Types of
Disabilities
According to the 2001 Census, 21 million people are suffering from some kind of disability which is equivalent to 2.1 per cent of the entire population. The data has being collected for five kinds of disabilities i.e. people with visual disability (48.5%), people with loco motor disability (27.9%), people with mental disability (10.3%), people with speech disability(7.5%), people with hearing disability (5.8%).

1. Cerebral Palsy

Cerebral Palsy is a non-progressive but not unchanging disorder of movement and/or posture due to an anomaly of the developing nervous system. It damages parts of the body which cannot be recovered nor can be worsened. However the movements, body positions, and related problems can be improved depending upon the child's treatment and degree of brain damage. In most cases there are lot of associated impairments, such as mental retardation, hearing and speech impairment.

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Types of Cerebral Palsy

Cerebral Palsy is different in each child. There are mainly three different ways in which cerebral palsy can appear.

a) Muscle Stiffness or "Spasticity": A child with spasticity has muscle stiffness which causes his/her body to be rigid or stiff and movements are slow and awkward. The muscle tension of the child increases when he/she is upset or excited or when the body is in certain position.

b) Uncontrolled Movements or "Athetosis": The child makes slow, wriggly, or sudden quick movements of feet, arms, hands or face muscles. The body makes lot of involuntary and fluctuating movements which affects the whole body. This leads to poor balance and the person falls easily

c) Poor balance or "Ataxia": Ataxia is characterized by low muscle tone, also known as "hypotonic." A child with ataxia usually has a wide-based gait, or walk. They have a poor sense of balance because of which their feet are wide apart. In appearance the person with cerebral palsy looks shaky and unsteady. This is a result of low muscle tone.

2. Learning Disability

Learning Disability is a group of neurological or brain-based problems that affect one or more ways that a person takes in, stores or uses information. LDs come in many forms and their effects are different from person to person. They relate to: Getting information into the brain (Input), Making sense of this information (Organization), Storing and retrieving information (Memory), Getting information back out (Output).

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By definition, people with Learning Disabilities have average to above average intelligence yet they have very specific impairments in one or more of the psychological processes related to learning.

Common learning disabilities

Dyslexia – a language-based disability in which a person has trouble understanding written words. It may also be referred to as reading disability or reading disorder.

Dyscalculia – a mathematical disability in which a person has a difficult time solving arithmetic problems and grasping math concepts.

Dysgraphia – a writing disability in which a person finds it hard to form letters or write within a defined space.

Auditory and Visual Processing Disorders – sensory disabilities in which a person has difficulty understanding language despite normal hearing and vision.

Nonverbal Learning Disabilities – a neurological disorder which originates in the right hemisphere of the brain, causing problems with visual-spatial, intuitive, organizational, evaluative and holistic processing functions.

Learning Disability is diagnosed most commonly as an outcome of a comprehensive psychological assessment. Using a number of standardized tests that have been given to thousands of people, psychologists will systematically look at how people think, problem-solve, remember, understand and express information.

3. Autism

Autism Spectrum Disorder is a complex condition that impacts normal brain development and affects a person's social relationships, communication, interests and behaviour. Studies indicate that ASD affects one in every 150 children. ASD usually appears early in life, often before the age of three, and is four to five times more common in boys than in girls.

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ASD is a general term that includes the following disorders: Autistic Disorder, Asperger's Disorder, Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS), Rett's Disorder, and Childhood Disintegrative Disorder (CDD). In each of these disorders, social interaction is most commonly affected.

The symptoms and characteristics of ASD can present themselves in a wide variety of combinations, from mild to severe. Although ASD is defined by certain sets of behaviours, individuals can exhibit any combination of the behaviours in any degree of severity. Children with the same diagnosis can act very differently and have varying skills. Therefore, there is no standard type or typical person with ASD.

4. Mental Retardation

Mental Retardation is a condition in which there is delay or deficiency in all aspects of development, i.e. there is global and noticeable deficiency in the development of motor, cognitive, social, and language functions. This is the most common form of developmental disability. In many ways, mental retardation is also representative of developmental disabilities in general, in its causation, nature, and care. In many ways, mental retardation is also representative of developmental disabilities in general, in its causation, nature, and care (WHO)

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According to Diagnostic and Statistical Manual for Mental disorders (DSM-4) for a person to have mental retardation following criteria should be fulfilled:

1. Significant sub average intellectual functioning i.e. an IQ of approx 70 or below
2. Deficits or impairments in adaptive functioning (person's daily living skills)
3. Onset before age of 18 years.

There are four different degrees of mental retardation depending upon the functional level of the person: mild mental retardation (IQ: 50-70), moderate mental retardation (IQ: 35-50), severe mental retardation (IQ: 20-40) and profound mental retardation (IQ: 20-25)

5. Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition that involves difficulties with inattention and hyperactivity-impulsivity that are developmentally inconsistent with the age of the child. ADHD is not a disorder of attention, as had long been assumed. Rather, it is a function of developmental failure in the brain circuitry that monitors inhibition and self-control. This loss of self-regulation impairs other important brain functions crucial for maintaining attention, including the ability to defer immediate rewards for later gain (Barkley, 1998).

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Behavior of children with ADHD can also include excessive motor activity. The high energy level and subsequent behavior are often misperceived as purposeful noncompliance when, in fact, they may be a manifestation of the disorder and require specific interventions. Children with ADHD exhibit a range of symptoms and levels of severity. In addition, many children with ADHD often are of at least average intelligence and have a range of personality characteristics and individual strengths.

6. Hearing Impairment

Hearing impairment is the inability of an individual to hear sounds adequately. This may be due to improper development, damage or disease to any part of the hearing mechanism.

Hearing is a prerequisite for the development of normal speech & language. A child learns to speak by hearing the speech of others in the family and surroundings.

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Types of Hearing Impairment are: Conductive hearing loss that results from defects in the outer or middle ear; the sound is not conducted efficiently to the inner ear; sensory neural hearing loss which is caused due to damage or disease of the inner ear or auditory nerve; mixed hearing loss which is the combination of conductive and sensory neural hearing loss; central hearing loss which is due to a damage, malformation or infections of the neural pathways and the hearing centers in the brain and functional hearing loss which is due to some psychogenic condition or maybe due to deliberate exaggeration of hearing thresholds for personal gains. The degree of hearing loss also can be from mild to profound. It is well recognized that hearing is critical to speech and language development, communication, and learning. Children with listening difficulties due to hearing loss or auditory processing problems continue to be an under identified and undeserved population.

There are four major ways in which hearing loss affects children–

1. It causes delay in the development of receptive and expressive communication skills (speech and language).
2. The language deficit causes learning problems that result in reduced academic achievement.
3. Communication difficulties often lead to social isolation and poor self-concept.
4. It may have an impact on vocational choices.

7. Speech and Language Impairment

There are many kinds of speech and hearing impairments. The four areas in which the impairment occurs are:

Articulation: speech impairments where the child produce sounds incorrectly (e.g.,lisp, difficulty articulating certain sounds, such as "l" or "r");

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Fluency: speech impairments where a child's flow of speech is disrupted by sounds, syllables, and words that are repeated, prolonged, or avoided and where there may be silent blocks or inappropriate inhalation, exhalation, or phonation patterns;

Voice: speech impairments where the child's voice has an abnormal quality to its pitch, resonance, or loudness; and

Language: language impairments where the child has problems expressing needs, ideas, or information, and/or in understanding what others say.

8. Visual Impairment

The term 'visual impairment' refers to people with irretrievable sight loss and this simple definition covers a wide spectrum of different impairments. It does not include those whose sight problems can be corrected by spectacles or contact lenses, though it does include those whose sight might be improved by medical intervention.

9. Polio

Poliomyelitis is a viral disease that affects the nerves and leads to partial or full paralysis. It usually begins when the child is small and often during illness like fever or diarrhea. Though it may affect any muscle of the body but it is most common in the legs. Paralysis is of the floppy type and muscles are sometimes partly weakened. The muscles and bones of the affected limb become thinner compared to other limbs and are shorter since it does not grow like other limbs.

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In India, Polio has been the single most common cause of physical disability among children.

However in past few years because of various government initiatives the prevalence rate of polio has reduced. Children in slum areas, where houses are very congested with no ventilation, are more often affected than those on the middle class. The reason behind this is poor sanitation with no proper facilities for toileting and lack of safe drinking water

10. Muscular Dystrophy

Muscular Dystrophy is a condition in which muscles, month by month and year by year, get weaker and weaker. It is a progressive condition, since the muscles gradually weakens. It mostly affects boys (rarely girls). The first signs appear around the ages 3 to 5, where the child may seem awkward or clumsy or begins to walk 'tiptoe'.

The condition gradually deteriorates. Muscle weakness first affects feet, fronts of thighs, hips, belly, shoulders and elbows. Later it affects hands, face and neck muscles. Most children becomes unable to walk by age 10 and may develop a severe curve of the spine. Heart and breathing muscles also get weak. Child usually dies before age 20 from heart failure or pneumonia.

11. Spina Bifida

Spina Bifida is a defect in the early development of the baby when it is in the womb. It happens when some of the backbones (vertebrae) do not close over the large central nerve, (the spinal cord). As a result, there remains a soft unprotected area of the spinal cord which bulges out in the centre of the back. This bulged out area (sac) may contain the covering (meningeal membrane) of the spinal cord with fluid (cerebro-spinal fluid) or sometimes nerve fibers or even part of the spinal cord.

The associated conditions are: muscle weakness and loss of feeling; the legs or the feet may be paralyzed; one or both hips may be dislocated; muscle spasms; poor urine and bowel control and hydrocephalus (water on the brain) which can lead to brain damage.

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