Understanding Disability

Diba Nahin
Dr. Ranjan Kumar
Difference between Impairment, Disability &
Handicapped

Impairment - Impairment is a damage to tissue due to

disease or trauma. A person who has poor or no vision
due to damage to retina or optic nerve may be said to
have a Visual Impairment.
Disability – Disability denotes the consequences of
impairment in terms of functional performance and
activity by the individual. A person who has an optic
nerve or retinal damage would have limitations in
performing those tasks that requires the use of
eyesight.
Handicap - Handicap is a disadvantage for an individual,
resulting from an impairment or disability, that limits
or prevents fulfillment of a role, that is normal for that
individual.
 The Charity Model

The charity model sees people with disabilities as victims of

their impairment. Depending on the disability, the disabled
persons cannot walk, talk, see, learn, or work. Disability is
seen as a deficit. Persons with disabilities are not able to help
themselves and to lead an independent life. Their situation is
tragic, and they are suffering. Consequently, they need
special services, special institutions, such as special schools or
homes because they are different. People with disabilities are
to be pitied and need our help, sympathy, charity, welfare in
order to be looked after. Sometimes people with disabilities
themselves adopt this concept, in which case they usually feel
“unable” and have a low sense of self-esteem.
 Medical Model
The medical model explained disability by
using three terms: Impairment, disability
and handicap.
The above explanations lead to a view that disability
is a problem that can be corrected though medical
care and treatment. Disability is seen as a health
related problem in the person that has to be corrected
by medical care.
 Social Model

 The social model points out that the

problems faced by people with disabilities
are caused not primarily by their
impairments, but by the way society is
primarily organized and structured to
meet the needs of non disabled
(normal) people.
 We can state the main features of the social model as follows:

 In this model, disability is not seen as the problem of the

individual.

 This model states that human beings have a diverse range of

abilities and skills and that people with disability are a part
of this diversity.
 Disability results from the failure on the
part of the society to make necessary
adjustments and modifications which will
enable the people with disability to
participate fully in all areas of life.

 The focus of services is on removing

barriers that prevent people with
disabilities from participating in society
on an equal basis. It involves changing
the 'disabling world'.
Needs:-
Children with disabilities may have some needs

1. Physio - Medical Needs-

 Medical Treatment.
 Surgery.
 Physiotherapy.
 Speech Therapy.
 Rehabilitation Aids.
2. Educational Needs –
 Removing architectural barriers.
 Trained Teacher (in Special Education).
 Plus Curriculum.
 Aids/Appliances.
 Appropriate Teaching Strategies.
3. Vocational Needs –
 Professional Training.
 Sheltered Workshop.
 Trained Teachers.

4. Empowerment Needs -
 Activities of daily living.
 Use of appropriate aids.
 Proper Education and training.

5. Social Rehabilitation Needs –

 Social acceptance.
 Causes During Pregnancy
Causes Prevention

1. Malnutrition or specific lack of so 1. Pregnant women should have

Causes During Pregnancy me proper nutrition. Regular medical
minerals during pregnancy. For check-up is very important.
example, Cretinism occurs due to 2. During pregnancy medicines
lack of iodine. should be taken only after
2. Medication during pregnancy. consulting the doctor.
Some medicines may be harmful 3. A pregnant woman should not be
for the baby. exposed to radiation, such as, x-
3. Radiation like x-ray during the first rays especially during the first
trimester. Trimester.
4. Infectious diseases like German 4. Women should be immunized
Measles, Tetanus, etc. against diseases like German
5. Repeated fits and high blood Measles and Tetanus at an
pressure in the pregnant woman appropriate time.
5. With repeated fits and high blood
pressure she must be under the
care of a qualified
 causes prevention

6. Accidents during pregnancy. Doctor so that the blood pressure is

under control and fits do not occur.
6. Climbing on stool, walking on
slippery floor to be avoided.
7. Over exertion during pregnancy.

7. Carrying heavy loads especially in

the fields, should not be done.
8. Addictions-smoking, alcohol intake.

8. Avoid smoking and drinking alcohol

9. RH Factor during pregnancy.

8. Blood Group testing and injection.

 During Delivery
causes prevention
1. Premature birth and problems at the 1. Foetal distress must be detected early
time of delivery can damage the brain. and a qualified doctor should be called
immediately.
• Prolonged labour.
• Difficult labour.
• Excessive bleeding during delivery.
• Complication of forceps. 2. In case of abnormal positioning of the
foetus in the womb, the delivery must be
conducted by a qualified doctor. Any
2. Abnormal position. For example, congenital abnormalities/respiratory
babies born with feet coming first. distress and fits should be immediately
looked into and the child must be sent to
a specialist.

3. Immediately after birth, the airway must

be cleared. If the baby’s colour is blue
then he must be given oxygen
3. Delayed birth cry. immediately.
 After Birth
Causes Prevention

Though the child is born normal 1. Proper nutrition during the early
certain factors after birth may cause years should be given; otherwise
damage to the brain which results in malnutrition may cause damage to
MR; there are:- the brain.
1. Poor nutrition
2. Illness, such as jaundice, fits etc. 2. Immunization should be given at the
Infections so the brain, such as appropriate times. Timely and
meningitis and encephalitis. proper treatment of infections and
illness should be ensured.
3. Accidents, head injury and
3. Necessary safety measures to be
poisoning.
undertaken to avoid accidents.
Keep drugs, chemicals and
poisons out of reach of children.
 What is Autism?
 Autism is a developmental disability that typically
appears during the first three years of life. It is
the most common condition in a group of
developmental disorders known as Autism
Spectrum Disorders (ASDs).

 Autism affects the normal development of the

brain that controls social interaction and
communications skills. It is a result of either
structural changes or chemical changes within
the brain.
 Types of Autism Spectrum
Disorders/PDD

Aspergers Heller
Syndrome Syndrome PDDNOS

Rett
Hyperlexia
Disorder Early Infantile or
Classical Autism
 Special Characteristics
of Autism

Impaired Impaired Social Unusual

Communication Interactions Behaviour
 Impaired Social Interaction
- Fail to form emotional attachments to significant people in their
environment. For example, they show no distress when their mother
leaves the room.

-May not share his interest or excitement with others. May not enjoy
physical contact like hugging or cuddling.

- None or abnormal social play.

-Gross impairment in ability to make peer friendships, although

he/she may enjoy the company of children younger or older to
him/her.

- Absence of imaginative activities such as, playing, acting of adult

roles, fantasy characters or animals, lack of interest in stories about
imaginary events.
 Impaired Communication
-- May respond to a question by repeating it. If you ask him/her “What is your
name?” he/she may respond by saying “What is your name.”

-- Frequently have delay in learning a language.

-- May not use language meaningfully.

-- May continuously repeat certain songs, words or rhymes.

-- May not begin or continue conversations with others despite adequate speech.

-- May have poor eye contact, body posture or gestures to initiate or modulate social
interactions.

-- Typically autistic children will occupy themselves for hours together in

stereotyped, repetitive, self-stimulatory behaviours. They may be attracted to
spinning or rotating objects, such as wheels, fans or other moving objects.
 Unusual Behavior
-- Children with autism generally show obsessive, rigid
behaviours. They may like too much order and sameness.
For example, familiar bedtime routines, insistence on one
type of food, one type of furniture arrangement etc. Any
slight change in the environment may upset them extremely.

-- They may laugh inappropriately and frequently.

-- They may become upset for no apparent reason.

-- There may be apparent indifference to pain, heat or cold.

-- Some children with autism are hyperactive.

 Locomotor Disability

Locomotor disability can be defined as a

person’s inability to execute distinctive
activities associated with moving both
himself and objects, from place to place
and such inability resulting from affliction of
musculoskeletal and/or nervous system.
 Neuro-motor Musculoskeletal
Impairment Conditions

1. Seizure Disorders (Epilepsy) 1. Arthritis

2. Spina Bifida 2. Club foot

3. Spinal Cord Injury 3. Trauma and Amputation

4. Polio: Infantile Paralysis 4. Muscular Dystrophy

5. Multiple Sclerosis

6. Stroke
 CEREBRAL PALSY
Cerebral Palsy is a disorder of movement
and posture caused by brain damage.
Definition – according to P.W.D. Act, 1995,
cerebral palsy means a group of non-
progressive conditions characterized by
abnormal motor control resulting from brain
damage or injuries occurring in the pre-
natal, natal, peri-natal or infant period of
development.
 Types of Cerebral Palsy

Cerebral Palsy

Spastic Athetoid Ataxia

 Characteristics
Type of CP Affected Area Movement

Spasticity Motor Cortex Stiff and difficult movement.

Rigid, Scissoring of hands
and legs.

Athetosis Basal Ganglia Slow and involuntary

movements

Ataxia Cerebellum Lack of coordination and

balance. Unsteady and
shaky. Nystagmus may be
present.
Mixed Combination of any of the above three types
 Based on body parts affected
C.P. can be classified as
Hemeplegia – One half of the body.

Diplegia – Lower half more affected than upper half.

Quadriplegia – Four limbs equally affected.

Monoplegia – One limb affected.

Bilateral Hemeplegia – Involvement of whole body but one half less

affected.

Paraplegia – Only lower limbs affected.

 Facts:-
** Cerebral Palsy is a condition, not an illness.

** Cerebral Palsy is not hereditary.

** Cerebral Palsy is not the fault of either parent.

** Persons with Cerebral Palsy may have normal intelligence

or be impaired.

** Cerebral Palsy is not a curse. It can afflict the rich and

poor, irrespective of caste or creed.
 What is Leprosy ?

It is an infectious disease that develops very slowly. It is

caused by germs (bacilli) that affect mostly the skin and
nerves. It can cause a variety of skin problems, loss of
feeling, and paralysis of the hands and feet:

Symptoms:

A slowly growing patch on the skin that does not itch or

hurt Tingling numbness, or some loss of feeling in the
hands and feet. If feeling is
clearly reduced inside a patch, leprosy is almost certain.
Slight
weakness or deformity in the hands and feet.
According to the provisions of the Persons with
Disabilities Act 1995, a “leprosy cured person”
Means Any person any who has been cured of
leprosy, but is Suffering from –

1. Loss of sensation in hands or feet as well as loss of

sensation and paresis in the eye and eye-lid but
with no manifest deformity;
2. Manifest deformity and paresis but having
sufficient
mobility in their hands and feet to enable them to
engage in normal economic activity;
3. Extreme physical deformity as well as advanced
age
which prevents him from undertaking any gainful
occupation.
 Causes

It can spread only from some persons who

have untreated leprosy, and only to other persons
who have ‘low resistance’ to the disease.

It is probably spread either through sneezing or

coughing, or through Skin contact.

Children who live in close contact with someone

who has untreated leprosy are more likely to get it.
 Mental Retardation
 Mental Retardation is a delay or slowness
in a child’s mental development.

 It is a condition and not a disease.

Persons with this condition will have less
mental ability or intelligence than others of
his age. They will also have deficits in all
other areas of development.
 Characteristics of Mental
Retardation
~~ Cannot Understand easily what they see, hear, touch, smell.

~~ May not clearly express their thoughts, needs and feelings.

~~ May not learn easily.

~~ Can’t make decisions.

~~ Have difficulty in remembering.

~~ May show problem behavior.

~~ May have physical problems.

 Classification of Mental Retardation

Mental Retardation

Mild Moderate Severe Profound

(55 to 69) (35 to 54) (20 to 34) (Below 20)

Educable Trainable Custodial

 Common Types of MR

1. Down’s Syndrome.

2. Microcephaly.

3. Cretinism.

4. Hydrocephaly.
 Mental Illness

Mental illnesses are disorders of the brain

that disrupt a person’s thinking, feeling, moods,
and ability to relate to others. Mental illness is an
illness that affects or is manifested in a person’s
brain that often results in a diminished capacity
for coping with the ordinary demands of life. It
may affect the way a person thinks, behaves, and
interacts with other people.
Mental illnesses can affect persons of any age,
race, religion, or income.
Most commonly diagnosed forms of
mental illness are:

•Depression.
•Anxiety.
•Panic attacks.
•Obsessive-compulsive disorder.
•Phobias.
•Manic depression (Bipolar disorder).
•Schizophrenia.
 Multiple Disabilities

 Multiple Disability means combination of

two or more disabilities. This combination
can occur in any order. Like :-
 Deaf blind.
 CP + MR.
 Hearing + MR.
 Visual + MR.
 CP+VI.
 Hearing Impairment
Hearing Impairment or ‘deafness’ refers to
the condition where hearing is affected by
disease, disorder or injury.

Types of Hearing Impairment :-

(1) Conductive.
(2) Sensory Neural .
(3) Mixed.
Hearing Impairment is categorized into the following :

•Mild Loss (20-40dB) - The person hears in most settings. She would have
difficulty in hearing faint or distant speech.

•Moderate Loss (40-60 dB) – The person may have a problem in hearing
group conversations or when there is background noise or have difficulty in
hearing conversational speech within 3-5 feet distance.

•Severe Loss (60-80 dB) – The person misses all but very loud speech; will
not be able to hear loud sounds beyond a distance of 1 foot.

* Profound Loss (80dB or more) – The person is unable to hear speech

except a very loud noise, cannot hear spoken language, will not be able to
rely on hearing as a primary channel of communication.
 VISUAL IMPAIRMENT
Broadly, we can divide visually impaired persons into two categories :-

 Blind person having no sight or light perception.

 Persons with low vision.
According to the Persons With Disabilities Act, 1995 , blindness refers to
a condition where a person suffers from any of the following conditions:

Blind -
 Total absence of sight; or
 Visual acuity not exceeding 6/60 or 20/200 (snellen) in the better eye, even
after best possible correction with glasses or contact lenses.
Low Vision -
 Persons with low vision are those whose central visual acuity is better than
20/200 and worse than 20/70.
 Though persons with low vision have significantly poor vision, still they can be
trained to use this residual vision.
The PWD Act has included Low Vision as a separate category.

However, there is no quantification in the

PWD Act but generally the parameters for low vision
are:

•Persons with low vision are those whose central visual acuity is
better than 20/200 and worse than 20/70.

•Though persons with low vision have significantly poor vision,

still they can be trained to use this residual vision.
 The management programme is
always designed
according to the child’s need
 Physical management is always based
according to the physical developmental
milestones.
 Head control.
 Rolling.
 Sitting.
 Standing.
 LEARNING DISABILITY
Learning disability are problems that affect the brains ability to receive,
process, analyse, or store information. These problems can make it
difficult for a student to learn as quickly as someone who isn’t affected
by learning disabilities.

A learning disability can't be cured or fixed; it is a lifelong issue. With

the right support and intervention, however, children with learning
disabilities can succeed in school and go on to successful, often
distinguished careers later in life.

Parents can help children with learning disabilities achieve such

success by encouraging their strengths, knowing their weaknesses,
understanding the educational system, working with professionals and
learning about strategies for dealing with specific difficulties.
 ATTENTION DEFICIT/HYPERACTIVITY
DISORDER (ADHD)

ADHD is a condition of the brain that affects a

person's ability to pay attention. It is most common
in school-age children.

ADHD IS A CHRONIC DISORDER, MEANING THAT

IT AFFECTS AN INDIVIDUAL THROUGHOUT LIFE.
THE SYMPTOMS ARE ALSO PERVASIVE,
MEANING THEY OCCUR IN MULTIPLE SETTINGS,
RATHER THAN JUST ONE.
Thank you