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SWING and the ICF International
Classification of Functioning,
Disability and Health
Session Learning Outcomes
By the end of the session you will have:
• A basic knowledge of ICF and definitions related
to people and their disabilities
• Awareness of the biopsychosocial approach to
disability
• Insight into the benefits of assistive technology
(AT) in improving performance
• A basic knowledge of the appropriate use of AT.
Activity
(15 min) – Think about the definitions below related to
people and their disabilities
Disabled people
Differently abled
People with special needs
Invalid
Impairment
?
Deficit
People with disabilities
Handicapped
DEFICIT
By deficit, is an absence, any kind of
“malformation”, a lack of or anomaly in an
organ, etc. of a mental, psychological or
physiological function.
Example of a deficit situation:
deaf person: their sensory deficit, manifested through a reduced or total
inability to perceive sounds and noises, represents a permanent
characteristic. It’s an “objective” feature, measurable in the same way as
their body type, colour of hair, colour of eyes, etc.
The use of a hearing aid which compensates for or amplifies the missing
function of the sensory organ can, to some extent, reduce the effects of the
deficit: helping increase auditory perception, but without modifying the
deficit or malfunction of the auditory system, which remains unchanged.
HANDICAP
A handicap is the result of a social and cultural
process: it is the consequence of the meeting
between the individual – with her/his own
physical and psychological (including any
deficits) characteristics – and their personal
history and context.
Example of a handicap situation:
A person with an auditory deficit, can develop a personal history of
adaptation to the different contexts in which they find themselves growing
up and living. This deaf person may be surrounded by an environment
which does not consider their deficit a serious impediment and, therefore,
does not undervalue them as an individual. Or vice versa.
DIFFERENCE
Difference between deficit and disability (handicap):
DEFICIT is a “given” element, which cannot be modified
and, in contemporary medical terms, is irreversible and
permanent.
HANDICAP is not innate in a person, but is a
“contextual condition”. We speak of a “handicapping
situation” (which can occur even when there is no
deficit), determined by the meeting between diverse
variables, therefore modifiable.
International Classification of
Impairments, Disabilities and
Handicaps (1980)
IMPAIRMENT
(Deficit)
any loss or
abnormality of
psychological,
physiological or
anatomical structure
or function
BODY
DISABILITY
HANDICAP
any restriction or lack
(resulting from an
impairment) of ability
to perform an activity
in the manner or
within the range
considered normal for
a human being.
a disadvantage for a
given individual that
limits or prevents the
fulfillment of a role
that is normal
ACTIVITY
SOCIETY
Deficit, Disability, Handicap
(10 min) – Identify and discuss a case example that
shows the difference between the impairment,
disability and handicaps as shown below.
DEFICIT
Cerebral
Palsy
- inability to move the legs
- inability to bear weight on
the feet
-Inability to move hands
properly
Aids: orthotics and surgery
- inability to associate sounds
with symbols
Severe
dyslexia
DISABILITY
-inability to walk.
- inability to use a keyboard
HANDICAP
- Social exclusion
(architectural barriers, lack of
AT, etc)
-Difficulty in using
public transport
Aids: Walkers,
braces, special keyboard
- inability to read
-Learning difficulties
(lack of AT, alternative
Reading strategies, visual
Learning, etc)
ICF (2001)
Maps the basic concepts of a person’s health and
functioning and aims to provide a unified and standard
language and framework for the description of health and
health-related states.
The ICF is structured around the components:
- Body functions and structure
- Activities (related to tasks and actions by an individual)
and participation (involvement in a life situation)
-Additional information on severity and environmental
factors.
Functioning and disability are viewed as a complex
interaction between personal factors, the health condition
and contextual factors of the environment.
ICF (2001)
ICF (2001)
One of the major innovations in ICF is the presence of an environmental factor
classification that makes it possible for the identification of environmental
barriers and facilitators (e.g. ICT, AT) for both capacity and performance of actions
and tasks in daily living.
Performance describes what an individual does in his or her current environment.
Performance can also be understood as "involvement in a life situation" or "the
lived experience" of people in their actual context.
Capacity describes an individual’s ability to
execute a task or an action.
LEVELS OF HUMAN
FUNCTIONING
• Body Functions are physiological functions of body
systems (including psychological functions) and Body
Structures are anatomical parts of the body such as
organs, limbs and their components;
• Activity is the execution of a task or action by an
individual;
• Participation is involvement in a life situation.
ICF application
• individual level (assessment of individuals; individual treatment
planning; evaluation of treatment and other interventions;
communication among physicans, nurses, physiotherapists,
occupational therapists and other health works, social services and
commmunity agencies; self-evaluation by consumers);
• institutional level (educational and training purposes; resource
planning and development; quality improvement; management and
outcome evaluation; managed care models of health care delivery);
• social level (eligibility criteria for state entitlements such as social
security benefits, disability pensions, workers’ compensation and
insurance; social policy development, including legislative reviews,
model legislation, regulations and guidelines, and definitions for antidiscrimination legislation; needs assessments; environmental
assessment for universal design, implementation of mandated
accessibility, identification of environmental facilitators and barriers,
and changes to social policy).
Assistive Technology
A broad range of devices,
services, strategies, and
practices that are used to
solve the problems faced by
individuals who have
disabilities.
Cook, A. M. & Hussey, S. M. (2002)
Assistive Technologies: Principles and
Practice, 2nd Edn. St. Louis, USA,
Mosby.
/RICHES - KICK-OFF MEETING 9-10th
December2013
Case Study 1
(15 min) – Read the following case study and idenitify
deficit and possible handicaps, barriers and facilitators
(included ICT).
Description:
- Name: Nikolaos Souflakos
- Age: 25
- Location: Nicosia, Cyprus
- Marital status: Single
- Job: Unemployed
- Impairment: Traumatic brain injury
Nikolaos (31) lives in Nicosia, Cyprus, and was involved in a severe car accident when he
was 19 years old. He was in a coma for 5 months and experienced permanent
neurobiological damage. He was able to fully recover from his back injury he sustained
during the same accident. Nikolaos has difficulty speaking and being understood
(expressive aphasia) while also experiencing blurred vision.
Case study 1
Nikolaos Souflakos
Possible AT solutions:
To communicate with his peers, Nikolaos uses software on his PC that allows
him to communicate using symbols which are transferred to sound. In addition,
he also uses text to speech software despite the fact that his linguistic skills
were severely affected by his brain injury. He therefore uses word prediction
software. On his mobile, he also uses such word prediction software and a
simplified interface based on symbols. He mainly uses Nokia phones because
the menu structure is similar across all newer models.
This persona was created for the ACCESSIBLE project which is financially supported by the
European Commission (www.accessible-project.eu – Accessible Applications Design and Development).
This persona is licensed under a Creative Commons Attribution-Share Alike 3.0 License.
Case Study 2
(15 min) – Read the following case study and idenitify
deficit and possible handicaps, barriers and facilitators
(included ICT).
Description:
Marta Guglielmi was a severly dyslexic student who failed her first year of Medicine.
As a result of This failure, her academic tutors advised her that she ought to seek advice
from Dyslexia Support Services.
Since the identification of her dyslexia, she received academic skills tuition from a specialist
tutor. She was taught many strategies to enable her to cope with the rigorous demands of her
chosen course of study. Her dyslexic profile is typical of the experiences related by dyslexic
students who have not been identified until they reached HE:
-Never seemed to obtain results that reflected time and effort
- Reflective learner who lacked self-confidence in academic skills
-Oral sentence structure lacked sequential fluency
- Could not process different types of information simultaneously (multi-tasking)
Case Study 2
Marta Guglielmi
Possible AT solutions:
- Mind-mapping software: in a creative manner to support her individual
cognitive
style.
- Text-to-speech software: to support her hesitant reading skills and to develop
critical reading skills
-Talking spelling checker and thesaurus: to by-pass her weak visual memory
skills and to tap into her auditory strength and ensure accuracy and efficiency.
-Coloured acetates and individualised screen colour backgrounds: to reduce
visual stress when reading
This persona is coming from Riddick et al., 1999; McLoughlin, 2001
Case Study 3
(15 min) – Read the following case study and idenitify
deficit and possible handicaps, barriers and facilitators
(included ICT).
Description:
Name: Paulina Reyes
- Age: 25
- Location: Murcia, Spain
- Marital status: Single
- Job: Unemployed
- Impairment: Blind
Paulina (25) was born blind, and lives in Murcia, Spain. Due to her visual impairment,
Paulina was unable to find a job after finishing high school. The only job opportunities she
had would have required her to move, which Paulina and her family did not want to do.
She started taking guitar lessons and can now play it to a good standard It was not easy
to learn in the beginning. She cannot read regular music scores so she has to use music
Braille.
Case Study 3
Paulina Reyes
Possible AT solutions – Part 1:
Paulina uses her PC on a daily basis for the text editor to write letters for
job applications and to visit Yahoo and check her emails using Internet Explorer.
She tried Hotmail and later Gmail, but there just was too much information on
the page. Yahoo email works well with her Jaws screenreader. She also uses
OCR software, a Braille embosser, and Adobe reader speech output. The
combination of all these technologies enables Paulina to use her PC to a
satisfactory degree. However, the investments she and her family had to make
to acquire this technology put some pressure on the family finances. The
internet was also an enormous help in finding information, Braille music scores,
and mp3 music. Paulina bought herself a smartphone which she uses
practically all the time.
This persona was created for the ACCESSIBLE project which is financially supported by the
European Commission (www.accessible-project.eu – Accessible Applications Design and Development).
This persona is licensed under a Creative Commons Attribution-Share Alike 3.0 License.
Case Study 3
Paulina Reyes
Possible AT solutions – Part 2:
Her choice of smartphone took into account its ease of use and came
recommended by a friend who is also blind. The device has large enough keys
that provide lots of tactile feedback when pressed. Paulina uses it to call
friends and family and to text, maintain her calendar, and listen to audiobooks
she downloads from the internet. She uses a VOCA to read her text messages
but, unfortunately, the Spanish output often has a faulty pronunciation.
This persona was created for the ACCESSIBLE project which is financially supported by the
European Commission (www.accessible-project.eu – Accessible Applications Design and Development).
This persona is licensed under a Creative Commons Attribution-Share Alike 3.0 License.