PRESENTED AT

ALLAMA IQBAL OPEN UNIVERSITY ISLAMABAD

ON THE OCCASION OF

GROUP TRAINING WORKSHOP OF M.A/ M.ED

(SPECIAL EDUCATION)

IMRAN NAZIR
THE MEDICAL APPROACH TO THE
HANDICAPPED

Muhammad Imran Nazir

GIFTED CHILDREN

Gifted children are those who

score in the top 2% on standardized
test of intelligence.
Gifted and talented children are
those whose performance is
consistently remarkable in any
potentially valuable area.
CHARACTERISTICS

 Better educational progress

 Creative
 Vocabulary
 Devoted
 Good Observer
 Find the solution
INTELLECTUALLY
CHALLENGED

Means significantly sub average

general intellectual functioning,
existing concurrently (at the same
time) with deficits in adaptive
behavior and marked during the
developmental period, that  a child’s
educational performance.
 Intellectual disability (ID), once
called Mental Retardation, is
characterized by below-average
intelligence or mental ability and a lack of
skills necessary for day-to-day living.
People with intellectual disabilities can
and do learn new skills, but they learn
them more slowly.
CLASSIFICATION OF I.C

Clinical Classification
• Mild: 55-69
• Moderate: 40-54
• Severe: 25-39
• Profound: <25
EDUCATIONAL
CLASSIFICATION

• Educable: 60-85
• Trainable: 30-59
• Custodial: <30
HEARING IMPAIRMENT

Means an impairment in hearing,

whether permanent or fluctuating,
that adversely affects a child’s
educational performance but is not
included under the definition of
“deafness.”
 Hearing loss, also known as hearing
impairment, is a partial or total inability to
hear. A deaf person has little to
no hearing. Hearing loss may occur in one or
both ears. Testing for poor hearing is
recommended for all newborns. Hearing loss
can be categorized as mild, moderate,
moderate-severe, severe, or profound. 0-20
db is called the normal hearing.
TYPES OF HEARING LOSS

• Conductive Hearing loss : Outer

or middle ear.
• Sensory neural hearing loss: Inner
ear & it has no treatment.
• Mixed hearing loss
DEGREES OF HEARING
LOSS
 Mild hearing loss: 26db-40db
 Moderate hearing loss: 41db-55db
 Moderately sever hearing loss:
56db-70db
 Sever hearing loss: 71db-90db
 Profound hearing loss: >91
OTHER TYPES OF H.L
 Deaf:Those in who the sense of hearing not
functional for the ordinary purpose of life.
 The hard of hearing: Those in whom the
sense of hearing although defective, is
functional with or without aid.
 Hearing impairment: A generic term
indicating a hearing disability that may range
in severity from mild to profound .
EFFECTS OF H.L

Lack of confidence
Inferiority complex
Aggressiveness
Avoidance
Insecurity
Shyness
PHYSICALLY
HANDICAPPED

Loss of or failure to develop

a specific bodily function or
functions, whether of movement,
sensation, coordination or speech,
but excluding mental impairments
or disabilities. 
ORTHOPEDIC
IMPAIRMENT

It involves the skeletal system bones,

joints, limbs and associated muscles.

Neurological impairment:
It involves the nervous system affecting
the ability to move, use, feet or
Control certain parts of body.
TYPES

 Quadriplegia: Both hand and legs are effected.

 Paraplegia: Move of legs effected.
 Hemiplegia: One side of the body effects.
 Diplegia: Legs are more effected than arms.
 Monoplegia: Only one part is effected from both arms
and legs.
 Triplegia: Three parts are effected.
 Double plegia: Both arms are more effected than legs.
CHARACTERISTICS

 Cerebral palsy: It is a long lasting

condition due to Lesion to brain &
Disorder in brain development.
 Intellectual weakness
 Movement of legs & arms
 Control over speech
 BLINDNESS

A persons whose visual acuity is 20/200 or less in the

better eye after the best possible correction with glasses or contact
lenses is considered legally blind. This means that the child can see
only at 20 feet what someone with normal sight can see at 200 feet.
 LOW VISION

The term low term refers to children and

adults whose vision is 20/70 or less and cannot
be fully corrected with conventional glasses.
Low vision is not the same as blindness, however
it usually interferes with the performance of
daily activities such as reading or driving.
A person with low vision may not recognize images
at a distance or be to differentiate colors of
similar tones.
CAUSES OF
VISUAL
IMPAIRMENT

The main underlying causes in this respect may be

outlined as:
 The transfer of genes and chromosomes associated
with visual impairments to the children from their
parents at the time of conception.
 The carelessness adopted by the pregnant mothers in
their diets, mal nutrition, use of strong drugs, being
affected from chronic diseases and affected with
serious accidents and incidents, the abnormal and
stressful psyche states.
 unhealthy living and psychological environmental
conditions faced by the mothers during pregnancy.

 Mishaps and incidents at the time of birth of the child, pre

mature delivery , effects of anesthetic agents and instruments
used in delivery infections caused to the children during
delivery, etc.

 Starvation, malnutrition, unhygienic, uncongenial and

unfavorable conditions faced by the children in their early
years.
 The ill effects of the infectious diseases like small pox,
chickenpox and measles etc.

 The diseases of the eye and infection.

 The deficiency of the vitamins and other nutrition

components, essential for maintaining health and well being
of the eyes.
 Theevil effects of fatal diseases like cancer, growth of
tumors, skin diseases, typhoid, malaria etc.

 The improper postures adopted at the work place and

specially at the time of reading and writing.

 The injury caused to the eyes with the carelessness adopted

in the day to day functioning as well as in professional
activities.
 The damage of the eye organs responsible for proper
sensational and perceptual activities through fatal accidents.
 The effects of poisoning and intoxicating substances,
alcoholism and drug addiction.
 The bad effects of the external objects (foreign body) like
dust, smoke and pollution,
 The ill effects of reading, writing and working in the
defective and improper light watching programs excessively
on the T.V and working with computers.
REFRACTIVE
ERROR

1.Myopia (Near Sightedness)

difficulty in seeing distant objects clearly.
2. Hyperopia (Far Sightedness)
Difficulty in seeing close objects clearly; It
represents a refractive error in which one feels difficulty
in seeing near objects clearly but can focus well on more
distant objects.
 CATARACT

 It represents a condition or state of cloudiness in the lens of the

eye which results into a blurred, distorted or incomplete vision
due to the blockage of the light necessary for having a clear
vision.
 Common symptoms

 Blurry vision

 Colors that seem faded

GLAUCOMA

 The impaired condition of the eye is characterized by

abnormally excess pressure within the eye due to
disturbance or blockages of the fluids that normally
circulate within the eye
 Symptoms of Glaucoma

 Hazy or blurred vision

 The appearance of rainbow-colored circles around bright

lights
 Severe eye and head pain

 vomiting (accompanying severe eye pain)

 RETINITIS PIGMENTOSA (RP)

Since retinitis Pigmentosa begins as rod degeneration, the

patient first notices increasing difficulty in night vision, followed
by difficulty seeing in the periphery.
Symptoms:
 Decreased vision at night or in low light

 Loss of side (peripheral) vision, causing "tunnel vision"

 Loss of central vision (in advanced cases)

 ALBINISM

It is an inherited condition resulting in decreased

pigment which causes abnormal optic nerve
development. In addition to decrease visual acuity
children with albinism may be sensitive to light.
Symptoms:
 Absence of color in the hair, skin, or iris of the eye

 Lighter than normal skin and hair

 Patchy, missing skin color Light sensitivity

(photophobia)
 Rapid eye movements
ALBINISM
COMMON TYPES
OF LOW VISION

1. Loss of Central Vision

The loss of central vision creates a blur
or blind spot, but side vision remains intact.
This makes it difficult to read, recognize faces,
and distinguish most details in the distance.
2. Loss of Peripheral Vision
Loss of peripheral vision is typified an
inability to distinguish anything to one side or
both sides.
3. Blurred Vision
Blurred vision causes both
near and far to appear to be out of
focus, even with the best
conventional spectacle correction
possible.
4.Extreme Light Sensitivity
Extreme light sensitivity exists when
standard levels of illumination overwhelm the
visual system, producing a washed out image
and/or glare disability. People with extreme light
sensitivity may actually suffer pain or discomfort
from relatively normal levels of illumination.
NIGHT BLINDNESS

Night blindness results in inability to see

outside at night under starlight or moonlight, or in dimly
lighted interior areas such as movie theaters or
restaurants.
COMMON CAUSES

Poverty and malnutrition

Poverty is one of the biggest causes of disability.
Poor people are most vulnerable to disability because
they are forced to live and work in unsafe environments
with poor sanitation, crowded living conditions, and with
little access to education, clean water, or enough good
food. This makes diseases such as tuberculosis and
polio--and the severe disabilities they cause-- much more
common because diseases get passed from one person to
another more easily.
WAR

In today's wars, more civilians than soldiers are

killed or disabled, and most of them are women and
children. Explosions cause people to become deaf, blind,
and lose their limbs, as well as causing other injuries.
Their mental health is also badly affected by the
violence. The destruction of homes, schools, health
centers, and means of livelihood that results from
conflicts and wars leads to increased disability, poverty,
and disease.
 Land mines, cluster bombs,
bullets, and chemicals used in
wars cause more disabilities in the
world today than anything else. They
often injure women who are carrying
out their daily activities, such as
farming, or gathering water and
wood.
ILLNESS

Some illnesses a pregnant woman may get can

cause physical or learning problems when her baby is
born. Illnesses that can cause birth defects include
German measles (rubella), which is a common cause of
deafness in newborn babies. There is a vaccine that gives
protection against rubella, but a woman who gets an
immunization of the rubella vaccine should not get
pregnant for one month afterward.
MEDICINES
AND INJECTIONS

When used correctly, certain injected

medicines, like some vaccinations, are
important to protect health and prevent
disability. However, there is a worldwide
epidemic of unnecessary injections. Each
year these unnecessary injections sicken,
kill, or disable millions of persons,
especially children.
A NEEDLE OR SYRINGE

Some medicines and drugs taken during

pregnancy can cause disability in the baby. The
overuse of inject able medicines, such as
oxytocin, to speed up childbirth and 'give force'
to the mother's labor, deprives the baby of
oxygen during birth. It is a major cause of
brain damage. Alcohol and tobacco used
during pregnancy can also damage a
developing baby.
DANGEROUS WORK
CONDITIONS
Women who work long hours
without enough rest are likely to have
accidents. Women who work in factories,
mines or on agricultural plantations can be
exposed to dangerous machinery, tools, or
chemicals. Accidents, overwork and
exposure to chemicals can all cause
disability.
ACCIDENTS

Many women and children get

disabling injuries at home by burns from
cooking fires, falls, road accidents, and
breathing or drinking toxic chemicals.
Workplace accidents, especially in less
regulated sectors such as construction,
agriculture, mining, and smaller
businesses, are a common source of
disability
POISONS AND
PESTICIDES

Poisons such as lead found in paints,

pesticides such as rat poison, and other
chemicals can cause disabilities in people
and cause birth defects in babies growing
in the womb. Smoking or chewing
tobacco, breathing smoke, and drinking
alcohol during pregnancy can also harm a
child before she is born.
 INHERITED
DISABILITIES

When close blood relatives such as

brothers and sisters, first cousins, or parents
and children have children together, the
children are much more likely to have
disabilities. Some disabilities are known to
be inherited, such as spinal muscular
atrophy and muscular dystrophy (diseases
of the muscle and of the nerve cells that
carry signals from the brain to the muscle,
making the muscles of the body get weaker
and weaker and slowly stop working).
NEED & SIGNIFICANCE
OF DEMOGRAPHIC DATA
ON DISABILITY
About 15% of the world's population lives
with some form of disability, of whom 2-4%
experience significant difficulties in functioning.
The global disability prevalence is higher than
previous WHO estimates, which date from the
1970s and suggested a figure of around 10%.
This global estimate for disability is on the rise
due to population ageing and the rapid spread of
chronic diseases, as well as improvements in the
methodologies used to measure disability.
 In Pakistan, there is social stigma attached to
persons with disabilities. Disabilities are concealed
within families so as not to limit the marriage prospects
of relatives who might otherwise be suspected of
carrying defective genes. Some superstitions about the
disabled. Families bear an extra expense in caring for a
disabled member, due to loss of additional labor,
increased demands on resources for taking care of the
disabled member, and increased need to compensate with
higher fertility.
 There is a lack of social institutional support for
care of the disabled. The population censuses of 1961
and 1981 were the first to collect information on the
disabled. The inadequacy of census data led to the
initiation of a national survey in 1984/85 for collecting
data on blindness, deafness, autism, leprosy, retardation,
and handicaps. A special in-depth survey on disabilities
was also conducted in Islamabad and Rawalpindi
districts in 1986. Data from the 1984/85 survey show
higher sex ratios for all disabilities for certain provinces
compared to the national ratios.
 If the trend accurately reflects increased
disabilities, the education of high risk groups
must be improved, accessibility to medical care
must be increased, and the population needs to
be educated about the disabled. Government
social programs need more accurate assessments
of the causes of disability and the size and
duration of disablement.
 SIGNIFICANCE

If the demographic data on the disability is correct then we may

bring the following changes & better out comes for he PWDs. We
can provide them the following facilities to them independent in
the society:
 Early identification & prevention
 Assessment on the right time
 Medical Rehabilitation
 Education
 Health
 Vocational Rehabilitation
 Social Integration
Thanks for your
attention!
QUESTIONS
?