Understanding Of Disability 2024-2025 Fall Semester PDF

Understanding of Disability 2024-2025 Fall Semester 2nd Week – Definition of Disability Hikmet UCGUN, PT, PhD Assistant Professor Department of Physiotherapy and Rehabilitation (Eng) Faculty of Health Sciences Istanbul Atlas University...

Understanding of Disability 2024-2025 Fall Semester 2nd Week – Definition of Disability Hikmet UCGUN, PT, PhD Assistant Professor Department of Physiotherapy and Rehabilitation (Eng) Faculty of Health Sciences Istanbul Atlas University © Hikmet UCGUN / May not be copied or reproduced without permission. Over 1 billion people are estimated to experience disability 12.29% This corresponds to about 15% of the world's population, in Turkey with up to 190 million (3.8%) people aged 15 years and older having significant difficulties in functioning, often requiring health care services The number of people experiencing disability is increasing due to a rise in chronic health conditions and population ageing Disability is a human rights issue, with people with disability being subject to multiple violations of their rights, including acts of violence, abuse, prejudice and disrespect because of their disability, which intersects with other forms of discrimination based on age and gender, among other factors People with disability also face barriers, stigmatization and discrimination when accessing health and health-related services and strategies Disability is a development priority because of its higher prevalence in lower-income countries and because disability and poverty reinforce and perpetuate one another AUTISM CHRONIC HEARING LOSS AND ILLNESS DEAFNESS INTELLECTUAL LEARNING MEMORY LOSS DISABILITY DISABILITY PHYSICAL DISABILITY SPEECH AND LANGUAGE DISABILITY VISION LOSS AND BLINDNESS  “Disability need not be an obstacle to success I have had motor neuron disease for practically all my adult life Yet it has not prevented me from having a prominent career in astrophysics and a happy family life” Professor Stephen W Hawking (January 1942, Oxford - March 2018, Cambridge) A disability is defined as a condition or function judged to be significantly impaired relative to the usual standard of an individual or group. The term is used to refer to individual functioning, including physical impairment, sensory impairment, cognitive impairment, intellectual impairment, mental illness, and various types of chronic disease Disability is a multidimensional experience for the person involved. There may be effects on organs or body parts and there may be effects on a What is a person's participation in areas of life Disability Correspondingly, three dimensions of disability are recognized in ICF: ? body structure and function (impairment), activity (activity restrictions) and participation (participation restrictions) The classification also recognizes the role of physical and social environmental factors in affecting disability outcomes PREVALENCE AND DIVERSITY OF DISABILITY 1 in 5 Americans has a disability Includes functional limitations Affects every race, culture, language, sexual orientation, income, and gender Disability is common Nearly everyone is likely to experience some form of disability in their life Disability is just one aspect of the diversity of the human experience Although any person can have a disability at any point in life, disability was more commonly reported by: Women aged 18 years or older: 24.4% of women, compared to 19.8% of men Older adults: Over a third of people 65 years or older reported a disability Understanding of Disability Affecting Disability Outcomes VISION HEARING MOVEMENT 01 03 05 02 04 06 THINKING LEARNING MENTAL HEALTH REMEMBERING COMMUNICATING 07 09 08 SOCIAL RELATIONSHIPS  The World Health Organization (WHO) published the International Classification of Functioning, Disability and Health (ICF) in 2001 that covers; A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions) According to the World Health Organization, disability has three dimensions: Impairment Activity DISABILITY limitation Participation restriction  1.Impairment in a person’s body structure or function, or Structural impairments are significant mental functioning; examples of impairments include loss of problems with an internal or external a limb, loss of vision or memory loss component of the body. Examples of these include a type of nerve damage 2.Activity limitation, such as difficulty seeing, hearing, that can result in multiple sclerosis, or a walking, or problem solving complete loss of a body component, as when a limb has been amputated 3.Participation restrictions in normal daily activities, such as working, engaging in social and recreational activities, and Functional impairments include the obtaining health care and preventive services complete or partial loss of function of a body part. Examples of these include pain that doesn’t go away or joints that no longer move easily. What is the difference between activity limitation and participation restriction? The World Health Organization (WHO) published the International Classification of Functioning, Disability and Health (ICF) in 2001. The ICF provides a standard language for classifying body function and structure, activity, participation levels, and conditions in the world around us that influence health. This description helps to assess the health, functioning, activities, and factors in the environment that either help or create barriers for people to fully participate in society. According to the ICF: Activity is the execution of a task or action by an individual Participation is a person’s involvement in a life situation Although “people with disabilities” sometimes refers to a single population, this is actually a diverse group of people with a wide range of needs Two people with the same type of disability can be affected in very different ways Some disabilities may be hidden or not easy to see Types of disabilities include various physical and mental impairments that can hamper or reduce a person's ability to carry out his day to day activities These impairments can be termed as disability of Classifications of the person to do his or her day to day activities Disabilities "Disability" can be broken down into a number of broad sub-categories, which include the following  1. Mobility and Physical Impairments This category of disability includes people with varying types of physical disabilities including: Upper limb(s) disability Lower limb(s) disability Manual dexterity Classifications of Disability in co-ordination with different organs of the Disabilities body Disability in mobility can be either an in-born or acquired with age problem. It could also be the effect of a disease. People who have a broken bone also fall into this category of disability 2. Spinal Cord Disability Spinal cord injury (SCI) can sometimes lead to lifelong disabilities. This kind of injury mostly occurs due to severe accidents The injury can be either complete or incomplete. In an incomplete injury, the messages conveyed by the spinal cord is not completely lost Whereas a complete injury results in a total disfunctioning of the sensory organs In some cases spinal cord disability can be a birth defect 3. Head Injuries - Brain Disability A disability in the brain occurs due to a brain injury. The magnitude of the brain injury can range from mild, moderate and severe. There are two types of brain injuries: Traumatic Brain Injury (TBI) Acquired Brain Injury (ABI) ABI is not a hereditary type defect but is the degeneration that occurs after birth. The causes of such cases of injury are many and are mainly because of external forces applied to the body parts TBI results in emotional dysfunctioning and behavioral disturbance 4. Vision Disability There are hundreds of thousands of people that have minor to various serious vision disability or impairments These injuries can also result into some serious problems or diseases like blindness and ocular trauma, to name a few Some of the common vision impairment includes scratched cornea, scratches on the sclera, diabetes related eye conditions, dry eyes and corneal graft  Hearing disabilities includes people that are completely or partially deaf (Deaf is the politically correct term for a person with hearing impairment) People who are partially deaf can often use hearing aids to assist their hearing. Deafness can be evident at birth or occur later in life from several biologic causes, for example HEARING Meningitis can damage the auditory nerve or the cochlea DISABILITY Deaf people use sign language as a means of communication. Hundreds of sign languages are in use around the world In linguistic terms, sign languages are as rich and complex as any oral language, despite the common misconception that they are not "real languages"  Cognitive Disabilities are kind of 6. Cognitive or impairment present in people Learning who are suffering from dyslexia Disabilities and various other learning difficulties and includes speech disorders 7. Psychological Disorders Affective Disorders: Disorders of mood or feeling states either short or long term. Mental Health Impairment is the term used to describe people who have experienced psychiatric problems or illness such as: Personality Disorders - Defined as deeply inadequate patterns of behavior and thought of sufficient severity to cause significant impairment to day-to-day activities Schizophrenia: A mental disorder characterized by disturbances of thinking, mood, and behavior  Invisible Disabilities are disabilities that are not 8. Invisible immediately apparent to others Disabilities It is estimated that 10% of people in the U.S. have a medical condition considered a type of invisible disability Disability can be: Related to conditions that are present at birth and may affect functions later in life, including cognition (memory, learning, and understanding), mobility (moving around in the environment), vision, hearing, behavior, and other areas These conditions may be Disorders in single genes (for example, Duchenne muscular dystrophy) Disorders of chromosomes (for example, Down syndrome) The result of the mother’s exposure during pregnancy to infections (for example, rubella) or substances, such as alcohol or cigarettes Associated with developmental conditions that become apparent during childhood (for example, autism spectrum disorder and attention- deficit/hyperactivity disorder) Related to an injury (for example, traumatic brain injury or spinal cord injury) Associated with a longstanding condition (for example, diabetes), which can cause a disability such as vision loss, nerve damage, or limb loss Progressive (for example, muscular dystrophy), static (for example, limb loss), or intermittent (for example, some forms of multiple sclerosis The ICF includes the following in the categories of activities and participation It is very important to improve the conditions in communities by providing accommodations that decrease or eliminate Learning and applying knowledge activity limitations and participation restrictions for people with disabilities, so they can participate in the roles and Managing tasks and demands activities of everyday life Mobility (moving and maintaining body positions, handling and moving objects, moving around in the environment, moving around using transportation) Managing self-care tasks Managing domestic life Establishing and managing interpersonal relationships and interactions Engaging in major life areas (education, employment, managing money or finances) Engaging in community, social, and civic life  Disability is not a disease Disability is a health condition that limits some part of the life ! “DISABILITY” Americans with Disabilities Act Definition: A person who has a physical or mental impairment that substantially limits one or more major life activities; a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment A person with a disability can not to engage in any substantial gainful activity because of a medically-determinable physical or mental impairment(s) COMMON HIDDEN DISABILITIES Many disabilities are hidden (not visible) ! Chronic Fatigue Syndrome Psychiatric Disabilities - major depression, bipolar disorder, schizophrenia and anxiety Cystic Fibrosis disorders, post-traumatic stress disorder Learning Disabilities Traumatic Brain Injury Visional problems Epilepsy Hearing problems HIV/AIDS Allergies Diabetes MODELS I. Medical Model: Person has to be fixed II. Rehabilitation Model: Person has to be rehabilitated III. Moral Model: We have to help person with a disability, charities emerged IV. Social Model: Regards disability as a normal aspect of life The transition from an individual, medical perspective to a structural, social perspective has been described as the shift from a “medical model” to a “social model” in which people are viewed as being disabled by society rather than by their bodies Differences Social Model Medical Model Stairs are the problem Impairments are the problem Solution: Build a ramp Solution: Cures and Prosthetics PREVALENCE AND DIVERSITY OF DISABILITY 1 in 5 Americans has a disability Includes functional limitations Affects every race, culture, language, sexual orientation, income, and gender Nearly everyone is likely to experience some form of disability in their life Disability is just one aspect of the diversity of the human experience Differences  TEMPORARY VS. PERMANENT Temporary Disabilities Permanent Disabilities Illnesses or injuries that A type of disability that an prohibit an individual from individual is not expected taking part in routine to recover from activities FUNCTIONAL DECLINE Disability is often measured by limitations in daily activities. These limitations are typically grouped into two categories: I. Limitations in Activities of Daily Living (ADLs) II. Limitations in Instrumental Activities of Daily Living (IADLs) OUTCOMES SECONDARY HEALTH CONDITIONS Even people with a disability can lead a Aging and disability lead to an increased likelihood healthy lifestyle of Secondary Health Conditions and Co-Morbid Conditions Disability Inclusion: I. Include people with disabilities in Physical Symptoms: everyday activities Pain II. Inclusion should lead to increased Fatigue participation Muscle Weakness Reactions to disability: certain reactions are thought to ocur early the process of adaptain to disability Among the most often discussed reactions are those of ✓ Shock ✓ Anxiety ✓ Denial ✓ Depression ✓ Internalized anger ✓ Externalized hostility ✓ Acknowledgement ✓ Adjustment Shock is perceived as the individual's initial reaction to the onset of a sudden and severe physical impairment (e.g., spinal cord injury, myocardial infarction), or psychological trauma (e.g., diagnosis of cancer, death of a loved one) It is a reaction noted by a psychic numbness resulting from the impact of an overwhelming traumatic experience Anxiety is viewed as a phase of panic-stricken reaction upon initial recognition of the magnitude of the traumatic event This reaction should not be confused with anxiety as a trait-like character concept Denial is considered a more problematic reaction to verify due to its subtle and often conflicting aspects, is seen as a defense mobilization against painful realization of the implication of one's condition, including the expectancy of recovery from the resulting physical impairment Depression It is a reaction 'Often observed among adventitiously impaired individuals, is typically conceived to reflect the initial realization of the loss of one's prior physical prowess stemming from the sustained bodily insult It is generally equated with a reactive response of bereavement for the lost body part or function Internalized Anger It is viewed as the exhibition of self- directed bitterness and resentment often associated with feelings of guilt and self-blame Externalized Hostility Toward other people object, or other aspects of the environment occurs when the person with a disability appears to be retaliating against his or her in imposed physical limitations Acknowledgement It is made up of the cognitive recognition (i.e., intellectual acceptance) of the future implications stemming from the disability and the gradual integration of the functional limitations associated with the condition into one's self-concept Adjustment reflects an affective internalization (ie., emotional acceptance) of the functional implications of an impairment into one's self-concept coupled with behavioral adaptation and social reintegration into the newly perceived life situation HOW TO TALK TO PEOPLE WITH DISABILITIES ? Be yourself and make sure you: Establish and maintain eye contact Talk directly to the person – not their companion Never speak about the person as if they can’t understand or respond Don’t assume a person can’t do things Ask someone first before helping; they may not need it Don’t pet or talk to a guide dog or service animal–these animals are working and shouldn’t be distracted Don’t assume a person with one disability has others (e.g., someone with low vision can hear you; there is no need to shout) PEOPLE FIRST LANGUAGE Say: Instead of: Children/adults with disabilities Handicapped, disabled, special needs He has a cognitive disability He’s mentally retarded She has Autism She’s autistic He has Down’s Syndrome He’s Down’s/mongoloid She has a learning disability She’s learning disabled He has a physical disability He’s quadriplegic/crippled She uses a wheelchair She’s confined to/wheelchair bound People without disabilities Normal or healthy people Rewrite The Following Sentences 1. Sheila is handicapped. 2. John is in the 5th grade and he is crippled. 3. Jane suffers from Cerebral Palsy. 4. Dave is confined to a wheelchair. 5. The disabled girl won 1st place in the Spelling Bee. 6. He is retarded. 7. Katie is brain damaged. 8. Michael’s walking is restricted because he uses crutches. 9. The handicapped should be excluded from activities. 10. Amy is a normal kid. 11.George is disabled and unable to do things. The Diagnostic Journey Before Diagnosis Parents may not appreciate the possibility that their infant may survive with long-term impairment or disability Some parents report that they felt isolated in their concerns, or that professionals did not act upon these concerns in a timely manner In a study of parental perception of disclosure of the diagnosis of cerebral palsy, 86% of parents reported that they were the first to suspect a problem Diagnostic Consultation The adaptation and resolution of a family with a disabled child are dependent on many factors; however, a commonly reported significant factor affecting this is the manner and circumstances of the diagnostic consultation Studies demonstrate that the empathy and language of the person who disclosed the diagnosis, the arrangements made for the consultation, and subsequent follow up are the key components  Thank You… © Hikmet UCGUN / May not be copied or reproduced without permission.