Learning Disabilities

TYPES OF DISABILITIES

SENSORY IMPAIRMENT

HEARING IMPAIRMENT • Any type of hearing loss, which may be related to either conductive or sensorineural problems.

PEOPLE WITH THIS INCLUDE: • Deaf • Hard of hearing

DEAFNESS deaf – physical condition of hearing loss • Deaf – special collectives •

• Prelingually deaf : early childhood • Since birth: sign language, lipreading • Later life: poor lipreading, average reading and writing skills.

For patient education to be effective, communciation must be…

VISIBLE

DISADVANTAGES OF HEARING LOSS • Problem in communication • May be unable to speak • Limited verbal abilities • Poor vocabulary

ADVANTAGES

MODES OF COMMUNICATION

SIGN LANGUAGE • American Sign Language (ASL) - Professional interpreter - Section 504 of the Rehab Act of 1973

LIPREADING All people who are deaf can read lips?? • • • •

Do not exaggerate lighting Remove barriers around your face Signing or written materials

WRITTEN MATERIALS -Most reliable way -Safest approach -Time-consuming -Stressful • Match readability of client. • Keep message simple • Visual Aids

VERBALIZATION BY THE CLIENT • Rapport/trusting relationship • Try writing down what you hear

SOUND AUGMENTATION - Patients not completely deaf • • • •

Hearing Aids Cupping of hands Stethoscope Stand/sit near “good” ear

TELECOMMUNICATION • Telecommunication devices for the deaf (TDD) • Television decoders • Caption films

GUIDELINES IN USING DIFFERENT MODES OF COMMUNICATION 1. be natural. 2. simple sentences 3. therapeutic touch 4. face and stand < 6 feet 5. be considerate 6. do not turn face away 7. Stand directly at light

NURSING INTERVENTION • Confirm messages been received and understood • Find effective strategies to give intended message clearly. • Ask patient what suits them.

VISUAL IMPAIRMENT • 20/200 VISION • VISUAL FIELD LIMITS IN BOTH EYES WITHIN 20 DEGREES DIAMETER

4 LEADING EYE DISEASES ASSOCIATED WITH AGING PROCESS

MACULAR DEGENERATION • deterioration of the macula, causing decrease in central vision

CATARACT • Opacity of the lens • vision is hazy

• complication of diabetes is a leading cause of blindness among middle-aged Americans. • leaking blood vessels can cause blinding areas

GLAUCOMA This disease increases the fluid pressure inside the eye, leading to loss of side vision and eventually total blindness. The increased pressure destroys the optic nerve.

Tips in caring for blind or visually impaired patients: Persons who have long standing blindness have learned to develop a heightened acuity to senses like hearing, taste, touch, smell

When explaining procedures, be descriptive as possible Because blind persons are unable to see shapes, sizes and placement of objects, tactile learning is an important technique to use when teaching

When using printed or handwritten materials, enlarge the print or handwriting

Proper lighting is of utmost importance in assisting the legally blind person to read the printed word

Providing contrast is a very helpful technique Audiotapes and cassette recorders are very useful tools If you are assisting a person who is blind to ambulate, always use the “sighted guide technique”

LEARNING DISABILITY

INPUT DISABILITIES •

TYPES:

1. Visual Perceptual Disorder • inability to read or difficulty with reading (dyslexia) •

people with this deficit tend to be auditory learners.

2. Auditory Perceptual Disorder • inability to distinguish subtle differences in sounds. example: blue and blow, ball and bell 3. Integrative Processing Disorder • inability to sequence visual, auditory or tactile stimuli. example: dog as god Abstraction- inability to infer meaning from words or phrases.

4. Short-term or Long Term Memory Disorder • inability to restore or recall what a person has learned an hour before, but he/she may be able to recall information at later point in time.

COMMUNICATION DISORDERS

AMPHASIA • problem with speaking, writing or understanding • multiple modality loss of language ability 2 TYPES 1. Expressive • affects the dominant cerebral hemisphere • caused by injury 1. Receptive • wernick’s area are affected • can hear but unable to understand the significance of the spoken word.

Working with an expressive aphasia client: • Recall word images • Repeat words spoken by the nurse.

Working with an receptive aphasia client: • Establish means for non verbal communication • Speak appropriately • Encourage and teach client • Acknowledge client’s frustration

Blanco suggest the following: • Don’t use baby talk • Speak normal tones • Speak in short, slow, simple sentences • Allow time to answer • Be patient, slow the person’s response down and involve the family

DYSARTHRIA • problem with the muscle controlling the speech • cause by a damage • affects the same muscles used in eating and speaking

Dreher makes the following suggestions to improve communication: • • • • •

Be sure environment is quite Repeat unclear parts of the subject Do not simplify your message Ask questions that need only short answers Encourage the person to use more oral movement.

LARYNGECTOMY • Cancer of the larynx • men>women • >60 SPEAKING AFTER LARYNGECTOMY: • Esophageal speech • Tracheoesophageal speech

CHRONIC ILLNESS 8 KEY PROBLEMS OF A CHRONICALLY ILL PATIENT • • • • • • • •

Problem management Control of symptoms Carrying out prescribed regimens Prevention/living with social isolation Adjustments to life changes Interaction with others and lifestyle Funding Other problems

MEASURES TO IMPROVE COMMUNICATIONS WITH A PERSON WITH A LARYNGECTOMY: • Seek quiet environment • Watch the speaker’s lips • Do not alter your message • If you don’t understand the speaker, repeat what you think the person said, and ask for more information