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It’s Not Always the Way it Seems An Introduction to Individuals with Developmental Disabilities Kathy Biddlestone, RN, BSN, CDDN [email protected] Cuyahoga County Board of Developmental Disabilities August 13, 2012 • "Things are not always what they seem; the first appearance deceives many; the intelligence of a few perceives what has been carefully hidden.“ Phaedrus Objectives Differentiate between the terms Intellectual Disability and Developmental Disability (I/DD) Identify 5 specialized care needs of individuals with I/DD Identify 5 challenges that meeting the disaster planning needs of individuals with I/DD. Escape/Rescue involves: • • • • • • Walking Running Driving Seeing Hearing Quickly responding to directions What is a Disability? • Expression of limitations in an individual’s function within a social context which represents a substantial disadvantage to the individual – – – – – – – Physical: CP; Para/Quadriplegia; CVA; Amputees Cognitive: TBI; CVA; I/DD Mental: Mental illness Sensory: Visual/Hearing Emotional; PTSD; separation/abandonment issues Developmental: Down syndrome; Autism; CP Or some combination of these. Current Terminology • Intellectual/Developmental Disability Often abbreviated IDD or DD Disability is not, “One Size Fits All” “Just Like Us” Individuals who happen to have a disability are part of our world’s facs.pppst.com facs.pppst.com What’s In a Name? The Evolution of the Terminology over 200 years – – – – – – – – Idiocy Feeblemindedness Mental deficiency Mental disability Mental handicap Mental Retardation Developmental Disabilities Intellectual Disabilities Rosa’s Law • Oct. 5, 2010 President Obama signed into law, a bill which removed the term mental retardation and replaced it with intellectual disability • Ohio adopted the change July 7, 2009 Only the name has changed… • The term ID covers the same population of individuals previously diagnosed with Mental Retardation • Every individual who is or was eligible for a diagnosis of mental retardation is eligible for a diagnosis of intellectual/developmental disability Why is this Important? • Essential role of the term Mental Retardation as it relates to public policy IDEA (2004) Individuals with Disabilities Act Social Security Disability Insurance Medicaid Home and Community Based Waivers Citizenship and Legal Status Early intervention and Education Civil and Criminal Justice Training and Employment Income Support Health Care Housing and Zoning FEMA So, just who are we talking about? • 19.3 % of the 257.2 million people representing the general population of the US • 49,639,600 • Depending on who you ask! Intellectual Disability • Intellectual disability is characterized by significant limitations both in intellectual functioning and in adaptive behavior which covers many everyday social and practical skills. Intellectual Disability • Originates before age 18. • Adaptive behavior is expressed in conceptual, social and practical adaptive skills. • Limitations are considered within the typical environments of the person’s age peers and culture. • Assessments consider cultural and linguistic diversity as well as differences in communication, sensory, motor and behavioral factors. • Within an individual, limitations often coexist with strengths IDD Class IQ Profound mental retardation Severe mental retardation Moderate mental retardation Mild mental retardation Borderline intellectual functioning Below 20 20–34 35–49 50–69 70–84 Developmental Disability A severe, chronic disability Manifested before the age of 22 Likely to continue indefinitely; WHICH results in substantial functional limitations in three or more of the following areas of major life activity: Self-care Receptive and expressive language Learning Mobility Self-direction Capacity of independent living Economic self-sufficiency Examples of Developmental Disabilities Epilepsy Autism and autism spectrum disorders Fetal Alcoholism Syndrome Lead Poisoning Intellectual disability Cerebral palsy Down syndrome Prader-Willi Syndrome Hearing /Vision Impairments Cystic Fibrosis • All people with an intellectual disability have a developmental disability however, not all people with a developmental disability have an intellectual disability. Specialized Care Needs Need for medical treatments/medications that they may not be able to perform independently. which may lead to the need for a caregiver with specialized and often individual specific training Swallowing/Feeding Concerns • Particularly in individuals with Cerebral Palsy and Down’s syndrome with dementia Adaptive Eating Equipment • Nosy Cup •bestmedicalsuppliesonsale.com • Bendable Fork phytopharmaonline.com Adaptive Eating Equipment • Velcro utensil •expressmedsupplies.com • Scoop Plate maddak.com Tube Feedings • Providing nutrition, hydration and medication through a tube inserted into the stomach or small intestine www.oralcancer.org Specialized Medical Needs Medications Glucometer use/Insulin Administration • Diabetes management often requires blood sugar testing, using a glucometer. orleebinamira.blogspot.com • It may also require management with oral medication and/or injected insulin. • isletsofhope.com Respiratory Issues Use of devices to provide inhaled medications • Nebulizer • Inhalers sportswallpaper.cc.cc www.natural-holistic-health.com Tracheostomy • tracheostomy is a surgical procedure to create an opening through the neck into the trachea (windpipe). A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs www.bmedesign.engr.wisc.edu • OXYGEN http://www.zorotools.com • CPAP alignmap.com Seizures • Triggers • Protection from harm • Medications – Diastat – Intranasal Versed – Sublingual medications Equipment Needs Specialized Customized Not often readily available Speech/Language Modalities Augmentative Speech Picture Board students.depaul.edu Schedule •http://www.autismcommunity.com/communicatio n/strategies-and-solutions/ Speech/Language Modalities Augmentative Speech • Springboard IPAD •lausd.k12.ca.us log.friendshipcircle.org Physical Mobility • Gait Trainer • Reverse Walker Lifting/Transferring • Gait Belt • Hydraulic Lift Power Mobility • Reclining Power Chair •hmebc.com • Scooter •bestmedicalsuppliesonsale.com Wheelchair Seating/Positioning Sensory Issues • Particularly in individuals with Autism or Autism Spectrum Disorders • difficulty filtering sensory input. • nervous systems do not know what to block out and what to amplify. • • • • • • Lights Noises Faces Touch Smells Textures Other Equipment Resources • Home Health Care Agencies • Home Health Departments of retail stores/pharmacies • Hospices • Hospital supply companies • Mobility companies Additional challenges • Inappropriate referrals to medical facilities, resulting in increased burden to already underresourced facilities. • Misidentification of disability as an acute medical condition. • Refusal to serve based on mislabeled conditions Our mission is to support and empower people with developmental disabilities to live, learn, work and play in the community. CCBDD Services Early Childhood Services & Supports School-Age Services & Supports Adult Services & Supports Family Support Program Community & Medicaid Services Support Administration Behavioral & Healthcare Services Assistive Technology Transportation Quality Assurance