The basic concept of Disability

1. The basic concept of Disability Dr. Rehab F. Gwada Lecture 1

2. Aims of Lecture 1- Define the concepts of disability. 2- Know the different between impairment, disability and handicap. 3- Appraise the models of disability . 4- Describe the types of disability. 5- Know the steps of the management as general.

3. Do you know a disabled person? What is his or her disability? What does he or she do for a living?

4. What is Disability? • Disability groups and other organizations may have their own definitions of disability. The concept of disability is complex. • Lets take a look at some definitions of the word "Disability" as defined by various organizations around the world.

5. What is Disability? The Disability Discrimination Act (DDA) defines a disabled person as someone who has a physicalor mental impairment that has a substantial and long-termadverse effect on his or her ability to carry out normal day-to-dayactivities. The adverse effect is substantial and long-term (meaning it has lasted for 12 months, or is likely to last for more than 12 months or for the rest of the person's life).

6. What is Disability? • In defining ‘normal day-to-day activities’ the DDA states that at least one of the following areas must be badly affected: • Mobility • Manual dexterity • Physical coordination • Continence • Ability to lift, carry or move everyday objects • Speech, hearing or eyesight • Memory or ability to concentrate, learn or understand • Understanding of the risk of physical danger.

7. What is Disability? Definitions of International Classification of Impairments, Disabilities and Handicaps (ICIDH) • World Health Organization in 1980, draws a three-fold distinction between impairment, disability and handicap, defined as follows: • Impairmentisany loss or abnormality of psychological, physiological or anatomical structure or function. • Disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. • Handicap is a disadvantage for a given individual, resulting from an impairment or a disability, that prevents the fulfillment of a role that is considered normal (depending on age, sex and social and cultural factors) for that individual.

8. handicapped • Handicap is therefore a function of the relationship between disabled persons and their environment. • It occurs when they encounter cultural, physical or social barriers which prevent their access to the various systems of society that are available to other citizens. • 'handicap'-focuses on the person as a social being and reflects the interaction with and adaptation to the person's surroundings.

9. Task( true or false ) • All disabled people are impaired • All handicapped people are disabled • A person can be impaired and necessarily be disabled. • A person can be disabled without Being handicapped.

10. International Classification of Functioning, Disability and Health (ICF) • the WHO released a major revision of the ICIDH in 2001, called (ICF) • Provide the rehabilitation disciplines with a universal language with which to discuss disability and related phenomena. • the ICF shows human function and decreases in functioning as the product of a dynamic interaction between various health conditions and contextual factors.

11. International Classification of Functioning, Disability and Health (ICF) The ICF identifies 3 levels of human function These levels, in turn, contain 3 domains of human function: • at the level of body parts. • the whole person. • The whole person in their complete environment. • body functions and structures. • Activities. • Participation. The term disability is used to denote a decrement at each level (ie, impairment, an activity limitation, and a participation restriction).

12. The International Classification of Function, Disability and Health (ICF)

13. The International Classification of Function, Disability and Health (ICF) • Health Conditions—diseases, disorders, and injuries. • Body Function—physiological or psychological functions of body systems • Body Structures—anatomical parts of the body • Impairments—problems in body functions or structure • Activity—the execution of a task or action by an individual • Activity Limitation—difficulties an individual may have in executing activities • Participation—involvement in a life situation • Participation Restriction—problems an individual may experience in involvement in life situations

14. Models of Disability I-THE MORAL MODEL II-THE MEDICAL MODEL • Is historically the oldest and is less prevalent today. • Regards disability as sin and shame, and often associated with feelings of guilt • Families have hidden away the disabled family member, keeping them out of school and excluded from any chance at having a meaningful role in society. • Came about as "modern" medicine began to develop in the 19th Century, along with the enhanced role of the physician in society. • Regards disability as a defect or sickness which must be cured through medical intervention • The individual with a disability come under the authority of the medical profession in order to get better. Thus, until recently, most disability policy issues have been regarded as health issues.

16. Models of Disability III-The Rehabilitation Model • Is similar to the medical model; it regards the person with a disability as in need of services from a rehabilitation professional who can provide training, therapy, counseling or other services to make up for the deficiency caused by the disability. • Historically, it gained acceptance after World War II when many disabled veterans needed to be re-introduced into society.

17. Models of Disability IV- The disability model • Which regards disability as a normal aspect of life, not as a deviance and rejects the notion that persons with disabilities are in some inherent way "defective". • As Professor David Pfeiffer has put it, "paralyzed limbs may not particularly limit a person's mobility as much as attitudinal barriers”. • Given this reality, if disability were more commonly recognized and expected in the way that we design our environments or our systems, it would not seem so abnormal.

18. Dimensions of disability: People with disabilities are not a homogeneous group • Type of disability • Physical • Sensory • Intellectual • Psychiatric • Severity • Severe • Moderate • Mild • Onset • Birth • Childhood • Adulthood • Visibility • Observable • Invisible • Causes • Birth Defect • Accident • Illness • Other Gender makes a huge difference

19. Select the best answer • A 36-year-old paraplegic patient who is unable to prepare his own meal or care for his own toileting or hygiene needs, according to ICIDH is • A)Disable and handicapped • B)Impaired only • C) Disable but not handicapped

20. Select the best answer • a 12-year-old paraplegic patient who can walk only with the assistance of crutches but who attends a regular school and is fully independent in activities of daily living , according to ICIDH is • A)Disable and handicapped • B)Impaired only • C)Handicapped • D) Disable but not handicapped

21. Select the best answer • Two individuals may sustain back injuries. The first, who worked as a clerk, was unable to walk, sit, stand, drive and care for her home. The second individual who worked in construction sustained a back injury but was not limited in any major life activity , according to ICIDH. • The first is considered to be an individual with: • Impairment - Disability The second is considered to be an individual with • Impairment - Disability

22. Types of Disability • Physical • Sensory • Intellectual/cognitive • Mental/Psychiatric • Developmental

23. 1-Physical disabilities • Persons with physical disabilities may experience functional, orthopedic, fine or gross motor impairments, which may impact upon their ability to walk, play and learn. • Physical disabilities are also often defined and categorized by some degree of limitation in the use of upper or lower extremities and maintaining posture and positioning. • So physical disabilities refer to a broad range include orthopedic ,neurological, cardiovascular and pulmonary disorders.

24. Physical disabilities(Causes) • Prenatal causes: Those disabilities that are acquired before birth. These may be due to diseases that have harmed the mother during pregnancy, or genetic incompatibilities between the parents. • Perinatal causes: Those disabilities that are acquired during birth. This could be due to prolonged lack of oxygen or the obstruction of the respiratory track, damage to the brain during birth (due to the accidental misuse of forceps, for example) or the baby being born prematurely. • Postnatal causes: Those disabilities gained after birth. They can be due to accidents, infection or other illnesses

25. 2-Sensory Disability • It is impairment of one of the senses. The term is used primarily to refer to vision and hearing impairment, but other senses can be impaired. • a-Visual impairment • b-Hearing impairment • c-Olfactory and gustatory impairment • d-Somatosensory impairment • e-Balance disorder

26. a)Visual Impairment • A visual impairment affects a person’s ability to see, and includes: • (1) inability to see images clearly and distinctly • (2)loss of visual field • (3) inability to detect small changes in brightness • (4) color blindness • (5)sensitivity to light. • A cane may be used to assist with mobility, and/or Braille may be used to read.

27. b)Hearing Impairment • Hearing impairments range from a mild hearing loss to total deafness. • People who are deaf may use American Sign Language or lip-read, and may speak for themselves or use a sign-language interpreter.

28. c-Olfactory and gustatory impairment • Impairment of the sense of smell and taste are commonly associated with aging but can also occur in younger people due to a wide variety of causes. • Complete loss of the sense of taste is known as ageusia, while dysgeusiais persistent abnormal sense of taste.

29. d-Somatosensory Impairment • Insensitivity to stimuli such as Touch , heat,cold , and pain are often an adjunct to a more general physical impairment involving neural pathways and is very commonly associated with paralysis (in which the motor neural circuits are also affected).

30. e-Balance disorder • It is a disturbance that causes an individual to feel unsteady. • Balance is the result of several body systems working together. The eyes (visual system), ears (vestibular system) and the body's sense of where it is in space (proprioception) need to be intact. The brain, which compiles this information, needs to be functioning effectively.

31. 3-Cognitive /Intellectual Impairment • A cognitive impairment affects a person’s ability to reason, understand, and learn. • Cognitive disabilities are separated into two categories: learning disabilities and mental retardation. • A learning disability is defined as " a heterogeneous group of disorders manifested by significant difficulties in the use of listening, speaking, reading, writing, reasoning or mathematical abilities. • These disorders are presumed to be due to central nervous system dysfunction.

32. DisabilityMental/Psychiatric • A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which are not a part of normal development or culture.

33. 5-Developmental Disability • the term developmental disability commonly refers to a severe and chronic disability that is often attributable to a mental or physical impairment that occurs prior to age 18.There are five most common types of developmental disability • Mental Retardation, • Cerebral Palsy, • Epilepsy, • Autism, • Neurological Impairments A developmental disability can result in functional limitations in: • self-care. • learning; language and communication. • mobility and movement. • socialization; independence.

34. Invisible Disability • They are disabilities that are not immediately apparent. • Some people with visual or auditory disabilities, who do not wear glasses or hearing aids, or discreet hearing aids, may not be obviously disabled. • Some people with chronic illnesses and conditions such as renal failure, diabetes, asthma, epilepsy and sleep disorders ,if those ailments significantly impair normal activities of daily living. • Other invisible disabilities include, AIDS, cancer, and autism.

35. Management 1-Different Therapy After evaluation and diagnosis, the case is directed to the suitable therapeutic program. The treatment my include: •Medications. •Physical therapy. •Occupational therapy. •Speech therapy. •Others

36. Management 2-Assistive technology or adaptive technology(AT) • It is an umbrella term that includes assistive, adaptive, and rehabilitative devices for people with disabilities toenhance their abilities and are better able to live independently and participate in their communities. • Assistive devices and technologies such as: • Wheelchairs. • Prostheses. • mobility aides. • hearing and visual aids. • specialized computer software and hardware.

37. Management 3 -Adapted sports • Organized sport for athletes with a disability is generally divided into three broad disability groups: • The deaf. • People with physical disabilities. • People with intellectual disabilities. • Each group has a distinct history, organization, competition program, and approach to sport. • Example: Wheel chair Basketball is a form of basketball usually played by the physically impaired. Participants play on specially designed wheelchairs, built specifically for the sport.

38. Changing concepts of disability Human rights issue Economics of disability The New Disability Business Case