearing loss do not use ASL.
The US Access Board develops ADA guidelines for the built environment, and these guidelines form the basis for the Department of Justice (DOJ) ADA Standards. DOJ also oversees other aspects of the ADA, including programmatic access, auxiliary aids and services, and effective communication.
Places of public accommodation often have no idea what they should or shouldn’t implement for communication. Physical access is clear—build something this high and this wide. In comparison, spelling out what “effective communication” is fuzzy. Who decides what is effective or not? Determining this can require filing complaints and/or litigation. The reason? Despite DOJ being the enforcement agency overseeing compliance, the process is primarily complaint driven. While the health department in various cities cites restaurants for violations, DOJ is not driving around and checking for ADA compliance in a similar fashion. The burden therefore shifts primarily to the people who need the protection, and there are few if any penalties for lack of compliance.
Both the Access Board and DOJ are able to form Federal Advisory Committees to help them with rule making, but only the Access Board does. Therefore, people with or parents of children with hearing loss are not inherently involved in developing DOJ rules.
The lack of clarity concerning “effective communication” permits companies to develop hearing access equipment that may not have the best interests of people with hearing loss in mind. Some are selling handheld captioning devices for watching films or live theater. It is well known that people cannot drive and text simultaneously because their eyes can only see one place at a time, so it seems incomprehensible that museums, theaters or entertainment venues expect people with hearing loss to watch two places at one time.
Businesses can provide substandard communication access, such as note writing, as long as the meaning gets transmitted. A major coffee corporation refused to provide hearing induction loops for hearing access at its counters and then rolled out a campaign to discuss race relations, failing to recognize that discrimination does not only involve race. In contrast, a bank decided to pilot hearing induction loops in New York City so customers with hearing loss could hear at the teller window and service desk and in the conference room; the bank is now expanding the program to all renovated and new locations. Two different companies have two different definitions of effective communication for people with hearing loss, who are thus reliant on companies to do the right thing.
Although state and local governments are covered by the ADA, federal government agencies are covered instead by section 504 of the Rehabilitation Act, which was the model for the ADA. Even among federal agencies there is a discrepancy in what is provided. The National Park Service’s Guidelines require hearing induction loops at its service desks and videos; the US Holocaust Memorial Museum (which is a quasi-federal agency) added them to its videos; and The Pentagon required the Intrepid Sea, Air & Space Museum to add induction loops to its space shuttle exhibit in order to receive the shuttle. Yet, the Smithsonian Institution (another quasi-federal agency) refuses to add hearing induction loops to its videos. Different federal agencies have conflicting definitions of effective communication.
There should be ONE central place to file complaints for lack of ADA compliance. The burden should shift to the government to determine which agency is responsible for addressing the lack of access and not the person seeking the accommodation. The Access Board should have full oversight for drafting standards for all access whether built in or programmatic. This will eliminate the loopholes. The DOJ’s role should be strictly enforcement. The ADA should clarify that effective communication for people with hearing loss means full spectrum including audible, visual AND qualified interpretation. There should be vigorous enforcement for lack of compliance. Advisory committees should be convened to provide clarity about what people with hearing loss need.
Otherwise, the promises of the ADA and Section 504 of the Rehabilitation Act will remain aspirations rather than becoming a reality.
People with hearing loss deserve to have this clarity and access, which is the intention of the ADA and the mandate it was meant to be.
Speech and Language Impairments
Source: Special Education Guide
Definition
The Individuals with Disabilities Education Act (IDEA) officially defines speech and language impairments as “a communication disorder such as stuttering, impaired articulation, a language impairment, or a voice impairment that adversely affects a child’s educational performance.”
Each point within this official definition represents a speech and language subcategory. “A communication disorder such as stuttering” provides an example of a fluency disorder; other fluency issues include unusual word repetition and hesitant speech.
“Impaired articulation” indicates impairments in which a child experiences challenges in pronouncing specific sounds. “A language impairment” can entail difficulty comprehending words properly, expressing oneself and listening to others. Finally, “a voice impairment” involves difficulty voicing words; for instance, throat issues
may cause an abnormally soft voice.
Common Traits
Speech and language impairments tend to emerge at a young age, and the earlier a child is diagnosed and receives services accordingly, the more likely that child can outgrow the disability.
Speech-language pathologists work with children with speech and language impairments, as well as with parents and teachers.
For example, a speech-language pathologist might work with a child with impaired articulation to help him or her learn to pronounce “s” and “z” sounds correctly.
If a child fails to meet the speech and language milestones set by American Speech-Language-Hearing Association (ASHA), he or she might have a speech and language impairment.
The National Dissemination Center for Children with Disabilities, commonly referred to as NICHCY, notes that parents are usually the first to suspect that a child might possess such an impairment.
However, it’s important to note that hearing issues, autism and a number of other disabilities can masquerade as speech and language impairments, and a child with a suspected impairment should be evaluated by a speech-language pathologist to avoid misdiagnosis.
Educational Challenges
The obstacles created by speech and language impairments vary by the specific case, but because communication is at the core of education, these impairments can impact a student’s entire educational experience.
Some of these challenges might involve:
- Communicating effectively with classmates and teachers
- Understanding and/or giving oral presentations
- Participating in classroom discussions
- Attaining normalcy within a group
Tips for Teachers and Parents
NICHCY recognizes early intervention as a helpful tool for children with speech and language impairments, and working with a speech-language pathologist during the preschool years can be a game changer.
Addressing issues, such as stuttering and articulation impairments, early can lessen potential communication difficulties later in a child’s educational career.
It’s worth mentioning that speech and language impairments requiring long-term attention generally remain manageable. A school’s speech-language pathologist should work with both teachers and parents to discuss a child’s needs and how to best meet them.
Bullying is an issue for some children with speech and language impairments; for instance, peers might mock a stutter or a lisp.
Bullying often becomes more than a social issue as it can distract the student who is the target from his or her classwork.
Taking time to teach about bullying can help to prevent this.
What Are Learning Disabilities?
Source: Learning Disabilities Association of America (LDA)
Learning disabilities may be defined in practical, medical and legal terms. The common theme in all three definitions is that a learning disability is a disorder in one or more basic psychological processes that may manifest itself as an imperfect ability in certain areas of learning, such as reading, written expression, or mathematics.
Practical Definition
The term “learning disabilities”, sometimes referred to as specific learning disabilities, is an umbrella term that covers a range of neurologically based disorders in learning and various degrees of severity of such disorders. Predecessor terms include: minimal brain damage and minimal brain dysfunction.
Broadly speaking, these disorders involve difficulty in one or more, but not uniformly in all, basic psychological processes:
- input (auditory and visual perception)
- integration (sequencing, abstraction, and organization)
- memory (working, short term, and long term memory)
- output (expressive language)
- motor (fine and gross motor)
Learning disabilities vary from individual to individual and may present in a variety of ways.
Learning disabilities may manifest as difficulty:
- processing information by visual and auditory, means, which may impact upon reading, spelling, writing, and understanding or using language
- prioritizing, organizing, doing mathematics, and following instructions
- storing or retrieving information from short or long term memory
- using spoken language, and
- clumsiness or difficulty with handwriting
Learning disabilities are not emotional disturbances, intellectual disabilities (formerly termed mental retardation), or sensory impairments.
They are not caused by inadequate parenting or lack of educational opportunity.
Cognitive assessment, including psychoeducational or neuropsychological evaluation, is of critical importance in diagnosing a learning disability.
Learning disabilities may be diagnosed by qualified school or educational psychologists, by clinical psychologists, and by clinical neuropsychologists who are trained and experienced in the assessment of learning disabilities.
Medical Definition
The draft Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) contains a section for Neurodevelopmental Disorders, and, within that section, a category for Specific Learning Disorder.
The Neurodevelopmental Disorders Section also contains categories for Communications Disorders and Motor Disorders. Specific Learning Disorder in draft DSM-V includes difficulties in reading, written expression, and mathematics.
DSM-IV-TR, which is currently in effect, includes: Reading Disorder, Mathematics Disorder, Disorder of Written Expression, and Learning Disorder Not Otherwise Specified (NOS).
Legal Definition
The Individuals with Disabilities Education Act (IDEA) provides that “specific learning disability” means "a disorder in 1 or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations.”
Such term “includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia." Such term does not include "a learning problem that is primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage." 20 U.S.C Section 1401 (30).
The term “learning disabilities” is not expressly defined in the Americans with Disabilities Act (ADA) , but courts have referred to the IDEA definition in cases involving the ADA.
Why Provide Educational Services of Accommodations to Individuals with Learning Disabilities?
Learning disabilities are life long impairments that may impact all areas of an individual’s life.
It is important to provide services and accommodations that are required by law, not just because of the legal requirement, but also because providing these services and accommodations benefits individuals with learning disabilities and society overall by facilitating full participation in society by individuals with learning disabilities.
How Do You Define Invisible Disability?
Source: Invisible Disabilities Association (IDA)
People often ask what the term invisible disability means. To define invisible disability in simple terms is a physical, mental or neurological condition that limits a person’s movements, senses, or activities that is invisible to the onlooker.
Unfortunately the very fact that these symptoms are invisible, can lead to misunderstandings, false perceptions and judgments.
“They are parking in an accessible parking space with a placard, but they look fine. I wonder if they have an invisible disability.“
Why define invisible disability?
In general, the term disability is often used to describe an ongoing physical challenge. This could be a bump in life that can be well managed or a mountain that creates serious changes and loss.
Either way, this term should not be used to describe a person as weaker or lesser than anyone else! Every person has a purpose, special uniqueness and value, no matter what hurdles they may face.
When we define invisible disability it helps us understand the subtle differences and challenges each person experiences in their daily lives.
In addition, just because a person has a disability, does not mean they are disabled. Many living with these challenges are still fully active in their work, families, sports or hobbies.
Some with disabilities are able to work full or part time, but struggle to get through their day, with little or no energy for other things.
Others are unable to maintain gainful or substantial employment due to their disability, have trouble with daily living activities and/or need assistance with their care.
According to the Americans with Disabilities Act of 1990 (ADA) an individual with a disability is a person who:
- Has a physical or mental impairment that substantially limits one or more major life activities;
- has a record of such an impairment; or is regarded as having such an impairment (Disability Discrimination).
Furthermore, “A person is considered to have a disability if he or she has difficulty performing certain functions (seeing, hearing, talking, walking, climbing stairs and lifting and carrying),
or has difficulty performing activities of daily living, or has difficulty with certain social roles (doing school work for children, working at a job and around the house for adults)” (Disabilities Affect One-Fifth of All Americans).
Given this basic knowledge, it is easy to see how work to define invisible disability is both critical to help so many who are overlooked but also daunting in scope.
Define invisible disability and open doors of communication and understanding.
Often people think the term, disability, only refers to people using a wheelchair or walker. On the contrary, the 1994-1995 Survey of Income and Program Participation (SIPP) found that 26 million Americans (almost 1 in 10) were considered to have a severe disability, while only 1.8 million used a wheelchair and 5.2 million used a cane, crutches or walker (Americans with Disabilities 94-95).
In other words, 74% of Americans who live with a severe disability do not use such devices.
Therefore, a disability cannot be determined solely on whether or not a person uses assistive equipment.
The term we define invisible disability refers to symptoms such as debilitating pain, fatigue, dizziness, cognitive dysfunctions, brain injuries, learning differences and mental health disorders, as well as hearing and vision impairments.
These are not always obvious to the onlooker, but can sometimes or always limit daily activities, range from mild challenges to severe limitations, and vary from person to person.
Also, someone who has a visible impairment or uses an assistive device such as a wheelchair, walker or cane can also have and invisible disability or invisible disabilities.
For example, whether or not a person utilizes an assistive device, if they are debilitated by such symptoms as described above, they live with invisible disabilities.
Opportunities for dialog begin when we define invisible disability.
Unfortunately, people often judge others by what they see and often conclude a person can or cannot do something by the way they look. This can be equally frustrating for those who may appear unable, but are perfectly capable, as well as those who appear able, but are not.
International Disability expert, Joni Eareckson Tada, explained it well when she told someone living with debilitating fatigue, “People have such high expectations of folks like you [with invisible disabilities], like, ‘come on, get your act together.’ but they have such low expectations of folks like me in wheelchairs, as though it’s expected that we can’t do much” (Joni).
The bottom line is that everyone with a disability is different, with varying challenges and needs, as well as abilities and attributes.
Thus, we all should learn to listen with our ears instead of judging with our eyes. This is why we define invisible disability.
- Need help getting your friends and family to better understand the invisible nature of your illness?
Check out the book
But You LOOK Good.
- Need a community where others understand you and your illness?
Join the Invisible Disabilities Community.
- Have you ever thought about sharing your person journey with illness and pain?
Be a part of the Invisible No More Campaign.
LIST OF ILLNESSES THAT ARE CONSIDERED INVISIBLE DISABILITIES:
We do not maintain a list of specific illnesses and diagnosis’s that are considered invisible disabilities. Invisible disabilities are such symptoms as debilitating fatigue, pain, cognitive dysfunctions and mental disorders, as well as hearing and eyesight impairments and more.
There are thousands of illnesses, disorders, diseases, dysfunctions, birth defects, impairments and injuries that can be debilitating. Therefore, all conditions that are debilitating are included when we talk about invisible disabilities throughout the website.
However, our focus is not to attempt to provide a vast amount of information about thousands of specific conditions (there are plenty of websites that do that).
We are here to provide awareness, education, connection and support for everyone who lives with a debilitating condition.
We do this by offering articles, pamphlets, booklets, resources, radio, video, seminars and more to give hope and compassion to all living with invisible disabilities as well as information for loved ones to better understand.
