DISABILITYDISABILITY In the Philippine scenario

Social Technology Bureau

Department of Social Welfare and Development

The face of disability The face of disability in the Philippinesin the PhilippinesThe face of disability The face of disability in the Philippinesin the Philippines•Pegged at 10% of the total populationPegged at 10% of the total population (should be 8.86M based on August 2007 (should be 8.86M based on August 2007 population census 88.6 million Filipinos )population census 88.6 million Filipinos )

•There could be more if we take the WHOThere could be more if we take the WHO projection for Asia-Pacific (10% - 15%)projection for Asia-Pacific (10% - 15%)

•PWD population is expected to grow byPWD population is expected to grow by 4% annually4% annually

•Recent violence in Mindanao has rendered Recent violence in Mindanao has rendered more people physically, emotionally,more people physically, emotionally, and psychologically disabled latelyand psychologically disabled lately •80% live in the rural areas80% live in the rural areas

•80% are impoverished80% are impoverished

•98% of children with disabilities do not 98% of children with disabilities do not go to schoolgo to school

•97% of PWD population do not get97% of PWD population do not get appropriate servicesappropriate services

•Pegged at 10% of the total populationPegged at 10% of the total population (should be 8.86M based on August 2007 (should be 8.86M based on August 2007 population census 88.6 million Filipinos )population census 88.6 million Filipinos )

•There could be more if we take the WHOThere could be more if we take the WHO projection for Asia-Pacific (10% - 15%)projection for Asia-Pacific (10% - 15%)

•PWD population is expected to grow byPWD population is expected to grow by 4% annually4% annually

•Recent violence in Mindanao has rendered Recent violence in Mindanao has rendered more people physically, emotionally,more people physically, emotionally, and psychologically disabled latelyand psychologically disabled lately •80% live in the rural areas80% live in the rural areas

•80% are impoverished80% are impoverished

•98% of children with disabilities do not 98% of children with disabilities do not go to schoolgo to school

•97% of PWD population do not get97% of PWD population do not get appropriate servicesappropriate services

Understanding the Cycle of Poverty & DisabilityUnderstanding the Cycle of Poverty & Disability

Source: http://www.dfif.gov.uk/Pubs/files/disability.pdf

There is a vicious circle between poverty and disability.Poor people are more at risk of acquiring a disability because of lack of access to good nutrition, health care, sanitation, and living conditions. Disability creates barriers to education, employment, and public services that could help an exit from poverty.

It is estimated that 100 million people in the world acquired a disability due to malnutrition.

Basic premisesBasic premises

Disability is the result of the interaction between people with Disability is the result of the interaction between people with different levels of functioning and an environment that does different levels of functioning and an environment that does not take these differences into account.not take these differences into account.

What is Disability?What is Disability?

Disability = functional limitation x environmentDisability = functional limitation x environment

Disability is part of everybody’s life-cycle. Everyone is likely Disability is part of everybody’s life-cycle. Everyone is likely to experience disability at some point during his/her lifetime to experience disability at some point during his/her lifetime because of illness, accident or ageing. because of illness, accident or ageing.

Disability resides in society, not in the person (UN CRPD Disability resides in society, not in the person (UN CRPD Handbook for ParliamentariansHandbook for Parliamentarians

An accessible physical environment benefits everyone, not An accessible physical environment benefits everyone, not just persons with disabilities. (Universal design)just persons with disabilities. (Universal design)

IMPAIRMENT

any loss or abnormality of psychological, physiological or anatomical structure or function.

An impairment may be missing or defective body part, an amputated limb, paralysis after polio, a facial disfigurement etc.

DISABILITY

any restriction or lack ( resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.

Disabilities as a result of an impairment may involve difficulties in walking, seeing, speaking, hearing, reading, writing among others.

HANDICAP

a disadvantage for a given individual resulting from an impairment or a disability that limits or prevents the fulfillment of a role that is normal for that individual.

A disability becomes a handicap when it interferes with one’s ability to do what is expected at a particular time in one’s life. Children with disabilities may become handicapped in caring for themselves, engaging in social interactions with other children and adults, communicating their thoughts and concerns, learning in and out of school and developing a capacity for independent economic activity.

TYPES OF DISABILITIES

PHYICAL DISABILITY

SENSORY DEFICIT

INTELLECTUAL DISABILITY

OTHER DISABILITIES

INTELLECTUAL DISABILITY

can be described as the presence of a below average general intellectual functioning associated with or resulting in difficulties in behaviours such as communication, self care, social skills, safety, work and leisure.

This was formerly known as mental retardation

CAUSES

infections before, during or after birthchromosomal and genetic abnormalities e.g. down syndromehead injurybirth injuries e.g. poor oxygen supply to baby’s brainlow birth weightgrowth or nutritional problems of the childpremature babiepoor diet and health care by the mother during pregnancysubstance abuse during pregnancy, including drug consumption, excessive alcohol intake and smoking.Side effects of drugs consumed during pregnancy which may be non-prescribed or used for critical illness.

MEASURES THAT MAY PREVENT INTELLECTUAL DISABILITY

good health care during pregnancy, labour and after birth

early detection of “high risk” pregnancies

screening tests for newborn babies

early detection of sensory disabilities

identifying special educational needs of children

FUNCTIONAL IMPLICATIONS

inability to process information and effectively communicate with others

this could affect an individual’s personal, social, educational, leisure and employment opportunities.

PHYSICAL DISABILITY

A disorder that limits physical mobility and dexterity.

It can be generalized into three groups:

limited or no control of some or all voluntary muscles

under developed skeletal structure

dysfunctional joints

CAUSES

accidents which could result to spinal cord injury, amputations and head injury.

Congenital conditions such as cerebral palsy, spina bifida and muscular dystrophy

Drug or alcohol abuse by pregnant women.

Inherited conditions.

FUNCTIONAL IMPLICATIONS

limited mobility makes it difficult to access pubic transport and places of study, and pursue to leisure, shopping and other interests.

Home settings has to be modified to enhance independence within the home in all activities of daily living, e.g. modified bathroom and toilet.

SENSORY DISABILITY

VISUAL IMPAIRMENTcan be defined as a limitation in one or more functions of the eye or visual system.the terms partially sighted, low vision, legally blind and totally blind are used to describe people with visual impairments.Partially sighted indicates that some type of visual problem has resulted in a need for special education .Low vision generally refers to severe visual impairment and applies to all individuals with sight who are unable to read the newspaper at a normal viewing distance, even with an aid of eyeglasses or contact lenses.Legally blind indicates that a person has less than 20/20 vision in the better eye, or a very limited field of vision.Totally blind refers to people who learn via Braille or other non visual media.

CAUSEScongenital at birth

inherited, that is transmitted geneticallyoccurred while the baby is growing in the wombtrauma at birthsome eye disorders may be present at birth but do not show until the child is older.

infectious diseases such as :rubellavenereal diseasetoxoplasmosistuberculosistrachoma

SOME COMMON EYE DISORDERS

cataractretinopathy of prematurityaniridia- congenital lack of the iris. This is genetically transmitted.Albinism- an inherited condition producing deficiency or total lack of pigment in the retina, iris, choroids, skin and hair.

FUNCTIONAL IMPLICATIONS

due to visual impairment, a child has little reason to explore the environment and thus may miss opportunities to have experience and learn.The child cannot see parents or peers, he or she is not able to imitate social behaviors or understand non verbal cues.Children with visual impairment may need additional help with special equipment and modifications in the regular curriculum to emphasize listening skills, communication, orientation and mobility and daily living skills.

OTHER DISABILITIES

attention deficit hyperactivity disorder

learning disability

autism

speech/language/communication disorder.

WHAT IS ADHD?

it is a developmental disorder characterized by three (3) predominant features:

– inattentiveness– impulsivity– restlessness or hyperactivity ( in many but not all

cases)

CAUSESgenetically transmittedchemical imbalance or deficiency in certain neurotransmitters

SIGNS OF ADHDinattention

impulsiveness

poor motor control

hyperactivity

lack of organizational skills

poor social skills

LEARNING DISABILITY

is a disorder in one or more of the basic psychological process involved in understanding or using spoken or written language. It may manifest itself in an imperfect ability to listen, think, speak, read, write and spell or to do mathematical calculations.

CAUSESinherited or genetically transmittedbrain injuryprenatal exposure to drugs, alcohol, smoking and toxic substances

OTHER SYMPTOMSshort attention spanpoor memorydifficulty with sequencing difficulty following instructions/directionsProblems in telling the difference between letters, numbers and sounds.Poor eye hand coordinationDifficulty in day to day performanceM

SPEECH/ LANGUAGE/COMMUNCATION DISORDER

refers to problems in communication and related areas such as oromotor functions. These problems range from simple sound substitutions to inability to understand or use language or use the oromotor mechanism for functional speech and feeding.

CAUSEShearing loss or impairmentneurological disordersmental retardationbrain injurydrug abuse physical impairments such as cleft lip or palateOther medical conditions

COMMUNICATION DISORDER

occurs mainly due to brain damage and can cause problems such as:

difficulty with speech production, e.g. slow or slurred speech

difficulty understanding speech and language.

Difficulty reading and writing

FUNCTIONAL IMPLICATIONSaffects a child’s confidence and self esteem

child may become socially withdrawn.

AUTISM

is a neurological disorder that affects an individual’s ability to think, feel and communicate with others.Is one of the most common developmental disability and its characteristics show themselves in the first three years of a child’s life.Children with austim do not look any different from other children. They are not physically disabled. The common factor that everyone with autim shares is a difficulty in understanding their world.

CAUSESthe exact cause of autism is not known. However, doctors believe that it could be due to failure in the development of the section of the brain that processes stimuli.

SYMPTOMS OF AUTISMdelayed language skillsplays alone and does not play with other childrenlacks feeling or interest towards other people’s attempts at communication.Short attention spanDislikes physical affection.Displays temper towards self or othersDifficulty in learning Ability to learn one day but not the next Difficulty with changes in routineLacks eye contactRepetitive and compulsive behavior which when interrupted may provoke temper tantrumsIn some, extraordinary talent or brilliance in specific skills

FUNCTIONAL IMPLICATION

Social Interactionall children who have been diagnosed as autistic have problems in the area of social interaction, social communication and imagination. They cannot understand the meanings of gestures, facial expressions or tone of voice. Due to this, they may appear aloof and indifferent to other people. These children may find it difficult to develop friendship with other children as they have limited capability to understand others.

Communication

children with difficulty understanding the purpose and meaning of body language, and spoken and written words. Thus, they will have difficulty communicating with others and participating in school, playing and taking part in leisure activities.

Behavior

in infancy, these children appear unusually sensitive to sensory stimuli such as food of different texture, sound and light. The normal preoccupation with their own hand and finger movements persists and become self stimulatory. In the second and third years, this self stimulatory behaviors may become more obvious die to withdrawal from environmental stimulation. Changes in daily routine for these children may lead to tantrums as a way of expressing their extreme confusion and / or frustration.

HEARING IMPAIRMENT

can be defined as the degree of hearing loss ranging from mild to profound.

CAUSESbefore birth- maternal rubella, RH incompatibility, drugs, accidents, irth cry, exposure to radiationduring birth- premature delivery, delivery complications, breach or instrumental delivery, delayed birth cry, trauma at birthafter birth- meningitis, infantile jaundice, trauma after birth, measles, mumps

COMMUNICATION OPTIONS FOR CHILDREN WITH HEARING IMPAIRMENT

Auditory-verbal therapyaims at early detection and identification of hearing impairment and integrates listening into the child’s total personality. Supports the concept of mainstreaming and integration of hearing impaired children into mainstream schools.

Oral-Aural approachprogram adds visual skills to the auditory approach and teaches children to receive information through speech reading, amplification of sounds and listening.

Total communicationuses all possible means ( listening, speech, reading and sign language) simultaneously to give children the ideas and concepts of language.

Sign Languageuses gestures as symbols for words and concepts. Signing exact English is a sign system using separate sign for each word as well as other English language grammatical elements.

INTERACTING WITH PEOPLE WITH

DISABILITIES (PWDs)

HOW TO TALK WITH A PWD?

Always address the person first- not the disabilitySpeak directly to someone who is hearing impaired or visually impaired rather than to an assistant or the guide.Be patient if the person needs extra time to do or say somethingIf the person uses a wheelchair, sit down to talk so you’re at the same level.Listen carefully and patiently to a person with speech impairment.

MAKING CONTACT Don’t touch a guide dog or a wheelchair or

crutches used by the person unless you’re asked to do so.WHEN AND HOW TO HELP?

Offer help if asked or if the need seems obvious. The PWD do not want pity or special favors.

WHAT IS THE BEST THING TO DO If unsure how to interact with a PWD, feel free to

ask the questions.

Always remember: Questions Don’t Hurt. Ignorance Does.

COURTESY RULES OF BLINDNESS

HOW TO TALK TO A BLIND PERSON

Talk to me directly

I just can’t see but I can hear clearly

Address your questions directly at me

Don’t ask me through my companion

HOW TO GUIDE A BLIND PERSON

Making contact- when you are ready to walk with a blind person, lightly touch the back of his/her hand.Grip and Stance- the blind person holds the arm slightly above the elbow. The blind person should always be half step behind the guide.Changing sides- guide should stay where he is while the blind person moves to the other side.Narrow spaces- where its difficult to walk two abreast the guide should make a definite move with his arm backwards and over to the center of his back.Opening doors- the blind person must be on the hinge side of the door. If not, he changes sides.Going up and downstairs- the sighted should tell the blind that they are approaching the stairs and whether they are going up or down.Seating- when being seated in front of the dinner table, the guide takes the blind persons’ hand and places it on the back of the chair so that the blind has tactile contact and knows where the chair is.Sitting at the table- the blind person must pull the chair away from the table with one hand holding at the edge of the table.Dining- if menu is provided, it should be quietly read to the one who is blind

ETIQUETTE RULESWHEN INTERACTING WITH SOMEONE WHO HAS MOBILITY IMPAIRMENT

When conversing with a person who uses a wheelchair or scooter, position yourself at eye level in front of the person.Be aware of what is and what is not accessible to a person who uses mobility devices.Rearrange furniture if there is something blocking the person’s path.Offer to tell where accessible rest rooms, telephones, and water fountains are located.There are different reasons that a person can have mobility impairment- spinal cord injury, multiple sclerosis, cerebral palsy, muscular dystrophy etc.People with mobility impairments can use a variety of assistive devices: scooters, crutches, canes, walkers, wheelchairs.Do not lean or hang on a person’s wheelchair or scooter.Do not hang a coat or bag on the person’s wheelchair unless the person says to do so.

These assistive devices are extensions of a person’s individual space.Act naturally. Do not be afraid to use phrases like “ I am going for a walk” or “ I have to run”. When giving directions, consider distance, weather conditions and physical obstacles.Ask before giving any assistance.Leave accessible parking places for those who need them.Do not park in the hatch marks of accessible spaces.Do not make assumptions about a person can or cannot do based on his disability.Do not feel sorry for a person who uses a scooter or wheelchair to get around.

Get the person’s attention before you start talking. You can wave to the person or tap him on the shoulder.Be sure that the light falls on your face.Avoid background noise to the extent that is possibleIf you are aware that the hard of hearing person has a better ear, stand or sit on that side.Speak as clearly as possible in a natural way and at a moderate pace. Don’t shout.If the person does not understand what you said, rephrase it.Do not obscure your mouth with your hands.Facial expression and body language are important clues. Use them properly.Do not become impatient. Stay positive and relaxed.Ask what you can do to facilitate communication.

Hearing impaired persons sometime find certain people easier to understand. If you have difficulty communicating . see if a co-worker can be understood more easily.Be courteous; Excuse yourself if you have to leave or interrupt a conversation.Do not ignore deaf people during conversations.Never talk about a hard of hearing person in his presence.

I have no legs,I have no legs,But I still have feelings,But I still have feelings,

I cannot see,I cannot see,But I think all the timeBut I think all the time

Although I’m deaf,Although I’m deaf,I still want to communicate,I still want to communicate,

Why do people see me as useless, thoughtless, Why do people see me as useless, thoughtless, talkless,talkless,

When I am as capable as any,When I am as capable as any,For thoughts about our world.For thoughts about our world.

——Coralie Severs, 14Coralie Severs, 14

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