I am differently able! Know me for my abilities, not my disability.
What is disability? - As defined by the World Health Organisation, a disability is the umbrella term for impairments, activity limitations and participation restrictions, referring to the negative aspects of the interaction between an individual (with a health condition) and that individual’s contextual factors (environmental and personal factors). Disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinder their full and effective participation in society on an equal basis with others.
For an easy to read, description on what disability is. Click here.
The basic principles and practices of social justice are:
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Equity - To ensure fair distribution of available resources across society.
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Access - Ensure all people have access to goods and services regardless of age, gender, ethnicity etc...
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Participation - Enable people to participate in decisions which affect their lives.
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Rights - To protect individual liberties to information about circumstances and decisions affecting them and to appeal decisions that are unfair.
These principles are expanded in the National Standards for Disability Services. This document was developed to help people with disabilities to be aware of their rights. The basic principles of social justice and the full standards are generic insofar as they apply more to the livelihood of people with disabilities, however, they can be applied to a fitness environment.
Two of these principles, access and equity, are very important when planning a fitness environment or program.
Accessibility is a general term used to describe the degree to which a product, device, service, or environment is available to be used by all intended audiences.
Participation means that people with disabilities are allowed and enabled to access the same facilities, participate in the same activities, and have the same privileges as their non-disabled peers. Participation also means participating on one's own terms rather than meeting predetermined societal norms.
Participation is both a right and a responsibility, influenced by and ascribed to the person and to the society. Participation does not occur in a vacuum; the environment dynamically influences participation.
Issues that affect, or are relevant to, access and participation for people with a disability, can be divided in to social, political, cultural and historical issues.
Social - Social issues that affect people can include, lack of community support, social norms and group conformity.
Social constructs of disability is a theory that is based on society creating disability itself, through the assumption that all people are able bodied and fully functioning. This assumption creates the disability, by placing barriers to participating in society before the person with a disability. It is thought that these assumptions, therefore, are the cause of the disabling nature of the person’s physical or mental attributes, and not necessarily the physical and mental attributes themselves.
Political - Lack of representation, ideology, values.
To improve outcomes for people with disabilities, changes can be brought about by legislation, policy changes, capacity building, or technological developments leading to:
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Accessible design of the built environment and transport.
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More accessible health, rehabilitation, education, and support services.
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More opportunities for work and employment for persons with disabilities.
Policy barriers are frequently related to a lack of awareness or enforcement of existing laws and regulations.
Cultural - Tradition, customs, religion, economics.
Cultural factors influence people's attitudes towards disability. And these factors differ in different communities. For example, in many developing countries, `individual rights' as expressed in western nations, do not exist. Traditionally in these countries, an individual is born in a kinship group, with a network of relationships that involve mutual obligations with regard to religious and economic factors. People look towards their immediate kin for welfare and help, rather than at the traditional western types of formal support services.
Because of this kind of relationship, the process of `empowerment' of an individual in this society is more complex, irrespective of whether he/she is a disabled person or otherwise. Hence, during planning of support programmes, planners have to also consider the different aspects of cultural influences in these communities. If this is not done, chances of non-participation by the disabled are high.
Historical - There has been a long history of misunderstanding, misdiagnosing, mistreating and misrepresenting people with disabilities. They have largely been provided for through solutions that segregate them, such as residential institutions and special schools.
Damaging historical ideas surrounding persons with a disability include:
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Traditional model - The traditional model of disability spanned from ancient history to the 19th century. In the traditional model, persons with disabilities where thought to be under the spell of witch craft, possessed by demons or the victims of a God’s punishment for their sins or the sins of their parents. They were shunned or ignored by society.
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Medical model - The medical model of disability considered the person with a disability to be a problem. They were measured against a scale of what was thought as normalcy. They were measured and considered only for what they could not do as opposed to what they could do. As a result, a person with a disability was severely restricted to a life that was decided for them.
Key issues facing people with a disability may include:
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Flexible workplaces - Difficulties with physical access to the workplace, getting to and from work, inflexible working hours and inadequate adjustments and adaptations to workplace equipment.
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Limited opportunities - Poor links between school and post-school programs and Commonwealth-administered disability employment services, under-representation in the vocational, education and training systems, limited scope and variety of jobs offered to people with disabilities, lower possibilities for promotion.
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Financial costs - Relying on a pension, employment in lower paying jobs, lower retention rates, additional transport, support, healthcare and other costs associated with their disability.
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Support services - Limited access to affordable, specialised support services including, assistive technology (for example, wheelchairs, hearing aids, voice-recognition software), case management for National Disability Insurance Scheme and Social Services, early childhood intervention services for children, life skills development, specialist accommodation support (such as personal care and domestic assistance), support to participate in community activities.
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Lack of community education - Stigma and discrimination against people with disabilities due to lack of factual information or ignorance.
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Barriers to inclusivity, access and equity - Transport (e.g. no lifts at train station, limited availability of modified taxis), Building design (e.g. no ramps and rails at entrance and exit, doors too narrow, bathrooms not modified). Use of services (e.g. reception counters too high, information not available in a range of languages). Communication (e.g. staff not trained in using alternative communication systems). Equipment (e.g. service not meeting equipment needs such as lifting devices). Staff and community attitudes (e.g. refusing a service based on a person's appearance or medical status).
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Barriers to empowerment - According to the Oxford Dictionary empowerment is the process of becoming stronger and more confident, especially in controlling one's life and claiming one's rights. Lack of stable employment that pays a living wage, physical barriers such as mobility and muscle control or needing modifications to accommodation, travel, communication, and a lack of reliable help and support services can impede on one's ability to achieve empowerment.
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Adequate information - Limited access to quality, up to date information. For example, internet access has been vital to most people but some may not be able to access the internet due to finances, requiring special equipment, unable to use technology due to lack of education or because of their disability. Access to technology and equipment that assists with information gathering is limited to a person's home or the premises of a service provider.
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Privacy - Ín some instaces the privacy or confidentiality of client records or information is not treated with the same amount of respect or consideration as would be the case with a non-disabled person. This is often the result of well-meaning intentions, however, it must not be allowed to occur. Informed consent should always be obtained before discussing or sharing anyone's records or information with others, even family members or carers.
There are millions of carers in Australia who provide unpaid care and support to family members and friends who have a disability, mental illness, chronic condition, terminal illness, drug or alcohol issues or who are frail aged. Caring is an important part of the human experience and is vital to the well being of the recipient.
Key issues facing carers of a person with a disability may include;
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Lack of understanding - Many people whom we would consider to be ‘carers’ still do not think of themselves as such, and as a result miss out on accessing services and support that is available.
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Caring needs to be recognised and valued - Carer issues may frequently be on the policy agenda but they seem to be issues of secondary importance to policy makers. Carers still struggle to be recognised by health care professionals. The lives of many carers are negatively affected by fatigue, social isolation, poor physical and mental health and financial stress.
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Financial security - Carers have a lower workforce participation rate than people with no caring responsibilities. Many are reliant on pensions and those who are in the paid workforce frequently face pressures maintaining their jobs.
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Flexible workplaces - Limited employment opportunities with employers who consistently offer flexible work arrangements.
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Support services - Not having access to a range of quality national carer services that meet their needs. For example mental health care, home help and respite care.
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Need for inclusion - Lack of diversity in disability support services can isolate carers who come from ethnic, linguistically or culturally diverse backgrounds.
Nearly everyone faces hardships and difficulties at one time or another. But for people with disabilities, barriers can be more frequent and have greater impact. The World Health Organization (WHO) describes barriers as factors in a person’s environment that, through their absence or presence, limit functioning and create disability.
On an individual level, people with a disability may face a number of additional barriers to accessibility and participation in health and fitness related activities compared with people without a disability. Not everyone will experience all these barriers.
It is important that an awareness of these barriers is created within an organisation. In the interest of facilitating active participation from people with a disability, once aware, steps can be taken to reduce or remove barriers.
The barriers are:
Cultural and/or religious barriers may exist due to the specific cultural or religious needs of the person with the disability or the attitudes and requirements of other people towards the person with a disability due to cultural or religious requirements.
For example dress codes, timing, or gender-specific needs. These can be managed through adjustment of the activity to meet these needs.
For example:
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Women may not be provided with the same level of support or opportunity that is allocated to men.
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Some cultures may seek to protect or even hide people with disabilities and not seek out care or services.
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Certain cultures and religions require specific dress codes, prayer or worship times, and dietary restrictions.
This can be overcome through education, adaption and training.
Family can be a barrier to participation due to family values, needs, and limitations.
For example:
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Families may have multiple children and each requiring care and attention.
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The family may have limited finances to spend on specialist equipment, services, or excursions.
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Family members may place limitations on a person's ability to participate by refusing to provide money or transport.
These can be managed through education and the provision of support to the family.
Community perception can be a barrier due to the way that the community as a whole sees disability. Emerging from a lack of understanding and leading people to have misconceptions about a person with a disability.
For example:
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Assuming a person with a disability is inferior, incapable, or not interested in participating.
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Not allowing them to participate because it was awkward, inconvenient, too expensive to modify, or too time-consuming.
These barriers can be overcome through education, promotion and inclusion in positive experiences.
The Centre of Research Excllence in Disability and Health which is part of the University of Melbourne recently conducted a survey of 2000 Victorians about their attitudes towards people with disability. Among the findings the following general community perceptions included:
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78% of people think people are unsure how to act around people with disability.
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63% of respondants think people become impatient with people with disability.
The impact of disability on participation can be managed through the resource, environmental and administrative modifications that can be made using the TREE method.
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Teaching Style - Communication and delivery strategies/ideas to assist students achieve success.
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Rules - Simplifying or changing rules, then re-introduce as skill levels increase.
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Equipment - Using different sizes, shapes, colours, textures, and/or weights of equipment.
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Environment - Varying the length, height, zones, floor, and seating/standing conditions of a playing area.
For more information on the TREE Method. Click here.
Communication barriers occur when sensory disabilities, such as hearing, seeing, learning disabilities or language difficulties have not been considered. These barriers relate to both the sending and receiving of information, and these can be managed through:
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Resources used to enhance sight, speech or hearing - Glasses/contact lenses; Text to speech devices; Hearing aids.
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Appropriate communication strategies - Normal tone of voice; Be polite and patient; Speak to the individual not their carer; Ask them what may help with communication; Don't pretend to understand, rather amend the question style by asking yes and no questions; Be flexible; Only refer to the disability if necessary or relevant; Offer assistance but do not presume it is necessary; Do not imply they are superhuman, courageous or special; Relax.
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Environmental control - For example, move to another location, increase or decrease noise, choose a different time.
In some cases, transport can be a barrier to participation and these may be managed through;
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Use of special vehicles.
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Use of community transport services.
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Locations selected based on accessibility, timing of activities and frequency of schedule.
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Subsiding the cost of transport.
Solutions for overcoming time and resource constraints include:
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Support networks or services to assist with transport, cleaning, personal needs, and shopping to allow for more free time.
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Grants or extra funds to allow for the purchase of specialised equipment.
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Simple modifications to physical environment to allow better access and faster mobility.
Confidence can be a barrier to participation, and this can be overcome through the use of:
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Encouragement.
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Skills development strategies.
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Communication strategies.
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Support.
The range of programmes delivered by support services may be a barrier to participation, and program directors should use a range of networks in order to overcome these barriers.
Examples of programmatic barriers include:
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Inconvenient scheduling.
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Lack of accessible equipment.
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Insufficient time set aside for medical examination and procedures.
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Little or no communication with participants and service provider’s attitudes.
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Lack of knowledge and understanding of people with disabilities.
Developmental disabilities describes any one of a number of conditions that emerge during key developmental periods in childhood which significantly impact a person's physical, cognitive, or behavioral health.
‘Acquired’ disability is a disability that has developed during the person’s lifetime, as a result of an accident or illness, rather than a disability the person was born with. Acquired disabilities can be visible and invisible.
Developmental disabilities
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Intellectual disability.
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Vision/hearing impairments.
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Cerebral palsy.
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Autism spectrum disorders.
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Attention deficit hyperactivity disorder (ADHD).
Accident related:
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Head trauma.
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Spinal injuries.
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Loss of vision.
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Loss of hearing.
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Injured limbs / loss of limbs.
Illness and health related:
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Post stroke.
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Post-traumatic stress.
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Multiple Sclerosis.
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Arthritis.
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Motor Neurone Disease.
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Mental Illness.
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Stress.
Requirements likely to be associated with some types of developmental and acquired disabilities, include:
An injury to the brain (as from stroke, near drowning, lack of oxygen, encephalitis, brain tumor, alcohol poisoning, or a blow to the head) that is not congenital, hereditary, or degenerative and that causes temporary or permanent symptoms.
Symptoms may include impairments in cognition (such as memory loss or poor concentration), emotional and behavioral changes (such as irritability, impulsivity, agitation, and depression), headaches, dizziness, fatigue, seizures, blurred vision, loss of taste or smell, impaired coordination, and numbness or paralysis of an extremity.
Requirements:
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Physical support such as wheelchairs, scooters, and other mobility aids, hoists, chairs and seating aids, modified clothing and footwear, self care aids.
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Emotional support such mental health and behavioural support for PTSD, anxiety, personality and mood changes, depression, anger.
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Communication support such as speech and communication aids to assist with language impairment, reading, writing or speech difficulties, or cognitive communication difficulties.
Autism is a condition that affects how a person thinks, feels, interacts with others, and experiences their environment. It is a lifelong disability that starts when a person is born and stays with them into old age.
Every Autistic person is unique. This is why autism is described as a ‘spectrum'. Autism Spectrum Disorder is characterised by social interaction and communication problems and/or restricted and repetitive patterns of behaviour, interests, activities.
Requirements:
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Reduction of distractions.
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Regiment and structure to daily activities.
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Sensory activity such as swinging or bouncing.
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Emotional support such as assistance to interact socially, and access to therapeutic animals.
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Communication support to read social cues and be involved in small group activity.
The term cognitive disability covers a whole variety of conditions that cause diminished cognitive and adaptive development, whether short-term or permanent. Characterised by problems remembering, difficulty processing information, problems accessing information or making decisions that affect everyday life.
Requirements:
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Carer to assist with daily activities.
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Emotional support to interact socially, learning to trust unfamiliar people.
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Memory support such as flashcards, notes, photographs, audio recording devices.
The term developmental delay describes when a child is slower to reach developmental milestones than other children, such as in the way they move, communicate, think and learn or through their behaviour and interaction with other children. Lifelong disabilities can arise due to lack of physical, mental or emotional development.
Requirements:
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Physical support due to reduced gross and/or fine motor skills. Apparatus to assist with issues related to posture and respiration.
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Communication support such as sign language, visual aids, learning through play.
An intellectual disability is characterised by someone having an IQ below 70 (the median IQ is 100), as well as significant difficulty with daily living such as self-care, safety, communication, and socialisation. People with an intellectual disability may process information more slowly, find communication and daily living skills hard, and also have difficulty with abstract concepts such as money and time.
Requirements:
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Physical support such as assistance required to travel from home to another facility.
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Educational assistance.
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Communication support such as sign language, visual aids, learning through play.
Neurological impairment refers to a broad group of disorders in which the central nervous system does not function properly and leads to some form of physical (paralysis) and/or mental problems. The central nervous system is made up of the brain and the spinal cord.
Requirements:
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Physical support such as accessible parking, entrances and interior spaces. Wheelchairs, scooters, and other mobility aids, hoists, chairs and seating aids, modified clothing and footwear, self care aids.
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Communication support such as voice amplifiers, book alternatives (for example, large print, braille, audio books, ebook readers), speech-generating devices, communication boards and similar devices.
Physical disabilities, place limitations on the functioning, stamina, mobility or dexterity of a person's physical performance. Some physical disabilities may limit other functions of the person's body including, blindness, sleep disorders, and respiratory disorders.
Requirements:
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Physical support such as accessible parking, entrances and interior spaces. Wheelchairs, scooters, and other mobility aids, hoists, chairs and seating aids, modified clothing and footwear, self care aids.
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Communication Support such as voice amplifiers, book alternatives (for example, large print, braille, audio books, ebook readers), speech-generating devices, communication boards and similar devices.
Sensory disabilities, or sensory impairments, affect one or more of a person’s senses: touch, hearing, sight, taste, smell, or spatial awareness. In some cases, a person may be suffering from dual sensory impairment (example sight and hearing).
A sensory disability can be loss of one or more senses, or being more sensitive to one or more senses. Having an under reactive or an over reactive sense of smell, taste, or touch.
Requirements:
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Communication Support such as alternative formats for printed material like large print, electronic, or braille for visually impaired. Communicating by sign language, or visual/pictures.
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Physical support such as guide dogs or a cane, hearing aids.
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Support required to participate in activities outside of their usual environments.
Speech and language disabilities impact verbal communication and language interpretation ability.
When a person has a speech disability, they will have trouble or not be able to make the necessary sounds required in order to speak fluently or clearly. Examples include stuttering, slurring, voice impairment.
When a person has a language disability, they will have difficulty interpreting information and communicating thoughts, ideas and feelings. For example dyslexia, difficulty recalling words, or difficulty using appropriate language in different settings, for instance at home, with friends, or at work or school.
Requirements:
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Emotional support such as counselling or psychological support for anxiety, frustration. Being more comfortable participating in small group or individual focused activities.
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Communication support such as electronic devices that convert text to speech or vice versa, pictures or visual aids, non verbal methods, or asking short answer questions.
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Visual and sound cues if not relying on speech to communicate.
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Requiring the aid of speech pathology.
