Disability Health Dictionary

Disability: From 4 Different Sources


A physical or mental loss or impairment that is measurable. (See also handicap; rehabilitation.)
Health Source: BMA Medical Dictionary
Author: The British Medical Association
Any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner, or within the range, considered to be normal for a human being. The term disability reflects the consequences of impairment in terms of functional performance and activity by the individual. Disabilities thus represent disturbances at the level of the person. See also “handicap”; “impairment”.
Health Source: Community Health
Author: Health Dictionary
An observable mental or physical loss or impairment which is measurable and which may be permanent or temporary. If the disability is serious enough to affect a person’s normal function adversely, it is described as a handicap.
Health Source: Medical Dictionary
Author: Health Dictionary
n. a substantial long-term restriction of functional ability or activity as a result of *impairment of the body or mind. Most modern definitions of disability, including that supplied by the World Health Organization, recognize that it is a complex condition that includes a social dimension. In other words, an individual’s experience of being disabled may in part reflect social and environmental factors that deny opportunities and full participation in society. See also handicap.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Learning Disability

Learning disability, previously called mental handicap, is a problem of markedly low intellectual functioning. In general, people with learning disability want to be seen as themselves, to learn new skills, to choose where to live, to have good health care, to have girlfriends or boyfriends, to make decisions about their lives, and to have enough money to live on. They may live at home with their families, or in small residential units with access to work and leisure and to other people in ordinary communities. Some people with learning disabilities, however, also have a MENTAL ILLNESS. Most can be treated as outpatients, but a few need more intensive inpatient treatment, and a very small minority with disturbed behaviour need secure (i.e. locked) settings.

In the United Kingdom, the 1993 Education Act refers to ‘learning diffculties’: generalised (severe or moderate), or speci?c (e.g. DYSLEXIA, dyspraxia [or APRAXIA], language disorder). The 1991 Social Security (Disability Living Allowance) Regulations use the term ‘severely mentally impaired’ if a person suffers from a state of arrested development or incomplete physical development of the brain which results in severe impairment of intelligence and social functioning. This is distinct from the consequences of DEMENTIA. Though ‘mental handicap’ is widely used, ‘learning disability’ is preferred by the Department of Health.

There is a distinction between impairment (a biological de?cit), disability (the functional consequence) and handicap (the social consequence).

People with profound learning disability are usually unable to communicate adequately and may be seriously movement-impaired. They are totally dependent on others for care and mobility. Those with moderate disability may achieve basic functional literacy (recognition of name, common signs) and numeracy (some understanding of money) but most have a life-long dependency for aspects of self-care (some fastenings for clothes, preparation of meals, menstrual hygiene, shaving) and need supervision for outdoor mobility.

Children with moderate learning disability develop at between half and three-quarters of the normal rate, and reach the standard of an average child of 8–11 years. They become independent for self-care and public transport unless they have associated disabilities. Most are capable of supervised or sheltered employment. Living independently and raising a family may be possible.

Occurrence Profound learning disability affects about 1 in 1,000; severe learning disability 3 in 1,000; and moderate learning disability requiring special service, 1 per cent. With improved health care, survival of people with profound or severe learning disability is increasing.

Causation Many children with profound or severe learning disability have a diagnosable biological brain disorder. Forty per cent have a chromosome disorder – see CHROMOSOMES (three quarters of whom have DOWN’S (DOWN) SYNDROME); a further 15 per cent have other genetic causes, brain malformations or recognisable syndromes. About 10 per cent suffered brain damage during pregnancy (e.g. from CYTOMEGALOVIRUS (CMV) infection) or from lack of oxygen during labour or delivery. A similar proportion suffer postnatal brain damage from head injury – accidental or otherwise – near-miss cot death or drowning, cardiac arrest, brain infection (ENCEPHALITIS or MENINGITIS), or in association with severe seizure disorders.

Explanations for moderate learning disability include Fragile X or other chromosome abnormalities in a tenth, neuro?bromatosis (see VON RECKLINGHAUSEN’S DISEASE), fetal alcohol syndrome and other causes of intra-uterine growth retardation. Genetic counselling should be considered for children with learning disability. Prenatal diagnosis is sometimes possible. In many children, especially those with mild or moderate disability, no known cause may be found.

Medical complications EPILEPSY affects 1 in 20 with moderate, 1 in 3 with severe and 2 in 3 with profound learning disability, although only 1 in 50 with Down’s syndrome is affected. One in 5 with severe or profound learning disability has CEREBRAL PALSY.

Psychological and psychiatric needs Over half of those with profound or severe – and many with moderate – learning disability show psychiatric or behavioural problems, especially in early years or adolescence. Symptoms may be atypical and hard to assess. Psychiatric disorders include autistic behaviour (see AUTISM) and SCHIZOPHRENIA. Emotional problems include anxiety, dependence and depression. Behavioural problems include tantrums, hyperactivity, self-injury, passivity, masturbation in public, and resistance to being shaved or helped with menstrual hygiene. There is greater vulnerability to abuse with its behavioural consequences.

Respite and care needs Respite care is arranged with link families for children or sta?ed family homes for adults where possible. Responsibility for care lies with social services departments which can advise also about bene?ts.

Education Special educational needs should be met in the least restrictive environment available to allow access to the national curriculum with appropriate modi?cation and support. For older children with learning disability, and for young children with severe or profound learning disability, this may be in a special day or boarding school. Other children can be provided for in mainstream schools with extra classroom support. The 1993 Education Act lays down stages of assessment and support up to a written statement of special educational needs with annual reviews.

Pupils with learning disability are entitled to remain at school until the age of 19, and most with severe or profound learning disability do so. Usually those with moderate learning disability move to further education after the age of 16.

Advice is available from the Mental Health Foundation, the British Institute of Learning Disabilities, MENCAP (Royal Society for Mentally Handicapped Children and Adults), and ENABLE (Scottish Society for the Mentally Handicapped).... learning disability

Developmental Disability

A severe, chronic disability which is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the person attains the age of 22; is likely to continue indefinitely; results in substantial functional limitations in three or more of the following areas of major life activity: self care, receptive and expressive language, learning, mobility, self direction, capacity of independent living, economic self-sufficiency; and reflects the person’s need for a combination and sequence of special, interdisciplinary or generic care treatments or services which are of lifelong or extended duration and are individually planned and coordinated.... developmental disability

Disability Postponement

Measures that can be initiated among those with a disease, usually a chronic disease, to lessen or delay the impact of disability from that disease, e.g. averting renal complications among those with diabetes.... disability postponement

Disability-adjusted Life Expectancy

A modification of conventional life expectancy to account for time lived with disability. It is the number of healthy years of life that can be expected on average in a given population. It is generally calculated at birth, but estimates can also be prepared at other ages. It adjusts the expectation of years of life for the loss on account of disability, using explicit weights for different health states.... disability-adjusted life expectancy

Disability-adjusted Life Years (dalys)

The number of healthy years of life lost due to premature death and disability.... disability-adjusted life years (dalys)

International Classification Of Functioning, Disability And Health (icf) A

Classification of health and health-related domains that describe body functions and structures, activities and participation. The domains are classified from body, individual and societal perspectives. Since an individual’s functioning and disability occurs in a context, this classification includes a list of environmental factors.... international classification of functioning, disability and health (icf) a

Disability Living Allowance

(DLA) (in Britain) a state benefit payable to help with the extra costs of looking after a child under the age of 16 with special needs. It has two components: a care component, payable at three rates to children needing help with personal care; and a mobility component, payable at two rates to those aged 3 years or over who need help with walking. The rates depend on the level of help required. DLA for adults aged 16–64 years has been replaced by the *personal independence payment (PIP). People aged over 65 years with a disability and requiring help may be eligible for the attendance allowance.... disability living allowance

Disability Rights Commission

see Equality and Human Rights Commission.... disability rights commission

Specific Learning Disability

Difficulty in one or more areas of learning in a child of average or above average intelligence.

Specific learning disabilities include dyslexia and dyscalculia, where there is a problem with mathematics.... specific learning disability

Disability-adjusted Life Year

(DALY) a common research measure of disease burden that accounts for both morbidity and mortality. One year lived in full health is equivalent to one DALY. Disabilities and disease states are assigned a weighting that reduces this figure, such that a year lived with disability is equivalent to less than one DALY. Some studies also use social weighting, in which years lived as a young adult receive a greater DALY weight than those lived as a young child or older adult. See also health-adjusted life expectancy; quality of life.... disability-adjusted life year



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