Introduction

A Person with Disability is defined as ;

“Any person unable to perform activities of daily living by himself as a result of a deficiency in his physical or mental capabilities.”

About 10% of population experience varying degrees of disability. Of this, 6% are able to cope with their disability, 4% require rehabilitation and only 1% have severe disability.

Persons with disabilities (PWD) are people with different abilities. For example a person with visual impairment/ blindness may not be able to see, but their other senses are better than that of the general population.

The most important thing is to learn to utilize available abilities to the fullest.

What are the types of disabilities?

• Visual impairment / Blindness
• Hearing Impairment / Deafness
• Physical Impairment
  • e.g. : Cerebral palsy, Stroke, Muscular Dystrophy, Spinal Injury, Limb amputation
• Learning Disabilities e.g. intellectual impairment, dyslexia, down syndrome
• Behaviour problems e.g. Autism, Attention Deficit Hyperactive Disorder (ADHD)
• Communication Problems

A person can have more than one disability. Disability can affect anyone at any point in their lifetime.

What are the causes of disability?

• Common causes in babies:
  • Genetics, for example Down’s Syndrome, Muscular Dystrophy
  • Stress to the foetus especially during the first three months of pregnancy;
    • Maternal disease e.g. Diabetes, hypertension
    • Substance abuse e.g. smoking, alcohol, drugs
    • Infection due to rubella, syphilis
  • Lack of nutrient in mothers diet e.g. lack of Folic Acid can cause conditions such as spina bifida, microcephaly, anencephaly
  • Trauma during pregnancy or at birth leading to lack of oxygen can cause damage to the brain e.g. cerebral palsy
  • Severe Jaundice (Kenicterus) in infants

• Common causes in older children and adults ;
  • Infection e.g. meningitis due to Heamophilus Influenza B or encephalitis due to measles
  • Injury (accidents/ abuse) e.g. physical, chemical, burns
  • Severe lack certain nutrients in the diet e.g. Vitamin A may cause blindness
  • Lack of iodine may result in Congenital Hypothyroidism (short stature and mental retardation)
  • Diseases e.g. complications of chronic disease such as stroke, diabetes.

Can disabilities be prevented?

Steps that can be taken to reduce probability of disabilities:

1. Practice healthy lifestyle. Avoid smoking, taking alcohol and drugs.
2. Avoid injury and accidents.
3. Get immunized:
   • All women should get immunized with rubella and tetanus vaccine.
   • All children should get immunized according to the current immunization schedule
4. Plan your pregnancy. Get advice from your doctor / health care worker on spacing of pregnancies, Folic Acid supplements and balanced diet.
5. Ensure regular follow up during pregnancy.
6. Share your complete medical history with your doctor.
7. Genetic counselling is helpful for perspective parents.

Screening for disabilities

Do we need to screen for disabilities?

YES

1. Adults may be able to relate the loss of any of their senses. However in some cases regular assessment is needed for early identification of a disability e.g.
   • Regular hearing assessment at work
   • Regular eye assessment for patients with chronic disease e.g. diabetes.
2. Children are not aware of what is ‘normal’ and therefore parents, carers and teachers; have to be aware of the normal development in children. When any delay is observed, child must be brought for assessment and confirmation of the problem.

How to detect disabilities in children?

• Regular assessment during pregnancy
  • Physical examination
  • Ultrasound on high risk cases in early pregnancy
• Test amniotic fluid for chromosomal abnormalities (Amniocentesis)
• Developmental assessment of children at health clinics in areas of ;
  • Gross motor (mobility)
  • Fine motor (hand function)
  • Activities of daily living
  • Hearing and communication
  • Behaviour and social

Rehabilitation

What needs to be done once a disability has been detected?

The PWD/carers should ensure the child or adult with disability ;

1. Register with Social Welfare Department.
   • The formats for registration are available at social welfare departments / health clinics and hospitals.
   • The format needs to be endorsed by a qualified doctor.
   • The PWD will then acquire an identity card as proof to enable them to receive the benefits due to PWDs.
2. Seek rehabilitation services relevant to their needs e.g. :
   • Medical rehabilitation
     • Rehabilitation in terms of :
       • Physiotherapy,
       • Occupational therapy,
       • Speech therapy,
       • Counseling is available in government and private hospitals and some clinics.
   • Educational rehabilitation.
     • Children with disabilities need to register with Special Education Department.
   • Social rehabilitation
     • To enable PWDs to learn to get along with others.
     • Early intervention programmes are available in some health clinics
     • Community Based Rehabilitation Centers throughout the country
   • Vocational rehabilitation
     • Currently available in some centers run by Social Welfare Department and NGOs related to specific disabilities.

How can a PWD get a suitable job?

Information on jobs and job placement can be aided by

Support groups

• The Human Resource Department

Tel: 03-88865000

• NGOs e.g. Jobstreet.com
  http://jobs4disabled.jobstreet.com/default.htm

• Malaysian Council for Rehabilitation
  Bangunan Sultan Salahuddin Abdul Aziz Shah
  No 16 Lorong Utara A
  4th Floor, Room 3
  46200 Petaling Jaya, Selangor.
  Tel: 03-7955 3510