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Usually people with Mental Retardation , Cerebral Palsy , Autism Spectrum Disorder , various Genetic And Chromosomal Disorders such as Down Syndrome and Fragile X Syndrome , and Fetal Alcohol Syndrome are described as having developmental disabilities. This use of the term is synonymous with the use of the term learning disability in the United Kingdom and '''intellectual disability''' in Australia , Europe , Canada and elsewhere. '''Cognitive disability''' is also used synonymously in some jurisdictions. Developmental disabilities are usually classified as severe, profound, moderate or mild, as assessed by the individual's need for supports. CAUSES OF DEVELOPMENTAL DISABILITIES There are many social, environmental and physical causes of developmental disabilities, although for some a definitive cause will never be determined. Common factors causing developmental disabilities include:
Developmental disabilities effect between 1 and 2% of the population in most western countries, although many government sources acknowledge that statistics are flawed in this area. The worldwide proportion of people with developmental disabilities is believed to be approximately 1.4% It is twice as common in males as in females, and some researchers have found that the prevalence of mild developmental disabilities is likely to be higher in areas of poverty and deprivation, and among people of certain ethnicities ([http://www.archive.official-documents.co.uk/document/cm50/5086/5086.htm Valuing People , p. 16). ASSOCIATED ISSUES Physical health issues There are many physical among people with developmental disabilities is estimated at 20 years below average, although this is increasing with advancements in adaptive and medical technologies, and as people are leading healthier, more fulfilling lives {Link without Title} . Mental health issues (dual diagnoses) Mental Health issues, and Psychiatric Illnesses , are more likely to occur in people with developmental disabilities than in the general population. A number of factors are attributed to the high incidence rate of dual diagnoses:
These problems are exacerbated by difficulties in diagnosis of mental health issues, and in appropriate treatment and medication, as for physical health issues [http://www.intellectualdisability.info/mental_phys_health/classification_ac.html . Abuse and vulnerability Abuse is a significant issue for people with developmental disabilities, and as a group they are regarded as vulnerable people in most jurisdictions. Common types of abuse include:
Lack of education, lack of self-esteem and self-advocacy skills, lack of understanding of social norms and appropriate behaviour and communication difficulties are strong contributing factors to the high incidence of abuse among this population. In addition to abuse from people in positions of power, peer abuse is recognised as a significant, if misunderstood problem. Rates of criminal offending among people with developmental disabilities are also disproportionately high, and it is widely acknowledged that criminal justice systems throughout the world are ill-equipped for the needs of people with developmental disabilities (as both perpetrators and victims of crime). [http://www.phac-aspc.gc.ca/ncfv-cnivf/familyviolence/html/fvintellectu_e.html [http://www.thearc.org/faqs/crimjustice.doc] SOCIETAL ATTITUDES TOWARDS DEVELOPMENTAL DISABILITIES Throughout history, people with developmental disabilities have been viewed as incapable and child-like in their capacity for decision-making and development. Until the Enlightenment in Europe, care and asylum was provided by families and the church (in monasteries and other religious communities), focussing on the provision of basic physical needs such as food, shelter and clothing. Stereotypes such as the dimwitted Yokel , and potentially harmful characterisations (such as demonic possession for people with epilepsy) were prominent in social attitudes of the time. The movement towards individualism in the 18th and 19th centuries, and the opportunities afforded by the Industrial Revolution, lead to housing and care using the asylum model. People were placed by, or removed from, their families (usually in infancy) and housed in large institutions (of up to 3000 people, although some institutions were home to many more, such as the Philadelphia State Hospital in Pennsylvania which housed 7000 people through the 1960s), many of which were self-sufficient through the labour of the residents. Some of these institutions provided a very basic level of education (such as differentiation between colours and basic word recognition and numeracy), but most continued to focus solely on the provision of basic needs. Conditions in such institutions varied widely, but the support provided was generally non-individualised, with aberrant behaviour and low levels of economic productivity regarded as a burden to society. Heavy tranquilisation and assembly line methods of support (such as 'birdfeeding' and cattle herding) were the norm, and the Medical Model Of Disability prevailed. Services were provided based on the relative ease to the provider, not based on the human needs of the individual. This segregation of people with developmental disabilities wasn't widely questioned by academics or policy-makers until the 1969 publication of Wolf Wolfensberger's seminal work "The Origin and Nature of Our Institutional Models" {Link without Title} , drawing on some of the ideas proposed by SG Howe a hundred years earlier. This book posited that society characterises people with disabilities as Deviant , sub-human and burdens of charity, resulting in the adoption of that 'deviant' role. He argued that this dehumanisation, and the segregated institutions that result from it, ignored the potential productive contributions that all people can make to society. He pushed for a shift in policy and practice that recognised the human needs of "retardates" and provided the same basic human rights as for the rest of the population. The publication of this book may be regarded as the first move towards the widespread adoption of the Social Model Of Disability in regard to these types of disabilities, and was the impetus for the development of government strategies for desegregation. Successful Lawsuit s against governments and an increasing awareness of human rights and self-advocacy also contributed to this process, resulting in the passing in the US of the ''Civil Rights of Institutionalized Persons Act'' in 1980. By the mid-1970s, some Western governments had begun to close institutions and move people into the community, some of this following the principles of Normalization. In some countries, this was complete by the late 1990s. In others, such as the UK, cuts reversed this process, leading to a revival of old practices of planned corruption, abuse and neglect. The abortion Law changes of 1994 also made discrimination on grounds of perceived potential learning difficulties flagrant. SERVICES AND SUPPORT Today, support services are provided by government agencies, Non-governmental Organisations and by Private Sector providers. Support services address some aspects of life for people with developmental disabilities and are usually theoretically based in community inclusion, using concepts such as Social Role Valorization and increased self-determination (using models such as Person Centred Planning ). Support services are funded through government block funding (paid directly to service providers by the government), through individualised funding packages (paid directly to the individual by the government, specifically for the purchase of services) or privately by the individual (although they may receive certain subsidies or discounts, paid by the government). Education and training See main article: Special Education Education and training opportunities for people with developmental disabilities have expanded greatly in recent times, with many governments mandating universal access to educational facilities, and more students moving out of Special School s and into Mainstream classrooms with support. Post-secondary Education and Vocational Training is also increasing for people with these types of disabilities, although many programs offer only segregated "access" courses in areas such as Literacy , Numeracy and other basic skills. Legislation (such as the UK's Disability Discrimination Act 1995 ) requires educational institutions and training providers to make 'reasonable adjustments' to curriculum and teaching methods in order to accommodate the learning needs of students with disabilities, wherever possible. home and community support Most people with developmental disabilities have always lived in the community, either with family members, or in their own homes (that they rent or own, living alone or with Flatmate s). Home and community supports range from one-to-one assistance from a support worker with aspects of living (such as Budgeting , Shopping or paying bills) to 24-hour support (including assistance with household tasks, such as Cooking and Cleaning , and personal care such as showering, dressing and the administration of medication). The need for 24-hour support is usually associated with difficulty recognising safety (such as responding to a fire or using a telephone) or for people with potentially dangerous medical conditions (such as asthma or diabetes) who are unable to manage their conditions without assistance. Supports of this type also include assistance to identify and undertake new hobbies or to get services (such as education), learning appropriate behaviour or recognition of community norms, or with relationships and expanding circles of friends. Most programs offering home and community support are designed with the goal of increasing the individual's independence, although it is recognised that people with more severe disabilities may never be able to achieve independence in some areas of life. Residential accommodation Some people with developmental disabilities live in residential accommodation (also known as group homes) with other people with similar assessed needs. These homes are usually staffed around the clock, and usually house between 3 and 15 residents. The prevalence of this type of support is gradually decreasing (although not in the UK) as residential accommodation is replaced by home and community support, which offers increased choice for individuals. Employment support Employment support usually consists of two types of support:
Workers with developmental disabilities have historically been paid less for their labour than those in the general workforce, although this is gradually changing with government initiatives, the enforcement of anti-discrimination legislation and changes in perceptions of capability in the general community. Day services Non-vocational day services are usually known as day centres, and are traditionally segregated services offering training in life skills (such as meal preparation and basic literacy), centre-based activities (such as craft, games and music classes) and external activities (such as day trips). Some more progressive day centres also support people to get vocational training (such as college courses) and offer individualised outreach services (planning and undertaking activities with the individual, with support offered one-to-one or in small groups). Traditional day centres were based on the principles of Occupational Therapy , and were created as respite for family members caring for people with disabilities. This is slowly changing (though not in the UK), as programmes become practical to increase independence. Advocacy Advocacy is a burgeoning support field for people with developmental disabilities. Advocacy groups exist in most jurisdictions, working with people with disabilities for systemic change (such as changes in policy and legislation) and for changes for individuals (such as claiming welfare benefits or when responding to abuse). Most advocacy groups also work to support people to increase their capacity for self-advocacy, teaching the skills necessary. Other types of support Other types of support for people with developmental disabilities may include:
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