Teacher Information Booklet Please note that the page references throughout this document refer to the Word versions of this document and the Word versions of the other documents cited herein. Page references in PDF and printed versions of these documents will be different. Bar None Community Awareness Kit for Schools ISBN: 978 1 74200 087 9 (print version) SCIS order number: 1417712 Full bibliographic details are available from Curriculum Corporation. Published by Office for Disability Department of Planning and Community Development 1 Spring Street, Melbourne, Victoria 3000 Phone: (03) 9208 3015 or 1300 880 043 (for the cost of a local call) TTY: (03) 9208 3631 (for people who are Deaf or hearing-impaired) Fax: (03) 9208 3633 Email: ofd@dpcd.vic.gov.au Website: www.officefordisability.vic.gov.au September 2009 © State Government of Victoria 2009 This publication is copyright. No part may be reproduced by any process except in accordance with provisions of the Copyright Act 1968. Authorised by the Victorian Government, Melbourne. 1 Ministerial foreword The Victorian Government in collaboration with the Association of Independent Schools of Victoria and the Catholic Education Office has great pleasure in presenting the Bar None Community Awareness Kit for Schools. The Kit builds on the exceptional work of teachers and schools by providing a number of user-friendly resources, aimed at creating welcoming and inclusive school communities for all, including young people with a disability. One in five Victorians has a disability, and like the rest of the community, strive to lead diverse and fulfilling lives. Often, due to physical, communication and attitudinal barriers, people with a disability do not enjoy the same opportunities as other Victorians. The Victorian Government is committed to addressing these issues and is working to ensure that people with a disability actively participate in all aspects of life, including in employment, sports and recreation, and at school, particularly in light of the UN Convention on the Rights of Persons with Disabilities that was ratified by Australia in 2008. As today’s school students move into adulthood and become employers, neighbours, friends and work colleagues, the community will benefit from a greater awareness of diversity and difference. We commend the Kit to you and urge you to share the resources with your teaching colleagues to ensure that the entire school celebrates diversity and difference and becomes a welcoming community for all. Hon Lisa Neville MP, Minister for Community Services Hon Maxine Morand MP, Minister for Children and Early Childhood Development Hon Bronwyn Pike MP, Minister for Education 2 Acknowledgements With the kind permission of the Disability Services Commission, Western Australia, components of this kit were reproduced from the Count Us In! Curriculum Support Package (visit www.disability.wa.gov.au/forschools.html). Parts of these resources were based on The City of Whitehorse Disability Awareness Resource Kit (visit www.whitehorse.vic.gov.au/Page/Download.asp?name=DisabilityA warenessResourceKit.pdf&size=3899183&link=../Files/DisabilityA warenessResourceKit.pdf). Parts of the Teacher Information Booklet are based on the Office for Disability’s Inclusive Consultation and Communication with People with a Disability Guide. This is an updated version of the original guide published by the Department of Human Services in 2004 and was produced with assistance from the Communication Aid Users Society Inc (CAUS) and Westernport Speaking Out Inc. Visit www.officefordisability.vic.gov.au/research_and_resources.htm to view the complete version. The Office for Disability appreciates the input of the following organisations during the development of these resources: 3 Able Australia Alpha Autism Inc Autism Victoria Blind Citizens Australia Brainlink Cerebral Palsy Education Centre Inc. Cystic Fibrosis Victoria Down Syndrome Association of Victoria Epilepsy Foundation of Victoria Fragile X Association Independence Australia Motor Neurone Disease Victoria Multiple Sclerosis Australia Muscular Dystrophy Australia People Living with HIV/AIDS Vic Prader-Willi Syndrome Association of Victoria SANE Australia Scope Victoria Spina Bifida Foundation of Victoria The National Organisation for Fetal Alcohol Syndrome and Related Disorders The Tourette Syndrome Association of Victoria VALID Vicdeaf Vision Australia Youth Disability Advocacy Service (YDAS) Thank you to the Reference Group for their invaluable input and feedback. The group consisted of: 4 Association for Children with a Disability Association of Independent Schools Victoria Australian Education Union Catholic Education Office, Victoria Department of Education and Early Childhood Development Department of Human Services Department of Planning and Community Development Early Childhood Intervention Australia Parents Victoria Star Victoria Victorian Curriculum Assessment Authority Victorian Disability Advisory Council Youth Disability Advocacy Service Thank you to the young people, their families and schools who are featured in the DVD. Thank you to Curriculum Corporation who assisted in producing the Bar None Community Awareness Kit for Schools. 5 Contents Introduction 9 Overview 11 Disability statistics 11 Defining disability 12 History of disability in Australia 15 Disability legislation and policy 18 Rights and responsibilities 18 Students with a disability 20 Blueprint for Education and Early Childhood Development 22 Communication 23 Accessible and appropriate language 23 Accessible and inclusive classrooms 25 Communication devices 29 Understanding impairments 31 Acquired brain injury 31 Autism Spectrum Disorders 32 Cerebral palsy 34 Complex communication needs 36 Cystic fibrosis 37 Deafness and hearing impairment 38 Developmental delay 40 6 Down syndrome 41 Dual sensory loss (Deafblind) 43 Epilepsy 43 Fetal alcohol spectrum disorder 45 Fragile X syndrome 46 HIV/AIDS 47 Intellectual disability 48 Motor neurone disease 49 Multiple sclerosis 50 Muscular dystrophy 51 Prader-Willi syndrome 52 Psychiatric disability 53 Spina bifida 55 Spinal cord injury 56 Tourette syndrome 57 Vision impairment 58 More resources 61 Websites 61 Books 62 Films 66 7 “Sometimes people assume that people with disabilities can’t do certain things. This is a myth! We just need to have friends and others to help us do well at school and do whatever we want with our future. I am a musician, actor, writer and director, as I have learnt that my disability does not need to stop me from doing important and exciting work.” Jess, Steering Committee Member, YDAS. 8 Introduction Given that young people spend so much time there, school is the ideal forum for increasing understanding of, and celebrating, diversity and difference. The Bar None Community Awareness Kit for Schools has been developed to support teachers to raise awareness of inclusion, understanding and tolerance in their classrooms. The kit is for teachers to use with all their students, to enhance their knowledge and understanding of disability and provide both teachers and students with the skills to create a welcoming, inclusive community. The kit is comprised of a number of components: 9 This Teacher Information Booklet provides teachers with general information and aims for a broad-brush understanding of some key issues related to disability. Disability is complex and multi-layered so the information contained is not exhaustive but rather an overview of key statistics, definitions and some suggestions for practical ways to create welcoming classrooms. Teachers are encouraged to source further information by following some of the links and contacts provided. A series of 15 Curriculum Units mapped to the Victorian Essential Learning Standards that include practical and engaging classroom activities for teachers of Prep to Year 8 to incorporate into their teaching and learning programs. A CD-ROM that contains Word and PDF versions of the Teacher Information Booklet, the curriculum units, and the Train the Trainer Module. A DVD that showcases a number of young people with a disability, and their families, teachers and principals. The DVD, which links to the curriculum units, highlights the skills, aspirations and contributions that all students with a disability can make to their school and wider communities. A Train the Trainer Module that links to the DVD and provides teachers and schools with support regarding the practical application of the kit in their teaching and learning programs. Each Victorian school has received one copy of this package, so we suggest you visit www.officefordisability.vic.gov.au/bar_none_kit_for_schools.htm to download and print off further copies to use in your classrooms and share with your teaching colleagues, to ensure the whole school is in a position to create a welcoming community. No doubt, your school and local community already have a number of credible, engaging tools and resources that address similar issues. We encourage you to use these in conjunction with this state-wide kit. 10 Overview Disability statistics In Victoria, 992,300 people have a disability, ie one in every five people or 20% of the population. In Australia, there are 3.9 million people with a disability. There are about 650 million people with a disability worldwide. Disability is strongly correlated to age. In Victoria, the incidence of disability increases with age from 4.4% of children to 95.9% of people aged over 90. As a consequence of our ageing population and medical advances, the incidence of disability in Victoria is increasing and the proportion of people with a disability in our society is growing. For example, in 1981, 15% of people had a disability; in 1993, the proportion had risen to 18% and in 2003 the figure had risen to 20%. The rate of disability among Aboriginal and Torres Strait Islander Australians is almost twice as high as that of nonIndigenous Australians. It is estimated that one in four people with a disability comes from a language background other than English, or is the child of parents from a language background other than English. One in three people knows someone with a disability. About 14% of Victorians care for someone with a disability. Australian figures taken from Australian Bureau of Statistics, Disability Ageing and Carers: Summary of Findings, Victoria, 2003; Australian Institute of Health and Welfare The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples 2008; National Ethnic Disability Alliance Factsheet 1, undated. International figures are taken from www.un.org/ disabilities/index.asp. 11 Defining disability Disability results from the interaction of three factors: medical condition, bodily function, and the social and physical environment. Some medical conditions affect the ability of a person to undertake physical and cognitive activities, for example stretching or reaching, or understanding information. This is called a functional impairment. Disability arises when a person cannot do everyday tasks because their social and physical environment does not account for their impairment. Disability can occur at any time in life. Some conditions that cause disability are present from birth. However, the great majority of people with a disability acquire their impairment as an adult. There are four broad categories of impairment: Intellectual and cognitive impairment People with an intellectual or cognitive impairment experience difficulty with comprehension and learning. Physical impairment Physical impairment affects a person’s mobility and can limit their ability to move about, to get up and sit down, to carry things, and to operate doorknobs, controls and levers. Psychiatric impairment Psychiatric impairment is a general term for illnesses that cause symptoms such as mood changes, psychotic episodes, auditory or visual hallucinations, or delusions. Sensory impairment A sensory impairment affects one or more of the five senses, most commonly hearing and sight. 12 Some people may have more than one type of impairment. For example, a person with a vision impairment may also have an intellectual or cognitive impairment. People with a disability are representative of the diversity of the Victorian population and may belong to a number of communities. Each person’s experience of disability is different. This is influenced by the person’s experiences of their individual condition and impairment, the attitudes of others towards their impairment, how much the community values the differences between people, and how easy it is for a person to get access to information, services and the physical environment. A comprehensive definition of disability appears in the Disability Discrimination Act 1992: Disability, in relation to a person, means: a total or partial loss of the person’s bodily or mental functions; or b total or partial loss of a part of the body; or c the presence in the body of organisms causing disease or illness; or d the presence in the body of organisms capable of causing disease or illness; e the malfunction, malformation or disfigurement of a part of a the person’s body; or f a disorder or malfunction that results in the person learning differently from a person without the disorder or malfunction; or g 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: h presently exists; or 13 i previously existed but no longer exists; or j may exist in the future; or k is imputed to a person. This definition includes conditions that may occur in the future. For example, a person who is well and healthy now may carry a gene that may lead to the development of Huntington’s Disease (a genetic, neurodegenerative disorder). This definition also includes imputed disability, for example a gay man may be discriminated against because it is believed he is HIV positive, whether or not that is the case. The definition includes as a disability such conditions as disfigurement, like a scar or a birthmark. While the cause and type of medical condition that people with a disability have varies greatly, across impairment types there are common barriers that exclude people with a disability. For example, information that is only available in standard print is a barrier to people with impaired eyesight, limited hand coordination or cognitive impairment. Entrances that only have steps are barriers to people with a variety of conditions affecting their ability to move and balance. Negative attitudes are a barrier to most people with a disability, especially people with psychiatric impairments, because of the various assumptions made about their capacity and worth. 14 History of disability in Australia In Australia, at the beginning of the 20th century, parents of children with a disability were commonly advised to place their children into care. As a result, people with a disability were segregated and isolated from the rest of the community and were often affected by sickness, poverty and drastically reduced life expectancy. Community-based organisations which developed in the 1940s and 1950s sought to improve the life chances of people with a disability. These formal supports were based initially on a medical model of disability, typified by segregation and institutionalisation. As parents increasingly rejected advice to institutionalise their children, the 1950s and 1960s saw the emergence of parent groups, the development of some new services and a growing demand for more community-based support services. During this period, and into the 1970s, people with a disability were primarily viewed as recipients of welfare. However, the emergence of the disability rights movement in the 1970s, led by people with a disability, began to change these attitudes and shifted the focus towards recognising the importance of human rights. The United Nations declared 1981 the International Year of Disabled Persons (IYDP). State governments around Australia supported IYDP with numerous grants to many disability groups run by people with a disability, as opposed to groups being run for them. The effect of IYDP was to galvanise support, bring disability into the public eye, and encourage some critical thinking about traditional attitudes to disability. Central to the new thinking was the understanding that it was not necessarily disability itself which made life difficult. It was often the barriers imposed by the environment or by attitudes. If these barriers could be constructed, then they could also be 15 deconstructed, to allow people with a disability to take part in the community. In other words, many of the problems were not about disability but about access or attitudes. This viewpoint is known as the social model of disability. In 1984, the Victorian Equal Opportunity Act was amended to make discrimination on the grounds of disability unlawful. Eight years later, the federal Disability Discrimination Act (DDA) was passed. By this time, people with a disability were no longer regarded as a set of medical symptoms or as welfare recipients, but as citizens in the community. In August 2005, the Disability Standards for Education came into effect. The standards came under the DDA and ensured that students with a disability were able to access and participate in education without experiencing discrimination. In 2006, the Disability Act was passed in Victoria. Also in 2006 a significant development in disability and human rights took place when the United Nations adopted the Convention on the Rights of Persons with Disabilities. This convention is a human rights instrument which reaffirms that all people with a disability must enjoy all human rights and fundamental freedoms afforded to a nation’s citizens. The 2006 Victorian Charter of Human Rights and Responsibilities Act requires public authorities in Victoria to give proper consideration to a range of civil and political rights when they make decisions. Australia ratified the Convention on the Rights of Persons with Disabilities on 17 July 2008. This means that Australia is now a signatory to a legally binding standard recognising people with a disability as equal and active citizens. 16 “Life throws out challenges to everyone and for me, my disability has been the biggest. Having said this, it has inspired me to finish high school and eventually go on and do further study...” Mario, Steering Committee Member, YDAS 17 Disability legislation and policy Rights and responsibilities The increased number and inclusion of people with a disability in the community have led to increased understanding and acceptance. This is reflected in the major legislative changes that have occurred across Australia in which the rights of people with a disability are protected and promoted to ensure they have the same opportunities, responsibilities, choices and access to services and facilities as the rest of the community. Victoria Disability Act 2006 This Act contains a set of principles that promotes the rights and responsibilities of people with a disability. Charter of Human Rights and Responsibilities Act 2006 This Charter ensures that people with a disability are able to enjoy the same civil and political rights and responsibilities as all other Victorians. Equal Opportunity Act 1995 This Act makes it unlawful to discriminate against people with a disability either directly or indirectly. The Victorian Equal Opportunity and Human Rights Commission (VEOHRC) receives more complaints about discrimination against people with a disability than any other personal attribute, such as race or gender. VEOHRC administers the Equal Opportunity Act 1995 and the Charter of Human Rights and Responsibilities Act 2006. Visit www.equalopportunitycommission.vic.gov.au/home.asp. 18 The following website contains further information about all relevant pieces of legislation: www.officefordisability.vic.gov.au/policies_and_legislation.htm. Commonwealth Disability Discrimination Act 1992 The Commonwealth Disability Discrimination Act 1992 has made it illegal to discriminate against a person with a disability, or their carer or family, in the areas of: education and employment access to premises and accommodation buying or selling of land activities of clubs and incorporated associations sport administration of Commonwealth laws and programs provision of goods and services. International UN Convention on the Rights of Persons with Disabilities The UN Convention on the Rights of Persons with Disabilities and its Optional Protocol were adopted in December 2006. Australia ratified the Convention in July 2008. This means that Australia is now a signatory to a legally binding standard recognising people with a disability as equal and active citizens. The general principles of the Convention are: 19 respect for dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons non-discrimination full and effective participation and inclusion in society respect for difference and acceptance of persons with disabilities as part of human diversity and humanity equality of opportunity accessibility equality between men and women respect for the evolving capacities of children with disabilities and respect for the right of children with disabilities to preserve their identities. Article 7 of the Convention relates to children with a disability. It focuses on respecting the interests of children with a disability and ensuring they are the main consideration in all actions. It mandates that children with a disability should have the right to express their views freely. Article 24 of the Convention relates to education. It requires states to recognise the right of people with a disability to an inclusive education and lifelong learning that will enable individuals to realise their potential. For more information on the Convention and other UN-related work, visit www.un.org/disabilities. Students with a disability Victoria The Education and Training Reform Act 2006 This Act ensures that Victoria has a robust and modern legislative framework for education. For further information, visit www.education.vic.gov.au/about/directions/reviewleg.htm. Commonwealth Disability Standards for Education The Disability Standards for Education 2005 clarify and make more explicit the obligations on schools and the rights of students under 20 the Disability Discrimination Act 1992. The standards cover enrolment, participation, curriculum development, student support services and harassment and victimisation. The standards are intended to give students with a disability the same rights as students without a disability. The standards are premised on the fundamental position that all students, including students with a disability, should be treated with dignity and enjoy the benefits of education and training in a supportive environment, which values and encourages participation by all students, including the students with a disability. To achieve this, the standards give students and prospective students with disabilities the right to education and training opportunities on the same basis as students without disabilities. This includes the right to comparable access, service and facilities, and the right to participate in education and training unimpeded by discrimination, including on the basis of stereotyped beliefs about the abilities and choices of students with disabilities. The standards apply to all Victorian schools (government, independent and Catholic), TAFE institutes and universities. For further information, visit www.ag.gov.au/www/agd/agd.nsf/Page/Humanrightsandantidiscri mination_DisabilityStandardsforEducation For other relevant policies, guidelines and protocols, visit the following websites: Department of Education and Early Childhood Development (DEECD) For information regarding the programs for students with disabilities, visit www.education.vic.gov.au/healthwellbeing/wellbeing/disability/defa ult.htm 21 Catholic Education Office of Victoria Use the search function, type in ‘disability’; relevant programs and requirements are listed. www.ceo.melb.catholic.edu.au Association of Independent Schools of Victoria (AISV) Use the search function, type in ‘disability’; relevant programs and requirements are listed. www.ais.vic.edu.au Blueprint for Education and Early Childhood Development The Blueprint encompasses both education and early childhood services, and government and non-government schools. It articulates a shared goal for all Victorian children and young people and aims to provide high-quality universal learning and development opportunities. The vision is that ‘every young Victorian thrives, learns and grows to enjoy a productive, rewarding and fulfilling life, while contributing to their local and global communities’. The vision is underpinned by a clear set of priorities, outcomes and strategies for achieving them. For further information, visit www.education.vic.gov.au/about/directions/blueprint2008/ default.htm. 22 Communication Accessible and appropriate language Language reflects and shapes the way we view the world. How we write and speak about people with a disability can have a profound effect on the way people with a disability are viewed by the community. Some words, by their very nature, degrade and diminish people with a disability. Others perpetuate stereotypes, removing entirely a person’s individuality. People with a disability are individuals first, with the same variety of desires, interests, problems, talents and faults as any other member of the community. Through the use of appropriate language, emphasis can be placed on this individuality, rather than on the disability. Communicating with and about people with a disability Making communication more accessible means you need to think about how you communicate and engage with people with a disability. The following points will help to ensure that our communication with and about people with a disability is positive and inclusive: 23 Put the person first, not their disability. For example, use the term ‘a person with a disability’ rather than ‘a disabled person’. Avoid stereotypes or labels, such as ‘the handicapped’, ‘the blind’ or ‘the disabled’. While many people may have the same or similar disabilities, they are all unique individuals who deserve to be treated with respect and dignity. Avoid using words and phrases that can be demeaning to people with a disability. For example, use ‘people who use a wheelchair’ rather than words such as ‘crippled’, ‘wheelchair- bound’, ‘incapacitated’ and ‘suffering from’. Talk about ‘people without disabilities’, rather than ‘able-bodied’ or ‘normal’ people. Remember, people with a disability can use whatever language they feel is appropriate to describe themselves. Face-to-face communication The following points will help you communicate more effectively with people with a disability. Remember, it’s okay to offer assistance to people with a disability, but it’s important to ask before you ‘jump in’ to help. Ask ‘Do you need a hand?’ or ‘Would you like assistance?’. If a person with a disability is accompanied by another person, address your questions directly to the person with a disability, rather than to the person with them. Don’t make assumptions or have preconceptions about people’s ability to understand. Speak to a person with a disability as you would speak to anyone else. In some situations, it may be useful to clarify that the person has understood what you have said. You might do this by asking open-ended questions, rather than questions requiring a ‘yes’ or ‘no’ answer. Remember that your body language is important. People with an intellectual disability or cognitive impairment often rely heavily on visual cues. For example, a frown or a sigh might be interpreted as displeasure and might influence the answers people give you. Written communication The following are some general points to remember: 24 Where feasible, provide information in a range of formats, such as video, audio tape, plain English or picture versions. Use pictures or drawings throughout your document to make it more interesting and easier to understand. For large documents, consider producing a summary version of your information to make it easier to read and comprehend. Use a larger font size and a sans serif font, as it is easier to read (for example, Tahoma, Arial, Courier or Helvetica in 14 or 16 point). Be specific and direct. Avoid jargon and acronyms wherever possible. Consider using posters that combine graphic images and verbal information if you need to convey a message over a longer period of time. Written information is generally accessible to people who are Deaf or who have a hearing impairment. However, you should use plain English. This is because English is sometimes the second language of people who use Auslan (Australian Sign Language). People with a print disability cannot read because they have a vision impairment or, due to a physical disability, have difficulty holding or turning a page of a printed document. Some people with developmental delay also have a print disability. Digital books and talking equipment, such as calculators and clocks, are often used by people with a print disability. Accessible and inclusive classrooms Like everyone in your classroom, students with a disability will require support to enhance their learning experience and to ensure they are reaching their full potential. Implementing the following steps, along with the tips in the ‘Accessible and appropriate language’ section of this booklet, and each student’s individual learning and support program, will ensure your classrooms are inclusive and welcoming for all. Working with 25 the student and their family regarding their individual needs and preferred learning styles will ensure optimal outcomes. These simple steps will not only benefit students with a disability, but also cater for different learning styles and even young people from language backgrounds other than English. People who are blind or have a vision impairment Provide enlarged worksheets. Use a larger font size and a sans serif font, as it is easier to read (for example, Tahoma, Arial, Courier or Helvetica in 14 or 16 point). Use dark pencils and markers to write. Use tactile cues to represent objects. Supply magnified or low vision devices, if appropriate. Use equipment with sound cues, where practical. It is important to explain the following points to all students: 26 When you meet a student who is blind or who has a vision impairment, always address him or her by name and introduce yourself by name. Make sure you are facing the student or students to whom you are speaking. When you enter or leave a room, say something that indicates your presence or that you are leaving. This will ensure the student who is blind or who has a vision impairment will not be embarrassed by speaking to an empty space. Speak clearly and in a normal voice. Most people who are blind or who have vision impairment can hear clearly. There is no need to raise your voice. Make sure you verbalise your thoughts and feelings. A person who is blind or who has a vision impairment cannot rely on the same visual cues as people who do not have vision impairment. When meeting a person who is blind or vision impaired, it is important to respect physical boundaries and apply the same courtesies as you would to anybody else. Unless a person asks for your hand/elbow for assistance, do not assume you can touch them. All students should be conscious of pushing their chairs under the desk when they are not occupied and should keep classroom furniture in the same place. People who are Deaf or hearing-impaired 27 Gain the student’s attention before speaking. Try a gentle tap on the shoulder, a wave or some other visual signal to gain attention. Face the student directly and maintain eye contact, positioning yourself opposite them and at the same level if possible. Look directly at the person while speaking. Even a slight turn of the head can make it difficult for them to read your lips. Make sure your mouth is visible. Speak evenly, not too fast or slow. Don’t exaggerate your mouth movements, as this will make it more difficult to lip-read. Do not shout; keep your volume up but natural. Use short sentences. Use gestures, visual cues and facial expressions to support what you say. If the student does not reply or seems to be having difficulty understanding, try to rephrase your message instead of repeating it exactly. If necessary, write down key words, or write down the message in simple language. It is better to communicate in writing than have messages misunderstood. It is important to ensure that all Deaf students/Deaf parents have access to an Interpreter when required. Visual clues, such as flashing lights to notify Deaf or hearingimpaired students of key bell times and so on, are also important. All students should be made aware of the following points: In written information, you may see the word ‘deaf’ with a lower-case, or small, ‘d’ when it refers to all people who are deaf or hearing-impaired. As a general rule, an upper-case, or capital, ‘D’ should be used when referring to Deaf people with a severe to profound degree of deafness (or hearing loss) who form a community with common language, shared cultural values, and a sense of history and continuity. Australian Sign Language (Auslan) is a community language used by Deaf people in Australia. It is a visual and living language with its own signs, syntax, grammar and idioms. It cannot be written in English word order, but skilled sign language interpreters can translate it into English. Finger spelling is a part of Auslan and represents letters of the alphabet. It is usually used for names of people and places. Not all hearing-impaired people use Auslan to communicate. Some people have residual hearing, which means that they have some hearing and can hear with the assistance of hearing aids or other devices. Others may lip-read. People who have mobility impairments and people who use wheelchairs 28 Ensure there is clear space for the person using the mobility aid/wheelchair to move about freely and turn. This may mean moving the classroom furniture around. In certain activities, particularly those that involve moving around the classroom or group activities, ensure there is extra time for the person to complete a task or have their turn. Ensure that short breaks are factored into planning for longer classroom activities. Ensure that stationery and other classroom items are easily accessible. Provide assistance, when requested. People who have an intellectual disability or cognitive impairment Give clear, short instructions, one at a time. In certain activities, ensure there is extra time for the student to complete a task or have their turn. In some instances, a student may need to be shown what has to be done, and sometimes more than once. Be prepared to use visual information. For example, people with an intellectual disability or cognitive impairment may use gestures or pointing to make their ideas clear. Rephrase information, using different words, if the person does not understand you. Keep your questions simple and make your answers easy to understand. Use short sentences. However, make sure you don’t lose the meaning of your information by using too few words. Give clear explanations of new or complex concepts. If you must use specialised words or concepts, make sure you explain them. Be specific and direct. Avoid acronyms, metaphors, puns and colloquialisms. For example, use ‘trains, trams and buses’ rather than ‘transport services’. Consider using photos or drawings to support and clarify your communication. Communication devices Some people with a disability use communication devices to assist them in expressing and receiving information. Below is a list of some of these devices. Teachers are encouraged to visit the websites listed on pages 36-37, 40 and 60 for further information. 29 30 Audio is most useful if the information can be read from beginning to end without needing to refer to other parts of the document. Braille is a system of writing used by people who are blind. In Braille, characters are represented by patterns of raised dots. Anything can be translated into Braille, including text, music, mathematics and foreign languages. A Teletypewriter (TTY) facility enables people who are Deaf or hearing-impaired to contact you. A TTY uses the telephone network to transmit text messages between TTYs. The user types a message onto a keyboard or computer that is connected to a telephone handset or modem. A TTY is not difficult to use. It is just like communicating over the telephone – only you type rather than speak. Makaton is a system used by people with little or no speech, who use key word signing to support their communication. Pictographs are visual cues that are clear and representational of the real thing or concept. Both adults and children can use the pictographs in a variety of settings to assist with overcoming communication and/or literacy difficulties. Pictographs help bridge the gap where communication is not occurring. The pictographs can be used in a variety of ways, depending on the requirements of the user. Communication can be assisted by the pictographs in situations where the user has communication difficulties due to physical disability, cognitive impairment or acquired brain injury, poor literacy skills or where English is a second language. Some common pictograph products are Boardmaker® and Photosymbols®. Understanding impairments The following information provides a short overview of a number of impairment types and the details of individual organisations to contact for further information. The list is not exhaustive, and we encourage teachers to follow the links provided, as well as use authoritative sites on the internet and other resources to seek more detailed information. The Office for Disability website also provides a database of guest speakers who are willing to speak at schools on a range of topics related to disability in general or some of the specific impairment types detailed below. Acquired brain injury Acquired brain injury (ABI) refers to any type of damage to the brain at any age from birth onwards. Damage to the brain can occur in many different ways: through illness, such as Alzheimer’s disease, a heavy blow to the head, or by the head being forced to move rapidly forwards and backwards, such as in a car accident. This sort of brain injury is often accompanied by a loss of consciousness: either short-term (less than 30 minutes) or longterm (hours, days, months), which is called coma. The effects of brain injury can be mild or severe, temporary or permanent. Some common causes of brain injury are: 31 car accidents and sporting assaults falls tumours strokes and aneurysms infections such as meningitis and encephalitis alcohol or substance abuse interruption of oxygen supply to the brain during near drowning, heart attack or suffocation, and neurological disorders such as dementia. Even minor brain injury can have a lasting impact. Sometimes the problems caused by minor brain damage are difficult to detect. For example, a person may feel less able to concentrate; they may be more forgetful or have more trouble making decisions. ABI is often called ‘the hidden disability’ because it can cause problems with a person’s cognitive functions (patterns of thinking and behaviour). These new thought processes, habits and unusual behaviours are not as easy to recognise as other physical disabilities. As a result, the challenges people with brain injury face are often misunderstood and ignored by others. Resources For more information, including fact sheets and booklets, visit www.brainlink.org.au or call (03) 9845 2952, or www.braininjuryaustralia.org.au or call (02) 8507 6555. Events Brain Injury Awareness Week is held annually in September. Autism Spectrum Disorders Autism Spectrum Disorders (ASDs) are neurodevelopmental disorders that cause substantial impairments in social interaction and communication and are associated with unusual behaviours and interests. Although not officially defined in any international medical classification code, the term ‘Autism Spectrum Disorder’ is commonly used to encompass Autistic Disorder, Asperger’s syndrome, and pervasive developmental disorder – not otherwise specified, which is also know as Atypical Autism. Some people with Autistic Disorder with an IQ in the typical range may also be described as having high-functioning autism. Although the cause of ASDs is unknown, it can be identified from early childhood onwards and affects a person throughout their whole life. 32 ASDs occur in all racial, ethnic and socioeconomic groups and are four times more likely to occur in boys than in girls. ASDs are described according to a spectrum, with varying degrees of pervasive impairment that range from mild to severe. The thinking and learning abilities of people with ASDs can vary – from gifted to severely impaired, with about 80% having an associated intellectual disability and 20% with intelligence within the normal range. Although people with these disorders exhibit impairment in social interaction, restricted, repetitive and stereotyped patterns of behaviour, interests and activities, and impairment in communication, they can also present measurable and admirable differences in perception, attention, memory and intelligence. The core features of an ASD include impairment in three main areas of functioning: Social interaction – one of the key features of Autism is differences in interpersonal relationships, such as reduced interest in people, an appearance of aloofness and a limited or impaired ability to relate to others. Communication – people with Autism usually have markedly delayed and disordered speech. Play and behaviour – people with Autism usually have rigid and limited play patterns with a noticeable lack of imagination and creativity. They may repetitively line up toys, sort by colour, or collect various objects such as pieces of string, special stones or objects of a certain colour or shape. Intense attachment to these objects can occur, with the child showing great distress if these objects are taken away or patterns disrupted. Information from this section has been taken from the following report: Tonge, B, Brereton, A and Bull, K (2008). Life Transition Problems: Young People with Autism Spectrum Disorders (specifically Dr A Brereton, Monash University, School of Psychology, Psychiatry and Psychological Medicine). 33 Resources For further information, visit Autism Victoria at www.autismvictoria.org.au/home or call (03) 9657 1600. For information about the Autism State Plan, go to the Department of Human Services website at http://autismstateplan.dhs.vic.gov.au. The guidelines (particularly section 3) listed on the following New Zealand government website have some useful information: www.moh.govt.nz/moh.nsf/indexmh/nz-asdguideline-apr08. Events Autism Awareness Month runs each year in May. For events in Victoria, visit www.autismvictoria.org.au/news/media.php. World Autism Awareness Day is held each year on 2 April. For further information, visit www.worldautismawarenessday.org/site/c.egLMI2ODKpF/b.39170 65/k.BE58/ Home.htm. For other ASD-related events, visit www.autismvictoria.org.au/events/victoria_ events.php. Cerebral palsy In Australia there are 20,000 people with cerebral palsy (CP). Currently, 2.5 people per thousand live births have CP. It is important to remember that cerebral palsy is a wide-ranging condition and affects people in many different ways – no two people with CP are affected in the same way. CP is a broad term for a wide range of physical impairments caused by damage to the parts of the brain that control movement, coordination and posture. CP affects the messages sent between the brain and the muscles. ‘Cerebral’ refers to the brain; ‘palsy’ can mean weakness or paralysis or lack of muscle control. 34 The term ‘CP’ is used when the damage has occurred to the developing brain either before or during birth or early in life. The damage is permanent and non-progressive, but the effect of the damage changes over times as the child grows. People with mild CP may have difficulties with movements requiring a greater degree of control, for example doing up buttons or riding a bike. People with severe CP may have many difficulties and require help with some or all aspects of daily life. Different parts of the body may be affected in different ways. For example, the legs may be affected more than the arms, or the right side may be affected more than the left. CP can result in tight muscles, poor control and coordination of the body and limbs, uncontrollable or jerky movements, poor balance and difficulty with speech and eating. Other disabilities or medical conditions may also be present. These may include hearing and vision impairments, epilepsy, difficulties in communication, impaired intellectual ability and learning difficulties. Difficulties in moving and speaking can affect participation in all school activities including the student’s ability to demonstrate what they are learning in the same way as their peers. Specialist educators and therapists will assist school personnel in identifying how movement problems can affect the student’s active participation. Together with teachers they plan ways that the student with CP can participate and learn. Resources CPEC runs professional development for schools that have children with Cerebral Palsy. For further information, visit the Cerebral Palsy Education Centre Inc. (CPEC) website at www.cpec.com.au or call (03) 9560 0700. Also see Scope’s website for the Scope Young Ambassador’s Program and information and training packages for schools at www.scopevic.org.au or call (03) 9843 3000. 35 Events National Cerebral Palsy Awareness Week is held nationally each year, usually in August. Visit www.tccp.com.au/content.php?page=319 for more details. Complex communication needs Complex communication needs (CCN) is a term used to describe the needs of people whose oral speech skills limit their ability to meet all of their participation and communication needs and their ability to participate independently in society. CCN may be experienced by people with developmental or acquired disabilities and may result from temporary or permanent conditions. Speech or language difficulties may be mild, moderate or severe. People who have CCN may use augmentative or alternative communication (AAC) strategies and techniques to support their communication. AAC may be used as an alternative to oral speech, to augment oral speech and/or to support expressive language and/or receptive language. The person may fit into one of the following categories: People who do not use oral speech and use AAC predominantly to support expressive and/or receptive language. People who use oral speech and may use AAC to support their receptive and/or expressive language. Resources The Communication Resource Centre at Scope has useful information: visit www.scopevic.org.au/therapy_crc.html or call (03) 9843 3000. Communication Rights Australia has some resources that will assist teachers. Visit the ‘products’ section on the website at www.caus.com.au or call (03) 9555 8552. 36 Other useful sites include http://aacintervention.com/index.htm and www.agosci.org.au. The website at http://depts.washington.edu/enables/myths/myths_aac_purpose_ edu.htm has some videos about young people using AAC in the classroom. Cystic fibrosis Cystic fibrosis (CF) is an inherited, recessive genetic condition which mainly affects the lungs, digestive system and the sweat glands. In Australia, a baby is born with CF every four days. The incidence is one in every 2,500 births. There are about 3,000 people with CF in Australia, and it is most common among Caucasians. CF is a life-shortening condition, and in the past most children with the condition did not survive childhood. However, today with improved treatment most people with CF are living into their late thirties and leading normal and productive lives. At present, there are promising research developments in a number of areas including gene therapy. In Australia, one in 25 people carries the gene for CF. Carriers do not have any symptoms of the condition. For a person to be born with CF, the gene must be passed on by both parents. CF is not contagious. Treatment for CF can be intensive and time-consuming. At present, there is no cure for CF and treatment is aimed at slowing progression of the condition. Almost all people with CF show some symptoms. Typically, they live with mild, moderate or severe lung disease and gastrointestinal problems. People with CF have a low immune system. Therefore other students with respiratory illness, gastroenteritis and chicken pox represent a significant health risk to the person with CF. A young person with CF may have the following symptoms: chronic coughing, sputum (phlegm) production, shortness of breath, pale appearance and frequent respiratory infections. 37 People with CF are usually encouraged to consume large meals that are high in protein, fat, salt and calories, and they need daily supplemental vitamins. Some young people need a mid-morning or mid-afternoon snack to help maintain proper nutrition. CF does not impair intellectual ability in any way. Most students with CF have a good attendance record but will require time off for clinic appointments and possible hospital admissions. Resources Cystic Fibrosis Victoria has developed a handbook and a number of other useful resources for teachers. Visit www.cfv.org.au or call 1800 633 685. Deafness and hearing impairment Hearing loss may occur as a result of congenital or hereditary factors, infection, trauma, ageing or exposure to excessive and prolonged noise. Descriptions of deafness and hearing impairment include the following: Deaf A medical term describing a significant hearing loss. Some people who are Deaf view themselves as members of the Deaf community and communicate in Auslan (Australian Sign Language). Members of this community are often described as Deaf, not deaf. The capitalisation of the letter denotes a linguistic and cultural allegiance to a minority community. Hard of hearing A term used to describe people who have a hearing loss and communicate predominantly orally. A person with a hearing loss can generally respond to auditory stimuli, including speech. 38 Hearing-impaired A generic term used to describe people with any degree of hearing loss. Most people who are Deaf dislike the term ‘hearing-impaired’, believing it promotes a negative image of Deaf people as defective and needing to be fixed. People who identify themselves as ‘hard of hearing’ may use the term ‘hearing-impaired’ interchangeably. Conductive hearing loss A condition arising from a problem in the external or middle ear. Conductive hearing losses do not cause the hearing to be lost completely, but there is a loss of volume. Sounds may be quiet but there is no distortion. Most types of conductive hearing loss can be treated medically or surgically. Causes include: an accumulation of earwax a collection of fluid in the middle ear abnormal bone growth in the middle ear middle-ear infections perforation of the ear drum. Sensorineural hearing loss With this type of deafness, people have problems with the cochlear or with the nerve which carries sound to the brain. Sensorineural hearing loss cannot be rectified surgically. The process by which a hearing loss affects language development is complex and multidimensional. Without ageappropriate communication skills, a child will find accessing education extremely difficult, therefore an early diagnosis of deafness is vital to help a child develop effective communication. Any degree of hearing loss affects a student’s ability to access their environment and can result in reduced opportunities to: 39 learn incidentally (for example, language and speech, general knowledge, social behaviour) acquire accurate speech and language patterns access information (through television, radio, tape, videos and theatre) communicate effectively. Some students may have parents who are Deaf and this may affect parent/teacher and student/parent/teacher interactions. It is important that schools ensure full participation by organising interpreters for events such as parent–teacher interviews. Resources Vicdeaf produces a Student Information Kit on Hearing Loss and Deafness as well as a number of information sheets. Vicdeaf also organises Deaf Awareness Training and Hearing Awareness Training. For details, visit www.vicdeaf.com.au or call (03) 9473 1111. The Aussie Deaf Kids website at www.aussiedeafkids.org.au provides relevant and easy-to-access information. It has online support and resources relating to children who are Deaf and hard of hearing, living in Australia. Also visit www.deafchildrenaustralia.org.au. Developmental delay Developmental delay refers to when a child does not reach developmental milestones at the expected times. It is an ongoing, major delay in the process of development that is expected to continue indefinitely and impairs the child’s ability to function in society. Developmental delay does not refer to a child who is slightly or only temporarily behind. Delay may occur in one or many areas of development: 40 gross motor – how children move fine motor – how children manipulate objects and use their hands speech and language development – how children communicate, understand and use language cognitive or intellectual development – how children understand, think, learn social and emotional development – how children relate with others and develop increasing independence. The term ‘developmental delay’ is often used in early childhood until the exact nature and cause of the delay is known. If the delay in development persists, it is usually related to problems in one or more of the following areas: understanding and learning moving communication hearing vision. A child with developmental delay is at risk of developmental disability but the outcome may not always be a lifelong disability; there are children who make good progress. Developmental delay can have many different causes, such as genetic causes (for example Down Syndrome), or complications of pregnancy and birth (for example prematurity or infections). Often, however, the specific cause is unknown. Some causes can be easily reversed if diagnosed early enough, such as hearing loss from chronic ear infections. Resources For further information, see www.rch.org.au/paed_handbook. Down syndrome Down syndrome is the world’s most common chromosomal disorder and cause of intellectual disability. It is not an illness or disease, and occurs at conception. It occurs in one of every 700 to 900 births worldwide and affects people of all ethnic and social 41 backgrounds. In Victoria, 45 to 65 babies are born each year with Down syndrome. The human body is made up of millions of cells, and in each cell there are 23 pairs of chromosomes, or 46 chromosomes in each cell. Down syndrome is caused by the presence of an extra chromosome, chromosome 21 (Down syndrome is also known as trisomy 21). People with Down syndrome therefore have 47 chromosomes in their cells instead of 46. This results in a range of physical characteristics, health and development indications and some degree of intellectual disability. Down syndrome is usually recognisable at birth and confirmed by a blood test. Down syndrome affects, but does not determine, development. People with Down syndrome are unique, with their own talents, abilities, thoughts and interests. Everyone with Down syndrome will experience some delay in all areas of their development, and some degree of learning disability. This will vary, however, from individual to individual. What happens after birth will be far more important in shaping the outlook for any individual with Down syndrome than the presence of an extra chromosome. Children with Down syndrome generally take longer to learn new skills and may require a greater degree of structure in activities than classmates in order to work independently. New skills may need to be broken down into smaller steps, and significantly more repetition may be required to retain learned skills. People with Down syndrome generally have specific difficulties with short-term memory, which affects learning spoken language, learning from listening and abilities in reasoning and problem solving. On the other hand, children with Down syndrome tend to show strength in visual learning and will benefit greatly from visual aids, cues and reinforcements. With appropriate education and health services, people with Down syndrome can look forward to long and fulfilling lives as valued and contributing members of their families and the broader community. 42 Resources Down Syndrome Association of Victoria has a range of materials available for education professionals. For further information, visit www.dsav.asn.au or call 1300 658 873. Events A world-wide Down Syndrome Day is held each year in March, while Down Syndrome Awareness Week is held nationally in October. Dual sensory loss (Deafblind) Deafblind describes a combination of vision loss and hearing loss. A person who is Deafblind may or may not have other physical or cognitive disabilities; each individual is different. Many people will not be totally deaf and totally blind but may have some remaining use of one or both senses. Others will have additional physical and/or learning disabilities. Hearing loss causes difficulties communicating with people using spoken language, and vision loss causes problems using visual languages, such as sign language. People who are Deafblind often use tactile signing, where sign language is received by placing hands over the signing hands. Resources Able Australia has recently developed a teacher’s guide as part of a Deafblind education program that aims to raise awareness of dual sensory loss. The resource is targeted at primary schools. For further information, visit www.ableaustralia.org.au or call 1300 225 369. Events Each year, Deafblind Awareness Week is held internationally in the last week of June. Visit the website above for further details. 43 Epilepsy Epilepsy is defined as a tendency to have recurrent seizures, and it is the most common serious brain disorder. A seizure occurs as a result of a sudden, usually brief, excessive electrical discharge in a group of brain cells. A seizure can consist of any of the following: a blank stare, tremors or jerks, a convulsion with a total loss of consciousness, strange feelings and sensations, unusual tastes or smells, lip-smacking and chewing, visual disturbances, aimless wandering or fiddling with clothes or objects. There are two main groups of seizures – partial and generalised. Partial seizures begin in one part of the brain. The effect of a partial seizure will depend on where the seizure occurs in the brain and what function that part of the brain controls. There are two types of partial seizures – simple partial and complex partial. There are a number of different generalised seizures, the most common of which is the tonic clonic seizure (formerly known as grand mal). Absence seizures (formerly known as petit mal) commonly begin during pre-school or primary school years. These are another example of a generalised seizure. People’s epilepsy circumstances vary significantly, and it is vital that schools take an individualised approach when supporting students with epilepsy. This process is enhanced by developing individualised epilepsy management plans that are informed by all relevant information about each student’s circumstances, such as seizure type/s, triggers and first aid protocols. Resources For further information about epilepsy, resources and education and management plans, visit the Epilepsy Foundation of Victoria website at www.epinet.org.au or call 1300 852 853. For information about planning for and supporting students with epilepsy in schools, visit 44 www.education.vic.gov.au/management/governance/referenceguid e/enviro/4_5.htm. Events The Victorian Epilepsy Awareness Week is held the week after Mother's Day in May each year. Trivia Challenge, an epilepsy awareness and education program linked to VELS is run each year for primary and secondary schools. A Family Respite Camp is also help annually. Visit www.epinet.org.au or call 1300 852 853 for information. Fetal alcohol spectrum disorder Fetal alcohol spectrum disorder (FASD) is a term that describes the range of effects that can occur in an individual who was exposed to alcohol during pregnancy. Alcohol is a neurotoxin (poison) and a teratogen, an agent that is known to cause birth defects and permanent brain injury to the fetus. The effects include physical, mental, behavioural and learning disabilities, with possible lifelong implications. FASD is not a diagnostic term. It represents a spectrum of disorders and includes the diagnostic terms of fetal alcohol syndrome, alcohol-related birth defects and alcohol neurodevelopmental disorder. Children with diagnoses included under the general term FASD often have: 45 brain damage poor growth developmental delay difficulty learning problems with vision difficulty remembering language and speech difficulties poor judgement birth defects social and behavioural issues low IQ or IQ that falls within the normal range difficulty sleeping high levels of activity a short attention span problems with abstract thinking difficulty forming and maintaining relationships. Resources For further information, visit the National Organisation for Fetal Alcohol Syndrome and Related Disorders at www.nofasard.org.au. Some other useful websites: www.elizabethrussell.com.au/russell-family-fetal-alcohol-disordersfoundation www.den.org.au http://fas-lorianhayes.tripod.com Fragile X syndrome Fragile X syndrome (FXS) is a genetic disorder caused by a mutation (a change in the DNA structure) in a gene on the X chromosome. It is the most common known cause of inherited developmental disability. Some individuals have the full mutation and are severely affected while others may fall into the premutation or carrier range. One in 4,000 males have the full mutation and one in 800 males are carriers. Fewer females have the full mutation but one in 260 are carriers. Individuals with FXS can present very differently. However, children may show a delay in speech, and in fine and gross motor 46 movements and coordination and experience learning difficulties. Speech is often repetitive, and stuttering may be a problem. Males with FXS frequently test in the mild to moderate range of intellectual disability when they are young. However as they grow older, they are sometimes reassessed as moderate or may even be in the severe range. Behavioural characteristics in males may include attention deficit disorders, speech disturbances, hand biting, hand flapping, autistic behaviours, poor eye contact and unusual responses to various touches, auditory or visual stimuli. The characteristics seen in males can also be seen in females, though females often have milder intellectual disability and a milder presentation of the behavioural or physical features. Intellectual disability occurs in all males who have the full mutation. About 60% of females who have the full mutation will have some degree of learning difficulties, which can vary from mild to severe. Resources For further information visit www.fragilex.org.au or call 1300 FX INFO. HIV/AIDS HIV stands for human immunodeficiency virus. It was identified in the early 1980s and belongs to a group of viruses called retroviruses. Recent research indicates that HIV existed as far back as the early 20th century. HIV prevents the body’s immune system from working properly. Normally, the immune system would fight off an infection, but HIV infects key cells in the body’s natural defences called CD4 cells, which coordinate the body’s response to infection. HIV can’t be cured but can be treated, and modern HIV treatments mean that many people with HIV are living long and healthy lives. However, they are still living with a chronic, life-threatening 47 condition, and there are considerable impacts on their overall health and wellbeing. If HIV isn’t treated, the gradual weakening of the immune system leaves the body vulnerable to serious infections and cancers which it would normally be able to fight off. These are called ‘opportunistic infections’ because they use the opportunity of the body’s weakened immunity to take hold. AIDS stands for acquired immune deficiency syndrome. If you develop certain opportunistic infections, you are diagnosed as having AIDS. Different people diagnosed as having AIDS may become unwell with different illnesses, depending on the specific opportunistic infections they develop. This is why AIDS is not considered a disease, but a syndrome – a collection of different signs and symptoms, all caused by the same virus, HIV. Resources The People Living with HIV/AIDS Victoria Inc website has some useful information: visit www.plwhavictoria.org.au or call (03) 98656772. Other useful sites include the following: www.vicaids.asn.au www.can.org.au www.napwa.org.au www.health.vic.gov.au/ideas/diseases/sti_hiv_questions The Department of Education and Early Childhood Development has a comprehensive guide to educating all school communities on sexually transmitted illnesses, including HIV. Visit www.education.vic.gov.au/studentlearning/teachingresources/healt h/sexuality/about.htm. Intellectual disability 48 Intellectual disability is a broad term used to describe any disability that significantly affects a person’s learning ability and development. Although the extent and nature of such disability varies a great deal with each person, people who have intellectual disability will have difficulties in learning, understanding, analysing or thinking things out. Sometimes people may also have difficulty in acquiring competence in one or more of the following areas: language, physical or social development. Intellectual disability is a lifelong disability that can affect many different areas of a person’s life. More than three-quarters of people with an intellectual disability have a mild intellectual disability. The remainder have a range of moderate, severe or profound intellectual disabilities and possibly some associated physical disabilities. An intellectual disability may become apparent early in life or may not be diagnosed until school age or later. Many factors can cause intellectual disability. However, in many cases, no identifiable cause is found. Some known causes include: brain injury during or after birth disorders of metabolism, growth or nutrition genetics chromosome anomalies extreme prematurity poor diet and inadequate health care, and drug misuse during pregnancy. Having an intellectual disability does not mean that a person is unable to learn. With appropriate support and training, people with an intellectual disability can develop skills which enable them to actively participate in daily life to their individual ability level. 49 Intellectual disability is not the same as mental illness or acquired brain injury. There are significant differences, even though in some cases the effects may appear to be the same. Resources Star Victoria provides a number of relevant resources. For further information, visit www.starvictoria.org.au or call 03 9650 2730. Motor neurone disease Motor neurone disease (MND) is the name given to a group of diseases in which the nerve cells (motor neurones) controlling the muscles are destroyed – those that enable us to move, speak, breathe and swallow. With no nerves to activate them, the muscles gradually weaken and waste away, resulting in a lack of mobility, loss of speech and eventually the inability to breathe. For most people, intellect and memory are not affected, nor are the senses of sight, hearing, taste, smell and sensation. Fronto-temporal cognitive changes (a type of dementia) have been associated with MND and are prominent in 5–10% of cases. Neuro-psychological studies also suggest that about one-third of people with MND may have very mild changes in cognitive skills. The cause of MND is essentially unknown. However, in 10% of cases, MND is inherited. Early symptoms may include stumbling, difficulty in holding objects, slurring of speech and difficulty swallowing. MND is predominant in people over 40 years of age, however in Australia there are cases affecting people as young as 18 years of age. The average survival time is two to five years from being diagnosed. At present, there is no cure, but coordinated research is being carried out across the world, including in Australia. Resources Visit the MND Victoria website at www.mnd.asn.au or call (03) 9830 2122. 50 The MND Australia resource kit for parents, ‘Talking with young people about MND for schools’, includes a booklet specially written for schools. Visit www.mndaust.asn.au for more information. This website at www.a1s411.ca may also be of interest. Multiple sclerosis Multiple sclerosis (MS) affects the central nervous system and can, to varying degrees, interfere with the transmission of nerve impulses throughout the brain, spinal cord and optic nerves. A simple explanation is conveyed by the term itself. Sclerosis is a Greek word meaning ‘hardened tissue or scars’ and multiple means many. Recurring episodes of MS can cause many scars to appear in the central nervous system as a result of the breakdown of the myelin, the insulating material that covers the nerve fibres. This can result in impairment of motor, sensory and cognitive functions to a greater or lesser extent. The term ‘multiple’ describes other aspects of what is often a frustratingly unpredictable disease. Episodes can occur at varying time intervals affecting different areas of the central nervous system. There is no one symptom that indicates the presence of MS. No single test can establish an accurate diagnosis. MS can be benign – in rare cases apparently disappearing altogether after one or two episodes, or it can progress steadily over many years, bringing about a slow deterioration in an individual’s capabilities. Although we do not yet understand why some people are susceptible and others are not, we do know that an estimated 18,000 Australians have MS. Resources For further information, visit www.mssociety.org.au or call (03) 9845 2700. Events 51 The MS Readathon is a national event held annually in June. Visit www.msreadathon.org.au for further information. Muscular dystrophy Muscular dystrophy is the term given to a group of hereditary, progressive diseases that cause the breakdown of muscle fibres leading to weak and wasted muscles. The genetic defect is present from the time of conception, but the signs are usually not evident until childhood, adolescence or adulthood, depending on the type of dystrophy. As a group, the muscular dystrophies are characterised by three common features: they are hereditary they are progressive each exhibits a characteristic, selective distribution of weakness. The different types of dystrophies affect different muscles and various other body systems and progress at different rates. The most common form of muscular dystrophy is Duchenne muscular dystrophy (DMD), in which symptoms usually appear between the ages of two and six. DMD is an X-linked chromosome (that is, carried by females) disorder. Females are rarely affected. In the population at large, the incidence of DMD in a male child is about 1:3,000 live births. As the disorder progresses, the ability to walk is lost and most boys need to use a wheelchair by the age of 12 and sometimes as young as 8 years old. Other effects may include learning difficulties and problems with joints, the spine, the heart and the respiratory system. Resources Visit the Muscular Dystrophy Australia website at www.mda.org.au or call (03) 9320 9555. Prader-Willi syndrome 52 Prader-Willi syndrome (PWS) is a complex medical condition that affects boys and girls equally and continues to affect them throughout their lives. PWS is a genetic disorder, and an abnormality of chromosome 15 is seen in the majority of people with PWS. People with PWS have an obsession with food and eating (from about age two), poor muscle tone and balance, learning difficulties, lack of normal sexual development, emotional instability and lack of maturity. It has been estimated that about one in 15,000 people from all cultural backgrounds are born with PWS; it is not inherited in 99% of cases. The name of the syndrome is derived from the names of the doctors who first described the disorder in 1956. Not every person affected by the syndrome will have all of the characteristics. They are also seen in varying degrees. Early diagnosis gives the child a more positive start with early intervention and sensible eating plans. There are two distinct clinical stages to the syndrome. The first stage occurs from birth through to the ages of two to four. Babies are born with extremely low muscle tone. They also sleep a lot, so it is important that when awake they receive visual stimulation and interaction. The second stage of the syndrome usually occurs from around two years, or in some cases later. Although diet remains the same, weight will start to balloon. This may be accompanied by a compulsion to eat and an obsession with food. If nothing is done to manage diet, or restrict food, then serious weight gain that can result in life threatening obesity will occur in 95% of cases. Resources The Prader-Willi Syndrome Association of Victoria has some useful resources, including ‘Guidelines for the Management of Prader-Willi Syndrome’. Visit www.pws.asn.au or call (03) 9889 7924. 53 Psychiatric disability Around one in five Australians experience some form of psychiatric disability every year. Mental illness affects how people feel, think and perceive the world around them. This, in turn, affects their ability to carry out everyday functions, to work and study, and to relate to other people. Mental illnesses are often highly distressing for those affected and those close to them, but it is important to understand that they are treatable. Mental illness is a general term referring to a group of illnesses which includes two broad categories: Anxiety and depression The most common form of mental illness is anxiety disorder. Affecting around 14% of Australians every year, anxiety disorders include obsessive compulsive disorder, phobias and generalised anxiety disorder. Depression affects around 6% of Australians every year. For most people with anxiety or depression, the most effective form of treatment is psychotherapy, although some may need medication for a period or longer term. Psychosis People with psychotic conditions such as schizophrenia commonly experience delusions, hallucinations and difficulty organising thoughts. Psychotic illness is far less prevalent than depression or anxiety, affecting around 1% of the population. The most effective form of treatment for psychotic conditions is medication, along with other forms of support and rehabilitation. With treatment, most people recover from a mental illness. However, with mental illness, as with physical illness, relapses can occur, especially during stressful periods such as exams, family breakdown and major transitions. 54 Research indicates that most mental illness is caused by a combination of genetic vulnerability combined with life stressors. Studies show that mental illness is just as prevalent among children and adolescents as among adults. They experience comparable disturbance to feelings, behaviours or thoughts that cause significant distress and interference with abilities to carry out day-to-day activities. Resources SANE Australia produces a wide range of materials on mental health. For further information, visit www.sane.org or call (03) 9682 5933. Two other useful sites are www.itsallright.org (a website dedicated to young people) and www.headspace.org.au (Australia’s National Youth Mental Health Foundation). Also see the Mental Illness Fellowship Victoria website at www.mifellowship.org. Spina bifida Spina bifida occurs when one or more vertebrae of the spine fail to form a complete bony arch around the spinal cord, causing the nerves to be exposed and subject to damage. At birth, they may protrude as a lump through the gap instead of growing down the spinal column. The meaning of the term arises from the Latin words spina (spine) and bifida (split or divided). The problems caused by spina bifida vary depending on the size of the opening between the backbone and spinal cord, its location on the back and the amount of damage to the spinal cord and brain. In Australia, about one baby in 1,000 is born with spina bifida. It is one of the most common malformations with which a baby can be born. The exact causes of spina bifida are as yet unknown. It is thought to result from a combination of environmental and genetic factors 55 Many children born with spina bifida have hydrocephalus. Hydrocephalus is a fluid build up in the brain which can cause brain damage, seizures or severe vision impairment unless treated with a surgical procedure called ‘shunting’. Spina bifida is a common form of neural tube defect. In some cases, children with spina bifida may experience a variety of learning difficulties – including not picking up on non-verbal cues. These learning difficulties are primarily linked to hydrocephalus and may include difficulty with paying attention, expressing or understanding language, and with reading and maths. Some individuals with spina bifida require assistive devices such as crutches, braces or wheelchairs. Depending on the degree of disability, remedial surgery, age and the opportunity to develop, children with spina bifida are able to lead full, active and independent lives. Resources For more information, visit the Spina Bifida Foundation of Victoria website at www.sbfv.org.au or contact (03) 9663 0075. Spinal cord injury Spinal cord injury (SCI) is damage to the spinal cord through injury or disease, resulting in muscle paralysis and sensory loss. Injury to the spinal cord may occur at different levels, and this determines the severity of the condition with higher lesions being associated with more severe disability. The most common causes of injury are trauma (road crashes, falls, diving) or disease (polio, spina bifida, Friedreich’s Ataxia). The spinal cord does not have to be severed for a loss of functioning to occur. In fact, in most people with SCI, the spinal cord is intact, but the damage due to compression or bruising results in loss of functioning. SCI is very different from back injuries such as ruptured discs, spinal stenosis or pinched nerves. 56 Injury to the spinal cord causes loss of function of the nerves, limbs and organs below the site of the injury. The effect of the injury depends on the nerves involved as well as the location of the injury. The injured areas may interrupt messages from the brain to those parts of the body below the area of damage. The higher the damage on the spinal cord, the greater the affected area, with varying degrees and amounts of paralysis and weakness. Two forms of SCI are: quadriplegia – impairment of function in the arms, torso, hips and legs paraplegia – impairment of function in the lower torso, hips and legs. Degrees of paralysis, sensations of touch and temperature vary greatly between individuals. Some functions may return over time. At the time of injury, the spinal cord swells. When the swelling goes down, some functioning may return. Especially in incomplete injuries, functioning may return as late as 18 months after the injury. However, only a very small fraction of people with SCIs recover all functioning. Attempts to regenerate function in the damaged area are focusing on regrowing nerves, blocking the mechanism that stops neurons from regrowing themselves, inserting new cells and bypassing the damaged area. The gender ratio for SCI is 70% males and 30% females. Resources Independence Australia has some useful resources, including a DVD. For further information visit www.independenceaustralia.com or call 1300 704 456. Another relevant organisation is Australian Quadriplegic Association: visit www.aqavic.org.au or call (03) 9489 0777. Tourette syndrome 57 Tourette syndrome (TS) is a neurological disorder which begins between the ages of two and 21 and often lasts throughout life. TS is a genetic or hereditary condition. In other words, it is not uncommon to find that several other members of the one family have features of TS. TS was previously considered to be an emotional or psychiatric condition, but more recent theories suggest that TS is caused by a chemical abnormality in the brain that affects the messages that take place between nerve cells. It seems that the most likely areas affected in the brain are the basal ganglia, the limbic system and their nerve connections. It was once thought that TS was a very rare condition. This is not true, and although different researchers have come up with different figures, it has been estimated that as many as one person in every hundred has TS. It is even more common in families who have a member with TS, and the chances of having another person with TS in such a family may be as high as one in 15. TS is characterised by rapid, repetitive multiple movements called tics and involuntary vocalisations. Tics are experienced as irresistible, similar to the urge to sneeze or to scratch a mosquito bite and must eventually be performed. Typically, tics increase as a result of tension or stress and decrease with relaxation or concentration on an absorbing task. The range of TS behaviours displayed by children is wide. It varies among individuals and sometimes from day to day. One tic may be recurrent, for example eye blinking, head jerking or shoulder shrugging. Others might appear and disappear unpredictably. Attention deficit hyperactivity disorder and obsessive compulsive disorder are often associated with TS, and other medical conditions such as opposition defiant disorder can co-exist. Resources Visit the Tourette Syndrome Association of Victoria website at www.tsavic.org.au or call (03) 9845 2700. 58 Vision impairment Vision impairment is the reduced vision caused by eye disease, accident or eye condition present from birth (congenital). It can be a partial or total loss of vision. In Australia, it is estimated that about 380,000 people are legally blind or have low vision. About 80% who have a vision impairment have some residual vision. This condition is referred to as low vision. Low vision is reduced vision that is severe enough to significantly impede the visual performance of vocational, recreational and/or social tasks. Low vision cannot be corrected to normal vision by regular eyeglasses or spectacles. Legal blindness is when a person cannot see at six metres what a sighted person can see at 60 metres (Snellen eye chart < 6/60). A person may be legally blind, yet still retain some functional vision. They may be able to respond to some visual stimulation like light and dark, shadows, shapes of objects and moving objects, providing them with some residual functional vision. It is estimated that 80–85% of all learning is done using the visual sense. As a result, vision impairment has the potential to affect all areas of development, including social relationships, communication and language, fine motor skills, play, mobility and cognitive development. Some children and adolescents who have a vision impairment may be tactual learners, visual learners or auditory learners, or a combination of these. Some may have no useful vision for learning and will use Braille (a tactile literacy and numeracy code using a combination of six dots) as their primary medium. Others may use enhanced or enlarged print to participate in the regular curriculum. Braille can also be used as a complementary method of learning in addition to other learning methods. A person with congenital blindness may have had difficulty forming accurate self-perceptions and perceptions of the world. They may misinterpret the feelings and intentions of others by relying on their 59 voices and speech rather than gestures, facial expressions and posture. The ability to learn and acquire skill through simple imitation of visual cues is hindered, so there may be learning gaps and distortions through a lack of the number and variety of experiences. Children and adolescents with severe vision impairment require a range of real-life experiences to enhance their understanding of the world around them. Resources Contact Blind Citizens Australia for further information: visit www.bca.org.au or call 1800 033 660 or (03) 9654 1400. Vision Australia has a host of useful resources, including school texts in alternative formats (Braille, large print and audio) and an extensive book (text and recreational reading) and equipment resource library. These are available on loan or at a cost. For information, visit www.visionaustralia.org.au or call 1300 84 74 66. The Statewide Vision Resource Centre also has some useful resources: visit www.svrc.vic.edu.au. Events International Guide Dog Day is held in April each year. Schools can contact Guide Dogs Victoria for resources and information. Visit: www.guidedogsvictoria.com.au. World Braille Day – 4 January each year White Cane Day – 5 October each year World Sight Day – 16 October each year 60 More resources Websites You may wish to source further information and ideas from the following websites: 61 On 3 December every year, International Day of People with a Disability is celebrated world-wide, recognising the skills, abilities, achievements and contributions of people with a disability. It also acts as a way of raising awareness of diversity. Organising a whole-school event to mark this day is an opportunity for your school to celebrate. For further information visit, www.idpwd.com.au. The Disability Services Division of the Department of Human Services has a host of material regarding disability, services, programs and plans. Visit www.dhs.vic.gov.au/ disability/disabilityserviceshome or call 1300 650 172. This website provides information about chronic illnesses such as thyroid conditions and diabetes. The resource, ‘Invisible Illness’, is a particularly relevant one for teachers: see www.chronicillness.org.au/invisible/default.htm. Each year, Interchange, an organisation that supports families of young people with a disability, holds an annual event, the Great Australia Sunny Sizzle, to raise awareness of disability and celebrate all abilities. Visit the website at www.sunnysizzle.org.au to find out how you can organise an event at your school. The Education Institute at the Royal Children’s Hospital works towards maximising learning and development outcomes for young people being treated at the hospital. There are some useful resources on their website at www.rch.org.au/edinst/index.cfm?doc_id=10385. Wheelchair Sports Victoria has a dedicated section for schools on its website at www.wsv. org.au/schools.html. The State Library of Victoria website at www.openroad.net.au/access/dakit has some useful teaching ideas. Arts Access provides access to arts and cultural activity for people who are disadvantaged, including people with a disability. Visit www.artsaccess.com.au/home. The Butterfly Kids Playground story is a series of books that introduce and focus on disabilities to create positive and inclusive attitudes towards those with a disability as well as awareness and understanding. Visit www.butterflykids.com.au/for_schools.html. The Association for Children with a Disability provides information and advocacy support for children with any type of disability and their families. Call 9818 2000 or 1800 654 013 (between Monday and Friday, 10am to 4pm) or visit www.acd.org.au, for more information. Books The books identified below are written about or include characters that have a disability. The list is not intended to serve as an endorsement of any of the materials. Teachers will need to evaluate them individually to determine which ones are most appropriate for their class needs. All books listed are currently available for purchase online or through major booksellers. The list is not exhaustive, and teachers are encouraged to identify additional children’s literature relating to disability by: contacting an organisation that specialises in the disability of interest and asking what children’s books involving disability they might recommend conducting web searches and visiting websites of publishers and/or major booksellers. These books can serve as excellent tools for communicating with children about disabilities, for providing children and young adults 62 with stories about people like themselves, and for featuring the personalities, friendships, challenges, accomplishments and daily lives of people with a disability. VELS levels 1, 2 and 3 Armitage, B & Armitage, D (illust.) (2000). My Brother Sammy. Bloomsbury. Booth, B & Lamarche, J (1991). Mandy. New York, NY: Lothrop. Chamberlin, K (1997). Night Search. Hollisdayburg, PA: Jason & Nordic (also available in Braille format). Cowen-Fletcher, J (2002). Mama Zooms. Scholastic. Dobkin, B (1994). Just a Little Different. Danbury, CT: Children’s Press. Dowley, R & Donnelly, S (illust.) (2001). Top Biker. Hodder Children’s Books. Ducksworth, G & Crispin, M (illust.) (2000). Anna’s New Friend. Spud Books. Dwight, L (1992). We Can Do It! New York, NY: Checkerboard Press, Inc. Heelan, J R (2000). Rolling Along: The story of Taylor and his wheelchair. Atlanta, GA: Peachtree. Jacques, T E & Reilly, M M (2000). What’s Wrong with the New Girl? (US only). Katz, I, Ritvo, E & Borowitz, F (illust.) (1993). Joey and Sam. West Hills, CA: Real Life Storybooks. 63 Lears, L (1998). Ian’s Walk: A story about Autism. Morton Grove, IL: Albert Whitman & Company. Lesley, E (2004). Looking After Louis. Polly Dunbar, IL: Albert Whitman & Company. McMahon, P (1995). Listen for the Bus: David’s story. Honesdale, PA: Boyds Mills Press, Inc. Martin, Jr, B, Archambault, J & Rand, T (illust.) (1995). Knots on a Counting Rope. New York, NY: Henry Holt. Messner, A W (1996). Captain Tommy. Stratham, NH: Potential Unlimited Publishing. Moran, G (1995). Imagine Me On a Sit-Ski! Morton Grove, IL: Albert Whitman & Company. Rickert, J E & McGahan, P (Photog.) (1999). Russ and the Firehouse. Bethesda, MD: Woodbine House. Ross, J W T, (2000). Susan Laughs. Henry Holt and Co. Thomas, P (2002). Don’t Call Me Special: A first look at disability. Hodder Wayland. Thompson, M (1996). Andy and his Yellow Frisbee. Bethesda, MD: Woodbine House. Twachtman-Cullen, D (1998). Trevor Trevor. Starfish Press. Useman, S & E, Pillo, C (illust.) (1999). Tibby Tried It. Washington, DC: Magination Press. VELS levels 4 and 5+ Bennett, V (2000). Monkey. Walker Books. Bergman, T (1989). Going Places: Children living with blindness. Milwaukee, WI: Gareth Stevens Children’s Books. Bertanga, J (1999). Bungee Hero. Barrington Stoke. 64 Blatchford, C H (1995). Nick’s Mission. Minneapolis, MN: Lerner. Breslin, T (2000). Whispers in the Graveyard. Mammoth. Cross, G (2001). Calling a Dead Man. Oxford University Press. Crew, G & Hathorn, L (2000). Dear Venny, Dear Saffron. Floris Books. Gay, J (2003). Wist. Tindal Street Press. Haddon, M (2003). The Curious Incident of the Dog in the NightTime. Red Fox. Jung, R (2002). Bambert’s Book of Missing Stories. Mammoth. Keith, L (2000). A Different Life. Livewire. King-Smith, D & Bailey, P (illust.) (1999). The Crow Starver. Corgi. Koertge, R (2002). Stoner and Spaz. Walker. Laird, E (ed.) (2000). Me and My Electric: A collection of short stories (Mammoth reads). Lebert, B (2001). Crazy. Puffin. Lovegrove, J & Miller, I (illust.) (2000). Wings. Barrington Stoke. Lowery, L (2002). Gathering Blue. Bloomsbury. Mankell, H (2000). Secrets in the Fire. Anne Connie Stukstrud. Mankell, H & Paterson, A (trans.) (2001). Playing with Fire. Allen & Unwin. Marlowe, J (2001). The Night Garden. Honno. Ogaz, N (2003). Buster and the Amazing Daisy. Jessica Kingsley Publishers. Orr, W (1998). Fighting Back. Orchard Books. Philbrick, R (2004). Freak the Mighty. Usborne. 65 Pimm, P (2002). Living With Cerebral Palsy. Hodder Wayland. Piper, D (1996). Jake’s the Name, Sixth Grade’s the Game. Unionville, NY: Royal Fireworks Press. Rainsbury, J & Evans, F (illust.). Crab-boy Cranc. Pont Books. Riordan, J (2004). The Gift. Oxford University Press. Rushton, R (2002). Last Seen Wearing Trainers. Anderson Press. Trueman, T (2002). Stuck in Neutral. Hodder Children’s Books. Welton, J (2004). Can I Tell You About Asperger’s Syndrome? Jessica Kingsley Publishers. Wescott, P (2002). Blindness. Hodder Wayland. Wild, M (2002). Jinx. Allen & Unwin. Zephaniah, B (1999). Face. Bloomsbury. Films Below are just a few Australian and international films featuring or about people with a disability that you may like to show in part or full. The list is not exhaustive; nor does it act as an endorsement. Teachers will need to assess whether or not they are suitable for their own classrooms. A Beautiful Mind (2001) The Black Balloon (2008) Edward Scissorhands (1990) Finding Nemo (2003) Forrest Gump (1994) Harvey Krumpet (2003) Heidi (1937) 66 The Hunchback of Notre Dame (animated Disney version 1996; original silent version 1939) The Miracle Worker (1962) Notting Hill (1999) Rain Man (1988) Shine (1996) Shrek (2001) What’s Eating Gilbert Grape? (1993) Yolk (2008) Simple internet searches will assist you in sourcing some more useful films. There is a long tradition in the movie industry of casting actors without a disability as characters with a disability. In many instances, actors have won awards for their portrayal of disability. This obviously impacts the authentic, live portrayal of a person with a disability. This is a theme that could be worth exploring with students in Year 7 or 8. 67 Why weren’t actors with a disability cast in the roles? Why do you think playing a person with a disability is interesting for a non-disabled actor? How do you think people with a disability feel about that?