Introduction to rehabilitation psychology

1. Disability
NOOR FATIMA AJMAL

2. Disability
A disability is defined as a condition or function judged to be significantly impaired relative to the
usual standard of an individual or group.
The term is used to refer to individual functioning, including physical impairment, sensory
impairment, cognitive impairment, intellectual impairment mental illness, and various types of
chronic disease. Classifications of disability also recognize the role of physical and social
environmental factors in affecting disability outcomes.
Disabilities can impact people in different ways, even when one person has the same type of
disability as another person. Some disabilities may be hidden, known as invisible disability.

3. Dimensions of Disability
Disability is conceptualized as being a multidimensional experience for the person involved. There may
be effects on organs or body parts, and there may be effects on a person's participation in areas of life.
The classification also recognizes the role of physical and social environmental factors in affecting
disability outcomes. Disabilities can impact people in different ways, even when one person has the
same type of disability as another person. Some disabilities may be hidden, known as invisible
disability.
Correspondingly, three dimensions of disability are recognized in ICF:
1. Body structure and function (and impairment thereof)
2. Activity (and activity restrictions)
3. Participation (and participation restrictions

4. Types of disabilities
There are many different types of disabilities such as
1. intellectual,
2. physical,
3. sensory,
4. mental illness

5. 1. intellectual disability
An intellectual disability is characterized by
someone having an IQ below 70 (the median
IQ is 100), as well as significant difficulty with
daily living such as self-care, safety,
communication, and socialization.
People with an intellectual disability may
process information more slowly, find
communication and daily living skills hard, and
also have difficulty with abstract concepts
such as money and time.

6. Types of intellectual disabilities
Fragile X syndrome
Fragile X syndrome is the most common
known cause of an inherited intellectual
disability worldwide. It is a genetic condition
caused by a mutation (a change in the DNA
structure) in the X chromosome.
People born with Fragile X syndrome may
experience a wide range of physical,
developmental, behavioural, and emotional
difficulties, however, the severity can be very
varied.
Down syndrome
Down syndrome is not a disease or illness, it is
a genetic disorder which occurs when
someone is born with a full, or partial, extra
copy of chromosome 21 in their DNA.
Down syndrome is the most common genetic
chromosomal disorder and cause of learning
disabilities in children

7. Developmental delay
When a child develops at a slower rate
compared to other children of the same age,
they may have a developmental delay.
One or more areas of development may be
affected including their ability to move,
communicate, learn, understand, or interact
with other children.
Prader-Willi Syndrome (PWS)
Prader-Willi syndrome (PWS) is a rare genetic
disorder which affects around 1 in 10,000 –
20,000 people. This disability is quite complex
and it’s caused by an abnormality in the genes
of chromosome 15.
One of the most common symptoms of PWS is
a constant and insatiable hunger which
typically begins at two years of age.

8. 2. Physical Disabilities
Physical disabilities may affect, either temporarily or permanently, a person’s physical capacity
and/or mobility.
There are may different causes of physical disabilities but they can include inherited or genetic
disorders, serious illnesses, and injury
Different types of physical disabilities may affect, either temporarily or permanently, a person's
physical capacity and/or mobility.

9. Acquired brain injury
Acquired brain injuries are due to damage that
happens to the brain after birth. They can be
caused through a wide range of factors including
a blow to the head, stroke, alcohol or drugs,
infection, disease such as AIDs or cancer, or a lack
of oxygen.
It is common for many people with a brain injury
to have trouble processing information, planning,
and solving problems. They may also experience
changes to their behaviour and personality,
physical and sensory abilities, or thinking and
learning.
The effects of brain injuries and the disabilities
they cause can be temporary or permanent.
Spinal cord injury (SCI)
The spinal cord can become injured if too much
pressure is applied and/or if the blood and
oxygen supply to the spinal cord is cut. When the
spinal cord has been damaged, it leads to a loss
of function such as mobility or feeling.
For some people, a spinal cord injury results in
paraplegia (loss of function below the chest), for
others it leads to quadriplegia (loss of function
below the neck).
Accidents account for 79% of spinal cord injuries
in Australia – mostly caused by motor vehicle
accidents and falls. Other causes include cancer,
arthritis, infections, blood clots, and
degenerative spinal conditions.

10. Spina bifida
Spina bifida is the incomplete formation of the
spine and spinal cord in utero. It can cause the
spinal cord and nerves to be exposed on the
surface of the back, instead of being inside a
canal of bone surrounded by muscle.
People with spina bifida experience a range of
mild to severe physical disabilities including
paralysis or weakness in the legs, bowel and
bladder incontinence, hydrocephalus (too
much fluid in the brain cavities), deformities of
the spine, and learning difficulties.
Cerebral palsy
Cerebral palsy is typically due to an injury to
the developing brain before or during birth,
caused by a reduced blood supply and lack of
oxygen to the brain.
Illnesses during pregnancy such as rubella (the
German measles), accidental injury to the
brain, meningitis in young children, and
premature birth can all be causes.

11. 3. Sensory disability
A sensory disability is a disability of the senses (e.g. sight, hearing, smell, touch, taste).
As 95% of the information about the world around us comes from our sight and hearing, a
sensory disability can affect how a person gathers information from the world around them.
Different types of sensory disabilities affect one or more senses; sight, hearing, smell, touch,
taste or spatial awareness

12. Types of sensory disabilities
Autism spectrum disorder (ASD)
Autism spectrum disorders are a lifelong
developmental disability. They affect the way
someone interacts with the world around them,
as well as with other people. Around 1 in 200 and
boys are four times more likely to have autism
than girls.
The effects of autism are wide ranging and can
include difficulties in social interaction and
communication, restricted and repetitive
interests and behaviors, and sensitivity to
sensory experiences– noise, light, touch etc. As
autism can be very variable, the word ‘spectrum’
describes the range of difficulties that someone
with autism may experience.
Blindness and low vision
A person is considered legally blind if they cannot
see at six meters what someone with normal
vision can see at 60 meters or if their field of
vision is less than 20 degrees in diameter.
A person is said to have low vision when they
have permanent vision loss which affects their
day to day and cannot be corrected with glasses
Blindness and low vision can occur as a result of
a number of different diseases, conditions, or
accidents. Some eye conditions are congenital
(present at or near birth), while others are
caused later in life. Some specific causes of vision
loss can include an injury to the eye, eye defects,
albinism, macular degeneration, diabetes,
glaucoma, cataracts, and tumors.

13. Hearing loss and deafness
Hearing loss, also known as a hearing
impairment, is the partial or total inability to
hear. If someone has very little or no hearing, the
term ‘deaf’ may be used.
Damage to any part of the external, middle, or
inner ear can cause hearing loss which can range
from being mild to profound.
Causes of hearing loss can be quite varied and
can include problems with the bones within the
ear, damage to the cochlear nerve, exposure to
noise, genetic disorders, exposure to diseases in
utero, age, trauma, and other diseases.
Sensory processing disorder
Sensory processing disorder is a condition where a
person has trouble receiving and responding to
information that comes in through the senses. This
may mean they misinterpret everyday sensory
information, such as touch, sound, and movement.
When someone has sensory processing disorder, they
are able to sense the information, however, the brain
perceives and analyses the information in an unusual
way. It may affect one sense only or it may affect
multiple senses.
Some people with sensory processing disorder are
oversensitive to things in their environment. Common
sounds may be painful or overwhelming, and the feel
of certain textures on the skin may be very
uncomfortable.

14. 4. mental illness
Mental illness is a general term that refers to a group of illnesses that significantly affects how a
person feels, thinks, behaves, and interacts with other people.
Mental illnesses can be very difficult and debilitating to those experiencing them, as well as their
families and friends. They can also be be permanent, temporary, or come and go.
Different types of mental illness affect a person's thinking, emotional state and behaviors.

15. Types of mental illnesses
Bipolar disorder
Bipolar disorder (formerly know as manic
depression), causes extreme mood swings
including emotional highs (mania) as well as
extreme lows (depression). These mood
swings come in ‘cycles’ which can last days,
weeks or even months
When episodes are extreme, some people
may experience suicidal thoughts and
symptoms of psychosis. A person may be
affected so much that they are unable to
distinguish reality from fantasy
Depression
Depression is a mental illness which
significantly affects the way someone feels,
causing a persistent lowering of their mood
and feelings of dejection and loss.
Depression has a variety of symptoms and will
affect everyone in different ways. Some of the
symptoms may include feeling extremely sad,
disturbed sleep, loss of interest and
motivation, feeling worthless, loss of pleasure
in activities, anxiety, changes in appetite or
weight, physical aches and pains, and impaired
concentration.

16. Anxiety disorders
People with anxiety disorders frequently have intense,
excessive, and persistent worry and fear about
everyday situations. These feelings interfere with daily
activities, are difficult to control, are out of proportion
to the actual danger, and can last a long time.
Examples of anxiety disorders include generalised
anxiety disorder, social anxiety disorder (social phobia)
and specific phobias
Other symptoms of anxiety disorders can include panic
attacks, trembling, sweating, difficulty breathing,
feeling faint, rapid heartbeat, nausea, or avoiding
certain situations.
Schizophrenia
Schizophrenia is a mental illness which influences the
way a person thinks, feels, and acts, often distorting
their perception of reality. It is a myth that those with
schizophrenia have a ‘split personality’– they have one
just like everyone else.
If not receiving treatment, people with schizophrenia
may experience persistent symptoms of psychosis.
They can have hallucinations such as seeing things,
hearing voices, smelling odours, and feeling sensations
on the skin. They can also have delusions which are
false beliefs that strongly persist in their mind, and
refuse to go away.
Other signs and symptoms can include low motivation,
dulled emotions, rambling and disorganised speech,
lack of desire to form social relationships, and a lack of
ability to express emotion.

17. Handicaps
Any disadvantage or characteristic that limits or prevents a person from performing various
physical, cognitive, or social tasks or from fulfilling particular roles within society. For example, a
non-accessible building entry or exit for a person in a wheelchair would be considered a
handicap, as would the person’s inability to walk. The term generally is considered negative and
its use has fallen into disapproval.
The condition that affects motor ability, communicating ability, vision, thoughts, cognition,
understanding, self-care, social interactions, education, usage of community amenities, self
hygiene has both biological and environmental causes.
 Handicap Is a product of an interaction of a person (with impairment & disability) and the
environment. The attention is paid to find the possible options available for decreasing of
handicap through the modification of the environment, and not only by attempting to improve
the impairment or disability.

18. Differences between
Impairment, Disability and handicap
Physical impairment pertains to a loss of an anatomical structure; for the benefit of this
exercise, let’s say the person lost a leg due to an accident. He can wear prosthetics as a
replacement of the lost leg.
Physical disability now refers to the inability to walk. To be able to navigate the surroundings,
the person can use a wheelchair.
Physical handicap now means that this person faces disadvantages that prevent him or her to
perform a normal role in life, such as not being able to climb stairs anymore. Or run a marathon.
Or be a basketball player. Here is where the environment plays a part. By providing wheelchair
access or lift for the person with physical disability, he or she will have no problem going up to
the next floors of a building. By providing multi-sport events for athletes with physical
disabilities, such as Paralympics, the person will still able to participate in sports.

22. Dyslexia is an example of learning impairment, a reading impairment in particular. Let’s say the
student has an above-average intelligence as well as good vision and hearing. Therefore, the
impairment is the brain’s inability to decode words to be able to read. The brain cannot correctly
associate the sounds with the letter symbols.
The inability to read is now the student’s learning disability. It can be improved by employing
specific intervention programmes such as multi-sensory instruction in teaching reading.
The person may experience various learning handicaps in school, and he or she may fail in class.
For example, the student may not be able to complete the reading requirements in class.
However, if certain adjustments are provided for the learner, such as taping lectures and
listening to books on audiotapes, then he or she may fare well, similar to his or her peers. This
will decrease the student’s handicap and will not interfere with his or her progress in school.

23. Forms of Disabilities & Handicaps
There are many forms of disabilities, & Handicaps such as those that affect a person's:
1. Vision
2. Hearing
3. Thinking
4. Learning
5. Movement
6. Mental health
7. Remembering
8. Communicating
9. Social relationships

24. The International Classification of
Functioning, Disability and Health (ICF)
The International Classification of Functioning,
Disability and Health, also known as ICF, is a
classification of the health components of functioning
and disability. The World Health Assembly on May
22nd, 2001, approved the International Classification of
Functioning, Disability and Health and its abbreviation
of "ICF." This classification was first created in 1980 and
then called the International Classification of
Impairments, Disabilities, and Handicaps, or ICIDH by
WHO to provide a unifying framework for classifying
the health components of functioning and disability.
The World Health Organization (WHO) published the
International Classification of Functioning, Disability
and Health (ICF) in 2001 that covers;
1. Activity
2. Participation
3. Body Structures
4. Body Functions
5. Personal Factors
6. Health Conditions
7. Activity Limitations
8. Functional Limitations
9. Environmental Factors
10. Participation Restrictions
11. The ICF is structured around:
12. Body functions and structure.
13. Additional information on severity and
environmental factors.
14. Activities (related to tasks and actions by an
individual) and participation (involvement in a life
situation).

25. Classifications of Disabilities
Categories of disability types include various physical and mental impairments that can hamper or
reduce a person's ability to carry out their day-to-day activities. These impairments can be termed as
disability of the person to do his/her day-to-day activities. Disability can be broken down into a
number of broad sub-categories, which include the following 8 main types of disability.
1. Mobility/Physical
2. Spinal Cord (SCI)
3. Head Injuries (TBI
4. Vision
5. Hearing
6. Cognitive/Learning
7. Psychological
8. Invisible

26. 1 - Mobility and Physical Impairments
This category of disability includes people with varying types of physical disabilities, including:
1. Upper limb(s) disability
2. Lower limb(s) disability
3. Manual dexterity
4. Disability in co-ordination with different organs of the body
Disability in mobility can be either an in-born or acquired with age problem. It could also be the
effect of a disease. People who have a broken bone also fall into this category of disability

27. 2 - Spinal Cord Disability
Spinal cord injury (SCI) can sometimes lead to lifelong disabilities. This kind of injury mostly
occurs due to severe accidents. The injury can be either complete or incomplete. In an
incomplete injury, the messages conveyed by the spinal cord are not completely lost. Whereas a
complete injury results in a total dis-functioning of the sensory organs.
In some cases, spinal cord disability can be a birth defect

28. 3 - Head Injuries - Brain Disability
A disability in the brain occurs due to a brain injury. The magnitude of the brain injury can range
from mild, moderate and severe. There are two types of brain injuries:
1. Acquired Brain Injury (ABI)
2. Traumatic Brain Injury (TBI)
ABI is not a hereditary type defect, but is the degeneration that occurs after birth. The causes of
such cases of injury are many and are mainly because of external forces applied to the body
parts. TBI results in emotional malfunctioning and behavioral disturbance.

29. 4 - Vision Disability
There are hundreds of thousands of people that have minor to various serious vision disability or
impairments. These injuries can also result into some serious problems or diseases like blindness
and ocular trauma, to name a few.
Some common vision impairment includes scratched cornea, scratches on the sclera, diabetes
related eye conditions, dry eyes and corneal graft

30. 5 - Hearing Disability
Hearing disabilities includes people who are completely or partially deaf, (Deaf is the politically
correct term for a person with hearing impairment). People who are partially deaf can often
use hearing aids to assist their hearing. Deafness can be evident at birth or occur later in life
from several biologic causes, for example, Meningitis can damage the auditory nerve or the
cochlea.
Deaf people use sign language as a means of communication. Hundreds of sign languages are in
use around the world. In linguistic terms, sign languages are as rich and complex as any oral
language, despite the common misconception that they are not "real languages".

31. 6 - Cognitive or Learning Disabilities
Cognitive Disabilities are impairments present in people who are suffering from dyslexia and
various other learning difficulties, and includes speech disorders
cognitive disabilities, intellectual disability, or developmental delay, a group of disorders defined
by diminished cognitive and adaptive development. Intellectual disabilities, also known as
developmental delay or mental retardation, are a group of disorders defined by diminished
cognitive and adaptive development.

32. 7 - Psychological Disorders
Affective Disorders: Disorders of mood or feeling states, either short or long term. Mental
Health Impairment is the term used to describe people who have experienced psychiatric
problems or illness, such as:
Personality Disorders - Defined as deeply inadequate patterns of behavior and thought of
sufficient severity to cause significant impairment to day-to-day activities.
Schizophrenia: A mental disorder characterized by disturbances of thinking, mood, and behavior

33. 8 - Invisible Disabilities
Invisible Disabilities are disabilities that are not immediately apparent to others.
invisible disabilities, are the medical conditions that are not immediately apparent, includes
example list of hidden disability conditions. Invisible disabilities can include chronic illnesses
such as renal failure, diabetes, and sleep disorders if those diseases significantly impair normal
activities of daily living. People with invisible disabilities, such as chronic pain or some sleep
disorders, are often accused of faking or imagining their disabilities.

34. The Models of Disability
Disability studies is an academic discipline that examines and theorizes about the social,
political, cultural, and economic factors that define disability.
Many models are explaining the different perspective of Disability.
They are as follow

35. 1. Biomedical Model of Health & Disability
The biomedical model of health is the most dominant in the western world and focuses on
health purely in terms of biological factors that are responsible for the disability.
Contained within the biomedical model of health is a medical model of disability. Similarly, this
focuses on disability purely in terms of the impairment that it gives the individual.
The biomedical model is often contrasted with the bio-psychosocial model

36. 2. Medical Model of Disability
The medical model of disability is presented as viewing disability as a problem of the person,
directly caused by disease, trauma, or other health condition which therefore requires sustained
medical care provided in the form of individual treatment by professionals.
In the medical model, management of the disability is aimed at a "cure," or the individual's
adjustment and behavioral change that would lead to an "almost-cure" or effective cure.
In the medical model, medical care is viewed as the main issue, and at the political level, the
principal response is that of modifying or reforming health-care policy

37. 3. Identity Model
Disability as an identity model is closely related to the social model of disability - yet with a
fundamental difference in emphasis - is the identity model (or affirmation model) of disability.
This model shares the social model's understanding that the experience of disability is socially
constructed, but differs to the extent that it 'claims disability as a positive identity' (Brewer et al.
2012:5).

38. 4. Social Model of Disability
The social model of disability sees the issue of "disability" as a socially created problem and a
matter of the full integration of individuals into society.
In this model, disability is not an attribute of an individual, but rather a complex collection of
conditions, many of which are created by the social environment. Hence, the management of
the problem requires social action and is the collective responsibility of society at large to make
the environmental modifications necessary for the full participation of people with disabilities in
all areas of social life
The issue is both cultural and ideological, requiring individual, community, and large-scale social
change. From this perspective, equal access for someone with an impairment/disability is a
human rights issue of major concern.

39. 5. Minority Model of Disability
The minority model of disability, also known as socio-political model of disability, adds to the
social model, the idea that disability is imposed on top of impairment via negative attitudes and
social barriers, in suggesting that people with disabilities constitute a estimative, (relating to or
possessing material existence), social category that shares in common the experience of
disability.
The minority model normalizes the experience of disability as a minority experience no more or
less aberrant or deviant than other minority groups' experiences (sex, race, sexual orientation,
etc.).

40. 6. Expert or Professional Model of
Disability
The expert or professional model of disability has provided a traditional response to disability
issues and can be seen as an offshoot of the medical model.
Within its framework, professionals follow a process of identifying the impairment and its
limitations (using the medical model), and taking the necessary action to improve the position of
the disabled person. This has tended to produce a system in which an authoritarian, over-active
service provider prescribes and acts for a passive client.

41. 7. Tragedy and/or Charity Model of Disability
The tragedy and/or charity model of disability depicts disabled people as victims of
circumstance who are deserving of pity.
This, along with the medical model, are the models most used by non-disabled people to define
and explain disability

42. 8. Moral Model of Disability
The moral model of disability refers to the attitude that people are morally responsible for their
own disability. For example, the disability may be seen as a result of bad actions of parents if
congenital, or as a result of practicing witchcraft if not.
This attitude may also be viewed as a religious fundamentalist offshoot of the original animal
roots of human beings when humans killed any baby that could not survive on its own in the
wild.

43. 9. Legitimacy Model of Disability
The legitimacy model of disability views disability as a value-based determination about which
explanations for the atypical are valid for membership in the disability category. This viewpoint
allows for multiple explanations and models to be considered as purposive and viable (DePoy &
Gilson, 2004)

44. 10. Empowering Model of Disability
The empowering model of disability allows for the person with a disability and his/her family to
decide the course of their treatment and what services they wish to benefit from.
This, in turn, turns the professional into a service provider whose role is to offer guidance and
carry out the client's decisions. In other words, this model "empowers" the individual to pursue
his/her own goals

45. 11. Social Adapted Model of Disability
The social adapted model of disability states although a person's disability poses some
limitations in an able-bodied society, oftentimes the surrounding society and environment are
more limiting than the disability itself

46. 12. Economic Model of Disability
The economic model of disability defines disability by a person's inability to participate in
work.
It also assesses the degree to which impairment affects an individual's productivity and the
economic consequences for the individual, employer and the state. Such consequences
include loss of earnings for and payment for assistance by the individual; lower profit margins
for the employer; and state welfare payments. This model is directly related to the
charity/tragedy model.

47. 13. Diversity Model of Disability
Disability as Human Variation, an alternative model intended to focus attention on how society's
systems respond to variation introduced by disability (Scotch and Shriner 1997). Under this
model, accessibility in the built environment, for example, is not solely achieved by anti-
discrimination regulation requiring a 'universal solution; the diversity of disability must be
acknowledged (Scotch and Shriner 1997).
Shriner and Scotch (2001) further question the socio-political definition of disability, in which
(all) barriers faced by people with disability are (built-environment) imposed and therefore
removable, feeling that this common underlying ideology of disability rights activists and
independent living movements insufficiently recognizes that impairment does have a bearing on
accessibility outcomes.

48. References
1. https://www.disabled-world.com/definitions/disability-models.php
2. https://journalofethics.ama-assn.org/article/history-physical-medicine-and-rehabilitation-
and-its-ethical-dimensions/2015-06
3. https://www.disabled-world.com/disability/types/cognitive/
4. https://www.aruma.com.au/about-us/about-disability/types-of-disabilities/