Disability

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Posted by bender 03/24/2009 @ 18:11

Tags : disability, health

News headlines
Montgomery Reworks Disability Program - Washington Post
By Ann E. Marimow After months of contentious debate, Montgomery County's elected officials took steps yesterday to inject more oversight and independence into the government's disability retirement system but balked at changing the program's...
Woman claims insurer wrongfully denied policy's disability benefits - St. Clair Record
By Kelly Holleran An Illinois woman has filed suit against an insurance company, alleging the company wrongfully denied her claim for disability benefits. Nancy Stachewicz says she purchased a group disability policy from National Union Fire Insurance...
Disability employment topic of Helena meeting - Montana's News Station
Attorneys, business managers and human resource managers were among those learning more about disability employment on Wednesday in Helena as the state hosted a one day seminar on disability employment, awareness and training. Keynote speaker John Kemp...
Disability groups give lawmakers 'D' - Dallas Morning News
The Legislature is "failing the disability community," according to a report card issued today by three disability rights groups. Reducing the wait lists for in home care services that help keep people with disabilities out of nursing homes?...
JHA's Market Surveys Offer Industry Perspective During Disability ... - Business Wire (press release)
PORTLAND, Maine--(BUSINESS WIRE)--JHA recently announced the release of their 2008 US Group Disability Market Survey and US Individual Disability Market Survey. As a participant in Disability Insurance Awareness Month (DIAM), JHA is pleased to make...
Government of Canada Program Helps People With Disabilities Find ... - Market Wire (press release)
PORT RENFREW, BRITISH COLUMBIA--(Marketwire - May 14, 2009) - A local person with disabilities will get help to prepare for and obtain employment thanks to Government of Canada support for a local employment project. Mr. John Duncan, Parliamentary...
New Scholarship Available for a Student With a Disability to ... - PR Newswire (press release)
MINNEAPOLIS , May 14 /PRNewswire/ -- A new four-year college scholarship is available to a student with a disability. The scholarship is for Aspen University, a leading, nationally accredited on-line university providing undergraduate and graduate...
Disability Perspective: Power Politics vs. Fairness - Beyond Chron
Who, then, protects the rights of people with disabilities and seniors, when bicyclists do whatever they choose? Any wonder why people with disabilities file--and win--so many lawsuits against the city, when the city is run by biased and duty-shirking...
Disability Insurance Provides Critical Protection From Income Loss ... - WELT ONLINE
There is perhaps no better time for people to assess whether they are adequately protected from income loss due to accident or illness than in May, which marks National Disability Insurance Awareness Month. Unfortunately, many people mistakenly assume...
"Good" cholesterol may guard against MS disability - Vancouver Sun
NEW YORK (Reuters Health) - High levels of HDL ("good") cholesterol may help protect against disabilities related to multiple sclerosis or MS. HDL has anti-inflammatory properties and thus it might benefit MS, a disease of chronic inflammation....

Disability

International Symbol of Accessibility

Disability is a lack of ability relative to a personal or group standard or norm. In reality there is often simply a spectrum of ability. Disability may involve physical impairment such as sensory impairment, cognitive or intellectual impairment, mental disorder (also known as psychiatric or psychosocial disability), or various types of chronic disease. A disability may occur during a person's lifetime or may be present from birth.

Disability may be seen as resulting directly from individuals, in which case the focus is typically on aspects of those individuals and how they could function better. This view is associated with what is generally termed a medical model of disability. Alternatively, the interaction between people and their environment/society may be emphasized. Here, the focus may be on the role of society in labeling some people as having a disability relative to others, while causing or maintaining disability in those people through attitudes and standards of accessibility that favor the majority (a prejudice dubbed "able-ism"). This view is commonly associated with a human rights or social model of disability.

On December 13, 2006, the United Nations formally agreed on the Convention on the Rights of Persons with Disabilities, the first human rights treaty of the 21st century, to protect and enhance the rights and opportunities of the world's estimated 650 million disabled people. Countries that sign up to the convention will be required to adopt national laws, and remove old ones, so that persons with disabilities would, for example, have equal rights to education, employment, and cultural life; the right to own and inherit property; not be discriminated against in marriage, children, etc; not be unwilling subjects in medical experiments.

In 1976, the United Nations launched its International Year for Disabled Persons (1981), later re-named the International Year of Disabled Persons. The UN Decade of Disabled Persons (1983-1993) featured a World Programme of Action Concerning Disabled Persons. In 1979, Frank Bowe was the only person with a disability representing any country in the planning of IYDP-1981. Today, many countries have named representatives who are themselves individuals with disabilities. The decade was closed in an address before the General Assembly by Robert Davila. Both Bowe and Davila are deaf. In 1984, UNESCO accepted sign language for use in education of deaf children and youth.

The disability rights movement, led by individuals with disabilities, began in the 1970s. This Self-advocacy is often seen as largely responsible for the shift toward independent living and accessibility. The term "Independent Living" was taken from 1959 California legislation that enabled people who had acquired a disability due to polio to leave hospital wards and move back into the community with the help of cash benefits for the purchase of personal assistance with the activities of daily living.

With its origins in the US civil rights and consumer movements of the late 1960s, the movement and its philosophy have since spread to other continents influencing people's self-perception, their ways of organizing themselves and their countries' social policy.

The Paralympic Games (meaning 'alongside the Olympics') are now held after the (Summer and Winter) Olympics.

Current issues and debates surrounding 'disability' include social and political rights, social inclusion and citizenship. In developed countries the debate has moved beyond a concern about the perceived cost of maintaining dependent people with a disability to an effort to find effective ways of ensuring people with a disability can participate in and contribute to society in all spheres of life.

Many are concerned, however, that the greatest need is in developing nations -- where the vast bulk of the estimated 650 million persons with disabilities reside. A great deal of work -- from basic physical accessibility through education to self-empowerment and self-supporting employment -- is needed.

In the past few years, disability rights activists have also focused on obtaining full sexual citizenship for the disabled.

The introduction to the ICF states that a variety of conceptual models has been proposed to understand and explain disability and functioning, which it seeks to integrate.

The medical model 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 "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 healthcare policy.

The social model of disability sees the issue of "disability" mainly as a socially created problem, and basically as a matter of the full integration of individuals into society (see Inclusion (disability rights)). 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, in this model, the management of the problem requires social action, and thus, it 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. Viewed from this perspective equal access for people with impairment/disability is a human rights issue of major concern.

The market model of disability is a new model that builds on the social model in recognizing people with disabilities and their Stakeholders represent a large group of consumers, employees and voters. It looks to personal identity to define disability and empowers people to chart their own destiny in everyday life, with a particular focus on economic empowerment. This model makes no judgements about ability, focusing on tangible and measurable results. Its mantra is 'results, at all levels, create value'. By this model, based on US Census data, there are 1.2 billion people in the world who consider themselves to have a disability. An additional 2 billion people are considered Stakeholders in disability(family/friends/employers), together with PWD representing 53% of the population. This model states that due to the size of the demographic, companies and governments will serve the desires, pushed by demand as the message becomes prevalent in the cultural mainstream.

The American Psychological Association style guide states that, when identifying a person with an impairment, the person's name or pronoun should come first, and descriptions of the impairment/disability should be used so that the impairment is identified, but is not modifying the person. Improper examples would be "A Borderline, a "Blind Person." For instance: people with/who have Down syndrome, a man with/who has schizophrenia (instead of a Schizophrenic man), and a girl with paraplegia/who is paraplegic. It also states that a person's adaptive equipment should be described functionally as something that assists a person, not as something that limits a person, e.g. "a woman who uses a wheelchair" rather than is "in" it or is "confined" to it.

A similar kind of 'people first' terminology is also used in the UK, but more often in the form 'people with impairments' (e.g. 'people with visual impairments', etc.). However, in the UK, the term 'disabled people' is generally preferred to 'people with disabilities'. It is argued under the social model that while someone's impairment (e.g. having a spinal cord injury) is an individual property, 'disability' is something created by external societal factors such as a lack of wheelchair access to their workplace.. This distinction between the individual property of impairment and the social property of disability is central to the social model. The term 'disabled people' as a political construction is also widely used by international organisations of disabled people, such as Disabled Peoples' International (DPI).

Many books on disability and disability rights point out that 'disabled' is an identity that one is not necessarily born with, as disabilities are more often acquired than congenital. Some disability rights activists use an acronym TAB, "Temporarily Able-Bodied", as a reminder that many people will develop disabilities at some point in their lives, due to accidents, illness (physical, mental or emotional), or late-emerging effects of genetics.

Palme maintained that if it cost the country $US 40,000 per year to enable a person with a disability to work at a job that paid $40,000, the society gained a net benefit, because the society benefited by allowing this worker to participate cooperatively, rather than to be a drain on other people's time and money.

Under the Disability Discrimination Act (DDA) (1995, extended in 2005), it is unlawful for organisations to discriminate (treat a disabled person less favourably, for reasons related to the person's disability, without justification) in employment; access to goods, facilities, services; managing, buying or renting land or property; education. Businesses must make "reasonable adjustments" to their policies or practices, or physical aspects of their premises, to avoid indirect discrimination.

A number of financial and care support services are available, including Incapacity Benefit and Disability Living Allowance .

The Employers' Forum on Disability (EFD) is a membership organisation of UK businesses. Following the introduction of the DDA the membership of EFD recognised the need for a tool with which they could measure their performance on disability year on year.

In 2005 80 organisations took part in the Disability Standard benchmark providing the first statistics highlighting the UK's performance as a nation of employers.

Following the success of the first benchmark Disability Standard 2007 saw the introduction of the Chief Executives' Diamond Awards for outstanding performance and 116 organisations taking the opportunity to compare trends across a large group of UK employers and monitor the progress they had made on disability.

2009 will see the third benchmark, Disability Standard 2009. EFD have promised that for the first time they will publish a list of the top ten performers who will be honoured at an award ceremony in December 2009.

The US Rehabilitation Act of 1973 requires all organizations that receive government funding to provide accessibility programs and services. A more recent law, the 1990 Americans with Disabilities Act (ADA), which came in to effect in 1992, prohibits private employers, state and local governments and employment agencies and labor unions from discriminating against qualified individuals with disabilities in job application procedures, hiring, firing, advancement, compensation, job training, or in the terms, conditions and privileges of employment. This includes organizations like retail businesses, movie theaters, and restaurants. They must make "reasonable accommodation" to people with different needs. Protection is extended to anyone with (A) a physical or mental impairment that substantially limits one or more of the major life activities of an individual (B) a record of such an impairment or (C) being regarded as having such an impairment. The second and third critiera are seen as ensuring protection from unjust discrimination based on a perception of risk, just because someone has a record of impairment or appears to have a disability or illness (e.g. features which may be erroneously taken as signs of an illness).

According to the 2000 U.S. Census, the African American community has the highest rate of disability at 20.8 percent, slightly higher than the overall disability rate of 19.4%. Although people have come to better understand and accept different types of disability, there still remains a stigma attached to the disabled community. African Americans with a disability are subject to not only this stigma but also to the additional forces of race discrimination. African American women who have a disability face tremendous discrimination due to their condition, race, and gender. Doctor Eddie Glenn of Howard University describes this situation as the "triple jeopardy" syndrome.

The US Social Security Administration defines disability in terms of inability to perform substantial gainful activity (SGA), by which it means “work paying minimum wage or better”. The agency pairs SGA with a "listing" of medical conditions that qualify individuals for benefits.

Under the Individuals with Disabilities Education Act, special educational support is limited to children and youth falling in to one of a dozen disability categories (e.g., specific learning disability) and adds that, to be eligible, students must require both special education (modified instruction) and related services (supports such as speech and language pathology).

It is illegal for California insurers to refuse to provide car insurance to properly licensed drivers solely because they have a disability. It is also illegal for them to refuse to provide car insurance "on the basis that the owner of the motor vehicle to be insured is blind," but they are allowed to exclude coverage for injuries and damages incurred while a blind unlicensed owner is actually operating the vehicle (the law is apparently structured to allow blind people to buy and insure cars which their friends, family, and caretakers can drive for them).

The demography of disability is difficult. Counting persons with disabilities is challenging. That is because disability is not just a status condition, entirely contained within the individual. Rather, it is an interaction between medical status (say, having low vision or being blind) and the environment.

Estimates of worldwide and country-wide numbers of individuals with disabilities are problematic. The varying approaches taken to defining disability notwithstanding, demographers agree that the world population of individuals with disabilities is very large. The World Health Organization, for example, estimates that there are as many as 600 million persons with disabilities. In the United States, Americans with disabilities constitute the third-largest minority (after persons of Hispanic origin and African Americans); all three of those minority groups number in the 30-some millions in America. According to the U.S. Bureau of the Census, as of 2004, there were some 32 million disabled adults (aged 18 or over) in the United States, plus another 5 million children and youth (under age 18). If one were to add impairments -- or limitations that fall short of being disabilities -- Census estimates put the figure at 51 million.

There is also widespread agreement among experts in the field that disability is more common in developing than in developed nations.

Disability benefit, or disability pension, is a major kind of disability insurance, and is provided by government agencies to people who are unable to work due to a disability, temporarily or permanently. In the U.S., disability benefit is provided within the category of Supplemental Security Income, and in Canada, within the Canada Pension Plan. In other countries, disability benefit may be provided under Social security systems.

Costs of disability pensions are steadily growing in Western countries, mainly European and the United States. It was reported that in the UK, expenditure on disability pensions accounted for 0.9% of Gross Domestic Product (GDP) in 1980, but two decades later had reached 2.6% of GDP. Several studies have reported a link between increased absence from work due to sickness and elevated risk of future disability pension.

A study by researchers in Denmark suggests that information on self-reported days of absence due to sickness can be used to effectively identify future potential groups for disability pension. These studies may provide useful information for policy makers, case managing authorities, employers, and physicians.

Private, for-profit disability insurance plays a role in providing incomes to disabled people, but the nationalized programs are the safety net that catch most claimants.

Assistive Technology (AT) is a generic term for devices and modifications (for a person or within a society) that help overcome or remove a disability. The first recorded example of the use of a prosthesis dates to at least 1800 BC.

A more recent notable example is the wheelchair, dating from the 17th century. The curb cut is a related structural innovation. Other modern examples are standing frames, text telephones, accessible keyboards, large print, Braille, & speech recognition computer software. People with disabilities often develop personal or community adaptations, such as strategies to suppress tics in public (for example in Tourette's syndrome), or sign language in deaf communities. Assistive technology or interventions are sometimes controversial or rejected, for example in the controversy over cochlear implants for children.

A number of symbols are in use to indicate whether certain accessibility adaptations have been made.

As the personal computer has become more ubiquitous, various organisations have been founded which develop software and hardware which make a computer more accessible for people with disabilities. Some software and hardware, such as SmartboxAT's The Grid, and Freedom Scientific's JAWS has been specifically designed for people with disabilities; other pieces of software and hardware, such as Nuance's Dragon NaturallySpeaking, were not developed specifically for people with disabilities, but can be used to increase accessibility.

Further, organisations such as AbilityNet and U Can Do IT, have been established to provide assessment services which determine which assistive technologies would best assist an individual client, and also to train people with disabilities in how to use computer-based assistive technology.

A New Zealand designed keyboard is also now available to disabled persons worldwide. It is designed specifically for disabled peoples needs. This keyboard is called LOMAK.

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Developmental disability

The term first appeared in U.S. law in 1970, when Congress used the term to describe the population of individuals who had historically been placed in state institutions, in its effort to improve conditions in these dehumanizing facilities (P.L. 91-517, “The Developmental Disabilities Services and Facilities Construction Act of 1970”). The law has since been amended many times, and now calls for the full community inclusion and self-determination of people with developmental disabilities (P.L. 106-402).

Frequently, people with mental retardation, cerebral palsy, autism spectrum disorder, various genetic and chromosomal disorders such as Down syndrome and Fragile X syndrome, and Fetal Alcohol Spectrum Disorder are described as having developmental disabilities. This use of the term is synonymous with the use of the term learning disability in the United Kingdom, and intellectual disability in Australia, Europe, Canada and elsewhere. Cognitive disability is also used synonymously in some jurisdictions.

Developmental disabilities are usually classified as severe, profound, moderate or mild, as assessed by the individual's need for supports, which may be lifelong.

Developmental disabilities affectn between 1 and 2% of the population in most western countries, although many government sources acknowledge that statistics are flawed in this area. The worldwide proportion of people with developmental disabilities is believed to be approximately 1.4%. It is twice as common in males as in females, and some researchers have found that the prevalence of mild developmental disabilities is likely to be higher in areas of poverty and deprivation, and among people of certain ethnicities.

There are many physical health factors associated with developmental disabilities. For some specific syndromes and diagnddfoses, these are inherent (such as poor heart function in people with Down's syndrome); however lack of access to health services and lack of understanding by medical professionals is also a major contributing factor. People with severe communication difficulties find it difficult to articulate their health needs, and without adequate support and education might not recognise ill health. Epilepsy, sensory problems (such as poor vision and hearing), obesity and poor dental health are over-represented in this population. Life expectancy among people with developmental disabilities as a group is estimated at 20 years below average, although this is increasing with advancements in adaptive and medical technologies, and as people are leading healthier, more fulfilling lives, and some specific diagnoses (such as Freeman-Sheldon syndrome) do not impact on life expectancy.

These problems are exacerbated by difficulties in diagnosis of mental health issues, and in appropriate treatment and medication, as for physical health issues..

Lack of education, lack of self-esteem and self-advocacy skills, lack of understanding of social norms and appropriate behaviour and communication difficulties are strong contributing factors to the high incidence of abuse among this population.

In addition to abuse from people in positions of power, peer abuse is recognised as a significant, if misunderstood, problem. Rates of criminal offending among people with developmental disabilities are also disproportionately high, and it is widely acknowledged that criminal justice systems throughout the world are ill-equipped for the needs of people with developmental disabilities (as both perpetrators and victims of crime).

Some people with developmental disabilities exhibit challenging behaviour, defined as "culturally abnormal behaviour(s) of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviour which is likely to seriously limit or deny access to the use of ordinary community facilities". Common types of challenging behaviour include self-injurious behaviour (such as hitting, headbutting, biting), aggressive behaviour (such as hitting others, screaming, spitting, kicking), inappropriate sexualised behaviour (such as public masturbation or groping), behaviour directed at property (such as throwing objects and stealing) and stereotyped behaviours (such as repetitive rocking, echolalia or elective incontinence).

Challenging behaviour in people with developmental disabilities may be caused by a number of factors, including biological (pain, medication, the need for sensory stimulation), social (boredom, seeking social interaction, the need for an element of control, lack of knowledge of community norms, insensitivity of staff and services to the person's wishes and needs), environmental (physical aspects such as noise and lighting, or gaining access to preferred objects or activities), psychological (feeling excluded, lonely, devalued, labelled, disempowered, living up to people's negative expectations) or simply a means of communication. A lot of the time, challenging behaviour is learned and brings rewards and it is very often possible to teach people new behaviours to achieve the same aims.

Experience and research suggests that what professionals call 'challenging behaviour' is often a reaction to the challenging environments that those providing services create around people with developmental disabilities. 'Challenging behaviour' in this context is a method of communicating dissatisfaction with the failure of those providing services to focus on what kind of life makes most sense to the person, and is often the only recourse a developmentally disabled person has against unsatisfactory services or treatment and the lack of opportunities made available to the person. This is especially the case where the services deliver lifestyles and ways of working that are centred on what suits the service provider and it's staff, rather than what best suits the person.

Throughout history, people with developmental disabilities have been viewed as incapable and incompetent in their capacity for decision-making and development. Until the Enlightenment in Europe, care and asylum was provided by families and the church (in monasteries and other religious communities), focusing on the provision of basic physical needs such as food, shelter and clothing. Stereotypes such as the dimwitted yokel, and potentially harmful characterisations (such as demonic possession for people with epilepsy) were prominent in social attitudes of the time.

The movement towards individualism in the 18th and 19th centuries, and the opportunities afforded by the Industrial Revolution, led to housing and care using the asylum model. People were placed by, or removed from, their families (usually in infancy) and housed in large institutions (of up to 3,000 people, although some institutions were home to many more, such as the Philadelphia State Hospital in Pennsylvania which housed 7,000 people through the 1960s), many of which were self-sufficient through the labour of the residents. Some of these institutions provided a very basic level of education (such as differentiation between colours and basic word recognition and numeracy), but most continued to focus solely on the provision of basic needs. Conditions in such institutions varied widely, but the support provided was generally non-individualised, with aberrant behaviour and low levels of economic productivity regarded as a burden to society. Heavy tranquilisation and assembly line methods of support (such as 'birdfeeding' and cattle herding) were the norm, and the medical model of disability prevailed. Services were provided based on the relative ease to the provider, not based on the human needs of the individual.

Ignoring the prevailing attitude, Civitans adopted service to the developmentally disabled as a major organizational emphasis in 1952. Their earliest efforts included workshops for special education teachers and daycamps for disabled children, all at a time when such training and programs were almost nonexistent. The segregation of people with developmental disabilities wasn't widely questioned by academics or policy-makers until the 1969 publication of Wolf Wolfensberger's seminal work "The Origin and Nature of Our Institutional Models", drawing on some of the ideas proposed by SG Howe a hundred years earlier. This book posited that society characterises people with disabilities as deviant, sub-human and burdens of charity, resulting in the adoption of that 'deviant' role. Wolfensberger argued that this dehumanisation, and the segregated institutions that result from it, ignored the potential productive contributions that all people can make to society. He pushed for a shift in policy and practice that recognised the human needs of "retardates" and provided the same basic human rights as for the rest of the population.

The publication of this book may be regarded as the first move towards the widespread adoption of the social model of disability in regard to these types of disabilities, and was the impetus for the development of government strategies for desegregation. Successful lawsuits against governments and an increasing awareness of human rights and self-advocacy also contributed to this process, resulting in the passing in the US of the Civil Rights of Institutionalized Persons Act in 1980.

From the 1960s to the present, most states have moved towards the elimination of segregated institutions. Along with the work Wolfensberger and others including Gunnar and Rosemary Dybwad, a number of scandalous revelations around the horrific conditions within state institutions created public outrage led to change to a more community-based method of providing services. By the mid-1970s, most governments had committed to de-institutionalisation, and had started preparing for the wholesale movement of people into the general community, in line with the principles of normalization. In most countries, this was essentially complete by the late 1990s, although the debate over whether or not to close institutions persists in some states, including Massachusetts.

It could be argued that we still have a very long way to go before people with such disabilities are seen as full citizens of society. Person Centred Planning and Person Centred Approaches are seen as methods of addressing the continued labelling and exclusion of socially devalued people, such as people with a developmental disability label, encouraging a focus on the person as someone with capacities and gifts, as well as support needs.

Today, support services are provided by government agencies, non-governmental organizations and by private sector providers. Support services address most aspects of life for people with developmental disabilities, and are usually theoretically based in community inclusion, using concepts such as social role valorization and increased self-determination (using models such as Person Centred Planning). Support services are funded through government block funding (paid directly to service providers by the government), through individualised funding packages (paid directly to the individual by the government, specifically for the purchase of services) or privately by the individual (although they may receive certain subsidies or discounts, paid by the government).

Education and training opportunities for people with developmental disabilities have expanded greatly in recent times, with many governments mandating universal access to educational facilities, and more students moving out of special schools and into mainstream classrooms with support.

Post-secondary education and vocational training is also increasing for people with these types of disabilities, although many programs offer only segregated "access" courses in areas such as literacy, numeracy and other basic skills. Legislation (such as the UK's Disability Discrimination Act 1995) requires educational institutions and training providers to make 'reasonable adjustments' to curriculum and teaching methods in order to accommodate the learning needs of students with disabilities, wherever possible. See also Intensive interaction.

Many people with developmental disabilities live in the general community, either with family members, or in their own homes (that they rent or own, living alone or with flatmates). At-home and community supports range from one-to-one assistance from a support worker with identified aspects of daily living (such as budgeting, shopping or paying bills) to full 24-hour support (including assistance with household tasks, such as cooking and cleaning, and personal care such as showering, dressing and the administration of medication). The need for full 24-hour support is usually associated with difficulties recognising safety issues (such as responding to a fire or using a telephone) or for people with potentially dangerous medical conditions (such as asthma or diabetes) who are unable to manage their conditions without assistance.

In the United States a support worker is known as a Direct Support Professional (DSP). The DSP works in assisting the individual with their ADLs and also acts as an advocate for the individual with a developmental disability, in communicating their needs, self expression and goals.

Supports of this type also include assistance to identify and undertake new hobbies or to access community services (such as education), learning appropriate behaviour or recognition of community norms, or with relationships and expanding circles of friends. Most programs offering at-home and community support are designed with the goal of increasing the individual's independence, although it is recognised that people with more severe disabilities may never be able to achieve full independence in some areas of daily life.

Some people with developmental disabilities live in residential accommodation (also known as group homes) with other people with similar assessed needs. These homes are usually staffed around the clock, and usually house between 3 and 15 residents. The prevalence of this type of support is gradually decreasing, however, as residential accommodation is replaced by at-home and community support, which can offer increased choice and self-determination for individuals. Some U.S. states still provide institutional care, such as the Texas State Schools.

Workers with developmental disabilities have historically been paid less for their labour than those in the general workforce, although this is gradually changing with government initiatives, the enforcement of anti-discrimination legislation and changes in perceptions of capability in the general community.

Non-vocational day services are usually known as day centres, and are traditionally segregated services offering training in life skills (such as meal preparation and basic literacy), centre-based activities (such as craft, games and music classes) and external activities (such as day trips). Some more progressive day centres also support people to access vocational training opportunities (such as college courses), and offer individualised outreach services (planning and undertaking activities with the individual, with support offered one-to-one or in small groups).

Traditional day centres were based on the principles of occupational therapy, and were created as respite for family members caring for their loved ones with disabilities. This is slowly changing, however, as programs offered become more skills-based and focused on increasing independence.

Advocacy is a burgeoning support field for people with developmental disabilities. Advocacy groups now exist in most jurisdictions, working collaboratively with people with disabilities for systemic change (such as changes in policy and legislation) and for changes for individuals (such as claiming welfare benefits or when responding to abuse). Most advocacy groups also work to support people, throughout the world, to increase their capacity for self-advocacy, teaching the skills necessary for people to advocate for their own needs.

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Disability Discrimination Act 1995

The Disability Discrimination Act 1995 (c.13) (DDA 1995) is an Act of the Parliament of the United Kingdom which makes it unlawful to discriminate against people in respect of their disabilities in relation to employment, the provision of goods and services, education and transport. It is a civil rights law. Other countries use constitutional, social rights or criminal law to make similar provisions. The Equality and Human Rights Commission provides support for the Act. Equivalent legislation exists in Northern Ireland, which is enforced by the Northern Ireland Equality Commission.

It is still permissible for employers to have reasonable medical criteria for employment, and to expect adequate performance from all employees once any reasonable adjustments have been made.

In addition to imposing obligations on employers, the Act places duties on service providers and requires "reasonable adjustments" to be made when providing access to goods, facilities, services and premises.

The DDA 1995 departs from the fundamental principles of older UK discrimination law (the Sex Discrimination Act 1975 and the Race Relations Act 1976). These Acts depend on the concepts of direct discrimination and indirect discrimination. However, these concepts are insufficient to deal with the issues of disability discrimination.

Sometimes there may be no reasonable adjustment, and the outcome is that a disabled person is treated less favourably. For example, if a person was not able to understand the implications of entering into a mortgage or loan agreement, and they did not have anyone authorised to act for them, it would not make sense to require a bank or building society to enter into that agreement. The Act therefore permits employers and service providers to justify less favourable treatment (and in some instances failure to make a reasonable adjustment) in certain circumstances.

An easier to understand example would be a medieval castle built in the 1400s, which is open to the public for tours, not making itself accessible to persons in wheelchairs because to do so would basically destroy the castle's historical aspects such as the tightness of circular staircases, etc.

The system of protection of disabled people, especially those with mental health problems to keep their homes, has been greatly enhanced by certain recent rulings in the UK Court of Appeal -- City of Manchester v Romano -- .

Under the act it is unlawful to discriminate against a disabled person by evicting them or subjecting them to other detriment unless justified under the limited number of justifications set out in the act.

The judges were very worried about the extent of the law and urged the UK parliament to change it. However there has since been a new act of parliament and there was no weakening of this protection.

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Source : Wikipedia