Rehabilitation of people with disabilities is a process aimed at enabling them to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Rehabilitation provides disabled people with the tools they need to attain independence and self-determination. Before we start on this topic of rehabilitation we must know that what we mean by word disability.
“Disability is a socially created problem and not an attribute of an individual”
Far from being a mere physical fact, disability is also a normative, cultural, and legal construct. What a society at a particular time in its history considers to be a disabling conditioning reflects its conception of a normal and socially functional human being; and hence in a way it reflects society’s self image. For instance, being a female, poor and homeless is considered disabling in several South East and Central Asian societies. The recognition of a physical and mental condition as disabling by a society is also a tacit acceptance by it of its responsibility towards people considered disabled. A society with a deep ethos of social responsibility is likely to be more open in its definition of disability. A very recent and a radical new development is the intervention of disabled people themselves in the social construction of disability. This perhaps is occurring for the first time in human history. It has contributed to a process away from negative definitions of disability as indicating abnormality and impairment to a positive definition that first and foremost asserts essential humanness, understood around notions of human rights and community life, of the disabled that they share with all others, and then within this shared framework identifies special features that make disabled people different from others.
Social values, norms and attitudes are not static and are liable to change depending on a wide range of factors and forces that operate at macro and micro level. Consequently, the formal notion of disability has undergone revisions to accommodate changes in social norms and attitudes.
What is Disability ?
What most often passes for a ‘common sense’ understanding of disability is that it is what ‘is wrong’ with someone.
“Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.
The World Health Organization (WHO) in 1976, provided a three-fold definition of impairment, disability and handicap explaining that ‘an impairment is any loss or abnormality of psychological, physiological or anatomical structure or function; a disability is 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 handicap is a disadvantage for a given individual, resulting from an impairment or a disability, that prevents the fulfillment of a role that is considered normal (depending on age, sex, social and cultural factors) for that individual.’ Such a description frames disability within a medical model, identifying people with disabilities as ill, different from their non-disabled peers and unable to take charge of their own lives. Moreover, the diagnostic parameters of a medical definition do not take note of the imperfections and deficiencies in the basic social structures and processes that fail to accommodate the difference on account of disabilities.
Medical understanding
Those viewing disability through this medical lens concede that it is unfortunate that many disabled people face social exclusion or poverty but these are seen as the result of the natural functional limitations imposed by their ‘disabilities’. Furthermore, as the problem is primarily medical, solutions are generally given over to various caring professionals either to cure, rehabilitate or to protect the individual with a disability.
Social understanding
The international disability movement (as represented by disabled people’s organisations - DPOs) has offered a radical alternative to the medical conception of disability by asserting that people are disadvantaged not by their impairments, but as a result of the limitations imposed on them by attitudinal, social, cultural, economic, and environmental barriers to their participation in society
Who is Disabled ?
According to the Persons with Disabilities (PWD) Act, 1995, “Disability” includes :-
Blindness;
Low vision;
Leprosy-cured;
Hearing impairment;
Loco motor disability;
Mental retardation; and
Mental illness;
The PWD Act (1995) further defines a “person with disability” as suffering from not less than forty per cent of any disability as certified by a medical authority
The PWD Act is currently under legislative review. The new definition of disability will include persons with any impairment that has a ’substantial and long-term adverse effect’ on the ability of a person to carry out normal day-to-day activities. This new defination will also include people diagnosed with Type 1 Diabetes, Cancer, HIV and also persons affected by disabilities listed in the 1995 act who have less than 40% disability.
Causes of Disability
The causes of disability can be broadly classified into three groups: genetic/hereditary factors, biological (including age-related) factors, and accidents.
There is some overlap between the categories as there may be more than one cause of disability: for example, increasing frailty may have contributed to an accident, which in turn may have caused or exacerbated a disability.
The most common causes of disability were diseases of the musculoskeletal system and connective tissue (40%), followed by diseases of the circulatory system (13%), problems of old age (8%), diseases of the respiratory system (7%) and of the ear and mastoid processes (7%). The relative frequency of cerebro vascular disease, diseases of the nervous system (in particular multiple sclerosis), and arthritis and rheumatism increased with severity of disability.
Rehabilitation
Rehabilitation is the process of assisting someone to improve and recover lost function after an event, illness or injury that has caused functional limitations. Rehabilitation is a huge field within health, promoting recovery for people after events such as :Stroke ,Spinal cord injury , Orthopaedic surgery ,Traumatic brain injury , burns.
Rehabilitation in Mental health includes Drug rehabilitation , the rehabilitation of criminal behavior (penology), Rehabilitation therapy aimed at improving neurocognitive function that has been lost or diminished by disease or traumatic injury (neuropsychology),And a branch of psychiatry dealing with restoration of mental health and life skills after mental illness ( Psychiatric rehabilitation)
Assistive technologies
Assistive technologies are applications of modern technology to make it easier for people with disabilities to live their lives independently and with confidence. The first law specifically advocating the development of assistive technology is the Technology-Related Assistance for Individuals with Disabilities Act of 1988. Since then numerous laws have been passed to expand the use of assistive technologies and support their development.
Many of the earliest applications of assistive technology were for people with hearing difficulty. For decades now, telecommunications companies have been required to provide systems that convert between text and speech for the hard of hearing, including teletext and closed captioning. These systems were implemented before the development of effective computer-based text-to-speech, so they were carried out by people trained to listen and type in real time.
Assistive technologies for computer use have boomed in recent years as access to computers and the internet have become a crucial component of modern life. With the help of screen readers and similar technology, people with visual impairments can use the internet almost as easily as a person without visual impairments. This has enabled the visually impaired to have access to the wealth of information available online.
Aside from technologies for the hearing- and visually-impaired, people with other kinds of disabilities also benefit from technology. Mobility technology and durable medical equipment allow people with conditions like cerebral palsy to get around independently-something that would have been nearly impossible not long ago. Mobility technologies have also helped many elderly people live much fuller lives than they would otherwise.
The emerging field of Rehabilitation engineering is the application of engineering sciences to design, develop, adapt, test, evaluate, apply, and distribute technological solutions to problems confronted by individuals with disabilities . The use of robotic devices to augment rehabilitation is the latest field and an emerging world of Rehabilitation robotics. And we are still Growing……………….
