Understanding Disability and Impairment Concepts

Objectives

• Students will be able to define impairment, identify disability, recognize causes of disability, define classification of disability, and define handicap by the end of the lecture.

Introduction

• Disabled people represent a significant social issue that should not be ignored.
• The best approach to assist disabled people is comprehensive rehabilitation, addressing all their needs during the process.

Impairment

• Impairment is defined as a loss or abnormality of psychological, physiological, or anatomical structure.
• Impairments of organs or functions of the organism can result in disability.
• Impairment concerns abnormalities in body structure, appearance, or organ/system function, stemming from any cause.
• Examples include blindness, deafness, limb amputation, and paralysis.

Disability

• Disability is a restriction or lack of ability to perform a normal daily activity, resulting from an impairment.
• It's a functional consequence of impairment.
• It relates to limitations in how people normally function in daily activities.

Handicap

• Handicap is a social concept.
• A handicap refers to a disadvantage for an individual, caused by an impairment or disability, that hinders interaction with both the physical and social environment.
• Examples include home confinement, inability to use public transport, and social isolation.

Relationship Between Impairment, Disability, and Handicap

• All disabled individuals are impaired, but not all impaired individuals are disabled.
• All handicapped individuals are disabled, but not all disabled individuals are handicapped.
• A person can have an impairment and not be disabled, and a person can be disabled but not handicapped.

Factors Influencing Disability

• Cognition, education, culture, psychological factors (gender, race, age), physical environment, and financial status all influence the experience of disability.

Classification of Disability

• Persistence:
  • Temporary: Lasting a specific period, for example, temporary limb paralysis after a stroke or a broken limb.
  • Permanent: Expected to persist until death, such as blindness or limb amputation.
• Time of onset:
  • From birth: Due to heredity, congenital factors, or injuries during childbirth.
  • Acquired: Later in life due to diseases or injuries (accidents)
• Progression:
  • Progressive: Deteriorating and leading to a more severe condition, such as partial vision loss progressing to complete blindness.
  • Regressive: Improving and leading to advancement or almost complete recovery, such as limb function restoration after a stroke through exercises.

Causes of Disability

• Heredity and congenital factors
• Diseases
• Malnutrition
• Trauma or injuries
• Natural changes related to aging

Disability Prevention

• First level prevention: Reducing occurrences of impairments (e.g., eradicating malnutrition, controlling communicable diseases).
• Second level prevention: Limiting or reversing disability caused by impairment (e.g., providing adequate medication for diseases, implementing essential surgery).
• Third level prevention: Preventing the transition from disability to handicap (e.g., rehabilitation programs, vocational training).

First Level Prevention Examples

• Eradicating malnutrition: Increasing food production and proper distribution.
• Smallpox eradication.
• Vaccination against polio, tuberculosis, measles, whooping cough.
• Comprehensive perinatal care through primary healthcare.
• Safe water and sanitation facilities.
• Accident reduction efforts.
• Socioeconomic development for individuals and countries.
• Health education.
• Limits on tobacco and alcohol use.
• Prevention of child neglect and abuse.

Second Level Prevention Examples

• Providing adequate drugs for leprosy, tuberculosis, ear infections, hypertension, and diabetes.
• Providing essential surgery for wounds, fractures, limb injuries, and cataracts.
• Implementing rehabilitation programs.
• Effective referral systems to health centers at district/regional levels.
• Vocational and educational counseling.
• This can reduce disability incidence and severity up to 10-20%.

Third Level Prevention Examples

• Rehabilitation programs
• Orthopedic braces and prosthetics
• Glasses for visual impairments
• Hearing aids
• Vocational schools and training for the disabled.
• Education and improved economic status for disabled individuals.
• Speech therapy
• Job provision for disabled individuals

Categories of Handicapped Persons

• Physically handicapped persons: Those with physical impairments (disabilities) of the organism
  • Disorders of the musculoskeletal system (arthritis, fractures, myopathy, contractures, amputations)
  • Neurological disorders (peripheral neuropathy, stroke, Parkinson's disease)
• Sensorily handicapped persons: Those with sensory impairments
  • Visually handicapped persons (visual impairments from cataracts or retinopathy)
  • Hearing handicapped persons (ear disease causing vertigo)
• Mentally handicapped persons: Those with mental impairments
  • Mentally retarded persons (due to illness in childhood, head trauma in childhood, pregnancy/birth related issues, heredity, or unknown cause)
  • Mentally ill persons
  • Persons suffering from epilepsy
• Severe mental diseases* (e.g., psychoses) (e.g., schizophrenia, manic depressive psychosis, paranoia)

Causes of Mental Retardation

• Illness during childhood (42%)
• Head trauma in childhood (10%)
• Pregnancy and birth-related problems (3%)
• Heredity (2%)
• Unknown cause (23%)

Mental Abilities in Retarded Persons

• Perception
• Memory
• Decision-making
• Judgment
• Reasoning
• Problem-solving

Intelligence

• Intelligence is the mental brightness or ability of a person to form ideas, recall memories, think, reason, solve problems, and adjust to changing circumstances.
• Intelligence is measured by special psychological methods.
• The amount of scores a person reaches on an intelligence test is known as the intelligence quotient or IQ.
• The range of IQ scores, along with descriptors, are used to classify various levels of intelligence and mental retardation.

Intervention in Dementia: Physical Therapy

• Aims: Enhancing physical function (mobility, balance coordination, strength); reducing fall risk; improving mood, stress, and calm; improving cardiovascular health; enabling activity; and improving sleep patterns.
• Types of Exercises: Recommend 30 minutes of cardiorespiratory exercise daily, including walking, cycling, and swimming. Strength and resistance training (10-15 repetitions of 8-10 exercises, 3 times per week). Flexibility and stretching exercises. Balance training (exercises specific to movement position to improve balance confidence). Gait training (educating movement patterns and mobility without support). Occupational therapy

Intervention in Dementia: Occupational Therapy

• Aims: Changing/enhancing environments to improve function and safety.
• Important safety considerations when assessing a home or apartment for someone with Alzheimer's or dementia. Examples include locking doors to areas with hazardous materials, or removing potentially dangerous electric equipment from areas where the patient may access them and installing hidden circuit breakers and gas valves (kitchen, bathroom.)
• Ensuring safety inside the home:
• Using color contrast in rugs, bedding, and window coverings to help patients perceive space and depth within their homes.
• Adding signs on bathroom doors and labeling drawers for items (socks, shirts) to help allow them to function at their highest possible level.

This quiz explores fundamental concepts related to disability, impairment, and handicap. It covers definitions, classifications, and the relationship between these key terms. Test your knowledge on rehabilitation approaches and various factors influencing disability.