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2 LANGUAGE:PREFFERED USAGE Always remember to emphasize the person, not the disability. Avoid the following terms when referring to individuals with disabilities:  Wheelchair bound/confined to a wheelchair  Afflicted/afflicted with/afflicted by  Blind as a bat  Deaf and dumb, deaf mute  Defect/defective  Deformed  Cripple/crip/crippled/the crippled crippling  Group home  Homebound  Invalid  Normal (as opposite of having a disability)  Pitiful  Poor, unfortunate  Stricken  Victim


4 SPECIFIC DISABILITIES BRSS is home to students with various disabilities. As a Personal Assistant you may be required to offer specific services depending on the varying needs of these specific disabilities. To learn more about specific disabilities click on the following:  Spinal Cord Injury Spinal Cord Injury  Cerebral Palsy Cerebral Palsy  Muscular Dystrophy Muscular Dystrophy  Freidreich’s Ataxia Freidreich’s Ataxia

5 SPINAL CORD INJURY In general, injuries that are higher in your spinal cord produce more paralysis. For example, a spinal cord injury at the neck may cause paralysis in both arms and legs and may make it impossible to breathe without a respirator, while a lower injury may affect only your legs and lower parts of your body. Spinal cord injuries are classified as partial or complete, depending on how much of the cord width is damaged.  In a partial spinal cord injury, the spinal cord is able to convey some messages to or from your brain. These individuals may retain some sensation and possibly some motor function below the affected area.  A complete spinal cord injury is defined by total or near total loss of motor function and sensation below the area of injury.

6 SPINAL CORD INJURY Spinal Cord Injuries of any kind may result in one or more of the following signs and symptoms:  Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord  Loss of movement  Loss of sensation, including the ability to feel heat, cold and touch  Loss of bowel or bladder control  Exaggerated reflex activities or spasms  Changes in sexual function, sexual sensitivity and fertility  Difficulty breathing, coughing or clearing secretions from your lungs

7 SPINAL CORD INJURY Complications of a spinal cord injury may include:  Urinary tract problems  Bowel management difficulties  Pressure sores  Deep vein thrombosis and pulmonary embolism  Lung and breathing problems  Autonomic dysreflexia – irritation or pain below the level of the injury sends a signal that fails to reach your brain, producing a reflex action that can constrict blood vessels. The result is a rise in blood pressure and a drop in heart rate that can result in stroke or seizure.  Spasticity  Weight control issues  Sexual dysfunction  Pain  New injuries For more information on spinal cord injuries visit:

8 CEREBRAL PALSY Cerebral Palsy is a group of disorders impairing control of movement that do not worsen over time. CP is divided into four different classifications to describe the different movement impairments. These classifications reflect the area of brain damaged. The four major classifications are:  Spastic  Athetoid/Dyskinetic  Ataxic  Mixed In 30 percent of these cases the spastic form is found along with one of the other types.

9 CEREBRAL PALSY The incidence of Cerebral Palsy is about 2 per 1000 live births. The incidence is higher in males than in females. Prevalence of Cerebral Palsy is best calculated around the school entry age of about six years. All types of CP are characterized by abnormal muscle tone, posture, reflexes, or motor development and coordination. The classical symptoms are spasticity, spasms, other involuntary movements, unsteady gait, problems with balance, and/or soft tissue findings consisting largely of decreased muscle mass. Scissor walking and toe walking are common among people with CP who are able to walk.

10 CEREBRAL PALSY The cause of the majority of cases of CP is uncertain. Contributing cases of CP are asphyxia, hypoxia of the brain, birth trauma, premature birth, central nervous system infections and certain infections in the mother during and before birth. CP is also more common in multiple births. CP is not a progressive disorder (meaning the actual brain damage does not worsen), but the symptoms can become worse over time due to ‘wear and tear’. People who have CP tend to develop arthritis at a younger age than normal because of the pressure placed on joints by excessively toned and stiff muscles.

11 MUSCULAR DYSTROPHY Muscular dystrophy refers to a group of genetic, hereditary muscle diseases that cause progressive muscle weakness. Muscular dystrophies are characterized by progressive skeletal weakness, defects in muscle proteins, and the death of muscle cells and tissue. Nine diseases including Duchenne, Becker, limb girdle, congenital, facioscapulohumeral, myotonic, oculopharyngeal, distal, and Emery-Dreifuss are always classified as muscular dystrophy.

12 MUSCULAR DYSTROPHY Most types of MD are multi-system disorders with manifestations in body systems including the heart, gastrointestinal and nervous systems, endocrine glands, skin, eyes, and other organs. The best-known type, Duchenne muscular dystrophy is inherited in an X-linked recessive pattern, meaning that the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes, and is thus considered sex linked. In males one altered copy of the gene in each cell is sufficient to cause the condition. Duchenne muscular dystrophy and Becker’s muscular dystrophy are caused by mutations of the gene for the dystrophin protein and lead to an overabundance of the enzyme creatine kinase. Muscular dystrophy is progressive and no specific treatment is known.

13 MUSCULAR DYSTROPHY Symptoms  Progressive Muscular Wasting (weakness)  Poor Balance  Frequent Falls  Walking Difficulty  Waddling Gait  Calf Pain  Limited Range of Movement  Muscle Contractures  Respiratory Difficulty  Drooping eyelids (ptosis)  Gonadal Atrophy  Scoliosis (curvature of the spine)  Inability to work

14 FREIDREICH’S ATAXIA Freidreich’s Ataxia is a rare, genetic, neurodegenerative, multi-symptom disorder. About 1 in 50,000 people in the United States have FA. Onset of symptoms is usually between the ages of 5 and 15, sometimes even earlier and sometimes significantly later.

15 FREIDREICH’S ATAXIA Symptoms:  Muscle weakness and loss of coordination (ataxia) in the arms and legs  Vision impairment, hearing loss, and slurred speech  Aggressive scoliosis (curvature of the spine)  Diabetes mellitus and carbohydrate intolerance  A serious heart condition (enlarged heart – hypertrophic cardiomyopathy)

16 FREIDREICH’S ATAXIA These symptoms reflect the death of cells in certain parts of the nervous system. The mental capabilities of people coping with FA remain completely intact. For most, progressive loss of muscle strength and control leads to motor incapacitation and the full time use of a wheelchair by the late teens or early twenties. The course of the disorder is progressive. Freidreich’s Ataxia is inherited recessively; a person develops the disorder only when he or she inherits genes from both parents.


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