Understanding Disabilities: Types, Causes, and Impacts
Types of Disabilities
Hearing Impairment
Hearing impairment is the loss that impairs sensory perception of sound stimuli, quality and quantity of sounds, also called hypoacusis.
- Hereditary Hypoacusis: Seem to be linked to an abnormality in a gene contained in the person. Constitute at least 50% of cases.
- Acquired Hearing Loss: Three types:
- Prenatal: During pregnancy
- Neonatal: At birth
- Postnatal: After birth
Visual Impairment
Visual System: A set of structures and organs that make vision and sense of sight possible.
Individual Variables: Level of cognitive development (integration, processing), fatigue, motivation, distractions.
Environmental Variables: Light conditions.
“We can understand visual impairment as a clear decrease in the ability of vision.”
Causes
- Hereditary Origin: Due to genes
- Cognitive Origin: From birth
- Acquired: Appears during the life cycle
Classification
- Blind People: Totally lacking vision
- Partially Blind: Perception of light, movement, contours
- Low Vision: Allows seeing objects at close range
- Limitations on Vision: Need enlightenment
Physical Disabilities
Physical disability is the presenting problem in the production, regulation, and execution of movements.
- Injuries of the Nervous System: Damage to the nerve centers of motor control such as cerebral palsy, Parkinson’s, spina bifida, multiple sclerosis, ALS.
- MSDs: From Bone-Joint: Arthritis, muscular dystrophy.
- Vascular Injuries of Origin: Such as stroke.
- Amputees or Failure of Limbs: Continuation of a traffic accident.
Cerebral Palsy
Cerebral palsy is a central nervous disorder that affects neuromotor areas and causes difficulty controlling and coordinating the body. It is permanent and is not progressive.
Types
- Spasticity: Increased muscle tone that can affect the whole body or part of it. (Tendons, muscles rigid and uncoordinated)
- Athetosis: Difficulty controlling voluntary movements
- Ataxia: Disturbance of balance and precision of movement, difficulty in measuring strength
- Mixed: Can present a combination of the above effects
Parkinson’s Disease
Parkinson’s disease is a degenerative neurological disease typical of older ages, which affects the control of movement, and the maintenance of muscle tone and posture. It follows a degenerative course, with increased mortality as it advances. The most important manifestations are:
- Tremor: Appears in the early stages, affecting the limbs.
- Slowness of Movement: It affects the face and axillary muscles; the most serious is the blocking or freezing where the affected person is suddenly motionless.
- Stiffness: Increases muscle tone in the affected limb.
- Alteration of Postural Reflexes: Difficulty maintaining stability and upright posture, difficulty walking.
Other Diseases
- Multiple Sclerosis: Progressive incurable disease, lower limb paralysis, loss of strength and alteration in sensation, coordination of movements and senses.
- Amyotrophic Lateral Sclerosis (ALS): Motor neuron disease that causes degeneration of the fibers, lower limb paralysis and cranial nerves, progressive muscular atrophy.
- Spina Bifida: Incomplete closure of the bony canal of the spinal cord produces motor, sensory and sphincter control problems.
- Traumatic Muscle Injury: Damage produced in the spinal cord caused by trauma resulting in loss of sensitivity, frequently occurs in falls from heights.
- Muscular Dystrophy: A group of degenerative diseases of hereditary, progressive degradation of muscle mass, but without affecting the nervous system.
- Arthritis: Pain and swelling in joints, which can be damaged over time, cause pain, difficulty moving or swelling in different parts of the body, especially hands and fingers, hips, knees and feet.
- Cerebral Vascular Accident: When blood flow is obstructed or blood does not reach the brain, it affects the motor neurons.
- Polio: Injury caused by a virus that causes an inflammatory attack of the anterior horns of the medulla, produces a flaccid paralysis with complete degeneration of muscles.
Level of Impact as per the Area
- Monoplegia: Only one limb
- Paraplegia: Only two legs
- Quadriplegia: Affects both upper and lower limbs
- Diplegia: Upper limbs more affected than lower limbs
- Hemiplegia: Affects symmetrical halves of the body
Mental Disabilities
Mental Retardation
Mental retardation is a disability characterized by significant limitations in intellectual functioning and adaptive behavior in practical skills. This disability begins before age 18.
It consists of three aspects:
- Limitations in Daily Functioning: Manifested before age 18, occur in two components: intellectual and adaptive behavior.
- Intellectual Component: Intellectual performance below normal is considered, established in an IQ < 70.
- Adaptive Behavior: Skills learned to function in daily life. These skills may include:
- Conceptual: Reading, writing, mathematical operations such as counting money.
- Social: Ability to communicate and relate to others, be responsible, and so on.
- Practical: Ability to take care of themselves and function (dressing, grooming, eating, traveling, shopping, cinema, etc.).
Various Degrees of Disability
- Deep: IQ below 25
- Grave: IQ 25 to 35
- Moderate: IQ 36 to 51
- Mild: IQ 52 to 70
- Narrow Borderline: IQ 70 to 83
Causes
- Genetic Factors: These are inherited.
- External Factors:
- Prenatal: They are not inherited, but congenital.
- Perinatal: Occurs in the 28th week of gestation and the first week of birth.
- Postnatal: After birth, due to infections, trauma, tumors, and so on.
Behavior Modification Techniques
These are a set of educational techniques aimed at achieving the perfection and consolidation of conduct that already exists, the acquisition of new behavior, or the reduction or elimination of certain behaviors.
- Additions: Stimuli in the form of rewards for the accomplishment of a behavior to ensure that it is acquired, e.g., watching a TV show if the table is picked up.
- Shaping: Consists of dividing the desired conduct into smaller steps.
- Token Economy: Enhancement that consists of winning or losing tokens exchangeable for prizes or rewards (reinforcements).
- Using Oral Instigators: Verbal requests that apply in the performance of any procedure to help achieve and repeat an answer.
- Modeling: Apprenticeship based on observation. A model (teacher) demonstrates a correct procedure for the user to imitate (modeling).
Barriers
Barriers are any impediment or obstacle that prevents access, utilization, enjoyment, interaction, and compression in a standardized, dignified, comfortable, and safe environment, product, or service.
- Physical Barriers: Architectural, urban, or transport boundaries.
Employment
- Regular Employment: Large firms are legally obliged to employ people with disabilities and provide tax benefits for hiring them.
- Sheltered Work: Done in special employment centers and occupational centers, facilitates the integration of disabled people with more pronounced disabilities.
Spina Bifida
What is Spina Bifida?
Spina bifida is a congenital anomaly characterized by the lack of fusion of one or more vertebral arches of the posterior, with or without spinal meningeal protrusion, where the content of the neural canal is exposed to the exterior. Every year, 400,000 children are born with a neural tube defect, totaling about 400 cases annually, which represents one per thousand live births.
Types of Spina Bifida
There are two types of spina bifida: hidden and open:
- Spina Bifida Occulta: The neural arches are not fused, and the skin lesion is covered throughout its exterior. A lock of hair, pigmented skin, or subcutaneous lipoma may appear in the area. The defect is very mild and in most cases has no clinical manifestations.
- Open Spina Bifida: In most cases, the lesion is covered by a membrane in the form of a cyst. If the cyst contains only meninges, the injury is known as Meningocele. If it is also covered by a lipoma, it is known as Lipomeningocele. In these cases, the consequences are milder. If the injury contains meninges and spinal cord, it is known as Myelomeningocele, which is the most frequent type.
Severity of Symptoms
In open spina bifida, the severity of symptoms depends on the following factors:
- Location of the lesion
- Extension of the lesion
- Associated malformations
Causes
The etiology of spina bifida is not known, but it is estimated to be multifactorial. It has been related to:
- Folic Acid Deficiency: In the mother
- Valproic Acid: A drug for the treatment of epilepsy
- Etretinate: A drug used in the treatment of psoriasis and acne
- Sex Hormones: Pregnancy hormone tests that were done in the 3rd and 4th weeks of fetal development. Fortunately, these are now obsolete.
- Genetics: Although not hereditary in the strictest sense of the word, there is an increased risk of having a second affected child if there was one before.
Prevention
Prevention is based on folic acid intake. It is recommended that all women of childbearing age take folic acid daily until they are pregnant or have not planned to become pregnant.
Consequences
Spina bifida is considered a multi-deforming disease with involvement of different organs as a result of the neurological involvement. The consequences are:
- Loss of Sensation Below the Injury: As a result of nerve and muscle injury
- Muscular Weakness Below the Level of Injury: This situation can range from mild to complete paralysis. The higher the spina bifida, the greater the muscle involvement.
- Latex Allergy: Affects up to 75% of people with spina bifida and can be present at birth or develop over time.
- Weakness of the Muscles of the Bladder and Intestinal Tract: Producing urinary and fecal incontinence.
- Hydrocephalus: This complication is very common in infants with spina bifida.
- Cerebrospinal Fluid (CSF): Hydrocephalus is an accumulation of this fluid in the brain, caused by poor circulation and the surplus not being absorbed. The brain produces pressure and dilates due to this situation, and it is necessary to eliminate this pressure to prevent brain damage.
Disabled People Throughout History
1. The Period of Denial of Disability: Until the 13th Century
People with deficits were rejected, scorned, even eliminated by society, considering them demented. Infanticide or other harmful practices were common.
2. The Period of Detention: 16th, 17th, and 18th Centuries
People with disabilities were separated from society and locked up in orphanages and asylums without receiving any attention. Some contributions began to emerge:
- Ponce de León created a school for the deaf.
- Juan Pablo Bonet published on the reduction of letters and the art of teaching the mute to speak.
- Valentin Haüy created the Institute for the Blind.
- Louis Braille developed the Braille reading and writing system.
3. The Period of Separation: Late 18th Century
Placement of people with disabilities in special schools became common.
- Philippe Pinel, a physician, advocated for the humane treatment of mentally handicapped people.
- Jean-Étienne Dominique Esquirol established the difference between idiocy and dementia.
- Édouard Séguin studied the education of mentally handicapped people and the development of special education programs.
4. The Rehabilitation Period: First Half of the 20th Century
The concept of rehabilitation and the term “deficiency” appeared.
5. The Normalization Period: 1968
Bengt Nirje introduced the term “normalization,” defined as “the possibility that the severely mentally handicapped develop a form of life as normal as possible in society.”
International Classification of Impairments, Disabilities and Handicaps (ICIDH)
- Deficiency: Any loss or abnormality of a psychological, physical, or anatomical structure. It may be innate or acquired, permanent or temporary.
- Disability: Any restriction or lack of capacity to perform an activity in the manner or within the range considered normal for a human being.
- Handicap: A disadvantage for a given individual, resulting from a deficit or disability that limits or prevents the performance of a function that is normal for them (depending on age, sex, and social and cultural factors).
International Classification of Functioning, Disability and Health (ICF)
This model presents disability as a mismatch between the person and the environment, the elements of this classification are:
* Health Condition: Any alteration of the health status of a person who can generate pain, distress or interference with activities of daily living.
* Failure: Are problems in physiological functions (mental, sensory, phonics, etc.) or body structures (anatomical), such as significant deviations or loss.
* Activity: The realization of a task or action by a person, covers the full range of critical areas (communication, mobility, self care) in this context speaks of activity limitations, difficulties an individual with certain state `health may have to perform various activities.
* Participation: The act of engaging in society “take part” “acceptance”, “inclusion” or “access resources” the problems an individual may experience in involvement in life situations.
* Contextual factors: They are the total background of a person’s life and style of vida.Puede have an effect on the health of a person can be: * Environmental external to the individual but would affect (natural environment, technology, services) * Personal: like sex, fitness, habits, lifestyles, life lived.
Types of disabilities: sensory, mental and physical.
VISUAL DISABILITY (FACTORS)
# Visual System: A set of structures and organs that make the vision and sense of vision.
# Variables of the individual level of cognitive development (integration, processing) fatigue, motivation, distractions.
# Environmental variables: light conditions,
“We can understand visual impairment as a clear decrease in the ability of the vision.”
CAUSES:
HEREDITARY ORIGIN: For the genes
Cognitive ORIGIN: From birth
PURCHASED FROM: Appears in the life cycle.
CLASSIFICATION:
No blind people: totally lacking in vision
No PARTIALLY BLIND: perception of light, buelta, contours
º LOW VISION: Lets see objects at close range
No LIMITATIONS ON THE VISION: They need enlightenment.
Hearing impairment: Loss impairs sensory perception of sound stimuli, quality and quantity of sounds, also called hipocausia
No Hipocausia hereditary seem to be linked to an abnormality in a gene conteniuda the person contistuyen least 50% of cases.
No hearing loss Adqurida: three types
* Prenatal: in pregnancy
* neonatal: at birth
* Postnatal: after birth.