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Monday, September 04, 2006

Disability Issues in Program Planning

Issues, Concerns, and Impact of the ADA in Service Delivery
In 1990, the Americans with Disabilities Act became law, and in so doing, created a legal duty to accommodate the disabled in all segments of society including the provision of recreation services. As with any new legislation, a great deal of concern has arisen regarding the practical implementation of services. Several key issues emerge:
• How to deliver services for a specialized population without cutting programs for everyone...especially on a “tight” budget.
• How much will accommodation cost?
• Is there enough interest to warrant the effort?
• What types of accommodations can be made for different disabilities?
• What does the ADA “really” mean?
• Where can one go for information and advice?
• How can one remain competitive and productive while complying with the law?

In order to address the above issues, it is first necessary to define “disability” and “handicap”. Although most persons have a general concept of these terms, an inclusive and definitive meaning has yet to be established among professionals. This lack of clarity further confounds the issues related to service provision as it is often unclear exactly what or who qualifies as disabled and in need of services. In order to establish a fundamental understanding of the terms, the Disabled People International (D.P.I.) definition will be used. According to the D.P.I. (cited in Gianni, 1996) definition, “disability” is defined as “the functional limitation within the individual caused by physical, mental, or sensory impairments”. These conditions are deemed disabling by diagnosis. “Handicap” is defined as “the loss or limitation of opportunities to take part in the normal life of the community on an equal level with others due to physical and social barriers” (cited in Gianni, 1996). A handicapping condition is therefore related to the individuals relationship to, and within, his/her community. In order to understand the level of handicap, it becomes necessary to examine the individuals affected by the disability, the social response to the disability, and the actual physical environment. Together, the internal, social, and physical environment determine the degree of handicap. Accordingly, an impairment which leads to a functional disability in one set of circumstances may not lead to a functional disability under a different, or an “enabling” set of circumstances. The concept of environment as central to determining the level of handicap gains greater importance when determining what may (or may not) be considered an appropriate program planning response to the ADA. Furthermore, in order to create meaningful leisure experiences for the disabled, it is necessary to fully conceptualize needs and desires in order to implement the programs towards maximum use.
Statistics
After having defined the working definition of disability and handicap, a numerical representation expressing the total percentage of disabled persons, as well as the various forms of disability, will allow the reader to conceptually grasp the range of disabling conditions. A greater understanding of the broad range of functional capacities, expectations, and needs of the population promote a proactive stance towards program planning for the disabled. Statistically relevent categories include: gender and age. Furthermore, the diagnosis of disability may be that of a “work” disability or a “severe” disability. A “work” disablity is defined as “a health condition (physical or mental) ...which limited the kind or amount of work they could do at a job or business.” (Census, 1990). A “severe” disability is defined as “an inability to perform one or more functional activities or one or more socially defined roles or tasks.” (Census, 1990). Severe disabilities are sub-divided into “functional acitivities” and “activities of daily living”. A “functional activity” is classified into six primary categories, “including seeing, hearing, speaking, lifting and carrying, climbing stirs, and walking.” (Census, 1990). An “activity of daily living” consist of six categories including “getting around inside the home, getting in or out of a bed or chair, taking a bath or shower, dressing, eating, and toileting.” (Census, 1996).

Total number of disabled in millions:
(U.S. Census, 1992)

According to the U.S. Census, 19.4% of the United States population is disabled; nearly 1 out of every five citizens. This figure excludes persons living in nursing homes or other institutions. The severely disabled population account for 9.6% of the total population.


Age and Disability

(U.S. Census, 1992)
According to the U.S. Census Bureau, the likelihood of acquiring a disability increass with age; ranging from a low5.8% for those 17yrs. Of age and younger, and rising to an alarming 84.2% for those who reach the age of 84yrs. Closely related to this phenomena is that of gender differentiation among the disabled. Since women generally outlive men, they experience a greater risk of disability. However, this does not account for the entire difference as women are more likely to be disabled in all age ranges.

The young and the elderly, men and women, all are affected by disability. It is estimated that well over 160million family members are also affected by the disabilty of a loved one. (Census, 1996). Given the high rate of disability within the population as a whole, and the increased likelihood of acquiring a disability with an aging population, recreation services cannot affort to ignore the needs of the disabled. Given the demographic shift in population growth, the issue of disability becomes a question of “when” more often than “if”. Program planning for the disabled is NOT for a select few, but rather an essential measure designed to reach nearly 1 out of every 5 persons in the community. Statistics support the need for services directed toward the disabled. Given an “enabling” environment and the opportunity for minimization of a handicap through a leisure pursuit, the questions of interest, productivity, and competitiveness become a questions of “tapping” the market. The disabled, by virtue of sheer numbers, are becoming an important market segment.
Categories
Just as other market segments, the disabled are a diverse population. In modern society there exist what superficially resembles a paradox; the unity of a group represents power and influence while the singularity of the individual demands recognition and respect. Taken as a whole, the disabled are a force for change as business recognizes the emerging market. As individuals, those needs cannot be met by a “one size fits all” approach. Given the technological advances of modern society, “personalized” service is becoming the norm. Everything from Levis jeans to real estate is “custom fit” to the individual. In the provision of recreation services, this becomes a critical issue. Not only are there health and safety concerns, but the various types and degrees of disability become a critical issue when the quality of service is analyzed. Disabilties are categorized into three main groups:
 Physcial ( including visual, hearing, and motor impairments).
 Cognitive (including developmentally delayed and degenerative conditions).
 Mental/Emotional (including substance abuse and depression).
Each category of disabilty

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