SWU 171 intro to social work

Dr. Hilary Haseley, phd, msw, acue

Overview

Chapter 8

Physical, cognitive, and developmental challenges

61 million adults, 1 in 4 have a physical, cognitive or developmental challenge

Disability- temporary or permanent reduction in function

Prefer to use asset-promoting language like physical and cognitive challenges and abilities rather than disability

Strengths first

defining Physical, Cognitive, and Developmental Challenges

Criteria to meet definition of disabled:

Condition substantially limits major life activity

History of chronic condition

Severe impairment lasting at least 12 months. that is severe and interferes with normal functions of living

Types of Physical, Cognitive, and Developmental Challenges

Co-occurring disabilities-having more than one disability

Categorical challenges- significant sensory impairments or mental illnesses, coupled with developmental delays

Functional challenges- limits to a person’s ability to perform daily activities, and can often be helped with assistive devices/technology

Adults with functional challenges are more likely to have obesity, diabetes, and heart disease

Types of challenges

Categorical disabilities- significant sensory impairment or mental illness and have developmental delays

Most likely need long term care

Eligible for special education instruction

Types of challenges

Functional disabilities- limit a person's ability to perform physical activities and can be improved with assistive devices or technology

Percentages of adults with functional disabilities

13.7% mobility- unable to walk or climb stairs

10.8% cognition- unable to concentrate or remember or make decisions

6.8% independent living- unable to do errands alone

5.9% hearing- deafness or serious difficult hearing

4.8% vision- blindness or serious seeing difficulty

3.7% self-care- unable to dress or bathe one’s self

Leading disease/disorder contributing to disability in the u.s.

Developmental challenges

A severe chronic condition that manifests before the age of 22 and is likely to continue indefinitely

May be caused by a genetic predisposition or an issue before, during or after birth

Increased attention for invisible disabilities- non-visible or non-apparent challanges, but careful to call it a disability, could be a chronic illness

autism

Neurobiological developmental disorder

Generally, appears before age 3

Affects normal brain development

May have trouble with nonverbal and verbal communication, social interactions

Asperger’s syndrome is now part of the ASD

Chronic condition affecting control of the body and or limb movement, muscle tone and coordination

Caused by damage to one or more specific areas of the brain as the brain develops

Cerebral palsy

Trisomy 21

Chromosomal disorder caused by the presence of an extra 21st chromosome

Impairment of cognitive ability and physical growth

Distinctive facial features

Down syndrome

Epilepsy

Brain disorder that causes a person to have recurring seizures

More prevalent than autism, cerebral palsy, multiple sclerosis and Parkinson's disease combined

65 million people globally have epilepsy

70% of cases the cause is unknown

Fetal Alcohol Syndrome

FAS- a pattern of physical and mental defects that develops in some unborn babies when their mother drinks alcohol during pregnancy

One of the most common intellectual disabilities that is 100% preventable

Lifelong effects

Most common cause of inherited mental incapacities

Most prevalent intellectual disability inherited through generations

Very subtle and difficult to diagnose

‘autism-like’ behaviors

Behavioral features and delays in speech and language

FRAGILE X SYNDROME

Most common genetic cause of life-threatening obesity in children

Uncommon genetic condition

Low levels of sex hormones, poor muscle tone, constant feeling of hunger

Usually floppy babies

PRADER-WILLI SYNDROME

Physical challenge: limits one or more basic physical activities

Mobility challenge: Limits function of moving

Highly individualized conditions

Orthopedic problems

Diseases/defects of muscle/bone that cause impaired movement

Can be caused by genetics, injury, disease, other disorders

Can cause problems with standing, sitting, walking, using hands

Physical or Mobility Challenges

Hearing and vision problems

Range widely from minor impairment to being legally blind

Hard of hearing: Mild-to-moderate hearing loss

Deaf: Moderate-to-severe hearing loss

Deaf people may be considered to have a medical problem or to consider themselves members of deaf community

Mental/Cognitive Challenges

Neurocognitive impairments block the cognition process

Examples

Intellectual disabilities/challenges

Characterized by significant limitations in intellectual functioning and adaptive behavior

Previously called mental retardation

Range from mild to profound, based on IQ

Learning differences

Neurological disorders, skill-based

Dyslexia-reading, writing and spelling, dysgraphia- putting thoughts on paper, dyscalculia, hinders math are examples

Caused by a blow to the head or penetration of skull

Can have many physical and intellectual effects

Some may appear immediately, some may be delayed effects

Traumatic Brain injury

Stigma and Discrimination

Discrimination due to social stigma

Stigma- a “stain” on the way a person is perceived that leads to them being shunned by others

Can occur at work, in health care, within families

Goffman’s theory is that discrimination is due to social stigma, due to one of the three factors:

Visible or outer deformations

Deviations in personal traits (e.g., alcoholism, criminality)

Imagined or real traits of an ethnic group, nationality, or religion

Goffman’s theory has been criticized because it focuses more on the stigmatized than the stigmatizers

Kids typically know disability stereotypes by age 10

In the past, people with challenges have been seen as pariahs, to be pitied, feared, ignored

Inspirational stories in media may exaggerate deficiencies in what has been termed “inspiration porn”

In the 1800s, treatments were often gruesome

Historical Background of Services

Post Revolutionary War—people were sent to prisons, and asylums

Industrial revolution led to increase in physical and cognitive challenges

Progressive Era led to reforms in institutions

Increase in challenges after the industrial revolution was due to workplace accidents and exposure to harmful substances

Deinstitutionalization

Community Mental Health Act of 1963

Removing people from institutions and integrating them into the community

From 1965 to 1980, 60% of people were moved from asylums into the community

Civil rights movement argued that people with special needs are disadvantaged as much by discrimination as thy are by their physical, cognitive, or developmental challenges

Deinstitutionalization

Independent-living centers emerged in the late 1960s

Deinstitutionalization left some people without the level of assistance they actually needed, leading to homelessness/incarceration

Community Living Initiative in 2009 increased opportunities for meaningful community living

Person-first language example: “Person living with schizophrenia” over “schizophrenic person”

Person with a special need rather than “disabled person”

Avoid stigmatizing language like “differently-abled” “cripple” or “Victim”

“inspirational Porn” language

Person first language

Inspiration porn

Services for Persons with Physical, Cognitive, and Developmental Challenges

Civil Rights—Social workers can advocate for clients who many be protected by acts that acknowledge the civil rights of people with challenges

Income support—Many people living with challenges cannot earn enough to support themselves financially. Social workers can assist with getting them public assistance

Can also help with four specific issues for this population:

Civil rights

Income support

Education and rehabilitation

Genetic counseling

class

Cost of assistive technology can be a barrier

People with challenges often lack health insurance or coverage for necessary services

similar needs regardless of class but receive different services

Gender and Sexual Orientation

Disability often associated with asexuality

Women with challenges at a higher risk of gender-based violence

LGBTQ+ people with challenges are marginalized

Women with challenges are treated differently in health care system

Women with challenges are Less likely to have weight checked or to be screened for breast/cervical cancer than women without challenges

Race and ethnicity

AGE

Adults with functional abilities are more likely to develop diabetes

Aging process begins earlier for some people with challenges

Adolescents with physical, cognitive or developmental challenges are more likely than children without to be excluded from vital sexual and reproductive health education programs

Economic and Social Justice

Equipment, devices, respite care, acute care, and chronic caregiving assistance are covered by the insurance industry and the law but with limits

Social workers advocate for clients to fight against discrimination

Social work must advocate for clients as the private, for-profit services sector becomes more powerful

Supportive Environment

Public accommodations required by law, but could be absent- ADA

Private companies doing better job of making spaces inclusive

Social workers need to focus on what the client wants and make no assumptions about services, as well as advocate for clients when services are lacking

Human Needs and Rights

Institutionalization can be devastating, but people need access to institutions

Self-determination key