Disabilities

Type and Characteristics

module 2
Najah Ummer
Assistant Professor,
Dept. of Psychology
Jain University, Kochi
SYLLABUS
 What is a Disability?
Disability refers to a limitation in performing
activities or participating in social,
educational, or occupational life due to a
physical, sensory, intellectual, or mental
impairment.
According to the World Health Organization
(WHO), disability is the result of the interaction
between a health condition and contextual
factors, including environmental and personal
factors.
 What is a Disability?
Impairment refers to a loss or abnormality in body structure or
function. It may be physical, sensory, intellectual, or psychological in
nature. Impairment is at the level of the body.
Example: Loss of vision, hearing loss, limb amputation, cognitive deficit.

A disorder is a clinically diagnosable condition that affects physical

or mental health. It is usually identified using diagnostic criteria. A
disorder may or may not lead to disability.
Example: Autism Spectrum Disorder, Schizophrenia, Major Depressive
Disorder.
 What is a Disability?
Disability refers to difficulty in performing activities due to an impairment
or disorder.
It is the functional limitation that affects daily living, communication,
learning, or mobility. Disability is at the level of activity limitation.
Example: A person with visual impairment may have difficulty reading
printed text.
Participation restriction refers to problems an individual faces while
engaging in social, educational, or occupational roles. This is influenced by
environmental and societal barriers.
Example: A child with hearing impairment may face difficulty participating
in classroom discussions.
 Causes of Disabilities
Congenital Causes
Conditions present at birth due to genetic or
developmental factors.
Example: Down syndrome, congenital blindness.
Example:

Genetic Causes
Disabilities inherited through genetic mutations
or chromosomal abnormalities.
Example: Muscular dystrophy.
Example:
 Causes of Disabilities
Prenatal and Perinatal
Factors affecting the baby during pregnancy or
birth. Examples: Maternal infections, Malnutrition,
Premature birth

Acquired Causes
Disabilities that develop after birth due to
Accidents or trauma, Brain injury, Infections,
Chronic illness, Substance abuse

Environmental Stressor
Broad classification of
disabilities

Sensory Disabilities: These affect the senses.

Visual Disability
Hearing Disability
Speech Disability

These primarily impact communication and

perception.
 Broad classification of
disabilities
Intellectual and Developmental Disabilities
These affect intellectual functioning and
developmental milestones.
Intellectual Disability
Intellectual
Autism Spectrum Disorder
Cerebral Palsy (developmental motor disorder)

These impact learning, adaptive functioning, and

behavior.
 Broad classification of
disabilities
Physical Disabilities: These affect movement and
physical functioning.
Orthopaedic Disabilities
Neuromuscular Disorders

These primarily impact mobility and motor control.

VISUAL DISABILITY
Visual disability refers to a significant limitation in
vision that cannot be fully corrected by glasses,
contact lenses, medication, or surgery.

It affects a person’s ability to perform daily

activities such as reading, writing, mobility, and
recognizing faces.
Visual disability may range from low vision to
complete blindness.
blindness.
tYPES & lIMITATIONS
11.. Blindness
Complete or near complete loss of vision.
2. Low Vision
2.
Partial loss of vision where the person has some usable
vision but requires assistive devices.

Visual disability may impact:

Academic performance
Mobility and independence
Employment opportunities
Social interaction
cAUSES
Visual disability may occur due to:
[Link]
. Congenital factors (present at birth)
[Link]
2 . Genetic conditions
[Link]
3 . Infections (e.g., measles, rubella)
[Link]
4 . Injury or trauma
[Link]
5 . Chronic illnesses (e.g., diabetes)
[Link]-related
6. Age-related conditions
CHARACTERISTICS
Individuals with visual disability may
experience:
Difficulty
D ifficulty reading printed material
Difficulty
Diff iculty recognizing faces
Problems with orientation and mobility
Increased dependence on auditory
and tactile cues
psychological aspects
Visual disability affects not only sensory functioning but also emotional and social
well-being.
Individuals, especially those with acquired vision loss, may experience grief,
frustration, anxiety, or depression due to sudden changes in independence.
Self-esteem and self-concept may be affected, particularly during adolescence,
as social comparison becomes stronger.
Difficulty interpreting non-verbal cues may lead to social withdrawal or reduced
confidence in social situations.
Family overprotection may unintentionally reduce autonomy and independence.
independence.
Psychosocial Rehabilitation
Rehabilitation focuses on restoring independence, confidence, and social
participation.
Psychological counselling helps individuals adjust emotionally and develop
coping strategies.
Orientation and mobility training,
training, along with assistive technology (Braille,
screen readers), improves functional independence.
Family education is important to encourage autonomy rather than dependency.
Vocational training and inclusive education promote long-term social
integration and dignity.
Hearing disability

Hearing disability refers to a partial or

complete loss of hearing that affects
communication and interaction.
It may range from mild hearing loss to
profound deafness.
Hearing impairment affects language
development, communication skills,
and social interaction.
 types of hearing disability

[Link]
. Conductive Hearing Loss
Problem in outer or middle ear affecting sound transmission.
2. Sensorineural Hearing Loss
[Link]
Damage to inner ear or auditory nerve.
3. Mixed Hearing Loss
[Link]
Combination of conductive and sensorineural loss.
4. Pre-lingual vs Post-lingual Deafness
[Link]-lingual
Before language development vs after language development.
Causes of hearing disability

Congenital factors
Genetic conditions
Maternal infections during
pregnancy
Birth complications
Ear infections
Exposure to loud noise
Head injury
characteristics

Difficulty hearing speech clearly

Delayed speech and language
development
Communication barriers
Dependence on visual cues
Difficulty following classroom
instruction
functional limitation

Academic challenges
Social withdrawal
Reduced peer interaction
Difficulty in employment
settings
Misinterpretation as
inattentiveness
 psychological aspect of hearing disability

[Link]
. Hearing disability can significantly affect emotional and social
development.
2. Children may experience frustration due to communication
[Link]
barriers.
3. There may be feelings of isolation or exclusion.
[Link]
4. Self-esteem may be affected, especially in adolescence.
[Link]-esteem
5. Communication barriers may lead to behavioral issues or
[Link]
withdrawal.
 psychosocial rehabilitation
Rehabilitation focuses on improving communication and
social participation.
Interventions include:
Hearing aids or cochlear implants
Speech therapy
Speech
Sign language training
Inclusive classroom support
Family counselling
Social acceptance and supportive environments are
crucial for long-term adjustment.
speech disability
Speech disability refers to difficulty
in producing clear and
understandable speech due to
problems in articulation, fluency,
voice, or motor coordination.
It affects verbal communication
but does not necessarily affect
intelligence.
types of speech disability

1. Articulation Disorders - Difficulty

pronouncing sounds correctly.
2. Fluency Disorders - Disruption in flow of
speech (e.g., stammering/stuttering).
3. Voice Disorders - Abnormal pitch, volume,
or quality of voice.
4. Motor Speech Disorders - Difficulty due
to neurological conditions (e.g., dysarthria).
causes of speech disability

Developmental delays
Hearing impairment
Neurological disorders
Cerebral palsy
Brain injury
Emotional factors
psychological and social impact

Speech difficulties may lead to:

Low self-confidence
Social anxiety
Avoidance of public speaking
Peer teasing or bullying
Withdrawal from social situations
psychosocial rehabilitation
Rehabilitation includes:
Speech therapy
Communication skills training
Confidence-building exercises
Family counselling
Inclusive classroom support
Focus is on communication competence,
not just speech clarity.
intellectual disability
Intellectual Disability is a
neurodevelopmental condition
characterized by significant limitations in
intellectual functioning and adaptive
behavior.
It originates during the developmental
period (before 18 years of age).
It affects reasoning,
reasoning, problem-solving,
learning, and independent functioning.
key diagnostic features
Intellectual Disability includes:
Below-average intellectual
functioning (typically IQ below 70)
Deficits in adaptive behavior
Onset during childhood
Adaptive behavior includes difficulties
difficulties in:
Communication, Social skills, Self-care,
Communication,
Practical daily living skills
levels of ID
Intellectual Disability is classified into:
Mild, Moderate, Severe, Profound
The level depends on adaptive
functioning as well, not only IQ score.
Mild cases may live semi-independently
with support.
Severe and profound
profound cases require
continuous supervision.
 causes of id
Intellectual Disability may result from:
Genetic conditions (e.g., Down syndrome)
Prenatal infections
Birth complications (oxygen deprivation)
Malnutrition
Brain injury
Environmental deprivation
Environmental
Sometimes the exact cause is unknown.
Sometimes
characteristics

Individuals may show:

Delayed developmental milestones
Delayed
Difficulty in abstract thinking
Slow learning pace
Poor problem-solving skills
Difficulty understanding
understanding social rules
Social immaturity
Social immaturity is common.
 psychological aspects of id

Intellectual Disability affects emotional and social

development.
Children may experience frustration due to academic
difficulty.
There may be low self-esteem due to comparison with peers.
They are more vulnerable to bullying and social exclusion.
Overprotection by family may reduce independence.
 psychosocial rehabilitation
Rehabilitation focuses on maximizing functional independence.
Interventions include:
Special education and individualized learning plans
Life skills training (money management, hygiene, travel training)
Behavioral interventions
Family education and counseling
Vocational training programs
The goal is not “cure” but improving adaptive functioning and quality
of life.
autism spectrum disorder
Autism Spectrum Disorder is a neurodevelopmental
disorder characterized by persistent difficulties in social
communication and interaction,
interaction, along with restricted
and repetitive patterns of behavior.
It begins in early childhood and affects social
functioning.
The term “spectrum”
“spectrum” indicates varying levels of severity.
 core features of asd
Autism is characterized by two main domains:
[Link]
. Social Communication Deficits:
Difficulty in maintaining eye contact
Difficulty understanding social cues
Limited peer interaction
2.. Restricted and Repetitive Behaviors:
2
Repetitive movements
Strong attachment to routines
Intense focus on specific interests
 diagnostic criteria (DSM-V-TR)

A. Persistent Deficits in Social Communication and Interaction

(All three required)

• Difficulty in social-emotional reciprocity (reduced sharing of interests or

emotions)
• Difficulty in non-verbal communication (poor eye contact, limited
gestures)
• Difficulty developing and maintaining relationships
 diagnostic criteria (DSM-V-TR)

B. Restricted and Repetitive Behaviors

(At least two required)

• Repetitive
Repetitive movements or speech (e.g., hand flapping, echolalia)
• Insistence on sameness and rigid routines
• Highly restricted or intense interests
• Hyper or hypo-reactivity to sensory input
diagnostic criteria (DSM-V-TR)

C. Additional Conditions
Conditions

• Symptoms must be present in early development

• Symptoms must cause significant functional impairment
• Not better explained by intellectual disability alone
 CAUSES OF ASD

Genetic factors
Neurobiological
Neurobio logical differences
Prenatal
Pr enatal factors
Advanced parental age

Autism is not caused by poor parenting.

psychological and psychosocial impact
Autism affects emotional regulation, self-concept, and social participation.
Children may experience frustration due to difficulty expressing needs and
understanding social cues.
Anxiety is common, especially when routines are disrupted or in unfamiliar
environments.
Adolescents may develop low self-esteem or depression due to peer rejection or
social exclusion.
Family stress and caregiver burden may also influence the child’s psychosocial
adjustment.
 psychosocial rehabilitation
Rehabilitation focuses on improving adaptive functioning and meaningful
participation in daily life.
Structured behavioral interventions help develop communication and social
interaction skills.
Social skills training promotes peer interaction and reduces isolation.
Parent training programs empower families to manage behavior effectively.
Inclusive education and community support reduce participation restrictions.
The goal is not normalization, but functional independence and improved
quality of life.
cerebral palsy
Cerebral Palsy is a group of permanent disorders affecting
movement and posture due to non-progressive damage to
the developing brain.
“Cerebral” refers to the brain and “Palsy” refers to weakness or
problems in muscle control.
It is important to understand that the brain injury does not
worsen over time.
However, the physical manifestations may change as the
child grows.
CP primarily affects motor functioning
functioning but may also affect
speech, cognition, vision, or hearing.
 Cerebral palsy occurs due to abnormal brain
causes development or injury before, during, or shortly after
birth.

Prenatal
P renatal Causes: Maternal infections,
Malnutrition, Exposure to toxins, Genetic
abnormalities
Perinatal Causes: Birth asphyxia (lack of
oxygen), Premature birth, Low birth weight
Postnatal Causes: Brain infections (meningitis),
(meningitis),
Severe head injury, Neonatal jaundice
 ASSOCIATED CONDITIONS

CP may be accompanied by:

Intellectual disability (not always)
Intellectual
Speech impairment
Vision or hearing problems
Seizures
Learning difficulties
Learning
 psychological aspects
CP affects more than physical movement.
Emotional Impact: Social Impact:
Frustration due to physical
Frustration Reduced participation in
limitations physical activities
Anxiety in social settings Risk of bullying
Fear of rejection
Fear Overprotection by family
Self-Concept:
Body image concerns during
adolescence
Feeling “different” from peers
 rehabilitation for CP
Rehabilitation is lifelong and Educational Support:
multidisciplinary. Inclusive education with
Physiotherapy: necessary
Improves muscle strength and accommodations.
mobility. Vocational Rehabilitation:
Occupational Therapy: Skill training based on
Trains daily living skills like dressing,
Trains ability.
eating, writing. Psychological Support:
Speech Therapy:
Therapy: Builds coping skills and
Improves communication ability. self-confidence.
Orthopaedic Disabilities
Orthopedic disability refers to severe, long-term, or permanent
impairments of the musculoskeletal system;
system; bones, joints,
muscles, ligaments, or spine that restrict movement,
coordination, and daily functioning.
It may be congenital (present at birth) or acquired later due to
injury or illness.
It primarily affects movement and physical coordination.
 Orthopaedic Disabilities

Orthopaedic disabilities may result from:

• Congenital deformities
• Accidents or trauma
• Spinal cord injury
• Amputation
• Bone diseases
• Severe burns
Some conditions are permanent,
permanent, while others may improve with treatment.
 common types
• Limb deformities
• Amputation
• Spinal cord injury
• Fractures leading to long term disability
• Polio related deformities

The severity may vary from mild mobility limitation to

complete paralysis.
 functional impact
Orthopaedic disabilities primarily affect:
• Walking and mobility
• Balance and posture
• Self-care activities
• Participation in sports and physical activities
• Access to public spaces

Environmental barriers increase disability.

 psychological & Psychosocial impact
Physical disability may influence:
• Self-esteem and body image
• Feelings of dependency
• Social withdrawal
• Anxiety about public appearance
• Risk of depression
Adolescents and young adults may struggle with identity and peer acceptance.
Overprotection
O verprotection by family may reduce autonomy.
 psychosocial rehabilitation
Rehabilitation focuses on maximizing independence and social participation.
• Physiotherapy for strength and mobility
• Assistive devices (wheelchair, crutches, prosthetics)
• Occupational therapy for daily living skills
• Psychological counselling for adjustment
• Vocational rehabilitation
• Environmental
Environmental modifications (ramps, accessible buildings)
Goal: Reduce participation restriction.
 neuromuscular disabilities
Neuromuscular disorders represent a broad range of conditions
that involve dysfunction of peripheral nerves, muscles or the
communication between them.
They interfere with communication between the nervous
system and muscles,
muscles, leading to muscle weakness,
weakness, loss of
coordination, and reduced movement.
Unlike cerebral palsy (which is non-progressive), many
neuromuscular disorders are progressive.
progressive.
 examples of NMD
[Link]
. Muscular Dystrophy: A genetic condition in which muscles gradually
weaken and break down over time.
[Link]
2. Multiple Sclerosis (MS): A disorder in which the immune system
damages the protective covering of nerves,
nerves, affecting movement and
coordination.
[Link]
3. Myasthenia Gravis: An autoimmune condition that causes muscle
weakness that worsens with activity and improves with rest.
rest.
[Link]
4. Motor Neuron Disease (e.g., ALS): A progressive condition in which the
nerve cells controlling muscles gradually stop working.
 causes
Neuromuscular disabilities may occur due
to:
• Genetic mutations
• Autoimmune disorders
• Degenerative nerve diseases
• Unknown causes
Some are inherited, while others develop
later in life.
 characteristics
• Muscle weakness
• Fatigue
• Progressive loss of mobility
• Difficulty swallowing or speaking (in some
cases)
• Reduced endurance

Severity may increase over time.

psychological & Psychosocial impact
Because many neuromuscular conditions are progressive,
emotional impact can be significant.
• Anxiety about future deterioration
• Depression due to loss of independence
• Fear of dependency
• Social isolation
• Identity crisis in young adults
Chronic illness adjustment becomes central.
psychosocial rehabilitation
Rehabilitation focuses on slowing functional decline and maximizing
independence.
• Physiotherapy to maintain muscle strength
• Occupational therapy for adaptive strategies
• Assistive devices
• Psychological counselling for chronic illness adjustment
• Family counselling
• Vocational re-planning
Since some conditions are progressive, rehabilitation focuses on
adaptation rather than restoration.