Disability & Special Educationan International Issue

Dr Saim Ali Soomro.

MCCM,MBBS.

Approximate 10% of the world population is disable.

Countries with Civil wars, insurgency, wars suffering from Terrorism are likely to have more people exposed to get disabilities.

Pakistan and Afghanistan are also among such countries.

There is need to setup rehabilitation institutes.

DEFINITIONS OF DISABILITY

The answer to “What is a disability?” varies by agency and even from year to year. A few years ago, there were eight categories of disability that qualified a student for special education services. Now there are thirteen categories.

A person with a developmental disability is entitled to a much wider array of services than students in special education without developmental disabilities. You might think “developmental disabilities” is one of those thirteen categories just mentioned - but it isn’t!

On the large format every one carries a disability with him or her no one is perfect in a world around us, as early its identified it can be rehabilitate.

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DEFINITIONS OF DISABILITY

Following are general Disabilities which we see in every day life around us.

Mental retardation Specific learning disabilities Serious emotional disturbance Visual impairment Hearing impairment Deafness Deaf-blindness Speech or language impairment Autism Orthopedic impairment Traumatic brain injury Multiple disabilities Other health impairments

Autism

DEFINITIONS OF DISABILITY

• World is also keen to support for social issues in under developed countries, there are multiple reasons for disabilities like infections, trauma, genetic disorders, social, Psychological & developmental causes are generally implicated in causes of Disabilities.

• Disabilities and accessibility are leading to Inclusive Education for mild to moderate disabilities.

• Severe Handicaps are managed in institutions.

Deafness

Hearing

Visual Impairment

Deaf-Blindness

Speech or LanguageImpairment

Orthopedic Impairment

Traumatic Brain Injury

Multiple Disabilities

Other Health Impairments

Serious EmotionalDisturbance

Specific Learning Disabilities

Mental Retardation

MENTAL RETARDATION

Definition: People with mental retardation have trouble learning, absorbing, and practicing everyday skills. Causes: 1. Genetics - where the baby was born with mental retardation, and short of having a different

mother or father, there is nothing that could have been done; 2. Fetal Alcohol Syndrome (FAS) - where the mother used alcohol during pregnancy, which makes this a preventable form of retardation; 3. Birth complications - where the child experienced anoxia (no oxygen) or hypoxia (not enough oxygen) during birth, which resulted in mental retardation; 4. Trauma to the head - where damage occurred or severe illness such as meningitis may also cause mental retardation.

Life Skills: Mental retardation cannot be cured; however, in a nurturing, patient environment, children and adults can often learn important skills such as toileting, reading, and speaking. There are different levels of severity in retardation; some people are able to have more independence than others. Most have difficulty communicating, which can be disturbing to their confidence and well-being.

Resources: There are programs and information that assist mentally retarded people with living a fulfilling life. For example, schools are required to develop individual education plans (IEPs) for children. Family, friends, and teachers can also teach social rules and self-care (dressing, teeth brushing) through the use of educational games.

SPECIFIC LEARNING DISABILITIES

Definition: Learning disability is defined by law as "an imperfect ability to read, write, speak, or perform mathematical calculations, which is not due to physical, sensory or emotional impairment, mental retardation or socio-cultural disadvantage."

Causes: A learning disability is not, by any means, a measure of a person’s intelligence. In fact, if you read the legal definition above, it specifically states that children with mental retardation are not included in this category. However, students with learning disabilities experience certain obstacles that do not allow them to be educated in the usual way. The most well-known type of learning disability is probably dyslexia. Dyslexia is a difficulty processing letters, numbers and other symbols. The most familiar characteristic of dyslexia is letter reversal, writing or reading "d" for "b", for example, or "p" for "q".

Life Skills: Programs for achieving basic academic and social skills, vocational training, two-year degrees, four year degrees, and graduate programs are available in most states; most of these programs are available only within educational institutions. (Learning Disabilities Association of America, 2005).

Resources: Because learning disabilities are primarily diagnosed in educational environments, they are the best resource for local, state, and national resources.

SERIOUS EMOTIONAL DISTURBANCE

Definition: These are behavior disorders or mental illnesses that persist over a long period of time and affect educational performance. This includes ADHD (Attention Deficit/Hyperactive Disorder), depression, bipolar disorder, conduct disorders and eating disorders to name a few.

Causes: Genetics, environment and a combination of the two can all contribute to these disorders. Behavior disorders may be inherited through one's genes, due to a chemical imbalance in the brain or occur as a result of brain injury. The person’s surroundings can also come into play. If the youth has been exposed to abuse, extreme stress, a death or loss in the family, and/or violence, he/she is more likely to develop these disorders.

Life Skills: In some cases, medication can be used to treat the disorder. In all cases, people with disabilities and their families can be helped by an understanding of the disorder and through families/communities working together to support the person. Teaching students how to overcome these disturbances is a time-consuming process, but often in conjunction with medication, it is possible.

Resources: In deciding if a student has a disorder that would fall into this category, medical and psychological evaluations should take place. A physician/pediatrician should almost always be consulted in these cases as should a therapist, psychologist or psychiatrist. Teachers and schools should accommodate students with these disturbances by providing a specialized education plan.

VISUAL IMPAIRMENT

Definition: The terms partially sighted, low vision, legally blind, and totally blind are used in the schools to describe students with visual impairments. They are defined as: 1. "Partially sighted" indicates some type of visual problem has resulted in a need for special education; 2. "Low vision" generally refers to a severe visual impairment, not necessarily limited to distance vision. Low vision applies to all individuals with sight who are unable to read the newspaper at a normal viewing distance, even with the aid of eyeglasses or contact lenses; 3. "Legally blind" means that a person has less than 20/200 vision in the better eye or a very limited field of vision (20 degrees at its widest point); and 4. “Totally blind” students learn via braille or other non-visual media.

Causes: Congenital blindness may be hereditary or be the result of infection at birth; however, other diseases may also result in blindness such as: amblyopia; diabetic retinopathy; glaucoma; macular degeneration; and trachoma (Teens Health, 2004).

Life Skills: Emphasis on basic skills such as eating, bathing, and dressing is given for the visually impaired. Because a huge majority of the learning process comes through sight, recognized learning strategies should be employed (Lichman, 2002).

Resources: Assessment is the first step to accessing resources for the individual. The severity of visual impairment must first be realized before the type of resources can be determined.

HEARING IMPAIRMENT

Definition: This is one of the categories that has most changed under the new classification. Once encompassing all levels of hearing loss, it is now broken up into three areas. The first, hearing impairment is a group in which there is an impairment in hearing that affects a child's educational performance but that is not included under the definition of deafness, which is a hearing impairment that is so severe that the child is impaired in understanding speech.

Causes: The most common cause of hearing loss in children is an infection of the middle ear called otitis media. Another large group of children acquired their hearing loss due to factors such as noise, drugs and toxins. Some acquired hearing loss may be a result of heredity.

Life Skills: According to Moss (2005), you should observe the way the individual uses their hearing and assist them in building their listening skills through encouragement and rewards. In some cases, adaptive hearing devices can help a student with hearing impairment, but even students with these devices cannot necessarily hear at the same level as a student without a hearing impairment. Every effort should be made to ensure a positive and meaningful experience for the person. When necessary, an interpreter should be provided. Integrating sign language into the curriculum can also improve the learning experience.

Resources: Each country defines the degree of hearing loss which determines a student's eligibility for special education services. Hard of hearing is defined as a hearing loss of 35-60 decibel in the better ear. In addition, to be eligible for special education services, the hearing loss must affect the student's educational performance.

DEAFNESS

Definition: Deafness is now a category of its own and means a hearing impairment that is so severe that the child is impaired in understanding speech.

Causes: The most common cause of hearing loss in children is an infection of the middle ear called otitis media. Another large group of children acquired their hearing loss due to factors such as noise, drugs and toxins. Some acquired hearing loss may be a result of heredity.

Life Skills: Communication is a major issue among students with deafness. An interpreter should be provided and integrating sign language into the curriculum can also improve the learning experience.

Resources: Each country defines the degree of hearing loss which determines a student's eligibility for special education services. Deafness is usually defined as a hearing loss of 70 decibels or greater in the better ear.

DEAF-BLINDNESS

Definition: This was previously grouped with hearing impairments and deafness, but should stand on its own. Deaf-blindness means a combination of hearing and visual impairments which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness.

Causes: Illness, accident or genetics can result in deaf-blindness. Hereditary causes can include Usher Syndrome and Down Syndrome. Other causes are issues that result from problems associated with premature birth, rubella and meningitis.

Life Skills: Persons with deaf-blindness can become isolated from the world around them if not worked with properly. Establishing a method of communication is key and several such methods exist. Teaching individuals how to be self-sufficient as much as possible such as getting dressed, getting around the home, etc., should also be a point of focus.

Resources: As stated above, deaf-blind individuals need to be accommodated in special education programs or with special education services that are specifically target toward deaf-blindness. State and local resources will include schools, special education professionals and medical professionals.

SPEECH OR LANGUAGE IMPAIRMENT

Definition: Communication or language disorders are disorders that affect communication and/or oral functioning that affects speech. These range from sound substitution or inability to produce certain sounds to the inability to understand language or produce speech that can be understood. The two types of speech disorders are: 1. Articulation disorder is when a child has a problem making the sounds necessary for speech such as stuttering or a lisp; 2. A phonological disorder is when a child has trouble with her actual voice when trying to make sounds.

Causes: There are a variety of causes for speech and language disorders such as hearing loss, autism, cerebral palsy, neurological disorders, brain injury and mental retardation. Physical problems such as cleft palate or lip (where the lip is split) may also occur. A language disorder is when a person cannot understand and/or communicate with other people because of some type of problem in the brain. Children with language disorders may have trouble with matching a word with its meaning, creating sentences, or comprehending what someone is saying.

SPEECH OR LANGUAGE IMPAIRMENT

Life Skills: Speech-language pathologists work directly with the child, family and teacher to improve a child’s speech. She can develop a therapy plan for a child that may involve exercises to work on certain sounds. She can talk to the student’s teacher about ways to help the child communicate in the classroom. There are also products on the market, such as computers with a speech function, that students may be able to use to communicate better.

Resources: Language disorders tend to be complex because they often involve cognitive problems, or problems with the brain. Because the early years of a child’s life are when language skills are developing, it is important that these disorders be caught as early as possible in order to begin treatment and work on overcoming or dealing with the disorder. Speech therapists can be valuable depending on the impairment.

AUTISM

Definition: This category includes people with all levels of pervasive development disorder – the most known of which being autism. Asperger’s Syndrome, Rett’s Syndrome and Childhood Disintegrative Disorder are also classified under PDD. All of have common deficits in social interaction and communication. Often, people with these disorders show very little interest in other people. They have a limited number of interests. They also tend to have difficulty with change and find comfort in repetition and structure.

Causes: Although the number of children diagnosed with autism has risen dramatically in the last 30 years, still no one knows what causes autism. Theories abound, but none have been proven to date.

Life Skills: Autistic individuals may have average or above average intelligence, however, their autism can keep them from achieving many goals. Because the two main facets of autism are issues with social interaction and communication, these are areas that need to be worked on to help people with this disorder to function in society.

Resources: Special education professionals, medical professionals and those who work in the psychological and psychiatric fields can be resources as far as information when it comes to autism. Local, state and national organizations can offer both information and support services as well.

ORTHOPEDIC IMPAIRMENT

Definition: According to the ADA (2005), an individual with an physical disability is a person who: 1. has a physical or mental impairment that substantially limits one or more major life activities; 2. has a record of such an impairment; or 3. is regarded as having such an impairment. These conditions can be related to any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more body systems such as neurological or muscoskeletal.

Causes: Causes for physical disabilities range from birth defects such as cerebral palsy or spina bifida to impairment resulting from degenerative or progressive diseases such as muscular dystrophy. Accidents are another cause.

Life Skills: Regardless of the physical disability, life skills should focus on assisting the individual with gaining the skills to increase their quality of life and independence. Skills should be broad, problem solving, age appropriate, and useful to the learner (Information Center on Disabilities & Gifted Education, 2005).

Resources: Physical disabilities affect motion and motor skills that we depend on every day of our lives. Depending on the disability and the age of the disabled person, many countries have developed resources available through elementary, high school, colleges, and employment offices some have special Institutes for rehabilitation & Education.

TRAUMATIC BRAIN INJURY

Definition: Damage to the brain caused by illness or accident. Brain injury is the most common cause of death and disability in children. A person with a mild traumatic brain injury may lose consciousness or memory at the time of the accident. They may look all right on the outside but have lasting changes in their personality or thinking. Other times, the effects can be even more serious causing mental retardation, learning disabilities, loss of vision or speech, inability to remember new things and number of other complications.

Causes: Traumatic Brain Injury (TBI) usually occurs in an accident. During an accident, the brain literally bounces back and forth inside the skull, often hitting in both the front and the back of the brain. Brain injury can also occur due to hypoxia (not enough oxygen) or anoxia (no oxygen). This occurs in drowning, suffocation and sometimes due to problems at birth.

TRAUMATIC BRAIN INJURY

Life Skills: Some people who suffer from a traumatic brain injury recover. In other cases, the damage can be permanent. A doctor can consult with the patient’s family regarding that issue. It is important to know that healing from a brain injury takes a long time. People recovering from a TBI get tired more easily than they did before. An individual with TBI and those around him/her often have difficulty with the fact that someone who looks the same, walks the same as always is now different. If needed, counseling should be sought. In addition, the patient will likely need assistance with his/her daily life – making the necessary adjustments to aid in living. These adjustments will vary depending on the severity of the injury.

Resources: Early consultation with Neuro physician, Special Educators, Speech therapists, Occupational Therapists can help with early rehabilitation.

MULTIPLE DISABILITIES

Definition: A combination of disabilities, such as mental retardation and orthopedic impairment, that cannot be served in programs for either individual disability alone.

Causes: Obviously, the causes can vary greatly. Sometimes they may be the result of the same things- such as a genetic issue, illness, or accident, other times, they may be unrelated.

Life Skills: Once assessments have been completed to determine the capabilities of the individual, life skills should set realistic goals that will assist the disabled in having success and increased confidence in their capabilities.

Resources: Any resources in addition to standard state, local and national agencies and local special education professionals will likely vary depending on disabilities.

OTHER HEALTH IMPAIRMENTS

Definition: Other health impairments cover a variety of diseases and disorders. This category that refers to people who have limited strength, energy or alertness that affects their ability to learn in a normal classroom.

Causes: Some of these disorders are present at birth, such as sickle cell anemia, asthma, hemophilia or epilepsy. Other impairments are caused by acquired conditions such as lead poisoning, rheumatic fever, HIV, or cancer. Less than .5% of students are diagnosed with other health impairments.

Life Skills: Once assessments have been completed to determine the capabilities of the individual, life skills should set realistic goals that will assist the disabled in having success and increased confidence in their capabilities.

Resources: In deciding if a student has a health impairment, a series of steps should be taken. A medical exam needs to be made taking into account a student’s medical history. Then the school needs to decide if a student is able to receive special education services by giving intelligence, achievement, behavior and other assessment tests as well as reviewing medical and other background information. Depending on the result of these tests, the school will decide if the child is able to receive special education services. If the school decides they are not able to receive these services, it is still possible for students to receive services under the Rehabilitation Act.

DEVELOPMENTAL DELAY

Definition: The term developmental delay means that the children are just a bit behind their peers. Special services are granted to these young children in the hopes that services will be needed only for a short time instead of for their entire school experience as may be seen with the aforementioned disabilities.

Causes: According to University of Michigan Health Systems (2005), developmental delay can have many different causes, such as genetic causes (like Down syndrome), or complications of pregnancy and birth (like prematurity/ or infections)… Some causes can be easily reversed if caught early enough, such as hearing loss from chronic ear infections, or lead poisoning.

DEVELOPMENTAL DELAY

Life Skills: Deciding who needs special services and how they are going to get them has always been an issue. The question is how can we be fair and equal to children requiring special needs? If they are identified too early they may be labeled incorrectly and then only perform at the level that is expected, which could lead to otherwise “average” children being taught at a slower rate simply because they hadn’t developed as quickly as others. On the other hand, if we wait too long to decide who needs services, those children may be set back further because they needed help way before it was given.

Resources: The Individuals with Disabilities Education Act (IDEA) of 1975 mandated states to provide all disabled or special needs children with a fair education. The goal was, and still is, to be sure that special needs children anywhere in the United States would get the same education and services because they would be tested the same way and labeled the same way. Depending on your state’s definition children as young as 3 and as old as 9 can still be classified as having a developmental delay. Even though some of the practices, rules, and labels vary by state the spirit of the law remains the same: help children with disabilities get what they need.

DEVELOPMENTAL DISABILITY

Definition: A developmental disability is a SEVERE mental or physical disability that occurs BEFORE age 22 and causes problems with major life activities such as speaking, moving, taking care of oneself and living independently.

Causes: Causes of developmental disability vary, but are more likely a result of experiences previously mentioned disabilities such as mental retardation, autism, or cerebral palsy; however, not everyone who has a disability has a developmental disability. The distinction is important because some services are only available to people with developmental disabilities.

Life Skills: People with disabilities are expected to need some type of help with daily living for their whole lives. Assessments are needed to determine the individual’s capabilities and the setting of realistic goals.

Resources: The majority of people experiencing developmental disabilities require a combination of types of services, such as speech therapy, special education and counseling. These services will be needed over a long period of time and must be planned for the individual. When this definition is applied to babies and young children from birth to age 5, they have many developmental delays with a large probability of disability if services are not given at this age.

How to Rehabilitate Place for Assessment Medically by Drs, Audiologists, Physiotherapists,

Special Educators ,Psychologists etc to assess Clinical, mentally, Cognitively, Psychologically each one is a Job of trained personnel.

Early Diagnosis and early intervention is key to better rehab. Each disability has its own requirements for rehab & Education called

Special Education. To develop a system you need to have a place with services of Drs,

Nurses, Physiotherapists, Orthotists, Speech therapists, Occupational therapists, Special Educators and Psychologists apart from Audiologists, Braillists etc/

Each Child is individually assessed and its IEP or FEP (Individual Education Plan or Family Education Plan) is made.

Before starting an Institute of rehab & Special Education , A mass campaign through electronic and Print media is highly regarded helpful for mass education & awareness.

Team members include: educators, physical therapists, occupational therapists, and speech-language pathologists)

Language development, social Skill development, functional Skill development (self-help), and vocational skill development.

Classroom arrangements Least-Restrictive

Environment Assistive Technology