Posts Tagged disability

[Abstract] Smart home and communication technology for people with disability: a scoping review



The links between disability, activity limitation and participation restriction are well established. Recent and continued advancement of technology, particularly smart home and communication technologies, presents new ways in which some of the limitations and restrictions experienced by people with disabilities can be overcome. The aim of this scoping review was to explore the impact of smart home and communication technology on the outcomes of people with disabilities and complex needs.


This review involved systematic searching of four databases, hand searches and data extraction. Eligibility criteria included [1] participant outcomes of [2] technology used within the home [3] among adults with a disability and complex needs.


Of the 2400 studies identified, 21 met our inclusion criteria. Studies were characterized by significant diversity in relation to disability and type of technology. Overall, technology appeared to improve independence, participation and quality of life among people with a disability and complex needs. Despite this, ethical considerations were raised given the vulnerability of this population, including potential risks through social participation and privacy concerns of using monitoring technology.


Smart home and communication technology can improve outcomes for people living with disabilities and complex needs. However, a number of factors impact the successful implementation of technology, including personalization, flexibility and ongoing support to the person with a disability and their close others. Future research should utilize high-quality study designs and established measures of important outcomes for this group.

  • There is a broad range of smart home and communication technology devices and systems available that may support the independence and participation of people with disabilities and complex needs; however, high-quality evidence documenting the impact of technology is lacking.
  • Soft-technology supports, including assessment, training and evaluation of technology implementation, may play just as important a role in shaping outcomes as the technology itself.
  • Systematic research is required to ensure there is quality evidence to inform investment in both technologies, and the soft-technology supports that promote its successful use.


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[BLOG POST] 5 Disability-Inclusive Sex Positions to Spice Up the Bedroom

By Jordan Davidson 

Sex is for every body — as long as the person you are being intimate with is a consenting adult. People with disabilities account for 20 percent of the population, but aren’t represented nearly as much as they should be when it comes to advertising, media and even pornography. Representation is important because everyone is entitled to a healthy and fulfilling sex life.

“The biggest myth is that people with disabilities are asexual or cannot have sex,” Eva Sweeney, host of “Cripping Up Sex With Eva,” told The Mighty. “I think this myth stems from the infantilization of people with disabilities. While some people with disabilities are asexual, the majority want and have sex.”

Just like most things in life, sex too can be modified. Whether you have a disability, your partner does or both of you do, there are plenty of ways to get creative in the bedroom. 

“Disability can affect sex but not in a bad way,” Sweeney said. “Different kinds of bodies might need to be more creative in the bedroom but this only spices things up and creates more conversation which is good for any relationship.”

Here are five poses Sweeney recommends for couples looking to spice things up in the bedroom — or any room, really.

1. Laying Down Side Straddle

When it comes to oral sex, Sweeney recommends having the person with a disability lie on their side and have their partner stimulate them orally from behind. “This position is great for people with spastic hips,” Sweeney added.

2. Modified Doggy-Style  

Doggy-style is a fun position for couples looking to switch things up. If you need to sit and can’t be the one doing the thrusting, ask your partner to back themselves on to you, moving back and forth.

Sweeney recommends talking to your partner before getting started. “Ask questions, respectful questions, and listen to your partner,” she said. “Also, you might want to feel your partner’s body before you get into the sexy time so you have a better understanding of how your partner’s body works.”

3. 69

Another oral sex position Sweeney recommends is “69.” “I would recommend 69, where one partner lays on his back and the other partner backs himself up on top,” she explained.

4. Modified Missionary

This modified missionary position is a great option if one person is able-bodied. Have the able-bodied partner stand at the bedside while the disabled partner lays at the edge of the bed. Add some pillows to the mix to help position yourself comfortably.

If it’s your first time with a new partner and a position requires you to move out of your wheelchair before you get into “sexy mode,” walk your partner through the transfer. Alternatively, Sweeney said, you can ask your aide to show them how to do the transfer.

5. Giving Oral Sex From Your Wheelchair

If you want to give oral sex from your wheelchair, ask your partner to lie on the edge of the bed and place the lower half of their body on your lap.

If you aren’t a fan of oral sex or want to explore your sexuality on your own, Sweeney recommends looking into toys. “There are so many toys to help you explore your sexuality,” she said. “Most people can find something that works for them.”

Illustrations for The Mighty by Jessica Oddi, co-creator of “The Disabled Life.” 

Jordan Davidson is The Mighty’s Managing Editor. Follow her on twitter @JA_Davids or email her at


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[TED Talk] To overcome challenges, stop comparing yourself to others – Dean Furness

When you stop comparing yourself to others, you can accomplish great things, says wheelchair athlete Dean Furness. He shares how, after losing the use of his legs in an accident, he discovered a powerful new mindset focused on redefining his “personal average” and getting better little by little.

via Dean Furness: To overcome challenges, stop comparing yourself to others | TED Talk

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[BLOG POST] Trista McGovern’s Photo Series De-stigmatizes Disability and Sexuality – The Mighty

Dismantling What We’ve Been Told About Disability and Sexuality


I thought it was Just Fine. The ingrained issues with being ~born~ very different, as well as developing more or having chronic conditions.

I thought it didn’t matter because I knew myself, and nothing phases me. I had a sound mind and a calm heart; logic and grit have always propelled me.

But every now and then, it jumps out at me.

It reminds me how much I know it infected my roots, discolored my branches and stunted my growth.

Disability is the largest minority, and the only one that can suddenly become an attribute to anyone at any point in their life. But it seems to be the one talked about the least; sexuality being the least discussed topic.

I’ve seen both persons with disabilities and/or visible differences as either objects to examine or as tokens for inspiration, but never ~just~ as humans within the umbrella of sexuality. Not in movies, photos, shows or even in your general damn conversations.

It seeps in without having to ever be blatantly named or shown. The carbon monoxide of disability.

I knew it was an issue when I was younger and couldn’t speak even to join a conversation. I knew it was an issue when my “friend” groped me and I was too frozen to stop it. I knew it was an issue when I had no fear, yet tensing up or shaking from intimacy was involuntary. I knew it was an issue when a partner affectionally traced my scars and I didn’t realize I reacted with crying.

I knew it was an issue when I simply retold the notions the world gave me with a blank face, but it caused my friend to sob.

I can’t speak for everyone with disabilities and/or major differences, but I know of some who can relate. I know it’s up to every individual to figure things out for themselves and how they relate to those around them — but how are we supposed to put ourselves in the conversation when we’re left in the other room? How do we get/feel invited to the circle when we seem covered in red flags? How can we rectify the twisted connotation that disabled means nonsexual when you perpetuate it? How can we process our layers of trauma when we’re too busy putting you at ease? How do we put ourselves out there when people with disabilities are three times more likely to be assaulted than literally anyone else? How can we expect healthy relationships when you’ll either love us or fuck us but rarely both?

How could I have discussed attraction, desire, sexuality or literally intimately using my body when people have shouted, “What the fuck is that?” at me for just physically existing at a bus stop? How could I tell a crush I liked them after they cried because they felt bad for my condition? How could I tell you how I like it when you assume I completely don’t? How could I believe your generic compliment when yesterday a friend called me repulsive? How can I pretend it’s not still a problem when a stranger makes a video post mocking my old Tinder profile on the internet? How could I bring these things up when you give me that look on your face?

This is not about my personal gritty details, or my various private relationships.

I’ve already done the work. I’ve ripped off the bandaids. I’ve soothed the once debilitating hyperawareness of how I’m perceived and treated. I’ve dismantled the machine to rebuild it correctly and discarded the parts not useful to me. I’ve translated the twisted, ingrained language so I could decipher what’s real and what’s not. I’ve walked across the coals and consoled you for watching.

I thought it was fine to just keep my progress and life private. Because it is what it is, right? But it’s not just about my lifetime of invisible obstacles I hid under the rug.

It’s less about stepping in the light and more about pointing out the lion. It’s less about me and more about why you might feel uncomfortable right now.

It’s about people who look different. The people who have been “othered.” The people who are wrongly infantilized. The people who have felt broken or lacking. The people who might be the most insatiable queer sluts you’ve ever met but get silenced into amicable pals.

It’s for anyone subtly forced into the dark corners under the impression that they don’t belong and are definitley not welcomed.

It’ll always be an issue in some form, but like with all things, I’ll keep trying to unlearn for myself and to show up for others.

Fuck that, fuck you, fuck me.

Photography: Emma Wondra Photography @emmawondra 

Models: Brian Pepinski @browniethunder + Trista McGovern @tristamariemcg

Writing and concept: Trista McGovern @tristamariemcg


via Trista McGovern’s Photo Series De-stigmatizes Disability and Sexuality | The Mighty


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[BLOG POST] 5 things I want others to know about disability

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Rebecca Sullivan is a blogger who uses her writing to express her experiences of living with cerebral palsy. Her work allows her to come to terms with her disability, and she hopes that it also inspires others to change the way they perceive the disabled community.

People with disabilities face lots of challenges. However, some of these can be reduced by society having greater awareness. I hope this article provides insight into some common misconceptions that people with disabilities face.

Rebecca sits in her colorful wheelchair in a garden wearing yellow.

1. Everyone with a disability is different 

People with disabilities are all different. Our experiences, our thoughts and our feelings are unique. Please don’t assume that every disabled person has the same preferences or that two people with the same condition will be affected in the same way.

As someone with cerebral palsy (CP), I am aware that the symptoms of CP will differ for each person. We should not be compared and our own separate desires should be taken into account.

Some people with CP walk, some use a wheelchair and some alternate between both. Some speak orally and some use an assistive device. We have the same diagnosis but are all different.

Disability does not have the same face for everybody, nor will it be the same experience for everyone.

2. Please don’t help me without asking

Sometimes, when people see me they may think I am struggling and their instinct is to help. However, it is always best to ask if someone wants help first.

I know from my own experience when someone has done things for me without asking it has felt as if my independence has been taken away. I feel obligated to accept their help so that I don’t come across as rude.

Rebecca posing in her wheelchair outside.

But I need to change this thinking. I need to be more vocal and politely say, “I am okay to do this, but thanks anyway” or ‘Could you help with this part” if I do need assistance with something.

I always appreciate it when I’m asked if I need assistance first. This shows they have seen me and given me the option of help rather than jumping to assumptions.

Additionally, if I say ‘no’ it is not out of stubbornness. It’s likely that this presumed difficulty is how I go about completing a task. For example, when I fix the bag on the back of my chair, it is just a routine to me, even though it might look like I’m struggling.

3. Don’t be afraid to get to know someone with a disability

Differences have a tendency to make others act funny. Sometimes, people are uncertain about knowing what to say or how to behave around people with differences. Because of this, it can make them avoid getting to know someone with a disability.

For some, having an encounter with someone who has a disability may be rare, so that person’s disability takes precedence over the actual person. I find this is one of the hardest things… observing a sympathetic smile while seeing fear in their eyes, or having a necessary but hurried conversation with someone.

I know seeing things from another point of view isn’t easy. Sometimes I try to break the ice and let people know that my disability is only one part of me. People have more to them than just their disability. I have cerebral palsy, just like I have brown hair.

Rachel smiling and sitting her wheelchair in a bright orange outfit.

4. It’s okay to ask questions

People have questions. Most people have an inquisitive nature – I know I do! But often people feel that they can’t ask questions about disability.

I know that in the past, when I have met someone new, for a moment or two there is some awkwardness and I get that feeling that they want to ask something but are unsure how to. I feel it’s best to gently let them know it’s okay to ask questions and perhaps bring up my disability first. This tends to reduce uneasiness.

5. It’s okay to ask me to repeat myself 

My speech is affected by my CP and therefore I am not always understood by others. Sometimes people don’t tell me that they didn’t understand what I said and respond with a completely different answer or stand there silently.

Instead of getting irritated with myself, I try to remind others that it is completely okay to ask me to repeat anything that they don’t understand.

I may repeat myself in a different way or spell out the specific word that the person is having difficulty understanding. I would rather repeat myself 10 times than have someone try to guess what I am saying.

I hope this list has helped change your perspective on disability or encourage you to think about what you want others to know about your disability.

By Rebecca Sullivan

To learn more about Rebecca and to read some of her work, visit her blog, From this Window.

via 5 things I want others to know about disability | Disability Horizons

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[Abstract + Similar articles] Recovering Functional Independence After a Stroke Through Modified Constraint-Induced Therapy


Background: Population ageing and changes in the epidemiological profile of neurological pathologies has resulted in an increase in patients with disabilities. Rehabilitation strategies such as Modified Constraint-Induced Movement Therapy (CIMTm) play a key role in treating patients with neurologic deficiencies and motor impairments. This intervention is intended to mitigate disability, promote maximum functional independence, and optimize social and economic participation of patients with upper extremity weakness. Our goal was to assess the recovery of functional independence in patients after a stroke using to CIMTm.

Patients and method: Thirty-six subjects who had suffered stroke took part in a randomised clinical trial. The treatment was applied through either collective or individual modalities for three hours per day for a period of ten days. Participant’s functional independence was assessed using the Functional Independence Measure (FIM) scale at the before and after of the intervention.

Results: An analysis of covariance carried out on the pre-test assessments indicates that the dependent variable presents significant differences (F1.31 = 42.78, p < 0.001, η2p = 0.72) in favour of the collective intervention modality.

Conclusion: Both modalities of CIMTm intervention promote functional independence. However, the greatest improvements were observed in participants in the collective modality. Improvements in functional independence pursue a reduction in learned non-use behaviours through greater use of the paretic upper extremity in everyday activities.

Similar articles

via Recovering Functional Independence After a Stroke Through Modified Constraint-Induced Therapy – PubMed

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[Abstract] Upper Limb Three-Dimensional Reachable Workspace Analysis Using the Kinect Sensor in Hemiplegic Stroke Patients



reachable workspace evaluation using the Kinect sensor was previously introduced as a novel upper limb outcome measure in neuromuscular and musculoskeletal conditions. This study investigated its usefulness in hemiplegic stroke patients.


Forty-one patients with hemiplegic stroke were included. Kinect-based reachable workspace analysis was performed on both paretic and nonparetic sides. Upper limb impairment was measured using the Fugl-Meyer Assessment and the Motricity Index on the paretic side. Disability was assessed using the shortened Disabilities of the Arm, Shoulder, and Hand questionnaire. Correlations between the relative surface areas, impairment scores, and disability were analyzed.


Quadrants 1, 3, and 4 as well as the total relative surface area of the paretic side were significantly reduced compared with the nonparetic side. The total relative surface area of the paretic side correlated with the Fugl-Meyer Assessment scores, the Motricity Index for Upper Extremity, and the Disabilities of the Arm, Shoulder, and Hand questionnaire score. Furthermore, quadrant 3 was the most important determinant of upper limb impairment and disability.


reachable workspace (a sensor-based measure that can be obtained relatively quickly and unobtrusively) could be a useful and alternative outcome measure for upper limb in hemiplegic stroke patients.

via Upper Limb Three-Dimensional Reachable Workspace Analysis Us… : American Journal of Physical Medicine & Rehabilitation

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[Abstract] Developments and clinical evaluations of robotic exoskeleton technology for human upper-limb rehabilitation

The development of upper limb and lower extremity robotic exoskeletons has emerged as a way to improve the quality of life as well as act as a primary rehabilitation device for individuals suffering from stroke or spinal cord injury. This paper contains extractions from the database of robotic exoskeleton for human upper limb rehabilitation and prime factors behind the burden of stroke. Various studies on stroke-induced deficiency from different countries were included in the review. The data were extracted from both clinical tests and surveys. Though there have been splendid advancements in this field, they still present enormous challenges. This paper provides the current developments, progress and research challenges in exoskeleton technology along with future research directions associated with the field of exoskeletons and orthosis. Robot-assisted training (RT) was found to be more effective than conventional training (CT) sessions. The present research articles in this field have many weaknesses as they do not cover the systematic review including the clinical studies and various surveys that lay a foundation for the requirement of robotic assistive devices. This review paper also discusses various exoskeleton devices that have been clinically evaluated.


via Developments and clinical evaluations of robotic exoskeleton technology for human upper-limb rehabilitation: Advanced Robotics: Vol 0, No 0

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[WEB PAGE] Definition of a Disability – Great Plains ADA Center

ADA-AA Definition of a Disability

The Americans with Disabilities Act (ADA) defines disability as a“physical or mental impairment that substantially limits one or more major life activities.” This is a legal definition, rather than a medical definition. The ADA definition of disability does not apply to disability-related services such as Social Security.  The definition of disability was expanded and clarified by the ADA Amendments Act in 2008.

The ADA definition of disability does not include a list of required medical conditions or categories. There is no “national registry” or any other type of certification process that people must complete to qualify as a person with a disability under the ADA.

At first glance, determining whether a person has a condition that meets the ADA definition of a disability may seem complicated and confusing.  However, the determination is based on three fairly straight-forward questions.

1) Is there a condition/impairment that impacts major life activities or body system functions?

  • When active-does not have to be a daily 24/7 impact.

2) Is the impact on major life activities or body system functions substantial?

  • Based on the level of impact when not using medication, an assistive device, receiving treatment, etc. (mitigating measure).
  • Based on comparison with the general population and peers.

3) Is the condition/impairment permanent or long-term?
The purpose of this article is to clarify this process by explaining the definition’s terminology and providing several real-life examples.

Major Life Activities

Major life activities are basic activities that most people can perform with little or no difficulty. These activities may be physical such as walking, seeing, hearing, standing, use of hands, etc.  Cognitive and social/emotional activities such as memory, paying attention, processing information, and maintaining well being and moods are considered major life activities.

Major life activities also include the activities required for body system functioning. Conditions which affect the functioning of the digestive, neurological, immune, and circulatory systems, etc. would be considered conditions that affect major life activities.

The definition of a disability was specifically expanded to include conditions or impairments that affect body functions (such as diabetes or rheumatoid arthritis) to ensure people with all types of disabilities are included in the definition and receive protections under the ADA.

Episodic Conditions and Remission

Some conditions and/or impairments have symptoms that are not always present. These types of conditions are called episodic. Disability is assessed on the impact of these conditions on major life activities and body functions when the symptoms are active.

If a person’s active symptoms meet the definition of a disability, then the individual is always covered by the ADA, even when the symptoms are not present. This reasoning also applies to conditions that may go into remission such as cancer.


Marla has multiple sclerosis and uses a wheelchair. At work, there are times when she walks short distances with a cane. When her condition is in remission, she only uses a cane. Some of Marla’s co-workers think she shouldn’t receive accommodations because she doesn’t always use a wheelchair.

Marla is considered a person with a disability at all times.  She does not have to use a wheelchair daily to receive accommodations related to using a wheelchair.

Jamal has completed chemotherapy and, at his last follow-up appointment, was told his cancer is in remission, but will still require follow-up care. Jamal is concerned that he will no longer be able to use his flex schedule to make-up time for follow-up appointments and continued treatments.

Jamal condition is in remission, but without continued treatment, the cancer would have a substantial impact on major life activities.  Jamal’s condition is considered a disability under the ADA.

Linn has Seasonal Affective Disorder. His symptoms of depression only affect major life activities at certain times of the year. Because Linn’s condition is long-term and impacts major life activities when present, it is considered a disability under the ADA, even though the condition is not always present.

Invisible Disabilities

A condition does not have to be visible or “readily apparent” to be considered a disability.  Many conditions that are not readily apparent to the general population still affect major life activities.  Whether or not a condition is “visible” is not a consideration when determining whether a person is covered by the ADA.  It is the impact of the condition on major life activities that determines disability.


Maria has dyslexia. She uses assistive technology to get information and prepare reports. Because reading and writing are major life activities, Maria is a person with a disability.

Joshua has been diagnosed with PTSD and receives treatment.  Joshua is outgoing and physically fit and probably would not be perceived as a person as a disability. However, based on how his condition affects his major life functioning (anxiety), Joshua is a person with a disability covered by the ADA.

Substantially Limited

Once it is determined that a person has a condition or impairment that affects major life activities, the next step is to assess the impact of the condition/impairment. The impact of the condition/impairment on a major life activity must be substantial to be considered a person with a disability under the ADA. The criteria used to determine whether or not the impact of a condition is substantial is based on two factors:

  • The nature and severity of impact on major life activities.
  • How long the impact will last or is expected to last (permanent or long-term).

A common sense assessment should be used to determine the nature and severity of a condition based upon comparing the person’s ability to perform a specific major life activity with that of most people in the general population. The same criteria is used for assessing body system functions.


Tamra is in her thirties. She has poor vision without glasses and must wear them to see clearly and function. Since wearing glasses or contacts to correct vision impairments is common in the general adult population, Tamra would not be considered a person with a disability.

Jean, on the other hand, is also in her thirties and has low vision and difficulty seeing contrast. She wears glasses, but still cannot see clearly and requires assistive technology to use computer screens and her smart phone. Jean’s level of visual difficulty is not typical for her age group in the general population. She would be considered to have a disability under the ADA.


Two employees have the diagnosis of asthma:

  • One employee uses an inhaler occasionally, and his asthma is very mild.
  • The other employee uses an inhaler occasionally, but flare-ups are severe and could be life-threatening.

In this example, the frequency that the condition occurs is the same, but the severity of the condition is different. The severity of asthma is the basis of determining which employee has a disability under the ADA.


Two employees experience migraine headaches.

One employee has a severe migraine headache two to three times a year, causing her to miss up to three days of work annually.

Another employee has a severe migraine headache 3-4 times a month, causing him to miss up to four days of work each month.

In this scenario, the severity of the condition is similar, but the frequency and impact on major life activities is different. While experiencing a migraine headache is not uncommon in the general population, the severity and frequency of the second employee’s migraines result in a substantial impact on major life activities.

Assessment of Disability and Mitigating Measures

Actions taken to eliminate or reduce the impact of an impairment/condition are called mitigating measures. This includes, but is not limited to, medication, treatments, assistive devices, hearing aids, wheelchairs, and therapies. The extent that a condition impacts major life activities is based upon how the condition affects a person without using a mitigating measure.


Bill has Type II diabetes, and insulin is his “mitigating measure.”  Bill has no limitations on his major life activities when he monitors his blood sugar and uses insulin. However, he uses insulin because his endocrine system is substantially impaired. Without insulin, the impact on his major life activities and overall body functions would be severe. Bill is covered by the ADA as a person with a disability.

Takeaway: Whether or not a person has a disability is based upon the impact of the condition or impairment on major life activities and body functions without the use of a mitigating measure.  A person does not have to use a reasonable accommodation in the workplace or other modifications to be covered by the ADA.

Length of Time or Duration of a Disability

Conditions and/or impairments that are short-term do not meet the definition of a disability under the ADA, even if the condition meets the other criteria:  substantial impact on major life activities.


Evan injured his back and is required to limit most physical activities for at least a week. He is in pain and must take medication.  However, he is expected to fully recover in 2 weeks.

Even though the impact of Evan’s condition is substantial, the impact is short-term and would not be considered a disability under the ADA.


Shawna became very ill with a life-threatening infection. She spent two days in the hospital before returning to work 1/2 days for a week. She then returned to work full time. Her infection is gone and she requires no extended treatment.

Although the impact of the condition was life-threatening, the impact was short-term with a full recovery.  Shawna would not be considered a person with a disability under the ADA.


Glenda was in a car accident. Her injuries were severe and she will require rehabilitation. Although Glenda is expected to fully recover, she will use a wheelchair and then a cane for at least six months.

Glenda’s injuries will not have a permanent impact on major life activities. However, she is covered under the ADA because of the length of time that her condition impacts major life activities.

Other Factors Covered by the ADA

ADA protections are provided to people who don’t have a disability, but may experience disability related discrimination based upon:

  • Having a record of a disability that is no longer present.
  • Having a condition or appearance that is regarded as a disability, but actually has no impact on major life activities.

Example: Record of Disability

Tim has been cancer-free for five years and is considered to be in complete remission. His employer does not promote him as expected because the employer says the “cancer may come back”.

Under the ADA, Tim is protected from discrimination that is based solely on his history of having a disability.

Example: Regarded As

Jenna has noticeable burn scars on her face.  Her scars have no impact on major life activities and require no medical care. However Jenna is turned away from a job interview because of her facial scars. The employer believes her scars will “make her unable to work with customers.”

Under the ADA, Jenna would be protected from discrimination because her employer regarded her scars as a disabling condition.

Definition of a Disability and Employment

A person with a condition that meets the definition of a disability under the ADA is protected from employment discrimination, but they must also be:

  • Qualified for the position they seek.
  • Able to perform the essential functions of the job with or without reasonable accommodations.

In other words, Title I of the ADA protects qualified individuals with disabilities who can perform the essential functions of the job with or without reasonable accommodations.

A person with a disability may be asked to provide documentation from their medical professional if their disability is not “readily apparent.”

Summary: Key Concepts

  • The definition of a disability is a legal definition rather than a medical definition.  The definition does not apply to qualifying for disability-related services such as Social Security.
  • There is no list of required medical conditions or categories included in the law. There is also no “national registry” or any other type of certification process that people must complete to be considered to have a disability under the ADA.
  • The ADA applies to all ages.  Children with disabilities are covered by the ADA.
  • The ADA makes no distinction between types of disabilities.  Individuals who meet the definition of a disability all have have the same rights under the ADA.
  • The criteria used to determine disability is based on the impact of the condition/impairment on major life activities instead of just the presence of the condition.
  • The impact of a condition on major life activities is assessed by how the condition affects major life activities without the use of mitigating measures (actions taken to alleviate symptoms or improve functioning such as medication, therapy, or hearing aids.)
  • The ADA protects people who have a past record of disability from discrimination.  The ADA also protects people who do not have a disability, but are “regarded as” having a disability.
  • The ADA protects people with disabilities from discrimination in the workplace, but they must be qualified for the job they hold or are seeking.

via Definition of a Disability | Great Plains ADA Center

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[ARTICLE] Seizures Do Not Affect Disability and Mortality Outcomes of Stroke: A Population-Based Study – Full Text


Although seizures are frequently seen after cerebrovascular accidents, their effects on long-term outcome in stroke patients are still unknown. Therefore, the aim of this study was to investigate the relationship between post-stroke seizures and the risk of long-term disability and mortality in stroke patients. This study is part of a larger population-based study. All patients were prospectively followed up by a face-to-face interview or a structured telephone interview. We enrolled 635 patients with first-ever stroke and without a history of seizures. Prevalence of ischemic stroke (IS) was 85.2%, while the remaining 14.8% of patients were affected by intracerebral hemorrhage (ICH). During the study period, 51 subjects (8%) developed post-stroke seizures. Patients with post-stroke seizures were younger, had a higher prevalence of ICH, had a more severe stroke at admission, were more likely to have an IS involving the total anterior circulation, and were more likely to have a lobar ICH than patients without seizures. Moreover, subjects with seizures had more frequently hemorrhagic transformation after IS and cortical strokes. At 24 months, the risk of disability in patients with seizures was almost twice than in those without seizures. However, the negative effect of seizures disappeared in multivariate analysis. Kaplan-Meier survival curves at 12 years were not significantly different between patients with and without post-stroke seizures. Using the Cox multivariate analysis, age, NIHSS at admission, and pre-stroke mRS were independently associated with all-cause long-term mortality. In our sample, seizures did not impair long-term outcome in patients affected by cerebrovascular accidents. The not significant, slight difference in favor of a better survival for patients with seizures may be attributed to the slight age difference between the two groups.

1. Introduction

Seizures are frequently seen after cerebrovascular accidents. Acute symptomatic or early seizures (ES) affect between 3% and 6% of all stroke patients [1,2,3,4,5,6], whereas unprovoked or late seizures (LS) have been reported in 10 to 12% of stroke patients [7,8].
Although determinants and correlates of ES and LS after stroke have been largely investigated [1,6,9,10,11,12,13,14,15,16,17], the effect of seizures on long-term outcome in stroke patients is still unknown. In fact, previous studies focused their interest on short-term mortality [2,12,18,19,20,21,22], and only a few of them reported results on disability that was assessed only at discharge [13,18,19,21,22].
Recently, Claessens et al. conducted a retrospective study to explore a possible association between post-stroke seizures and long-term mortality. After correction for possible confounding variables, the authors concluded that seizures were not significantly related to mortality risk [23]. Conversely, in the prospective Future study, Arntz et al. showed that post-stroke seizures negatively affect long-term disability and mortality [24,25]. Differences in the population study might explain these conflicting findings. In particular, Claessens et al. included only patients with intracerebral hemorrhage (ICH), whereas Arntz et al. included only young patients, aged 18 to 50 years, after transient ischemic attack (TIA), ischemic stroke (IS) or ICH [23,24,25]. Bearing in mind that ICH accounts for almost 15% of all strokes and that cerebrovascular accidents are largely more common in subjects older than 50 years, these results cannot be directly generalizable to all stroke patients.
Therefore, the aim of this study was to investigate the relationship between post-stroke seizures and the risk of long-term disability and mortality in patients affected by cerebrovascular accidents.[…]

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