definitions of various groups falling in Special Education, disability.

1. Disability & Special Education
an International Issue
Dr Saim Ali Soomro.
MCCM,MBBS.

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Approximate 10% of the world
population is disable.
Countries with Civil wars,
insurgency, wars suffering from
Terrorism are likely to have more
people exposed to get disabilities.
Pakistan and Afghanistan are also
among such countries.
There is need to setup
rehabilitation institutes.

3. DEFINITIONS OF DISABILITY
The answer to “What is a disability?” varies by agency and even
from year to year. A few years ago, there were eight categories of
disability that qualified a student for special education services.
Now there are thirteen categories.
A person with a developmental disability is entitled to a much wider
array of services than students in special education without
developmental disabilities. You might think “developmental
disabilities” is one of those thirteen categories just mentioned - but
it isn’t!
On the large format every one carries a disability with him or her no
one is perfect in a world around us, as early its identified it can be
rehabilitate.
.

4. DEFINITIONS OF DISABILITY
Following are general Disabilities which we see in every day life
around us.
 Mental retardation
 Specific learning disabilities
 Serious emotional disturbance
 Visual impairment
 Hearing impairment
 Deafness
 Deaf-blindness
 Speech or language impairment
 Autism
 Orthopedic impairment
 Traumatic brain injury
 Multiple disabilities
 Other health impairments

5. Mental Retardation
Specific Learning
Disabilities
Serious Emotional
Disturbance
DEFINITIONS OF DISABILITY
Visual Impairment
Hearing
•
Deafness
Deaf-Blindness
Speech or Language
Impairment
Autism
Orthopedic Impairment
Traumatic Brain Injury
Multiple Disabilities
Other Health
Impairments
•
•
World is also keen to support for social issues in under
developed countries, there are multiple reasons for
disabilities like infections, trauma, genetic disorders, social,
Psychological & developmental causes are generally
implicated in causes of Disabilities.
Disabilities and accessibility are leading to Inclusive
Education for mild to moderate disabilities.
Severe Handicaps are managed in institutions.

6. MENTAL RETARDATION
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Definition: People with mental retardation have trouble learning, absorbing, and
practicing everyday skills.
Causes: 1. Genetics - where the baby was born with mental retardation, and short of
having a different mother or father, there is nothing that could have been done; 2. Fetal
Alcohol Syndrome (FAS) - where the mother used alcohol during pregnancy, which
makes this a preventable form of retardation; 3. Birth complications - where the child
experienced anoxia (no oxygen) or hypoxia (not enough oxygen) during birth, which
resulted in mental retardation; 4. Trauma to the head - where damage occurred or severe
illness such as meningitis may also cause mental retardation.
Life Skills: Mental retardation cannot be cured; however, in a nurturing, patient
environment, children and adults can often learn important skills such as toileting,
reading, and speaking. There are different levels of severity in retardation; some people
are able to have more independence than others. Most have difficulty communicating,
which can be disturbing to their confidence and well-being.
Resources: There are programs and information that assist mentally retarded people
with living a fulfilling life. For example, schools are required to develop individual
education plans (IEPs) for children. Family, friends, and teachers can also teach social
rules and self-care (dressing, teeth brushing) through the use of educational games.

7. SPECIFIC LEARNING DISABILITIES
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Definition: Learning disability is defined by law as "an imperfect ability to read, write,
speak, or perform mathematical calculations, which is not due to physical, sensory or
emotional impairment, mental retardation or socio-cultural disadvantage."
Causes: A learning disability is not, by any means, a measure of a person’s intelligence.
In fact, if you read the legal definition above, it specifically states that children with
mental retardation are not included in this category. However, students with learning
disabilities experience certain obstacles that do not allow them to be educated in the
usual way. The most well-known type of learning disability is probably dyslexia.
Dyslexia is a difficulty processing letters, numbers and other symbols. The most familiar
characteristic of dyslexia is letter reversal, writing or reading "d" for "b", for example, or
"p" for "q".
Life Skills: Programs for achieving basic academic and social skills, vocational training,
two-year degrees, four year degrees, and graduate programs are available in most states;
most of these programs are available only within educational institutions. (Learning
Disabilities Association of America, 2005).
Resources: Because learning disabilities are primarily diagnosed in educational
environments, they are the best resource for local, state, and national resources.

8. SERIOUS EMOTIONAL DISTURBANCE
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Definition: These are behavior disorders or mental illnesses that persist over a long
period of time and affect educational performance. This includes ADHD (Attention
Deficit/Hyperactive Disorder), depression, bipolar disorder, conduct disorders and eating
disorders to name a few.
Causes: Genetics, environment and a combination of the two can all contribute to these
disorders. Behavior disorders may be inherited through one's genes, due to a chemical
imbalance in the brain or occur as a result of brain injury. The person’s surroundings can
also come into play. If the youth has been exposed to abuse, extreme stress, a death or
loss in the family, and/or violence, he/she is more likely to develop these disorders.
Life Skills: In some cases, medication can be used to treat the disorder. In all cases,
people with disabilities and their families can be helped by an understanding of the
disorder and through families/communities working together to support the person.
Teaching students how to overcome these disturbances is a time-consuming process, but
often in conjunction with medication, it is possible.
Resources: In deciding if a student has a disorder that would fall into this category,
medical and psychological evaluations should take place. A physician/pediatrician should
almost always be consulted in these cases as should a therapist, psychologist or
psychiatrist. Teachers and schools should accommodate students with these disturbances
by providing a specialized education plan.

9. VISUAL IMPAIRMENT
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Definition: The terms partially sighted, low vision, legally blind, and totally blind are
used in the schools to describe students with visual impairments. They are defined as: 1.
"Partially sighted" indicates some type of visual problem has resulted in a need for
special education; 2. "Low vision" generally refers to a severe visual impairment, not
necessarily limited to distance vision. Low vision applies to all individuals with sight
who are unable to read the newspaper at a normal viewing distance, even with the aid of
eyeglasses or contact lenses; 3. "Legally blind" means that a person has less than 20/200
vision in the better eye or a very limited field of vision (20 degrees at its widest point);
and 4. “Totally blind” students learn via braille or other non-visual media.
Causes: Congenital blindness may be hereditary or be the result of infection at birth;
however, other diseases may also result in blindness such as: amblyopia; diabetic
retinopathy; glaucoma; macular degeneration; and trachoma (Teens Health, 2004).
Life Skills: Emphasis on basic skills such as eating, bathing, and dressing is given for
the visually impaired. Because a huge majority of the learning process comes through
sight, recognized learning strategies should be employed (Lichman, 2002).
Resources: Assessment is the first step to accessing resources for the individual. The
severity of visual impairment must first be realized before the type of resources can be
determined.

10. HEARING IMPAIRMENT
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Definition: This is one of the categories that has most changed under the new
classification. Once encompassing all levels of hearing loss, it is now broken up into
three areas. The first, hearing impairment is a group in which there is an impairment in
hearing that affects a child's educational performance but that is not included under the
definition of deafness, which is a hearing impairment that is so severe that the child is
impaired in understanding speech.
Causes: The most common cause of hearing loss in children is an infection of the middle
ear called otitis media. Another large group of children acquired their hearing loss due to
factors such as noise, drugs and toxins. Some acquired hearing loss may be a result of
heredity.
Life Skills: According to Moss (2005), you should observe the way the individual uses
their hearing and assist them in building their listening skills through encouragement and
rewards. In some cases, adaptive hearing devices can help a student with hearing
impairment, but even students with these devices cannot necessarily hear at the same
level as a student without a hearing impairment. Every effort should be made to ensure a
positive and meaningful experience for the person. When necessary, an interpreter should
be provided. Integrating sign language into the curriculum can also improve the learning
experience.
Resources: Each country defines the degree of hearing loss which determines a student's
eligibility for special education services. Hard of hearing is defined as a hearing loss of
35-60 decibel in the better ear. In addition, to be eligible for special education services,
the hearing loss must affect the student's educational performance.

11. DEAFNESS
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Definition: Deafness is now a category of its own and means a hearing impairment that
is so severe that the child is impaired in understanding speech.
Causes: The most common cause of hearing loss in children is an infection of the middle
ear called otitis media. Another large group of children acquired their hearing loss due to
factors such as noise, drugs and toxins. Some acquired hearing loss may be a result of
heredity.
Life Skills: Communication is a major issue among students with deafness. An
interpreter should be provided and integrating sign language into the curriculum can also
improve the learning experience.
Resources: Each country defines the degree of hearing loss which determines a student's
eligibility for special education services. Deafness is usually defined as a hearing loss of
70 decibels or greater in the better ear.

12. DEAF-BLINDNESS
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Definition: This was previously grouped with hearing impairments and deafness, but
should stand on its own. Deaf-blindness means a combination of hearing and visual
impairments which causes such severe communication and other developmental and
educational needs that they cannot be accommodated in special education programs
solely for children with deafness or children with blindness.
Causes: Illness, accident or genetics can result in deaf-blindness. Hereditary causes can
include Usher Syndrome and Down Syndrome. Other causes are issues that result from
problems associated with premature birth, rubella and meningitis.
Life Skills: Persons with deaf-blindness can become isolated from the world around
them if not worked with properly. Establishing a method of communication is key and
several such methods exist. Teaching individuals how to be self-sufficient as much as
possible such as getting dressed, getting around the home, etc., should also be a point of
focus.
Resources: As stated above, deaf-blind individuals need to be accommodated in special
education programs or with special education services that are specifically target toward
deaf-blindness. State and local resources will include schools, special education
professionals and medical professionals.

13. SPEECH OR LANGUAGE IMPAIRMENT
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Definition: Communication or language disorders are disorders that affect
communication and/or oral functioning that affects speech. These range from sound
substitution or inability to produce certain sounds to the inability to understand language
or produce speech that can be understood. The two types of speech disorders are: 1.
Articulation disorder is when a child has a problem making the sounds necessary for
speech such as stuttering or a lisp; 2. A phonological disorder is when a child has trouble
with her actual voice when trying to make sounds.
Causes: There are a variety of causes for speech and language disorders such as hearing
loss, autism, cerebral palsy, neurological disorders, brain injury and mental retardation.
Physical problems such as cleft palate or lip (where the lip is split) may also occur. A
language disorder is when a person cannot understand and/or communicate with other
people because of some type of problem in the brain. Children with language disorders
may have trouble with matching a word with its meaning, creating sentences, or
comprehending what someone is saying.

14. SPEECH OR LANGUAGE IMPAIRMENT
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Life Skills: Speech-language pathologists work directly with the child, family and
teacher to improve a child’s speech. She can develop a therapy plan for a child that may
involve exercises to work on certain sounds. She can talk to the student’s teacher about
ways to help the child communicate in the classroom. There are also products on the
market, such as computers with a speech function, that students may be able to use to
communicate better.
Resources: Language disorders tend to be complex because they often involve cognitive
problems, or problems with the brain. Because the early years of a child’s life are when
language skills are developing, it is important that these disorders be caught as early as
possible in order to begin treatment and work on overcoming or dealing with the
disorder. Speech therapists can be valuable depending on the impairment.

15. AUTISM
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Definition: This category includes people with all levels of pervasive development
disorder – the most known of which being autism. Asperger’s Syndrome, Rett’s
Syndrome and Childhood Disintegrative Disorder are also classified under PDD. All of
have common deficits in social interaction and communication. Often, people with these
disorders show very little interest in other people. They have a limited number of
interests. They also tend to have difficulty with change and find comfort in repetition and
structure.
Causes: Although the number of children diagnosed with autism has risen dramatically
in the last 30 years, still no one knows what causes autism. Theories abound, but none
have been proven to date.
Life Skills: Autistic individuals may have average or above average intelligence,
however, their autism can keep them from achieving many goals. Because the two main
facets of autism are issues with social interaction and communication, these are areas that
need to be worked on to help people with this disorder to function in society.
Resources: Special education professionals, medical professionals and those who work
in the psychological and psychiatric fields can be resources as far as information when it
comes to autism. Local, state and national organizations can offer both information and
support services as well.

16. ORTHOPEDIC IMPAIRMENT
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Definition: According to the ADA (2005), an individual with an physical disability is a
person who: 1. has a physical or mental impairment that substantially limits one or more
major life activities; 2. has a record of such an impairment; or 3. is regarded as having
such an impairment. These conditions can be related to any physiological disorder or
condition, cosmetic disfigurement, or anatomical loss affecting one or more body
systems such as neurological or muscoskeletal.
Causes: Causes for physical disabilities range from birth defects such as cerebral palsy or
spina bifida to impairment resulting from degenerative or progressive diseases such as
muscular dystrophy. Accidents are another cause.
Life Skills: Regardless of the physical disability, life skills should focus on assisting the
individual with gaining the skills to increase their quality of life and independence.
Skills should be broad, problem solving, age appropriate, and useful to the learner
(Information Center on Disabilities & Gifted Education, 2005).
Resources: Physical disabilities affect motion and motor skills that we depend on every
day of our lives. Depending on the disability and the age of the disabled person, many
countries have developed resources available through elementary, high school, colleges,
and employment offices some have special Institutes for rehabilitation & Education.

17. TRAUMATIC BRAIN INJURY
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Definition: Damage to the brain caused by illness or accident. Brain injury is the most
common cause of death and disability in children. A person with a mild traumatic brain
injury may lose consciousness or memory at the time of the accident. They may look all
right on the outside but have lasting changes in their personality or thinking. Other times,
the effects can be even more serious causing mental retardation, learning disabilities, loss
of vision or speech, inability to remember new things and number of other complications.
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Causes: Traumatic Brain Injury (TBI) usually occurs in an accident. During an accident,
the brain literally bounces back and forth inside the skull, often hitting in both the front
and the back of the brain. Brain injury can also occur due to hypoxia (not enough
oxygen) or anoxia (no oxygen). This occurs in drowning, suffocation and sometimes due
to problems at birth.

18. TRAUMATIC BRAIN INJURY
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Life Skills: Some people who suffer from a traumatic brain injury
recover. In other cases, the damage can be permanent. A doctor
can consult with the patient’s family regarding that issue. It is
important to know that healing from a brain injury takes a long
time. People recovering from a TBI get tired more easily than they
did before. An individual with TBI and those around him/her often
have difficulty with the fact that someone who looks the same,
walks the same as always is now different. If needed, counseling
should be sought. In addition, the patient will likely need
assistance with his/her daily life – making the necessary
adjustments to aid in living. These adjustments will vary
depending on the severity of the injury.
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Resources: Early consultation with Neuro physician, Special
Educators, Speech therapists, Occupational Therapists can help
with early rehabilitation.

19. MULTIPLE DISABILITIES
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Definition: A combination of disabilities, such as mental retardation and orthopedic
impairment, that cannot be served in programs for either individual disability alone.
Causes: Obviously, the causes can vary greatly. Sometimes they may be the result of the
same things- such as a genetic issue, illness, or accident, other times, they may be
unrelated.
Life Skills: Once assessments have been completed to determine the capabilities of the
individual, life skills should set realistic goals that will assist the disabled in having
success and increased confidence in their capabilities.
Resources: Any resources in addition to standard state, local and national agencies and
local special education professionals will likely vary depending on disabilities.

20. OTHER HEALTH IMPAIRMENTS
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Definition: Other health impairments cover a variety of diseases and disorders. This
category that refers to people who have limited strength, energy or alertness that affects
their ability to learn in a normal classroom.
Causes: Some of these disorders are present at birth, such as sickle cell anemia, asthma,
hemophilia or epilepsy. Other impairments are caused by acquired conditions such as
lead poisoning, rheumatic fever, HIV, or cancer. Less than .5% of students are diagnosed
with other health impairments.
Life Skills: Once assessments have been completed to determine the capabilities of the
individual, life skills should set realistic goals that will assist the disabled in having
success and increased confidence in their capabilities.
Resources: In deciding if a student has a health impairment, a series of steps should be
taken. A medical exam needs to be made taking into account a student’s medical history.
Then the school needs to decide if a student is able to receive special education services
by giving intelligence, achievement, behavior and other assessment tests as well as
reviewing medical and other background information. Depending on the result of these
tests, the school will decide if the child is able to receive special education services. If the
school decides they are not able to receive these services, it is still possible for students
to receive services under the Rehabilitation Act.

21. DEVELOPMENTAL DELAY
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Definition: The term developmental delay means that the children are just a bit
behind their peers. Special services are granted to these young children in the
hopes that services will be needed only for a short time instead of for their entire
school experience as may be seen with the aforementioned disabilities.
Causes: According to University of Michigan Health Systems (2005),
developmental delay can have many different causes, such as genetic causes
(like Down syndrome), or complications of pregnancy and birth (like
prematurity/ or infections)… Some causes can be easily reversed if caught early
enough, such as hearing loss from chronic ear infections, or lead poisoning.

22. DEVELOPMENTAL DELAY
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Life Skills: Deciding who needs special services and how they are going to get them has
always been an issue. The question is how can we be fair and equal to children requiring
special needs? If they are identified too early they may be labeled incorrectly and then
only perform at the level that is expected, which could lead to otherwise “average”
children being taught at a slower rate simply because they hadn’t developed as quickly as
others. On the other hand, if we wait too long to decide who needs services, those
children may be set back further because they needed help way before it was given.
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Resources: The Individuals with Disabilities Education Act (IDEA) of 1975 mandated
states to provide all disabled or special needs children with a fair education. The goal
was, and still is, to be sure that special needs children anywhere in the United States
would get the same education and services because they would be tested the same way
and labeled the same way. Depending on your state’s definition children as young as 3
and as old as 9 can still be classified as having a developmental delay. Even though
some of the practices, rules, and labels vary by state the spirit of the law remains the
same: help children with disabilities get what they need.

23. DEVELOPMENTAL DISABILITY
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Definition: A developmental disability is a SEVERE mental or physical disability that
occurs BEFORE age 22 and causes problems with major life activities such as speaking,
moving, taking care of oneself and living independently.
Causes: Causes of developmental disability vary, but are more likely a result of
experiences previously mentioned disabilities such as mental retardation, autism, or
cerebral palsy; however, not everyone who has a disability has a developmental
disability. The distinction is important because some services are only available to people
with developmental disabilities.
Life Skills: People with disabilities are expected to need some type of help with daily
living for their whole lives. Assessments are needed to determine the individual’s
capabilities and the setting of realistic goals.
Resources: The majority of people experiencing developmental disabilities require a
combination of types of services, such as speech therapy, special education and
counseling. These services will be needed over a long period of time and must be
planned for the individual. When this definition is applied to babies and young children
from birth to age 5, they have many developmental delays with a large probability of
disability if services are not given at this age.

24. How to Rehabilitate
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Place for Assessment Medically by Drs, Audiologists, Physiotherapists,
Special Educators ,Psychologists etc to assess Clinical, mentally,
Cognitively, Psychologically each one is a Job of trained personnel.
Early Diagnosis and early intervention is key to better rehab.
Each disability has its own requirements for rehab & Education called
Special Education.
To develop a system you need to have a place with services of Drs,
Nurses, Physiotherapists, Orthotists, Speech therapists, Occupational
therapists, Special Educators and Psychologists apart from Audiologists,
Braillists etc/
Each Child is individually assessed and its IEP or FEP (Individual
Education Plan or Family Education Plan) is made.
Before starting an Institute of rehab & Special Education , A mass
campaign through electronic and Print media is highly regarded helpful for
mass education & awareness.

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Team members
include: educators,
physical therapists,
occupational
therapists, and
speech-language
pathologists)
Language
development, social
Skill development,
functional Skill
development (selfhelp), and