Mount Alexander Shire Council Disability Awareness Presentation 10th December 2012

Topics Introductions What is disability – facts and figures What is inclusion and how do we become more inclusive? Impact of disability and barriers to inclusion Communication strategies and language of disability Behaviours of concern

What do we mean by disability? Disability Discrimination Act 1992 Disability, in relation to a person, means: total or partial loss of the person's bodily or mental functions; or total or partial loss of a part of the body; or the presence in the body of organisms causing disease or illness; or the presence in the body of organisms capable of causing disease or illness; or the malfunction, malformation or disfigurement of a part of the person's body; or a disorder or malfunction that results in the person learning differently from a person without the disorder or malfunction; or a disorder, illness or disease that affects a person's thought processes, perception of reality, emotions or judgment or that results in disturbed behaviour; and includes a disability that: presently exists; or previously existed but no longer exists; or may exist in the future; or is imputed to a person.

Prevalence We are all on the list! Statistics estimate that : 20% of the Australian population have a disability. Disability is strongly correlated to age. The disability rate increases with age from 4% of children with disability, to 41% of people aged 65 to 69, and 92% of people 90 years and over. We are all on the list!

Ways in which we think of disability Medical model Rights model Social Model

What is inclusion? Look at the following case studies and consider what they tell us about inclusion

Case studies Kay attends water aerobics. She seems to enjoy the sessions, but once they are over, she changes and rushes off with her support worker to her next activity Peter is non verbal. He has a communication board but no-one at the centre knows how to use it. Yesterday he became very angry and began yelling and hitting out at people. Jasmine coaches a basketball team. Her boss has been told she has autism but this has not affected her work. A week ago there was a fire drill and she hasn’t been back since.

Inclusion Is more than presence Supports social inclusion Allows for independence and dignity Recognises the impact of disability Takes time and effort It is not.. Tokenism Something that only effects certain people

So, what is Inclusion? Inclusion is…. Guaranteeing full enjoyment of life without discrimination Changing the attitudinal and environmental barriers that result in disabling people with impairments

What does it mean for us? We are creating barriers to inclusion when…… We make assumptions and don’t clarify them We do not fully involve someone (i.e. allow just a presence) We shield individuals or groups to protect them We do things for other people they can do for themselves or haven’t asked us to do for them We are supporting inclusion when... We challenge our assumptions and values We are willing to overcome our discomfort We learn to embrace differences We recognise that people express themselves differently We advocate and support the public to be more tolerant

Impact of disability Physical disability Sensory disability Wheelchairs, poor mobility, arthritis, cerebral palsy Sensory disability Blind or with low vision Deaf or hard of hearing Intellectual disability Communication impairments Autism Mental illness Age related

People with physical disability Mobility issues (note not all people with physical disability use a wheelchair) Vertigo Loss of balance Fatigue Functional difficulties e.g. with hand movements Poor bladder function.

What causes physical disability? Accidents which could result in:  spinal injury amputation acquired brain injury affecting motor skills and limb control Medical conditions such as:  cerebral palsy - spina bifida chronic fatigue inherited conditions passed on genetically (for example limb deficiency) Age  

Barriers to inclusion Surfaces - uneven, polished Access – pathways, doorways, door weight, door handles, stairs Toilet access Parking Social facilities Lack of hoists Access to information Objects out of reach Narrow spaces

Communications and people with physical disability Do not move or touch wheelchair without permission Move into eye line Ask if help is needed and accept “NO”

People who are deaf or hard of hearing May be affected by background noise May miss spoken cues May miss verbal or sound alarms Do not all lip read

Communicating with people who are deaf or hard of hearing Get the person’s attention before you speak Face the person directly and maintain eye contact Make sure your mouth is visible Don’t shout, keep your volume up but natural Use short sentences Use visual cues and facial expressions If you are not being understood, repeat message in different words, or write message down Hearing loops

Communicating with people who are blind or have low vision Identify yourself and ask others to do the same Address people by name Explain sudden noises Don't shout Talk about what you and others are doing Show the person where things are placed Don't move objects without telling the student Don't pat assistant animals If you are leaving, tell the person where you are going, and when you will be back Give clear directions, don't talk about "here" and "there"

Intellectual Disability • Significantly below average intelligence (lQ of 70 or less). The score is obtained from a standardised test whereby 100 is an average • Shortcomings in everyday life skills. Personal skills such as self care are inadequate compared with other people of the same age and culture • Disability appears before eighteenth birthday

People with an intellectual disability may: Learn slowly Have short term memory issues Be easily confused Lack social skills Find abstract and potential concepts hard Have difficulty concentrating Give expected or “right” responses React adversely to change

Communications with people with an intellectual disability Use the same tone of voice and eye contact as for anyone else Use age appropriate language Use plain English, familiar words and short sentences Accept that you may have to repeat information again Introduce a person to others in a group Give one instruction at a time Give positive feedback Talk in the here and now avoiding jargon and slang

Communications with people with speech impairment Speak directly to the person not their carer Maintain eye contact Use normal speech, volume and pitch and usual lip movement Encourage but don’t push the person to express themselves Accept and respond to all forms of communication Avoid completing words and phrases for the person Take time to listen and wait for their response Ask how a communication board or other device works if used Ask for something to be repeated rather than pretend you understand when you didn’t Be comfortable with silence

People with autism spectrum disorder Pattern of behaviour in three key areas communication, social interaction, and imaginative thought. May also coexist with other conditions or disorders, e.g. intellectual disability, speech and language disorders, anxiety and depression (especially in adolescents and adults), epilepsy, attention disorders, Tourette Syndrome, and Down Syndrome

People with Autism Spectrum Disorder may: Need a structured environment Have problems with social interaction Have problems with generalisations Have difficulty with double meanings Have problems with some noises Have problems with some lights React adversely to change Be fixated on one subject

Communication and people with autism spectrum disorder A structured predictable environment Rules to aid social interaction Explain metaphors / words with double meanings Teach generalisations Use concrete and visual methods: non verbal cues, pictures Avoid long strings of verbal instructions Break tasks into components Be aware of noises which hurt ears : PA systems, bells, buzzers or scraping chairs Be aware of fluorescent and flickering lights Black print on coloured paper to avoid contrast (not bright yellow)

Myths and mental health People with mental health disorders are likely to be violent People with mental health disorders are not very intelligent People with mental health disorders are likely to behave oddly

Some mental health disorders Schizophrenia Bi- Polar Disorder Depression Anxiety Obsessive Compulsive Disorder (OCD) Eating disorders Post traumatic stress disorder

People with a mental illness may experience: Lack of motivation Unexplained anger, expressions of emotion Have difficulty making decisions Concentration problems Lack of confidence High levels of anxiety Effects of medication

Effects of medication Drowsiness and lethargy Restlessness Dry mouth/persistent thirst Problems with coordination e.g. shakiness/tremors in hands Involuntary movements of mouth, tongue and other parts of the body Headaches, nausea Vision difficulties Quiet space to rest Flexible attendance requirements Frequent breaks, go for walks Frequent drink breaks Adapt physical actions to minimise impact of shakes. Talk rather than do as per need Encourage person to explain this to peers Empathise, provide outside breaks, place to rest Provide oral explanations

Age related disability Can (and probably will) happen to all of us Physical – arthritis, mobility, effects of medication Sensory – sight and hearing Poor bladder function Dementia Depression

Language of disability Is language important or is it all political correctness gone mad?

Language of disability Use Don’t use Person with disability Disabled person Person suffering from.. An epileptic/paraplegic Crippled Abnormal Impairment Handicap Accessible parking/toilet Disabled parking/toilet Seizure Fit Uses a wheelchair Wheel chair bound Person with an intellectual disability Mentally retarded Non- disabled, person without a disability Normal Is blind or has low vision Visually impaired

General communication strategies Remember that a person with a disability is a person- like everyone else. Speak directly to them not their companion. Don’t shout or raise your voice. Be willing to communicate in different ways and to learn how to use new tools for communication. If you don’t know what to do or say, relax and allow the person with a disability to speak/communicate. Take time to listen to their response- this is very important. Be honest, don’t pretend that you have understood them. Ask the person to try again using a different term or ask someone else who knows the person to help out. Remember, as in any conversation, maintain eye contact as you normally would. Remember the person is not sick, so the person should be viewed as healthy. Offer assistance when it’s asked for or if the need seems obvious, don’t overdo or insist on it. Respect the person’s right to indicate the type of help they need. Always talk to the person in an age appropriate manner and especially not as a child. Find out the person’s abilities and the things they like to do as a way of getting to know the person better.

Written communication Provide a range of formats Use pictures and drawings to reinforce words. Use Easy English where possible Use large font size (16 or 18) and a sans serif font Page numbers should be the same size as the text Avoid using blocks of capital letters: a mix of upper and lower case Separate paragraphs with blank lines Margins left justified only and the same width both sides Use paper with a matt finish Use black text on white paper and avoid red or green text.

Enrolments Do we have to include? No-one is obliged to disclose an impairment

Questions to ask Ask everyone (with or without disability): Is there anything which might prevent you fully participating in this activity? Is there any support you might need to fully participate? You will not be discriminated against but failure to disclose may mean we cannot provide the support or medical attention you need

Case study Maria normally attends aerobics with her support worker without incident. On one occasion the support worker cannot attend and Maria becomes extremely distressed, bursts into tears and runs out saying she can’t stay any longer. How can we assist Maria?

Behaviours of concern What is a behaviour of concern? Why is it happening? Who can help? Making your expectations known Code of conduct Consideration of dignity

Critical incident planning Safety first: You Person concerned Rest of the community Keep calm Do not man handle Call the police Debrief

Look after yourself At some point you will feel tired, frustrated, irritable, overwhelmed. This is normal – but don’t react negatively. Recognise when this is happening Find someone to talk to Have a break