It is prudent to find out about the types of disability or disorders that are present in the party. Try to gauge the implications this might have and what resources will be required to deal with any possible ‘worst case scenario’ while planning the proposed activity.
Acquired Brain Injury (ABI), in contrast to those with an intellectual disability, is caused by an injury to the brain and is not present at birth. There may be the presence of strong emotional issues regarding the changes in lifestyle caused by the disabling event (e.g. anger). Effects can include poor coordination and/or paralysis. Sense of balance, touch, smell, hearing and taste may be affected as well as thought processes. There may be difficulty in communicating and in controlling what others may deem to be inappropriate behaviour.
Arthritis primarily affects the joints in the body and can affect both the young and old. There are significant difficulties associated with mobility restrictions, chronic pain and fatigue. Those with moderate to severe arthritis may be excluded from activities that contain excessive risk of joint strain (e.g. skiing).
Asthma can have an acute onset due to a number of triggers such as pollen, cigarette smoke or physical exertion. Breathing is made difficult and reliever medication should always be readily at hand. In some cases asthma can be fatal.
Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) tend to occur in children rather than adults. Behaviours may include poor concentration, hyperactivity, withdrawal and being generally anti-social. Hyperactivity is often present but not always, hence the two terms. It is important not to have activities which are too long in nature and to have breaks and alternative options. Provide clear and simple instructions and give reminders in a gentle manner.
Autism is a developmental disability which can strongly affect social and communication skills. People with autism are generally less sociable than the norm, may or may not interact with others in the group, and may or may not communicate verbally. There can be great difficulty in dealing with changes in routine and there is a tendency to display obsessive behaviour (e.g. playing with water). Provide information regularly and well before planned activities to minimise anxiety.
Cardiovascular Disorders may either be congenital (e.g. faulty valves) or acquired
(e.g. hypertension). Monitor physiological responses to physical activity. Watch out for symptoms such as: chest pain, dizziness, shortness of breath, excessive fatigue and irregular heart beat.
Cerebral Palsy is a result of damage to areas of the brain affecting motor skills at or near the time of birth. Depending on the extent of damage to the brain there may also be sensory, communication, learning or other related difficulties. Multiple disabilities may be present (e.g. epilepsy). The effects vary greatly, and may include: being in a wheelchair or able to walk unaided, may or may not communicate verbally, and may require assistance with feeding and toiletting.
Cystic Fibrosis is inherited. It affects the respiratory and digestive system. Discourage both active and passive smoking anywhere near people with this condition. Fatigue sets in easily and they may suffer from depression.
Dementia is a loss of intellectual ability usually caused by the ageing process, but sometimes caused by disease (e.g. multiple sclerosis). Be patient, encouraging and use prompts where necessary.
Developmental Delay usually but not always refers to children rather than adults. A delay exists in the development of areas such as speech, fine and gross motor skills and social skills. In many cases, the deficits are permanent.
Down’s Syndrome is a disability caused by congenital disorder. Affected people generally have reduced intellectual functioning, and may have significant speech and communication difficulties.
Diabetes is a result of an inability to regulate blood sugar levels by converting sugar to energy. There is insulin dependent (requires medication and diet control) and non-insulin dependent diabetes (diet controlled). The participant will usually have a regime which is followed to control sugar levels—ensure it is followed. Where there is high physical exertion or in a cold environment, allowance will need to be made for greater energy spent. There is often decreased circulation to the extremities, which requires greater care in cool/wet environments.
Epilepsy is a disturbance in the electrochemical activity of the brain. There are several types and the extent may vary widely. Epilepsy may manifest itself in a momentary pause while performing an activity (absence seizure) to violent, uncontrollable convulsions (tonic-clonic seizure). Daily medication is commonly used to help control epilepsy. It is important to avoid restraining a person during a seizure and to simply protect the person by removing hard objects such as chairs, etc. that could harm. Rest and reassurance will be required when the participant is recovering. If a seizure lasts for more than ten minutes, an ambulance will need to be called.
Haemophilia is a genetic disorder which affects the blood’s clotting mechanism. The participant should have a customised action plan for any bleeds. Do not administer aspirin, as this will cause internal haemorrhage. Remember good hygiene practices and wear gloves.
Hearing Impairment requires facing the person when talking to facilitate lip reading and communication of facial expressions. Speak normally and not in a child-like manner. Some people with hearing impairment may communicate with sign language (e.g. AUSLAN).
Hydrocephalus is a build up of cerebrospinal fluid in the cranium due to an imbalance between production and absorption. Usually controlled by a shunt (tubing) which drains away excess fluid. Be careful about activities which will lower the partici-pant’s head in relation to the body or any deterioration in condition which may indicate a shunt malfunction. Such deterioration in condition may include headache, dizziness, blurred or double vision, increased difficulty with speech, and motor coordination.
Intellectual Disability can cover an extremely wide ranging area of intellectual difficulties. For some, there is a genetic cause (e.g. Down Syndrome) but for many the cause is unknown. A good talk with the regular carer will be of great benefit as the type of assistance required will vary enormously. Use short, simple sentences and clarify with the person to see that they have understood.
Limb Deficiency may be congenital or due to accident or surgery. If a prosthesis (artificial limb) is worn, ensure that the stump and socket are kept clean and dry. If stump socks are used, make sure you have spares.
Multiple Sclerosis is a disease of the central nervous system with an unknown cause and no known cure as yet. Some may use a wheelchair, others may have speech slurring or vision impairment. Symptoms vary greatly, so ask what assistance may be required.
Muscular Dystrophy is a disease causing muscle wasting and shortened lifespan. It only affects males and most affected boys are in wheelchairs by their teens. Many affected people have limited use of upper body muscles.
Paraplegia, Quadriplegia and Hemiplegia – Paraplegia is spinal cord damage affecting lower half of body. Quadriplegia is spinal cord damage affecting upper and lower halves of the body, and Hemiplegia is paralysis of one side of the body.
Psychiatric Disability is caused by the presence of a psychiatric illness (e.g. decreased feelings of self worth caused by schizophrenia). Medication is commonly used to assist persons with a psychiatric disability. Be aware of behaviour patterns that may be present and avoid situations which are known to cause undue distress or anxiety. Medication can have many side effects including suppression of normal body language.
Spina Bifida is caused by the incorrect development of parts of the brain and spinal cord, and can sometimes be identified by the presence of lumps along the spinal column. Those with a severe condition may require extensive personal care and use a wheelchair. Problems with bowel function are common.
Stroke or Cerebral Vascular Accident (CVA) is caused by haemorrhaging in the brain. The effects of any brain injury varies greatly, depending upon the location and extent of the haemorrhaging (refer to ABI). Be positive, patient and encourage independence.
Vision Impairment covers a wide range of sight difficulties. The majority of visually impaired people have partial vision and there are different types of visual impairment. You might find that some individuals may be able to see objects to the side of them better than to the front. Others might be able to see contrasts better than actual forms or shapes. Be aware of hazards and remove where possible or communicate their proximity to the individual when appropriate. Commentary is invaluable as it allows the participant to form a ‘picture’ of their environment and to understand what is going on around them.