DEFINE terms & major category of disability.

(according to WHO International Classification of Function-ICF)

I will facilitate you on how you can OUTLINE main characteristics of each

DISCUSS special needs per kind: includes communication methods suited for particular disability kind

5 minutes- c/o Avonel

You can refer to previous knowledge

Instruction: (5 minutes) 1. All in circle

2. Let out a piece of item in you pocket or handbag that

represent him/her 3. Each should explain to the group how his/her item is like him/her Example: This glue stick is like me, because when I

start something I stick to it

What do we mean by: 1. IMPAIRMENT 2. DISABILITY 3. HANDICAP

Give an examples

Impairment- (functional damage) any loss or abnormality of psychological, physiological or anatomical structure or function. Disability- (restriction of normal activities) any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being. Handicap- (resulting social disadvantage) limitation imposed by the environment that results in disabled person being unable to participate. Simple terms: Impairment a problem with a structure or organ of the body; Disability is a functional limitation with regard to a particular activity; and Handicap refers to a disadvantage in filling a role in life relative to a peer group.

A child who has a form of cerebral palsy. What is the Impairment, disability & handicap? Impairment: CP causes his legs to be stiff, tight, and difficult to move. He cannot stand or walk. CP condition that unable him to move the legs easily at the joints, inability to bear weight on the feet. Without surgery & orthotics childs level of impairment may increase
as imbalanced muscle contraction over a period of time can cause hip dislocation & deformed bone growth.

Disability: the inability to walk is a disability. Without support (PT & special equipment) he might be unable to cope up with his day to day activities a child of his age can "normally do. Handicap: limiting condition that leads to the extent that it prevents him from fulfilling a normal role at home, preschool, and community. Example: no ramps for wheelchair in public places; societal attitudes
(humiliation etc)

ICF

is a classification of the health components of functioning and disability. it integrates medical and social aspects of a persons her health condition For clinicians- creates a profile & knowledge on how a disease affects ones functioning enables better planning of services, treatment, & rehabilitation for persons with long-term disabilities or chronic conditions.

1. Deafness / Hearing Impairment

2. Blindness and Visual Impairment

3. Physical disability or motor developmental disability 4. Intellectual Disability (Mental Retardation)

EID

Distribution of disabled population 6.4% of total population (48,419)- Citizen living with some form of disability. 51.1% (24,764) females; 48.8% (23,652) males Common disability kind in Guyana 1. Vision-sight 2. Mobility 3. Body movement 4. Hearing 5. Mental impairment 6. Loss of sense of taste

*2002 Population & Housing Census- Chapter 8

stats

Picture game Instruction: Each group is to prepare a talk about the assigned disability kind (15 minutes preparation) Present it in the most creative way
(10 minutes presentation per group)

Understanding Sexual & Reproductiv Health Needs of AWD Workshop 11-13th September 2012 National Library Maria Sheena SHAINE Villareal PT/MSpEd and Early Identification & Intervention Adviser/ Ministry of Health

Deaf

An individual who has had a hearing profile or an audiogram of 90 Db (decibel) or worse in the best ear, across speech frequency. Clinical term which refers to any loss of hearing weather mild, moderate or severe. An individual who has a hearing loss as determined by the standardized test but has some usable hearing.

Hearing
Impairment

Hard of hearing

Culturally deaf

Term refers to a person who adheres to behavioral norms of the Deaf Community and who uses visual/gesture language as his/her primary mode of communication.

Level

Management

Behavioral Feature

Mild 20-50 Db loss Some difficulty hearing. Needs to be disability in best ear placed in front of the class to be able to hear teacher. Understand normal speech, speaks normally. May wear a hearing aid. Moderate 50-70 Db loss Difficulty in hearing speech even with in best ear hearing aid. Affects expressive speech. Severe/ 71-90 Db No useful hearing evident. Profound 91 Db Totally deaf No hearing at all

Causes: 1. Present at birth- genetic causes, brain damage

from lack of oxygen or other causes affecting

inner ear & unknown causes

2. Acquired- middle ear infection, injuries & noise

(at 3000, 4000, or 6000 Hz. As noise damage progresses, damage spreads to affect lower and higher frequencies.)

Visual Disability
Level

Measurement

Behavioral Features

Mild Can see chart with Can get around without difficulty pinhole when corrected by glasses
Mode 6/18 or 20/60 Can move about with a cane rate (6-meters by 18-letter size= Condition cannot be corrected by
log mar; 20-feet by 60 letter size= snellen chart)

glasses
No vision except light. Needs cane

Severe 6/60 or 20/200

(6-meters by 60-letter size= log mar; 20-feet by 60 letter size= snellen chart)

Classification
Low vision
WHO classification: visual acuity of less than 20/60 (6/18), but equal to or better than 20/200 (6/60), or corresponding visual field loss to less than 20 degrees, in the better eye with best possible correction. Blindness that has some angle of fixation. Vision of 20/200 (6/60) or less in the better eye with best correction possible. This means that a legally blind individual would have to stand 20 feet (6.1 m) from an object to see itwith corrective lenses with the same degree of clarity as a normally sighted person could from 200 feet (61 m). Used to describe severe visual impairment with residual vision. Can be given optical devices such as magnifying lenses & telescope. Visual acuity of less than 20/400 (6/120), or corresponding visual field loss to less than 10 degrees, in the better eye with best possible correction. Is the complete lack of form & visual light perception.

Legally blind

Blindness

Total blindness

PHYSICAL DISABILITY

is any impairment which limits the physical function of one or more limbs or fine or gross motor ability. Motor problems can be causes when a part of the body is injured, deformed or defective. Usually caused by damage to the brain or nerves. Examples: amputation, paraplegia, hemiplegia, cerebral palsy Early signs: slowness or failure to develop milestone (lift head, roll over, sit, balance, stand & walk as well as pulling, pushing or banging objects), abnormality in the limbs, one side of body move less or weak or stiff. Motor problem that affects 1. sitting/balance 2. use of arms/hands 3. use of legs

Motor Function

Expected age N milestone

Mild

Moderate

Severe

Sitting/ balance Use of arms

5-6 monthssit unaided 7-12 monthsdrink in a cup, uses hands to dress, claps and start to use hands to build blocks 1-2 yearswalks, kicks & climb furniture

Some difficulty in Needs support prolonged sitting, to sit upright no support need Grasp maybe weak, can hold most instruments (spoon, pen, knife), can dress self Difficulty in holding small things (like picking up pills) using arms for dressing

Requires full support Does not use hands for any more than reaching or pointing

Milestone

Use of legs

Walks unaided may limp or have an artificial leg; difficult climbing steep/ steps or may drag 1 foot.

Needs Cannot walk at maximum aid all to walk but can move about

is a generalized disorder appearing before adulthood, characterized by significantly impaired cognitive functioning & deficits in two or more adaptive behaviors (communication, interpersonal- social skills, self help & self
care skills).

Measured by 2 components: 1. Mental functioning or cognition=

IQ score under 70

2. Individuals' functional skills in their environment.

Note: A person with a below-average intelligence quotient (BAIQ) may not be considered mentally retarded.

3. Before age 18

Degree of disability/class
Borderline IQ 71-84

Motor
Normal
Usually normal

Speech
Normal
Maybe mildly delayed but speaks in simple sentences

Understanding
Normal
Fair in everyday situations but takes time to learn. Maybe easily confused by too much language. Limited academic ability Unlikely to learn any significant academic skills but will know signs & simple words. Quite able to understand things relevant to her/ himself

Independence
Normal
Can live independently but maybe exploited by others who recognize their gullibility

Mild IQ 50-69
(Cognitive function of half to 2/3 of Normal;.unidentified until child goes to school)

Can develop simple Moderate- IQ 35- Often 49 (apparent within delayed in functional; speech,

ID

the first years of life) infancy but or may speak only CNS is intact single words. Can make their needs & thought known

Can achieve independence in self help skills but cannot live totally alone. Would need a guardian such as in small group home.

Severe- IQ 20-34 and Profound- IQ below 20 (will need more intensive support and supervision his or her entire life)

Severe delays maybe unable to walk

Single or no words. Unlikely Can make simple gestures

Minimal independence in self help skills but will need help & supervision.

Can manifest as difficulty in processing verbal & non-verbal information, difficulty understanding written or spoken language that is due to a neurological difference in brain structure or function. Its not a problem of low IQ (can be average or above average). The problem is due to how the person learns NOT due to low intelligence LD versus Developmental delay DD- low average over all intellectual functioning. Due to mental retardation or CP,
epilepsy, ASD & other neurologic condition

Problem in one or more area: 1. Reading- Dyslexia 2. Math- Dyscalculia 3. Writing- dysgraphia 4. LD in language & communication
understanding or both). Language skills & development

(spoken &

5. LD with behavioral- social skills 6. cognitive development & memory 7. attention & organization 8. test taking

Group of disorder caused by damage to the brain before, during or after birth. It affects persons ability to move, maintain balance & speak. CP is the most common physical diability Causes: genetic, lack of oxygen, cerebral hemorrhage (bleeding in the brain or stroke) jaundice in new born or accidental forceps deliveries Symptom & signs depends on location of the injury in the brain. Ex. Cortex which control movement- spastic CP, basal nuclei under base of brain- balance & coordination is affected

4 Main types: 1. Spastic- increase muscle tone. Stiff muscles, movement awkward 2. Athetoid- slow contorting movements affect limbs and face. Balance & speech is affected. Severe delay in walking 3. Ataxic- unsteadiness, broad base walking and gross tremors of limbs & trunk 4. Mixed spastic & athetoid 3 physical types: 1. Quadriplegia- all four limbs & trunk is affected 2. Diplegia- legs are only affected. (diplegia vs paraplegiaDipledia is due to cortical damage, paraplegia is due to SCI or disease)

3. Hemiplegia- one side of body is affected

describes a range of conditions classified as Pervasive developmental dso (include Autism, Asperger, Pervasive
developmental not specified, childhood diintegrative dso & Rett syndrome)

characterized by delays or abnormal functioning before the age of three years in one or more of the following domains: (1) social interaction- poor use of nonverbal communication, difficulty in peer relations, lack of social-emotional reciprocity, and lack of shared enjoyment; (2) communication- failure to develop speech, use of stereotyped or delayed
echolalia, and difficulties maintaining conversations; Social and communication

Picture

& (3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities- unusual preoccupations
impairments may also cause a lack of symbolic or imaginative play.

with narrow interests, inflexibility to nonfunctional routines, stereotyped and repetitive mannerisms, and preoccupations with parts of object

Instruction: Group once again to discuss 1. communication difficulties per

disability kind.
2. how can we

communicate better,
more effectively?

 1.

Challenges: Creating environment for AWD to speak freely on

sensitive topic & not be embarrassed.

2.

Attitude toward PWD & their right to information & services

(showing of disapproval, surprise, condescension, or pity will not help)

3. 4.

Relationship between adolescent & their parents Specific difficulties in communicating with young people with specific disabilities

Effective communication is base on trust & ability of service provider to communicate within their level. Utilize communication tools ex. interpreters, visual aids Deaf- Interpreters, sign language or lip reading Blind & VI- due to no body language (inability to read body language, give eye contact or receive a nod or smile). Use other form of communication: use of touch, speech synthesizer, screen view programs, reading machines. Low vision devices, visual aids & large print text. Physical disability- non-verbal language is critical. Should have a positive & caring attitude.

Intellectual Impairment: Basic principle: 1. speak clearly 2. use simple language 3. use visual cues 4. minimal information at a time 5. Repetition 6. practical situation & examples- No to long explanation 7. if its complicated break down information into small steps . 8. Be generous in praise and use of reinforcements.

Autism Spectrum disorder Difficulties 1. resistance to change- Establish routine 2. Difficulty in expressing needs/ lack of speech- use other ways to communicate 3. Repeating words & phrases 4. Distress not apparent to others & tantrums 5. Anti-social tendency 6. Lack of affection & no perception to danger 7. Poor eye contact 8. Inappropriate attachment to objects 9. Unresponsive & ignores if spoken to 10. Sustained odd play 11. Low tolerance to certain food texture

Situation: HI adolescent goes through same developmental stages with hearing counterpart. But auditory limitation cause differences in ability to acquire & transmit information on sexual matters. Deaf community tend to stay together & form intimate friendship among themselves. Guidance for professionals & parents- to appreciate sexuality while encouraging them to practice appropriate behavior & acceptable behavior Use of interpreters: during classes & counseling sessions

 1.

Situation: challenges to blind Ability to understand the relationship between objects

(Concept development)

Avoiding objects or irregularities on the ground 3. Self help skills 4. Functions of objects & abstract ideas 5. Color Learn concept of braille & appropriate technical aidsso children can learn same range of academic skills as sighted peers. Use of talking software
2.

Situation: physically disabled adolescent- sometimes stigmatized & always stared at. They have same social & sexual aspiration as their peers but often over looked. Sexual problems are most likely to result from their isolation & physical impairment.

Mild ID/MR- teaching instruction should be CLEAR, SIMPLE & SPOKEN SLOWLY and repeated. Instruction: broken into a series of simple steps, use visuals to solidify information & use information delivery methods Moderate ID/MR- they have normal physical & sexual development at puberty but due to limited grasp of nuances of social skills- sometimes behave inappropriately leading to misunderstanding/misinterpretation (oversexed). Note DS girls- is fertile boys are not. 50% chance will inherit DS. Severe & profound ID/MR- growth, sexual development & feelings are normal, but may not able to handle hygenic aspect of menstruation & in institutional setting they may masturbateopnely