This lesson covers the major types of disabilities, how these disabilities impact activities of daily living, and how to make disability-specific accommodations to facilitate adjustment.
The learner will identify and articulate specific needs for accommodation related to the major categories of disability.
The learner will demonstrate the capacity to establish environments and formulate activities that lead to greater accommodation of persons with a variety of disabilities.
What is the definition of disability?
The Americans with Disabilities Act (ADA) is a law written to protect persons with disabilities from discrimination. The ADA defines disability as any physical or mental impairment that substantially limits one or more major life activities such as:
Deciding whether a student meets the definition of disability under the ADA is handled on a case-by-case basis. Keep in mind that persons are not entitled to protection under the ADA simply because they have been diagnosed with a disability. The disability must substantially limit their ability to perform major life activities.
To help you understand the many disabilities covered by the ADA, a partial list follows:
What are the major types of disabilities and how do I recognize these disabilities? First, it is not necessary to know or have a detailed comprehension of and individual's specific diagnosis in order to begin to establish reasonable accommodations. It is more important to understand the major types of disabilities and how these types of disabilities impact functional capacities. It is also important to know that many children have multiple developmental conditions that may include functional disabilities in more than one category. Talking to parents about a child's functional needs can go a long way toward identifying specific accommodations the child will need.
Developmental Delay is usually identified in infants or young children who do not meet certain developmental benchmarks such as head lifting, rolling over, crawling, walking or developing hand-eye coordination. In some cases, children outgrow the developmental delay and catch up with their typically developing peers. In other cases, the developmental delay is an indication of a more severe condition or developmental disability. A number of resources are provided here to assist in identifying typical developmental benchmarks.
Perceptual Disability is not related to intellectual capacity; rather it is related to the manner in which sensory information is processed to the brain. Individuals with perceptual disabilities may have difficulty interpreting numbers or symbols, or they may transpose letters or numbers. Although they may be able to hear sounds, they may have difficulty correlating the meaning of sounds to language or symbols. They may have difficulty in recognizing spatial orientation or identifying colors, or they may have difficulty recognizing people by their faces. This disability may take many forms but within each manifestation is the commonality of the individual's inability to interpret certain sensory information in its proper context. Sometimes called learning disabilities, perceptual disabilities among children may be identified when otherwise achieving children have significant difficulties comprehending language or math concepts.
Communication Disabilities include the inability to vocalize and/or articulate words. Communication disabilities may also include inappropriate or unexpected articulations (as in Tourette's Syndrome) or uncontrollable articulations that may be related to a variety of physical, cognitive, and behavioral factors. Individuals with communication disabilities may not be able to speak at all, they may vocalize sounds that are unintelligible, or they may shout or make sounds and vocalizations that are considered socially inappropriate.
A cognitive or intellectual disability was once referred to as "mental retardation" a term that is now considered perjorative, but is still commonly used in many legal constructs. This type of disability is characterized by difficulty in attaining thinking or reasoning skills because of specific disorders to parts of the brain that control intellectual functioning. A person with a cognitive or intellectual disability may have difficulty understanding complex concepts or commands. The individual may exhibit significant delays in measured intelligence, adaptive functioning, and academic functioning. Having an intellectual disability does not mean that an individual cannot learn. It means that it may take longer for the individual to attain certain skills, and it may mean that repetition is necessary to ensure that the individual retains skills once they are learned.
Physical disability is the lack of capacity to perform physical activities that incorporate a wide range of movements that are considered typical among fully functional children and adults. Physical disability may be temporary, such as the inability to ambulate while a broken ankle is healing, or permanent, such as lifelong disability acquired from conditions such a cerebral palsy or muscular dystrophy. Physical disability may be mild, such as the inability to use a keyboard due to carpal tunnel syndrome, or severe such as quadriplegia acquired from a spinal cord injury. Physical disability includes a wide variety of conditions, all related to movement disorders.
Individuals who are blind or vision impaired have low vision or no vision even with eyeglasses, contact lenses, medicine or surgery. Vision impairment can range from mild to severe. The leading causes of vision impairment and blindness in the United States are age-related eye diseases: macular degeneration, cataract and glaucoma. Other eye disorders, eye injuries and birth conditions can also cause vision loss.
Individuals who are deaf or hard of hearing have loss of the ability to detect certain frequencies or sounds. Deafness or hearing loss may range from mild to severe. The severity of a hearing impairment is categorized according to how much louder a sound must be made before the listener can detect it. In profound deafness, even the loudest sounds may not be detected. There is another aspect to hearing that involves the quality of a sound rather than amplitude. This is usually measured by tests of speech discrimination. Basically, these tests require that the sound is not only detected but understood.
These terms are used to refer to a psychological or physiological pattern that is usually associated with distress or atypical behaviors that may have negative impact on the individual and those around him or her. Categories of diagnoses may include conditions related to mood, anxiety, personality and many other categories. In many cases there is no single accepted or consistent cause of psychological or behavioral disability, but many conditions can be successfully treated with a combination of medication and therapeutic intervention.
Several related conditions are grouped under the heading "Pervasive Developmental Disorder." The most common is autism. Other manifestations include Asperger's Syndrome, Rhett's Syndrome, and Childhood Disintegrative Disorder. These conditions are neurological disorders that typically appear in the first three years of the life of children who appeared to be developing in a typical manner. These conditions impact the normal development of the brain in the areas of social interaction and communication skills. The disorder makes it hard for individuals affected to communicate with others and relate to the outside world. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resistance to changes in routines. Individuals may also experience sensitivities in the five senses of sight, hearing, touch, smell and taste.
Use the developmental milestones charts to identify specific developmental delays, and provide extra supports to the child when specific delays are identified. It is often difficult to obtain a differential diagnosis in very young children because certain developmental benchmarks must take place before it becomes apparent that a child is late in achieving these benchmarks. "Developmental Delay" is a term used to define a condition that is unclear because the child is too young for a specific diagnosis. In many cases, the child outgrows the developmental delay, and rapidly catches up with peers. In other cases, a developmental disability is recognized. As an adult working regularly with the child, you have a unique opportunity to observe and report to parents, teachers, health professionals and others who may be part of a multidisciplinary approach to addressing the child's specific needs as they emerge.
It is important to understand how the child's perceptual disability affects him/her. Begin by talking to parents. Ask questions about behaviors that may indicate that the child is experiencing perceptual difficulties, and ask what methods parents use that are effective in assisting the child. Because the perceptual disability is related to information processing, it may be necessary to provide an alternative method for the child to receive information. For instance, if a child evidences dyslexia, reading out loud for auditory processing may be required. If a child has difficulty processing color information, you might make up a game where a sound, a signal, or even a taste is used to help identify a color. If a child shows difficulty in processing too much sensory information at one time, a quiet space might be effective in limiting the sensory stimulus. If a child has difficulty recognizing faces, encourage them to look for other identifying characteristics that do not typically change from day to day, such as sound of voice, height or hair color.
Children may have varying levels of communication difficulites. Some children can speak, but they have difficulty with articulation. It is important to learn to listen to children with articulation challenges, and to help them communicate by vocalizing their messages back to them, repeating as necessary to make sure you understand what the child is attempting to communicate. Don't pretend to understand if you don't. Children with severe communication disabilities need alternative methods of communicating information to others. While writing is one way to do this, it is more cumbersome to write a sentence than it is to speak conversationally. In some instances, children may have multiple disabilities that prevent them from being able to write. Therefore, it is important to have clear methods for children to communicate basic, essential information; I am hungry, I need to go to the bathroom, I hurt, etc. Children can be taught to use signs or signals to communicate these needs. Many children with significant speech difficulties benefit from technology, often called "communicators." Once they are set up, these devices are fairly simple to use, and most adult program leaders can be taught how to assist the child in using their communicator in the community setting.
Having a cognitive or intellectual disability does not mean that the child is incapable of learning or capacity to participate in activities with peers. It means that the child may take longer to learn how to perform certain tasks, for instance, how to play a game. Generally, activities require more repetition in order for information to be retained. Take the time to carefully explain tasks and provide very direct guidance and demonstration to the child. Peer role models and peer assistants are particularly helpful for children with intellectual disabilities. Watch for behaviors or signals that indicate that the child is having difficulty understanding instructions or comprehending messages. On the other hand, you shouldn't assume that the child with an intellectual disability is comprehending just because those behaviors or signals aren't evident. You can test the child's comprehension by asking questions and clarifying instructions until you are confident that the child has a grasp of the concept you are sharing. Keep things pleasant and fun, but remember that repetition is key. You should ask the child to demonstrate the task, perform the activity, or repeat the message as many times as necessary (or over a period of several days or weeks) in order to reinforce the concept.
Accommodations for physical disability are those accommodations and direct assistance services that make the physical environment accessible to the child. Depending on the type and level of physical disability, these accommodations may vary greatly. Children with mild physical disabilities may need some assistance, but generally, they are capable of performing most activities own their own. It is always preferable to assist the child in finding a way to accomplish an activity as independently as possible. Children who use wheelchairs or who have limited ambulation capacities quite literally need a "level playing field." Remove or address obstacles and changes in elevation, such as steps, that may present difficulty in accessing portions of the environment. Children who have limited use of arms and hands may need reaching or grabbing devices, or personal assistance services. Children with certain types of physical disabilities may need adaptations such as grab bars or rails. It is important to identify specific physical limitations, and how each limitation impacts the child. Once each functional need is identified, create a plan to address each need, taking into consideration the capacity of the child to perform activities as independently as possible.
Many children wear glasses, and their vision issues are usually corrected with these lenses. Adults who interact with young children particularly may identify children who have undiagnosed vision issues. You should alert parents if children evidence difficulty seeing things close up or at a distance, or if they report that their vision is blurry. Children who are blind or significantly visually impaired cannot see properly even with corrective lenses. These children may need initial guidance in gaining an understanding of their context with an environment. It is helpful to provide the child with a tour or verbal explanation of the space and the people around him/her. You can guide the child by asking him/her to touch your elbow and walk beside/slightly behind you as you navigate the space. Remember to guide, not push or pull, and describe the environment as you go. Some children who are blind or visually impaired have had training in Braille. Many are likely to be familiar with computer screen-readers and large print formats. Tactile experiences are wonderful ways to share art and other traditionally "visual" media. The types of accommodations needed for children with blindness or vision impairment can vary, depending on whether the child has low vision or no vision. Talk with parents about the types of accommodations that are best for the child's individual needs.
The types of accommodations needed for children who are deaf or hard of hearing vary depending on whether the child is hard of hearing or has no hearing. Children who are hard of hearing may use hearing aids and other sound amplification and communication devices. Children who are deaf may also use computerized communication devices. They may also use sign language and other methods of visual communication, such as blinking lights instead of sound notifications, TTY devices, and other visual references. Children who are deaf as well as the adults who interact with them may also benefit from exposure to the Deaf Culture. Deaf Culture is a term applied to the social movement that holds deafness to be a difference in human experience rather than a disability per se.
All children experience emotional outbursts and at times, engage in behaviors that require appropriate disciplinary or behavior modification techniques. Most children can be taught how to self-attenuate and thus minimize inappropriate behaviors. It is important to understand that children with psychological and/or behavioral disabilities may have great difficulty controlling certain behaviors that might otherwise be considered maladaptive or socially inappropriate, and these children may not respond to traditional behavior modification techniques. Certain therapies and medications may be tried with varying levels of success with these children. Key to addressing the behaviors in a setting with other children is establishing an environment in which the child can participate and interact as fully as possible, while minimizing exposure to stimulus that might trigger the undesirable behavior. This could include quiet time, greater involvement of adult aides, or removing the child from situations that are likely to trigger an event. It is important to talk with parents, teachers and others who have familiarity with the child to gain as full an understanding as possible of the situations that might trigger an outburst.
Children with Autism and Pervasive DD have a tendency to withdraw into their own world. While they need the exposure and opportunity to interact with other children, the sensory stimulus may be overwhelming, so children with these disabilities should have plenty of opportunities for quiet time. Children with Autism/PDD respond well to structured environments. They exhibit greater cooperation when they are given simple yet explicit instructions about what is happening right now, and what to expect next. They are often visual learners, which means they usually respond well to activities that involve visual completion and/or computer or interactive screen-learning activities. Children with Autism and Pervasive DD have difficulty with social interaction, therefore they may disengage when they are given lengthy verbal instructions. On the other hand, they may be capable of memorizing in great detail, and performing learned tasks with great precision. Communicate with a combination of simple language and visual cues. Because of the way these children learn, they may enjoy taking things apart to see how they work.
Disabilities don't always come in neat packages. Therefore, it is not uncommon for children to have multiple forms of developmental disabilities. Children with severe developmental disabilities may have many functional affects, which could include physical, intellectual, speech, hearing and/or visual disabilities, or any other major manifestation of disability. It is important to take the time to learn how each child is affected by his or her disabilities, and to create a personalized plan to engage each child to the fullest extent possible.
All community based programs should have emergency plans. These plans should take into consideration the functional needs of children with disabilities. For instance, if a fire alarm goes off, how is a deaf child alerted? If an emergency evacuation must take place, how is the child who uses a wheelchair evacuated? The emergency plan should take into consideration the specialized needs of each child, in the context of each foreseeable emergency, and all children should have the opportunity to practice their emergency drills. The time to address emergency needs is long before an emergency occurs.
Develop your own reference chart that contains: A description of the different major types of disabilities, the functional needs of each category, and the most common accommodations for each functional need.
Definition and Types of Disabilities
This slide presentation describes major types of disabilities and
assists the learner in identification of these disability categories.
http://www.youtube.com/watch?v=vG0-APjacJw
Adaptive Technology for Children with Disabilities
Children and Toys: TN Technology Access Center demonstrates use of a
large button switch to aid a child with cerebral palsy in the
development of motor skills.
http://www.youtube.com/watch?v=TRCqH9TOqTU
Understanding Modifications and Accommodations
Methods of helping students with Special Needs in the
Inclusion Setting
http://www.metacafe.com/watch/1789393/understanding_modifications_and_accommodations
EverybodyOnline
Helping disabled persons to use digital technologies
http://www.youtube.com/watch?v=1muqdVqxxrU
Kids Included Together presents:
Accommodations for Children with Vision Disabilities
http://www.youtube.com/watch?v=GphRsFHfg-M
Dr. Michael M. Behrmann
Discusses Legal Mandates and Assistive Technology
http://www.researchchannel.org/prog/displayevent.aspx?fID=568&rID=5221
Discovering Assistive Technology
http://discoveringat.blogspot.com/2008/05/types-of-disabilities-accommodations.html
University of Washington Online Faculty Room
http://www.washington.edu/doit/Faculty/Strategies/Disability/