CATEGORIES OF DIVERSE DISABILITIES There is no one universally acceptable approach to describing categories of disabilities. The categories below incorporate terms often found in special education, disability rights, and medical literature. It is important to remember that within each category of disability there are differences between individuals in the type, degree, and impact of their disability. In addition, a person may have more than one disability.

CONGENITAL DISABILITIES The term “congenital disability” refers to an irregularity present at birth, which may or may not be due to genetic factors. Examples are Spina Bifida and Cerebral Palsy.

ACQUIRED DISABILITIES Acquired disabilities result from accident or disease after birth.

PHYSICAL DISABILITIES A physical disability means a physical condition that significantly interferes with at least one major life activity of an individual. This category includes anatomical loss or musculoskeletal, neurological, respiratory or cardiovascular impairment. Physical disabilities can be either congenital or acquired after birth as a result of accident or disease. Examples of physical disabilities include orthopedic impairments, health impairments such as a heart conditions, rheumatic fever, asthma, hemophilia, and leukemia, motor coordination/manipulation, traumatic brain injury, and mobility impairments.

SENSORY DISABILITIES The term “sensory disability” is generally used when referring to vision or hearing impairments. Subgroups under these headings include deafness, hard of hearing, blindness, visual impairment, or deaf-blindness. Hearing Impairment The term “hearing impairment” is often used to describe a wide range of hearing losses, including deafness. Deafness may be viewed as a hearing impairment so severe that an individual cannot understand what is being said even with a hearing aid. In contrast, an individual with a hearing loss can generally respond to auditory stimuli, including speech. Hearing loss and deafness affect individuals of all ages and may occur at any time from infancy through old age. Visual Impairments

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness The terms partially sighted, low vision, legally blind, and totally blind are used in the educational context to describe students with visual impairments. “Partially sighted” indicates some type of visual problem has resulted in a need for special education. “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. “Legally blind” indicates that a person has less than 20/200 vision in the better eye or a very limited field of vision. Totally blind individuals have no vision and must rely on non-visual modes of communication. Eye disorders leading to visual impairments include retinal degeneration, albinism, cataracts, glaucoma, diabetic retinopathy, congenital disorders, and infection. Deaf-Blindness Deaf-Blindness is a category of disability involving a combination of hearing and visual impairments causing severe communication, developmental, and educational problems. Students with deaf-blindness usually receive specialized services as they cannot effectively be accommodated in programs specifically designed for students who are deaf or students who are blind.

DEVELOPMENTAL DISABILITIES A developmental disability is a severe, chronic disability of an individual 5 years of age or older that: • is attributable to a mental or physical impairment or combination of both; • is evident before an individual reaches the age of 22; • is likely to continue indefinitely; • results in substantial functional limitations in three or more areas of major life activity; • reflects an individual’s need for long-term coordinated services and supports.

Examples of specific conditions that fall within this category include Autism, Mental Retardation and Cerebral Palsy.

COGNITIVE DISABILITIES Cognitive disability involves the brain’s inability to process, retrieve, store and manipulate information. Cognitive disability refers to impairments to attention, orientation, memory, problem solving, judgment, information processing (reading, writing, mathematics) and behavior. A cognitive impairment is defined as “any disorder requiring special attention to or alternate methods for communicating concepts and instructions...”

Mental Retardation Mental retardation is a term used when a person has certain limitations in mental functioning and in skills such as communicating, taking care of him or herself, and social skills. These PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness limitations will cause a child to learn and develop more slowly than a typical child. Children with mental retardation may take longer to learn to speak, walk, and take care of their personal needs such as dressing or eating. They are likely to have trouble learning in school. They will learn, but it will take them longer. There may be some things they cannot learn.

Learning Disabilities Learning disabilities are considered a disorder in one or more of the psychological processes involved in understanding or using spoken or written language or in processing information. This term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.

There are many conflicting theories about what causes learning disabilities and how many there are. Learning disabilities may impair an individual’s ability to listen, think, speak, read, write, spell, or to do mathematical calculations. It is important to remember that there is a high degree of interrelationship among the areas of learning. Therefore, youth with learning disabilities may exhibit a combination of characteristics. These problems may mildly, moderately, or severely impair the learning process.

Attention-Deficit/Hyperactivity Disorder (AD/HD) AD/HD is a condition that can make it hard for a person to sit still, control behavior, and pay attention. These difficulties usually begin before the person is 7 years old. However, these behaviors may not be noticed until the child is older. Boys are three times more likely than girls to have AD/HD. There are three main symptoms of AD/HD. These are: • Problems with paying attention, • Being very active (called hyperactivity), and • Acting before thinking (called impulsivity).

Doctors do not know just what causes AD/HD. However, researchers who study the brain believe that some people with AD/HD do not have enough of certain chemicals (called neurotransmitters) in their brain. These chemicals help the brain control behavior.

Traumatic brain injury Traumatic brain injury is defined in special education law as “an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to head injuries that impair one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psycho-social behavior; physical functions; information processing; and speech.” The term is not used to describe brain injuries that are congenital or degenerative.

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness Emotional Disturbance Many terms are used to describe emotional, behavioral or mental disorders. Currently, students with such disorders are categorized as having an “emotional disturbance,” which is defined under the Individuals with Disabilities Education Act (IDEA) as “...a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance— • An inability to learn that cannot be explained by intellectual, sensory, or health factors; • An inability to build or maintain satisfactory interpersonal relationships with peers and teachers; • Inappropriate types of behavior or feelings under normal circumstances; • A general pervasive mood of unhappiness or depression; or • A tendency to develop physical symptoms or fears associated with personal or school problems. As defined by the IDEA, the term “emotional disturbance” includes schizophrenia but does not apply to children who are socially maladjusted.

MENTAL HEALTH & PSYCHIATRIC DISABILITIES Mental illness is a term that describes a broad range of mental and emotional conditions. Mental illness also refers to one portion of the broader ADA term “mental impairment,” and is different from other covered mental impairments such as mental retardation, organic brain damage, and learning disabilities. The term ‘psychiatric disability’ is used when mental illness significantly interferes with major life activities such as learning, thinking, communicating, and sleeping. The most common forms of mental illness are anxiety disorders, depressive disorders, and schizophrenia. The type, intensity and duration of symptoms vary from person to person.

Mental illness often develops between the ages of 18 and 25. This often means that post- secondary educational plans are disrupted. Because of the cyclic nature of many mental illnesses, individuals may function very well for months or years and then suddenly run into difficulty. Medications used for treatment can also reduce concentration, blur vision and induce physical problems like dry mouth, nausea, tremors and insomnia.

SPEECH AND LANGUAGE DISABILITIES Speech and language disorders refer to problems in communication and related areas such as oral motor function. These include simple sound substitutions, an inability to understand, or a physical inability to speak or eat. Examples include stuttering, impaired articulation, language impairment, or a voice impairment. Some causes of speech and language disorders include neurological disorders, brain injury, drug abuse, or physical impairments such as

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness cleft lip or palate. Language disorders may be related to other disabilities such as mental retardation, autism, or cerebral palsy. Frequently, however, the cause is unknown.

Much of the information above is adapted from material developed by the following organizations. More information on specific disabilities can be found on their web sites.

National Information Center for Children and Youth with Disabilities www.nichcy.org LD Online www.ldonline.com

National Mental Health Association www.nmha.org

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness HISTORY OF DISABILITY IN BRIEF An outline of characteristics, attitudes, and practices toward people with disabilities from ancient times to the present. For an in-depth presentation of historical information visit the website of the Minnesota Governor’s Council on Developmental Disabilities: www.mncdd.org

Ancient Era 1500 B.C. — 475 A.D.

1. Language of the Times  Inferior  Idiot  Fool

2. Solution for Disabilities  Abandonment – legally required in Sparta to abandon “deformed & sickly” infants  Death – Aristotle said, “…no deformed child shall live.”  Use person as a plaything – court jester

Middle Ages, Renaissance & Reformation 476 A.D. - 1500 A.D.

1. Cruel Treatment  “Cities of the Damned”— made up of “deviants” such as madmen and incurables  Ships of Fools—people with disabilities were put on a ship and displayed from port to port; eventually abandoned  Begging was a necessity

2. Role of Religion  “Children of a Caring God”—belief of Koran, Confucius, & Zoroaster  “Filled with Satan”—Martin Luther’s belief

The 17 th and 18 th Centuries

Age of Confusion: Seeds of Change

1. Pervasive Attitudes  Idiot Cages—used to “keep people with disabilities out of trouble,” but also for entertaining townspeople  Thomas Malthus—advocated elimination of “defective” people

2. The Enlightenment  Influential thinkers such as John Locke & Jean Jacques Rousseau: persons with intellectual disabilities are capable of learning  Education of “deaf-mutes”

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness  Philip Pinel — first to say mentally deranged were diseased rather than sinful or immoral

1800-1950: The Rise of Institutions

1. Common Practices of 19 th Century  “Warning out”—the opposite of the welcome mat: newcomer with disabilities was not welcome in town  “Passing on”—transporting people with disabilities via cart to the next town

2. 1848: Beginning of Public Institutions  Created to train, teach, socialize and self-help  Dorothea Dix and Maria Montessori were pioneers

3. 1875: Shift in Focus  with large numbers, institutions began to focus on life as a resident, not on education for living on the outside  “Protection” of the person with a disability shifted to “suspicion”  Segregation and sterilization

4. Language of the Times  Idiotic  Feeble-minded  Unteachable idiots  Moron

5. Holocaust  100,000 children and adults with disabilities were killed  considered morally bad or genetically flawed

The Awakening 1950-1980

1. The Power of Parents  1940-1950: strong national movement—”The retarded can be helped.”  1950’s: international community sought same rights  30 years of parent advocacy focused on winning civil and legal rights for their children  1960-1970: state institutions, community service, education, job opportunities, legislation improved  Famous people become public about family members with disabilities; no longer hidden: o President Kennedy’s sister Rosemary o Pearl Buck’s daughter Carol o Dale Evans’ daughter Robin

2. The Independent Living Movement

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness Current Life for People with Disabilities

Key Legislative Advancements o 1965: Elementary & Secondary Education Act: Funding was made available to educate the “educationally deprived”

o 1973: Section 504 of the Rehab Act: People with disabilities are protected from discrimination in all federal programs

o 1975: Education for all Handicapped Children Act: Amended in the 90’s and is now known as the Individuals with Disabilities Education Act (IDEA). This law ensures that public schools offer all children with disabilities a free appropriate education in the least restrictive environment appropriate to their individual needs

o 1990: Americans with Disabilities Act: Goal is full participation and independence for persons with disabilities

o 2001: The Olmstead Supreme Court Decision interpreting the ADA : “The Federal Government must assist States and localities to implement swiftly the Olmstead decision, so as to help ensure that all Americans have the opportunity to live close to their families and friends, to live more independently, to engage in productive employment, and to participate in community life.”

Language of the Times o Person with a disability o Child with Down Syndrome o Uses a wheelchair

Significant Progress Towards Inclusiveness and Accessibility o Schools o Recreation Areas o Restaurants o Hospitals o Stores o Public Transportation o Housing o Workplace

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness TWO MODELS OF DISABILITY: A

CONTRAST Adapted from a diagram authored by Carol J. Gill, PhD.

Medical Model Disability is a deficiency or abnormality. Disability is a negative. Disability resides in the individual. The remedy for disability-related problems is cure or normalization of the individual.

Interactional Model Disability is a difference. Being disabled in itself is neutral. Disability derives from the interaction between the individual and society. The remedy for disability-related problems is change in the interaction between individual and society. THE AGENT OF CHANGE CAN BE THE INDIVIDUAL, AN ADVOCATE, OR ANYONE WHO AFFECTS THE ARRANGEMENTS BETWEEN THE INDIVIDUAL AND SOCIETY.

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness IT’S THE ‘PERSON FIRST THEN THE

DISABILITY What do you see first?

• The wheelchair? • The physical problem? • The person?

If you saw a person in a wheelchair unable to get up the stairs into a building, would you think “There is a handicapped person unable to find a ramp?” Or would you think “There is a person with a disability who is handicapped by an inaccessible building?” What is the proper way to speak to or about someone who has a disability? Consider how you would introduce someone — Jane Doe — who doesn’t have a disability. You would give her name, where she lives, what she does or what she is interested in: she likes swimming, or eating Mexican food, or watching movies. Why say it differently for a person with a disability? Every person is made up of many characteristics — mental as well as physical. Few people want to be identified only by their ability to play tennis or by their love for fried onions. In speaking or writing, remember that children and adults with disabilities are like everyone else — except they happen to have a disability. Therefore, here are a few tips for improving your language related to people with disabilities. 1. Speak of the person first, then the disability. 2. Emphasize abilities, not limitations. 3. Do not label people as part of a disability group. Don’t say “the disabled;” say “people with disabilities.” 4. Don’t give excessive praise or attention to a person with a disability; don’t patronize them. 5. Choice and independence are important. Let the person do or speak for him or herself as much as possible. 6. A disability is a functional limitation that interferes with a person’s ability to walk, hear, talk, learn, etc. Use handicap to describe a situation or barrier imposed by society, the environment, or oneself.

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness Say. . . Instead of. . . person with a disability disabled or handicapped child person with cerebral palsy C.P., or spastic person who is deaf or deaf and dumb hard of hearing person with mental retarded; retard impairment or retardation person with epilepsy or epileptic person with seizure disorder person who has... afflicted, suffers from, victim without speech, nonverbal mute, or dumb developmental delay slow emotional disorder, or crazy, insane, or mentally ill mental illness uses a wheelchair confined to a wheelchair with Down syndrome mongoloid; retard has a learning disability is learning disabled nondisabled normal, healthy has a physical disability crippled congenital disability birth defect condition disease (unless it’s a disease) seizures fits or spells cleft lip hare lip mobility impaired lame medically involved, or sickly has chronic illness paralyzed invalid or paralytic has hemiplegia hemiplegic (paralysis of one side of the body) has quadriplegia quadriplegic (paralysis of both arms and legs) has paraplegia paraplegic (loss of function in lower body only) of short stature dwarf or midget accessible parking handicapped parking

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness BASIC DISABILITY ETIQUETTE TIPS The following tips are things to keep in mind when interacting with people with disabilities. Remember each person is an individual. Never assume you know what a person with a disability wants or needs.

• If offering any assistance, always wait for a response and then follow the individual’s instructions. • When talking to a person with a disability, talk directly to that individual, not the friend, companion or Sign Language interpreter who may be present. • Respect all assistive devices (i.e. canes, wheelchairs, crutches, communication boards) as personal property. Unless given permission, do not move, play with or use them. • Remember that people with disabilities are interested in the same topics of conversations as non-disabled individuals. • When introduced to a person with a disability, it is appropriate to offer to shake hands. People with limited hand use or who wear artificial limbs can usually shake hands. (Shaking hands with your left hand is an acceptable greeting.) • If talking with a person using a wheelchair for any length of time, try to place yourself at their eye level. (This is to avoid stiff necks and “talking down” to the individual.) • Remember to show your face while talking with someone who is Deaf or hard of hearing. • Do not shout or raise your voice unless asked to do so. • If greeting someone who is blind or has a visual impairment, identify yourself and those who may be accompanying you. • Do not pet or make a service dog the focus of conversation. • Let the individual know if you move or need to end the conversation. • When interacting with a person who is visually impaired, follow their lead. If they need assistance, they will ask. • Allow the person to negotiate their surroundings, e.g., finding the door handle, locating a chair, etc. • Treat adults as adults. Address people with disabilities by their first name only when extending the same familiarity to all others.

PACER Center, Inc. 2004 Building Program Capacity to Serve Youth with Disabilities #1: Disability Awareness