Viewing Disability As Diversity When Providing Physical Therapy
Viewing Disability as Diversity When Providing Physical Therapy
Combined Sections Meeting 2015
Speaker(s): Susan Magasi, PhD, OT Marilyn Moffat, PT, DPT, PhD, DSc (hon), GCS, CSCS, CEEAA, FAPTA Susan Roush, PhD, PT Nancy Sharby, DPT
Session Type: Educational Sessions Session Level: Multiple Level
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Page 1 of 17 total pages
February 4‐7, 2015 Indianapolis, IN
www.aptahpa.org HPA The Catalyst is the Section on Health Policy & Administration of the American Physical Therapy Association American Physical Therapy Association Combined Sections Meeting Disability as Diversity Indianapolis; February 2015
Susan E. Roush, PhD, PT; University of Rhode Island
Nancy Sharby, DPT Northeastern University (Boston)
Susan Magasi, PhD; University of Illinois at Chicago
Viewing Disability as Diversity Marilyn. Moffat, PT; New York University & WCPT When Providing Physical Therapy
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Disability as Diversity: Overview Disability as Diversity Introduction Models of disabilities Understanding what is important to others… ICF – focus on Function, Independence and Participation “Golden Rule” vs. “Platinum Rule” ICF Case analyses Applying Disability Studies to Physical Therapy Global Research Final case analysis & wrap-up
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Disability as Diversity Disability as Diversity
Fundamental Negative Bias Fundamental Negative Bias
Concept from the 1950s and 60s Erving Goffman Beatrice Wright Examples
Stigma Stereotypes Bias
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1 Disability as Diversity Disability as Diversity
Fundamental Negative Bias Fundamental Negative Bias
“So, why is it often assumed people with Unfortunately, also seen in healthcare, disabilities are unhappy?” including physical therapy
BBC News Magazine
Shakespeare T. A. Point of View: Happiness and Disability. BBC News Magazine. 31 May 2014.
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Disability as Diversity Fundamental Negative Bias Fundamental Negative Bias
Test results: Health care professionals consistently rate ‘Positive’ is really negative from patient’s POV the quality of life of persons with ‘Negative’ is really position from patient’s POV disabilities lower than those persons’ self-reported quality of life Terms such as ‘good’ and ‘bad’
Lack of ‘person-first’ language
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Disability as Diversity Disability as Diversity
Models of Disability Models of disability
None fit perfectly Moral Medical Social Cultural Each has advantages and disadvantages
Olkin R. Could you hold the door for me? Including disability in diversity. APTA CSM 2015 Indianapolis Cultural Diversity & Ethnic Minority Psychology, v8 n2 p130-37; May 2002. APTA CSM 2015 Indianapolis
2 Disability as Diversity – Moral Model Disability as Diversity – Moral Model
Disability = punishment for wrong doing “God gives us only what we can bear”
Caused by moral lapse, sin, failure of faith “There is a reason I was chosen to have this Individuals are responsible for their condition disability”
Frequently tied to religion “She didn’t deserve that”
Disability brings shame “Why Me?”
“Physical therapists do God’s work” APTA CSM 2015 Indianapolis APTA CSM 2015 Indianapolis
Disability as Diversity – Moral Model Disability as Diversity–Medical Model Disability is something to be fixed Advantages: Disadvantages: AKA Deficit model • Special • Shame, relationship stigma & Pathology/abnormality is paramount with God marginalization Impairment=disability Cure or amelioration sought • Sense of a greater purpose Lessened but not absent sense of patients
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Disability as Diversity–Medical Model Disability as Diversity–Medical Model
Paternalism: Negative consequences for those who do not value and strive for “normal” outcome Services for, but not by, persons with disabilities e.g. Non-adherence
Uncooperative Fixing impairment > facilitating function
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3 Disability as Diversity–Medical Model Disability as Diversity–Medical Model
Physical Therapy Lack of acceptance of people with But, we are the good guys, right? disabilities as peers
Attitudinal obstacles to accommodation are Educated to identify differences from ‘normal’ typically the most difficult to overcome Remediate abnormalities Goals are often therapist-generated Goals are linked to “normal,” not to function Attitudes create the greatest barrier to accommodations and inclusion
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Disability as Diversity – Social Model Disability as Diversity – Social Model
Disability = social construct Change grounded in Civil Rights “Nothing about us, without us” Society’s lack of accommodation is the cause of disability Reject charity model E.g. protests against Jerry Lewis Disability Rights Movement telethons*
*McBryde Johnson H. Too old to die young. Henry APTA CSM 2015 Indianapolis Holt & Co. 2005 APTA CSM 2015 Indianapolis
Disability as Diversity – Social Model Disability as Diversity – Social Model
Advantages Disadvantages Reliant on: • Broad social & De-emphasizing impairments ❚ Integration/ political changes inclusion needed and emphasizing social justice ❚ Impairments not disabilities • Cost Changing attitudes is essential ❚ No stigma
4 Disability as Diversity–Culture Model Disability as Diversity
AKA Minority Group model Paradox of Physical Therapy
Disability = rich perspective on the Functioning in the Medical Model human condition that is while simultaneously respecting celebrated and valued disability as diversity
E.g. Deaf culture Autism and neuro-typical
Who Is Disabled? Disability as Diversity ❚ People with disabilities (PWD) as a
Creating ICF applications that further minority group function, independence and participation ❚ 56.7 million ❙ Number of people in the United States in 2010 with a disability Dr. Nancy Sharby: 20 minutes ❚ 19% community dwelling population ❚ A disability can occur at birth or at any point in a person’s life.
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Who is Disabled? What is an impairment?
❚ PWD are the largest minority in America An impairment exists when a person has a ❚ Disability crosses gender, sexual physical, sensory or intellectual condition orientation, income, race/culture that potentially limits full participation in ❚ Disability is a heterogeneous group social and/or physical environments. ❙ Impairment is nothing more than a description ❙ Physical, intellectual, sensory or psychiatric of a difference in the body or mind ❚ Only 8% of PWD are born with a disability ❙ Anybody can “join”
5 ❚ Everyone with a disability has an impairment ❚ If impairment means abnormality, what ❙ Change/abnormality that affects how the body works ❙ Anatomically does it says about the person behind the ❙ Physiologically impairment? ❚ Does having an impairment always mean you have a disability? ❚ Does having an impairment mean that you must have it “fixed? ❚ Does everyone with an impairment want it fixed?
Disability Definitions are Americans With Based on Social Norms Disabilities Act 1990
❚ Norms based on statistical definitions ❚ Social Norms ❚ "an individual must have an impairment ❙ Based on experiences of non-disabled that prevents or severely restricts the ❙ Marginalizes the experience of PWD individual from doing activities that are of ❙ Oppresses the rights of PWD central importance to most people's daily ❚ What are some common social norms in lives" America in the 21st century?
Social Security Wikipedia Administration
❚ Disability is the gap between what the person ❙ Inability to engage in any substantial gainful can do and what the person needs or wants to activity by reason of any medically do determinable physical or mental impairment… ❚ A disability (or lack of a given ability, as the ❙ Or that can result in death "dis" qualifier denotes) ❙ Can be expected to be present for 12 or more ❙ may be physical, cognitive/mental, sensory, months emotional, developmental or some combination of these.
6 American Medical Association Medical Model of Disability
❚ Rehabilitation classically defined disability as a personal deficiency or deviation from ❚ An alteration of an individual’s capacity to meet documented norms personal, social or occupational demands ❙ Impairment is undesirable because of an impairment ❙ Having an impairment is a personal tragedy ❙ Goals ❘ “fix”it ❘ To be “normal ❘ Create independence from others ❙ Client is should fully participate
International Classification of Disability, Illness and Function Environmental Factors
❙ Barriers ❘ Architectural/built ❘ We don’t want sympathy, we want ramps ❙ Disability is a social condition ❘ Looks beyond the individual and focuses on barriers to participation that are imposed by individuals and society ❘ Nothing about us without us
Environmental Factors
“focusing on the client’s impairment as the problem rather than treating environmental OT, despite what may be the best of (physical, social, political, and economic) intentions on the part of its practitioners, barriers as the true problem, rehabilitation serves to perpetuate the process of reinforces the perception that disability is an disablement of impaired people.” individual matter requiring private solutions rather than a matter of socially produced barriers requiring public, political solutions” Gary Keilhoffer
7 Personal Factors: Does Everyone Personal Factors Want to be “Normal?”
❚ Education ❚ “We define disability by the meaning the ❚ Age disability carries for the individual. PWD are people in which a disability is part of their ❚ Interests lives—not the definition of their lives. Having ❚ Goals a disability means difference, not tragedy” ❚ Race, culture, religion/spirituality/faith ❚ Capacities (strengths) ❚ Supports Mackelprang and Salsgiver. Disability: A diversity model approach in human service practice, 1999, p 63
Common Social Differences in World View Norms for PWD PWD Non-Disabled ❚ Finely tuned capacity for inter-personal ❚ Achievement ❙ Acceptance of human differences communication ❚ Independence ❙ Positive orientation toward ❚ Flexible, adaptive, resourceful approach to ❚ Mastery over the helping and being helped environment tasks and problems ❙ Tolerance for dealing with ❚ Future oriented the unpredictable ❚ Skill in managing multiple problems ❚ Autonomous/individualistic ❙ Understanding that needs ❚ Artifacts ❚ Direct communication are different depending on abilities ❚ C J Gill, A psychological review of disability culture. ❙ Sense of humor about Disabilities studies Quarterly, 1995; 15; 16-19 disability ❙ Interdependence (collectivist)
CRPD Disability as Diversity ❚ νPreamble of Convention states: ❚ •‘Disability is an evolving concept, and that disability results from the interaction between persons with Case analyses with the ICF focused on function, independence and participation impairments and attitudinal and environmental barriers that hinders full and effective participation in society on All presenters an equal basis with others’ 20 minutes ❚ νArticle 1 of the Convention states:
❚ •‘Persons with disabilities include those who have long-
term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others’. APTA CSM 2015 Indianapolis
8 The Challenge Disability as Diversity ❚ How can you integrate disability studies Describing and applying concepts of thinking into a profession - like physical Disability Studies to PT education therapy - aimed at helping, healing and
“fixing”? Dr. Susan Magasi
20 minutes ❚ Through the creation of transformational
learning opportunities
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❚ Listen to the disability community…
❚ Partner with the disability community Credo for support ❙ E.g., Knowledge Translation Collaboratives elective ❚ Challenge stereotypes
❚ Know your limits and those of the #@x! people say to people with disabilities profession. *includes a few sexual references ❙ Therapy is but a slice of the lives of the people we serve
Shift you professional lens Shift you professional lens to: to:
❚ See beyond ❚ See beyond the disability but recognize its the micro to impact – include physical, mental health, understand the sensory, cognitive impact the environmental ❚ Re-conceptualize the label of expert and factors have see power on
participation.
9 Disability as Diversity
Global perspectives
Disability in physical therapist education Provide support and practice
❚ Create a safe space for exploration and Dr. Marilyn Moffet integration. ❚ Prepare students for the clinical realities 20 minutes
and challenges of culture shift. APTA CSM 2015 Indianapolis
Disability as Diversity WCPT
• 106 Member Organisations (no individual membership) CURRENT GLOBAL RESEARCH ON • Representing 350,000 Physical Therapists DISABILITY IN PHYSICAL THERAPIST EDUCATION AND PRACTICE
Marilyn Moffat PT, DPT, PhD, DSc (hon), GCS, CSCS, CEEAA, FAPTA President, World Confederation for Physical Therapy
BACKGROUND BACKGROUND
PREVALENCE OF DISABILITY DEFINITIONS OF DISABILITY
• Variation in the reported prevalence of disability • In 1999 WHO defined disability as “any restriction or lack depending on the definition (United Nations Fact Sheet on Persons with Disabilities, World Health Organization, 2011) of ability to perform an activity in the manner or within • Estimates of number of people with disabilities the range considered normal for human beings” (WHO, 1999) worldwide range from 0.2% to 21% - most frequently quoted figure is 15% • 2 years later in 2002, the WHO developed the ICF Model • Persons with moderate or severe levels of disability are estimated to make up 5.5% of the global population and revised the definition to “a multidimensional • Based on population and survey data, nearly 70% of this phenomenon resulting from the interaction between 5.5% live in developing countries people and their physical and social environment” (WHO, • Because of baby boomers aging, population growth, and 2002) medical advances in lifesaving procedures, conservative assessments indicate that number of people with moderate or severe disability is expected to grow to 525 million by 2035 (WHO, 2002)
10 BACKGROUND BACKGROUND
WCPT DEFINITION OF DISABILITY (2014) INTERNATIONAL POLICIES ON DISABILITY
• The umbrella term for impairments, activity limitations, and • The Convention on the Rights of Persons with participation restrictions that results from the interaction between an individual’s health condition and the personal and Disabilities and the United Nations Standard Rules on environmental contextual factors. Personal factors are the the Equalization of Opportunities for Persons with particular background of an individual’s life and living, and Disabilities laid the foundation for social integration and comprise features of the individual that are not part of a equalization of opportunities for people with disabilities - health condition or health states, such as: gender, race age, accepted policy for UN, WHO, and WCPT for years fitness, lifestyle, habits, coping styles, social background, education, profession, past and current experience, overall • The participation of people with disabilities in education, behavior pattern, character style, individual psychological the work force, and communities has long been a assets, and other characteristics, all or any of which may play guiding principle for health policy development, a role in disability in any level. Environmental factors are planning, implementation, monitoring, and evaluation, external factors that make up the physical, social and attitudinal environment in which people live and conduct their even if is not quite a reality worldwide lives. Disability can be described at three levels: body (impairment of body function or structure), person (activity limitations), and society (participation restrictions).
BACKGROUND BACKGROUND
INTERNATIONAL POLICIES ON DISABILITY EDUCATION & EMPLOYMENT AS HUMAN RIGHTS
• The International Classification of Functioning, Disability • Equalization of opportunities, and access to education and Health (ICF) attempts to address disability in a way and employment considered basic human rights that minimizes subjective, attitudinal biases and rather • International guidelines and often, national legislation than emphasize disability, the model shifts the focus to have been developed to ensure that those with the abilities of people (WHO, 2002) disabilities enjoy these human rights
• Extent to which national implementation makes this a • The key aspects of these policies and the ICF model hold practical reality is variable true for those people with disabilities who wish to pursue education and employment as physical • Although human rights treaties and documents have significant potential to improve the QoL for those with therapists disabilities, they are often under-utilized
BACKGROUND BACKGROUND EDUCATION EDUCATION & EMPLOYMENT AS HUMAN RIGHTS • Although need for PTs continues to grow worldwide, • Society, health professional educators, and employers limited progress in maximizing opportunities for persons with disabilities to participate in higher education and in struggle with how to reduce the barriers to participation particular PT education for those with disabilities • Internationally, varying interpretations of guidelines for • Education and employment of persons with disabilities - persons with disabilities regarding accommodations for specifically physical therapists - must include attending college and participation in health professional training comprehensive integrated policies and strategies to • Some barriers to education for persons with disabilities address an individual’s participation include: • Modifying a job position, making physical changes to the – Under-estimation of potential to achieve work environment, or adjusting the method of task – Negative societal attitudes completion are ways to facilitate a qualified individual – Discriminatory practices – Absence of urgency with disability to participate in professional education, – Institutional policy apply for a job, perform work functions, and have equal – Lack of knowledge and resources related to reasonable access to others in the workplace accommodation – Inability to identify specific professional requirements
11 BACKGROUND BACKGROUND EDUCATION (cont) EDUCATION (cont)
• In higher education several factors influence opportunity • Nursing has reported that students with learning and success of persons with disabilities - institutional disabilities struggle with various aspects of the policy and practice, peers’ attitudes, and faculty curriculum (Carol, 2004; Kolanko, 2003) attitudes • In a study that investigated experiences of occupational • Inclusion of - and accommodations for – students in therapy students with disabilities - revealed that physical therapy and other health professions with students with disabilities: (1) have a strong desire to disabilities have been explored for both academic and "work around it," (2) desire support and understanding clinical components of education both within and outside the academic environment, (3) • One challenge seems to be defining the “essential understand that disability is an essential part of who functions” necessary for students (DeLisa and Thomas, (2005) they are as people, and (4) believe that having a Ingram, 1997; Losh and Church, 1999; Rangel, Wittry, Boucher and Sanders, disability will enhance their own practice (Velde, Chapin and 2001) Wittman, 2005) • Others have explored difficulties and issues related to making accommodations for students (Beckel, 2012; Francis,
Salzman, Polomsky and Huffman, 2007; Ward, Ingram and Mirone, 1998)
BACKGROUND BACKGROUND
PEER ATTITUDES TOWARD STUDENTS WITH DISABILITIES PEER ATTITUDES TOWARD STUDENTS WITH DISABILITIES
• How people react to someone with a disability based on • Therefore persons with disabilities entering into health meaning of disability within their culture professions education program might face same • College students no different than population at large, attitudes and biases that they would from general public and therefore bring those attitudes and biases to field of (Lyons, 1991; Rosenthal, Chan and Livneh, 2006; Sahin and Akyol, 2010) study • Doctoral dissertation questioned physical therapists’ • In general, found that college students have more attitudes toward physical therapists with disabilities in positive attitudes toward persons with physical academic and clinical settings (Kowalski, 2004) disabilities than other types of disability (Chan, Hedl, Parker, Lam, • Study indicated that OT students’ attitudes towards Chan and Yu, 1988; Jaques, Linkowski, Sieka, 1970; Manders, 2006) persons with disabilities became significantly more • Students entering the health professions would be held positive as they moved through their academic training; to a higher standard related to their attitudes toward however, when they entered college their attitudes were persons with disabilities - although, no data to indicate the same as students entering a business program (Estes, Deyer, Hansen and Russel, 1991) that is the case
BACKGROUND BACKGROUND
FACULTY ATTITUDES TOWARD STUDENTS WITH EMPLOYMENT AND PRACTICE DISABILITIES
• Little is known about faculty attitudes toward students • Knowledge about employment of PTs with disabilities with disabilities in the health professions very limited • In UK, level and nature of support necessary for nursing • Research that does exist has focused primarily on and medical students to be successful was studied (Storr, Wray and Draper, 2011; Little, 1999) employers’ attitudes toward hiring and accommodating • In one study, attitudes, knowledge and concerns of persons with disabilities nursing educators toward students with physical disabilities were investigated and found faculty have a reduced level of confidence in: 1) students’ ability to provide safe patient services; 2) ability of institution to make reasonable adjustments for individual situations; and 3) ability to change the persistence of a fundamental negative bias of students and educators (Sowers and Smith, 2001) • Another study identified benefits of having a person with a disability instructing a cohort of medical students (Tracy and Iacono, 2008)
12 BACKGROUND SURVEY FINDINGS ATTITUDES TOWARD THE HIRING AND ACCOMMODATION OF PERSONS WITH DISABILITIES • In 2013, WCPT undertook a study to describe the attitudes of key stakeholders regarding education and • Aside from limited access to educational opportunities, practice for physical therapists with disabilities in other factors may dissuade persons with disabilities from different international settings seeking employment • Survey was distributed to leaders of all 106 WCPT • Perceptions and attitudes toward employees with Member Organizations - information was received from disabilities have been: 1) fear of discrimination; and 2) twenty-five inability or unwillingness of the employer to make accommodations • All Regions were represented in the group of 25 - Africa • Research indicates that hiring and accommodating (4), Asia West Pacific (7), Europe (9), North America persons with disabilities benefits employers; however, Caribbean (4), South America (1) issues of harassment and alienation by some co-workers exists, which is problematic since inclusion in workplace is commonly what defines a person as dependent or independent (Hartnett, Stuart, Thurman, Loy and Batiste, 2010)
SURVEY FINDINGS INTERNATIONAL REGULATIONS GUIDELINES USED PT Student Education (25) PT Practice (N=25)
FIRST QUESTIONS Used Not Don't Used Not Don't
Used Know Used Know • When asked to indicate if various international regulations, ILO Code of Practice on 9 13 3 8 10 7 guidelines, standards and polices are used to guide formal Managing Disability in (36%) (52%) (12%) (32%) (40%) (28%) entry-level education of PT students in their country, data the Workplace indicated that disability in education is a consideration for ILO Vocational 8 13 4 9 10 6 many member organizations and that international policies Rehabilitation and (32%) (52%) (16%) (36%) (40%) (24%) (particularly the WHO and UN) influence standards in practice Employment (Disabled for nearly one half of survey respondent countries Persons) Convention • When asked to indicate if various international regulations, UN Convention on the 14 9 2 12 6 7 guidelines, standards and polices are used to guide clinical Rights of Persons With (56%) (36%) (8%) (48%) (24%) (28%) practice for PTs with disabilities (existing or acquired), data Disabilities indicated that disability in clinical practice is a consideration UN Standard Rules on 11 10 4 10 7 8 the Equalization of (44%) (40%) (16%) (40%) (28%) (32%) for many member countries; however, more than half of Rights of Persons with survey respondents reported that their countries either do not Disabilities use, or they do not know if they use, international policies as WHO ICF 18 7 0 16 6 3 a guide to influence standards in practice (see next Table) (72%) (28%) (0%) (64%) (24%) (12%)
SURVEY FINDINGS NATIONAL, PROVINCIAL OR STATE REGULATIONS, STANDARDS, POLICIES OR GUIDELINES USED NEXT QUESTIONS PT Student Education PT Practice • When asked to indicate if any national, provincial or N=25 N=25 state regulations, standards, policies or guidelines are Yes No Don't Yes No Don't used to guide formal entry-level education of PT know know students in their country, data indicated that for majority Disability 16 6 3 17 3 5 of MOs who responded, local agencies strongly Discrimination (64%) (24%) (12%) (68%) (12%) (20%) influence educational policy for physical therapy Legislation students with disabilities Employment 18 5 2 18 2 5 • When asked to indicate if any national, provincial or Legislation (72%) (20%) (8%) (72%) (8%) (20%) state regulations, standards, policies or guidelines are used to guide clinical practice for PTs with disabilities Accessibility 16 5 4 14 3 8 (existing or acquired), data indicated that, similar to Guidelines (64%) (20%) (16%) (56%) (12%) (32%) educational policy, local agencies strongly influence clinical practice guidelines for PT practitioners with Other* 4 9 12 4 8 13 disabilities among the majority of member organizations (16%) (36%) (48%) (16%) (32%) (52%) who responded (see next Table)
13 SURVEY FINDINGS DISABILITY TYPE AND SEVERITY - STUDENTS
STUDENT PHYSICAL THERAPISTS QUESTION Infec ous Disease
• When asked to indicate nature of impairments among Learning / Intellectual
students entering into PT professional entry-level Mental Health education, data indicated that schools of physical therapy are admitting students with disabilities, however Mul Complex Comorbidity
Physical - Cardiorespiratory those students tend to have mild levels of disability Mild
Moderate • It was much less common for a participant to report that Physical - Neurological Disability Type Severe students with severe disability were admitted to Don't Know Physical - Musculoskeletal educational programs Sensory - Speech
Sensory - Visual
Sensory - Hearing
0 5 10 15 20 25 30 Number
SURVEY FINDINGS DISABILITY TYPE AND SEVERITY - EMPLOYEES
PROFESSIONAL PHYSICAL THERAPISTS QUESTION Infec ous Disease
• When asked to indicate nature of impairments Learning / Intellectual
(developed after entry-level education) among physical Mental Health therapists that have been accommodated in practice to support continued work as a PT, data reflected similar Mul Complex Comorbidity
Physical - Cardiorespiratory trends to those found in PT professional education Mild
Moderate • Employers are accommodating physical therapy Physical - Neurological Disability Type Severe practitioners with disability, however, those practitioners Don't Know Physical - Musculoskeletal tend to have mild levels of disability • It was much less common for a MO to report Sensory - Speech accommodations for employees with severe disability Sensory - Visual
Sensory - Hearing
0 5 10 15 20 25 30 Number
DISCUSSION SUPPORTING DISABILITY
• Although survey response rate was low, data can be used ACCESSIBILITY to make some suggestions about how to move forward • ANTICIPATE ACCESS REQUIREMENTS - Be proactive! and make the education and practice of physical therapy Anticipate the access needs of all learners. Discuss more accessible for persons with disabilities teaching methods with other staff, both informally and • In the health services delivery environment, the provider- patient relationship strongly influences the success of during organised staff training sessions. Peer review and treatment reflection on practice will ensure that modification of • Having a physical therapy workforce that better reflects teaching strategies is ongoing. Encourage regular the general population would enhance the provider- evaluation and feedback from students and act on it. Take patient/client relationship and serve to alter unfounded the opportunity to improve the accessibility of the attitudes and biases toward persons with disabilities curriculum in all development work and during • Physical therapist educators, employers and the profession at large will benefit from an improved revalidation procedures. understanding about how access to the profession can • WORK IN PARTNERSHIP - Work closely with staff from be optimized for persons with disabilities the university's disability service. Contact external disability organisations or services. Talk with students with disabilities themselves.
14 SUPPORTING DISABILITY SUPPORTING DISABILITY
ACCESS TO WORK ASSISTIVE TECHNOLOGY & LOW TECH EQUIPMENT • Americans with Disability Act – helpful in this area - • Technology can be used to improve access: provides a clear and comprehensive national mandate for – To make teaching and learning materials more elimination of discrimination against individuals with accessible disabilities – To produce materials in a range of accessible formats • Employer has legal duty to comply – As alternative means of producing and accessing text – To improve independent access to information, particularly electronic information • Technology can be a key factor for students with disabilities, enabling access to many courses • Provide materials in appropriate formats • Student should have option to see and test out variety of available equipment (e.g., hardware, software, low vision equipment)
SUPPORTING DISABILITY SUPPORTING DISABILITY DISCLOSURE LANGUAGE & TERMINOLOGY • Term may have significant negative connotations • Language used influences how one thinks of people and situations • Implies disability is something to be ashamed of, and to be kept hidden • Language of the Medical Model encourages one to see disability as a ‘problem’ that should be dealt with by the • Discourages a person with a disability from discussing person with a disability the implications of disability and increases the pressure to 'pass' as 'normal’ • The Social Model uses language that locates the ‘problem’ within social “attitudes, systems and practices” • Belongs to Medical Model that act as barriers to full participation • In contrast, if you ask one to 'tell’ about their impairment, this indicates that regard disability as just another component of their individuality (such as age, gender or place of birth) and are far more likely to believe that responses will not be negative • Use language that reflects a positive attitude to difference so communication is on going
SUPPORTING DISABILITY SUPPORTING DISABILITY
CLINICAL AFFILIATIONS CLINICAL AFFILIATIONS (cont) • Develop a culture of awareness and support that will • Have an open and non-judgmental approach improve the practice environment for everyone • Encourage and support the student to establish an • Discuss disability issues and possible support strategies atmosphere of trust and safety in advance • Try to be as patient as possible • Have specific staff development sessions to raise • Not place undue emphasis on time pressures awareness of disability issues • Contact with colleagues who have experience of supporting students/colleagues with disabilities • Management support by providing time and resources for staff development in this area • Good communication with the universities that send students • Access to resources, information, advice and guidance
15 SUPPORTING DISABILITY MOVING FORWARD LINKING DISABILITIES AND ACCOMMODATIONS TO INCLUSION PHYSICAL THERAPY EDUCATION AND PRACTICE • Inclusion is based on principle that everyone is valued • Inextricably linked to the concept of equality, it positively • A person with a disability must be qualified to perform the roles and duties of a physical therapist, including welcomes diversity within society essential job functions and job-related requirements • Disability is regarded as a welcome difference, not as a • Because type and severity of disabilities ranges so deficit or burden widely - no way to create objective guidelines that would cover all peoples’ situations • Encourage student involvement in all aspects of program • Accommodations can be made for specific functions of development and change management the job; however, physical therapists must be equally educated and qualified thus creating a barrier for those with intellectual disabilities or mental health impairments • Physical therapists must also have the ability to provide and demonstrate treatment interventions for patients, therefore some physical disabilities may be challenging to accommodate in physical therapy practice • However, are many disabilities (physical and mental) that could be accommodated with minimal or no difficulty
Disability as Diversity
Final case analysis & wrap-up Where the world of physical therapy meets
All presenters: 15 minutes
www.wcpt.org/congress
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