Inclusiveness - Chapter One
Inclusiveness - Chapter One
Inclusiveness - Chapter One
(SNIE 1012)
CHAPTER ONE
Understanding Disabilities and Vulnerabilities
What is disability?
I. Medical Approach
Disability is pathology (physiological, biological and intellectual). Disability means
functional limitations due to physical, intellectual or psychic impairment, health or psychic
disorders on a person (WHO,1996). The medical definition has given rise to the idea that
people are individual objects to be ―treated‖, ―changed" or ―improved" and made more
―normal‖. The medical definition views the disabled person as needing to ―fit in ‖rather
than thinking about how society itself should change. This medical definition does not
adequately explain the interaction between societal conditions or expectations and unique
circumstances of an individual
II. The social definition of disability:
• Disability is a highly varied and complex condition with a range of implications for social
identity and behavior.
• Disability largely depends on the context and is a consequence of discrimination, prejudice
and exclusion.
• Emphasizes the shortcomings in the environment and in many organized activities in
society, for example on information, communication and education, which prevent persons
with disabilities from participating on equal terms.
According to Medical model:
✔ Child is faulty
✔ Diagnosis and labeling
✔ Impairment is focus of attention
✔ Segregation and alternative services
✔ Re-entry if normal enough or permanent exclusion
✔ Society remains unchanged
According to Social model:
✔ Child is valued
✔ Strengths and needs identified
✔ Barriers identified and solutions developed
✔ Resources made available
✔ Diversity welcomed; child is welcomed
✔ Society evolves
2.2. Causes of disability
What do you think is the causes of disability? Some people, especially in the past times, wrongly
believe that disability is a punishment from God. There are some who still believe that disability
is a form of personal punishment for individual with disability, a kind of karma for their past
mistakes, which is totally unacceptable now days.
I. Genetic Causes
Abnormalities in genes and genetic inheritance can cause intellectual disability in children. In
some countries, Down syndrome is the most common genetic condition. Sometimes,
diseases, illnesses, and over-exposure to x-rays can cause a genetic disorder.
II. Environmental
Poverty and malnutrition in pregnant mothers can cause a deficiency in vital minerals and result
in deformation issues in the unborn child. After birth, poverty and malnutrition can also cause
poor development of vital organs in the child, which can eventually lead to disability. The use of
drugs, alcohol, tobacco, the exposure to certain toxic chemicals and illnesses, toxoplasmosis,
cytomegalovirus, rubella and syphilis by a pregnant mother can cause intellectual disability to
the child. Childhood diseases such as a whooping cough, measles, and chicken pox may lead to
meningitis and encephalitis. This can cause damage to the brain of the child. Toxic material such
as lead and mercury can damage the brain too. Unfortunate life events such as drowning,
automobile accidents, falls and so on can result in people losing their sight, hearing, limbs
and other vital parts of their body and cause disability.
The human body is a phenomenal thing. Scientists have still not figured out what and how some
things in the body, cells, brain, and genes come about. Humans have still not found all the
answers to all the defects in the human body .
Sometimes society makes it difficult for people with some impairment to function freely. When
society develops infrastructure such as houses, roads, parks and other public places without
consideration to people with impairment, the basically make it impossible for them to take care
of themselves. For example, if a school is built with a ramp in addition to stairs, it makes it
easy for people with wheelchairs to move about freely. This way, their impairment is not
made worse. Lack of education, support services, health and opportunities for people with
impairment can cause additional disability to people with disabilities and even people with no
disability.
Some nine major disabilities are listed and briefly discussed in the coming pages below.
Visual impairment in general designates two sub- classifications. These are blindness and low
vision.
A. Blindness, total or partial inability to see because of disease or disorder of the eye, optic
nerve, or brain. The term blindness typically refers to vision loss that is not correctable with
eyeglasses or contact lenses. Blindness may not mean a total absence of sight, however. Some
people who are considered blind may be able to perceive slowly moving lights or colors.
B. The term low vision is used for moderately impaired vision. People with low vision may have
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.
Activities
Different people define the term hearing impairment differently. The definitions given to hearing
impairment convey different meaning to different people. Different definitions and terminologies
may be used in different countries for different purpose. Pasonella and Carat from legal point of
view, define hearing impairment as a generic term indicating a continuum of hearing loss from
mild to profound, which includes the sub-classifications of the hard of hearing and deaf.
A. Hard of Hearing: "A hearing impairment, whether permanent of fluctuating, which adversely
affects a child's educational performance but which is not included under the definition of 'deaf'."
Whelan, R. J. (1988). This term can also be used to describe persons with enough (usually with
hearing aids) as a primary modality of acquisition of language and in communication with
others.
B. Deaf: Those who have difficulty understanding speech, even with hearing aids but can
successfully communicate in sign language. Cultural definitions of deafness, on the other hand,
emphasize an individual‘s various abilities, use of sign language, and connections with the
culturally deaf community.
Speech and language impairment means a communication disorder such as stuttering, impaired
articulation, language impairment, or a voice impairment that adversely affects a child‘s
educational performance. It is disorder that adversely affects the child's ability to talk,
understand, read, and write. This disability category can be divided into two groups: speech
impairments and language impairments.
A. Speech Impairments: There are three basic types of speech impairments: articulation
disorders, fluency disorders, and voice disorders.
I. 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:
III. Voice disorders are problems with the quality or use of one's voice resulting from disorders
in the larynx. Voice disorders are characterized by abnormal production and/or absences of vocal
quality, pitch, loudness, resonance, and/or duration.
B. Language Impairments
There are five basic areas of language impairments: phonological disorders, morphological
disorders, semantic disorders, syntactical deficits, and pragmatic difficulties.
I. Phonological disorders are defined as 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. Apraxia of speech
is a specific phonological disorder where the student may want to speak but has difficulty
planning what to say and the motor movements to use.
IV. Syntactic deficits are characterized by difficulty in acquiring the rules that govern word
order and others aspects of grammar such as subject-verb agreement. Typically, these students
produce shorter and less elaborate sentences with fewer cohesive conjunctions than their peers.
1.3.5.Autism
Children with autism vary literally in their use of words, (Rutter, 1966). Communication
deficiencies may leave a lasting mark of social retardation on the child. The link, between social
skills and language is made evident by the often spontaneous appearance of affectionate
and dependent behavior in these children after they have been trained to speak (Churchill, 1966
& Hewett, 1965).
According to Individuals with Disabilities Education Act (IDEA), the term Emotional and
Behavioral Disorders means a condition exhibiting one or more of the following characteristics
over a long period of time and to a marked degree that adversely affects educational performance
An individual having behavioral or emotional disorders can exhibit widely varied types of
behavior. Therefore, different classification systems of behavioral and emotional disorders can
be used for special education. Different professionals have developed a classification system,
which shows some promise for educational practice. These include:
• Conduct disorder: individuals may seek attention, are disruptive and act out. The disorder is
classified by type: overt (with violence or tantrums) versus covert (with lying, stealing, and/or
drug use).
• Socialized aggression: individuals join subculture group of peers who are openly
disrespectful to their peers, teachers, and parents. Common are delinquency and dropping out of
school.
Early symptoms include stealing, running away from home, habitual lying, cruelty to animals,
and fire setting.
• Attention problems- These individuals may have attention deficit, are easily destructible and
have poor concentration. They are frequently impulsive and may not think the consequence of
their actions.
• Psychotic behavior: These individuals show more bizarre behavior. They may
hallucinate, deal in a fantasy world and may even talk in gibberish.
• Motor excess: These students are hyperactive. They cannot sit nor listen to others nor keep
their attention focused.
Kauffman (1993) conclude that emotion or behavioral disorders fall into two broad
classifications:
1) Externalizing Behavior: also called under controlled disorder, include such problems
disobedience, disruptiveness, fighting, tempers tantrums, irresponsibility, jealous, anger,
attention seeking etc…
2) Internalizing Behavior: also known as over controlled disorders, include such problems
anxiety, immaturity, shyness, social withdrawal, feeling of inadequacy (inferiority), guilt,
depression and worries a great deal
Behavioral and emotion disorders result from many causes, these includes the following.
2. Family factors- include family interactions, family influence, child abuse, neglect, and poor
disciplinary practices at home.
3. Cultural factors- include some traditional and cultural negative practices, for example
watching violence and sexually oriented movies and TV programs.
4. Environmental factors- include peer pressure, living in impoverished areas, and schooling
practices that are unresponsive to individual needs.
A. Sub average intellectual functioning: It refers to general mental capacity, such as learning,
reasoning, problem solving, and so on. One way to measure intellectual functioning is an IQ test.
Generally, an IQ test score of around 70 or as high as 75 indicates a limitation in intellectual
functioning.
B. Significant limitations exist in two or more adaptive skill areas: It is the collection of
conceptual, social, and practical skills that are learned and performed by people in their everyday
lives.
● Conceptual skills—language and literacy; money, time, and number concepts; and self-
direction.
People with intellectual disabilities academic learning can be affected, as well as their ability to
adapt to home, school, and community environments are presented under the following sub-
headings:
● General Cognition: People with intellectual disabilities vary physically and emotionally,
as well as by personality, disposition/character, and beliefs. Their apparent slowness in
learning may be related to the delayed rate of intellectual development (Wehman, 1997).
● Learning and Memory: The learning and memory capabilities of people with
intellectual disabilities are significantly below average in comparison to peers without
disabilities. Children with intellectual disabilities may not spontaneously use appropriate
learning or memory retention strategies and may have difficulty in realizing the
conditions or actions that aid learning and memory. However, these strategies can be
taught (Fletcher, Huffman, & Bray, 2003; Hunt & Marshall, 2002; Werts, Wolery,
Holocombe, & Gast, 1995; Wolery & Schuster, 1997).
● Attention: To acquire information, children must attend to the learning task for the
required length of time and control distractions. Children with intellectual disabilities
may have difficulty distinguishing and attending to relevant questions in both learning
and social situations (Saunders, 2001). The problem is not that the student will not pay
attention, but rather that the student does not understand or does not filter the information
to get to the salient features (Hunt & Marshall, 2002; Meyen & Skrtic, 1988).
● Adaptive Skills: The adaptive skills of people with intellectual disabilities are often not
comparable to those of their peers without disabilities. A child with intellectual
disabilities may have 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 (Hardman et al., 2008). The lack or underdevelopment of
these skills notably affects memory, rehearsal skills, organizational ability, and being in
control of the process of learning (Erez & Peled, 2001; Hunt & Marshall, 2002).
● Speech and Language: People with intellectual disabilities may have delayed speech,
language comprehension and formulation difficulties. Language problems are generally
associated with delays in language development rather than with a bizarre use of
language (Beirne-Smith et al., 2006; Moore-Brown & Montgomery, 2006). People with
intellectual disabilities may show delayed functioning on pragmatic aspects of language,
such as turn taking, selecting acceptable topics for conversation, knowing when to speak
knowing when to be silent, and similar contextual skills (Haring, McCormick, & Haring,
1994; Yoder, Retish, & Wade, 1996).
● Motivation: People with intellectual disabilities are often described as lacking
motivation, or outer-directed behavior. Past experiences of failure and the anxiety
generated by those failures may make them appear to be fewer goals directed and lacking
in motivation. The result of failure is often learned helplessness. The history of failure is
likely to lead to dependence on external sources of reinforcement or reward rather than
on internal sources of reward. They are less likely to self-starters motivated by self-
approval (Beirne-Smith et al.,2002; Taylor et al., 2005).
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. (The term
orthopedic impairment generally refers to conditions of muscular or skeletal system and
sometimes to physical disabling conditions of the nervous system).
Health impairment is a condition that requires ongoing medical attention. It includes asthma,
heart defects, cancer, diabetes, hemophilia. HIV/AIDS, etc.
I. Physical disabilities:- based on the impact of physical disability on mobility and motor skills,
it is divided into three. These are:-
A. Mild physical disability:- these individuals are able to walk without aids and may make
normal developmental progress.
B. Moderate physical disability:- individuals can walk with braces and crutches and may have
difficulty with fine-motor skills and speech production.
C. Severe physical disability:-these are individuals who are wheel-chair dependent and may
need special help to achieve regular development.
A. The neurological system (the brain ,spinal cord & nerve) related problems.
B. Musculo skeletal system ( the muscles, bones and joints) are deficient due to various causes.
Additional problems that can be associated with cerebral palsy include learning disabilities,
mental retardation. Seizures, speech impairments, eating problems, sensory impairments, and
joint and bone deformities such as spinal curvatures and contractures (permanently fixed, tight
muscles and joints). Approximately 40 percent of those with cerebral palsy have normal
intelligence; the remainders have from mild to severe retardation. This is an extremely
heterogeneous group having unique abilities and needs.
Epilepsy:-is disorder that occurs when the brain cells are not working properly and is often
called a seizure disorder.
Some children and youth with epilepsy have only a momentary loss of attention (petit mal
seizures); others fall to the floor and then move uncontrollably
Fortunately, 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.
Spinal bifida and spinal cord injury:- damage to the spinal cord leads to paralysis and loss of
sensation in the affected areas of the body. The spinal blfida is a birth defect of the backbone
(spinal column). The cause si unknown but it usually occurs in the first twenty-six days of
pregnancy.
B. Musculoskeletal system: - it includes the muscles and their supporting framework and the
skeleton. The list of the impairment and associated with musculoskeletal malformation are
the following:
● 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.
● Amputation:- a small number of children have missing limbs because of congenital
abnormalities or injuiry 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.
● Marfan syndrome is a genetic disorder in which the muscles are poorly developed and the
spine is curved. Individuals with marfan syndrome may have either long, thin limbs,
prominent shoulder blades, spinal curvature, flat feet, or long fingers & thumbs. The
heart and blood vessels are usually affected. The greatest danger is damage to aorta, which
can lead to heart failure. Individuals with marfan syndrome need to avoid heavy exercise and
lifting heavy objects.
● Achondroplasis:- is a genetic disorder that affects 1 in 10,000 births. Children with this
disorder usually develop a normal torso 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.
● Polio:- is viral disease that invade the brain and cause severe paralysis of the total body
system. In its mild form results in partial paralysis. Post polio muscles that were previously
damaged weaken, and in some persons, other muscles that were not previously affected
weaken as well.
● 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
Any disease that interferes with learning can make students eligible for special services. These
disease caused problems are as follow.
1. Heart disease:- this is common among young people. It is 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. His time heart implantation helps children to get cured.
2. 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.
3. Acquired immune deficiency syndrome (AIDS):- is a very severe disease caused by human
immunodeficiency virus (HIV) infection and transmitted primarily through exchange of
bodily fluids in transfusions or unprotected sex, and by contaminated needles in addictive drug
use.
4. Hemophilia:- is a hereditary disease in which the blood clots very slowly or not all.
The disorder is transmitted by sex-linked recessive gene and nearly always occurs in males.
8. Sickle-cell anemia Hereditary and chronic blood disease (occurring primarly in African
Americans) characterized by red blood cells that are distored and that do not circulate properly
10. Lead poisoning Disorder caused by ingesting lead-based paint chips or other
substances containing lead
11. Rheumatic fever Disease characterized by painful swelling and inflammation of the joints
that can spread to the hear and central nervous system.
12. Tuberculosis Infectious disease that commonly affects the lungs and may affect other
tissues of the body.
13. Cancer Abnormal growth of cells that can affect any organ system
1.3.9. Vulnerability
Vulnerable means being at risk of being harmed. Everyone can be harmed, so being
vulnerable is part of being human. In principle, everyone is vulnerable to some adverse event or
circumstance, but some people are more vulnerable than others. For instance, people with
disabilities are more likely as a group to experience greater vulnerability. They are also often
more severely affected by the vulnerability they experience. Based on the existing literature,
vulnerability can be generally defined as a complex phenomenon that refers to the following
dimensions:
5. Health difficulties: disadvantages resulting from poor mental health, physical health or
disabilities;
Vulnerability may be causes by 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). Other causes includes; lack of access to information and
knowledge, lack of public awareness, limited access to political power and representation
(political vulnerability), (Aysan,1993). When people are socially disadvantaged or lack political
voice, their vulnerability is exacerbated further. The economic vulnerability is related to a
number of interacting elements, including its importance in the overall national economy, trade
and foreign-exchange earnings, aid and investments, international prices of commodities and
inputs, and production and consumption patterns. Environmental vulnerability concerns land
degradation, earthquake, flood, hurricane, drought, storms (Monsoon rain, El Niño), water
scarcity, deforestation, and the other threats to biodiversity.
The following are thought to be characteristics of vulnerable people (with examples of groups of
potentially vulnerable people):
1. Less physically or mentally capable (infants, older adults, people with disabilities)
4. Restricted by society to grow and develop according to their needs and potentials
People who are helped by others (who are then restricted by commitments) are still
vulnerable people, which includes the following extracted from various researches.
A. Women: particularly women in developing nations and those who are living in rural areas
are vulnerable for many backward traditional practices. These women are oppressed by the
culture and do not get access to education and employment (Comfort et al., 1999; Morrow,
1999; McEntire et al. (2002; Thomalla et al. (2006; Laukkonen et al. (2009; Rubin, 2010;
GNCSODR, 2013; GP DRR, 2013).
B. Children: Significant number of children are vulnerable and at risk for development
(Morrow, 1999; McEntire et al., 2002; Thomalla et al., 2006; Laukkonen et al., 2009 Dinh et al.,
2012; Rubin, 2010; GP DRR, 2013; GNCSODR, 2013; Dinh et al. (2012). Children are
vulnerable for psychological and physical abuse This include illegally working children, children
who are pregnant or become mothers, children born out of marriage, children from a single-
parent, delinquent children, homeless children, HIV- infected children, uneducated children,
institutionalized children, married children, mentally ill children, migrant children, orphans,
sexually exploited children, street children, war-affected children…etc.
D. Poverty: People are vulnerable for many undesirable phenomena due to poverty. This may
be resulted in, poor households and large households, inequality, absences of access to health
services, important resources for life, lack of access to education, information, financial and
natural resources and lack of social networks (Morrow,
1999; McEntire et al., 2002; Brooks, 2003; Dwyer et al., 2004; Vincent, 2004; Leichenko et al.,
2004; National ResearchCouncil, 2006; Naudé et al., 2007; Kahn and Salman, 2012;
MacDonald, 2013).
E. Disabilities: People with disabilities very much vulnerable for many kind of risks. This
includes abuses, poverty, illiteracy, health problems, psychological and social problems
(Comfort et al., 1999; McEntire et al., 2002; Naudé et al., 2007; Cutter et al., 2010; Dinh et al.,
2012; . Balica et al., 2012; GNCSODR, 2013).
F. Age: Old people or very young children are vulnerable for all kinds evils (Comfort et al.,
1999; Morrow, 1999; McEntire et al. 2002; Cardona (2003; Vincent, 2004; Naudé et al., 2007;
Dinh et al., 2012; Adikari et al., 2013; GNCSODR,2013).
G. Illiteracy and less education: People with high rates of illiteracy and lack quality
educational opportunities are vulnerable for absence all kinds of developments (Cardona, 2003;
Adger et al., 2004; Leichenko et al., 2004; Naudé et al., 2007; Kahn and Salman, 2012; Adikari
et al., 2013).
H. Sickness: Uncured health problems for example people living with HIV/AIDS are much
vulnerable for psychosocial problems, poverty and health (Vincent, 2004; Adger et al.,
2004; Naudé et al., 2007).
I. Gifted and Talentedness: Gifted and talented children are vulnerable for socio- emotional
developments. Due to lack of psychological support they may feel isolation as they are pulled
from their regular classrooms and given instruction in separate settings and due to myths and
expectations of themselves and the public (Shechtman& Silektor, 2012, p. 63; Schuler, 2000).