Centers for Disease Control and Prevention Disability Overview Impairments Activity Limitations and Participation Restrictions What is a disability A disability is any condition of the body or mind impairment that makes it more difficult for the person with the condition to do certain acti ID: 692222
Download Presentation The PPT/PDF document "Understanding Disabilities" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Understanding Disabilities
Centers for Disease Control and PreventionSlide2
Disability Overview: Impairments, Activity Limitations, and Participation Restrictions
What is a disability?
A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions)
There are many types of disabilities, such as those that affect a person’s:
Vision
Movement
Thinking
Remembering
Learning
Communicating
Hearing
Mental health
Social relationshipsSlide3
Disabilities Can Be:
Related to conditions that are present at birth and may affect functions later in life, including cognition (memory, learning, and understanding), mobility (moving around in the environment), vision, hearing, behavior, and other areas.
These conditions may be:
Disorders in single genes (example
Duchenne
Muscular Dystrophy)
Disorders of chromosomes (example Down Syndrome)
The result of the mother’s exposure during pregnancy to infections (example Rubella) or substances, such as alcohol or cigarettesSlide4
Disabilities Can Be:
Associated with developmental conditions that become apparent during childhood (example Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder)
Related to injury (example Traumatic Brain Injury or Spinal Cord Injury)
Associated with a longstanding condition (example Diabetes) which can cause a disability such as vision loss, nerve damage, or limb loss
Progressive
Static (Limb loss)
Intermittent (some forms of MS)Slide5
Disability Overview
Although “people with disabilities” sometimes refers to a single population, this is actually a diverse group of people with a wide range of needs. Two people with the same type of disability can be affected in very different ways. Some disabilities may be hidden or not easy to see.
According to World Health Organization, disability has 3 dimensions:
Impairment
Activity Limitation
Participation RestrictionsSlide6
Disability Overview: 3 Dimensions of Disabilities
Impairment (absence of or significant difference)
in a person’s body structure or function, or mental functioning; For example, problems in the structure of the brain can result in difficulty with mental functions such as memory, or problems with the structure of the eyes or ears can result in difficulty with the functions of vision or hearing
Activity limitation
, such as a difficulty seeing, hearing, walking, or problem solving
Participation restrictions
in normal daily activities, such as working, engaging in social and recreational activities, and obtaining health care and prevention servicesSlide7
Disability Overview: Impairment
Structural Impairments
Significant problems with an internal or external component of the body (examples: a type of nerve damage that can result in MS or a complete loss of a body component, as when a limb has been amputated)
Functional Impairments
Complete
or partial loss of function of a body part (examples: pain that doesn’t go away or joints that no longer move easilySlide8
Disability Overview: Difference between Activity Limitation & Participation Restriction
According to International Classifications of Functioning, Disability and Health (ICF):
Activity
is the execution of a task or action by an individual
Participation
is a person’s involvement in a life situation
The ICF acknowledges that the distinction between these two categories is somewhat unclear and combines them, although basically, activities take place at a personal level and participation involves engagement in life roles, such as employment, education, or relationships
Activity Limitations and Participation Restrictions have to do with difficulties in individual experiences in performing tasks and engaging in social rolesSlide9
Disability Overview: Difference between Activity Limitations and Participation Restrictions
Activities and Participation can be made easier or more difficult as a result of environmental factors, such as technology, support and relationships, services, policies, or the beliefs of others
It is very important to improve the conditions in communities by providing accommodations that decrease or eliminate activity limitations and participation restrictions for people with disabilities, so they can participate in the roles and activities of every day life Slide10
Categories of Activities and Participation
Learning and applying knowledge
Managing tasks and demands
Mobility (moving and maintaining body positions, handling and moving objects, moving around in the environment, moving around using transportation)
Managing self care tasks
Managing domestic life
Establishing and managing interpersonal relationships and interactions
Engaging in major life areas (education, employment, managing money or finances)
Engaging in community, social, and civic lifeSlide11
Common Barriers to Participation Experienced by People with Disabilities
Nearly everyone faces hardships and difficulties at one time or another, but for people with disabilities, barriers can be more frequent and have greater impact
Barriers are more than just physical obstacles: They are factors in a person’s environment that, through their absence or presence, limit functioning and create disability
A physical environment that is not accessible
Lack of relevant assistive technology (assistive, adaptive, rehabilitative devices)
Negative attitudes of people towards disability
Services, systems and policies that are either nonexistent or that hinder the involvement of all people with a health condition in all areas of lifeSlide12
Most Common Barriers:
Attitudinal
Communication
Physical
Policy
Programmatic
Social
Transportation Slide13
Attitudinal Barriers
Most basic and contribute to other barriers
Some people may not be aware that difficulties in getting to or into a place can limit a person with a disability from participating in everyday life and common daily activities
Examples of attitudinal barriers include:
Stereotyping
: people sometimes stereotype those with disabilities, assuming their quality of life is poor or that they are unhealthy because of their impairments
Stigma
,
prejudice
, and
discrimination
: within society, these attitudes may come from people’s ideas related to disability. People may see disability as a personal tragedy, as something that needs to be cured or prevented, as a punishment for wrongdoing, or as an indication of the lack of ability to behave as expected in societySlide14
Attitudinal Barriers
Today’s society’s understanding of disability is improving as we recognize “disability” as what occurs when a person’s functional needs are not addressed in his or her physical and social environment.
By not considering disability a personal deficit or shortcoming, and instead thinking of it as a social responsibility in which all people can be supported to live independent and full lives, it becomes easier to recognize and address challenges that all people (including those with disabilities) experienceSlide15
Communication Barriers
Experienced by people who have disabilities that affect hearing, speaking, reading, writing, and/or understanding, and who use different ways to communicate than people who do not have these disabilities
Examples of communication barriers:
Written health promotion messages with barriers that prevent people with vision impairments from receiving the message
Use of small print or no large print versions of material
No Braille or versions for people who use screen readersSlide16
Examples of Communication Barriers cont
:
Auditory health messages may be inaccessible to people with hearing impairments
Videos that do not include captioning
Oral communications without accompanying manual interpretation (such as American Sign Language)
The use of technical language, long sentences, and words with many syllables may be significant barriers to understanding for people with cognitive impairmentsSlide17
Physical Barriers
Structural obstacles in natural or manmade environments that prevent or block mobility or access
Examples of physical barriers
Steps and curbs that block a person with mobility impairment from entering a building or using a sidewalk
Mammography equipment that requires a woman with mobility impairment to stand
Absence of a weight scale that accommodates wheelchairs or others who have difficulty stepping upSlide18
Policy Barriers
Frequently related to lack of awareness or enforcement of existing laws and regulations that require programs and activities be accessible to people with disabilities
Examples of policy barriers
Denying qualified individuals with disabilities the opportunity to participate in or benefit from federally funded programs, services, or other benefits
Denying individuals with disabilities access to programs, services, benefits, or opportunities to participate as a result of physical barriers
Denying reasonable accommodations to qualified individuals with disabilities, so that they can perform the essential functions of the job for which they have applied or have been hired to performSlide19
Programmatic Barriers
Limit the effective delivery of public health or healthcare program for people with different types of impairments
Examples of programmatic barriers
Inconvenient scheduling
Lack of accessible equipment (such as mammography screening equipment)
Insufficient time set aside for medical examination and procedures
Little or no communication with patients/participants
Provider’s attitudes, knowledge, and understanding of people with disabilitiesSlide20
Social Barriers
Related to the condition in which people are born, grow, live, learn, work, and age or social determinants of health that can contribute to decreased functioning among people with disabilities
Examples of social barriers
People with disabilities are far less likely to be employed. The unemployment rate in 2012 for people with disabilities was more than 1 in 10 (13.9%) compared to less than 1 in 10 (6%) for those without disabilities
Adults age 25 years and older with disabilities are less likely to have completed high school compared to their peers without disabilities
People with disabilities are more likely to live in poverty compared to people without disabilities
Children with disabilities are almost 4 times more likely to experience violence than children without disabilities Slide21
Transportation Barriers
Are due to a lack of adequate transportation that interferes with a person’s ability to be independent and to function in society
Examples of transportation barriers
Lack of access to accessible or convenient transportation for people who are not able to drive because of vision or cognitive impairments or mobility impairments
Public transportation may be unavailable or at inconvenient distances/locations or not accessible for those with disabilitiesSlide22
Inclusion Strategies
Inclusion of people with disabilities into everyday activities involves practices and policies designed to identify and remove barriers that hamper individuals’ ability to have full participation in society, the same as people without disabilities
Inclusion involves:
Getting fair treatment from others (nondiscrimination)
Making products, communications, and the physical environment more usable by as many people as possible (universal design)
Modifying items, procedures, or systems to enable a person with a disability to use them to the maximum extent possible (reasonable
accommodations)
Eliminating the belief that people with disabilities are unhealthy or less capable of doing things (stigma, stereotypes)Slide23
Types of Inclusion Strategies
National Policy and Legislation
Universal Design
Accessibility
Reasonable Accommodations
Independent Living
Assisted Living
People First
LanguageSlide24
National Policy and Legislation
Three federal laws protect the rights of people with disabilities and ensure their inclusion in many aspects of society
Section 504 of the Rehabilitation Act of 1973
The Americans with Disabilities Act (ADA) of 1990, which was followed by the ADA Amendments Act of 2008 in an attempt to restore the original intent of the legislation
The Patient Protection and Affordable Care Act in 2010Slide25
Section 504 of the Rehabilitation ACT
Federal law that protects individuals from discrimination based on disability
The nondiscrimination requirements of the law apply to employers and organizations that receive financial assistance from federal departments or agencies
Section 504 forbids organizations and employers from denying individuals with disabilities an equal opportunity to receive program benefits and services. It defines the rights of individuals with disabilities to participate in, and have access to, program
benefits
and servicesSlide26
Americans with Disabilities Act
As amended protects the civil rights of people with disabilities, and has helped remove or reduce many barriers for people with disabilities
The legislation required the elimination of discrimination against people with disabilities
The ADA has expanded opportunities for people with disabilities by reducing barriers, changing perceptions, and increasing participation in community lifeSlide27
ADA Act Cont
:
ADA guarantees equal opportunity for individuals with disabilities in several areas:
Employment
Public accommodations such as restaurants, hotels, theaters, doctors’ offices, pharmacies, retail stores, museums, libraries, parks, private schools, and day care centers
Transportation
State and local government services
Telecommunications such as telephones, televisions, and computersSlide28
People with Disabilities and the Patient Protection and Affordable Care Act
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, commonly referred to as ACA
For people with disabilities, the ACA:
Provides more health care choices and enhanced protection for Americans with disabilities
Provides new health care options for long term support services
Improves the Medicaid home and community based services option
Provides access to high quality and affordable health care for many with disabilities
Mandates accessible preventative screening equipment
Designates disability status as a demographic category and mandates data collection to assess health disparitiesSlide29
Universal Design
The intent of universal design is to simplify life for everyone by making products, communications, and the physical environment more usable by as many people as possible at little or no extra cost
Universal design benefits people of all ages and abilities
Center for Universal Design at North Carolina State University has developed 7 principles for universal designSlide30
Principles for Universal Design
1.
Equitable use
: the design is useful and marketable to people with diverse abilities (example: power doors with sensors at entrances that are convenient for all users)
2.
Flexibility in use
: the design accommodates a wide range of individual preferences and abilities (example: an automated teller machine (ATM) that has enhancements in the way it looks, feels, or sounds so that people with vision or hearing impairments can use it; a tapered card opening for ease in inserting or removing a bank card; a palm rest to aid those with arm mobility or strength limitations)
3.
Simple and intuitive use
: use of the design is easy to understand, regardless of the user’s experience, knowledge, language skills, or current concentration level (example: including an instruction manual with clear drawings and no text)Slide31
Principles for Universal Design
cont
:
4.
Perceptible information
: the design communicates necessary information effectively to the user, regardless of the current light, visual, or sound conditions or the person’s abilities to read, see, or hear (example: alarm systems that can be both seen and heard; routinely making captioning available in all television or video presentations)
5.
Tolerance for error
: the design minimizes hazards and the harmful consequences of accidental or unintended actions (example: ground-fault interrupter electrical outlet that reduces risk of shock in bathrooms and kitchens)Slide32
Principles for Universal Design cont
:
6.
Low physical effort
: the design can be used efficiently and comfortably with minimum fatigue (example: easy-to-use handles that make opening doors easier for people of all ages and abilities)
7.
Size and space for approach and use
: appropriate size and space is provided for approach, reach, manipulation, and use regardless of person’s body size, posture, or mobility (example: counters and service windows are low enough for everyone to reach, including people who use wheelchairs; curb cuts or sidewalk ramps, essential for people in wheelchairs, but are used by all people, and also convenient for people pushing baby strollers)Slide33
Accessibility
Accessibility is when the needs of people with disabilities are specifically considered, and products, services, and facilities are built or modified so that they can be used by people of all abilities
Examples of
Accessibility:
Parking spaces are close to entrances
Floor spaces and hallways are free of equipment and other barriers
Staff and healthcare professionals can use sign language or have access to someone who can use sign languageSlide34
Reasonable Accommodations
Alterations that have been made to items, procedures, or systems that enable a person with a disability to
use
them to the maximum extent possible
Can also be a modification to an existing environment or process to increase the participation by an individual with an impairment or activity limitation
Braille, large print, or audio books are examples of accommodations for people who are blind or have visual limitations
For people who are deaf or who have difficulty hearing, accommodations may take form of having an American Sign Language interpreter available during meetings or presentations, or exchanging written messages
Communication accommodations do not have to be elaborated, but they must be able to convey information effectivelySlide35
Assistive Technology
Assistive technologies (ATs) are devices or equipment that can be used to help a person with a disability fully engage in life activities
ATs can help enhance functional independence and make daily living tasks easier through the use of aids that help a person travel, communicate with others, learn, work, and participate in social and recreational activities
Example of AT can be anything from a low-tech device, such as a magnifying glass, to a high tech device, such as a computer that talks and helps someone communicate
Other examples are wheelchairs, walkers, and scooters, which are mobility aids that can be used by persons with physical disabilities
Smartphones have greatly expanded the availability of assistive technology for people with vision or hearing difficulties, or who have problems with effectively communicating their thoughts because of mental or physical limitationsSlide36
Independent Living
Independent living is about people with disabilities having voice, choice, and control over their everyday lives
The person may not need any assistance or might need help with only complex issues, such as managing money, rather
than
day-today living skills
Whether an adult with disabilities continues to live at home or moves into the community depends in large part on his/her ability to manage everyday tasks with little or no help (example: is the person able to clean the house, cook, shop, and pay bills, or able to use public transportation)Slide37
Assisted Living
Assisted living is for adults who need help with everyday tasks
They may need help with dressing, bathing, eating, or using the bathroom, but they don’t need full-time nursing care
Some assisted living facilities are part of retirement communities
Others are near nursing homes, so a person can move easily if needs changeSlide38
People First Language
People first language is used to speak appropriately and respectfully with and about people with disabilities
It emphasizes the person first not the disability by starting the phrase with the words “person who” or “person with”Slide39
People First Language Cont
:
People first language
Person with a disability
Person without a disability
Person with an intellectual, cognitive, developmental disability
Person with an emotional or behavioral disability, person with a mental health or a psychiatric disability
Language to avoid
The disabled, handicapped
Normal person, healthy person
Retarded, slow, simple, moronic, defective or retarded, afflicted, special person
Insane, crazy, psycho, maniac, nutsSlide40
People First Language Cont
:
People first language
Person who is hard of hearing
Person who is deaf
Person who is blind/visually impaired
Person who has a communication disorder, is unable to speak, or uses a device to speak
Language to avoid
Hearing impaired, suffers a hearing loss
Deaf and dumb, mute
The blind
Mute, dumbSlide41
People First Language Cont
:
People first language
Person who uses a wheelchair
Person with a physical disability
Person with epilepsy or seizure disorder
Person with multiple sclerosis
Person with cerebral palsy
Language to avoid
Confined or restricted to a wheelchair, wheelchair bound
Crippled, lame, deformed, invalid, spastic
Epileptic
Afflicted by MS
CP victimSlide42
People First Language Cont
:
People first language
Accessible parking or bathrooms
Person of short stature
Person with Down syndrome
Person who is successful, productive
Language to avoid
Handicapped parking or bathroom
Midget
Mongoloid
Has overcome his/her disability, is courageousSlide43
Including People with Disabilities in Public Health Programs and Activities
Centers for Disease Control and Prevention (CDC) operates on the principle that people with disabilities are best served by public health when they are included in all public health programs and activities such as:
Education and counselling programs that promote physical activity, improve nutrition or reduce the use of tobacco, alcohol or drugs
Blood pressure and cholesterol assessment during annual health exams, and screening for illnesses such as cancer, diabetes, and heart disease
People with disabilities need public health programs and healthcare services for the same reasons anyone does – to be healthy, active, and engaged as part of the communitySlide44
CDC’s approach:
Work across public health systems to encourage including accessibility features for all people with disabilities
Focus on specific functional populations as a whole, with accommodations as necessary
Example: those with vision or hearing loss, or mobility limitation
Develop and implement public health programs for people with specific conditions
A public health strategy is to use prevention efforts to help make the broadest health impact possible on the health of populations, in this case, people with disabilities
Public health is directed at improving the health of communities or populations, and is distinguishable from clinical health, which is directed at the health of the individualSlide45
Disabilities and Health Programs
CDC supports state-based disability and health programs dedicated to improve the health of people with disabilities, which broadens expertise and information-sharing among
states
19 of these state-based programs promote equity in health, prevent chronic disease (such as diabetes, asthma, and high blood pressure), and increase the quality of life for people with disabilities. Each program customizes its activities to meet its state’s needs
These state programs represent a network of standardized programs committed to helping people with disabilities benefit from public health services to the greatest extent possible
These states serve as communities of practice and play a much needed role in identifying effective practices, policies, and services for people with disabilitiesSlide46
Disabilities and Health Programs Cont
:
State based disability and health programs also inform policy and practice
Such programs ensure that individuals with disabilities are included in disease prevention and health promotion activities
within
the state
CDS also supports and provides funding to National Centers on Health Promotion for People with Disabilities also known as National Centers on Disability to prevent disease and promote health and wellness for people with disabilities
The purpose of the National Centers on Disability is to improve the quality of life of individuals living with disabilities by providing health information, education and consultation to healthcare professionals, people with disabilities, caregivers, media, researchers, policymakers and the publicSlide47
Disabilities and Health Programs Cont
:
The National Centers on Disability accomplish their goals by implementing the following activities
Serve as a resource for increasing knowledge and changing attitudes and practices as it relates to people with disabilities
Educate policymakers about differences in health among people with disabilities
Build collaborations with consumers, local health organizations, CDC and other relevant partners
Share information about programs, methods, and materials and lessons learned
Measure and document the National Centers on Disability impact using common methods of evaluation and reporting activities, such as the population reached by activities, and outcomes/impact indicators
Identify the health needs of people with disabilities