Inclusiveness (SNIE 1012)

Chapter 1: Understanding Disabilities and Vulnerabilities

Chapter objectives
At the end of completing this chapter, the you will be able to:
Define disability and vulnerability
List different types of disabilities and vulnerabilities
Explain a brief causes of disability and vulnerability
Describe the brief historical movements from segregation to
inclusion
 Describe the effect of attitude on the move towards inclusion
 Discuss models of disability
 INTRODUCTION
1.1 Definitions of Basic Terms
i.Impairment/የአካል ጉዳተኛ:- a lack/abnormality of an anatomic, physiological
or psychological structure or function or deviation on a person.
 a physical/mental condition that may limit what a person can do-a
physical/mental disability- a problem, situation/event that makes progress or
success difficult
ii.Disability:- the term disability is ambiguous as there is no single agreement
on the concept (Mitra, 2006).
 disability is any condition of the body or mind that makes it more difficult
for the person with the condition to do certain activities (activity limitation) and
interact with the world around them (participation restrictions).
Societal, environmental & systemic barriers are the most popular disabling
factors.
Views/approaches about disabilities
1.Medical Approach- functional limitations due to physical, intellectual
or psychic impairment, health or psychic disorders on a person (WHO,1996)
2.The social approach:- disability largely depends on the context and is
a consequence of discrimination, prejudice and exclusion.
How to view Disabilities How to view solutions
Medical model Social model Medical model Social model
Child is faulty Child is valued Segregation and Resources made
alternative services available
Diagnosis and Strengths and needs Re-entry if normal Diversity
labeling identified enough or permanent welcomed; child
exclusion is welcomed
Impairment is focus Barriers identified and Society remains Society evolves
of attention solutions developed unchanged
 Causes of disability
1.Genetic Causes:- abnormalities in genes and genetic inheritance e.g.
Down syndrome, diseases, illnesses, and over-exposure to x-rays can
cause a genetic disorder.
2.Environmental:- poverty and malnutrition in pregnant mothers as well
it can cause poor development of vital organs in the child, which can
eventually lead to disability after birth, exposure to certain toxic
chemicals and illnesses etc.
3.Unknown Causes:- humans have still not found all the answers to all
the defects in the human body
4.Inaccessible environments:-sometimes society makes it difficult for
people with some impairment to function freely e.g. infrastructure
 Types of impairments/Disabilities
1. Visual impairment:- any kind of vision loss, whether it's someone
who cannot see at all or someone who has partial vision loss.
i. Blindness -vision loss that is not correctable with eyeglasses/lens
ii. Low vision:- partial sight -a visual impairment that affects only central
vision—the area directly in front of the eyes—or peripheral vision—
the area to either side of and slightly behind the eyes.
2. Hearing Impairment:- a general term indicating a continuum of
hearing loss from mild to profound
i. Hard of Hearing:- "A hearing impairment, whether permanent of
fluctuating, which adversely affects a child's educational performance
ii. Deaf:- Those who have difficulty understanding speech, even with
hearing aids but can successfully communicate in sign language.
3. Specific learning disability:- a disorder in one or more of the basic
psychological processes involved in understanding or in using
language, spoken or written.
• Specific learning disability manifested in the imperfect ability to
listen, think, speak, read, write, spell, or to do mathematical
calculations.
• The person looks perfectly ―normal and seems to be a very bright
and intelligent person, yet may be unable to demonstrate the skill
level expected from someone of a similar age.
 3.1.Types of Specific Learning Disabilities
a. Auditory Processing Disorder (APD):- a condition that adversely affects
how sound that travels unimpeded through the ear is processed or
interpreted by the brain.
b. Dyscalculia:-affects a person‘s ability to understand numbers and learn math.
c. Dysgraphia:- affects a person‘s handwriting ability and fine motor skills,
e.g. illegible handwriting, inconsistent spacing, poor spatial planning on
paper, poor spelling, and difficulty composing writing as well as thinking
and writing at the same time.
d. Dyslexia/Language-Based Learning Disability:- affects reading and
related language-based processing skills. e.g. can affect reading fluency;
decoding, reading comprehension, recall, writing, spelling, and sometimes
speech and can exist along with other related disorders.
e. Language Processing Disorder:- difficulty attaching meaning to sound
groups that form words, sentences and stories.
• While an auditory processing disordered/APD affects the interpretation of
all sounds coming into the brain, while Language Processing Disorder
(LPD) relates only to the processing of language.
• Language processing disorder can affect expressive language and/or
receptive language.
f. Non-Verbal Learning Disabilities:- is a disorder which is usually
characterized by a significant discrepancy between higher verbal skills
and weaker motor, visual-spatial and social skills.
• Typically, an individual with has trouble interpreting nonverbal cues like
facial expressions or body language, and may have poor coordination.
g. Visual Perceptual/Visual Motor Deficit:- a disorder that affects the
understanding of information that a person sees, or the ability to draw or copy.
4. Speech and Language Impairments:- a communication disorder such as stuttering,
impaired articulation, language impairment, or a voice impairment that adversely affect
a child‘s educational performance.
4.1. Speech Impairments:- articulation disorders, fluency disorders, and voice disorders.
a. Articulation disorders:- are errors in the production of speech sounds that may be
related to anatomical or physiological limitations in the skeletal, muscular, or
neuromuscular support for speech production.
*These disorders include; Omissions (bo for boat), Substitutions (wabbit for rabbit),
Distortions (shlip for sip)
b. Fluency disorders :- difficulties with the rhythm and timing of speech characterized by
hesitations, repetitions/prolongations of sounds, syllables, words/phrases e.g. Stuttering
Cluttering
c. Voice disorders:- problems with the quality of one's voice resulting from disorders in th
larynx
• Characterized by abnormal production and/or absences of vocal quality, pitch, loudnes
resonance, and/or duration
4.2. Language Impairments:- includes phonological disorders, morphological
disorders, semantic disorders, syntactical deficits, and pragmatic difficulties .
i. Phonological disorders :-the abnormal organization of the phonological
system, or a significant deficit in speech production or perception.
 A child with a phonological disorder may be described as hard to understand
or as not saying the sounds correctly e.g.. d, p, b
 Apraxia of speech is a specific phonological disorder where the child may want
to speak but has difficulty planning what to say and the motor movements to
use.
ii. Morphological disorders:- difficulties with morphological inflections
(inflections on nouns, verbs, and adjectives that signal different kinds of
meanings) e.g. a particular form, shape, or structure- e.g. plural and singular,
conjunction and so on
iii. Semantic disorders:- characterized by poor vocabulary development,
inappropriate use of word meanings, and/or inability to comprehend word
meanings.
iv. Syntactic deficits:- characterized by difficulty in acquiring the rules that
govern word order and others aspects of grammar such as subject-verb
agreement.
v. Pragmatic difficulties:- a problems in understanding and using language
in different social contexts. E.g. understanding of the rules for making eye
contact, respecting personal space, requesting information, and
introducing topics.

5. Autism :- a developmental disability significantly affecting verbal and

nonverbal communication and social interaction, generally evident before age
3 that adversely affects a child‘s educational performance.
 Engaging in repetitive activities and stereotyped movements, resistance to
environmental change or change in daily routines, and unusual responses to
sensory experiences.
 Autism is a neurodevelopment disorder defined by impairments in social and
communication development, accompanied by stereotyped patterns of
behavior and interest (Landa, 2007).
6. Emotional and Behavioral Disorders:- a condition exhibiting one or
more of the following characteristics over a long period of time and
adversely affects educational performance
a. An inability to learn that cannot be explained by intellectual, sensory,
or health factors;
b. An inability to build or maintain satisfactory interpersonal
relationships with peers and teachers;
c. Inappropriate types of behavior or feelings under normal
circumstances;
d.A general pervasive mood of unhappiness or depression; or
e.A tendency to develop physical symptoms or fears associated with
personal or school problems.
Classification of behavioral and emotional disorders
i.Conduct disorder: seek attention, disruptive and act out (overt -with
violence or tantrums) versus covert (with lying, stealing, and/or drug use).
ii.Socialized aggression: individuals join subculture group of peers who are
openly disrespectful to their peers, teachers, and parents (delinquency &
dropping out of school)
iii.Attention problems- attention deficit, easily destructible, poor
concentration, impulsive
iv.Anxiety/Withdrawn- self-conscious, reserved, and unsure of themselves,
anxious and frequently depressed.
v.Psychotic behavior- show more bizarre/strange behavior, hallucinate, deal in
a fantasy world and may even talk in gibberish/nonsense.
vi.Motor excess: hyperactive-cannot sit nor listen to others nor keep their
attention focused.
Kauffman (1993) conclude that emotion or behavioral disorders fall into
two broad classifications:
i.Externalizing Behavior: under controlled disorder-problems
disobedience, disruptiveness, fighting, tempers tantrums,
irresponsibility, jealous, anger, attention seeking etc…
ii.Internalizing Behavior: over controlled disorders-problems anxiety,
immaturity, shyness, social withdrawal, feeling of inadequacy
(inferiority), guilt, depression and worries a great deal
Causes of behavioral and emotional disorders
1. Biological- includes genetic disorders, brain damage, and
malnutrition, allergies, temperament and damage to the central nervous
system.
2. Family factors- family interactions, family influence, child abuse,
neglect, and poor disciplinary practices at home.
3. Cultural factors- traditional and cultural negative practices, for
example watching violence and sexually oriented movies and TV
programs.
4. Environmental factors- peer pressure, living in impoverished areas,
and schooling practices that are unresponsive to individual needs.
7.Intellectual Disability:- significant limitations in both intellectual
functioning and in adaptive behavior, which covers many everyday social
and practical skills (before 18)
Criteria for an intellectual disability
1.Sub average intellectual functioning:- general mental capacity, such as
learning, reasoning, problem solving, and so on (IQ<70)
2.Significant limitations exist in two or more adaptive skill areas: such as
a.Conceptual skills:- language and literacy; money, time, and number concepts;
and self-direction.
b.Social skills :- interpersonal skills, social responsibility, self-esteem,
gullibility, innocence, social problem solving, and the ability to follow
rules/obey laws and to avoid being victimized.
c.Practical skills:- activities of daily living (personal care), occupational skills,
healthcare, travel/transportation, schedules/routines, safety, use of money, use
of the telephone.
 Impact of Intellectual Disability on individual
1.General Cognition-vary physically and emotionally, personality, disposition,
beliefs.
2.Learning and Memory: significantly below average in comparison to peers
without disabilities
3.Attention: difficulty distinguishing and attending to relevant questions in both
learning and social situations
4.Adaptive Skills: difficulty in both learning and applying skills for a number of
reasons, including a higher level of distractibility, inattentiveness, failure to read
social cues, and impulsive behavior
5.Speech and Language: have delayed speech, language comprehension and
formulation difficulties.
6.Motivation: lacking motivation, or outer-directed behavior.
7.Academic Achievement: lead to persistent problems in academic achievement
8.Physical characteristics: severe & profound intellectual disabilities have multiple
disabilities that affect nearly every aspect of intellectual & physical development
Levels and areas of support for intellectual disabilities
Level of Duration of Frequency Setting of support Amount of professional
support support of support assistance
Intermitte Only as Occasional Usually only one or two Occasional consultation
nt/ for needed or (e.g. 1–2 or monitoring by
mild infrequent classes/activities) professional
Limited/ As needed, Regular, but Several settings, but not Occasional or regular
for but sometimes frequency usually all
Levels of support for individuals with intellectual disabilities
contact with
moderate continuing varies professionals
Extensive/ Usually Regular, but Several settings, but not Regular contact with
for sever continuing frequency usually all professionals at least
varies once a week
Pervasive/ May be Frequent or Nearly all settings Continuous contact and
for lifelong continuous monitoring by
profound professionals
8. Physical disability/Orthopedic Impairment and Health impairment
a.Physical disability: is a condition that interferes with the individual‘s
ability to use his or her body.
•Many but not all, physical disabilities are orthopedic impairments.
•Orthopedic impairment refers to conditions of muscular or skeletal
system and sometimes to physical disabling conditions of the nervous
system.
b. Health impairment:- is a condition that requires ongoing medical
attention.
•It includes asthma, heart defects, cancer, diabetes, hemophilia.
HIV/AIDS, etc.
Classification and Characteristics of physical impairment
i.Mild physical disability:- these individuals are able to walk without
aids and may make normal developmental progress.
ii.Moderate physical disability:- individuals can walk with braces and
crutches and may have difficulty with fine-motor skills and speech
production.
iii.Severe physical disability:-wheel-chair dependent and may need
special help to achieve regular development.

The physical disability could be broadly classified into two

i.The neurological system:- the brain, spinal cord and nerve related
problems
ii.Musculo-skeletal system:- the muscles, bones and joints deficient
i.The neurological system- with a neurological condition/problems
1. Cerebral palsy or a traumatic brain injury:- the brain either sends the
wrong instructions or interprets feedback incorrectly.
 In both cases, the result is poorly coordinated movement.
With the spinal cord injury or deformity, the path ways between the brain
and the muscles are interrupted
Subsequently messages are transmitted but never received.
The result is muscle paralysis and loss of sensation beyond the point
where the spinal cord or the nerve is damaged.
Approximately 40% of those with cerebral palsy have normal
intelligence; the remainders/60% have from mild to severe retardation
In general, cerebral palsy is a disorder of posture, movement and non
progression insult/damage of the developing brain
2. Epilepsy:-occurs when the brain cells are not working properly and
is often called a seizure disorder.
 It is characterized by recurring seizures, which are spontaneous
abnormal discharge of electrical impulses of the brain.
 If once epilepsy is diagnosed, it can usually be controlled with
medication and does not interfere with performance in school.
 Most individuals with epilepsy have normal intelligence.
3. Spinal bifida and spinal cord injury:- is a congenital spinal cord
injury(spinal column).
 The herniated area is associated with injury to the spine & spinal cord.
 The cause is unknown but it usually occurs in the first 26 days of
pregnancy.
II.Musculoskeletal system:
It includes the muscles and their supporting framework and the skeleton
1.Progressive muscle weakness (muscular dystrophy);
2.Inflammation of the joints (arthritis), or
3.Loss of various parts of the body (amputation)
Impairment and associated with musculoskeletal malformation
1.Muscular dystrophy:- is an inherited condition accruing mainly in males, in which
the muscles weaken and deteriorate.
•The weakness usually appears around 3 to 4 years of age and worsens progressively.
•By age 11 most victims can't longer walk
•Death comes 25 and 35 years from respiratory failure or cardiac arrest
2. Arthritis:-is an inflammation of the joints.
 Symptoms include swollen and stiff joints, fever, and pain in the joints during
acute periods.
 Prolonged inflammation can lead joint deformities that can eventually affect
mobility.
3. Amputation:- a small number of children have missing limbs because of
congenital abnormalities or injury or disease (malignant bone tumors in the limbs).
 These children can use customized prosthetic devices (artificial hands, arms, or
legs) to replace limp functions and increase independence in daily activities.
4.Marfan syndrome:- is a genetic disorder in which the
muscles are poorly developed and the spine is curved.
•The heart and blood vessels are usually affected.
•Individuals with marfan syndrome need to avoid heavy
exercise and lifting heavy objects.
5. Achondroplasias:- is a genetic disorder that affects 1 in 10,000 births.
• Children with this disorder usually develop a normal trunk but have a straight
upper back and a curved lower back (sway back).
• These children are at risk of sudden death during sleep from compression of
the spinal cord interfering with their breathing.
• The disability may be lessened through the use of the back braces or by
surgery.
6. Polio:- is viral disease that invade the brain and cause severe paralysis of
the total body system.
7. Club foot:- is a major orthopedic problem affecting about 9,000 infants
each year. This term is used to describe various ankle or foot deformities,
i.e.
 Twisting inward (equino varus), the most severe form
 Sharply angled at the heel (calcanel vaigus), most common
 The front part of the foot turned inward.
 Club foot conditions can be treated with
physical therapy more severe cases,
surgery is necessary
8. Cleft lip and cleft palate:- are openings in the lip or roof of the mouth,
respectively, that fail to close before birth, the cause is unknown.
 Most cleft problems can be repaired through surgery.
Health Impairments
a.Heart disease:- caused by improper circulation of blood by the heart some of the
disorders are congenital (present at birth); others are the product of inflammatory
heart disease. Some students
have heart value disorders; others have disorders of the blood vessels.
this time
heart implantation helps children to get cured.
b.Cystic fibrosis:- is a hereditary disease that affects the lungs and pancreas.
•It leads to recurrent respiratory and digestive problems including abnormal
amounts of thick mucus, sweet and saliva.
•The disease is so progressive and few who have it
survive beyond age 20.
•Children with such disease often spend significant
timeout of school.
c.Acquired immune deficiency syndrome (AIDS)
d. Hemophilia:- hereditary disease - the blood clots very slowly/not all.
*Transmitted by
sex-linked recessive gene and nearly occurs in males.
e. Asthma: is a chronic respiratory condition characterized by repealed
explode of breathing difficulties especially while exhaling.
f. Diabetes: developmental or hereditary disorder characterized by
inadequate secretion or use of insulin
g. Nephrosis & Nephritis:- Kidney disorders or diseases caused by
infections, poisoning, burns, accidents or other diseases.
*Nephrosis is any degenerative disease of the kidney tubules, the tiny
canals that make up much of the substance of the kidney.
*Nephritis is the inflammation of the kidneys
h. Tuberculosis:- infectious disease that commonly affects the lungs and
may affect other tissues of the body.
j. Sickle-cell anemia:- hereditary and chronic blood disease characterized by red
blood cells that are distorted and that do not circulate properly
k.Leukemia:- characterized by excessive production of white blood Cells
l. Lead poisoning :- disorder caused by ingesting lead-based paint chips or other
substances containing lead
m.Rheumatic fever:- disease characterized by painful swelling and inflammation
of the joints that can spread to the heart and central nervous system.
9. Vulnerability (being at risk of being harmed)
•Vulnerability a complex phenomenon that refers to the following dimensions :
1. Economic difficulties/lack of financial resources: poverty, low living standards,
housing problems (e.g. too damp, too expensive, too cold or difficult to heat) etc.;
2. Social exclusion: limited access to facilities such as transportations, schools,
libraries or medical services;
3. Lack of social support from social networks: no assistance from family
members, friends, neighbors or colleagues (referring to practical help as well as
emotional support) like highly gifted individuals;
4. Stigmatization: being a victim of stereotypes, being devalued, confronted with
disgraceful behavior because of belonging to a particular social or ethnic group;
5. Health difficulties: disadvantages resulting from poor mental health, physical
health or disabilities;
6. Being a victim of crime: in family context especially of violence. ««
Causes of Vulnerability
i.Rapid population growth, poverty and hunger, poor health, low levels
of education, gender inequality, fragile and hazardous location, and
lack of access to resources and services, including knowledge and
technological means, disintegration of social patterns (social
vulnerability).
ii.Lack of access to information and knowledge, lack of public
awareness, limited access to political power and representation (political
vulnerability).
iii.Environmental vulnerability concerns land degradation, earthquake,
flood, hurricane, drought, storms, water scarcity, deforestation, and the
other threats to biodiversity.
Characteristics of Vulnerable People
1.Less physically or mentally capable (infants, older adults, people with
disabilities)
2.Fewer material and/or financial resources (low-income households,
homeless)
3.Less knowledge or experience (children, illiterate, foreigners, tourists)
4.Restricted by society to grow and develop according to their needs and
potentials (e.g. the talented and the gifted)
5.People who are helped by others (who are then restricted by
commitments) are still vulnerable people, which includes the following
extracted from various researches.
Other group of People who are helped by others are also considered as venerable people
1.Women: in developing nations and those who are living in rural areas are vulnerable
for many backward traditional practices.
2.Children: are vulnerable and at risk for development (psychological and physical abuse)
3.Minorities: some people are vulnerable due to their minority background.
4.Poverty: people are vulnerable for many undesirable phenomena due to poverty.
5.Disabilities: People with disabilities very much vulnerable for many kind of risks.
6.Age: old people or very young children are vulnerable for all kinds of evils
7.Illiteracy and less education: People with high rates of illiteracy and lack quality
educational opportunities are vulnerable for absence all kinds of developments
8.Sickness: uncured health problems for example people living with HIV/AIDS are
much vulnerable for psychosocial problems, poverty and health
9.Gifted and Talented: gifted and talented children are vulnerable for socio-emotional
developments.