People with Disabilities
There are many populations that social workers provide services for daily. One such population is People with Disabilities. Disabilities can take many forms, such as physical, cognitive, or mental illness (Centers for Disease Control and Prevention, 2016). The broad range of potential disabilities can pose many unique challenges for social workers. It is also important to note that while disabilities can be a singular occurrence for some individuals, often disabilities span across many population segments. It is common for people with disabilities to suffer from victimization, stigmatization, and segregation in our society. Therefore, all social workers no matter what area of social work they are in should knowledgeable on the types of disabilities and those who live their lives with them.
Forms of Disabilities
There are various forms of disabilities that people can suffer from. The three major forms of disabilities are physical, cognitive, and mental illness, with most disabilities falling within these three categories. To better understand disabilities, let’s consider the three categories.
Physical Disability: a limitation on a person’s physical functioning, mobility, dexterity or stamina.
Cognitive Disability: a generalized disorder characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors that appears before adulthood.
Mental Illness: a wide range of mental health conditions — disorders that affect mood, thinking and behavior.(Merriam-Webster’s collegiate dictionary, 1999)
Physical disabilities can take many forms and can occur at any time in an individual’s life. Many physical abnormalities can occur before a person is born, developing in utero. Known as congenital disorders and most commonly referred to as birth defects, these impairments can take many forms. Some can be a minor as a birth mark or as severe as a missing limb or internal abnormalities (Nemours, 2017). When a birth defect proves to be severe and long lasting, it has the potential to develop into a disability. Infants born with missing limbs or improperly developed physical traits will often grow to have a physical disability. Some physical birth defects can be corrected or improved with medical technology, such as surgeries to correct cleft palates; however there are many physical birth defects that cannot be corrected potentially leading to a physical disability.
There are also physical disabilities that occur after birth at any time in an individual’s life. Major accidents are the most common cause of physical disabilities after birth. Car accidents are a common accident that can cause physical disabilities at any time in life. Car accidents can lead to minor injuries, but in severe cases can cause lifelong physical disabilities such as severed limbs and brain injuries (Disabled World, 2015). Military personnel are also at high risk of procuring physical disabilities through outside means. War can lead to various physical disabilities due to military engagements. The most recent military conflicts have led to high numbers of physical disabilities resulting from IEDs (Intermittent Explosive Devices) which have caused loss of limbs and .
Physical disabilities can impact individuals in a variety of ways. Depending on the nature of the physical impairment individuals may be limited on where they can travel, the type of employment they can procure, and even their personal relationships. Social workers must be prepared to not only address the physical limitations that a physical disability can pose, but also the emotional impact that one may have on a client. Working with clients who have a physical disability can be a unique and rewarding experience. Each client will require an individualized approach, as not everyone who has a physical disability will cope in a uniformed way.
Cognitive disabilities, also known as intellectual disabilities, are other forms of disabilities that social workers will encounter in the field. There are many types of cognitive disabilities that can vary in severity.
Some common types of cognitive disabilities are:
- Down Syndrome
- Traumatic Brain Injury (TBI)
- Learning Disabilities
Cognitive disabilities, like physical disabilities, can be present at birth. Cognitive disabilities at birth can be almost impossible to distinguish and usually begin to present in early childhood. Some indicators of cognitive disabilities can be present in infancy, such as the infant failing to meet certain milestones or presenting with unusual symptoms such as lack of sleep and inconsolable crying. While these indicators can be present, it is often difficult for medical professionals to diagnose cognitive disabilities in infants and toddlers.
Most cognitive disabilities are diagnosed in childhood and early adolescence. There are several that can be conducted to determine the presence of a cognitive disability. While many medical professionals may suspect a cognitive disability, most often patients are referred out to have the appropriate assessments completed. Once a diagnosis is made there are several forms of that can be performed depending on the type of cognitive disability.
Even with the advancements in medical technology, unfortunately there are no “cures” for cognitive disabilities. While various therapies and some medications can help improve cognition and stall deterioration in some, there is no way to fully heal the cognitive disability. Cognitive disabilities can impact individuals on many levels, from employment to personal relationships. Depending on the severity of the cognitive impairment, some individuals may never be able to live independently or function in mainstream society. Social workers working with this population must be prepared for the diversity within and the individual challenges faced by those with cognitive disabilities.
While many may not consider mental illness to be a category of disability, there are several mental illnesses that impact an individual’s life in such a way that it can be classified as a disability. Mental illnesses such as Schizophrenia, Borderline Personality Disorder, and Bipolar Disorder can be so severe that an individual’s everyday life is impacted. When a mental illness impairs an individual’s ability to function, it can be considered a disability.
For some mental illnesses, medication can help alleviate symptoms. This is especially true regarding disorders such as Schizophrenia and Bipolar disorder. While there is no cure for these disorders, medication in combination with behavioral therapies can reduce the symptoms. However, there are some mental illnesses that even with medication and therapy can still make coping difficult. Agoraphobia is one disorder that can severely impact everyday functions, to the point where the individual may not even be able to leave their home due to anxiety.
Mental illnesses in themselves can be considered disabilities when they impact an individual’s life to the point of impairing functioning. Mental illnesses can also contribute to other health concerns and behavioral symptoms that greatly impact lives. For more information on mental illness please see Chapter 10: Mental Health and Substance Use.
Did You Know…
Agoraphobia consists of an individual experiencing marked anxiety in at least two of the following: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, being outside of the home alone. (DSM-5, 2013, p. 217)
The Americans with Disability Act (ADA)
The Americans with Disability Act (ADA) was put into place in 1990. It guarantees equal rights for those with disabilities in the United States. It prohibits discrimination against those with disabilities “in all areas of public life, including jobs, schools, transportation, and all public and private places that are open to the general public” (ADA National Network, 2017). While this policy has created great advancements for those with disabilities, especially in education and employment, discrimination still takes place on a daily basis in our country.
Youth with Disabilities
As mentioned previously in this chapter, the age of diagnosis of disabilities can vary depending on the type of disability and potential origin. Most cognitive disabilities such as learning disabilities and autism are diagnosed in early childhood. Symptoms can vary in type and severity, the less severe generally being observed later. Children who are diagnosed with any type of disability face many challenges. Physical disabilities are often able to physically seen, therefore being diagnosed much sooner. Cognitive disabilities and mental illnesses do not manifest in a physical manner, therefore leading to later diagnosis. Parents, caregivers, and teachers are often the first to notice symptoms of a cognitive disability and/or mental illness. While cognitive disabilities have standard procedures for diagnosing, mental illnesses in children can often be difficult to diagnose. Many mental health professionals may be hesitant to make a mental illness diagnosis for a young child, as the brain is just beginning to develop and symptoms can vary.
The K-12 Education System
For cognitive disabilities and mental illnesses, the K-12 education system can pose particular challenges and resources for children. Depending on the geographic area, children with disabilities may find either a helpful system with resources or an overtaxed system with an inability to adequately help.
Higher Education System
The higher education system can also pose some unique challenges for people with disabilities. While many universities and community colleges have disability accommodations, the quality of these accommodations can vary depending on the institution. For many with physical disabilities, colleges and universities can be difficult places to maneuver – literally. There have been instances of universities failing in snow removal so that those who require mobility assistance such as wheelchairs are not able to traverse the campus. There have also been accounts of buildings being poorly designed so that doorways are not easily accessible for those who are not able to walk.
Accommodations for those with cognitive disabilities can also vary depending on the institution. Many higher education institutions have made efforts to be inclusive for those with cognitive disabilities, per ADA requirements. Most offer accommodations for those who qualify such as tutoring, alternate exam areas to allow for more time and individuals who are dedicated to helping those with cognitive disabilities succeed. People with cognitive disabilities in the higher education system most often have resources available to them provided by the institution, which is a change from the past, where even fifty years ago they would not have been accepted into the system.
For people with disabilities, the workplace can present certain difficulties. Discrimination in the work place for people with disabilities is unfortunately all too common. No matter what form of disability, employers can be quick to judge an individual’s abilities based solely on their disability. This is most common with physical and cognitive disabilities as they are more visible. Those with mental illness will also face discrimination in the work place as employers may see them as “too challenging” to employ. Some discrimination can be unintentional as well. Employers may make unnecessary accommodations for their employees with disabilities or may conduct themselves in a manner that is unintentionally condescending. Discrimination in the workplace can be both intentional and unintentional (Workplace Fairness, 2017).
While some employers can be hesitant or outright refuse to hire people with disabilities, others do not share such reservations. For employers who hire people with disabilities, accommodations must be made at times. The ADA requires that all public buildings be wheelchair accessible and many businesses have made great strides towards that goals. For those with cognitive disabilities and mental illnesses, accommodations can be made to make employment more inclusive such as training for other employees and trying to be educated on the topic.
Health insurance is a major factor for employers when hiring people with disabilities. Many employers may be hesitant to hire people with disabilities due to their health insurance provider. Some health insurance companies offer less coverage, some do not even offer mental health services in their packages. This could influence whether people with disabilities will be hired at certain workplaces, as the health insurance coverage may not be adequate to cover specialized medical care.
Aging with a Disability
As stated in the Gerontology portion of this chapter, aging with a disability can pose particular challenges. Often as those with disabilities begin to age, the familial caregivers become unable to provide care or pass away. This leads many with more severe disabilities to being placed in assisted living facilities, adult foster care, or nursing facilities. Nursing facilities provide around the clock medical care; however assisted living facilities and adult foster care homes do not.
Health insurance is also a major issue for those aging with a disability. For some, health insurance can be easily obtained. Medicaid and Medicare are the two main health insurances utilized by the aging. With the current political climate, it is unsure how available these resources will be for those with disabilities or what services they will provide. Social workers must be ready to contend with an ever changing political landscape of the country.
Abuse and Neglect
People with disabilities, like any other section of the population, are at risk for abuse and neglect. For children with disabilities, any suspected neglect or abuse should be reported to your local Child Protective Services. For adults with disabilities, any suspected abuse or neglect should be reported to your local Adult Protective Services.
Case Study: Carolyn Grant
Case Study: Carolyn Grant
Carolyn is 21-years-old, and autistic with moderate intellectual disabilities. She attends a special school program to assist with her disabilities. On a recent field trip, Carolyn’s teacher left her and two male students unsupervised in the school van for a brief period of time. While the teacher was gone, one of the young men took Carolyn’s shirt off, fondled her bare breasts, and took a picture of them. When the students returned to school, he showed the pictures to other students. Carolyn told her mother about what happened and her mother contacted APS for help.
What to do in the event of abuse/neglect for children with disabilities
What to do in the event of abuse/neglect for adults with disabilities
People with disabilities face challenges in modern society that other population segments do not experience. With the various and sometimes limited resources offered, social workers must know how to navigate a system to better provide for their clients. With the rising cost of health care and an ever changing political environment, social workers are tasked with advocating and serving those in the population who may not be able to do so themselves. Both people of advanced age and people with disabilities are valuable contributing members of our world and as social workers we must stand to make a better future for all.
Alzheimer’s Association. (2017). Alzheimer’s and dementia. Chicago: Alzheimer’s Association National Office.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Association.
Merriam-Webster’s collegiate dictionary (10th ed.). (1999). Springfield, MA: Merriam-Webster Incorporated.
National Adult Protective Services Association. (2017). Abuse case studies. Retrieved from http://www.napsa-now.org/about-napsa/success/abuse-case-study/
National Center on Elder Abuse. (2005).. Washington, DC: National Center on Elder Abuse.