Chapter Three
Identification and Differentiated
Services
Thought Shower
• What factors hinder person with disability?
• Which needs of human being more accessible
for person with disability?
• How social and psychological environments
enable person with disability?
• How to prevent conditions associated with
disability and vulnerability?
Factors related to the person
• The Nature of the Disability
• The Individual’s Personality
• The Meaning of the Disability to the Individual
• The Individual’s Current Life Circumstances
• The Individual's Support System
Economic Factors and Disability
• Economic deprivation on the onset of
pathology
• Economic resources can limit the options and
abilities of someone who requires personal
assistance services
• The economic status of the community may
have a more profound impact than the status
of the individual on the probability
Political Factors and Disability
• Have impact through its role in designing
public policy
• Function of public funds spent to make
buildings and transportation systems
accessible
• Those with severe disabling conditions, access
to personal assistance services may be
required for participation in almost all
activities,
Psychological Factors of Disability
• Social Cognitive Processes
• Self-Efficacy Beliefs
• Psychological Control
• Coping Patterns
• Personality Disposition
The Family and Disability
• The networks of people with disabilities are
more likely to be dominated by family members.
• Families can providing such tangible services as
housekeeping and transportation
• They providing personal assistance in activities
of daily living.
• They provide economic support to help with the
purchase of assistive technologies and to pay for
personal assistance
Needs of Persons with Disabilities and
Vulnerabilities
Basic needs of persons with disabilities
and vulnerabilities
• a) Full access to the Environment (towns,
countryside & buildings)
• b) An accessible Transport system
• c) Technical aids and equipment
• d) Accessible/adapted housing
• e) Personal Assistance and support
Cond…
• f) Inclusive Education and Training
• g) An adequate Income
• h) Equal opportunities for Employment
• i) Appropriate and accessible Information
• j) Advocacy (towards self-advocacy)
• k) Counseling
Gender and disability
• Many of male and females with disabilities
have creativity and skill in finding ways to do
things and consequently being able to build
friendships with other men in their
communities.
Identity and disability
• People with disabilities are not primarily
clients or service users but rather are known
members of their communities with a shared
and, at times, intergenerational history.
Belongingness and disability
• Persons with disabilities and vulnerable
groups have struggled to come to terms with a
body and mind which seem unfamiliar to
them, in which they have to make
adjustments or accommodations both for
themselves and in terms of their relationships
with others.
The Health Care Needs of Persons with
Disabilities and Vulnerabilities
• Secondary conditions
• Co-morbid conditions
• Age-related conditions
• Engaging in health risk behaviors
Barriers to Health Care for Persons with
Disabilities and Vulnerable Groups
• Prohibitive costs
• Limited availability of services
• Physical barriers
• Inadequate skills and knowledge of health
workers
Addressing for Inclusive Barriers to Health
Care
• Policy and legislation
• Financing
• Service delivery
• Human resources
Some Enabling and Disabling Factors in the
Physical Environment
Type of Factor Type of Environment
Natural Environment Built Environment
Dry climate Ramps
Flat terrain Adequate lighting
Enabling
Clear paths Braille signage
Snow Steps
Rocky terrain Low-wattage lighting
Disabling
High humidity Absence of flashing light alerting systems
Examples of Environmental Modification
• Mobility aids
• Communication aids
• Accessible structural elements
• Accessible features
• Job accommodations
• Differential use of personnel
Mobility aids
Hand Orthosis
Mouth stick
Prosthetic limb
Wheelchair (manual and/or motorized)
Canes
Crutches
• Braces
Communication aids
Telephone amplifier or TDD
Voice-activated computer
Closed or real-time captioning
Computer-assisted note taker
Print enlarger
Reading machines
Books on tape
Sign language or oral interpreters
Braille writer
Cochlear implant
• Communication boards
Accessible structural elements
Ramps Elevators
Wide doors
Safety bars
Nonskid floors
Sound-reflective building materials
Enhanced lighting
Electrical sockets that meet appropriate reach ranges
• Hardwired flashing alerting systems
Accessible features
Built up handles
Voice-activated computer
Automobile hand controls
Job accommodations
Simplification of task
Flexible work hours
Rest breaks
Splitting job into parts
Relegate nonessential functions to others
Differential use of personnel
Personal care assistants
Note takers
Secretaries Editors
Sign language interpreters
Element of Social and Psychological
Environment
Type of Factor Element of Social and Psychological Environment
Culture Psychological Political Economic
Expecting people with Having an active Mandating relay Tax credits to hire
disabling conditions to be coping strategy systems in all states people with
productive disabling conditions
Expecting everyone to know Cognitive Banning Targeted earned
sign language restructuring discrimination against income tax credits
people who can
Enabling
perform the essential
functions of the job
Stigmatizing people with Catastrophizing Segregating children Economic
disabling conditions with mobility disincentives to get
impairments in off Social Security
schools Disability Income
benefits
Valuing physical beauty Denial Voting against No subsidies or tax
Disabling
paratransit system credits for
purchasing assistive
technology
Strategies to Disability inclusive
intervention and Rehabilitation
Prevention
• i) Primary prevention
• ii) Secondary prevention (early
intervention)
• iii) Tertiary prevention (rehabilitation)
Primary prevention
• Actions to avoid or remove the cause of a
health problem in an individual or a
population before it arises.
• It includes health promotion and specific
protection (for example, HIV education).
Secondary prevention (early
intervention)
• Actions to detect a health and disabling
conditions at an early stage in an individual or
a population, facilitating cure, or reducing or
preventing spread, or reducing or preventing
its long-term effects (for example, supporting
women with intellectual disability to access
breast cancer screening).
Tertiary prevention (rehabilitation)
• Actions to reduce the impact of an already
established disease by restoring function and
reducing disease related complications (for
example, rehabilitation for children with
musculoskeletal impairment).
Disability-specific Support Activities
• Implement Disability Inclusive Project/ Program
• Implement effective Intervention and
Rehabilitation
• Rehabilitation Nurses
• Rehabilitation Psychologists
• Neuropsychologists
• Therapeutic Recreation Specialists
• Rehabilitation Counselors
• Orthotists and Prosthetists
Tips For Program And Project Cycle
Management
• Education and vocational training
• Health
• Relief and social services
• Infrastructure and camp improvement, shelter,
water and sanitation and environmental health
• Livelihoods, employment and microfinance
• Protection
• Humanitarian and emergency response
Community-Based Rehabilitation
• It is a strategy that can address the needs of
peoples with disabilities with in their
communities
• It is a common sense strategy for enhancing
the quality of life of peoples with disabilities
by improving services delivery in order to
reach all in need by providing more equitable
opportunities and by promoting and
protecting their rights .
CBR involves:
• A. The participation of people with disabilities and their
representatives at all stages of the development of the
program
• B. The formulation and implementation of national policies
to support the equal participation of people with disabilities
• C. The establishment of a system for program management
Cond…
• D. The multi-sectoral collaboration of governmental and
nongovernmental sectors to support communities as they
assume responsibility for the inclusion of their members
who experience disabilities.
• E. CBR focuses on strengthening the capacity of peoples
with disabilities, and their families.
• F. CBR focuses on challenging negative views and barriers
in society to enable equal rights and opportunities.
Major Objectives of Community Based
Rehabilitation
• Empowered to maximize their physical and
mental abilities,
• Have access to regular services and
opportunities and become active,
• Contributing members of their communities and
then societies,
• Promotes the human rights of people with
disabilities through attitude changes within the
community.
Implement Technologies for Disability
• Inclusion Inclusiveness and Information
Technology (ICT)
• Assistive Technology (AT)
AT and User Needs: A Classification
Scheme
• People with Communication Disabilities
• People with Cognitive Disabilities
• People with Motor Disabilities
Implement Inclusive Job Opportunities
and Employment
• The right to work is fundamental to being a full and
equal member of society, and it applies to all persons,
regardless of whether or not they have a disability.
• A decent job in the open labor market is a key bulwark
against poverty.
• It also enables people to build self-esteem, form social
relationships, and to gain skills and knowledge.
• Moreover, a productive workforce is essential for
overall economic growth.
Barriers of employment
• Attitudes and Discrimination
• Accessibility
• Education and Training
• Social Networks
• Women Disabilities
• Legal Barriers
• Inflexible Work Arrangements
• Dismissal on the Basis of Disability
• The Benefit Trap
Strategies to Improve Employment for
Persons with Disabilities and Vulnerabilities
• Anti-Discrimination Legislation
• Vocational Education And Training
• Wage Subsidies
• Supported Employment
• Workplace Accommodation Schemes
• Workers’ Compensation
• Quota Systems
• Sheltered Workshops
• Private Sector Initiatives
Cond…
• Employer Networks
• Support Disability-Inclusive Business
• Social Enterprises
• Support Persons with Disabilities in the Workplace
• Building a More Inclusive Society
• Boost Education and Training Opportunities
• Break Down Attitudinal Barriers and Challenge
Discrimination
• Improve Data Collection on Disability and Employment
