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Questions On Disabilities

1) Read Chapter 1-(in separate attachment)

Question-

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Using the Chapter 1 readings for context, describe how coping and adjustment may differ for people with acquired disabilities as opposed to congenital disabilities (occuring at birth), or how adjustment may be different at different stage of human development (such as early childhood, adolescence, adulthood, late adulthood).

Responds: 300 word min.

Brett responded:

The experience of disability is different for everyone and coping and adjustment certainly vary for people who have acquired disabilities vs. individuals with congenital disabilities.  My late mother became deaf when she was 19 or 20 years old and as a result she spoke much more clearly than a lot of people I have come into contact with (including my stepfather) who were born deaf.  My mother had that first period of her life where she could hear herself speak and develop her speaking skills.  My stepfather never had this benefit and while I can understand him quite well now he doesn’t speak nearly as well as my mother did.  My stepfather is well versed and fluent in sign language and while my mother could sign she was not as good whether due to the fact she had to learn it later in life to help cope with her deafness or if language (including sign language) comes more naturally to some people vs. others or that language skills are easier to teach and develop in young people.  I am teaching my 7 1/2 month old son to sign through the use of signs and having him watch videos in the hope that he will be able to sign well as he gets older to more easily communicate with my stepfather.

I think other factors can influence how people cope, adjust and deal with disabilities, whether acquired or congenital, depending on the type of support they get from their families, schools, friends and treatment providers.  A person with a very good support system at home and in school is more likely to cope and adjust to their disability then a person who lacks the same support structure.  A solid support structure can instill confidence, repetition, reassuring behavior and reactions, and provide a safe environment for a person with an acquired or congenital disability to learn, grow, and thrive in life with their disability.  On the flip side the same lack of support can result in someone having a negative view of themselves, thinking they are different from everyone else, and lacking the ability to be independent and confident in their everyday life. 

When a person becomes disabled (if not at birth) will also have a big influence on how they cope and adjust to a major change in their life.  If someone becomes disabled as a child or as an adult, the amount of time they have to learn, gain support, and understand what their disability means will have a large effect on how they view themselves.  As the book points out, everyone experiences disability differently and that does not even factor in the large number of disabilities as no two individuals with the same disability are guaranteed to encounter the same symptoms.

Falvo, D. (2014). Medical and psychosocial aspects of chronic illness and disability (5th edition).  Burlington, MA: Jones & Bartlett Learning.

Respond to Brett post- 250 word min

2) Question-

Describe your reaction to TED talk by Aimee Mullins, specifically how she contextualizes disability as opposed to how others have historically thought of disability.  Please comment on at least one post from your classmates.   

TEDTalk- WATCH: The Opportunity of Adversity (by Aimee Mullins)

No INITIAL respond needed, just respond to Don (below)…

Don Posted-

I am going to be 60 in November. When I grow up I want to be just like Aimee Mullins! As a person with several disabilities I was inspired by her talk. Aimee Mullins was not going to be defined by societal norms. She was not going to be told what she should, or could, accomplish in her life. She clearly establishes the context of the world she was born into with her use of dictionary definitions of the word disabled. I was appalled at the definitions that were from the 1980’s, up until the present day.  Although much has changed in the way we perceive and support the other abled, there is still such a long, long, long, way to go!

The title of her talk alone, The Opportunity of Adversity, is changing the context, or the lens, through which we view disability. I have lived in a world, since I was a young boy growing up in the 50’s and 60’s, were I was taught that only the strong survive. Aimee Mullins tells us, “It’s not the strongest of the species that survives, nor is it the most intelligent that survives; it is the one that is most adaptable to change.” (Mullins, 2009) Here is this one statement Mullins changes not only the context of how we should view the other abled, she changes the whole conversation.

Later on she challenges mine, yours, and society’s definition of what normal is. “I think the greatest adversity that we’ve created for ourselves is this idea of normalcy. Now, who’s normal? There’s no normal.” (Mullins, 2009) I have often wondered who decided what normal is. We have a great example of that going on right now. America’s biggest sporting event is taking place Sunday, the Super Bowl. One of the participants, Marshawn Lynch, does not speak to the media. In many places he is being vilified for not talking to the media. He is being threatened with huge fines. It is being said he is “not normal” or at the very least that is being inferred. Why should he have to talk with the media? Just to conform and be “normal?” Aimee Mullins challenges us to question what is normal and more importantly who gets to define it.

I think the greatest compliment I can give Aimee Mullins is to let her know I have decided to, come dance with her!

Mullins, A. (2009, October). The opportunity of adversity . Retrieved from TEDMED: http://www.ted.com/talks/aimee_mullins_the_opportunity_of_adversity/transcript?language=en

Respond to Don: 250 word min

3) Question-

Please use this case study “Ms. S experienced her first generalized tonic seizure at age 18, shortly after she entered college.  After several other seizures in the next year, she began taking medication to manage her seizures.  She is now beginning her junior year in college and plans to pursue a career as an elementary school teacher, but has concerns regarding the appropriateness of her career choice given her history of seizures”

1. Which specific information about Ms. S.’s health condition may be relevant to her career choice?

2. Which aspects of employment as an elementary school teacher may be important to consider?

3. Are there any accommodations that may be needed? If so, which accommodations should be pursued? (Remember you can use askjan.org if you need accommodation advice) www.askjan.org

Responds: 300 word min.

Elana Responded:

Which specific information about Ms. S.’s health condition may be relevant to her career choice? Information that may be relevant would be potential triggers for her seizures and documenting when her last recent seizure took place. Are there any specific triggers that are located within a school environment that would require accommodative measures? In addition, does her medication cause her any specific side effects that may hinder her work performance throughout the work day?  Is stress a facet to consider when considering her career choice?

Which aspects of employment as an elementary school teacher may be important to consider? The job of an elementary school teacher revolves around many facets.  The main job responsibility of a teacher is to ensure that her students are constantly supervised at all times.  In addition, younger students may require additional attention and resources.  Teachers are now required to develop numerous lesson plans and additional work outside of the school day which requires a great amount of time management. Furthermore, if a seizure occurred who would be responsible or looking after the students? Certain activities recommend that individuals with epilepsy have a partner with them in case a seizure occurs, would this practice be implemented when working with students.  Who would be able to take charge of the situation if a seizure occurred when working with an elementary population?

Are there any accommodations that may be needed? If so, which accommodations should be pursued? I referenced askjan.org to provide me with accommodation recommendations for the client.  These measures include but are not limited too; * Memory enhancing resources.  This may include voice recordings of instructions, or lesson plans, in addition to charts which are descriptive of steps, pictorial instructions or prompt verbal cues. *Time management, this is inclusive of a wall calendar, which may be referenced for specific due dates for lesson plans, exams or field trips.  In addition,  a checklist of assignments of an electronic organizer which would hold of these important dates and serve as a reminder *Stress management resources such as an employee assistance program, a modified work schedule or an on call support from doctor or other family member. *Transportation, this may be covered by a co-worker who is paired up Ms. S and whom provides a car pool service.  The adjustment of a work-day schedule to fit within then time frames of public transportation. *Balancing climbing– This is demonstrated by fall protection or the utilization of a schools elevator.  This enables Ms.S to move freely around the school, without worrying about walking up and down the stairways. *Fatigue– This may be reduced by a minimized workweek by implementing a part time schedule or taking on the role of a substitute teacher.  Providing a specific area which may be utilized as a rest area for breaks. *Photosensitivity – The school may provide fluorescent light tube covers to minimize the glare of the lights in the room.  In addition to the avoidance of prolonged exposure to computers by implementing/reinforcing breaks. *Develop a plan of action in case a seizure potentially occurs. Most importantly, this strategic course of action would need to be addressed and practiced.  This may include an awareness of visual or audible warning signs by a co-worker, knowledge of when to call 9-1-1 and emergency contact information on Ms.S.

Responds to Elana 250 word min:

4) Question-

Aphasia is a common symptoms following a significant stroke affecting the left side of the brain, particularly in areas around the sylvian fissure (lateral sulcus).  Wernicke’s aphasia is associated with damage along the lateral sulcus where the temporal lobe and parietal lob meet.  This type of aphasia has normal sounding rhythm and syntax to their speech, but the words are non-sensical.  They sometimes call this fluent aphasia.  Broca’s aphasia is a result of injury to the frontal lobe again near the lateral sulcus.  This type of aphasia, sometimes called non-fluent (or expressive aphasia) has speech that is choppy, pressured, and often missing the “in-between” words. 

No initial responded needed, just respond to Jennifer…

Jennifer Responds:

We use communication for so much in our daily life, and sometimes I think we take this for granted – until there is a problem that effects it and communication becomes difficult and not so ‘automatic’.  After watching the video, it became clear just how difficult it is for people who have aphasia.  One of the concerns expressed by one of the participants in the group was the perception that people may take the difficult communication as a deficit in intelligence, which is not the case.  Even people who know the person may begin to treat them differently, which causes frustration at home and at the workplace.  Socially, a person who had perhaps enjoyed going out and socializing with friends now may find this difficult if not impossible. Friends and family may not fully understand the disability and begin to treat the person differently or begin to avoid them altogether because it is difficult or uncomfortable to communicate with them. At work, especially if a significant part of their job requires communication, their job performance could be greatly affected and may even lead to job loss.  The serious repercussions of this disability can lead to frustration, isolation, and depression.

Strategies I might try in working with people with aphasia would be being patient, listening, and encouraging them.  I liked how the SLP in the video encouraged the gentleman, even though he could not verbalize the word, by pointing out to him that he had in fact communicated by using hand gestures in conjunction with the part of the word that he could remember.  I thought the hand gesture suggestion is great, because often communication can be facilitated in this way if speech is compromised.  Being patient is very important, as it allows the person time to process and verbalize without feeling stressed or pressured to do so.  Listening closely to what they are trying to communicate is also very important, as words may be missing or an incorrect word may be said, and if we are listening closely, we can still get a grasp of what the person is trying to communicate, and reflect back to them our understanding of what they said for confirmation from them. 

Respond to Jennifer: 300 word min

5) Question-

Using the Falvo text, the Journal of Clinical Psychiatry article and any other sources respond to the following:

1. Describe the AAIDD classification of intellectual disability.

2. Describe how the diagnosis of Autism has changed and what could be potential consequences.

No initial responded needed, just respond to Debbie..

Responds from Debbie-1. Describe the AAIDD classification of intellectual disability.

The AAIDD classification of intellectual disability, per Falvo, is characterized by: “significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills.  This disability originates before age 18.” (p.196)    The FSIQ of a person must be below a 70 and there was must be at least 2 or more functional impairments in the area of adaptive functioning.  The WISC or the Stanford-Binet Intelligence Scale may be used.  Adaptive functioning must take into context the person’s developmental stage, culture, and environment.  Two of the more widely used tests are the Vineland Adaptive Behavior Scales and the American Association on Mental Retardation Adaptive Behavior Scale (ABS).  The AAIDD defines intellectual disability in terms of the types of supports individuals require on a daily basis to function.  This replaces the previous categorization that was based solely on IQ scores.  The classification of supports required are as follows:  Intermittent, Limited, Extensive, and Pervasive.  On a side note, OPWDD (Office for People with Developmental Disabilities), formally known as OMRDD (Office of Mental Retardation/Development Disabilities), previously made persons eligible for services based on an IQ below 70.  They have since changed the qualification to an IQ below 60.  They are also looking for functional limitations and require the results of the Vineland II.  According to Wiki Psychology, the 2nd edition “offers a Motor Skills Domain and an optional Maladaptive Behavior Index to provide more in-depth information.”  While many became ineligible for services, on a positive note, there are individuals whose IQ well exceeds 60 but who demonstrate the need for extensive or pervasive supports for daily living, who are now eligible for services.  One group who has benefited from this change are individuals diagnosed with Asperger’s (under the DSM-IV.  With the development of the DSM-5, this population is now at-risk of ineligibility; see question #2).  Eligibility for OPWDD services opens many doors for funding including; intensive case management, Medicaid service coordination, day programming (including transportation), and extended services for Supported Employment.   

Respond to Debbie 250 word min

6) Question

Using the “Sex(abled) video, the sexuality section in the Falvo text (Chapter 12), and your own thoughts and experiences as context, describe prominent issues related to forming intimate relationships by people with intellectual disabilities.  You may consider the viewpoints from caregivers and family members, educators, societal attitudes, counselors or support personnel, and viewpoints from people with disabilities.  You may include disabilities outside of intellectual disabilities if you wish.

No initial respond, just reply to Jennifer J

Respond from Jennifer J.

I have been working with people that have intellectual disabilities for many years now. I have experienced many of these individuals dating and even some married couples. One of the important things that the text discussed is sex education. I think many of the clients I’ve worked with, especially the younger ones would benefit greatly from a sex education class. One hindrance is that many people with intellectual disabilities are treated like children by staff and guardians. If they want to partake in sexual activity they should be treated like adults and be informed. People with intellectual disabilities want the same things anyone would, to fall in love, get married, and even have children. This is where being clear, honest and informational will be important.

For example one young woman I work with is transitioning out of high school. She talks quite often about how she wants to get married and have babies. She says that babies are, “cute.” I try to explain to her the serious responsibilities of having a child. Feeding them, changing them, bringing them to doctors’ appointments and schools. This is a difficult discussion for me to have with her as my aim is to promote her independence and decision making. Unfortunately though she is still developing her own living skills and there is no possibility she could care for an infant. I do however think it is important to accept and promote her need for intimacy. I try to help her focus on the marriage part. As she does have a boyfriend. Getting married and at least having an intimate relationship is a higher likelihood for her than having a child.

I’ve seen in most cases guardians being okay with dating, and have experienced a guardian being okay with their adult child having sex. Their opinion was that their child misses out on most normal experiences in life that they should be able to participate intimately with a partner if they mutually consent to it. One thing brought up in the video that was useful is that there is a wider definition of what constitutes as sex. So the intimacy needs depend on the individual, and what makes them feel satisfied with their relationship.

Respond to Jennifer J-250 word min

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