SLIDE 1: INTRODUCTION TO "DISABILITIES"
We are now ready to begin the first module: Introduction to "Disabilities". In this section, we will learn what a disability is, get some numbers to show how many people we are talking about, and learn some ways to serve people with various types of disabilities.
When you are done with this slide,
either click on the right arrow under the slide or the next set of words listed
in the column to the left of the slide. You will use this method to move through
the slides in each of the modules. If you are interrupted part way through a
session, you can get back to where you stopped by clicking on the arrow until
you get to that slide or by clicking directly on that slide title listed at
the left of the slide. You can also use the same method in reverse to get back
to a slide you wish to review.
SLIDE 2: WHAT IS A
DISABILITY?
So, what is a disability? Often we think about it in terms of knowing a disability when we see one. People in wheelchairs are a good example, right? Did I have a disability when I broke my foot and used a wheelchair to get around in ice and snow (four wheels were more stable than two crutches)? How about when a friend had an at-risk pregnancy and she used a wheelchair to attend an arts and crafts fair to stay off her feet? Some disabilities are invisible. Learning disabilities, for example, are hard to spot, difficult to diagnose, and impossible to get good prevalence data, but one estimate is that 10 to 15 percent of the general population has a learning disability (www.seakingwdc.org/ld/LD-B.htm). Using the "knowing it when you see it" criteria doesn't help here.
Is a temporary condition, like my broken foot, a disability? Or does someone have to have a lifelong disability to be considered a person with a disability? A 22-year-old has a motorcycle accident and becomes a quadriplegic. Does he have a disability? Will he have it the rest of his life? Does it matter?
How about health conditions? Are AIDS, asthma, and pregnancy, for example, considered disabilities?
These questions aren't random, and
we'll talk about why as you move through the next few slides.
SLIDE 3: DISABILITIES DEFINED
One way to define a disability is with the existence of a diagnosed condition. Down syndrome and cerebral palsy, for example, are specific disabilities that can be diagnosed and labeled; however, some disabilities are difficult to diagnose (autism and learning disabilities, for example), and others have degrees of disability (only has peripheral vision versus total blindness, for example). This is part of the difficulty with disability determination.
In some instances, using the criteria that the condition prevents an individual's ability to work is used as a definition of disability. Social Security Disability Insurance (SSDI) is one example of this. If someone who has worked develops a condition that meets the criteria of Social Security Determination, he or she can receive SSDI. With advances in technology and many of the current state and federal initiatives, however, people with the most significant disabilities are getting jobs. So who decides whether a person with a disability is able to work or not?
Many areas have moved to functional definitions of disability based on state or federal laws or established convention. For example, the U.S. Census Bureau uses the following definition:
U.S. Bureau of the Census. (1997).
Census brief, CENBR/97-5. Washington, DC: Author.
SLIDE 4: FUNCTIONAL DEFINITIONS
So, let's consider some of the functional components of various disabilities starting with learning disabilities. By definition, people with learning disabilities have no primary problem with intellectual functioning; vision, hearing, or motor abilities; or environmental, cultural, or economic disadvantages. They do have deficits in perceptual, integrative, or expressive processes involving understanding or use of spoken or written language.
Another term used to describe one sector of the disability population is mental retardation. Although there is some concern with this term and other phrases such as cognitive disability and mental disability have been used, there is currently no better phrase to describe this population. The definition used to define mental retardation is the one adopted by the American Association on Mental Retardation (1992).
Physical disabilities generally refer to conditions that seriously impair locomotion or motor functions and adversely affects daily activities. This group would include people with cerebral palsy, amputations, para- and quadriplegia, fractures, and burns that cause contractures. Other terms that might be used include "Orthopedic impairment" and "Motor disorder".
Individuals with vision loss, even with correction from glasses or contact lenses, are considered people with visual impairments. Few people are totally blind. Most have some level of shading.
Hearing loss that adversely affects daily functioning is generally defined as a hearing impairment. The impairment can be permanent or fluctuating, mild to profound, and affect one or both ears.
A range of disorders constitutes communication impairments. They include the ability to produce intelligible sounds and the ability to understand spoken or written language. The impairment may be a primary or secondary disability.
Behavior disorders, mental illness, emotional disorders, and mental health needs are terms used to define another range of disorders. They can include anxiety disorders, depression, schizophrenia, bipolar disorder, and eating disorders. The diagnosis is generally associated with a condition that exists over a long period of time and to a marked degree, interferes with daily functioning, and may be a primary or secondary diagnosis.
Health impairments are those that adversely affect performance and limit strength, vitality, or alertness due to chronic or acute health problems. Severe heart and respiratory conditions would fit in this category. Again, the disability may be a primary or secondary diagnosis.
The phrase "primary or secondary
diagnosis" has been used throughout this section. When a person has a secondary
diagnosis, they may be included in the group with multiple disabilities. One
group of people profoundly impacted by multiple disabilities are those who are
blind and deaf, as Helen Keller was.
SLIDE 5: ANOTHER WAY TO
VIEW
Most of the definitions for disabilities
think about the issue from the medical model: "Fix the person". There
is another way to view the disability issue. When you use a civil rights model
you think about fixing society. What can we do to minimize the barriers people
with disabilities confront every day? Rather than expecting people with disabilities
to make the adjustments, are there other types of curb cuts out there that we
can initiate?
SLIDE 6: NUMBERS, PLEASE
For lots of reasons, it's difficult to give definite numbers. Schools have pretty good numbers for students who qualify for special education services, but that only covers ages three to approximately eighteen. Until the 2000 U.S. Census, no one collected data across the lifespan.
Here are a few numbers that have been put together. A 1986 Harris poll estimated that 15% of Americans age 16 and older have a disability. In 1998, Julie Klauber estimated that 20% of the American population has a disability. A recent article in the Journal of the American Medical Association stated that seven percent have attention deficit hyperactivity disorder. And some learning disability surveys state that 20% have learning disabilities alone.
In 1997, the Census Bureau issued a special report entitled Americans with Disabilities, by Jack McNeil. This document, part of their Current Population Reports series, reported on Americans 15-years-old and over. The report stated that 33 million had severe disabilities. Twenty-five million had ambulatory disabilities that required such aid as the use of a wheelchair, cane, crutches, or a walker. Individuals with difficulty using their hands and fingers to pick up objects such as a glass or pencil numbered 6.8 million. Eight million had hearing loss, and 7.7 million had difficulty seeing the words and letters in ordinary newspaper print.
The Census Bureau also reported that
the likelihood of having a disability increased with age; therefore, there will
be rapid increases in the number of people with disabilities as the Baby Boom
population ages. Modern medical technology is also enhancing the survival rate
of at-risk infants and aging individuals, another contributing factor to the
increase in the numbers of people with disabilities.
SLIDE 7: SERVICE CONSIDERATIONS
In 2000, a book entitled Adaptive Technology for the Internet by Barbara Mates, a librarian at Cleveland Public Library, was published. This book provides a lot of valuable information, including tips for working with individuals with specific disabilities. In the next module, we will discuss assistive technology to support access to the Internet. Here, we will consider some of Barbara's tips that do not need software and hardware.
First and foremost, see the person before you see the disability. More important than the wheelchair or companion dog, for example, is the person who has information, recreation, and education needs just like every other library patron. Beginning your interaction in this manner will help put both of you more at ease.
When providing assistance to people with visual impairments who want to use the computer, use explicit instructions to guide them. For example, you should tell them to press the large key on the third row down on the right of the keyboard rather than simply saying that they should hit the Enter key. When you leave the person, be sure you tell them you are leaving, tell them your name, and give them specific directions for locating you to seek additional assistance. Don't assume they will sense that you are gone or that they will be able to find you when they need you. If there is a companion dog, do not pet or talk to the animal.
People with hearing impairments use a variety of means for communicating. These include writing, sign language, and lip reading. Start by determining what methods work best with each patron with a hearing impairment. Be sure you have their attention when you are talking to them. Don't turn your back or cover your mouth while talking with an individual who is reading your lips. If they have a sign language interpreter, talk to the person with the hearing impairment, not the interpreter. Because there are some sounds that are more difficult to hear than others, rephrase your statement rather than simply repeating the same words over and over again if you can't be understood.
When assisting individuals who use wheelchairs, try to talk to them at eye level if you are having an extended conversation. That does not mean kneeling down as you would with a child, but pulling up a chair for a more professional interaction. When working at a computer, find a table that has been adjusted to accommodate the wheelchair and put any needed instructions within easy reach of the individual. Finally, don't touch the wheelchair without permission. Many people who use wheelchairs see them as an extension of their bodies, and touching the chair is like touching them.
There are various types of cognitive
disabilities including learning disabilities and mental retardation. Although
the intellectual level of each is different, many of the same tips work with
each population. They may not be able to read instructions, so you might have
to read them aloud. Some words may be too difficult to understand, so other
words or a demonstration of what you are talking about may be needed. Try to
minimize distractions.
SLIDE 8: NEXT MODULE
While the tips should help you feel more comfortable working with people with disabilities, some individuals may need assistive technology to help them access the Internet. In the next module, we will discuss the different types of devices that are available, what they can do, and who might use them.
If you have any comments about the modules, please feel free to share them with Elbert Johns via e-mail at [email protected] or Marilyn Irwin at [email protected].
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Copyright © 2003
Indiana Institute on Disability and Community
Indiana University, Bloomington