Everyone is Different: ADA Trainer Network Module 2e Everyone is Different: A Review of Types of Disabilities The intent of this module is to familiarize participants with a variety of types of disabilities in their work and/or personal lives.   For each disability type, two slides are given. One slide gives a basic overview of each disability type. This is followed by another slide that gives basic tips for interacting with someone with this type of disability. Presenting these slides is fairly straightforward and self-explanatory. When going through these slides, take a brief pause after each disability’s pair of slides to ask if there are questions. If needed, you can demonstrate a particular point through a brief role play. For example, if a participant is confused about how to politely tell someone that they can’t understand what they are saying, role play the situation briefly by demonstrating some strategies that could be used in this situation. Trainer’s Name Trainer’s Title Phone Email/Web Address

Disclaimer Information, materials, and/or technical assistance are intended solely as informal guidance, and are neither a determination of your legal rights or responsibilities under the ADA, nor binding on any agency with enforcement responsibility under the ADA. The Northeast ADA Center is authorized by the National Institute on Disability and Rehabilitation Research (NIDRR) to provide information, materials, and technical assistance to individuals and entities that are covered by the ADA. The contents of this document were developed under a grant from the Department of Education, NIDRR grant number H133 A110020. However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.

About Specific Disabilities Neurological disabilities Physical and Mobility disabilities Speech disabilities Learning disabilities Psychiatric disabilities Hearing disabilities Visual disabilities Intellectual disabilities This slide introduces this module and the different types of disabilities covered in the presentation. Some of these conditions may be very obvious, such as when a person uses a wheelchair to get around. Others may not be obvious, such as when a person has a learning disability.

About Neurological Disabilities… May affect: • Physical functioning (e.g. Alzheimer’s, epilepsy, cerebral palsy, traumatic brain injury, stroke) May affect: • Physical functioning • Interactions with others • Learning and memory The course and effects of the disability are unique to each individual Neurological conditions may impact a person’s functioning in several ways – physically, emotionally, and cognitively.

Neurological Disabilities Some key points… Treat adults like adults Don’t make assumptions! For example… • People with neurological impairments may use different ways of communicating – don’t assume they are less intelligent • People with neurological impairments may walk differently; some may appear to be intoxicated Offering help … ask if/how they would like assistance Explain that sometimes the gait patterns or way that people with neurological disabilities walk can look as if they are intoxicated. While people with and without disabilities may drink, it should not be assumed that the person is drunk.

About Physical and Mobility Disabilities… Includes any impairment that impacts a person’s use of their body or limbs • In 2010 there were 3.6 million wheelchair users, and 11.6 million cane, crutch, or walker users 60% of mobility device users are over age 65 May involve using mobility devices, prosthetics, and other equipment to aid in performing manual tasks or moving around US Census, 2010 Avoid simply reading the slide. For example, when mentioning that 60% of wheelchair users are over age 65, note that this means nearly half are younger and many are of working age.  

Physical & Mobility Disabilities Some key points… Evaluate whether your business is accessible to someone using a physical or mobility aid Treat the device/aid as an extension of the person’s body. Never touch/push on a mobility aid without the person’s permission – It’s part of their personal space Match your pace to the other person’s Sit down or kneel to be at eye level when communicating for a long period of time with someone using a wheelchair Offering help- ask if/how they would like assistance It is ok to offer help. For example, it’s usually OK to pick up something that was dropped. When in doubt—ask if they would like assistance and if so, how you can best provide assistance.

About Speech Disabilities… 2.8 million people have difficulty having their speech understood Can arise from a number of different causes Don’t confuse a speech disability with an intellectual disability Speech disabilities can sometimes be accompanied by facial muscle and/or vocal inflections You may also encounter people with speech disabilities. Here are some things to be aware of about these kinds of disabilities. Census 2010

Speech Disabilities Some key points… Don’t jump in to finish the sentence—let the person speak! Don’t pretend you understand what’s being said when you don’t Give the conversation your full attention Avoid speaking louder or slower Take your time, relax and listen- don’t try to rush the conversation or second guess what the person has to say Don’t ignore someone with a speech disability because you’re afraid you won’t understand what they have to say It’s OK to ask the person to repeat themselves or to write down what they’re saying Here are some things to keep in mind when communicating with someone who has a speech disability.

About Learning Disabilities… LD is a childhood disorder characterized by difficulty with certain skills such as reading or writing, and math computations. LD may affect the ability to interpret what one sees or hears or the ability to link information from different parts of the brain. Often LD is accompanied by other disorders, especially ADHD, which can compound the learning disability by making it difficult to listen, focus attention, or absorb new material. Some people only have problems learning in one area. Other people have multiple learning problems.   Generally diagnosed in childhood, learning disabilities can cause challenges throughout life. More mild cases may not be detected until adulthood.

Learning Disabilities Some key points Do not associate LD with lower intelligence Do not assume people with LD cannot read Recognize that people with LD may need to be given information in a different way People often mistake LD for lower intelligence; by definition, people with LD have average or higher IQs. While some people have LD in reading, often they can learn to read. Some people with LD are able to read but have difficulty with math or writing.

About Psychiatric Disabilities… Examples: depression, anxiety disorder, bipolar disorder, Schizophrenia 61.5 million adults (1 in 4) experience a mental illness in a given year. 13.6 million (1 in 17) lives with a severe mental illness Many myths about this disability but the reality is… Most mental illnesses are treatable. Psychiatric disabilities are the result of a brain disorder- not of a poor character or a “weak” personality. Don’t assume people with psychiatric disabilities are violent Psychiatric disabilities are more prevalent than most people realize and there are still a lot of myths about these disabilities.   These conditions are treatable enabling individuals with these conditions to be productive in the workplace and in their communities. Generally, they are no more violent than other people. We are seeing more people with some of these conditions -specifically Post-traumatic Stress Disorder (PTSD) and depression) with our retuning veterans from the wars in Afghanistan and Iraq. National Alliance on Mental Illness (NAMI), 2013

PTSD, Depression and TBI “Signature Disabilities” off veterans of wars in Afghanistan and Iraq About 20 % of recently returned veterans screened positive for depression or PTSD (RAND, 2008) Rate of PTSD among returning service members is 20% for Iraq war veterans, and 11% for Afghan war veterans. (NIH, 2009) 19% of soldiers received a probable TBI, with more subtle (and more difficult to diagnose) blast-related injuries being the most common (RAND, 2008) Many veterans have more than one disability - 30% of returning veterans screened positive for PTSD, TBI and/or major depression (RAND, 2008) Common disabilities among veterans of the wars in Afghanistan and Iraq are post-traumatic stress disorder (PTSD), depression and traumatic brain injury (TBI). These conditions are not readily apparent and can impact individuals in subtle ways. PTSD can arise from other kinds of life trauma, and like depression, is experienced by the civilian population, too. TBI may or may not significantly impact emotional functioning depending on the nature and degree of the injury. A person can sustain TBI from non-war related injuries due to automobile accidents, falls, etc.

Psychiatric Disabilities Some key points… Don’t confuse mental illness with intellectual disabilities People with psychiatric disabilities are generally no more violent than the rest of the population Don’t assume that people with psychiatric disabilities can’t make decisions or handle any stress Avoid making these common assumptions about people with psychiatric disabilities.

About Visual Disabilities… 8.1 million people have difficulty seeing, 2 million of whom are blind Varying levels of visual disability Not all people with visual disabilities read Braille Many new developments in IT aid people with visual disabilities There are different levels of visual impairment, including blindness. Census 2012

Visual Disabilities Some key points… Give the person conversation cues: Identify yourself when you start to speak Say goodbye when you leave the conversation Give the person a brief description of their surroundings “There’s a table about two feet in front of you. The door is about 5 feet away on our left.” Ask them if they would like assistance and what kind It’s best not to assume what kind of help a person with a visual impairment needs- ask them if they want help and if so, how they would prefer you guide them- by the elbow, or with verbal directives, etc. Don’t push them or attempt to physically steer them.

About Hearing Disabilities… 7.6 million Americans have trouble hearing normal conversation; the number increases sharply with age About 11% of people over age 65 have difficulty hearing Human speech is often the most challenging sound Most difficult to hear when there are a lot of “ambient” sounds Hearing aids may not totally “fix” the problem The human voice is one of the most difficult sounds for someone with a hearing impairment to decipher and it can be especially difficult to hear if there are other background noises. Hearing aids are not helpful for every type of hearing loss and even with hearing aids, a person may have difficulty hearing some sounds or hearing in certain environments. Census 2012

Hearing Disabilities Many communication methods. Ask which they prefer. -- Lip reading -- (Video) Relay Service -- Texting -- Signing -- Writing -- TTY Phones -- Skype/Instant Messaging Everyone is different; ask the person how he or she would prefer that you communicate with each other.

Hearing Disabilities Some key points… To get a person’s attention, wave or gently tap the person on the shoulder Look directly at the person when you are speaking Make a true effort to communicate, don’t try to be “polite” by saying you understand when you don’t Look directly at the person, not at their signer/interpreter Offer to write back and forth if necessary Communicate your willingness to serve the person by your facial expression, not your tone of voice Hearing Disabilities Some key points… Here are some things to keep in mind when interacting with someone who has a hearing disability.

About Intellectual Disabilities… Characterized by lower test of functional and mental ability 10.6 million Americans (Census 2012) About 87% of people with this disability will be only slightly below average in learning new things Can arise from a number of different causes Varying levels of intellectual disability also means varying levels of intellectual capability Not the same as mental illness Not always present with other developmental disabilities! Intellectual disability is one kind of developmental disability. Sometimes the term “developmental disability” is used to refer to people with intellectual disabilities. However, it may also refer to other developmental disabilities such as autism and cerebral palsy. People with these other developmental disabilities often have average or above average IQs.

Intellectual Disabilities Some key points… In general when interacting with people with intellectual disabilities, it is helpful to… Use familiar wording and rephrase if necessary Use “concrete” reasoning, avoid abstractions Avoid assumptions — there is a wide range in capabilities among people with intellectual disabilities Intellectual Disabilities Some key points… In general, these are some good things to keep in mind when interacting with people with intellectual disabilities.

Remember… The same disability can affect different people in very different ways Treat every person as an individual Everyone is different To summarize this module, remind participants that the key to interacting effectively with people with disabilities is to treat them with respect. Treat everyone as equal, but not the same. In other words, treat them as valued human beings and take into account their individual differences.

Additional Resources www.barking-dagenham.gov.uk/6-living/accessibility/etiquette/etiquett-menu.html --This website gives a comprehensive overview of various etiquette and language issues specific to different types of disabilities. www.unitedspinal.org/pdf/DisabilityEtiquette.pdf -- This website, created by the United Spinal Organization, provides tips for interacting with people with a variety of disabilities. www.sanantonio.gov/planning/disability_handbook/disability_handbook.asp -- Created for the City of San Antonio, Texas, this website gives an excellent handbook covering a broad array of disability-related issues, focusing on language and etiquette. Conclude the slide presentation by advising participants of other resources about understanding and relating to people with different types of disabilities.

Employment and Disability Institute Northeast ADA Center Employment and Disability Institute Cornell University Dolgen Hall Room 201 Ithaca, New York 14853-3901 Toll-Free : 800.949.4232 (NY, NJ, PR, USVI) Telephone 607.255.6686 Fax 607.255.2763 TTY 607.255.6686 Email northeastada@cornell.edu Web www.northeastada.org The contents of this presentation were developed under a grant from the Department of Education, NIDRR grant number H133 A110020. However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government. National Network: Please insert your center’s contact information into this slide. Conclude by reminding participants that the training materials were produced by the Northeast ADA Center in collaboration with the National ADA Network. Remind them of the free and confidential technical assistance and other services available from your local ADA Center and from the ADA Centers throughout the country.