Appendix B: Project Examples

I. Disability Awareness Training Script

Overview and Purpose of Training:

Disability awareness training is an important part of creating an inclusive program and environment, and is a great first step in overcoming any concerns, negative attitudes, and stereotypes that other program members may have regarding working with people who have disabilities. Don’t overlook the importance of Disability awareness training. When asked to work alongside people with disabilities for the first time, many Corpsmembers were initially uncomfortable. Negative attitudes and misconceptions about people with disabilities were most often the result of lack of awareness, rather than malice or apathy. Take adequate time to discuss the issues. Make sure to have Corpsmembers with disabilities present to answer questions and facilitate discussion.

This training is designed to provide a broad overview of key disability issues and to increase knowledge and awareness of:

• Common Myths about Individuals with Disabilities
• History of Disability Rights Movement
• The Old and New Paradigm of Disability
• People-First Language
• Different Disabilities
• Disability Etiquette

Please adapt the training materials to meet the needs of your program. There is enough information in this training to take approximately two hours to present and discuss the materials. This training is intended to serve as a starting point for disability awareness in your organization. However, you may already have access to a similar training or be able to work with a local disability-related organization to develop your own training materials. In that case, we would encourage you to use the training that best meets your program’s unique needs.

This training script is intended to support the accompanying PowerPoint slides found in this appendix and provide trainers with a detailed outline of the content of the slides. The script includes the contents of each slide along with any notes about the content in a text format and can serve as an alternative format for individuals that may not be able to access the content of the PowerPoint slides due to a visual impairment or other disability. Throughout the PowerPoint slides, a variety of clip art graphics depicting individuals with different disabilities are used. In addition, there are several photographs included in the slides. In the note section of relevant slides, a photo description is provided for individuals with visual impairments. For additional tips on making your training event accessible to all individuals, please refer back to the material in Section II Step 8 “Development of Disability Awareness Training” of the toolkit. A list of references and resources to help you find additional materials on the information provided in the training is provided at the end of the presentation.

Section 1: Disability Myths and Realities

SLIDE 1: Disability Awareness: Including People with Disabilities in Service

Staff and/or Member Training

• Title slide with picture of members of the Utah Conservation Corps’ 2008 Access Crew at the scenic overlook at Tony Grove Lake in Logan Canyon.
• Also included on the slide are the logos of the Utah Conservation Corps and the Center for Persons with Disabilities.

SLIDE 2: Purpose of Training

• Increase knowledge and awareness of:
• Common Myths and Facts about Individuals with Disabilities
• History of Disability Rights Movement
• The Old and New Paradigm of Disability
• People-First Language
• Different Disabilities
• Disability Etiquette
• Effective Communication Techniques

SLIDE 3: Question

• How many of you have a family member or friend with a disability?

NOTE: If you think about this question for more than a few minutes, chances are that most, if not all of us in this room, know someone with a disability that is fairly close to us. Disability is a natural part of life and when we stop to consider who we know that may have a disability, we begin to realize how common disability is and we begin to realize that disability issues are relevant to all of us.

SLIDE 4: Largest and Most Diverse Group

• People with disabilities constitute our largest (one in five Americans) and most diverse minority group, encompassing all ages, genders, religions, ethnicities, and socioeconomic levels. It is also the only group that any person can join at any time (Snow, 2008).

ASK: What does it mean that disability is “the only group that any person can join at anytime?” Does this help clarify the idea that disability issues really are important to all of us?

At some point in each of our lives, the physical accessibility of a location or the prevailing societal attitudes about disability may become a very real and personal concern. It is in our own best interest to begin to make our communities more inclusive and to break down all physical and attitudinal barriers.

SLIDE 5: Invisible but Potent Barrier

• Attitudes determine whether or not children and adults with disabilities receive equal opportunities for success.
• While physical barriers are coming down, attitudes change very slowly. Negative attitudes and discrimination are the greatest obstacle people with disabilities face today (Snow, 2008).
• Negative attitudes usually stem from preconceptions, misunderstandings and misinformation.

ASK: Why are attitudes the greatest barrier people with disabilities face? (With negative attitudes, people with disabilities are never given a chance.)

SLIDE 6: Myths and Realities

• Can you think of some stereotypes about people with disabilities?

ASK: Ask group members for ideas about common stereotypes or myths about people with disabilities. For each myth or stereotype that is mentioned ask the group what they think the reality is.

SLIDE 7: Myths and Realities (cont.)

Myth: People with disabilities are heroes who are inspirational and brave.

Reality Check:

• Adjusting to a disability requires adapting to a lifestyle, not courage (Easter Seals, 2007).
• Individuals with disabilities are just people who have trouble with some life activities. They don’t want to be put on a pedestal. They want to be treated the same as everyone else.
• Individuals with disabilities don’t want to be stereotyped based on just one aspect of their life.

SLIDE 8: Myths and Realities (cont.)

Myth: Having a disability impacts all areas of a person’s functioning –e.g., speaking louder to a person who is using a wheelchair.

Reality Check:

• Even though some disabilities affect more than one area of functioning, it should never be assumed that a person has more than one disability. Individuals with disabilities need to be spoken to directly and treated as an adult, with respect and dignity.

SLIDE 9: Myths and Realities (cont.)

Myth: The lives of people with disabilities are very different than the lives of people without disabilities.

Reality Check:

• Individuals with disabilities work, have families, grocery shop, pay taxes, vote, plan and dream like everyone else (Easter Seals, 2007). They are just people – moms and dads, daughters and sons, employees and employers, friends and neighbors, students and teachers, doctors, engineers, reporters, actors, scientists, presidents, and more (Snow, 2008).

SLIDE 10: Myths and Realities (cont.)

Myth: People with disabilities do not contribute to society and “drain” the system.

Reality Check:

• People with disabilities have made significant contributions: President Roosevelt (polio), Milton (blind at 43 wrote Paradise Lost), Beethoven (deaf when composed 9th symphony), Stephen Hawking (Lou Gehrigs), Einstein (learning – didn’t speak until 3, hard time with math in school), and Edison (couldn’t read until 12, hard time writing).
• People with disabilities have the same potential and talents as everyone else.

SLIDE 11: Myths and Realities (cont.)

Myth: People who are blind acquire a “sixth sense” and people who are Deaf read lips.

Reality Check:

• Although most people who are blind develop their remaining senses more fully, they do not have a “sixth sense.”
• Lip-reading skills vary among people who use them and are never entirely reliable.

SLIDE 12: Misperceptions

Be aware of common misperceptions and assumptions:

• People with cerebral palsy may appear to be under the influence of drugs or alcohol.
• People with traumatic brain injuries may act belligerent or irresponsible.
• People who are hard of hearing may initially appear to be unresponsive.

ASK: Do you think that many individuals generally experience at least a little discomfort when interacting with people with disabilities?

How do you think that these myths and misperceptions contribute to this level of discomfort and make people less likely to engage with a person with disabilities?

Section 2: History of Disability Rights Movement

SLIDE 13: History of Disability Rights Movement

Photo Description: Signing of the Americans with Disabilities Act. President George H.W. Bush (center) is flanked by Evan Kemp, Chairman, Equal Employment Opportunity Commission (left) and Justin Dart, Chairman, President’s Committee on Employment of People with Disabilities (right). Standing are the Rev. Harold Wilke (left) and Sandra Swift Parrino, Chairperson, National Council on Disability (right).

SLIDE 14: Ways of Thinking about Disability

• OLD Paradigm: “The person is defective and needs fixing.”
• NEW Paradigm: “Fix the environment, not the individual.”

NOTE: The old paradigm (medical model) regards disability as a defect or sickness which must be cured through medical intervention. This model/paradigm continues to influence our attitudes and shape our world. It has dominated the formulation of disability policy for years.

The new paradigm (social model) sees disability as a natural part of the human condition that does not diminish rights. Disability is a consequence of societal, attitudinal, and social barriers that prevent people with disabilities from participating in society to the maximum extent possible.

SLIDE 15: The Old Paradigm of Disability

• People with disabilities were defective and in need of fixing.
• If they couldn’t be fixed…excluded, segregated, and denied services.
• Out of sight out of mind, the norm.
• Ugly laws into the mid 1970’s
• Elements of the Old Paradigm no longer explicit…but still implied in some attitudes, programs, policies, and environments.

NOTE: This is the way society has viewed disability in the past. Ugly laws refer to actual laws on the books that made it illegal to be a person with a disability and be out in public. In Chicago, up until the 1970’s, a person with a physical disability or “deformity” could be fined for being in public. We no longer have ugly laws in the books, but we still have a lot of elements of this view in attitudes and environments.

SLIDE 16: The New Paradigm of Disability (cont.)

Two Core Precepts:

1. Disability is a natural part of the human experience that in no way diminishes a person’s right to fully participate in all aspects of society.
2. The approach is to fix the environment, not the individual.

NOTE: This is the view of disability that disability advocates have been promoting for decades. It is the view that advocates have worked very hard to establish as the foundation for all disability legislation and policies since the late 60’s/early 70’s.

SLIDE 17: Disability Rights

The Civil Rights movement of the 1960’s didn’t specifically include people with disabilities, but it inspired disability activists to make themselves heard.

The following is an overview of some of the major milestones in the disability rights movement:

• In 1968, the Architectural Barriers Act (ABA) required “any building or facility built, renovated, or leased with Federal funds, be built to be accessible to and usable by physically disabled persons.”
• In 1970, “Rolling Quads” hit the Berkeley campus igniting the Independent Living Movement.

NOTE: Inspired by the heightened awareness and civil rights successes of the 1960’s, disability rights activists such as Ed Roberts in California and Judy Heumann in New York took the lead in overcoming discrimination and extending the basic right to full participation in society to include people with disabilities.

In 1970, Ed Roberts led a group of students with disabilities to start the “Rolling Quads” program on the Berkeley campus - a group that will soon set its sights on accessibility issues across the nation. A couple years later, Ed founded the nation’s first Independent Living Center in Berkeley, California.

SLIDE 18: 1973 Rehabilitation Act ___

“No otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.” (Rehabilitation Act of 1973, Section 504 of Title V).

NOTE: In 1973, after a flood of angry letters and protests, Congress overrode Nixon’s veto and passed the Rehabilitation Act, which prohibits discrimination in federal programs and services and all other programs or services receiving federal funding.

SLIDE 19: Additional Legislation

• In 1975, the Education of All Handicapped Children Act (renamed the Individuals with Disabilities Education Act or IDEA) is passed.
• In 1977, Judy Heumann leads a 25 day sit-in at the Federal Building in San Francisco.
• In 1978, ADAPT holds a public transit bus hostage in Denver.

NOTE: 1975, “IDEA” was passed requiring free, appropriate public education in the least restrictive environment possible for children with disabilities.

April 5, 1977: Judy Heumann led disabled residents of San Francisco in a dramatic month-long sit-in at a government building, demanding access to federally funded buildings through enforcement of “Section 504.“ The sit-in resulted in winning civil rights for the nearly 50 million people with physical and mental impairments living in the United States.

In 1978, Wade Blank and 19 disabled activists hold a public transit bus “hostage” on the corner of Broadway and Colfax in Denver, Colorado -- ADAPT will eventually mushroom into the nation’s first grassroots disability rights activist organization.

SLIDE 20: The ADA

Closely modeled after the Civil Rights Act, the landmark Americans with Disabilities Act (ADA) of 1990 provided a federal mandate to eliminate discrimination against people with disabilities in all aspects of life. The primary goal of the ADA is equal participation of individuals with disabilities in the “mainstream” of American society.

NOTE: The landmark Americans with Disabilities Act (ADA) of 1990, provides comprehensive civil rights protections to qualified individuals with disabilities in the areas of employment, public accommodations, state and local government services, and telecommunications.

SLIDE 21: Not the End of the Story

To be effective, laws must be enforced and attitudes must change.

• Programs such as The Corps Network’s Inclusion Project work to ensure that individuals with disabilities have full access to their communities and the unobstructed right to direct their own lives in the most independent and integrated setting possible.

SLIDE 22: The Disability Policy Framework for Advocates

At the end of the day we have to ask ourselves…is change being implemented?

Four Goals of Disability Policy:

• Equality of Opportunity
• Full Participation
• Independent Living
• Economic Self-Sufficiency (Petty et al., 2004)

Are you addressing these goals in your program?

SLIDE 23: Promoting Inclusion Among AmeriCorps Members

All crew members should be involved in group decisions.

• Project goals benefit from both non-physical and physical abilities.
• Delegate tasks to appropriate people.
• Each task must be a legitimate function.
  (Otherwise, people will see right through it!)

NOTE: This slide provides examples of ways an inclusive service program naturally supports the Four Goals of Disability Policy (equality of opportunity, full participation, independent living, and economic self-sufficiency).

• Making decisions with people is a credit to their intelligence, insight and judgment, building their dignity.
• In the traditional UCC crew setting, project goals are reliant upon the ability to perform physical tasks.
• For example, if the task is to create a raised bed garden, someone who has a C4 spinal cord injury may be given the step of designing the garden and selecting plants, while someone else with more physical abilities constructs the beds.
• If tasks seem contrived, people with disabilities will feel patronized or devalued.

Projects must be designed to include people with diverse backgrounds and abilities.

Each delegated task must be a significant contribution to the project goal(s).

Delegate carefully. Be careful not to set members up for failure or competition.

SLIDE 24: Creating an Inclusive Environment

Photo Description: Picture of a sign at the top of a steep incline at a zoo. On the sign, which is in the shape of a red triangle, is a picture of a person in a wheelchair going down a steep incline. At the end of the incline is a picture of a crocodile with an open mouth. Needless to say, this sign does not indicate a welcoming or inclusive environment for individuals with disabilities.

SLIDE 25: Key Elements of Inclusion

• Understanding the Power of Language
• Disability Etiquette
• Awareness of Different Disabilities
• Practicing Effective Communication

SLIDE 26: How Many Errors?

• A wheelchair bound suspect made off with $10,000 in a bank robbery. The thief, apparently confined to a wheelchair and afflicted with cerebral palsy, pulled a gun on a teller. The teller told police the gunman was spastic, waving the gun around, and made everyone nervous. The suspect was given $10,000 in small bills. The handicapped robber roared out of the bank and disappeared into traffic. The police later caught him when the wheelchair got stuck on a curb cut blocked by a truck. The teller identified the suspect in a police lineup. Police said he also suffered from cerebral palsy since birth.

NOTE: Give participants a few minutes to read through the above paragraph and have them note any errors that they find. This paragraph will be revisited at the end of this section so have participants keep their responses to themselves for now. You may need to read the paragraph out loud if there is anyone in the audience that would have trouble reading the paragraph on their own.

SLIDE 27: The Power of Language

Outdated language perpetuates stereotypes that bring out pity, fear, and patronizing attitudes (NPR’s “Beyond Affliction”).

How might use of the following terms influence the way crew members with disabilities are perceived?

• The disabled
• Suffering from epilepsy
• A victim of cerebral palsy
• Confined to a wheelchair
• Crippled

NOTE: The use of outdated language and words to describe people with disabilities contributes greatly to perpetuating old stereotypes.

People with disabilities should no longer be viewed as helpless, tragic victims.

Awareness (of how language influences attitudes) is the first step!

Activity:

Outdated, insensitive language can be offensive and hurtful. Consider how you might challenge this type of language if it is used by your staff, crew leaders, or crew members.

Discussion:

The disabled: lumps people with disabilities together under one huge category and dismisses individual differences.

Suffering from ____: encourages pity.

A Victim of ____: promotes disempowered, helpless image.

Confined to a wheelchair: negative and inaccurate.

Crippled: encourages pity.

Part of your role as staff/crew leader is to set an example and use appropriate language when talking about disability.

Handouts:

You may consider using the “Talking About Disability” article available from the Memphis Center for Independent Living Center at http://www.mcil.org/mcil/mcil/talking.htm as a handout for training participants.

SLIDE 28: Terms for Disabilities have Changed

• Attitudes are often shaped by language.
• Lumping people into a stigmatized group brings attention to their disabilities while obscuring individual characteristics (Longmore, 1985).
• Negative stereotypical words cause harmful perceptions and damage self-image (Snow, 2008).
• Terms have changed as we have progressed medically, socially, and ethically, to be more respectful and accurate.

NOTE: Language shapes attitudes. Disability status is only one variable in the full range of human experience. When thinking about disabilities, it is important to put the person first. Using accurate, sensitive, and respectful terminology is a good first step.

SLIDE 29: People-First Language!

PUT PEOPLE FIRST, not their disability.

• People with disabilities are people first. They are not a homogenous group of “the handicapped” or “the disabled.”
• People-first language shifts the focus away from a person’s disability, as it puts the person first, with a simple description of their disability, when necessary.
• It describes what a person has, not who a person is.

NOTE: Crippled, deformed, suffers from, victim of, the retarded, infirmed, the deaf and dumb, etc. are never acceptable under any circumstances. Also, do not use nouns to describe people, such as epileptic, diabetic, etc.

Handouts:

You may consider using the “To Ensure Inclusion, Freedom, and Respect for All We Must Use People First Language” article by Kathy Snow available through her website Disability is Natural at www.disabilityisnatural.com/images/PDF/pfl09.pdf as a handout for training participants.

SLIDE 30: Examples

Say…

• Person with a disability, not handicapped person.
• Person who uses a wheelchair, not wheelchair-bound or confined to a wheelchair.
• Person who has cerebral palsy, not person “afflicted” with or “suffering” from.
• Child with muscular dystrophy, not special needs child.
• Child with Down Syndrome, not Down’s Kid.

NOTE:

• Person with a disability, not handicapped person. (Handicaps refer to barriers, not people. Implies person is incapable of ever overcoming effects).
• Person who uses a wheelchair, not wheelchair-bound or confined to a wheelchair. (Mobility devices provide freedom).
• Person who has polio, not person “afflicted” with or “suffering” from. (Implies the person is living a reduced quality of life, “tragic martyr” stereotype).
• Child with muscular dystrophy, not special needs child. (People with disabilities don’t want to be considered “special,” they are like everyone else).
• Child with Down Syndrome not Down’s Kid.

SLIDE 31: Impact of Words

The movie Tropic Thunder repeatedly uses the word, “retard.” The point is made that the worst thing for an actor to do is to go “full retard.”

• People with disabilities were not consulted and a number of groups protested.
• Why is this movie offensive to people with disabilities?
• Why does this matter?

NOTE: Ask group members to discuss these questions and share their thoughts and opinions.

SLIDE 32: Because Words Can Hurt!

• There is a limit to satire. Making offensive, mean, humiliating jokes isn’t funny.
• People with intellectual disabilities are always harmed when words such as “retard,” “imbecile,” “idiot,” and “moron,” are used.
• These words reject, dehumanize, and demean. This may encourage young people and others to tease and/or torment their peers.

SLIDE 33: Thoughts from People with Down Syndrome

John Stephens said it hurts and scares him when he hears jokes about “retards” on the bus. He says, “Nothing scares me as much as feeling all alone in a world that moves so much faster than I do” (J. Stephens, Roanoke Times, 8/19/08).

• Eddie Barbanell said the word makes him feel rejected, stupid, and demeaned.
• Loretta Claiborne said the word has been used to mock and degrade her. She asked that we stop using this word because of its effect on the hearts and minds of people with disabilities (M. Shriver, Los Angeles Times, 2008).

SLIDE 34: How Many Errors Revisited

• A wheelchair bound suspect made off with $10,000 in a bank robbery. The thief, apparently confined to a wheelchair and afflicted with cerebral palsy, pulled a gun on a teller. The teller told police the gunman was spastic, waving the gun around, and made everyone nervous. The suspect was given $10,000 in small bills. The handicapped robber roared out of the bank and disappeared into traffic. The police later caught him when the wheelchair got stuck on a curb cut blocked by a truck. The teller identified the suspect in a police lineup. Police said he also suffered from cerebral palsy since birth.

NOTE: How many people caught all of the errors? Do these phrases stand out more now that you have learned about people-first language? Why does using respective terminology make a difference?

SLIDE 35: Why Use Person First Language?

People are not their disability and their potential can not be predicted by their diagnosis (Snow, 2008).

• Accurately portrays people with disabilities as independent, productive, valued, and respected members of society.
• Demonstrates you are well mannered, sensitive, and informed. Provides a positive role model.

SLIDE 36: Understanding Specific Disabilities

Familiarize yourself with the characteristics of specific disabilities so that you can better recognize, understand, and accommodate individual needs.

However, be aware of limiting labels and the broad spectrum of abilities within a group of people described as having the same disability!

NOTE: Photo Description: Seven members of the UCC Access to Service inclusive crew in front of thermal pools in Yellowstone.

Remember that two individuals with the same disability can be affected in completely different ways. For example, if two individuals both have cerebral palsy, one may walk but have his or her speech affected and the other may use a wheelchair but have his or her speech speech unaffected.

SLIDE 37: Developmental Disabilities

• Diverse groups of severe chronic conditions that affect major life activities such as language, mobility, learning, self-care, self-direction, and independent living.
• Begins anytime during development from birth to 22 years of age and usually lasts throughout a person’s lifetime.
• Includes autism, cerebral palsy, Down Syndrome, and intellectual disabilities.

NOTE: Intellectual disabilities refer to conditions that were formerly referred to as mental retardation. Thanks to the work of many self-advocates and their allies, the official term is now intellectual disability. Even national organizations that used to have mental retardation in their official title have changed it to intellectual disabilities.

SLIDE 38: Developmental Disabilities - Common Behavior Traits

Eager to please

• May become frustrated easily
• May have difficulty following instructions
• May have trouble assessing situations
• Lack of impulse control
• Difficulty with new or stressful situations

SLIDE 39: Cognitive/Intellectual Disabilities

• Characterized by a significantly low score on an intelligence or mental ability test.
• Substantial limitations to think, remember, interpret social cues, and understand numbers and symbols.
• Possible communication difficulties:
  • Limited vocabulary
  • Short attention span
  • Slower information processing
  • Difficulty understanding questions
  • Memory gaps

NOTE: Examples include Down Syndrome, autism, and significant learning disabilities. Although intellectual disabilities fit under the broad umbrella of developmental disabilities, it can be useful to discuss them as a separate group of disabilities. Similarly, some people discuss cognitive disabilities and traumatic brain injury together because they have similar characteristics, but we have chosen to separate them out for this presentation.

SLIDE 40: Traumatic Brain Injury

• Common to have decreased:
  • Attention
  • Initiation
  • Mood regulation
  • Executive function (say exactly what they think)
  • Memory (often forget appointments)
  • Increased impulsivity
  • Easily fatigued

NOTE: Remember that every person with a TBI is unique. Two people can have a very similar injury to the brain and experience very different symptoms.

SLIDE 41: Persons with Mental Illness

• Wide range of treatable conditions with varying symptoms that may come and go including depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, and post traumatic stress disorder.
• May be insecure and fearful, find it difficult to concentrate, become agitated or withdrawn, emotionally changeable, show little empathy, and have trouble with reality.

SLIDE 42: Muscular/Neurological

A broad range of disabilities affect movement, including:

• Cerebral Palsy, caused by damage to the brain, characterized by an inability to control motor functions. May experience speech difficulties, unsteady gait, and slow reaction time. Does not affect intelligence but may co-exist with intellectual disability.
• Multiple Sclerosis is a chronic disease which attacks the central nervous system (brain, spinal cord, and optic nerves). Severity and symptoms vary, often experience fatigue, tremors, pain and coordination difficulties. Vision, speech, hearing, and cognitive function may be affected.

SLIDE 43: Muscular/Neurological (cont.)

• Muscular Dystrophy is a genetic degenerative disease with nine different types which cause muscles to irreversibly atrophy. Symptoms vary but often include fatigue, muscle weakness, and paralysis.
• Stroke is a brain injury caused by the sudden interruption of blood flow to the brain. Can affect motor control, communication, cognition, and personality. Often experience weakness on one side of the body. May also have memory loss and speech difficulties.

SLIDE 44: Mobility Impairments

• Often due to another disability such as MS or CP, or an injury such as a spinal cord injury.
• Impact on ability of individual to move about in certain environments varies widely.
• Individuals may use a cane, walker, crutches, wheelchair, scooter, or other mobility device to navigate the environment.

SLIDE 45: Common Health Concerns Related to Spinal Cord Injuries

• Autonomic Dysreflexia
• Body Temperature Regulation
• Pressure Sores
• Skin Care
• Liquids/Hydration

NOTE:

• Autonomic Dysreflexia: This is an emergency situation seen in individuals with spinal cord injuries.
  • Common Symptoms include:
    • -severe pounding headache
    • -seeing spots and/or blurred vision
    • -slow heart rate
    • -goose bumps above the level of the spinal cord injury
    • -sweating above the level of injury
  • What to do:
    • Find and remove the cause. Autonomic Dysreflexia will not be relieved until the cause is removed.
  • Check the following:
    • -catheter kinks or blockage
    • -cuts, bruises, or ulcers
    • -sunburn
    • -tight clothing
• Body Temperature Regulation: People with SCI’s are particularly susceptible to hypothermia. SCI’s result in the lack of ability to transmit sensory feedback determining skin temperature and in the lack of ability to cause muscles to shiver to keep warm. People with SCI’s will need to manually check their skin temperature below the level of injury.
  • Prevention/Solution:
    • -Allow plenty of time to put on warm clothes – it may take a little longer for individuals with mobility impairments. (Bring extra warm, dry clothes, food and a thermos of hot tea)
• Pressure Sores: Occur in people with SCI’s. Also called decubitus ulcers or bedsores. They are caused when a person’s body position does not change while the skin is pinched for an extended period of time between a bony area and hard surface (often the hip or tail bone). It is a serious problem and difficult to heal.
  • Solution:
    • Make sure their seat is comfortably padded and stable (foam or gel pads or blankets). They should change their positions frequently, at least every hour, and keep their skin clean and dry.
  • Symptoms:
    • Red, discolored area
  • What to do:
    • Take pressure off and seek help! Dress wound.
• Skin Care: Make sun block, hats, long sleeves/pants available. (Sometimes people with SCI’s ignore or forget about skin below the level of injury).
• Liquids/Hydration: Drink plenty of water (gallon per person per day when working outside).

  Sometimes people with SCI’s will not want to drink because they don’t want to deal with their catheter, bathroom transfers, etc. Be aware of this and communicate that there is plenty of time and space to meet individual needs.

SLIDE 46: Hidden Disabilities

May Include:

• Traumatic Brain Injuries
• Mental Illness
• Learning Disabilities
• Mild Multiple Sclerosis
• Hard of Hearing
• Chemical Sensitivities
• Heart Disease
• Arthritis
• Chronic Fatigue

NOTE: Why is it important to be aware of hidden disabilities?

SLIDE 47: Individual Differences

In the next section some standard guidelines for disability etiquette and common courtesies are presented, along with some general communication tips related to specific disabilities. This information is very general and is simply intended to provide a broad overview. Please keep in mind that each individual is unique.

SLIDE 48: Disability Etiquette

• People with disabilities are entitled to the same courtesies you would extend to anyone, including personal privacy. If you find it inappropriate to ask people about their sex lives, or their complexions, or their incomes, extend the courtesy to people with disabilities.
• If you don’t make a habit of leaning or hanging on people, don’t lean or hang on someone’s wheelchair. Wheelchairs are an extension of personal space. (Easter Seals, 2009)

NOTE: You may wish to use the following information from Easter Seals as a handout. Available online at http://www.easterseals.com/site/PageServer?pagename=ntl_etiquette

Most of these points are covered in the following slides, however a handout that participants can take with them may be helpful.

Disability Etiquette

• If you don’t make a habit of leaning or hanging on people, don’t lean or hang on someone’s wheelchair. Wheelchairs are an extension of personal space.
• When you offer to assist someone with a vision impairment, allow the person to take your arm. This will help you to guide, rather than propel or lead the person.
• Treat adults as adults. Call a person by his or her first name only when you extend this familiarity to everyone present. Don’t patronize people who use wheelchairs by patting them on the head. Reserve this sign of affection for children.

In conversation...

• When talking with someone who has a disability, speak directly to him or her, rather than through a companion who may be along.
• Relax. Don’t be embarrassed if you happen to use common expressions such as “See you later” or “I’ve got to run”, that seem to relate to the person’s disability.
• To get the attention of a person who has a hearing disability, tap the person on the shoulder or wave your hand. Look directly at the person and speak clearly, slowly, and expressively to establish if the person can read your lips. Not everyone with hearing impairments can lip-read. Those who do will rely on facial expressions and other body language to help understand. Show consideration by facing a light source and keeping your hands and food away from your mouth when speaking. Keep mustaches well-trimmed. Shouting won’t help, but written notes will.
• When talking with a person in a wheelchair for more than a few minutes, place yourself at the wheelchair user’s eye level to spare both of you a stiff neck.
• When greeting a person with a severe loss of vision, always identify yourself and others who may be with you. Say, for example, “On my right is Andy Clark”. When conversing in a group, remember to say the name of the person to whom you are speaking to give vocal cue. Speak in a normal tone of voice, indicate when you move from one place to another, and let it be known when the conversation is at an end.
• Give whole, unhurried attention when you’re talking to a person who has difficulty speaking. Keep your manner encouraging rather than correcting, and be patient rather than speak for the person. When necessary, ask questions that require short answers or a nod or shake of the head. Never pretend to understand if you are having difficulty doing so. Repeat what you understand. The person’s reaction will guide you to understanding.

Common courtesies...

• If you would like to help someone with a disability, ask if he or she needs help before you act, and listen to any instructions the person may want to give.
• When giving directions to a person in a wheelchair, consider distance, weather conditions, and physical obstacles such as stairs, curbs, and steep hills.
• When directing a person with a visual impairment, use specifics such as “left a hundred feet” or “right two yards”.
• Be considerate of the extra time it might take a person with a disability to get things done or said. Let the person set the pace in walking and talking.
• When planning events involving persons with disabilities, consider their needs ahead of time. If an insurmountable barrier exists, let them know about it prior to the event.

SLIDE 49: Disability Etiquette (cont.)

• When you offer to assist someone with a visual impairment, allow the person to take your arm. This will help you to guide, rather than propel or lead, the person.
• Treat adults as adults. Call a person by his or her first name only when you extend this familiarity to everyone present. Don’t patronize people who use wheelchairs by patting them on the head. Reserve this sign of affection for children. (Easter Seals, 2009)

SLIDE 50: Disability Etiquette

Relax. Don’t be embarrassed if you happen to use common expressions, such as:

• “See you later” or “Nice seeing you” to a woman who is blind.
• “Gotta run” to someone in a wheelchair.
• “Talk to you later” to a person who is Deaf.
• Put the person first and when in doubt ask the individual you are speaking with what to say (Easter Seals, 2009).

SLIDE 51: Common Courtesies (cont.)

• If you would like to help someone with a disability, ask if he or she needs help before you act, and listen to any instructions the person may want to give.
• When giving directions to a person in a wheelchair, consider distance, weather conditions and physical obstacles such as stairs, curbs and steep hills.
• When directing a person with a visual impairment, use specifics such as “left a hundred feet” or “right two yards”.

NOTE: Encourage frank and honest discussion about needs and expectations. The person needing assistance is the most able trainer. Always begin by asking the person needing assistance what she/he needs or how they would like to proceed.

SLIDE 52: Common Courtesies

• Be considerate of the extra time it might take a person with a disability to get things done or said. Let the person set the pace in walking and talking.
• When planning events involving persons with disabilities, consider their needs ahead of time. If an insurmountable barrier exists, let them know about it prior to the event. (Easter Seals, 2009)

SLIDE 53: General Communication Recommendations

• Don’t make assumptions.
• Don’t patronize or say, “honey” or “sweetie.”
• Individuals with disabilities want to be treated with respect, dignity, and courtesy.

SLIDE 54: Communicating with People who are Deaf or Hard of Hearing

• Make sure you have the person’s attention.
• Use a quiet environment without bright or distracting backgrounds.
• If a person uses an interpreter or personal assistant, maintain eye contact and talk with the person, not their interpreter or assistant.
• Speak clearly, at a normal pace.
• Be patient and take time to communicate.
• Use facial expressions and body language.
• Ask the person what will make communication easier.

SLIDE 55: Communicating with a Person who is Blind

• Visual impairments can range from mild to severe.
• Identify yourself and anyone with you. Don’t just start talking. Let the person know when you leave.
• Convey specific descriptive visual information (e.g. there is a table on your right).
• Speak in a normal tone of voice.
• Always ask the person what is the best way to provide assistance.

SLIDE 56: Communicating with a Person who is Blind (cont.)

• If you need to guide the person, offer your arm and let the person hold on to you.
• If you offer a seat, place the person’s hand on the back or arm of the chair or pat the chair.
• Don’t pet or grab a guide dog.
• When guiding or giving directions, focus on the individual, not the dog.
• Don’t separate the guide dog from the person.

SLIDE 57: Communicating with People who have Intellectual Disabilities

• Talk to the person to get a sense of their abilities.
• Use short words and sentences, but don’t patronize or talk to the person like a child if they are an adult.
• Be prepared to repeat what the person said to make sure you understand. Rephrase and ask questions in different ways.
• Check to see if the person understands you.
• They may be easily distracted – redirect attention if needed.

SLIDE 58: Communicating with People who have Intellectual Disabilities (cont.)

• Give instructions for tasks one at a time. Break long tasks down in small steps. Allow extra time.
• Try to describe things in clear and concrete terms, not abstract terms.
• Offer assistance in understanding instructions or completing forms if needed.
• Be patient and supportive. They may feel frustrated – most things are harder and take longer.
• Praise success and give immediate feedback.

SLIDE 59: Communicating with a Person who has a TBI

• Get the person’s attention, redirect if needed.
• Simplify the environment and remove distractions.
• Limit the amount presented and highlight relevant/important information.
• Summarize and repeat information often.
• Remind of appointments.
• Provide written information/checklists.

SLIDE 60: Communicating with a Person Who is Experiencing a Mental Health Crisis

• Be supportive, respectful, and accepting.
• Stay calm and speak softly.
• Get attention and repeat if necessary.
• Keep things clear and simple.
• Ignore delusions, don’t argue. Change the subject.
• Allow the person to leave if needed and return later (C. Amenson, CAMI, 2008).

SLIDE 61: Communicating with People who have Difficulty Speaking

• People with cerebral palsy, Down Syndrome, and some other disabilities may be difficult to understand.
• Provide extra time and let people talk at their own pace. Give them your complete attention.
• Ask them to repeat if you don’t understand. Never pretend to understand. Ask yes/no questions if necessary.
• Repeat or rephrase what the person is saying to clarify that you understand.
• Be patient, flexible, and encouraging.

SLIDE 62: Communicating with People who use Wheelchairs or Scooters

• Offer to shake hands, even if the person appears to have little strength or movement.
• When talking to a person in a wheelchair or scooter at any length, sit or kneel so that they don’t have to strain their neck.
• Don’t lean on, push, pat or touch a person’s wheelchair. It is inappropriate and could be dangerous.
• If a person is unable to hold a pen, ask how you can help. For instance, If you would like assistance, I can help you fill out this form.
• Talk directly to the person.

SLIDE 63: Final Myth and Reality

Myth: There is nothing one person can do to eliminate the barriers to inclusion.

Reality Check: Everyone can contribute to change by:

• Fully accepting people with disabilities in all environments.
• Ensuring that meetings and events are accessible.
• Not using accessible parking so it will be available.
• Understanding children’s curiosity.
• Writing producers/editors when they portray someone positively and speaking up against negative phrases/images.
• Hiring qualified persons with disabilities.
• Using person-first language.
• Any other ideas?

SLIDE 64: Remember…

Two Core Precepts:

1. Disability is a natural part of the human experience that in no way diminishes a person’s right to fully participate in all aspects of society.
2. The approach is to fix the environment, not the individual.

SLIDE 65: Practice Scenarios

The use of scenarios in training gives Corpsmembers the opportunity to role play and think about how they would communicate and respond to situations in advance. Scenarios are often based upon actual experiences and the lessons learned from them.

Scenario #1: You are serving as crew leader of an inclusive (mixed-ability) crew. During the first week of training, a Corpsmember who is prone to seizures communicates to you that her seizures are not usually a problem and will not interfere with work. She explains that she needs to be watched, however, because she could walk off a cliff or walk into oncoming traffic while experiencing a seizure. You do not have any experience with seizures and feel uncomfortable with this responsibility.

What do you do?

SLIDE 66: Scenario #2

You are the crew leader of an eight person inclusive (mixed-ability) crew. The crew is made up of 50% Corpsmembers with physical disabilities. One Corpsmember has a C6 spinal cord injury and uses a manual chair, one Corpsmember is blind, one Corpsmember has MS causing him to tire easily and have difficulty with balance, and one is prone to seizures and has mild cerebral palsy that affects his speech. The other four members have no known disabilities.

At the end of the summer, all 10 of the conservation corps crews are hiking into a high alpine lake to celebrate the end of the field season. The hike is approximately ½ mile downhill over rugged, rocky terrain.

How do you get the entire inclusive crew to the lake?

SLIDE 67: Scenario #3

Bob, one of your crew members, does not have control of his bowel movements. He is able to manage his disability in everyday life at home. The crew is going camping for a week while surveying trails and campgrounds in Grand Teton National Park. Although the group campground is physically accessible, it only has a pit toilet and water hydrant. Bob states that he cannot maintain his bowel program with these facilities and requests to stay in a lodge or motel on the overnight camping trips. This is determined to be a reasonable accommodation. Bob fears that he will be alienated from the group while serving on overnight projects.

Describe how you will decrease his fears and make sure that he feels a part of the crew.

SLIDE 68: Scenario #4

Fred, one of your crew members, is fully able to complete the essential functions of the job and requires no physical assistance on day projects. On overnight camping trips he needs assistance with dressing and going to the bathroom. Hiring a personal aid for overnight projects is determined to be a reasonable accommodation. When the aid is on projects with Fred, she is stuck in the field and wants to go out with the crew during the day. She hovers over Fred during the work day and assists him with everything which interferes with his independence and ability to be a team player. Fred doesn’t seem to mind. However, you feel it interferes with group dynamics and the whole notion of inclusion.

What do you do?

SLIDE 69: “Life is either a daring adventure or nothing.” Helen Keller__

Photo Description: Three individuals in the midst of a rugged red rock desert in Utah. Two individuals are using wheelchairs and the third individual is using crutches.

SLIDE 70: Thanks!

Photo Description: Logos for Utah Conservation Corps, Center for Persons with Disabilities, Mitsubishi Electric America Foundation, AmeriCorps, The Corps Network.

In 2007, the UCC was awarded funding from the Mitsubishi Electric America Foundation through The Corps Network, and the Utah Commission on Volunteers granted the UCC an additional AmeriCorps grant to start Access to Service!

The development of this training material and the accompanying toolkit with DVD was supported in part by each of the organizations listed below:

• Utah Conservation Corps
• Center for Persons with Disabilities at Utah State University
• Mitsubishi Electric America Foundation
• Utah Commission on Volunteers
• The Corps Network

SLIDE 71: References

• Amenson, C. (2008). Communicating with a person with a mental Illness. California Alliance for the Mentally Ill, San Luis Obispo, CA.
• Easter Seals, 2007 and 2009 available- http://www.easterseals.com/site/PageServer.
• Longmore, P. K. (1985). Screening stereotypes: Images of disabled people. Social Policy, 16(1), 31-37.
• National Public Radio “Beyond Affliction: The Disability History Project” available- http://www.npr.org/programs/disability.
• Petty, R., Holt, J., Chambless, C. & George, C. (2004). Olmstead and community: implementing the new freedom initiative. Houston TX: Independent Living Research Utilization.
• Snow, K. (2008). “Disability is Natural” available- http://www.disabilityisnatural.com/
• Shriver, M. (August 22, 2008). “ The ‘R-word’ is no joke” Los Angeles Times, available - http://www.latimes.com/news/opinion/commentary/la-oe-shriver22-2008aug22,0,7263175.story.
• Stephens, J. (August 19, 2008). “When Words Wound” Roanoke Times available- http://www.roanoke.com/archives/.

Full slide presentation is available by contacting kate.stephens@usu.edu.