Aristotle University of Thessaloniki Social and Health Policy Committee
Trainer’s manual
Thessaloniki, December 2013
Table of Contents
Introduction............................................................................................................ 5 Part Ι – Theoretical Part ............................................................................................. 8 1. The DAReLearning project training ............................................................................ 8 2. Disability – Overview .............................................................................................10 2.1 Equal Educational Opportunities ..........................................................................10 2.2 Understanding Disability – Medical and Social Models .................................................12 2.3 Myths and Stereotypes ......................................................................................14 2.4 Language Etiquette ..........................................................................................16 3. Different Types of Disability – Overview .....................................................................19 3.1 Mental Health Difficulties ..................................................................................19 3.2 Visual Impairments ..........................................................................................22 3.3 Hearing Impairments ........................................................................................24 3.4 Mobility Impairments ........................................................................................26 4. Strategies for Teaching Disabled Students ...................................................................28 4.1 General Guidelines ..........................................................................................28 4.2 Strategies for Teaching Students with Mental Health difficulties ...................................28 4.3 Strategies for Teaching Students with Visual Impairments ...........................................32 4.4 Strategies for Teaching Students with Hearing Impairments ........................................40 4.5 Strategies for Teaching Students with Mobility Impairments ........................................42
Part ΙI – Practical Part...............................................................................................45 5. The training .......................................................................................................45 5.1 A guide to the Practical Part of the Manual .............................................................45 5.2 The Training Programme Guide ...........................................................................46 5.3 Language and Stereotypes .................................................................................48 5.3.1 Activity: People first language ..................................................................... 48 5.3.2 Activity: Character traits of people with and without disabilities ........................... 54 5.3.3 Activity: Stereotyping and how to defy it in an educational context ....................... 58 5.4 Mental Health.................................................................................................63 5.4.1 Activity: Young adult mental health .............................................................. 63 5.4.2 Activity: Myths concerning mental illness assessment inventory ............................ 66 5.4.3 Activity: Mental health difficulties and symptoms ............................................. 69 5.4.4 Activity: Academic Difficulties and a Guide to student support ............................. 73 5.5 Visual impairments ..........................................................................................78 5.5.1 Activity: Sighted guide techniques ................................................................ 78 5.5.2 Theoretical background for the activity .......................................................... 80 5.5.3 Strategies for teaching students with visual impairment...................................... 80 5.5.4 Assistive Technologies ............................................................................... 80 5.6 Hearing Impairments ........................................................................................84 5.6.1 Activity: Classifiers ................................................................................... 84 5.6.2 Theoretical Background for the Activity ......................................................... 85 5.6.3 Strategies for Teaching Students with Hearing Impairments ................................. 87 5.6.4 Assistive Technologies ............................................................................... 88 5.7 Mobility impairments ........................................................................................90 5.7.1 Activity: Experience of disability/ Medical and Social model of disability/ Wheelchair etiquette/ Stereotypes of mobility disability ........................................................... 90 5.7.2 Communication and teaching strategies ....................................................... 101 5.7.3 Activity: Exclusion/ Assistive technologies .................................................... 102
5.8 Reasonable adjustments .................................................................................. 109 5.8.1 Activity: How to remove barriers ................................................................ 109 6. Supplementary information .................................................................................. 115 6.1 Test your knowledge ...................................................................................... 115 7. The Ending ....................................................................................................... 121 8. Questionnaires .................................................................................................. 122 8.1 Evaluation questionnaire ................................................................................. 122 9. Bibliography ..................................................................................................... 126 10. Annex ........................................................................................................... 129 Annex 1: Character traits of people with and without disabilities .................................... 129 Annex 2: Sighted guide techniques .......................................................................... 131 Annex 3: Greek Sign Language alphabet ................................................................... 132 Annex 4: Reasonable adjustments ........................................................................... 133
Introduction
This manual is one of the outcomes of the Life Long Learning project “DARELearning: Disability awareness of academic teachers – improvements through e-learning”. The project started in January 2012 and has been implemented in the framework of the Social and Health Policy Committee of Aristotle University of Thessaloniki, with academic responsible Dr Alexis Benos, professor of Hygiene, Social Medicine and Primary Health Care at A.U.Th. Project leader is the Jagiellonski University of Krakow (Poland), and the other project partners are the Charles University of Prague (Czech Republic) and the Pierre and Marie Curie University of Paris (France). The main goal of the project is two-fold: on one hand, to contribute to the better understanding of the problems faced by students with disabilities as members of the society in general and of the academic community, especially. On the other hand, to contribute to the improvement of the professional skills of academic teachers in the contemporary teaching methods for students with disabilities. Students with disabilities often experience discrimination and exclusion, even within the university community. The Social and Health Policy Committee of the Aristotle University of Thessaloniki, recognising the right of all to education and social life, adopts the social model of disability, which exceeds the perception of disability as a medical condition. Of crucial importance is the way society is organised -social prejudices, stereotypes and poor infrastructure- that creates barriers to inclusion and prevents people with disabilities to equally take part in social life and education. Through DAReLearning project we develop educational tools (in class seminars and online learning platform) aimed at tackling discrimination and removing inclusion barriers of students with disabilities and guided by the principles: •
promoting a society for all
•
overcome prejudices in all areas of life
•
combating exclusion and protecting diversity
•
creating equal opportunities
•
same requirements from people with disabilities as from the other members of the society, with the assumption that equal rights are given for access to education and for personal and professional development
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moving away from the medical model, which perceives disability as a physical defect or imperfection, and, contrary, dealing with the situation of disability as one only of the characteristics of a person.
In class seminars and distant learning (e-learning) are complementary and designed to serve as the impetus for the expansion of knowledge on disability issues and a source of inspiration for further exploration and analysis.
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The trainer's manual contains information and tools necessary for the trainer of the disability awareness training course. The material is intended as a springboard and inspiration for the trainer to develop his/her own ideas, which can be used during the training. It also facilitates creative work on setting new goals for academic teachers, which are aimed at raising awareness of different aspects of disability in the academic context. The training package is designed so that it can be delivered by a single trainer. If delivered by more than one trainer the timing and programme structure may need to be adjusted slightly. The basic version of the training material was prepared for groups of 12 participants academic teachers. The trainer's manual is divided in two parts, the theoretical and the practical. The theoretical part, sessions 1, 2, 3 and 4, includes information necessary to understand the contemporary way of thinking about disability, an outline of different kinds of disabilities and strategies for teaching students with different kinds of impairments. The practical part, sessions 5-10, contains suggestions for the trainer, the training programme guide, description of activities together with the theoretical background necessary to conduct these activities. More specifically: Session 1, which opens the theoretical part, briefly describes the idea of the training and the DAReLearning project whose main objective is to extend knowledge and competence of disability among academic teachers. Session 2 is a general introduction to disability-related issues. It focuses on the points concerning medical and social models of understanding disability, myths and stereotypes regarding disability, language etiquette and equal educational opportunities. Session 3 contains an overview of different kinds of disabilities. The trainer will find here additional theoretical and practical information about issues discussed during the training. In Session 4 strategies for teaching students with various kinds of disabilities are presented. The practical part opens with Session 5, which is actually the training programme guide including the division of sessions (one session per selected disability) and the description of activities with supplementary information (theoretical background for the activity). Session 6 includes supplementary information, the Test Your Knowledge quiz, which may be used during the seminar, if there is time and/or the group is particularly interested Session 7 is the ending of the training course. Session 8 contains the evaluation questionnaire of the training programme. There are bibliography (Session 9) and annexes (Session 10) that contain all materials necessary to conduct the whole training (films, PowerPoint presentations, educational materials, etc). The theoretical part of the manual is based on the two previous DARE programme manuals, with cultural adaptations to the context of the Greek educational system and the particularities of Aristotle University of Thessaloniki. The practical part, the experiential activities, has been developed within the work group of Aristotle University of Thessaloniki. Specifically, the selection, composition and implementation of the experiential activities, as well as the editing of the theoretical part, are the result of the cooperation of: 6
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Paschalina Kalle, consultant of the Panhellenic Association of Blind People-Regional Department of Central Macedonia - session of visual impairments
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Katherine-Louuza Quartanou, A.U.Th employee and founder member of the initiative Disabled Access Friendly campaign - sessions of mobility impairments and stereotypeslanguage etiquette-reasonable adjustments
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Spyros Kouzelis, employee of Social and Health Policy Committee of A.U.Th and interpreter of greek sign language - session of hearing impairments
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Elisavet Neofytidou and Alta Paneras, psychologists of the Centre for Counseling and Psychological Support of A.U.Th - session of mental health
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Ioanna Paspala, PhD in Physical Education, employee of Social and Health Policy Committee of A.U.Th - session of mobility impairments.
The organisation and editing of the overall manual publication have been implemented by Antonis Galanopoulos, psychologist, employee of Social and Health Policy Committee of A.U.Th and Paschalina Kyrgiafini, chemical engineer, administrative staff of A.U.Th. The coordination of work falls under the responsibility of Alexis Benos, professor of Hygiene and Primary Health Care, Department of Medicine of A.U.Th. The training programme DAReLearning, adapted to the cultural and educational particularities of each partner-state, especially as it concerns the experiential activities, is published in the four corresponding languages (Polish, French, Czech and Greek), while each version is also available in English. The DAReLearning website for information and awareness raising on disability issues and elearning course is operating at the address: http://www.dareproject.eu/
Thessaloniki, December 2013
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Part Ι – Theoretical Part
1. The DAReLearning project training
DARE is an acronym for Disability Awareness - A New Challenge for Employees. The DARE project was approved by the European Commission in 2007 and was financed within the framework of the Lifelong Learning Programme. The activities of the project were coordinated by the Jagiellonian University in Krakow and its partners were: the Padua University in Italy and organisations which work with disability: Learning-Difference Ltd in Great Britain, Euroinform Ltd in Bulgaria and FEPAMIC in Spain. The idea of the project originated out of the burning need to raise the level of knowledge and competence of academic teachers and public administrative staff on disability, as, more and more often, they encounter disabled people in their everyday work. The DARE2 project, that followed, was carried out in 2009-2011. The DARE2 consortium members were: the University of Iceland in Reykjavik, the Cyprus Adult Education in Cyprus and the Jagiellonian University as the promoter. The main DARE2 project outcome is training materials for academic teachers and SME managers. These aim at providing the trainees with complete knowledge concerning disability, its types and barriers faced by disabled persons in daily life and university study, as well as ways to eliminate them. The training programme and supplementary materials were created on the basis of the British experiences, where disability awareness training is highly developed, and antidiscrimination legislation supports the efforts aimed at including disabled students into the mainstream education. High quality of the DARE training programme was achieved thanks to consultations with a great number of external experts –an international Quality Management Group consisting of experts with long-standing work experience in increasing the participation of disabled persons in the knowledge society. The DAReLearning programme renews and supplements the previous DARE training programmes. The DAReLearning training package is a group work course, which allows the absorbing of knowledge and acquiring of skills through experiencing and discovering solutions during discussions and through individual reflection. According to the standards of modern methodology, the workshops are conducted with the use of varied methods, which allow taking advantage of participants’ experiences. A variety of multimedia materials are used during the training, e.g. educational films and presentations, and the activities intended for use during the training are based on activation methods such as mind shower, discussions, and role-playing activities. The trainer monitors the whole training, supervises group work, transfers thematic information, answers questions and 8
explains problematic issues. However, the essential elements of the training are the participants’ experiences, reflections and the results of group work. The DAReLearning seminars include general information on disability issues and dedicate a specific session to each of the visual, hearing, mobility impairments and mental health disorders. Each session starts with experiential activities which aim to communicate the experience of disability and mental health problems and to highlight the crucial importance of the relationship between a person with a disability and his/her social and built environment. Sessions are enriched with theoretical information and discussion on the thematics: 1. stereotypes and society perceptions of disability – logical explanations instead of existing myths 2. communication and teaching strategies for the academic support of students with disabilities 3. assistive technologies for the reinforcement of the access of students with disabilities to education and the compensation of impairments The trainers manual of the DAReLearning training programme reflects the thematic sessions of the training seminars on disability. It presents in a more comprehensive and detailed manner the issues raised during the seminars and seeks to contribute to the integration and systematisation of knowledge gained during the in class training.
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2. Disability – Overview
2.1 Equal Educational Opportunities In order to fully understand the purpose of ensuring equal educational opportunities for all students, including disabled students, it is important to look at higher education from the perspective of a few vital terms presented below. They allow better understanding of the importance of joint efforts taken in connection with specific academic difficulties encountered by students.
Inclusive education – inclusion into the mainstream of education The modern model of education (inclusive education) refers to a broad range of groups whose social activity is a prerequisite of diversity in society, thus leading to the increase of its potential. Enabling individuals to develop their intellectual and creative potential irrespective of aspects such as ethnic origin, sexual orientation, sex, impairment, level of ability, financial status, cultural background, etc becomes the aim of inclusive education. The concept of inclusive education assumes that diversity is one of the fundamental values, which enriches a given group.
Diversity One of the most important terms which is associated with the effects of group activities is the term synergy. The term refers to the effect of organised group work, which is much better than the expected effect being the sum of individual actions. The combination of different experiences, perspectives, skills, temperamental features and cognitive styles accelerates and enriches work and its outcomes. Diversity in a group is a special catalyst in this process. Consequently, ensuring social diversity of participants in the process of education is a tool with which it is possible to attain the common good. The greater the diversity, the greater the chances for individual development. Acknowledgement of the significance of diversity is strictly associated with the acknowledgement of the benefits of creative cooperation.
Educational support State parties signing the United Nations Convention on the Rights of Persons with Disabilities, Article 24 on education pledged to: ‘ensure an inclusive education system at all levels and lifelong learning directed to the full development of human potential’ and that persons with disabilities would not be excluded from the general education system on the basis of disability. Educational support, offered to disabled persons in the academic
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environment, cannot lower assessment standards, cannot consist of giving a disabled person extra privileges or simplifications because of his/her disability. This support should be given by alterations applied to the form of the teaching process, in accordance with the specific requirements of students, and not by changing the content.
Standards of excellence in the educational process The access of disabled people to education would not contribute to ensuring their effective participation in a free society, if it did not mean the access to equal requirements and uniform assessment criteria (the UN Convention, Art. 24). In order to make the access to education really equal, the option of equal access to its results must be guaranteed such as professional competence and good prospects on the job market, which can be achieved only by strict academic requirements, which in turn, can only be realized and enforced by high and consistent standards of individualized support. The requirements for gaining a place in tertiary education in Greece are different for students with disabilities than they are for students without disabilities. Students without disabilities have to sit the special entrance examinations for tertiary education, whereas students with disabilities just need to be in possession of a high school leaving certificate. An additional 5% of places are awarded to students with disabilities on this basis. It is hard to say whether or not this constitutes a privilege, as a chain of circumstances may have preceded this stage, such as unsatisfactory access to secondary school education. However, it is not in accordance with the principle that students with disabilities should be competent and only receive accommodations or compensations for their disability. Whereas students without disabilities who finish school in June are awarded places in tertiary education by the end of August, students with disabilities, who also finish school in June, have to obtain a certification of their degree of disability from a state hospital, a procedure that takes place in the following October, and submit their application in November. This means that they are not able to start tertiary education until the second semester in the following January and as a result suffer a pointless delay. Indeed, they may lose a whole year, as in order to avoid the social disadvantages of starting later than other first year students, who by January will have networked, made friendships and learned about university life together, they chose to start the following October. This procedure is not in accordance with the principle that people with disabilities should have equal access to education. Recommendation: The procedure for obtaining the certification of disability should take place earlier in the year so that students with disabilities can enter the first year of tertiary education at the same time as other students. When submitting their application, students with disabilities are excluded from applying to schools that have stated that they do not accept students with certain disabilities. The criteria on which these exclusions are based are not clear and the exclusions are not the same for all universities, even though the courses offered are 11
equivalent. This is not in accordance with the European Union policy on disability, which is built on an explicit commitment to the social model of disability and emphasises equal access to education and lifelong learning. Recommendation: students with mobility disability should not be excluded from any form of tertiary education at any location.
2.2 Understanding Disability – Medical and Social Models Our attitude to disabled people largely depends on the way of understanding disability which we adopt (consciously or not). The medical model and the social model (later called the interactive one) are examples of many more models of understanding disability. The main differences between these two are demonstrated in the table below:
Medical model
Social model
disability versus ability
deficiency, dysfunction, aberration from the norm
difference
subjective approach to a person with a disability
disregarded
emphasised
a source of disability
located within an individual
located outside the person, results from the interaction between the person and the environment
assessment
being disabled means being stigmatised, it is negative
being disabled is neutral, it is not subject to evaluation
Result
exclusion of a person with dysfunctions from social and professional life
normal functioning in the community – after the barriers have been removed.
reasons for problems
limitations which exist within an individual preventing him/her from participation in situations of everyday life (incapacity for work, study, independent living).
mental, administrative, architectural and other barriers present in the environment of the individual in question
solution to the problem
treatment, removal of the dysfunction by means of medical procedures
change in the interaction between an individual and his/her social and physical environment.
duties of the state
providing medical and social care
creating a friendly, barrier free environment
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education and employment
creating special schools and protected work places, isolation from the community
ensuring equal educational and employment opportunities, inclusion in the mainstream of social life consistently with the rule of equal rights and responsibilities.
The medical model of understanding disability gives priority to treatment and rehabilitation. The activities aimed at the realisation of personal goals, including the educational pursuit, are not given so much prominence. The adoption of the social model allows for the change in priorities. Different kinds of support, including medical assistance, play a servile role to the process of personal development. The social model states that the environment should be adjusted to the needs of disabled people. The task of implementation of this assumption makes the environment and the society gradually more and more friendly and open to diversity. Every year the access of people with disabilities to education and employment is broader, and the concept of ensuring equal opportunities no longer surprises teachers at institutions of higher education or nondisabled students. The participation of disabled people in the mainstream education, including tertiary education, is on the increase. Disability is a factor which in some cases should be taken into full account, but in some contexts it is of no consequence and should remain such. It is considered in great detail when plans for the adaptation of the physical environment are made and implemented. Also, when it is necessary to modify students' and teachers’ attitudes. However, as far as achievements, requirements, assessment criteria are concerned, disability should not be a crucial factor. Substantial changes aimed at understanding disability in social categories, and not only medical, originated in the second half of the twentieth century in the USA. The guiding principle for perceiving disability in relational categories, i.e. as resulting from interactions between a disabled person and the environment, was a humanist idea promoting human rights, acceptance and respect for diversity. A new concept of social perception of disability created the need for the improvement of the quality of life of disabled people in order to put an end to their social exclusion and observe human rights (G. L. Albrecht, K. D. Seelman, M. Bury, 2001).
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2.3 Myths and Stereotypes
Stereotypes are widespread generalisations which refer to a group of people. Identical characteristics are indiscriminately attributed to all members of this group, irrespective of actual differences between them. The opinions associated with stereotypes may be negative or positive, yet they always remain false and not consistent with reality. The presence of patterns of thinking is a commonplace phenomenon. Simplifications and generalisations, which allow an automatic categorization of an individual enable quick, though a superficial grasp of a situation, assessment of behaviour of an individual and our own reaction to it. Generalisations allow lowering the degree of insecurity felt in a new context by placing an individual, a group or a situation within a broader category. Expectations and notions referring to the whole group conveyed by means of specific terms strongly influence what we notice in a given situation, what we think about and what we remember in relation to some person. Many barriers, which disabled people encounter in daily life, arise from stereotypes and false convictions, expectations, simplifications and clichéd patterns of thinking which are deeply rooted in the minds of people and lead to the distortion of reality. One of the examples is the unwillingness to admit disabled children to general access schools or offer jobs to disabled adults on the grounds of the assumption that these individuals will not cope with their duties. Even very accurate information testifying to the abilities of the individual in question may be ignored, erroneously interpreted, forgotten – being not consistent with the scheme of ideas concerning the whole group. In terms of Greek reality the idea of “shame” has to be introduced. Beliefs existed until the recent past, and may still exist today, that those living with disabilities have shamed their families in some way, and even nowadays there may be a tendency for their families to hide members with disabilities away as much as possible. While stereotypes mainly refer to the cognitive sphere (false knowledge of a group), prejudices are based on unjustified, negative if not hostile feelings for people who are representatives of a given group. Strong prejudices reinforced by negative stereotypes may find an outlet in actions, leading to discrimination. The so-called ‘self-fulfilling prophecy’ may seemingly confirm the stereotypes. People have certain expectations concerning some person, which influence their behaviour in relation to this person. As a result, this person does not stand much chance to act in the way which is not consistent with the expectations of others. An example of it is a stereotype of a 'non-independent disabled person’. Because of this fixed opinion, when we meet a disabled person, we tend to do his/her tasks for him/her, substitute, offer readyto-use solutions. Our behaviour may lead to the actual passivity of this person. It may make him/her wait for assistance from the environment. This in turn is consistent with our original expectations and seems to confirm the stereotype of a 'non-independent disabled person’. Meanwhile, a change in our attitude would provoke a parallel change in another
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person’s behaviour. It would allow seeing him/her in real terms, giving him/her space to reveal the scope of independence and believing that he/she may be effective. Stereotypes are often associated with myths present in the culture and derived from history, tradition and reports transmitted by word of mouth. Below you may find some examples of myths and facts connected with disabled people:
Myths
Facts
All people with disabilities are deeply unhappy and every day suffer because of their constraints. Consequently, they need assistance and sympathy from non-disabled people.
People with disabilities may be happy and have a fulfilling personal and professional life. It is often the case that the question of disability is not uppermost in their minds and the more so it does not determine the quality of life.
All disabled people who have succeeded are heroes and extraordinary individuals who should be models for others to follow.
Disabled and non-disabled persons hold the same right to succeed and fail. Achieving (or failing to achieve) goals one sets is the results of action taken by an individual and his/her character, and not disability or its absence.
All people with disabilities are ill and/or have a serious problem with themselves.
Disability is intrinsic to human experience and is not an illness.
All people with serious disabilities or who have a few coexisting disabilities should stay in hospitals, specialised units or hospices all the time.
People with coexisting disabilities provided with adequate support do not have to be fully dependent. They may decide to live in their own house and take a number of actions, whose scope depends on the individual range of skills possessed.
During the training the trainer should be particularly alert to examples of stereotypical thinking revealed in the participants’ statements. Every time it occurs during the workshops, the trainer should correct such statements by explaining the relevant associated myth/stereotype and by referring to facts and a rational way of perceiving disability in accordance with the social model. It is also important to make the participants realise the existence of both false derogatory preconceptions about disabled people and the ones which idealise this group. The myths which refer to e.g. exceptional sensitivity and patience or courage of disabled people may be a serious obstacle to the free expression of emotions which are not consistent with a stereotypical way of perceiving them.
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Whilst it is useful to show examples of disabled people who have been or who are successful, as it often breaks the mindset that “disabled people cannot achieve”, such examples must be used in the context of their uniqueness. Not every disabled person will be a movie star or a top athlete just like non-disabled people. Such examples are so “untypical” that they do not change stereotypical assumptions. In fact they can create another stereotype of disabled person – the “super hero” reinforcing the concept of “overcoming” of “courage” that all disabled people “must” follow. It is better if there are examples showing a range of achievement and success to show the diversity within disability just as there is diversity in the whole population.
2.4 Language Etiquette Language, being the basic means of communication is strictly related to the process of perceiving the world. The meanings of words, hidden in the language, give information on the system of values of a given cultural community. Language is also a tool which serves to express emotions and pass judgments. Categorisation of the world by means of the language is somewhat risky, as it e.g. means social labeling and stigmatising of some groups of people. To a large extent it concerns disabled people in the case of whom common use of terminology which carries negative connotations, often of patronizing, pejorative or euphemistic character may result in their social exclusion. In order to avoid this phenomenon, it is important to choose the words which indicate the subjective treatment of disabled people. To emphasise the awareness of the fact that disability does not necessarily concern all areas of functioning, it is better to express it in appropriate behaviour towards a disabled person than by using terms which distort the reality of disability, e.g. ‘differently abled'. The table presented below contains information and examples which facilitate distinguishing between the stigmatising terms and the correct ones. Note that the language shapes the sphere of attitudes and emotions, influencing particular associations and readiness for some kinds of behaviour. Stigmatising terms may place disabled people in the position of those who need care, have been wronged, are dependent. In this way a complex pattern of inappropriate social notions is created. These notions are preserved in the inadequate language and popularised through it.
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Stigmatising terms
Recommended terms
handicap
disability, impairment
cripple, invalid, sufferer, handicapped, differently able, wronged by fate
a disabled person
the disabled
disabled people
the blind
a blind person/people, visually impaired person/people, partially sighted person/people
the deaf and dumb
a deaf/Deaf* person, deaf people/hard of hearing people, hearing impaired person/people
a child/person with special needs
a disabled child/person
special needs
specific requirements
an invalid wheelchair
wheelchair
confined/chained to a wheelchair
a wheelchair user, a person using a wheelchair
retarded, a retard
a person with cognitive impairment, mental retardation, developmental disability
a psycho, a psychopath, a paranoid, a mental, a freak
a person with mental health difficulties
schizophrenic, schizo, schizoid
a person who has schizophrenia
epileptic
a person with epilepsy
autistic
a person who has autism
Downs, Mongoloid, Mongol, Mong, Panface
a person/child with Down’s Syndrome
spastic, spazz
a person with cerebral palsy, a person with mobility disability
diabetic
a person who has diabetes
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a child/person of special care
a disabled child/person
wronged by fate
a person with a disability
dyslexic
a person with dyslexia
The term ‘a deaf person’ does not necessarily carry negative connotations; it is accepted by the deaf community as it constitutes one of the factors enabling social and cultural identification. More and more often it is therefore spelt with capital 'd’ (Deaf people).
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3. Different Types of Disability – Overview The classifications of different kinds of disability presented below are not intended to be an encyclopaedic reference source. The purpose of these descriptions is to give the trainer basic information about a given type of impairment and indicate possible difficulties disabled students may have in the academic context as well as emphasise the necessity of applying reasonable adjustments and appropriate educational strategies.
3.1 Mental Health Difficulties Mental disability is one of the most varied of all disabilities and at the same time one of the most difficult as regards its public perception. The incidence of mental health difficulties and their impact on the student’s academic progress may be interpreted as lack of good will in fulfilling one’s obligations or arouse fear, reluctance and the sense of insecurity. Mental disability is usually identified with mental illness whilst contemporary psychiatry applies the term ‘mental illnesses’ only to psychoses, that is those mental health difficulties in the course of which hallucinations, delusions, enhanced activity or visible psychomotor slowing down occur (examples: depression, schizophrenia, bipolar affective disorder and chronic delusional disorders). In actual fact, mental disability may be also caused by a number of other non-psychotic mental health difficulties (examples: personality disorders, anxiety disorders, eating disorders, somatoform disorders and stressrelated disorders). If one wants to understand the academic situation of the student experiencing mental health difficulties, becoming familiar with the most intense symptoms he/she experiences in a full relapse of the disorder (to which the university environment is unable to find an adequate response as they require intensified treatment) is not the most important task. Far more important than the knowledge of a specific medical diagnosis is the understanding and perceiving of subtle health-related difficulties which the student may experience in periods of remission or low-intensity symptoms whilst he/she participates in academic life. The difficulties experienced by persons with mental disabilities may have an impact on many areas of their functioning in the academic context. In persons with mental health difficulties symptoms persist much longer and are more intense causing suffering and disturbing the person’s individual and social functioning. It is just such features as the presence of mental symptoms which can be ascertained clinically, of suffering related to them and of disturbances of the individual’s functioning that determine the psychiatrist’ diagnosis of a mental health difficulties.
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Students with mental disabilities can experience health problems throughout the period of university study. The type, intensity and duration of symptoms may change over time and vary between individual students with similar medical diagnoses. Symptoms rarely form a regular pattern, which makes it difficult to make long-term forecasts as to the student’s functioning and because of which in different periods of university study students will need different methods of support from the university. A useful tool in examining the individual needs of specific students is cooperation offered by a Counselling and Support Service consultant taking care of the student together with an expert psychiatrist, as well as the academic teachers delivering the university classes attended by the student in question. A teacher/lecturer who can see a change in a student’s behaviour which testifies to his/her worse mental condition can react to it as first. At this stage it may be important to react only to the change observed concerning the way the students performs academically, referring to facts and specific observations rather than to the teacher’s own conjectures as to the student’s personal sphere and suspicions as to the medical diagnosis of his/her state. In this way, the teacher/lecturer will be able to act within his/her qualifications, without being burdened with responsibility and without negative consequences for the student. At this stage it may be of key importance to give the student the assurance that his/her difficulties are accepted, that no extra meanings are attributed to them (laziness, disrespect, arrogance, lack of intelligence or commitment to studying), and the student is not left to his/her own devices. It is then worthwhile to show the student a focal point in the university structure he/she could turn to with the problems he/she faces (e.g. the Counselling and Support Service) whilst remaining open to cooperation with a given unit as part of the educational support offered to the student (more information concerning support can be found in section 4.2). Symptoms of a student’s mental difficulties which a teacher/lecturer can observe include: •
Increased physical and mental fatigability: the student complains about his/her inability to cope with the covering of the required course material despite his/her considerable abilities in general; he/she is sleepy, weary; seems absent, not getting enough sleep, bored and uninvolved;
•
Enhanced problems with focusing attention for longer caused by e.g. anxiety, obsessive thoughts with emotionally-charged content, enhanced or significantly decreased level of excitement, taking medication;
•
Worsened memory functioning (mainly short-term) frequently accompanying depressive disorders, anxiety disorders and the obsessive-compulsive complex;
•
Experience of: long-lasting sadness, decreased intensity of emotions felt, loss of satisfaction, apathy, slowing down, difficulties in making effort and being involved, all of which often accompany the difficulties mentioned above;
•
Difficulties in planning academic tasks resulting, for instance, from difficulties in predicting changes in one’s psychophysical condition, caused by the changeable 20
image of the illness itself or difficulties concerning the correct assessment of one’s abilities, and so setting goals commensurate with one’s abilities; •
Excessive touchiness, irritability, lower resistance to frustration;
•
Accelerated speaking pace, unclear messages, increased excitement and activity, excitability, increased directness in interactions going as far as inadequacy in relations with others;
•
Periodical difficulties in undertaking social contacts, related to, for instance, taking care of administrative matters, participation in consultations, work in a task force with other students; social withdrawal, decreased intensity of peer contacts, visible alienation, rapid exhaustion with being in crowded places, the presence of others, being observed by others;
•
Difficulty in adhering to general rules defining the framework for particular types of human interactions (e.g. student - student, student – teacher/lecturer, student – dean), violating time limits (extending contact, making contact too frequently), communication limits or physical boundaries in contacts with others;
•
Stronger attachment to structure, or constancy and predictability of events, places etc;
•
Ritualised, repeatable behaviour serving to tame the anxiety. In the case of students experiencing stronger mental tension such behaviour may be more expressive, intensive and intrusive;
•
Enhanced ‘self-limiting’ behaviour. It aims at a temporary alleviation of anxiety, including the fear of being assessed. It makes actions aim at the short-term management of difficult emotions rather than the effective attainment of set goals. A paradoxical positive effect of such actions may be the likelihood of finding an apparent justification of a possible failure in the future, other than the problem inherent to the student himself/herself (e.g. ‘I have failed the examination not because I am no good but because I unnecessarily concentrated on something else than what was required of me’). Developing such a conviction can give students thinking about themselves along the ‘I am no good’ lines because of mood or personality disorders a temporary boost of their mental comfort. In the end, such behaviour safeguards their weak self-esteem and is frequent amongst students. It is worthwhile, however, to pay attention to situations where it considerably disturbs the student’s functioning in the academic context. Self-limiting behaviour may include:
being notoriously late, frequently absent
uneconomical distribution of one’s strength in periods of preparing for examinations
studying almost exclusively by night
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using stimulants when special psychophysical fitness is required, intensive use of various forms of activity, e.g. the Internet, not reflecting the hierarchy of the student’s tasks and goals
renouncing support, rescheduling and cancelling meetings and consultations
recurring infections in response to more academic challenges
concentration on just a section of the course material and returning to it, thus lowering the likelihood of perfecting the whole too long concentration at the stage of preparation for the work proper, e.g. further search for increasingly detailed materials when it is already necessary to study their content
neat rewriting of notes taken earlier despite their legibility.
The types of behaviour described above, which can be observed in the academic context, may be used not just to protect the student’s self-esteem but may also accompany various specific disorders as symptoms. It should be borne in mind that such behaviour can be linked to specific difficulties in the realm of thoughts and emotions. A preliminary interpretation of unsatisfactory behaviour on the part of a student may be incomplete or wrong, if one fails to appreciate the fact that such behaviour may reflect the student’s mental-health difficulties. Mental health can be seen as a continuum with the poles defining, on the one hand, a mental equilibrium and, on the other, lack thereof, along which a given person locates himself/herself in various places, depending on his/her reaction to a variety of factors. On many occasions it is very difficult to pinpoint one moment when mental discomfort exceeds the border arbitrarily delineated as a boundary of illness. Frequently, the student himself/herself finds it difficult to specify the moment when a problem of his/her mental well-being already requires action aimed at ensuring medical assistance or educational support. At this stage, effective support may take the form of encouragement to make efforts to improve one’s mental condition.
3.2 Visual Impairments Disability appears as a result of the interaction of an individual with the environment. If the conditions for communication, study and everyday functioning are well organized, visual impairment is not perceived as a deficit or a deficiency, but simply as a variation with which possibilities and limitations of specific activities are connected. Children blind from birth may not realise what visual functions are or how they differ from their sighted friends. Existing classifications of visual impairments serve to give uniform definitions, terminology and criteria for observed variation. The purpose is to examine the problem by measuring 22
its scale and a possibility of comparison. In practice, it is evident that classifications simplify the problem, they fail to grasp the whole range of difficulties connected with vision and their consequences. The World Health Organisation (WHO) classification of visual acuity presented below comprises some ranges of visual acuity, measured on the basis of distance from which it is possible to read correctly a line of specially prepared signs: -
the most common (visual acuity value above 0.3)
-
poor sight (visual acuity value between 0.3 – 0.05)
-
blindness (visual acuity value between 0.05 – 0.00)
There are many variations in the nature of visual impairment. The degree to which an individual may use visual functions is another factor, which in a broader sense differentiates between visually impaired people. Visual functions that may be impaired are: - acuity of vision, - field of vision, - light sensitivity, - contrast sensitivity, - colour sensitivity, - shape and movement sensitivity. The combination of individual factors and functions means a very broad range of potential difficulties in the process of visual reception and perception. The information on a student’s ability to compensate for his/her vision impairment in fields such as communication, mobility, orientation, general knowledge of the world and the range of daily activities is in many cases more important for the assessment of student’s individual situation than information on the kind, degree and the cause of his/her visual impairment. These abilities do not depend solely on the medical diagnosis and the moment of onset of vision problems, but also with his/her personality, his/her environment and encouragement that a person with visual impairment receives from those around him/her. Knowing only the medical diagnosis of a student, we are not able to fully determine the level of his/her functioning. Only a student with visual impairment is able to give accurate information about what he/she can see and cannot see. Many disabled students use their own learning strategies, which work for them. Hence, it is very difficult to propose universal procedures for support. The method of adaptation (e.g. the intensity of light in the room) ideal for one person may prove to be of no use for another, even for those who may have been diagnosed with a very similar medical condition. Thus, in order to avoid misunderstandings and troublesome situations, it must be ensured that a strategy
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offered to a blind person does actually help. It is important to remember that a student must be perceived through the abilities he/she possesses and not the degree, scope or kind of difficulties he/she experiences. In this way we move away from labels, prejudices and stereotypes connected with disability (in this case visual impairment), and move towards equal treatment of all students. The main problems faced by students with visual impairment are connected with the use of written and visual sources of information such as books, lecturer’s notes, announcements on notice boards, illustrations, PowerPoint presentations shown during lectures. The adaptation of materials to an electronic or other alternative form may be time-consuming and require a lot of effort. Another hindrance is a student’s inability or limited ability to make notes during lectures. These obstacles can be removed easily by the implementation of adequate teaching strategies, support and the application of assistive technology. More about these issues you can find in Chapter 4.3 Strategies for Teaching Students with Visual Impairments.
3.3 Hearing Impairments The perception of a hard of hearing and deaf/Deaf person in the social context should be redefined from the common way of perceiving them solely as clients of medical care and hearing and speech specialists. Once you remove them from being defined by their impairment or treatment aimed at bringing their hearing closer to the norm, they become citizens of the society with all rights. According to the social model, their disability results from the interactions with the society, which to a large extent, are associated with the lack of knowledge of ways of communicating and presenting information with hard of hearing and deaf/Deaf people. There are three major ways of communication used by hard of hearing or deaf/Deaf people: sign language, oral (e.g. a hard of hearing person using their residual hearing ability to enable communication by speech) and bilingualism (combining sign language and written/spoken language). The choice of appropriate strategies for communicating with a hard of hearing and/or deaf/Deaf student is individual and depends on the preferences of the individual in question. Preferences can be connected with many different factors including: •
age of onset of hearing loss,
•
degree of hearing loss (mild, moderate, severe, profound),
•
the environment and their experience of communication (e.g. the influential role of parents and peers in their environment – especially in a specific kind of kindergarten, school: with hearing, hard of hearing and deaf/Deaf peers).
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A student with mild hearing loss may experience certain difficulties in hearing speech in unfavourable acoustic conditions (e.g. in a noisy environment), as well as hearing speech that is whispered or very quiet. He/she may use hearing aids and complement aural/oral information by lip-reading. He/she usually communicates by speech. A student with moderate hearing loss may have difficulties with full discrimination of speech sounds. He/she may use hearing aids and lip-read. He/she usually communicates by speech. A student with severe hearing loss may have difficulties with hearing and sound discrimination even with the use of hearing aids. For communication he/she largely depends on information presented in a visual way – by means of lip-reading or using a written form. He/she may use the Greek Sign Language. Technological devices, which use a visual channel (e.g. interactive boards, videophones) as well as graphic teaching materials, are of great support for such an individual. Also remember that hearing impaired students with mild to severe hearing loss cannot easily hear and therefore cannot regulate their own voice easily, so his/her speech may sound different to what you expect. It will take practice for you to get to know each hearing impaired student's way of speaking. A student with profound hearing loss may derive little or no benefit from hearing aids; may not hear very loud sounds (e.g. a pneumatic drill). He/she predominantly uses visual channel for communication (lip-reading, writing) and perceiving the world. He/she may use the Greek Sign Language.
A person for whom the Greek Sign Language (GSL) is the first language may have difficulties reading and writing in the Greek language because of different syntax and structure of GSL. These potential difficulties do not reflect a student’s intelligence. It is more likely because teachers and schools do not have enough skills in GSL and understanding of Deaf culture to adequately teach them written Greek. It is good to provide GSL interpreter, use all kinds of visualization during classes and give access to materials prior to the commencement of the course (e.g. PowerPoint presentations, bibliography, an explanation of new or specific terms or technical words).
The choice of the language and educational support It largely depends on the age of onset of hearing loss (a person who developed some degree of hearing loss and/or became deaf will tend to use spoken/written language). A person who was born deaf will most likely prefer using sign language. The choice of the language may depend on the context, too. A student may use sign language during classes and the Greek language in personal contacts with other hearing students. Ask the students how they prefer to communicate and use that method in class.
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A student’s method of communicating also depends on the support offered to him/her: appropriate acoustics and conditions for lip-reading, visualization of didactic materials and information, providing a GSL interpreter. Specific kinds of support are described in Chapter 4.4 Strategies for Teaching Students with Hearing Impairments. •
Persons with mild and moderate hearing loss are usually referred to as hard of hearing. Those with severe or profound deafness are usually called deaf/Deaf. People who use the Greek Sign Language identify with a language-cultural minority and postulate that its name should be spelled with capital D: Deaf.
•
Persons who have hearing difficulties due to hearing loss in one ear usually compensate for their impairment with the other, hearing ear – e.g. turn towards the speaker with their ‘good’ ear or take a seat in a lecture room in a place where the hearing ear is directed towards the speaker.
•
Apart from hearing aids, students may have cochlear implants, which transmit aural sensations to the aural nerves through electrical conduction.
3.4 Mobility Impairments When asked about their first association with disability, many people automatically think of mobility impairment. One may often get a feeling that a student using a wheelchair is a typical representative of ‘all’ disabled people. This is compounded when the international logo used to represent disability is a person in a wheelchair e.g. parking bays in car parks. Yet mobility impairments do not concern only wheelchair users. Moreover, people with mobility impairments differ from one another, and the range of differences between them resembles diversity among non-disabled people. In this case, as well as in the context of other disabilities, one should always remember that the distinctness of the feature concerning disability should not dominate the image of a student with his/her individual character, interests, vices and virtues. However, the knowledge of types, causes and difficulties related to mobility impairment allows better understanding and identification of reasonable adjustments. Mobility impairment manifests itself in many different ways. They may be temporary or chronic, changeable, stable, degenerative. They may affect the whole body or some of its parts (e.g. arms, legs, spine). The main causes of mobility impairment include: cerebral palsy, multiple sclerosis, effects of brain tumours, cranial trepanation, side effects of treatment for neurological disorders, damage to the spinal cord, muscular dystrophy, myasthenia gravis, traumatic brain and/or spine injury, injuries sustained in traffic accidents. The main and most common barrier that students with mobility impairment face is the lack of architectural accessibility in the environment. Some places cannot be entered at all whilst others are not wheelchair user-friendly or even dangerous inside (e.g. because of 26
narrow passages, slippery floor surface, high thresholds and platforms). Elimination of architectural barriers removes or reduces many consequences of mobility impairment. One must remember that difficulties with mobility may not be the most important or only impairment for that person. The most frequent conditions associated with mobility impairment are: •
neurological problems,
•
problems with the cardiovascular system (blood circulation),
•
problems with thermoregulation (body temperature),
•
perception difficulties (e.g. distance),
•
speech and communication difficulties,
•
memory and information processing problems,
•
difficulties in writing, making gestures, manual activities,
•
pain, decreased physical strength,
•
restricted range of self-care skills.
Remember that mobility impairment also places a student in a specific psychological situation. To a large extent we control our environment by means of movement. The identity of a child as well as his/her awareness of being different from the environment is formed in the course of expansion into and active exploration of the surroundings, which is possible thanks to moving. The lack of full range of movement often means much stronger dependence on others in the process of learning, from the early age to the period of studies. It affects the sense of control and power (in this case independence), sometimes leading to the feeling of reduced autonomy and excessive dependence on others around, as well as experiencing restrictions being imposed upon them by others. This is one reason why dance therapy and expressive movement therapy are recommended as forms of activities conducive to the reconstruction and reinforcement of personal limits and the increase in the confidence in one’s abilities. Note that your interaction with a disabled student should strengthen the student’s autonomy and not weaken it. This can be achieved by e.g. not forcing unsolicited help on a student, not performing actions for him/her that he/she can do without help. On the other hand, you can achieve it by suggesting options and a variety of potential ways of reaching his/her goal (e.g. professional or intellectual). When adjusting the lessons to the requirements of a person with mobility impairment, one should ask the student what causes the biggest problems and adjust appropriate teaching strategies.
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4. Strategies for Teaching Disabled Students Teaching strategies are an important element of the training for academic teachers. Because of time frames and the necessity to maintain the dynamics and attention of the group, the trainer presents during the training the most important teaching strategies, which are directly associated with a given activity. Below there is an extension of the information conveyed during the training. It may be helpful to know this more detailed information e.g. when the group becomes particularly interested in a specific topic. Note that the participants will receive an analogous range of teaching strategies in their manuals (you can refer to it during the training). Therefore, it is a good idea to devote more time during the training to discuss doubts, alterations and innovations put forward by members of the group rather than present an extensive list of strategies.
4.1 General Guidelines Recommendations: •
Do not lower requirements or assessment criteria. If a student has difficulties completing assigned tasks or learn some topics, establish individual credit criteria (e.g. divide the material into parts, offer additional consultations, extend time for task completion) but do not exempt a student from obligatory material, rather make it more accessible.
•
Gain information about individual possibilities and needs of a given student, implement appropriate solutions and forms of support – even people with the same kind and degree of disability may need individual adjustments.
•
Be open and flexible; do not assume a student will fail because of his/her disability.
4.2 Strategies for Teaching Students with Mental Health difficulties As there is a great variety of difficulties in academic performance experienced by persons with mental disabilities, it is recommended that academic teachers approach work with such students in a flexible manner. It should also be remembered that any adaptations need to be adjusted to the student’s current state of health, which may require periodical consultations between the student and a psychiatrist. Using educational strategies appropriately selected for mentally disabled students’ individual needs will facilitate their acquisition of the very same practical skills and theoretical knowledge that can be acquired by persons without such disabilities.
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Students with mental disabilities may require: •
Adjusting the organisation of work during classes to the student’s current difficulties: work in a smaller group, allowing the student to answer from where he/she is sitting so as to reduce his/her social exposure, allowing the student to have short periods of activity with breaks for rest;
•
Improving the reception of lectures by allowing the student to record them or making a lecture outline available before the lecture;
•
Providing the student with some extra time to prepare homework, in particular extensive written papers, and splitting them into smaller parts, if necessary;
•
Assistance in organising the student’s work, in particular through splitting tasks into smaller parts (including examinations and course tests that require learning large portions of material. Whilst defining the course material portioning criterion it is important to take into consideration content-based links in the material so as to allow the student receiving educational support to also show his/her ability to make connections between subjects and to prove his/her knowledge of the whole material, if that is required of the other students;
•
Extension of the duration of the studies/academic year and rescheduling examination dates due to the periodical deterioration of the student’s mental condition or hospital stays;
•
Allowing the student to be absent from classes/lectures more frequently than others – students may skip classes/lectures because of health reasons. In such situations it is recommended that support be offered to them in catching up as well as making the relevant classroom/lecture material available to them;
•
Finding an agreement concerning the format in which the student will be catching up should he/she fall behind because of his/her absence or worsened mental condition. Students should be allowed to take tests of their knowledge of course material in a flexible manner depending on their mental well-being, whilst on the other hand they should feel obliged to conclusively pass the test of their knowledge of a course material portion within a time specified by the teacher, their health permitting. Consistency towards the student is of utmost importance;
•
Taking into consideration specific and sometimes only periodical difficulties experienced by the student in making social contact. It may be helpful to issue consent concerning transfer of guidelines, making arrangements, consulting work or sending written contributions in the electronic format;
•
Taking into consideration the fact that the medication taken by the student may have such side effects as drowsiness, slowed reaction time, weakened memory and concentration problems;
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•
Understanding that certain students may need assistance of a personal adviser, psychologist or psychiatrist. In such situations they should be encouraged to seek professional help and contact the Psychological Support Service of the University;
•
Spreading course tests over time throughout the term so as to reduce the negative effects of excessive stress, a possible risk factor as regards the recurrence of full symptoms of the student’s illness;
•
Adapting the examination format to the student’s current mental-health difficulties: extension of the duration of oral, written and practical examinations, offering the possibility of preparation for an oral contribution in writing by putting down key information, presenting examination questions both orally and in writing during oral examinations, thus making it easier for the student to focus on their content, replacing oral examinations with written ones;
•
Spreading examinations over the session because of the difficulties related to memory and concentration disorders as well as low tolerance of the stress generated by the examination session;
•
Respecting the student’s right not to disclose his/her psychiatric diagnosis.
Behavioural Strategies for Teachers vis a vis Students with Mental Health Difficulties Additional guidelines, important in academic-context contacts between the teacher/lecturer and the mentally ill student, comprise ways to delineate the boundaries of the teacher’s personal responsibility in such interactions. Teachers sometimes deny students’ mental-health problems outright or treat them with fear and hostility it breeds just because they have failed to answer the following questions: ‘How should I behave?’, ‘What should I do?’ and ‘What is it that I need not do?’. Paradoxically, people around students with mental disabilities do not make any contact aimed at supporting them for fear of their potential responsibility for the results of their actions taken intuitively. In consequence, a social vacuum is created around such students, they receive no support and the negative impacts of the illness multiply, as do the students’ fear of disclosing the ill condition to the people around them in the future. A vicious circle is created of lack of support and its consequences. This can be counteracted by applying the following guidelines concerning contacts with mentally ill students: • The student and/or the Centre for Counselling and Psychological Support may be offered one’s own observations concerning any change(s) in the student’s behaviour in the academic context, referring to specific observable facts. One should refrain, however, from formulating diagnoses, one’s own conjectures and advice which may be applied in the personal sphere. In this way the teacher/lecturer will be kept outside the diagnostic realm as regards the student’s mental health. In relation to the teacher/lecturer, the student stands the chance of remaining a student rather than a 30
person with mental health difficulties. This is particularly valuable given the fact that confronted with his/her own mental-health issues the student can experience an unsettling of the self image he/has had thus far. As a result, he/she may need a particular reinforcement in his/her performance of the roles played so far and the shape of the relations enjoyed with others to date. Moreover, the upholding of the natural teacher/lecturer - student relation supports the student in getting out of the role of an ‘ill person’ sometimes imposed by the healthcare system. Sharing his/her observations concerning any change(s) in the student’s behaviour, the teacher/lecturer should inform him/her of a place where support is provided, for example at the university (its Counselling and Support Service). The teacher/lecturer can also issue signs of his/her own readiness to cooperate towards developing an educational support strategy appropriate for a given student. Assuming the role of someone responsible for supporting the student in his/her psychological issues or of an adviser may entail a major burden for the teacher/lecturer, which paradoxically could in the future lead to withdrawing from the relation with the student who needs basic support already at the stage of problem recognition; • In the course of providing educational support for students with Mental health difficulties it is vital to clearly involve them in the co-creation of plans, give them a chance to express their individual positions and accept them wherever it is possible. For the student who has experienced a mental-disorder episode the sense of being in control, having some causative power, autonomy and responsibility for the decisions taken may be a factor conducive to returning to his/her active participation in social life. This role is also played by the emphasis placed not so much on the student’s difficulties (symptoms) but his/her research interests, educational plans and progress. Receiving personal, confidential information from the student one should not pass it on to third persons, unless due to the circumstances its non-disclosure would mean acting against the safety of the student himself/herself or other people. Its disclosure may necessitate reporting the situation to dedicated services. When in doubt, the lecturer/teacher is not left to his/her own devices. Advisable action to be taken in any given circumstances may be agreed in cooperation with the Counselling and Support Service or a similar unit within the university; • A mental health difficulties need not entail a higher risk of attempting suicide. Still, it is worthwhile to be familiar with some basic principles of emergency response, should a problem be discerned related to the suicide risk of the student (not necessarily mentally ill!). Contrary to popular belief, persons experiencing suicidal thoughts most frequently issue clear signals of their intention to commit suicide. In response to such signals like talking about death, bidding farewell, handing out mementoes, making suggestions that one will not take part in something to happen in the future etc. one should ask the direct question whether the student has suicidal thoughts. In this context it should be borne in mind that touching upon the subject of suicide cannot possibly encourage anyone to commit it whilst it often becomes a turning point on the way towards getting out of the sense of hopelessness, narrowing 31
down one’s prospects and loneliness accompanying suicidal thoughts. By showing the courage of asking that question the person observing signals of experiencing suicidal thoughts proves that such an experience is something one can manage. It is also important that the student is immediately referred to a source of information concerning further support options (e.g. the Counselling and Support Service). Experiencing suicidal thoughts can temporarily limit the student’s cognitive abilities (a symptom known as ‘cognitive constriction’, linked to the experience of high tension, preoccupying attention resources with obsessive thoughts and the sense that only ‘here and now’ exists related to one’s sense of suffering). In such circumstances, one should use simple unambiguous sentences to help the student formulate a clear action plan (What are you doing now? What next?). It is necessary to make sure the student contacts the Counselling and Support Service (the teacher/lecturer’s telephone assistance may be advisable) or, outside that Service duty hours, the admissions of the nearest psychiatric hospital. When in doubt or difficulties, the lecturer/teacher can count on support and should not feel left to his/her own devices; • It should be borne in mind that the student has the right to independently select a university programme to pursue. Academic teachers should not restrict access to knowledge or opportunities of performing a certain profession because of the student’s disability. This is true for the circumstances of students with various disabilities, yet most frequently the problem is prominent in the case of students experiencing mental-health difficulties since myths are made of mental-problem symptoms and stereotypes abound as regards these persons. Often, as is the case with other specific academic difficulties, it may be difficult to decide what kind of adaptation is best for a student experiencing mental-health issues at a given time. His/her mental condition and medication taken may change and so influence, in a variety of ways, the student’s cognitive and general academic performance. It should be remembered that the teacher/lecturer has no obligation to take upon himself/herself the decision concerning what at any given time makes a reasonably selected adaptation given the specific impact of the disability in question. Whilst such a decision should be left to the Counselling and Support Service consultants, the teacher/lecturer’s suggestions as to the organisation and substance of his/her course remain valuable.
4.3 Strategies for Teaching Students with Visual Impairments The implementation of strategies listed below during lectures and classes will improve the quality of teaching blind and partially sighted students and ensure equal educational opportunities. Recommendations: • Encourage students to take seats close to the lecturer. In this way people with poor visual impairment will better hear his/her voice as well as receive visual stimuli. 32
• Inform in advance about the change of location where classes or lectures will be held so that students who do not know this location can get there easily. • Allow students to record your classes/lectures on a dictaphone after they declare that such recordings will be used exclusively for educational purposes. For some students this may prove to be indispensable educational support. • Make sure that the rooms and the student’s working place are well-lit, according to his/her individual preferences. Some students will need extra light provided by a small lamp. The lecturer’s place should be well-lit too, because otherwise a partially sighted student may feel discomfort not being able to take advantage of available non-verbal information from the lecturer. • If possible, make sure that the acoustics of the room where classes or lectures are held are good. • Make sure that the room has no obstacles which may pose a threat to a blind person's safety, e.g. cables, a screen hanging low. • Allow students with visual impairments to use additional optical aids (a magnifying glass) or electronic equipment, e.g. laptop computers, Braille notebooks, enlargers. • Provide the students with the content of your lectures/classes in an electronic form – in a text format or as a html file – which can be read with the use of talking software. Ideally, the materials should be provided well before the lecture/class, e.g. by e-mail or e-learning platform. Thanks to the opportunity of getting acquainted with the materials before the lecture/classes, students participate more actively. Knowing the structure of the lecture, they can order the new knowledge (in their mind or making additional notes in Braille) on the basis of the materials received earlier. Note that this is an innovative solution which is beneficial from the point of view of all students who participate the teaching process. It is used in relation to the whole groups with very good results. • Describe the elements you refer to during a lecture or presentation, always read out the displayed text. • Precisely describe visual reality (information featuring on/in diagrams, graphs, slides, tables, etc) to the blind student using specific words so as to facilitate imagining them (e.g. a line connecting points a and b rather than a line connecting two points). • Dictated information should be accompanied by writing it on board at the same time at a pace which enables note-taking. • Make legible materials and multimedia presentations available to students. This mainly means selecting the right font size, as agreed with the student, as well as using contrasts or identical colours of varied intensity. • Make sure that materials printed out in enlarged font are legible.
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• Prepare for students a list of obligatory reading well ahead, as his/her reading process requires more time. The printed text has to be adapted to be accessible. Besides, reading with the use of optical or electronic devices takes longer. This is another example of an element which can contribute to the overall improvement in teaching results. • Allow the student to take exams/tests in an alternative form. The decision concerning the form should be made in advance. The changes may involve replacing written tests with oral exams, using test sheet prepared in Braille or with the enlarged font (most often: 16-18), using specialist equipment such as a computer with a speech synthesiser, enlarging software, a Braille ruler, taking an exam with the help of an assistant and having examination time extended.
Behaviour in the presence of a student with visual impairment It is a good idea to get acquainted with some rules concerning our behaviour in the presence of a student with visual impairment. The advice below will allow avoiding embarrassment on the part of both sighted and visually impaired people. Recommendations: •
Behave normally, treat a disabled person naturally assuming that it is good to ask if you do not know when and what kind of support is consistent with individual requirements.
•
Look at the face of your visually impaired student, address him/her directly and not his/her guide.
•
When you talk to somebody, especially if in the room there are many other people, use the forms (e.g. a name), which clearly indicate who you address.
•
Do not be afraid to offer support in e.g. crossing the street, finding the right building or bus. It is a good idea to ask the person what he/she needs, but not to press too much or feel irritated when he/she refuses.
•
Remember that most people with visual impairment are partially-sighted (some of them do not stand out from the crowd in any sense) and their abilities and the kinds of support they require are varied.
•
Take into account the difficulties arising from the lack of access of a blind or visually impaired person to information available through the sense of vision, which plays a vital role in social interactions. Facial expressions, direction of looking, specific eye movements, gestures, sometimes proxemics (the use of physical space between people as they interact). Signals accessible visually often carry information about emotions of the interlocutor, his/her involvement or weariness during the conversation, wish to take the floor, kind attitude, disapproval, acceptance of what is said, etc. A person who does not see may feel discomfort if
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there are no auditory counterparts of these signals in communication. If one wants to show approval, appreciation or interest, he/she should use words, sounds commonly used for such a purpose or timbre, tone and dynamics of voice. Consider how your communication is received without being accompanied by visual elements, e.g. tone of voice without the facial expression or stance. Remember that blind people are usually adept at using other senses as a great source of knowledge when interacting with other people. •
Do not comment on a person's disability do not avoid the topic at all cost. Do ’Look!’, ‘we haven’t seen for a long meaning that the one which refers to them all the time.
nor pay too much attention to it. However, not be afraid to use expressions such as: time’, ‘see you’ – they have a broader the sense of vision, and blind people use
Recommendations for people who are a blind person’s guides • Inform him/her about your presence, signal that you are ready to guide by gently touching his/her arm. • When guiding a person with visual impairment, let him/her take your arm just above the elbow and make him/her walk one half-step behind you. •
Inform him/her about the location and where he/she is going.
• Do not leave this person alone in the middle of the room without any spatial elements he/she could touch. •
Inform him/her if you are going to move away.
•
Indicate a chair by placing his/her hand on the chair back.
• Allow a disabled person to move freely – do not force him/her to the seat, do not pull at him/her by the arm. A blind person (if he/she has not got any coexisting motor disability) accompanied by a guide walks up the stairs, seats him/herself easily.
If a student has a guide dog • Allow the dog enter everywhere with the student. Guide dogs are always vaccinated, placid, obedient and before they begin working as guide dogs they are specially selected and well trained. • Avoid distracting dog’s attention, do not pat or feed it. The owner is the only person who can give it commands, award or punish it. Thanks to it the dog obeys a blind person, is focused on its work and, because of it, is a good guide dog that ensures his master’s safety. • Ensure space for a guide dog next to the student’s desk.
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Rules for Adaptation of Materials to the Requirements of Blind and Partially Sighted People It is possible and necessary for blind and partially-sighted students to learn the material which is obligatory for all students in order to complete studies. However, a blind or a partially sighted student may not be able to fully benefit from the generally available materials before they are adapted in an appropriate way. The sets of rules presented below comprise the methods which are used most often in the process of adaptation of the materials.
Adaptation of Teaching Materials to the Requirements of Blind Students The most important method of reading by students with visual disability is by scanning the printed text and reading it with the use of talking software, the so-called screen reader and speech synthesizer. It is also possible to read with the use of Braille ruler or Braille printouts. In the case of Braille printout, it is necessary to prepare an electronic form of the text, preferably as a text format or a html file. (You will find detailed information on electronic equipment in the section on assistive technologies). Difficulties may arise when teaching material is presented in a visual form – as photographs, graphs, diagrams. In this case a different form of adaptation from mere scanning of the book is necessary. Some kinds of adaptations can be made by a learner him/herself (e.g. scanning), others – the more advanced and time-consuming ones – require action from a sighted person: a teacher or a worker or assistant appointed by university authorities for this purpose. In any case it must be remembered that the process is time-consuming and involves extra work. This fact must be taken into consideration when exam or test dates are set, reading lists are announced or additional learning materials to be used in class are distributed.
Rules for Illustration Adaptation for Blind People •
avoid graphic elements that were used only to make the text more attractive or include information already mentioned in the text,
•
in place of an illustration include a short and precise description which contains detailed information on the location of vital graphic elements, spatial and logical correlations between the elements,
•
describe the content of tables and charts in the written form,
•
use convex after presenting the illustration in a more schematic way,
•
use original ideas and forms, e.g. sound recording (sound instead of a photo), items that can be examined through the sense of touch, smell, taste; objects (boxes, cut out fragments of a circle, three-dimensional models) which
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visualise spatial relations, percentage, the shape of an object of considerable size, etc. Note that the process of adaptation of a textbook does not refer to the visual content only. Some fragments of the text should be changed so that the whole can be comprehensible. In the case of longer texts, it is worth using the so-called ‘editorial commentary’ which explains to the adapted textbook user the way in which illustrations, stressed elements, bulleting, page numbers, were adapted. All adaptations must be made with great attention to detail. It is important to try to preserve maximum consistency with the original, without omitting or simplifying significant content or adding elements which are not in the original text.
Using the Braille Alphabet The Braille alphabet is associated with blind people. It is sometimes believed that blind people, if deprived of materials in Braille, have no access to information. Notice that not all blind people know how to use this system. One of the reasons for it may be using remaining vision to read (these people prefer using large print texts, sometimes using optical aids). Sometimes coexisting palm dysfunction makes tactile perception of Braille dots impossible. Some people simply have never learnt Braille (e.g. if they lost vision only recently and prefer using a computer). The Braille alphabet is also superseded by modern technology. At present blind people predominantly use a computer with specialised software. There are also special devices which use an electronic form of Braille – the socalled Braille rulers, notebooks or monitors, where six-dot Braille cells are available in the form of dots which appear and disappear on the matrix operated by special software. This notebook allows the presentation in the Braille form of every text which was originally encoded in an electronic form and recording the text with the use of the combinations of six keys which correspond to individual dots. The options which take advantage of stateof-the-art technology are much more convenient that gathering materials in the form of the Braille printouts which are heavy, occupy much space and in order to be created, they need an electronic form anyway. The Braille alphabet was created in the nineteenth century by Louis Braille, who himself was blind. He derived the idea from a secret code devised for the military, which could be read in darkness by means of touch. Braille based the rules for the alphabet on the raised six-dot cell, measuring 6.5 mm in height. This shape and size ensure the best conditions for tactile perception. A six-dot cell or character consists of two columns containing three dots each. Each point corresponds with a number between 1 and 6. (Fig.1).
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Fig. 1 Six-dot Braille cell (enlarged). Black points represent a raised dot. Different combinations of raised dots stand for different letters in the alphabet and punctuation marks. Dot 1 stands for the letter ‘a’, dots 1 and 2 stand for the letter ‘b’, dots 1 and 4 stand for the letter ‘c’, etc. (fig.2).
Fig.2. The letters of the Latin alphabet in Braille. The Braille system is universal. It can be used to convert a text in different languages, but a math text or a music score can be rendered in Braille too. Therefore, the term Braille language, which is sometimes used, is not correct. Braille is simply another form of notation of the Latin alphabet or transliteration of another alphabet on the basis of the Latin alphabet.
Adaptation of Teaching Materials to the Requirements of Partially Sighted Students Partially-sighted people choose very different reading methods depending on individual possibilities of using vision and developed learning strategies. Some students read black, enlarged print, others use a scanner or talking software and devices which allow enlargement of the text. Some partially sighted people are able to read ordinary print e.g. using optical devices. It is a good idea to discuss the options for adaptations with the person they are prepared for. Only then we can be sure that the offered solution will be suitable.
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Rules for Illustration Adaptation for Partially Sighted People •
drawings should be presented in an enlarged format, be clear and in good contrast,
•
avoid dark background, many similar colours, a large number of irrelevant details, graphic content in the form of watermarks, text placed against the background of illustrations, as well as placing illustrations against the background of the text,
•
large-sized illustrations can be divided into separate ones which constitute the parts of the original illustration,
•
information from the illustration should also be included in the text so that a person will not have to rely on the visual message only.
Rules for Adaptation of Printed Texts for Partially Sighted People •
use enlarged font (preferred font size is 16-18),
•
use non-serif font type (i.e. without crosswise and slanting features at the end of letters) e.g. Arial, Verdana, Helvetica; the shape of letters of such typeface is best suited to visual perception. It is also important not to use ornamental fonts or fonts which imitate handwriting,
•
use bold type to highlight important information; avoid italics, underlining, spacing out and using capital letters for longer fragments,
•
there should be no more than 60-70 signs in a line,
•
use double spacing between the lines,
•
use a flush left, ragged right text alignment, avoid justifying the text,
•
do not use background (e.g. grey boxes that should be filled in) and colour letters; the most visible is black font against the yellow or white background; blind people may wish to express their individual preferences as to the background colour which facilitates reading the most,
•
avoid placing the text around the illustrations, especially if it means the necessity to continue reading in a different place,
•
in extensive publications ensure wide margins and a possibility of opening the book flat,
•
print on a matt paper of proper thickness so that there is no show-through from the other side of the sheet,
•
in test sheets space for answers or answers should be provided under questions; do not use the form which requires searching for data in columns or comparing it. 39
•
Making adaptations is in compliance with the Copyright Law, which allows adaptations of the printed work to the needs of disabled people to the extent directly resulting from the nature of disability. There is no obligation to inform the author about making such adaptations.
It must be stressed that adaptations of textual materials and illustrations do not have to be prepared by lecturers themselves. Teachers may count on support (technological and related to the form) of the employees of the Social and Health Policy Committee of AUTh.
4.4 Strategies for Teaching Students with Hearing Impairments You should ensure the best conditions for class participation for deaf and hard of hearing students. Below there is a list of recommended strategies. Recommendations: −
Make relevant materials available to the student well ahead of the lecture/classes (e.g. notes in an electronic or paper form, main points, list of new specialised terms, bibliography), in this way facilitating his/her more active participation.
−
Make sure lectures/classes are held in well-lit rooms with good acoustics. Remember to reduce noise (by e.g. closing the windows).
−
Enable students to use available technological solutions such as hearing-supporting systems: FM, induction loop (more about these in the section on assistive technology) or dictaphones to record classes.
−
During seminars and group exercises desks should be arranged, or the deaf person(s) is allowed to sit in such a way that the faces of all the students (if possible) are visible for students who are deaf and/or hard of hearing (e.g. in a semi-circle), thus making it easier for lip-reading students to take part in discussions.
−
Avoid standing with your back against the window or another source of light as the speaker’s face is then in the shade, which hinders lip-reading.
−
Before speaking capture the student’s attention, make sure you establish eye contact so that the student will know that words are directed at him/her. Check that the student is able to shift attention to different speakers during the lecture or class. A visual system, helping signal who is going to speak can be introduced (e.g. by raising a hand) and this will make a big difference.
−
Before a specific exercise is started, the sequence of the activities to be performed should be explained in detail. It is useful to formulate instructions in writing and verify their understanding by asking specific questions related to the text.
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−
While communicating, face the student. Avoid covering the mouth, speak clearly, yet without exaggerated articulation and at a regular pace. Speaking too slowly may distort the natural rhythm of speech and make lip-reading difficult for people for whom it facilitates communication.
−
Use clear and unambiguous phrases/expressions while speaking, stressing the most important issues and key words. Explain the meaning of complicated linguistic constructions, in particular specialist language. (If the student lip-reads, it is useful to repeat a given utterance and/or rephrase it, as many words are articulated in a similar way whilst around 60% of lip reading is based on guessing, so changing words increases the chances of correct understanding).
−
New, unknown vocabulary (particularly specialist) and key concepts should be written down in a visible place, e.g. on the board or distributed as materials for students.
−
Offer deaf students extra time and assistance in editing written work, since they can experience difficulties in formulating sentences observing the standards of style, grammar, phraseology and lexis of the Greek language because of the different principles governing sign language.
−
During classes/lectures use visual aids that facilitate the reception of information through the sense of vision (e.g. multimedia presentations, transparencies, graphs, diagrams, animations, maps, models, illustrations or photographs). Audio or video materials should be accompanied by the text of the recording.
−
Make short breaks for rest during classes as lip-reading is tiring, it affects attention and memory negatively.
−
Remember that students who lip-read or use assistance of a sign language interpreter are unable to read or take notes whilst participating in the discussion. The teacher should give the student extra time for reading the materials or make them available in advance.
−
The form of examinations should be tailored to the individual requirements of the student. It is typically recommended to give written tests rather than oral exams to deaf students.
If the student uses the support of a sign language interpreter •
Make the materials available to the interpreter before the class/lecture so that he/she can prepare the interpretation well.
•
During the class/lecture remember that simultaneous interpretation relies on the interpreter being able to hear your voice clearly, which is why fast speech is not recommended and why it is so important that you speak freely but at a natural, comfortable pace. 41
•
During a conversation, always address the deaf student directly, not the interpreter. Avoid the phrases such as tell him/her, ask him/her.
•
Provide the interpreter with a place conducive to good work so that while standing or sitting he/she can be close to the speaker (there is usually an optimum distance between the interpreter and the student). It may be helpful to offer a list of the other students in the group and the schedule.
•
Remember that the interpreter may need to take a break for rest of around 30 minutes. If the course is very demanding or it is for a long period of time, the interpretation may be performed by two or more interpreters working alternately. Indeed this is preferable in such circumstances to guarantee adequate support. It is good to agree the duration and frequency of breaks with a student and their interpreter.
•
During discussions ensure discipline and manners as at any given time it is only possible to interpret what one speaker is saying at a time.
•
Make sure the deaf student has some extra time for his/her contribution as interpreting the question and the student’s answer is more time-consuming.
•
Pay due attention to the fact that the student concentrating on the interpreter is unable to divide his/her attention and do other things like reading notes at the same time.
4.5 Strategies for Teaching Students with Mobility Impairments Recommendations presented below may help organise the best possible support for students with mobility impairment during classes at university. Recommendations: •
While communicating with a student in a wheelchair assume a position facilitating eye contact. Avoid holding a conversation standing, looking down on the interlocutor. One of the best, most polite and natural ways is to sit down on a chair whilst talking.
•
Make sure that the room is accessible to all. Check the desk arrangement and see whether the room can be entered in a wheelchair. Check the room for heavy doors and high thresholds as well as how much time it takes to cover the distance outside the building. Make sure desks are of a comfortable height or the table height can be adjusted if necessary e.g. for a wheelchair user.
•
If lectures/classes are scheduled to take place in inaccessible rooms, try to find another accessible room located on the ground floor.
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•
Ensure enough time for the student to freely move between rooms or buildings for the next classes.
•
During oral examinations and other situations related to speaking, if the student has speaking difficulties, let him/her set his/her own pace. It is important to devote some time to understanding his/her answer rather than end the response for him/her. In the case of unclear pronunciation, ask the student to repeat or apply an alternative communication technique, e.g. a written form. If problems with verbal communication are aggravated, the student may be using additional equipment. Its use requires the extension of examination time.
•
Make sure that the students who find it difficult to write quickly and legibly due to hand or motor impairments have enough time at written examinations, and possibly guarantee them an option of writing the test using a computer or an assistant.
•
Give consent to record the lectures, provide lecture/class materials (ideally in advance) for students who find it difficult to make notes in a traditional way.
At the Aristotle University of Thessaloniki, the recording of lectures is not allowed because these could be then circulated generally and could result in students not bothering to attend lectures. •
Provide an assistant for students who due to hand/arm motor impairments are unable to perform obligatory tasks themselves (for instance lab exercises). If such assistance is in place, ensure that the assistant works only as directed or guided by the student and does not support him/her in interpreting the results obtained. At the Aristotle University of Thessaloniki, the university neither provides nor endorses a procedure whereby an official note-taker can take notes on behalf of a student unable to do so himself due to some kind of disability. This is because the university wants to guard against the possibility of such notes being photocopied or even sold. However, a blind eye is turned if on an unofficial and friendly basis a fellow student takes notes on behalf of a student with disabilities, or simply gives him a photocopy of his own notes.
•
Do not force your unsolicited help on a disabled person, do not invade his/her personal zone e.g. by forcing a person into a chair, pushing the wheelchair (unless a student approves of/asks for this kind of assistance).
•
Be aware of other difficulties which coexist with mobility impairment. A student may experience severe bodily discomfort during lectures/classes or examinations. Owing to this, he/she may need frequent breaks, he may have to leave the room to change his/her body position, take exams divided into smaller parts e.g. because of the inability to sit for a long period of time without the aggravation of his/her symptoms. Students may experience discomfort connected with pain, difficulties with thermoregulation, increased fatigue, also specific somatic symptoms whose
43
occurrence sometimes accompanies mobility impairment difficulties). The above naturally hinder concentration on tasks.
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(e.g.
breathing
Part ΙI – Practical Part
5. The training 5.1 A guide to the Practical Part of the Manual
The practical part of the manual reflects the structure of the training, which is divided into five sections devoted to different kinds of disability. In the training programme, these are marked with the following symbols: VI (visual) – section concerning visual impairment HI (hearing) – section concerning hearing impairment MY (mobility) – section concerning mobility impairment MH (mental health) – section concerning mental health difficulties G (general) – section concerning general information Each section contains information referring to the following modules: • social stereotypes concerning perceiving and thinking about disability; rational explanations in place of existing myths, • experience of disability: showing the relations between a disabled person and society, and not its medical context, • communication and teaching strategies: developing suggestions regarding academic support for disabled students, • assistive technologies and disability: their role in the access to education and compensating for impairment. The experiential activities, included in each section, are available in the form of a plan where they are described in great detail. This allows the trainer to be prepared in advance and conduct the activity effectively. The plans contain additional theoretical information and commentaries on PowerPoint presentation, which are necessary for the trainer to conduct the activity correctly. The complete set of the materials for the trainer, apart from this manual, consist of: • PowerPoint presentations available on CD: slides contain key conclusions following from activities and important information concerning a given section (teaching 45
strategies, practical suggestions, assistive technologies). Commentaries on slides contain theoretical background which can be used by the trainer when discussing the content of the presentations, • educational films which contain additional commentaries with information to be used by the trainer during the work with a group, • an electronic form of the manual for the trainer and participant, which caters for the individual requirements of the reader.
The trainer should have access to a room with chairs and tables for the participants and all stationery materials necessary to conduct all activities. The presentations and films should be copied prior the training to the hard drive of the computer to which a multimedia projector with loudspeakers is connected.
5.2 The Training Programme Guide
The duration of the training is estimated to 6hours, plus additional 30 min to be used by the trainer depending on the activity level of the group and interests of its members. The table below summarises the content of the training programme. The reference number of the activities is read according to the example:
AT/VI/7 AT – academic teachers VI – disability [VI – visual impairment, HI – hearing impairment, MY – mobility impairment, MH – mental health difficulties, G - general] 7 – number of activity
Estimated time refers to the total time for the experiential activity and the corresponding theoretical part.
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The training programme guide
Reference number AT/G/1 AT/G/2 AT/G/3
Activities
People first language
Character traits of people with and without disabilities Stereotyping and how to defy it in an educational context
Symbol
Estimated time
G
20 minutes
G
20 minutes
G
20 minutes
AT/MH/4
Young adult mental health
MH
25 minutes
AT/MH/5
Myths concerning mental illness Assessment Inventory.
MH
25 minutes
MH
25 minutes
MH
25 minutes
Mental illness’s stigmatisation AT/MH/6 AT/MH/7
Mental health difficulties and symptoms Academic Difficulties and a Guide to student support
AT/VI/8
Sighted guide techniques
VI
60 minutes
AT/HI/9
Classifiers
HI
60 minutes
MY
35 minutes
MY
25 minutes
G
20 minutes
AT/MY/10
Experience of disability (the medical and social model of disability) Wheelchair etiquette Stereotypes of mobility disability
AT/MY/11 AT/G/12
Exclusion / Assistive technology How to remove barriers
5 minutes
Summary
15 minutes
Questions/ evaluation
5 minutes
Closing
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5.3 Language and Stereotypes
5.3.1 Activity: People first language
Reference number
AT/G/1
Title
People first language
Overall objectives
To illustrate the power of language to reinforce differences
Specific objectives
•
To become familiar with the idea of people first language
•
To practice using people first language
Method
Mini lecture using PPT; mind shower / problem solving
Work format
Group
Materials
PPT
Duration
20 minutes
Instruction and sequence
The trainer shows slides (2) – (5) of the powerpoint presentation.
PEOPLE FIRST LANGUAGE
The kind of language used both in the press and by you and me in everyday life reflects how we think about disability. Language is a mirror of values and so it is very important to be careful about the way in which we use words. It’s not just what you say or mean that counts, but how you say it, both in 48
terms of tone and the choice of words you use. Our words have the power to inspire, motivate, and uplift people. They also have the power to hurt, isolate and oppress individuals or entire segments of society. Negative language can lead to harmful action, discrimination, abuse, negative stereotypes and even violence. Through our language, we can recognise our common humanity, or we can reinforce our differences; we can relate to others, or we can build walls. There have been horrific examples of the power of words. It is acknowledged that in pre-World War II Germany, Jews, as well as people with disabilities, were easier to eliminate because they had been dehumanised through language by the Nazi propaganda machine. Since language reflects our value and attitudes, it can become necessary to make changes to the way in which we refer to individuals and groups to avoid further oppressing those members of society. For example, in the States the long used and degrading term “Nigger” finally became “Negro”, then “Black” and now “African American”. We should make sure that the words we choose acknowledge that people with disabilities are first and foremost people, people who have individual abilities, interests and needs, who are seeking to lead ordinary lives. They are mothers, fathers, sons, daughters, sisters, brothers, friends, neighbours, colleagues, students and teachers, just ordinary people with common goals for a home, a job and a family. People with disabilities do not want to be labelled and they do not want to be defined by their particular disability or medical diagnosis. Would you like to be known for your eczema, sensitive bowel syndrome or short sightedness? Do you want to known by your problems or by other characteristics? Disability is just another part of the human experience, an aspect of human diversity, like other areas of human variation. The disability is only one part of the whole person. Therefore it is preferable to use "people first" language to first refer to the person as an individual, who may be further defined in terms of his/her characteristic, disability, or functional limitation if this is appropriate and necessary. When we put the disability first, we unfairly, and probably unconsciously, label the individual, and labels contribute to negative stereotypes. For example it is better to say a person who is deaf, rather than a deaf person. Say a woman with arthritis, a child who has a learning disability, or a person with a disability. This way, the emphasis is placed on the person, not the disability. People have diseases, impairments, and disabilities; they are not the sum product of their medical conditions. People have paraplegia; they are not “paraplegics”. Never equate a person with a disability, for example by referring to someone as a retard, a cripple, an epileptic or a quadriplegic, just in the same way as you would not refer to someone as being a myopic, but as someone who wears glasses. It should be people first, too, for indicating disability groups. Say people 49
with cystic fibrosis or people who have cancer. Talking about the disabled, the blind or the deaf implies a homogenous group separate from society as a whole. People with disabilities also do not want to be seen as victims or objects of pity and charity. So avoid eliciting unwanted sympathy with negative or sensational descriptions that suggest tragedy, such as afflicted with, crippled with, suffers from, or is a victim of. For example, it is preferable to say a person with AIDS to an unfortunate person who suffers from AIDS, or an AIDS victim. Our attitudes towards people with disabilities are also revealed when talking about people who are not disabled. When we say “able-bodied" “healthy” “whole” or “normal", we should be aware of the subtle message or implication that people with disabilities are not “able" or “healthy" “whole” or are “abnormal”. If it is necessary to make comparisons, it is better to adhere to people first language guidelines and say "people without disabilities”. Using euphemisms does not change reality. Terms such as handicapable, differently abled, special, and challenged reinforce the idea that people cannot accept or deal honestly with their disabilities. Also individuals with disabilities should never be referred to as patients or cases unless their relationship with their doctor is under discussion, or if they are referenced in the context of a hospital or clinical setting. In the same way as racial identification is only appropriate if of some significance when describing or referring to an individual, ask yourself if it is really necessary to refer to a person’s disability. Is it relevant to the conversation or situation? Disability should not be the primary, defining characteristic of an individual but merely one aspect of the whole person. References to a medical diagnosis may be neither appropriate nor necessary.
“IF THOUGHT CORRUPTS LANGUAGE, LANGUAGE CAN ALSO CORRUPT THOUGHT”
GEORGE ORWELL
Both thoughts and words can shape reality. Thomas Merton (1948) first
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coined the term “self-fulfilling prophecy” meaning that the words used about a person have a powerful impact on the person. Words have a powerful impact on society too, and as society’s language changes, perceptions and attitudes will change, and society’s acceptance and respect for people with disabilities will increase. This is not just political correctness but good manners and respect, which will help create a more inclusive society.
Mind Shower / Problem Solving The trainees are invited to transpose the sentences in the left hand column into sentences which use people first language and appropriate vocabulary. The first sentence and its model answer is given for them, the subsequent sentences appear one by one on the screen, firstly without their model answers.
NO
YES
This student is a handicapped patient and the victim of a terrible disease. In fact he is a cripple.
This student is a person with disabilities who has a disease which means he can’t walk.
At this university the handicapped, the disabled, invalids and people who are wheelchair bound or afflicted by other medical problems can use the disabled parking and the disabled toilets.
At this university accessible parking and toilets are available for people with disabilities.
He is physically challenged which is why he is confined to a wheelchair.
He is a person with a physical disability and a wheelchair user.
Unlike normal or healthy people, quadriplegics and spastics are usually in a wheelchair.
Unlike people without disabilities, people with quadriplegia or spasticity usually use a wheelchair.
1. Handicapped This is labeling and defines this student by his disability. Patient Inappropriate since we are not referring to this person in the context of a hospital. Victim, cripple These are negative descriptions that suggest tragedy and solicit sympathy. The term “cripple” equates that person with his disability.
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Here is a different version that carries the same information following the “people first” guidelines.
2. The handicapped, the disabled, invalids Using “the” implies that these are people from homogeneous groups, which are separate from society as a whole. Wheelchair bound, afflicted Negative descriptions that suggest tragedy and solicit sympathy. Question: can you produce a “people first” version?
3. Physically challenged The use of the word “challenge” is a euphemism that doesn’t change reality. This expression reinforces the idea that people cannot accept or deal honestly with their disabilities. Confined to Negative Question: can you produce a “people first” version? Normal or healthy people This carries the subtle message or implication that people with disabilities are abnormal and not healthy. Quadraplegics and spastics People have diseases, impairments, and disabilities; they are not the sum product of their medical conditions. People have spasticity; they are not “spastics”. In a wheelchair The use of the word “in” implies passivity, whereas a wheelchair is something that facilitates activity. Question: can you produce a “people first” version?
Theoretical background of the exercise The terminology one uses reflects his/her personal attitudes as well as the ones retained in culture and transmitted through language. The terms such as an invalid, cripple, the deaf and dumb, the blind, etc reinforce thinking of disability in terms of a defect, deficiency or disadvantage. Disability understood in this way provokes social acts of charity, ‘bending over’ alleged suffering, harm and injustice. Such a description of disability generates overprotective 52
attitudes towards a disabled person. As a result, he/she is not treated in accordance with the concept of equal rights and responsibilities. The social interactive model, which reflects a modern way of thinking, stresses the objectivity required when looking at disability. Using non-stigmatising vocabulary creates grounds that support the concept of equality in relation to disability. During the training you should - as mentioned earlier – pay attention to terms of unclear character. Ones that are too descriptive or euphemistic (e.g. ‘a person with certain emotional difficulties’ when referring to a person with schizophrenia) do not convey accurately the problem connected with a specific kind of impairment. Also, this may suggest apprehension on the part of the person who uses such terms in which case it will be good to discover what assumptions and personal experiences have caused the participant(s) to use such terms.
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5.3.2 Activity: Character traits of people with and without disabilities
Reference number
AT/G/2
Title
Character traits of people with and without disabilities
Overall objectives
Specific objectives
Method
•
To illustrate how deep rooted the stereotyped character traits of disabled people are
•
To show that fewer positive attributes are attributed to disabled people than to people without disabilities
•
To illustrate that disability is seen as undesirable and inferior
The trainees will: •
question their own perceptions of disabled people
•
understand better the underlying factors contributing to deep rooted stereotyping
1. First the trainer invites trainees to think of words that come into their head when they think about someone with a mobility disability, and how they feel about that person (show pps slide 2).
What words come into my head when I think about a someone with a disability? How do I feel about this person?
2. Quiz (using Annex 1) Work format
Whole group
Materials
The trainer shows slide 3 from the powerpoint presentation. Each participant gets a sheet of paper with the following tables (Annex 1)
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Table 1 Attribute
10 negative attributes associated with people with disabilities
argumentative bossy complaining conceited demanding dependent. depressed distant helpless insecure isolated lonely loud mouthed nervous over-confident self-centred shy silent unhappy unpopular unsociable
Table 2
Attribute
All the positive attributes associated with people without disabilities
amusing bright capable curious decent dependable desirable easy going energetic fun to be with good natured 55
All the positive attributes associated with people with disabilities
happy hard-working honest humourous independent intelligent likeable mature non-egotisitical optimistic outgoing polite popular proud quiet self-assured self-disciplined sociable talkative undemanding well-mannered Duration
20 min
Instruction and sequence
The trainer shows slide (3) from the powerpoint presentation.
Exercise on attributes Please answer as your society’s “Mr. Average�
Answering as an average person in their society, trainees have to 1. tick the 10 negative attributes people in your society might typically associate with a disabled person. There are 21 attributes in total. 2. tick all the positive attributes people in your society might typically associate with a person without disabilities. There are 32 positive attributes in total. 3. tick all the positive attributes people in your society might typically associate with a disabled person. There are 32 positive attributes in total.
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(For the purposes of the activity the attributes have been divided already into positive and negative, and there will be no discussion as to whether these have been done correctly e.g. some could be considered positive or negative (proud, quiet)? Trainer’s comments and conclusions
The trainer shows slide (4) from the power point presentation. How do you react when you see a disabled person. Is your reaction the same as it would be to someone without disabilities? Do you have to make a conscious effort to see beyond their physical condition? Do you unconsciously attribute characteristics to that person, which are not based on reality or knowledge of that person, in other words are you influenced by stereotypes? Actually the girl sitting on the grass has a mobility disability and the wheelchair in which the other girl is sitting is hers. The second girl who is in the wheelchair is an actress and she doesn’t have a disability. Has that changed your opinion of them at all? The trainer shows slide (5) from the powerpoint presentation.
The creation of stereotypes is deep-rooted and complex, and is influenced by how disability is represented historically, politically, medically and socially. Let’s see what kind of a result this process has had on all of us. If someone is noticeably "different" from us, we tend to stereotype them by emphasizing their difference and ignoring their other qualities. It doesn't matter if the difference is the colour of a person's skin, the way they dress, or whether they have a disability. The trainer shows slide (6) from the powerpoint presentation.
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Ideals in the Western world • • • • • • • •
Wealth Social status Appearance Sexually attractive Strength Have fun Independence Control and power
What a person without disabilities thinks a person with a disability thinks about himself. • Not able to achieve • Not able to participate • Ugly • Sexually unattractive • Nothing to offer • Wants to be “normal” • Dependent
Stereotyping of disabled people includes assumptions that they feel ugly, a burden, suffer, crave to be ‘normal”, are naive and sheltered, have nothing significant or worthwhile to offer, that they envy people without disabilities, are asexual, bitter and require care and therapy, and are generally incapable of full participation in everyday life. Compare these assumptions with the ideals in the Western world of appearance, strength, social status, power, independence and wealth to which we are encouraged to aspire. Stereotyped views frequently act as self-fulfilling prophecies, forcing the disabled person into a role.
5.3.3 Activity: Stereotyping and how to defy it in an educational context
Reference number
AT/G/3
Title
Stereotyping and how to defy it in an educational context
Overall objectives:
•
To illustrate some of the typical stereotypes of disability
•
To provide ideas on how to break down stereotyping of disabled people in an educational context
Specific objectives:
The trainees will consider ways to defy stereotyping in an educational context
Method
PPT
Work format
Group
58
Materials
PPT
Duration
20 minutes
Instruction and sequence
The instructor shows slide (2) – (6) from the PPT presentation illustrating stereotypes of disabled people: •
Putting the disabled person on a pedestal. Claiming they are an inspiration, brave, courageous, an example to us all.
•
Super-achievers, the heroes with disabilities who climb mountains, win competitions, graduate from Oxford and are awarded gold medals at the Paralympics, and who by performing super-successfully somehow overcome or appear to lose their disabilities.
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•
Representing the disabled person as having compensatory special gifts or abilities that enable them to heroically overcome their disabilities and be seen as something other than disabled e.g the blind person who is musically gifted.
•
Victims - vulnerable, weak, dependent, the object of pity as a result of an accident, violence or abuse.
•
Pitiful and sweet - pathetic, innocent, grateful for small gestures, sometimes speak gentle words of extraordinary wisdom, need to be looked after, in film and fiction often find miracle cure.
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2. The instructor shows slides (7) of the PPT presentation talking about defying stereotypes in an educational context: The way forward.
•
Recognize the benefits of diversity in a group and point this out to your students. All students, non-minority and minority alike, learn better when the learning takes place in a setting where they are confronted with others who are different than themselves.
•
See your disabled students as whole people with the same suite of frailties, desires, struggles as everyone else. See them as students first – their disability does not define them.
•
Encourage extended contact and collaboration between students with and without disabilities where everyone has equal status. Ensure that the relationships are not one-sided – everyone should both give and receive.
•
Place emphasis on the abilities of a disabled student and foster an understanding amongst all students that it is the inability to react with the environment that causes the disability, not the student’s medical condition itself (social/interactive model of disability).
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Theoretical background for the activity – Disability and Identity Identity is an answer to the question: ‘Who am I?’ Some of the qualities which constitute identity may be referred to as ‘central’. These are the qualities which make us identify with representatives of different groups, which to a greater extent and relatively permanently decide about who we are (e.g. sex, mother tongue, key elements of life philosophy). Within individual identity one can distinguish certain elements, which can be described by means of a spatial metaphor as being further removed from the core of identity – they are more ‘peripheral’. They refer to characteristics more changeable in time, of lesser importance to the picture of the self of a given individual (e.g. actions performed temporarily, acquired skills). A very important aspect of majority of peripheral features is the fact that they refer to the sphere of individual choice and influence, they are susceptible to changes in the environment and they are modified by new experiences. The place of disability in the scheme of own opinions of oneself largely depends on the degree to which a given community supports a disabled person as to his/her scope of influence and effectiveness of his/her actions concerning overcoming his/her disability. The interactive model of disability assumes that disability is not something unequivocally unremovable and does not necessarily have an influence on a person’s identity. Under this interactive approach, disability does not have to be 'central’ to the construct of identity. It is a state arising from the interaction of a given person with the environment formed by the majority and from the point of view of the needs of the majority. However, according to the medical model, disability is within an individual and is identified with a specific physical feature, a characteristic kind of behaviour or a way of experiencing it. Sometimes because of the discrepancy between these two perspectives (individual and external) a person, who does not have his/her identity built mainly on the basis of the fact of being disabled, is perceived in many contexts as a disabled person, regardless of environmental limitations and the fact if they are encountered or not. It reduces the effectiveness of a disabled person in choosing the roles for him/herself and the chances of full self-realisation within the assumed roles. A person not categorised as a disabled person can be, depending on the context, viewed on the basis of different indicators of his/her identity and different social roles. Thanks to it, this person is at the same time supported in performing these roles. The possibility of expression of disabled persons is in this respect often much restricted. Those individuals, perceived mainly in the context of disability, receive less encouragement and reinforcement necessary for selfrealisation while assuming other roles. What is required from the representatives of the academic environment, which a disabled person enters, is the support offered to him/her in the role of a student. It is also vital that a disabled person is perceived from the perspective of these qualities, which he/she tries to display as a member of an academic community, and not just as a disabled person.
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5.4 Mental Health
5.4.1 Activity: Young adult mental health
Reference number
AT/MH/4
Title
Young Adult Mental Health
Overall objectives
Increasing the trainees awareness of the particular Mental health difficulties faced by young adults.
Specific objectives
The trainees will: 1. Explore their knowledge regarding the mental health of young adults 2. Identify relationships between social changes and stressors (e.g. economy) and young adult mental health 3. Broaden their general knowledge concerning the mental health of young adults
Method
Group activities and discussions
Work format
Group discussion, PPT presentation
Materials
Paper for note taking
Duration
25 min
Instruction and sequence
• The trainees in small groups will be asked to share their memories of the stressors and difficulties they encountered during their college years (around 5-7 minutes). • The trainees in small groups will ask to share their recent experiences based on their observations and communication with college students regarding what they consider to be their current stressors and difficulties. • The trainees will present to the whole group what they have identified as similar and different in the experience of stressors and difficulties faced by college students in the past and in the present. • Volunteer role play of student today and student of the past discussing stressors. • Similarities and differences will be identified and noted. At the end of the activity the trainer asks the trainees whether any information was entirely new or surprising to them. • Possible explanations for the changes identified in the mental health of 63
young adults over the years will be explored with the group. Trainer’s comments and conclusions
The trainer will try to bring together identified themes regarding the similarities and the differences identified in the experiences reported. The trainer will try to draw out possible explanations.
Comment on ppt slide
The trainer will share information with the group based on the experience of the Centre for Counselling and Psychological Support of the Aristotle University of Thessaloniki regarding the mental health of college students and the changes observed over the past decade regarding the stressors they report.
Literature
• Paneras, A. (2010). Changes over a Decade in Greek University Students Mental Health. As presented at the 2nd Internationals Conference ‘Children and Youth in Changing Societies’ 2-4/12/2010 • American college health association (2006) American college Health Association- National College Health Assessment (ACHA-NCHA) Spring 2004 Reference Group Report Data (Abridged) Journal of American College Health, 54 (4), pp 201-2011. Jaschik, S. (2009), Mental Health of Campus Inside Higher Ed. April 21 retrieved from http://www.insidehighered.com/news/2009/04/21/ving •
st
Theoretical background •
“We’re seeing more students coming to college with mental health issues” APA, 2007
American college health association (2004) •
Nearly half the students have felt so depressed they had trouble functioning
•
24.5% were on psychiatric medication (compared to 17% in 2000)
•
Sharp rise in number of students with sever crises, e.g. major depression, bipolar disorder, eating disorders and drug and alcohol problems
•
Increase in anxiety disorders and panic attacks
Center for the Study of Collegiate Mental Health, Penn State University study 66 university counseling centers participated with responses from more than 28.000 students who received mental health services in 2008 Findings 1. One in every four students had seriously considered suicide 2. 95% had never harmed anyone intentionally 3. 51% had prior counseling experience 64
4. 33% reported prior use of psychiatric medications
5% had received drug or alcohol treatment
15% of women and 4% of men reported high levels of concern about eating and body image. 16% of gay students had such concerns.
Mental health and academic performance were linked
Changes in the past ten years at the Center for Psychotherapy and Counseling Support of the Aristotle University of Thessaloniki -
Increase of students
-
Increase of referrals from students
-
Severity of the presenting problem 1. More longstanding issues 2. More severe disturbances 3. More obvious dysfunction 4. Increase of psychiatric diagnoses
-
Increase in cases who have already visited mental health professionals in the past
-
Increase of cases who have received psychiatric medications in the past
-
Increase of cases with long standing unaddressed mental health problems
Factors affecting the student mental health •
Age 1. Entering adulthood- increase of stress 2. Defining adult identity
•
Family 1. Increased dysfunction 2. Over-protectiveness 3. Dependent on parents 4. Society 5. Increase of stress and anxiety in childhood 6. Stress and uncertainty regarding the future
•
Decrease in stigma
•
Lifestyle 1. Increase of freedom 2. Increase of responsibility 65
3. Changes in social life 4. Changes in roles •
Alcohol and drug use 1. Availability 2. Widespread use 3. Normalisation of excessive use
5.4.2 Activity: Myths concerning mental illness assessment inventory
Reference number
AT/MH/5
Title
Myths concerning mental illness Assessment Inventory. Mental illness’s stigmatisation.
Overall objectives
To provide information and ensure the trainees’ awareness of problems encountered by people with mental health impairment and their stigmatisation.
Specific objectives
The trainees will: •
Recognise and become conscious of their personal beliefs and attitudes towards mental illness
•
Learn about established myths and stereotypes regarding mental illness and overcome every single prejudice of theirs
•
Be capable of clearly perceiving and understanding all difficulties encountered by a person experiencing mental illness and become aware of mental health issues.
Method
Self-completion inventory (11 questions), group discussion in plenum, PowerPoint Presentation
Work format
Individual assessment and justification, group discussion in plenum, answers’ presentation (either in speech or both in speech and PowerPoint presentation)
Materials
Answering Sheet Forms (true or false questions, along with justification)
Duration
25 minutes
66
Instruction and sequence
1. The inventory is handed out to the trainees and they are asked to fill it out spontaneously on the sole basis of their own knowledge concerning mental health disorders (5 minutes). Answers’ format: True or False 2. The trainer will encourage all trainees to fill out the inventory and check up on or note down, if they wish, their perceptions regarding this delicate issue. 3. The trainer will encourage them to speak out about their answers, as well as to express openly/justify the possible reactions (thoughts or feelings) provoked in them through these questions.
Trainer’s comments and conclusions
Discussion about their perception and attitudes towards mental health disorders
Comment on ppt slide
Brief activity assessment. Summary of answers bringing out stereotypes regarding mental illness.
Literature
Schulze, B. & Angermeyer, C. M. (2002). Perspektivenwechsel: Stigma aus der Sicht schizophren Erkrankter, ihrer Angehörigen und von Mitarbeitern in der psychiatrischen Versorgung Neuropsychiatrie, 16, (1&2), 78 – 86. Oikonomou, M., Gramandani, Ch., Louki, E., Giotis, L. & Stefanis, K. (2006). Mental Disorder and Stigma: The way to destigmatisation. A schizophrenia anti-stigma Project led by the University Mental Health Research Institute (UMHRI). Psychology 13 (3), 28-43. What is mental illness? Bulletin (2007), Mental Health and Workforce Division of the Australian Government Department of Health and Ageing. Available on the following website: www.mmha.org.au. (13/6/2012).
The Quiz 1. Persons experiencing serious mental-health difficulties such as schizophrenia are aggressive and pose a threat to those around them. FALSE. According to statistical data, violence occurs as frequently amongst mentally ill persons as it does in the general population. Psychotic persons are more frequently fearful, disoriented and despaired than aggressive. 2. In a population, mental health difficulties are very rare. FALSE. Mental health difficulties are very common in a population (around 25% of a population experience them). 3. Mental health difficulties are identical to mental disability. FALSE. By definition, people with learning disability have lowered intelligence levels (IQ <70). The definition of Mental health difficulties does not include the intelligence level and they can
67
be experienced by persons with any IQ level. Most persons experiencing Mental health difficulties have an IQ above 70. 4. Drugs used in treating Mental health difficulties may have side effects which impair the daily functioning of the drug-taking persons. TRUE. Drugs used in the treatment of Mental health difficulties may cause side effects which have a negative impact on the functioning of the person taking them. In particular, many side effects are associated with neuroleptic medication. These are: sleepiness, sense of slowed-down thinking, muscular stiffness and disturbed sight accommodation. 5. No-one experiencing Mental Health Difficulties is able to decide about himself/herself or take conscious decisions. FALSE. Most persons with Mental health difficulties are able to make conscious decisions on their own. Only mentally ill persons, that is those experiencing psychotic conditions, may have periodical difficulties as regards making clear and conscious decisions about themselves. 6. Are mental illnesses a form of mental impairment or brain damage? No. Mental illnesses are just like any other physical disease, such as heart diseases, diabetes or asthma. 7. Are mental illnesses incurable and lifelong? No. Many people recover fully from them, provided they are early and properly treated and do not sustain further episodes of their disease. Yet, for others, mental illness may be recurrent throughout their lives and thus require ongoing treatment. 8. Are people born with mental illnesses? No. Family history may have to do with vulnerability to specific mental illnesses, such as the bipolar mental disorder. Yet, there are many other risk factors that bring on a mental illness, such as anxiety, mourning for a loss, a severe breakup, physical and sexual abuse, unemployment, social isolation, as well as some major physical illnesses or impairments. 9. Can anyone develop or be affected by a mental illness? Yes. We are all vulnerable to mental health problems. Many people find themselves more at ease with the idea of having a nervous breakdown, rather than having a mental illness. Nevertheless, it is important to talk openly about mental diseases, as this reduces the stigmatisation and helps people to seek early help and treatment. 10. Should people affected by a mental illness be isolated from society? No. Most people affected by a mental illness recover quickly and do not even need hospital care, besides some exceptions who might need hospitalisation, so as to receive medical treatment. Thanks to improvements on medical treatment over the last decades, most people live within the community and there is no need for the isolation and the confinement of the past. 11. Is stigmatisation amongst major issues people with mental illnesses encounter? Yes. One of the greatest obstacles people recovering from a mental illness encounter is other peopleâ&#x20AC;&#x2122;s negative attitude towards them, such as prejudice and discrimination patterns. 68
Importantly, in this activity the trainer should pay attention to such phenomena as: generalisation or overinterpretation when, for instance, a trainee cites the results of an observation, research or survey concerning disability that has been conducted on a too small or specific subgroup of persons with disabilities.
Theoretical background of the activity Mental illness, and primarily schizophrenia, inflicts a high amount of social rejection and stigmatisation, a phenomenon witnessed worldwide. Within society, there are several prevalent stereotypes concerning mental disorders, namely that a chronic mental disorder can be attributed to substance or drug abuse, criminality, as well as to other forms of deviant behaviour, that the persons affected by a mental illness are themselves responsible for manifesting it, that they, unlike people with physical impairment, are capable of keeping it under control, and thus they do not deserve any kind of assistance or support. Stigmatisation of the mentally ill people can representations of mental health and mental illness, social, professional and personal level, minimising managing all disorders and problems experienced not families as well (Oikonomou et al., 2006).
bring about misled perceptions and and may provoke major discrimination at whatsoever the potential of effectively only by the persons affected, but by their
5.4.3 Activity: Mental health difficulties and symptoms
Reference number
AT/MH/6
Title
Mental health difficulties and symptoms
Overall objectives
To acquire a basic Knowledge background concerning mental health difficulties and illnesses’ characteristics.
Specific objectives
The trainees will:
Method
•
Exchange their opinions regarding their own experiences about mental illness and familiarise with it.
•
Recognise characteristic symptoms of the students’ mental disorders, as well as their impact on their functionality and their everyday behaviour within the academic educational context.
•
Become capable of telling apart and understanding the differences between mental health and mental illness.
Discussion in groups, brief lectures
69
Work format
Work in small groups (3-4 persons), PowerPoint lectures (presentations)
Materials
Paper – pencils, PowerPoint
Duration
25 minutes
Instruction and sequence
1. In the beginning, the trainer will explain to the trainees that they will carry out an activity, in order to learn about and understand mental illnesses / difficulties. They will form groups of 3-4 persons. Each group will then discuss and write down on a piece of paper each member’s perceptions of what a mental disorder represents to them. 2. The trainer will encourage each group’s trainees to write down and evoke different examples-cases and share their experiences. 3. The trainer will emphasise on the following instructions: “Describe to your partners the phenomenological image of a person suffering from a mental disorder or experiencing mental health problems. You may use more concrete elements or descriptions of people with mental difficulties you have come across during your educational career, as to their physical appearance, the ways (verbal and non-verbal) in which they communicate and their behaviour towards other people”. 4. Later on, the trainer will invite all participants to present before the group everything they noted down and discuss their respective reactions. 5. In the end, a brief presentation will take place related to mental illnesses (symptoms):depression, anxiety disorders, etc.
Trainer’s comments and conclusions
Presentation of theoretical background concerning the topic of mental illness
Comment on ppt slide
Definitions, symptomatology, clinical cases from the general bibliography
Literature
ICD-10 or Gotzamanis, C. (1996). Diagnostic criteria (DSM-IV), Athens: Litsas editions. Manos, N. (1997). Basic Elements of Clinical Psychiatry. Thessaloniki: University Studio. Reinecker, H. (21994). Lehrbuch der klinischen Psychologie. Göttingen: Hofgrefe.
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Theoretical background of the activity In contemporary psychiatry, diagnosing mental-health difficulties is based on the ‘Classification of Mental and Behavioural Disorders’ contained in the ‘International Statistical Classification of Diseases and Related Health Problems’ (ICD-10). Because of the stigmatising tinge to the phrase ‘mental illness’, in modern psychiatric classifications, the term ‘illness’ has been replaced with the notion of ‘disorder’. This reflects the belief that diagnosis in psychiatry is based on somewhat different premises than in other medical disciplines: reasons for certain psychiatric disorders are complex or insufficiently explored whilst diagnosis is made mainly on the basis of the clinical picture (observed symptoms) and the course of the disorder. It is just in this sense that Mental health difficulties are not typical illnesses. According to ICD-10, a Mental health difficulties is a complex of clinically found symptoms or behaviours which, in most cases, are linked to suffering and disturbed functioning at the individual level. Mental illness is a narrower term. In contemporary psychiatry, mental illnesses are only psychoses, that is Mental health difficulties in the course of which hallucinations, delusions, overactivity or visible psychomotor retardation occur. A typical definition of a mentally ill person can be found in Article 3 of the Polish Act on the Protection of Mental Health: ‘a mentally ill person is a person who exhibits psychotic disorders’. A definition of ‘psychoticity’, in turn, is contained in the International Statistical Classification of Diseases and Related Health Problems ICD-10 – it is a ‘descriptive term, it does not involve assumption about psychodynamic mechanisms but simply indicates the presence of hallucinations, delusions, the presence of certain behavioural disorders like gross excitement/overactivity, marked psychomotor retardation/catatonic behaviour’.
Hallucinations – an unreal sensation (visual, aural, olfactory, gustatory, sensory) appearing with no external stimuli, like the proverbial pink elephants seen by persons addicted to alcohol when deprived of the substance or voices heard by persons with schizophrenia. Delusions – false beliefs and opinions contradicting reality whilst the person expressing them claims they are real despite obvious evidence proving their being untrue or very unlikely. False beliefs can relate to all the aspects of the reality around the student. Example: a student may be convinced that a teacher/lecturer takes his/her thoughts away from him/her or is able to read them. Catatonic behaviour – considerable slowing down leading to inertia, the patient remaining in an uncomfortable position for a very long time.
The symptoms of mental illness mentioned above considerably disturb one’s insight, that is the sense of being ill, as well as the ability to cope with daily life or retain appropriate contact with reality through which they have a significant impact on the learning process and social functioning in the academic environment. The incidence of mental illness symptoms in a person may entail specific legal consequences like hospitalisation without the person’s consent in the circumstances laid down in the relevant act of law (e.g. when he/she puts his/her own or other people’s life or health at risk because of the illness).
71
Mental illness symptoms may be periodically present in persons with diagnosed depression, affective bipolar disorder, schizophrenia, schizoaffective disorder and chronic delusional disorders, whilst using certain psychoactive substances, in particular with hallucinogenic properties (cocaine, LSD), as well as coming off such substances in the case of addicted persons. It is, however, incorrect to use the term ‘mental illness’ for all Mental health difficulties.
The pair-work activity concerning the reception of reality by mentally ill persons
The correct sequence of the cat pictures: 1. 2. 3. Most typical descriptions of picture 1: -
most realistic, the cat is somewhat sad, it may be a bit scared (large eyes), the picture’s mood is peaceful, pleasant
-
the trainer highlights opinions contributed by the trainees which illustrate a realistic reflection of reality
Most typical descriptions of picture 2: -
the cat is scared or aggressive, with no eyes, a black space instead, a mood of anxiety, horror, sadness, an ‘aura field’ visible around the cat
- the trainer highlights opinions contributed by the trainees which define the picture’s mood and deviations from reality Most typical descriptions of pictures 3&4 (the sequence of these two pictures does not matter as they both show the wildest deviations from the realistic representation of the kittens): -
the cat resembles an owl, a Chinese dragon, it is hard to say where the top or bottom of the picture is, the cat resembling a dragon is very scary, were it not shown in a sequence of cat pictures, it would be difficult to see a cat in it,
-
the trainer highlights opinions contributed by the trainees which pay attention to breaking with the realistic notion of a cat’s image and pointing to difficulties in the reception of the pictures
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5.4.4 Activity: Academic Difficulties and a Guide to student support
Reference number
AT/MH/7
Title
Academic Difficulties and a Guide to student support
Overall objectives
1. To acquire Knowledge about and become aware of students’ mental difficulties and their impact on their academic course. 2. To discover and adopt recommended handling & support strategies.
Specific objectives
The trainees will: •
Acquire Knowledge about psychosocial and educational problems students with mental illnesses encounter
•
Think through how to handle and provide help to these students, and try to discover the most effective methods to do this
•
Become conscious of the importance to collaborate with other services of the university community, in order to provide students with mental health issues with multidimensional effective support.
Method
Creation of a group guide involving directions / suggestions to solve the problem, brainstorming, case study, group discussion in plenum (pros and cons of all suggestions), brief lectures, alternative suggestions
Work format
Discussion in groups, PowerPoint presentation
Materials
Paper-pencils for writing down their guide, case study texts
Duration
25 minutes
Instruction and sequence
1. The trainer will explain the process of the present activity, whose target is to recognise and understand impediments and barriers that a student with mental impairment faces. 2. The trainer will encourage trainees to consider cases of students with mental disorders and specific problems they encounter. He will explain to them that they should study those cases in groups of 3-4 persons, and then try to make spontaneous suggestions on how to support the students. 3. The trainer will ask of all participants to create a guide to student support, for students with mental problems and educational difficulties 4. They will discuss in plenum ways to support these by some means vulnerable students. 5. The trainer will present his own suggestions – convergence of views /
73
suggestions.
Trainer’s comments and conclusions
The trainer points out to the trainees that they should contemplate in group student support strategies regarding educational issues.
Comment on ppt slide
Presentation of major symptoms’ correlation with the students’ educational and learning course.
Literature
1. Krohne, W. H. (1990). Sress und Stressbewältigung. In Schwarzer, R. Gesundheitspsychologie. Göttingen: Hofgrefe. 2. Hautziner, M. & De Jong-Meyer, R. (21994). Depressionen. In Reinecker, H. Lehrbuch der Klinischen Psychologie. Göttingen: Hofgrefe. 3. Manos, N. (1997). Basic Elements of Clinical Psychiatry. Thessaloniki: University Studio.
The reference to strategies for confronting difficulties of students with mental illnesses applied by their teachers during their academic course is of utmost importance. It is equally important to encourage participating teachers to cooperate at any rate with the competent university authorities and student support services.
Theoretical background of the activity Specific features of Mental health difficulties include the fact that their symptoms vary even in students with identical psychiatric diagnoses, there are periods when symptoms are more intense and periods of better mental well-being (remission), there are differences as to the type of symptoms present in various periods of a worsened mental condition and it is difficult to make long-term prognosis of the student’s mental health. Because of that, students with mental disabilities will require different methods of educational support from the university in various periods of study. Because Mental health difficulties are complex and diverse, information on a given person’s psychiatric diagnosis alone is too general to ensure the student receives assistance adjusted to his/her needs. Cooperation between a consultant of the Counseling and Psychological Support Centre taking care of the disabled student with an expert psychiatrist and academic teachers tends to be useful in defining specific students’ individual needs. It should be stressed that the difficulties experienced by students with mental disabilities have an impact on many areas of their functioning in the academic context.
Selected mental health difficulties, their impact on studying at university and relevant educational guidelines (Information contained in the PPT presentation) Schizophrenia – symptoms with most impact on functioning in the academic context: •
Delusions, hallucinations
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•
Disorders of abstract thinking, stereotype-driven thinking
•
Impoverishment of verbal expression, lack of spontaneity, inability to hold a smooth conversation
•
Pauses or fillers whilst thinking resulting in absent-mindedness (lack of a logical link between individual parts of a verbal expression: sentences or even words)
•
Less initiative, interest, energy
Depression – symptoms with most impact on functioning in the academic context: •
Less energy, more fatigability
•
Decreased ability to concentrate and think, indecision, hesitation
•
Concentration and memory disorders
•
Slower thinking
•
Slowing down of intentional movements
•
Delusions (of guilt, hypochondriac, nihilistic, of reference, of persecution)
•
Sleep disorders
Affective bipolar disorder – periods of mania and depression episodes punctuated by periods with no symptoms
Mania – symptoms with most impact on functioning in the academic context: •
Increased activity or physical anxiety
•
Distractible attention, finding it difficult to concentrate
•
Racing thoughts or a subjective sense of their acceleration
•
Easy distractibility or constant changes of activity or plans
•
Increased ease of coming into contact with other people and keeping no distance in interactions
•
Delusions (of grandeur, self-referential, erotic or of persecution)
Agoraphobia – an anxiety disorder where the leading syndrome is fear of travelling alone (e.g. by public transport), leaving one’s home, being in places difficult to get out of (like lecture halls, cinemas, theatres etc.) Agoraphobia – impact of symptoms on functioning in the academic context: •
Failure to come to classes/lectures because of anxiety felt in the street and on public transport
•
Being late for classes/lectures for the same reasons
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•
Leaving classes/lectures in progress due to anxiety attacks (e.g. in the lecture hall)
•
Concentration disorders usually accompanying anxiety attacks
Social phobias – characterised by the presence of anxiety when being the focus of attention, fear of behaving in an embarrassing or awkward manner and avoidance of such situations Social phobias – impact of symptoms on functioning in the academic context: •
Avoidance of speaking in public
•
Avoidance of seminars and other classes requiring speaking in front of a group
•
Avoidance of oral examinations
•
Poor assessment of the student’s activity
•
Concentration and attention disorders during group-based classes
Generalised anxiety disorder – symptoms with most impact on functioning in the academic context: •
Concentration and attention disorders (finding it difficult to focus attention)
•
Sense of constant tension and heightened reactivity to stimuli
•
Long-lasting anxiety with no specific reason
•
Constant worrying about daily business
•
Inability to rest
•
Difficulties in falling asleep
Obsessive-compulsive disorder (neurosis) – symptoms with most impact on functioning in the academic context: •
Being lost in obsessive thoughts/activities
•
Concentration and attention disorders
•
Perfectionism
•
Anxiety related to obsessions
Bulimia, anorexia - symptoms with most impact on functioning in the academic context: •
Concentration and attention disorders
•
Memory disorders
•
Slowed thinking and intentional movements
•
Perfectionism and excessive demands
•
Loss of body weight <17.5 BMI (anorexia) – BMI (body mass index) 76
•
Weight-loss strategies (vomiting, purging, strenuous physical exercises, starving)
•
Ruining the body or body functioning disorders related to weight-losing strategies
•
Distorted body image
The trainer’s comments summing up the activity: Despite a variety of symptoms and diagnoses as regards Mental health difficulties their impact on the limitation of the ability to fulfil one’s student’s duties may be very similar and it is recommended that similar educational strategies be used. Educational difficulties related to mental disability most frequently concern: −
Difficulties in concentration and holding one’s attention
−
Worsened memory functions
−
Slowing down of intentional movements
−
Slowing down of the thinking pace
−
Other disturbances in thinking processes (obsessive thoughts, delusions)
−
Fear of speaking in public or other difficulties in social interactions
−
Setting excessive requirements for oneself and perfectionism
Because of the symptoms or periods of health deterioration experienced by the students, including those requiring hospitalisation, students with mental disabilities may: −
Be absent from classes/lectures more frequently than others
−
Be coming late to classes/lectures
−
Leave classes/lectures whilst they are in progress
−
Behave in incomprehensible ways not directly related to the subject matter of the classes/lectures
−
Miss the set examination dates
−
Find it hard to manage projects requiring longer work e.g. written within the time scheduled for them
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5.5 Visual impairments
5.5.1 Activity: Sighted guide techniques
Reference number
AT/VI/8
Title
Sighted guide techniques
Overall objectives
To get to know the right way one can direct or guide a blind person
Specific objectives
The trainees will: • Realize through the role playing experience how important the stable surrounding is for a blind person to feel safe. •
Understand the possible fears a place may cause to a blind person
• See what changes on blind people’s bodies’ posture and behaviour depending on the surroundings. • Be asked to decide if they want to use the blindfold so that they experience what a blind person does. None of them will be forced to join this task. Method
Role playing practice, experiential activity, mini lecture
Work format
Group work
Materials
Blind folds will be used so that the participants will experience what a blind person experiences. Through this process, they will realize the importance of the right directions and instructions White cane will be used to show the difficulty to recognise the right path when there is no travel tools or anything else so that blind people can navigate more easily Pairs of glasses that affect the vision that will help the participants to realize how important this is not only to navigate but to understand the directions given by another person.
Duration Instruction and sequence
60 min 1. The trainer introduces the participants to the topic. He/She explains what is useful to tell to a blind person when you give instructions, and what is not. 2. The trainer separates the participants into groups of two, in order 78
to exercise on orientating a blind person by giving instructions orally. 3. In every group, one of the participants should “become” the blind person and the other one should take the role of the instructor. Initially the instructions will be given by the trainer. Later, the participant, whose role is to give directions, should take initiatives to guide the blind person towards different spots. 4. The participants in the group of two will be encouraged to shift roles. 5. The trainer says: “Give instructions to the blind person to walk out of the room we are right now.” The blind person needs specific instructions so that they can move safely and fast. Some of the most common instructions are: “Get up” “Raise your right hand and you will touch the wall. Move forward to the end of the wall” 6. The trainer explains that a blind person is already educated to follow directions. So he/she separates the useful instructions of the ones that can be very confusing to the blind person. 7. The trainer explains the techniques of guiding a blind person instead of directing them to move within a place 8. The trainer says “ If a blind person reaches a point where they can’t receive any more directions, you should guide them with your body/arm” 9. The trainer explains what is supposed to be done and what is offensive to do to a blind person when one offers to guide them to a place. 10. The trainer says “First introduce yourselves by saying your name out loud and offer your help nicely. Then reach out your hand so that the back side of your palm touches theirs.” 11. The trainer explains the techniques to guide a blind person and the most common mistakes people do while trying to guide blind people, so that the participants fully understand the right way to guide. Trainer’s comments and conclusions
The activity is conducted with the trainer’s active participation. He/She monitors the group work and, if necessary, guides the groups towards good solutions
Comment on ppt slide
He/She makes short explanatory comments about what is referred as technology or as blind sighted techniques within the ppt slides. 79
Literature
WELSH, 1981 “FOUNDATIONS OF ORIENTATION AND MOBILITY”
5.5.2 Theoretical background for the activity Unfortunately Greece is only becoming more energetic as far as concerns research and development about blindness. Therefore there are no references we could attach to indicate the importance of the source. However, sighted guide techniques are the same all over the world. Every year the American Federation of the Blinds update the text and give more specific directions out to the public so that blind people access as much as possible.
5.5.3 Strategies for teaching students with visual impairment Recommendations: • in the classroom, provide the person with a workplace that will enable him/her to benefit from the classes (audibility and light); • allow the students to use assistive devices including a touch screen tablet or phone, laptop; • provide the students with lecture materials in an electronic form prior to a given lecture; • when you use visual materials during lectures, describe them in a detailed way; • provide the students with the content of your lectures/classes in an adapted form (electronic, enlarged print, Braille), consent to the adaptation of the format of exams, exam time extension.
5.5.4 Assistive Technologies Ongoing progress in the field of assistive technologies brings numerous solutions and facilities for blind and partially sighted people. Thanks to technological advancement, at present there are virtually no limitations in the access to different kinds of texts. Today people with visual impairment can read, write, use the Internet and perform many other actions independently and they do not have to rely on sighted people. Adapting a computer workplace for a person with visual impairment you should remember some basic principles: •
Take into account the requirements of both blind and partially sighted people while choosing software and additional equipment. 80
•
Ensure a quiet room or good quality headphones to guarantee comfortable working conditions in noise-free environment for a person with visual impairment as well as people around him/her.
•
Create safe conditions around the workplace (no trailing cables that one might trip over, avoid excessive furniture, avoid slippery floor surfaces).
The most popular and important devices and tools created for blind and partially impaired people are described below. The presented solutions do not eliminate a disability, but they remove most of its consequences. As a result, the nature of a blind or partially sighted student’s work becomes similar to that of a sighted person.
Computer workplace The basic working tool for a student with a visual impairment is a computer or a laptop with a scanner and specialised software. For partially-sighted people a big monitor (19’’ or 21’’), keyboard with enlarged or colour letter keys, additional lamp providing extra light are helpful. Headphones are also very useful.
Specialised software Basic software can be divided into: -
programmes for partially sighted people, (e.g., ZoomText, Magic),
-
programmes which read what is being displayed on the screen (screen readers such as Jaws, SuperNova, Window-Eyes),
-
speech synthesizers which are compatible with screen readers (e.g. Ivona, Agata)
Such software installed on the computer enables a blind or partially-sighted person to use Windows operating system, text files, Internet search engines, e-mail and other useful applications. A sighted person watches an image on the screen, while a blind person listens to the content of the screen read out by the speech synthesizer. The programmes such as Jaws and Window-Eyes allow monitoring of the text that is being edited and navigating through documents and settings of the computer by means of the keyboard, which blind students use instead of a mouse.
Scanners Scanners are highly useful devices with which printed text is adapted to an electronic form. The text of a book can be scanned and decoded by special OCR (Optical Character Recognition) software (e.g. FineReader). As a result, the content of the book or another document is received in the form of a text file and thus can be read out by talking software or the text can be enlarged on the screen. It can also be displayed on a Braille monitor or printed out on a Braille printer. Apart from large stationary scanners there are also small and light portable scanners, e.g. PenScan (a pen-size scanner). They are useful tools for students who use a reading room or are out of university buildings. 81
Magnifying glass A magnifying glass is important support for partially sighted people. Apart from a traditional magnifying glass, there is an electronic magnifying glass, which can enlarge a text or a picture and show it on the display screen or a computer screen. A magnifying glass is particularly useful for watching visual elements such as maps, illustrations, diagrams, etc.
Enlargers Enlargers are separate, easy-to-use devices that can enlarge the content of a paper document, e.g. a book, a dozen or a few dozen times. The majority of enlargers allow the change of contrast, background colour and a text in such a way that it is adapted to the needs of the user in the best possible way. There are also portable enlargers that are used together with a camera. They enlarge distant materials e.g. during a lecture when the lecturer uses a projector or other visual aids.
Braille notebooks Braille notebooks (e.g. Braille Sense, Braille Wave, Pronto), also called Braille rulers or monitors are usually portable devices that assist people who use the Braille alphabet. The Braille ruler transforms any text in an electronic form into a Braille version. It can be used to write in Braille with the use of keys that correspond to Braille cells. A ruler can replace a computer screen too. It may be used as a portable notebook. Depending on the model, Braille notebooks differ in the number of simultaneously displayed characters. They may be equipped with additional functions, e.g. a diary, speech synthesizer, small screen which displays the text (which enables a sighted person to work with a ruler user).
Braille printers These devices (e.g. Index Braille) are used for printing any text that is in an electronic form on special, thick paper. Depending on the model, Braille printers have additional functions, e.g. printing on both sides, own speech synthesizer, buttons labelled in words and Braille. These devices are very loud so they are kept in special soundproof cases to ensure the comfort of using especially when situated in an office environment.
Portable players These small, light portable players can play the files recorded in text format, MP3, Daisy. The Daisy format is a form of text recording created for and used with the equipment called Daisy. It allows fast navigation through a long text with useful features such as page marking, which, for example, facilitates the reading of books. This technology replaces former players used to play books or newspapers recorded on cassettes.
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Warmers A warmer (e.g Piaf) is a device that produces tactile graphics. With the use of this device and special paper, called swell or capsule paper, convex graphics can be generated. An embossed image is formed in the place of a drawing or a printout from an ordinary printer. Convex graphics is a good way of presenting ideas which cannot be easily explained with words, e.g. as in the case of maps, charts and some symbols.
Digital Dictaphones Digital Dictaphones are useful for students with visual impairment, especially during lectures when the method of verbal transmission of knowledge predominates.
Satellite navigation devices Talking GPS devices enhance moving around in the open area, finding places and routes. These devices are usually equipped with memory of points of interest thanks to which it is easy to set the route or remember some characteristic places in the area.
Talking mobile phones and tablets They operate on the same rules as ordinary mobile phones and tablets, except that blind people have the visual content read out (e.g. the application or the message). Both these last two types of assistive technology also provide essential social independence for visually impaired students â&#x20AC;&#x201C; a vital aspect of student life and support towards achieving equality.
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5.6 Hearing Impairments
5.6.1 Activity: Classifiers
Reference number
AT/HI/9
Title
Classifiers
Overall objectives
1. to inform about the existence of different methods of communicating of deaf/Deaf and hard of hearing people, 2. to emphasise the role of visual information in the process of communication of deaf/Deaf people, 3. to build awareness of grammar and semantics of the Greek Sign Language (GSL)
Specific objectives
The trainees will: 1. be able to understand the three most important ways of communicating of deaf/Deaf and hard of hearing people, 2. remember and invent new if needed classifiers every time it is necessary during a conversation, 3. be explained why GSL is considered to be a natural language with its own grammar and semantics and equal to Greek spoken language,
Method
Lectures, activity
Work format
Group work
Materials
PowerPoint presentation, films
Duration
60 min
Instruction and sequence
1. The trainer introduces the subject matter of the activity by describing three major kinds of communication strategies used by Deaf and/or hard of hearing people: sign language, oral, bilingualism (PowerPoint presentation). 2. The trainer shows the films about the Classifiers which illustrate different kind of classifiers. Classifiers are set in groups depending on their origin. Classifiers for moves, for people, for furniture, for buildings. The participants are supposed to understand the way our hands are visually transformed into people, furniture, animals only by shaping their classifier. After the activity, the trainer explains the impact of the usage
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of classifiers has on deaf/hard of hearing people’s comprehension. The trainer says: ‘There are three basic ways of communicating of deaf/Deaf and hard of hearing people: sign language, oral, bilingualism’. (The trainer projects a PowerPoint presentation and briefly describes the above mentioned methods of communication). The trainer continues saying: ‘During the training you will learn more details about the first method of communication, i.e. sign language’. Trainer’s comments and conclusions
In section: Theoretical Background for the Activity
Comment on ppt slide
Ways of communicating of deaf/Deaf and hard of hearing people
Literature
Hoffmeister 1978, Kantor 1980, Schick 1990, Supalla 1992, Newport and Meier 1985, Slobin 2000, Dively, Metzger, Taub and Baer 2002, Kourbetis 2007
5.6.2 Theoretical Background for the Activity There are three major methods of communication used by deaf/Deaf and hard of hearing people: •
sign language
•
oral language
•
bilingualism
Sign language •
It is a language which incorporates visual-spatial coordination.
•
It has its own rules (e.g. visual grammar).
•
It is grammatically different from spoken language (e.g. no articles, no passive form, different words position/order in the sentence).
•
It does not have a written form and there is no one-to-one correspondence between signs and words
•
It uses finger spelling (a form of dactylology) e.g. for personal names, new concepts, new words (annex 6).
•
It’s not a universal international language (each country has its own indigenous sign language).
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Similarly to oral languages, sign language is used indigenously within the territory of a given country. There are different native sign languages across the world, e.g. GSL (Greek Sign Language), ASL (American Sign Language), BSL (British Sign Language), LSF (La Langue des Signes Française – French Sign Language). An exception to this rule of geography is found in the North American continent. Here ASL is predominantly used in both the USA and Canada.
Classifiers – Detailed Description Classifier constructions are used to express position, size and shape description and how objects are handled manually. The particular hand shape used to express any of these constructions is what functions as the classifier. Various hand shapes can represent whole entities; show how objects are handled or instruments are used; and be used to express various characteristics of entities such as dimensions, shape, texture, position, and path and manner of motion. Hand shapes are one of the five fundamental building blocks of a sign: Hand shape, movement, location, orientation, and non-manual markers. The hand shape is literally the shape in which we form our hand during the production of a sign. All signs have a hand shape. Classifiers are signs that use hand shapes which are associated with specific categories (classes) size, shape, or usage. Over time certain hand shapes have been used so often to show certain types of things, shapes, amounts, or sizes, that when you hold up or use one of those hand shapes people (who know the language) automatically think of a particular category (or class) of: •
Things (objects, people, animals)
•
Shapes
•
Amounts
•
Sizes
•
Usage
The commonly recognized hand shapes that are typically used to show different classes of things, shapes, and sizes are called "classifiers". The movement and placement of a classifier hand shape can be used to convey information about a referent's movement, type, size, shape, location or extent. Usually a classifier is not understandable unless first the signer indicates the object the classifier is informing us about. For example for the sentence “ my car is parked in the basement” after the signer signs “Car” then he uses the classifiers which is commonly used for cars which is the palm facing the floor and the fingers close to each other to demonstrate the move of a car being parked in the basement. Therefore the deaf / hard of hearing person will understand better the sentence.
Myths concerning GSL • Sign language is universal. (A myth concerning the assumption that sign language is easy to learn and hence available to anyone and that it unites all deaf persons was created by the early writers who dealt with the question of sign language. The Abbe de l'Épée, a priest 86
and Rémy Valade, the author of the first grammar book on the French Sign Language believed that sign language imitated objects and events). • Reality must be word-based. (In GSL, as in other sign languages, reality is presented by means of signs. GSL is not a code of the Greek language, but an independent language whose signs directly represent concepts. This language enables Deaf people to identify themselves as members of a distinct linguistic-cultural minority). • Signs of sign language are simply natural gestures. (For those who do not know GSL a conversation carried out in sign language may seem to consist of waving hands, using gestures, non-verbal communication (e.g. body language). In fact, GSL is a natural language which has its own complex vocabulary and grammar). • Sign language is iconic and concrete. (A similarity between signs of GSL and visual reality does not mean the absence of abstract signs. If only iconic signs existed, hearing people would understand them fast and easily, which obviously is not the case. Sign language comprises both concrete and abstract signs. GSL also allows creating new signs as it is a living language – like spoken Greek, it is always evolving).
Linguistic research Linguistic research on American Sign Language (ASL) proved that ASL from the perspective of this field of science is a real language. Key ASL researchers include William Stokoe – a structure of ASL (1960), James Woodward – sociolinguistics (1973), Scott K. Liddel – syntax (1973)).
5.6.3 Strategies for Teaching Students with Hearing Impairments Recommendations: •
during a conversation, one should always address the deaf person, and not the interpreter. Do not use expressions (to the interpreter) such as: tell him/her, ask him/her;
•
make the materials available to the interpreter before the class/lecture, so that he/she can prepare the interpretation well
•
provide the interpreter with a place conducive to good work so that while standing or sitting he/she can be close to the speaker; (usually there is an optimum distance between the interpreter and the student)
•
pay due attention to the fact that the student concentrating on the interpreter is unable to divide his/her attention and do other things like reading notes at the same time
•
remember that the interpreter may need to take a break for rest of around 30 minutes. If the course is very demanding, the interpretation may be performed by two or more interpreters working alternately. It is good to set the duration and frequency of breaks with a student and an interpreter.
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5.6.4 Assistive Technologies Assistive technologies used by deaf/Deaf and hard of hearing people use two kinds of sensory modality: sound and image. Below examples of technological solutions which use these modalities are presented.
FM Listening System FM personal listening systems are wireless/infrared communication systems between a teacher and a single student wearing a hearing aid that improves the quality of speech reception. It consists of two parts: a transmitter and a receiver. The transmitter (a digital remote control or a microphone clipped to the lecturerâ&#x20AC;&#x2122;s clothes or lying on the table) catches the speaker's voice and transmits it via radio waves directly to the receiver attached to a student's hearing aid. FM system makes communication in different situations possible. With its help one can communicate at school, home, talk under difficult acoustic conditions, use TV, listen to music, make phone calls, listen to recordings recorded on a Dictaphone or digital recorder.
Induction loop This device amplifies sound for groups in large environments. The cables go around the room and they are connected to an amplifier. The loop works with hearing aids which are within its field. It is most commonly used in public buildings, lecture rooms, churches, theatres etc.
Interactive board An interactive board is a device connected to a computer. It is possible to project everything from the computer monitor onto its surface. You can also write down information with the use of a special interactive pen and store it in the memory of your computer. It allows sending electronic notes to students, which is particularly helpful to students who lip-read. During the lecture/class they may focus on the lecturer and observe the materials not distracting their attention by making notes. Another advantage of the interactive board is the ability to use visualization, which deaf people take advantage of to a large extent.
System of visual calling This is a system of light diodes built into the surface of studentsâ&#x20AC;&#x2122; desks and is controlled by the teacher. The lamp on a studentâ&#x20AC;&#x2122;s desk switches on when the teacher presses the button with the number of that desk. The system is based on visual communication used by deaf people. It can be used to signal that e.g. the time for doing a task is over or that a student is supposed to answer some questions. It is particularly important because deaf people when focused on individual work (e.g. writing a test) will not react to the voice of the teacher.
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Captioning This solution converts speech to text with the assistance of a stenographer â&#x20AC;&#x201C; a person trained in the use of the special keyboard and software. The text is then displayed on the screen of e.g. a computer. More advanced devices which use a projector are used during lectures and conferences. It can also be used in distance learning context.
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5.7 Mobility impairments
5.7.1 Activity: Experience of disability/ Medical and Social model of disability/ Wheelchair etiquette/ Stereotypes of mobility disability Reference number
AT/MY/10
Title
Medical vs. Social model of disability / Wheelchair Etiquette / Stereotypes of mobility disability
Overall objectives
1. To give a simple illustration of the difference between the medical and social model of disability
Specific objectives
2.
To illustrate wheelchair etiquette
3.
To stimulate thought on stereotyping of mobility disability
The trainees will: •
See how simple and easy it can be to remove barriers and change the environment to help people with mobility disability
•
Find out about guidelines for wheelchair etiquette
•
Question their own perception of mobility disability
Method
Staged role play
Work format
Whole group, with two people acting as members of the audience, but who are actually part of the role play.
Materials
PPT
Duration
35 minutes
Instruction and sequence
Room is set up with chairs like this: (X = chair) SCREEN FOR POWER POINT EMPTY AREA FOR TRAINER XXX
XXX
XXX
XXX
XXX
XXX
(1) Trainer appears in wheelchair. “I want to make a good presentation with the maximum impact, both for my own personal and professional satisfaction, and for the satisfaction of
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the audience. I admit it’s going to be quite difficult, as a wheelchair user, to make a good presentation, but I will do my best. To solve this problem, can I first ask whether there is a neurologist in the audience who can give me a quick fix or some pills, or a physiotherapist to get me quickly on my feet again?” “Since there is actually there is no cure for my physical condition, the restructuring of my body is not possible, can I make another suggestion and that is a restructuring of the social and physical environment. This is possible and very simple. Can everyone kindly help change the seating arrangements?” Immediately someone from the audience, who is not a genuine member of the audience but someone part of the role play, gets up to “help” and moves the wheelchair without asking permission, pats the wheelchair user affectionately on the head/shoulder, a second stooge from the audience addresses a couple of questions to this “helper” such as “Does he want this chair here?” “Does he want us to lower the screen?” SCREEN FOR POWER POINT EMPTY AREA FOR TRAINER XXX
XXX XXX
XXX XXX
XXX
The “helper”, who all this time has been touching the wheelchair, in withdrawing from the situation then slaps the wheelchair user on the back, and whilst standing very close and above him, asks “What was it? An accident?” At this point the wheelchair user addresses the audience and says that his kind helper has just asked why exactly he has ended up in a wheelchair, and says he guesses many of you have been wondering that. Then the trainer gets up and walks normally. (2) The trainer then asks the following question: “Were you surprised when I got up and walked?” The first solution reflects the medical model of disability. The second solution reflects the social or interactive model of disability, change the environment and remove barriers. With this solution I can see the whole audience, make eye contact, move easily amongst trainees and I am not so disabled by my environment.
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(3) The trainer shows slides (1) – (4) of the power point presentation which summarises the differences between the medical and social models of disability.
Medical Model of Disability The disabled person is the problem. Impairment – your problem! Disability – your problem! Let’s look at what is ‘wrong’ with disabled people and find ways to make them better.
The first idea that this man was disabled by his medical condition, that HE is the problem, is in line with the traditional medical model of disability. Through the medical model, disability is understood as an individual problem. If somebody has an impairment – a visual, mobility or hearing impairment, for example – their inability to see, walk or hear is understood as their disability. It regards the difficulties that people with impairments experience as being caused by their bodies and how they work. A typical definition based on this restricted perception is historically offered by the World Health Organisation: Disability: any restriction or lack of ability to perform any activity in the manner or within the range considered normal for a human being, and resulting from an impairment. The medical model of disability also affects the way people with disabilities think about themselves. They may internalise the negative message that all their problems stem from not having ‘normal’ bodies and that their impairments invariably prevent them from taking part in social or other activities. And how does the medical model of disability deal with disability? 92
It focuses on curing or at least managing illness or by identifying the illness or disability from an in-depth clinical perspective, understanding it, and learning to control and/or alter its course. It encourages investment in resources in health care and related services in an attempt to cure disabilities medically and improve functioning to allow disabled persons a more "normal" life. The medical profession's responsibility and role in this area is seen as central.
Interactive, social model of disability Society is the problem Impairment – is part of me! Disability – is society’s problem! Let’s look at removing the barriers (things that get in the way), which make people disabled.
The social model was created by people with disabilities themselves. The denial of opportunities, the restriction of choice and self-determination and the lack of control over the support systems in their lives led them to question the assumptions underlying the traditional dominance of the medical model. It was clear to them that, in the absence of any cure for their physical condition, their impairment must be regarded as a constant and unchangeable factor in the relationship between themselves and the society with which they attempt to interact. So any failure in the interaction must be overcome through a restructuring of the social and physical environment, since restructuring of their bodies is not possible. It is not the individual’s impairment which creates disability but the way in which society responds to these impairments. And how does the social model deal with disability? It focuses on eliminating barriers created by society or the physical environment that limit someone with disabilities from enjoying their human rights, from gaining equal access to information, education, employment,
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public transport, housing and social/recreational opportunities. This includes promoting positive attitudes, changing the environment to be accessible for all and providing information in a way that everyone can understand. It is now more widely recognised that the needs of people with disabilities are often given little or no consideration and that they are unnecessarily and unjustly restricted in or prevented from taking part in a whole range of social activities which non-disabled people have access to and take for granted.
•
Disability is only a difference, such as gender (being a boy or a girl), or race.
•
Having a disability is neither good nor bad, it is just part of who you are.
•
In the medical model the negative consequences derive from the person’s impairment, whereas in the interactive model they result from the interaction of the person with a disability with the environment. While physical variations may cause individual functional limitation or impairments, these do not have to lead to disability unless society fails to take account of and include people regardless of their individual differences.
•
Rights are denied when a person with a disability lives in an inaccessible society. For persons with disabilities to be fully included, we need to change our societies, including rules, attitudes and infrastructure. It can be more beneficial to someone with a disability to spend money on adapting the environment than on 94
medical technology and research. Disability results from an interaction between a non-inclusive society and an individual. For example a wheelchair user might have difficulty attending university, not because of the wheelchair, but because there are environmental barriers such as inaccessible buses or staircases that impede access. The same person could easily graduate from university if the environment were accessible. •
Changes are a responsibility of government, but can also be triggered and promoted and achieved by all of us, and what I want to stress here is that we all need to have an ACTIVE attitude. We are society. Discrimination against someone or excluding them doesn’t just mean you have done something, it can equally mean you have not done something that should be done.
(4) The trainer shows slides (5) – (11) of the power point presentation, which talks about wheelchair etiquette. The trainer highlights the mistakes that were made in the previous staged activity: How to reach a balance
You can be pretty sure that no one uses a wheelchair through choice. People use wheelchairs for many different reasons, and you should avoid making assumptions and having preconceived ideas of why they use a wheelchair and what they can and can’t do. If you're interacting with a wheelchair user for the first time, it can be difficult to know how to act. You don't want to cross any boundaries or accidentally offend someone, but at the same time you want to be helpful and understanding. Here's how to find a good balance. Greet as usual – shake hands!
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Greet as usual shake hands!
Offer to shake hands, even if you are not sure if this is easy for the wheelchair user, or if someone has an artificial limb.
Donâ&#x20AC;&#x2122;t think you know what someone can or canâ&#x20AC;&#x2122;t do
You don't know what this person's physical abilities are. Just because someone uses a wheelchair it does not mean that they are paralyzed or that they are incapable of taking a few steps. Some people only use a wheelchair because they cannot stand for long, or have a mobility problem. Do not test whether a person is genuinely paralyzed. If you see someone who uses a wheelchair moving their legs or standing up, do not question their ability or disability, and try not to act surprised.
Speak to the person who uses the wheelchair The helper from the audience addressed his questions to my other helper, who was standing by me, not directly to me. Try and be at the same level as the wheelchair user, or move backwards a bit. The helper stood over me, forcing me to crane my neck.
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If someone is accompanying that person (pushing the wheelchair, for example), don’t talk to this companion about the person in the wheelchair for example, "Will he/she be needing help with..?" to figure out how to help. This is insulting for someone who uses a wheelchair as it implies that he/she is not able to answer on his/her own. Always address him or her directly and respectfully. When you find that you are going to continue the conversation for a bit longer than you had thought, suggest you go somewhere where you can take a seat so that your faces are at a similar height. If you can't relocate to a seating area, then stand a few feet away, so that the person does not have to lift their head to look at you.
Think before you ask questions and think before you make comments The helper asked me “Was it an accident?”
The phrases are figurative, not literal, and someone who uses a wheelchair understands that. A wheelchair user knows that when you say “let’s go for a walk” you don’t expect him to walk. Talk naturally because it can be more uncomfortable if you blunder the conversation to avoid such phrases, 97
because it shows that you are focusing on the person’s disability. Comments like “So what was it? An accident or...?” are intrusive and upsetting; someone who uses a wheelchair will offer this information if they feel like it. Drawing attention to the person’s disability is negative so don’t focus the conversation around how difficult it must be to get around the town and the limitations imposed. Anyone who uses a wheelchair will have heard this conversation many times before and feels as if they are being defined by their disability, not by character. Stories about other people who use wheelchairs, other illnesses and mobility problems are also not really welcome, as again they focus the conversation on disability. So conduct a conversation in the same way as you would with any new acquaintance. You may be burning with many questions but it might not be appropriate to ask them, so think first.
Ask before you touch the wheelchair user or the wheelchair, or move the wheelchair The helper not only touched me as if I were a child, he could also have caused me pain by slapping me on the back, and he also moved the wheelchair without my permission. This is the equivalent of someone physically picking you up and putting you down somewhere else.
Wheelchairs users are at children’s height, and people often touch their shoulders or heads in the same way that they touch children. Other people want to show they are friends by banging their back or doing a high five, but these things are not a good idea. If you touch an adult in the same way as you touch a child it makes them feel uncomfortable. Also you must be careful not to hurt a wheelchair user by mistake, as they may have medical problems you don’t know about. A wheelchair user considers his wheelchair as part of himself, so don’t touch it without asking first. Never move someone’s wheelchair without asking them first, even if they are not using it at the time. Think before you offer to help 98
The helper did not ask me if I needed help, he made an assumption.
It can be difficult to know when to offer to help. Wheelchair users are proud to be able to do things by themselves. If you see a situation where you think you could help, ask first, and listen to the answer. If the wheelchair user says he doesn’t need help, then don’t help. Your interaction with a disabled student should strengthen a student’s autonomy and not weaken it. This can be achieved by e.g. not forcing unsolicited help on a student, not performing actions for him/her that he/she can do without help. On the other hand, you can achieve it by suggesting options and a variety of potential ways of reaching his/her goal (e.g. professional or intellectual). Trainer’s comments and conclusions
The trainer asks audience to honestly say whether, when they perceived him as a wheelchair user, anyone had •
Felt sorry for him
•
Saw him as a victim
•
Saw him as a hero, in the sense that even though he was a wheelchair user he was working as a trainer
•
Whether they saw him as inspirational, and would have gone home and said that despite the fact that he was a wheelchair user he was a great speaker
People with disabilities are often seen as individuals to be •
pitied
•
feared
•
ignored
•
hidden away
They are often portrayed as 99
1. victims 2. superhuman heroes, who climb mountains, win competitions, graduate from Oxford and are awarded gold medals at the Paralympics, and who by performing super-successfully somehow overcome or appear to lose their disabilities and are an inspiration to us all 3. under achievers, who evoke our pity, tend to be reliant on other people or charity for their well-being, and in general have greatly reduced expectations in life 4. baddies: Impairments are frequently used in the media to embody or personify evil and to add atmosphere and dramatic effect. These characters are one-dimensional and defined in a bad way by their disability Media coverage frequently focuses on â&#x20AC;˘
heart warming features
â&#x20AC;˘
inspirational stories that reinforce stereotypes and are patronising
The reinforcement by the media of negative stereotypes of people with disabilities affects the disabled community as a whole. The majority of people with disabilities are shown by the media in dramatic, dangerous or challenging situations, and the lack of disabled characters in normal, everyday roles and situations perpetuates their lack of visibility in society, and their exclusion from many areas of life. A more rational portrayal of people with disabilities would be one showing that they are just everyday people, who happen to have some kind of disability, mothers, fathers, brothers, sisters, friends, neighbours, colleagues, employees and employers. How central disability is to their identity depends on the degree to which a given community supports a disabled person, but also on his/her ability to influence, and the effectiveness of his/her actions in managing his/her impairment. According to the social model of disability, disability does not have to affect a personâ&#x20AC;&#x2122;s identity. It is a state arising from the interaction of a given person with the environment they find themselves in, an environment that has been formed by the majority and from the point of view of the needs of the majority rather than from the needs of the disabled person. Comment on ppt slide
Incorporated in the ppt presentation as detailed above.
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5.7.2 Communication and teaching strategies Recommendations: •
Follow rules of etiquette already illustrated above.
•
Impose the same requirements on disabled and non-disabled students.
•
Make sure you have the necessary information in advance regarding access and accommodations so that you are prepared to discuss issues with students with disabilities. Finding solutions on the spot is not always the best policy.
•
If lectures/classes are scheduled to take place in inaccessible rooms, try to find another more accessible room e.g. located on the ground floor or accessible by a lift/elevator.
•
Ensure enough time for the student to move between rooms or buildings to get to the next lecture/class.
•
Give consent to an adjusted form of exams including the format of papers and tests and time extensions where appropriate.
•
Give consent to allow the student to record the lectures and/or use a laptop, in case the student has difficulties in writing or processing information.
•
Provide an assistant for students who due to their impairments are unable to perform manual tasks themselves e.g. someone to write for them or to conduct laboratory experiments.
Behaviour in the presence of a person with mobility impairment Recommendations: •
Behave as you would with all students; treat a disabled person naturally without concentrating on his/her disability too much.
•
While communicating with a student in wheelchair, assume a position facilitating eye contact. Avoid holding a conversation standing, making you look down on the student.
•
Treat each disabled student individually, based on their actual situation and not on the basis of prejudices and stereotypes.
•
Do not force your unsolicited help on a disabled person; do not invade his/her personal zone e.g. by forcing a person into a chair, pushing their wheelchair without their consent.
•
Ask what kind of support they would like you to offer and to what degree and in what way.
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5.7.3 Activity: Exclusion/ Assistive technologies
Reference number
AT/MY/11
Title
Exclusion / Assistive technology
Overall objectives:
Specific objectives:
Method
•
To stimulate thought on being excluded because of a physical disability
•
To give an example of best practice in terms of providing assistive technology for students with disabilities
The trainees will: •
Experience how it feels to be excluded because of a physical disability
•
Realise the scale of disability in EU
•
See examples of assistive technology being used by students with disabilities
Game Video clip
Work format
Whole group
Materials
PPT Video clip http://www.washington.edu/doit/Video/index.php?vid=30&t=1
Duration
25 minutes
Instruction and sequence
(1) The trainer asks the trainees: “Put up your hand if you would like more money.” Everyone that put their hand up please come and stand over here. Show slide (2) from the power point presentation
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UK size
European size
US size
3 4 5 6 7 8
36 37 38 39 40 41
5 6 7 8 9 10
The good news is that there is more money for everyone, as long as you have the right shoe size. If you hear your shoe size called, you can go over to the other side of the room to collect your money. If you don’t hear your shoe size called, please stay here.
Call out all shoe sizes from 36 – 44, except 38.
So no one with shoe size 38 gets any money. Pity. I feel bad for you. But you do understand that you are excluded because you are different, because you have size 38 feet. None of the rest of us do – in fact you can see that the majority of us don’t have size 38 feet. Thank goodness! And that’s because the rest of us were born lucky. In fact, we were born perfect without the misfortune of having size 38 feet. I feel sorry for you, but what can I do? You realise that you’re just an unfortunate minority – I can’t change all the rules and the system and the infrastructure for you. Maybe you could try and change the size of your feet? So we get the money and you don’t.
•
Is this fair?
•
Is it their fault?
•
Can they change the size of their feet?
•
How do they feel?
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Letâ&#x20AC;&#x2122;s change the criteria so that the prize is no longer money but the chance to use a computer and instead of the excluding factor being having feet size 38 it is now the fact that you have a physical disability of some kind. This disability prevents you from using computers, which have been designed for people without disabilities in mind.
Show slide (3) from the powerpoint presentation
How many people are there in the EU with disabilities? 80 million 40 million 20 million 5 million 1 million
People with shoe size 38 are different, and people with disabilities are different. Question: How many people with disabilities do you think there are in the EU? Answer: Around 80 million people in the EU, a sixth of its population, have a disability.
In terms of our example this means 80 million people wear shoe size 38, and the reality of what they are excluded from is full social and economic participation because of barriers associated to attitudes and the physical environment. Going back to our example of accessible computers, the good news is that lots of changes can be made. Assistive technology is available, which means that having size 38 feet or some kind of disability is no longer a restrictive factor to using a computer:
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Working Together: Computers and People with Mobility Impairments
http://www.washington.edu/doit/
(2) The trainer shows slide (4) from the power point presentation and plays the following video clip: http://www.washington.edu/doit/Video/index.php?vid=30&t=1
Trainerâ&#x20AC;&#x2122;s comments and conclusions
Each person with mobility disability has fairly unique needs. There isn't any specific blanket technology that covers everybody. Some people may have limited use of one hand; others may need specific positioning for a chair or may experience fatigue; so those things need to be taken into consideration as a unique adaptation for each person. An individual's mobility impairment may or may not be obvious to others, and people with similar medical conditions may need different types of adaptive technology. The important thing is to work closely with the person using the computer to figure out the best fit. You can't use a computer if you can't reach it. You have to be able to get in the building, get through the aisles, and sit comfortably at the work station. Computers should be in locations that are accessible to people using wheelchairs. The furniture makes a difference, too. It's important to be flexible in the way you position keyboards, computer screens, and table height. Adjustable tables can be cranked higher or lower, so that the monitor is at the most comfortable height. Keyboard trays can move up and down, or tilt, to make typing easier. The most important part of selecting adaptive technology is to recognize the needs of the individual using it. The best adaptations are the ones the user himself chooses. Without access to technology it is nearly impossible for someone with disabilities to participate fully in society.
The trainer shows slide (5) from the power point presentation. 105
Literature
European Commission Eurostat Directorate E: Social statistics. Unit F-2: Labour market. Ad hoc module 2002 on ‘Employment of disabled people
http://www.washington.edu/doit/Video/index.php?vid=30&t=1
Assistive technologies Rapid development and progress in the field of modern technologies has brought a broad range of solutions for people with mobility impairments. At present, students who have different kinds of mobility difficulties, e.g. impairments with hands, or no hands, or quadriplegia, can use a computer independently after it has been adapted to their individual requirements. Technological solutions presented below are examples of equipment adapted to the requirements of people who have different kinds of difficulties in working on a computer because of their mobility impairment.
Keyboard adaptation A well selected keyboard is of key importance to students who, either because of problems with muscle pressure (inadequate, uncoordinated movements), control of direction and strength of movement, shaking, poor hand control, hand amputations, are not able or find it difficult to use a standard keyboard. The problems may include an inability to type with fingers, pressing the wrong key or a few keys simultaneously, applying too little pressure, pressing the key for too long, inability to press a combination of keys (e.g. shift+alt+ctrl). Students with motor impairments can choose from the following adapted keyboards: •
with enlarged keys,
•
with special overlays which increase the precision of hitting the right key,
•
three-dimensional with an alternative arrangement of keys – created for one-handed users,
•
allowing typing with feet,
•
allowing typing with mouth or head by means of a mouthstick or headstick,
•
touch screens which take over the function of a keyboard.
Armrests Installing individually selected and adjusted armrests may be a considerable improvement. They prevent excessive tiring of hands/arms, help maintain the right position of hands/arms ensuring comfortable working conditions for a disabled user.
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Trackballs Enlarged trackballs are devices that can substitute a standard computer mouse. Their solid construction is not susceptible to inadvertent movements. They can tolerate too strong pressure of a hand and using them does not require precision or high manual dexterity (as in the case of traditional computer mice).
Switches and Large Buttons Switches are very simple peripheral devices. Big, solid buttons are relatively easy to press even for people with limited manual function. Such devices substitute traditional mouse clicking, which makes it easier for a person to use a computer and other devices. They can be installed on different kinds of rests or booms, which enables placing buttons in a correct position within a desk or a wheelchair.
Integra Switch Is a piece of equipment specifically designed for people who cannot move their arms or head. There is a mouthpiece that allows operating a computer by mouth: by means of sipping and puffing. This device substitutes a computer mouse. Sipping on the switch is identical to activating the right button of a mouse, and puffing activates the left one. Alternative equipment allows for control by eyelid or head movements. The device when strapped to a disabled person’s forehead allows touch-free control of the computer. The use of this device requires some skill, but once it is acquired, the device becomes an invaluable tool for people who are paralysed or have very limited movement. It facilitates computer use; and using the computer e.g. converting text to synthesized speech, it can also facilitate communication. When adapting a computer workplace for a student with mobility impairment, one should remember the following: •
it is virtually possible to adapt a workplace for any impairment, thus enabling independent work
•
most people will require individual adjustment of equipment, it is difficult to find universal solutions “straight out of the box”
•
adaptive technologies are required especially by people with paresis, paralysis, or without hands
Safe conditions around the workplace should be assured by: •
removing cables which one may trip over,
•
ensuring stable desks with a correct height, including desks that are adjustable,
•
eliminating narrow passages and other architectural barriers, there are guidelines on minimum specifications for wheelchair access, for example.
When adapting a workplace for a person with a physical impairment, one should take into consideration the degree and kind of impairment. It is especially important to pay attention to
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activities that are most difficult to perform, but also the compensatory abilities of a person (e.g. what they can do). Virtually in all cases it is possible to adapt equipment in a way which enables computer use without problems. Architectural adjustments are necessary, and possible, especially for wheelchair or walking cane users. A wheelchair must fit in under the desk/table, move through doorways and lifts/elevators easily. Stable worktops against which one can lean while standing up, no additional objects which can be easily knocked off, floor with non-slippery surface are other important elements for wheelchair and cane users, and for those who have difficulties in walking and maintaining balance.
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5.8 Reasonable adjustments
5.8.1 Activity: How to remove barriers
Reference number
AT/G/12
Title
How to remove barriers?
Overall objectives:
To provide guidelines for academic teachers on the reasonable adjustment of the university environment to the requirements of people with disabilities with a range of different impairments.
Specific objectives:
The trainees will: •
be able to propose different kinds of adaptations to the environment in a given situation of a student with disabilities
•
Suggest accommodations that could be provided for students with disabilities in different situations. Guess what disability a student might have on the basis of the accommodation provided.
Method
Mind shower / problem-solving
Work format
Group work
Materials
Sheets of paper with a table – versions A, B (annex 4), paper, pencils, PowerPoint presentation
Duration
20 min
Instruction and sequence
The trainer shows slide (2) of the powerpoint presentation. The trainer divides the trainees into groups of three and gives them either set A (Annex 4, Table 1) or set B (Annex 4, Table 2). Each set contains examples of situations in which disabled people might find themselves (lefthand column of the table) and examples of solutions to these potential situations (right-hand column). The trainees have to attempt to fill in the empty boxes (about 7 min). The objective of the activity is to think about appropriate forms of support or ‘reasonable adjustments’.
The trainer shows slide (3) of the power point presentation.
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Reasonable accommodation • means necessary and appropriate modification and adjustments not imposing a disproportionate or undue burden, where needed in a particular case, to ensure to persons with disabilities the enjoyment or exercise on an equal basis with others of all human rights (…). UN Convention on the Rights of Persons with Disabilities ONZ from 13 December 2006, art. 2.
After the trainees have had a chance to fill in their sheets, the trainer moderates the group work so as to let the trainees know that some of the proposed solutions might be good support for disabled people. The trainer shows slides (4) – (9) of the powerpoint presentation.
Reasonable accommodation Example
Solution
A deaf student who lip-reads will take part in the discussion.
Arrange the desks and tables in a semicircle.
The trainer asks if anyone had any different ideas.
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Reasonable accommodation Example
Solution
A student without hands needs to sit an exam.
Provide a personal assistant.
The trainer asks if anyone had any different ideas.
Reasonable accommodation Example
Solution
A student with visual impairments attends a lecture.
Invite the student to sit at the front and make sure that there is good lighting in the room, particularly where the student will sit and where you will deliver your lecture.
The trainer asks if anyone had any different ideas.
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Reasonable accommodation Example
Solution
There are steps up to the entrance of the classroom making independent access impossible for a wheelchair user.
Exchange the classroom for a more accessible one.
The trainer asks if anyone had any different ideas.
Reasonable accommodation Example
Solution
A blind student takes part in the class during which a PowerPoint presentation is projected.
The teacher precisely describes the slides using specific words which facilitate imagining them and reads aloud any displayed text.
The trainer asks if anyone had any different ideas.
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Reasonable accommodation Example
Solution
A sign language interpreter informs the teacher that he or she will interpret the lecture.
The teacher provides the interpreter with needed materials and sets the breaks in the lecture because it will last for about 2 hours.
The trainer asks if anyone had any different ideas.
Trainer’s comments and conclusions
•
It is vital to provide a reasonable adjustment of the environment to meet the needs of disabled people.
•
The proposed solutions are only suggestions. Actual solutions should relate directly to the individual requirements of a disabled person.
•
Refusal to make reasonable adjustments may be perceived as direct or indirect discrimination.
The trainer shows slide (10) of the powerpoint presentation.
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Conclusions • provide a reasonable adjustment of the surrounding to meet the requirements of people with disabilities. • solutions should be based on individual requirements. • Ignoring the concept of reasonable adjustment may be perceived as direct or indirect discrimination.
Theoretical background for the activity The United Nations Convention on the Rights of Persons with Disabilities adopted on 13th December 2006 aims to protect and ‘ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity’ (Art. 1). It is important to take actions to combat discrimination against disabled people and ensure their effective participation in diverse areas of life. Article 24 on education also refers to the necessity of ensuring access to tertiary education on equal basis and providing of reasonable adjustment tailored to the individual requirements of disabled persons. The Convention was signed by all Member States of the European Union.
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6. Supplementary information
6.1 Test your knowledge
Academic teachers Questions Test your knowledge about disabled people Below you will find 24 statements referring to different aspects of a disabled persons’ life. Read each of them and decide which ones are TRUE (T) and which are FALSE (F).
No.
Questions
Answers
1.
It is tactless to say such expressions as: “you see?”, “read it”, or “see you later” to a blind person.
T
F
2.
People with mental health difficulties can work professionally.
T
F
3.
Visually impaired students, who have the enlarged font in their exams, read slower than their sighted friends.
T
F
4.
Extra time during exams for disabled students is unfair to the other students.
T
F
5.
People with mental health difficulties are characterised by a low level of intelligence.
T
F
6.
Euphoria, irritability and increased activity can be the symptoms of an illness.
T
F
7.
All deaf/Deaf students use sign language.
T
F
8.
Architectural barriers apply only to people with physical impairment.
T
F
9.
The majority of people who committed suicide had signalled their intentions.
T
F
10.
In order to be understandable to a deaf student, one should speak with an overdone articulation and at a very slow pace.
T
F
11.
A blind person can use a computer independently.
T
F
12.
All deaf students use hearing aids.
T
F
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13.
Each deaf person is mute.
T
F
14.
Blind students can use only textbooks written in Braille.
T
F
15.
An episode of mental health difficulties always means the beginning of an incurable illness.
T
F
16.
Deaf students usually need more time for written assignments if their first language is Greek Sign Language (GSL).
T
F
17.
Each person in a wheelchair is paralysed.
T
F
18.
Blind people are able to understand complicated mathematical formula.
T
F
19.
It is advisable that there should always be an additional person during a meeting between a lecturer and a student with mental health difficulties.
T
F
20.
Students with hearing difficulties must take exams in the written form.
T
F
21.
People with epilepsy should not live in studentsâ&#x20AC;&#x2122; dorms.
T
F
22.
Deaf students cannot learn foreign oral languages.
T
F
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Academic teachers Answers Test your knowledge about disabled people
1. It is tactless to say such expressions as: “you see?”, “read it”, or “see you later” to a blind person. FALSE: The expressions related to visual perception are so popular that their meaning goes far beyond their literal sense. Expressions such as “to see” or “to read” are used both by sighted and blind people and they mean “to get acquainted” with a given thing, place or text, “you see” is popularly known as “you understand?” and so on. Artificially avoiding or trying hard to replace such words with others can draw attention to the disability of a person and hence may make our interlocutor feel uncomfortable. 2. People with mental health difficulties can work professionally. TRUE: People with mental health difficulties can be officially employed. A job can also be a key form of socio-professional rehabilitation for such people. As in the case of all other employees, a positive opinion from the occupational health doctor is required. 3. Visually impaired students, who have the enlarged font in their exams, read slower than their sighted friends. TRUE: The enlarged font helps visually impaired students to read, but they still need more time to decipher the text. The amount of extra time needed must be determined by consulting with a specialist. 4. Extra time during exams for disabled students is unfair to the other students. FALSE: Extra time for the students who really need it is vital and is a fundamental part of an equal opportunities approach; it does not give them any extra advantage. 5. People with mental health difficulties are characterised by a low level of intelligence. FALSE: A mental illness may affect any of us – regardless of intelligence, social or financial status. And whilst their performance may be affected at times, their intelligence will remain constant. 6. Euphoria, irritability and increased activity can be the symptoms of an illness. TRUE: In manic episodes of bipolar illnesses, we can discern the rise of selfconsciousness, feelings of greatness and strong interest in activities that cause pleasure. Often, these euphoric and optimistic moods transform into irritation, oversensitivity and excitement. 7. All deaf/Deaf students use sign language. FALSE: The most frequent users of the sign language are people with profound, prelingual deafness (the ones who were born deaf or who became deaf before they had learned to talk/read). The hearing loss at a later age (after mastering speech) often 117
implies that the people do not know this language but again this is not true as most deaf people live in a hearing community they have to learn the spoken language, at least to be able to read text. Moreover, there is nothing like a universal international sign language, but there are many national sign languages, e.g.: Greek Sign Language (GSL), Polish Sign Language (PJM), British Sign Language (BSL), American Sign Language (ASL). 8. Architectural barriers apply only to people with physical impairment. FALSE: Apart from the people in wheelchairs or using crutches, architectural barriers are also problematic for the elderly, people pushing strollers, blind and visually impaired people. 9.
The majority of people who committed suicide had signalled their intentions. TRUE: Eight in ten people who committed suicide had talked about it before. The majority of people at risk encounter difficulties in choosing whether to live or die.
10. In order to be understandable to a deaf student, one should speak with an overdone articulation and at a very slow pace. FALSE: Speaking too slow impedes lip-reading and overdone articulation makes the communication artificial as it distorts the natural lip patterns. 11. A blind person can use a computer independently. TRUE: Blind and visually impaired people use special software which enables them to decode information from the screen through the speech synthesizer or font enlarger (for people with limited sight). Using various keyboard shortcuts, a blind person can navigate text files, Internet web pages and computer settings easily and quickly. 12. All deaf students use hearing aids. FALSE: Among the technical aids used by deaf students there are not only hearing aids but also cochlear implants which transmit aural sensations to the aural nerves through electrical conduction. It is worth mentioning that some deaf people, mainly with profound deafness, do not wear any hearing aids because they are of no use. 13. Each deaf person is mute. FALSE: Deaf people have the correct build of vocal organs and they are able to learn to speak. Deaf â&#x20AC;&#x201C; mute people often have profound, pre-lingual deafness and the sign language is their first language. Only a small group of such people can master sound speech to the level where their speech is clear enough to use in conversation with hearing people. 14. Blind students can use only textbooks written in Braille. FALSE: Blind students often use materials in the electronic form because they can decode the information using the software for speech synthesis (or the Braille monitor). Sometimes, blind students use materials in the Braille, which are prepared especially for them (e.g. in language courses). Unfortunately, university textbooks do not have their Braille versions yet. What is more, not all blind people (for many different reasons) know Braille. It is common especially when they still have some residual vision,
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or have lost their sight recently or have additional impairments, e.g. inability to use touch for reading purposes. 15. An episode of mental health difficulties always means the beginning of an incurable illness. FALSE: An episode of mental health difficulties may, but does not necessarily always, mean the beginning of an incurable illness. Many people come back to social functioning at a satisfactory level. 16. Deaf students usually need more time for written assignments if their first language is Greek Sign Language (GSL). TRUE: It is because the student is being made to work in their second language. Though it is possible for Deaf people to acquire fluency in a spoken language (text and perhaps speech) most do not due to an inadequate education system. A student who uses the Greek Sign Language may have some difficulties with formulating written sentences according to stylistic rules, grammar, phraseology, or Greek lexis of the spoken Greek language. It is because there are different grammatical rules governing the two languages. 17. Each person in a wheelchair is paralysed. FALSE: Apart from those who are paralysed wheelchairs are also used by people with other impairments. Some of them can use their legs or are able to move without a wheelchair, but the orthopaedic help improves their functioning. 18. Blind people are able to understand complicated mathematical formula. TRUE: There are the Braille labels for mathematical formula, but also forms of electronic notation and computer programs, which enable presentation of formulas for blind or visually impaired people. The computer user can listen to the formula through the speech synthesizer, read it on the Braille monitor or print on the Braille printer. The diversity level of these capabilities among blind people is the same as among the seeing ones. 19. It is advisable that there should always be an additional person during a meeting between a lecturer and a student with mental health difficulties. FALSE: A one-to-one conversation of a student with his/her lecturer often helps to reduce fear and tension connected with broader social situations and because of that it encourages positive outcomes (e.g.: a passed exam). The majority of students undergoing treatment do not pose a threat to other people. 20. Students with hearing difficulties must take exams in the written form. FALSE: The form of an exam should be suited according to the specific requirements of students. For deaf/Deaf students who communicate using sign language or have an unclear articulation, the most appropriate way to exchange information between a teacher and a student can be written tests or using an interpreter. In some countries it is possible for Deaf students to take an exam using sign language through an interpreter or by using video. It is also possible to adapt some words in a written text to make the exam more accessible to a Deaf student without compromising the exam or
119
giving them an unfair advantage. These adaptations offer a safer guarantee for the correct evaluation of academic achievement. For deaf students who are comfortable using speech or writing they should be granted the possibility of choice between the oral and written form of an exam. 21. People with epilepsy should not live in studentsâ&#x20AC;&#x2122; dorms. FALSE: A student with epilepsy is being assigned to a particular dorm according to general rules. For security reasons, he/she may inform the roommates about the specificity of his/her disability. 22. Deaf students cannot learn foreign oral languages. FALSE: Deaf students can learn oral foreign languages, as long as they are provided with appropriate support and methodology to accommodate their deafness.
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7. The Ending This manual provides the trainer with basic tools necessary to conduct a training course for academic teachers. During the process of developing training materials a special emphasis was placed on the use of learning methods and transferring knowledge in an interesting way. Such an approach facilitates understanding and remembering of the training material by the participants. Consequently, the role of the trainer is very important. He/she is not only an authority on disability, but also the one who introduces the participants to disability-related issues through activities, initiates experiences, and moderates ongoing discussions and encourages further learning beyond the time of the course. We believe that the training conducted with the help of the manual, which is the outcome of the DAReLearning project, will bring about the increase in both the knowledge of disability and sensitivity to the requirements of disabled people. Making reasonable adjustments and implementing adequate teaching strategies will widen access for disabled people to social life. The increase in awareness of disability-related issues raises the comfort not only of students, but also of teachers who, feeling more confident in this area, stop treating disabled people as students endowed with special rights or students whose presence at university is undesirable. We hope that disability awareness training courses for academic teachers and public administration employees will be more and more popular in the countries of the European Union. We wish the trainers who decide to use this package successful work with groups and lasting outcomes in raising disability awareness in society. Should you have any remarks, queries and comments concerning the training materials and the training itself, please contact directly
the coordinator of the project:
the greek partner:
The Jagiellonian University
Aristotle University of Thessaloniki
Disability Support Service
Social and Health Policy Committee
Address: ul. Retoryka 1/210
University campus
31-108 Krak贸w (Poland)
Thessaloniki 54124
E-mail: bon@uj.edu.pl
E-mail: socialcom@ad.auth.gr
Tel: +48 12 4242950
Tel:+ 30 2310 991376
www.bon.uj.edu.pl
www.auth.gr
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8. Questionnaires
8.1 Evaluation questionnaire
Disability Awareness workshop Evaluation questionnaire
The set of questions presented below has been prepared to get to know your views concerning the workshop. They will be useful in designing the final version of the blended-learning disability awareness workshop for academic teachers. Please mark your answer as an X or enter it on the dotted line(s).
1. Please evaluate the workshop organisation on a scale from 1 (lowest score) to 5 (highest score) Place where the workshop took place
1
2
3
4
5
Workshop duration
1
2
3
4
5
Teaching methods used
1
2
3
4
5
Quality and usability of the training materials
1
2
3
4
5
General workshop evaluation
1
2
3
4
5
Please explain (if below 4) ………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………
2. Please evaluate your trainer on a scale from 1 (lowest score) to 5 (highest score) I. Language and Stereotypes Knowledge of the subject discussed
1
2
3
4
5
Communication skills
1
2
3
4
5
Interaction with the group
1
2
3
4
5
Please explain (if below 4) 122
………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………
II. Mental health difficulties Knowledge of the subject discussed
1
2
3
4
5
Communication skills
1
2
3
4
5
Interaction with the group
1
2
3
4
5
Please explain (if below 4) ………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………… III. Visual impairments Knowledge of the subject discussed
1
2
3
4
5
Communication skills
1
2
3
4
5
Interaction with the group
1
2
3
4
5
Please explain (if below 4) ………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………… IV. Hearing impairments Knowledge of the subject discussed
1
2
3
4
5
Communication skills
1
2
3
4
5
Interaction with the group
1
2
3
4
5
Please explain (if below 4) ………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………
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V. Mobility impairments Knowledge of the subject discussed
1
2
3
4
5
Communication skills
1
2
3
4
5
Interaction with the group
1
2
3
4
5
Please explain (if below 4) ………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………
3. Workshop usability Did the workshop meet your expectations?
1
2
3
4
5
Did the workshop improve your competences concerning teaching students with mental health difficulties?
1
2
3
4
5
Is the content discussed during the workshop going to be useful in your teaching work at university?
1
2
3
4
5
Please explain (if below 4) ………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………… 4. Which activity did you like most and why? ………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………
5. Which activity did you like least and why? ………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………… 6. Was there anything missing during the workshop (concerning its substance or organisation)? …………………………………………………………………………………………………………………………………………………………. ………………………………………………………………………………………………………………………………………………..
7. What do you think is the most important thing you took home from the workshop? ………………………………………………………………………………………………………………………………………………………… ……….………………………………………………………………………………………………………………………………………………..
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Trainee information: Participant profile: I am:
an academic teacher a PhD student
My university (name): …………………………………………………………………………………………………………….. Faculty: …………………………………………………………………………………………………………………….………………
Date: ………………………………
Thank you for completing the questionnaire!
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9. Bibliography
Albrecht G. L., Seelman K. D., Bury M., Handboook of disability studies, Sage Publications, California 2001. American college health association (2006) American college Health AssociationNational College Health Assessment (ACHA-NCHA) Spring 2004 Reference Group Report Data (Abridged) Journal of American College Health, 54 (4), pp 201-2011. Aronson E., T. D. Wilson, Akert R. M., Psychologia społeczna: serce i umysł [Social Psychology], Wydawnictwo Zysk i S-ka, Poznań,1997. Bilikiewicz, A., Psychiatria. Podręcznik dla studentów medycyny [Psychiatry. A Coursebook for Medical Students], Wydawnictwo Lekarskie PZWL, Warszawa 2009. Dirksen – H, L. Bauman, Open your eyes. Deaf Studies Talking, University of Minessota Press, Minneapolis 2008. Dively, V., Metzger, M., Taub, S. and Baer A. (Eds.). (2002), Signed Languages: Discoveries from International Research: Theoretical Issues in Sign Language Research Conference 1998, Washington DC: Gallaudet University Press Farmer M., Riddick B., Sterling Ch., Dyslexia & Inclusion, Assessment & Support in Higher Education, Whurr Publishers, London 2002. Gałkowski T., Szeląg E., Jastrzębowska G., Podstawy neurologopedii. Podręcznik akademicki [Neurological Speech Therapy Basics. An academic coursebook], Wydawnictwo Uniwersytetu Opolskiego, Opole 2005. Gotzamanis, C. (1996). Diagnostic criteria (DSM-IV), Athens: Litsas editions. Hautziner, M. & De Jong-Meyer, R. (1994). Depressionen. In Reinecker, H. Lehrbuch der Klinischen Psychologie. Göttingen: Hofgrefe. Hoffmeister, R. (1978).The Influential Point. Temple University, Philadelphia, PA. Hoffmeister, R. (1980). The Acquisition of Sign Language. In H. Lane & F. Grosjean Jaschik, S. (2009), Mental Health of Campus Inside Higher Ed. April 21st retrieved from http://www.insidehighered.com/news/2009/04/21/ving Kantor, R. (1980). The acquisition of classifiers in American Sign Language. Sign Language Studies, 28,193-208 Kirby A., Gry szkoleniowe – materiały dla trenerów, zestaw I. [Games for trainers Volume 1], Oficyna Ekonomiczna, Kraków, 2002. Kończyk D. (red.), Zasady adaptacji materiałów dydaktycznych do potrzeb osób Słabowidzących [Rules for Adaptation of Materials to the Needs of Partially Sighted People], Uniwersytet Warszawski, Warszawa, 2008. Konwencja Praw Osób Niepełnosprawnych ONZ z dnia 13 grudnia 2006. [The United Nations Convention on the Rights of People with Disabilities from 13th December 2006] 126
Kourbetis, V. (1996) Greek Sign Language: 20 little myths. NID, Athens Krasowicz-Kupic G., Psychologia dysleksji [Psychology of Dyslexia],
PWN, Warszawa
2008. Krohne, W. H. (1990). Sress und Gesundheitspsychologie. Göttingen: Hofgrefe.
Stressbewältigung.
In
Schwarzer,
R.
Kyle J. G., Woll B., Sign Language. The study of deaf people and their language, Cambridge University Press, Cambridge 1985. Lampropoulou V. (1997) Comments about phonological analysis of Greek Sign Language. Patras: University of Patras. Maliszewski N., Regulacyjna rola utajonej postawy [The Regulatory Role of Implicit Attitude], Wydawnictwo Uniwersytetu Warszawskiego, Warszawa 2005. Manos, N. (1997). Basic Elements of Clinical Psychiatry. Thessaloniki: University Studio. Miles T. R., Gilroy D., E. A. Du Pre, Dyslexia at College, Routledge, London 2008. Nęcka E., Orzechowski J., Szymura B., Psychologia poznawcza [Cognitive Psychology], Wydawnictwo Naukowe PWN, Warszawa 2006. Newport, E. & Meier, R. 1985. The Acquisition of American Sign Language. Ιn D.I. Slobin (Ed.), Τhe Cross-linguistic Study of Language Acquisition. LEA, NJ. Oikonomou, M., Gramandani, Ch., Louki, E., Giotis, L. & Stefanis, K. (2006). Mental Disorder and Stigma: The way to destigmatisation. A schizophrenia anti-stigma Project led by the University Mental Health Research Institute (UMHRI). Psychology 13 (3), 28-43. Open university: http://www.open.ac.uk/inclusiveteaching/pages/understanding-andawareness/models-of-disability. Paneras, A. (2010). Changes over a Decade in Greek University Students Mental Health. As presented at the 2nd Internationals Conference ‘Children and Youth in Changing Societies’ 2-4/12/2010 Papaspyrou, Ch. (1997) Kinematic Language and general theory of language, Ellinika Grammata, Athens. Reinecker, H. (1994). Lehrbuch der klinischen Psychologie. Göttingen: Hofgrefe. Schick, B. & Moeller, M. P. (1992). What is learnable in manually coded English sign systems? Applied Psycholinguistics, 13, 313-340. Schulze, B. & Angermeyer, C. M. (2002). Perspektivenwechsel: Stigma aus der Sicht schizophren Erkrankter, ihrer Angehörigen und von Mitarbeitern in der psychiatrischen Versorgung Neuropsychiatrie, 16, (1&2), 78 – 86. Supalla, S. (1991). Manually Coded English: The modalitiy question in signed language development. In P. Siple & Fisher, S. (Eds.), Theoretical Issues in sign language research, Volume 2: Psychology (pp. 85-109), Silver Spring, MD: TJ Publishers. Wciórka B. i J., Choroby psychiczne – społeczny stereotyp i dystans [Mental Illnesses – a Social Stereotype and Distance], CBOS Warszawa, 2002.
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Wdówik P., Zasady adaptacji materiałów dydaktycznych do potrzeb osób niewidomych [Rules for Adaptation of Materials to the Requirements of Blind People], Uniwersytet Warszawski, Warszawa 2008. Welsh, R. L., Blasch, B. B. (Eds.). 1981. Foundations of orientations and mobility. New York: American Foundation for the Blind. What is mental illness? Bulletin (2007), Mental Health and Workforce Division of the Australian Government Department of Health and Ageing. Available on the following website: www.mmha.org.au. (13/6/2012).
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10. Annex Annex 1: Character traits of people with and without disabilities Activity 5.3.2: Character traits of people with and without disabilities
Table 1 Attribute
10 negative attributes associated with people with disabilities
argumentative bossy complaining conceited demanding dependent. depressed distant helpless insecure isolated lonely loud mouthed nervous over-confident self-centred shy silent unhappy unpopular unsociable
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Table 2 Attribute
All the positive attributes associated with people without disabilities
amusing bright capable curious decent dependable desirable easy going energetic fun to be with good natured happy hard-working honest humourous independent intelligent likeable mature non-egotisitical optimistic outgoing polite popular proud quiet self-assured self-disciplined sociable talkative undemanding well-mannered
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All the positive attributes associated with people with disabilities
Annex 2: Sighted guide techniques Activity 5.4.1 Sighted guide techniques
Contact/approach The guide approaches distinctively the person with visual impairments and touches his/her arm with the external side of his/her hand.
Handling The blind person The blind holds the guide from the elbow. The guide is preceded by a step and his body should be considered a shield.
Stairs The guide is always preceded by a step from the blind person, so that the movements of his/her body warn the blind person for upward or downward spiral stair.
Narrow passage The guide brings his/her hand slightly back diagonal and the blind person comes right behind the guide's body.
Change of direction The guide and the blind person come face to face and the guide tends his/her free hand to the blind person.
Change of side The blind person, without losing contact with his/her guide, is transferred to the other hand of the guide, always having as a reference the back to the guide.
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Annex 3: Greek Sign Language alphabet
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Annex 4: Reasonable adjustments Activity 5.8.1: How to remove barriers
Table 1 Example A student who is deaf and lip-reads will take part in the discussion.
Solution
Discuss with the student the most suitable way to be assessed and offer to provide a personal assistant. A student with visual impairments attends a lecture. Exchange the classroom for a more accessible one. A student who is blind takes part in the class during which a PowerPoint presentation is projected. The teacher provides the interpreter with needed materials and sets the breaks in the lecture because it will last for about 2 hours.
Table 2 Example Arrange desks a semicircle.
Solution and tables
in
A student without hands needs to sit an exam. Invite the student to sit at the front and make sure that there is good lighting in the room, particularly where the student will sit and where you will deliver your lecture. There are steps up to the entrance of the classroom making independent access impossible for a wheelchair user. The teacher precisely describes the slides using specific words which facilitate imagining them and reads aloud any displayed text. A sign language interpreter informs the teacher that he or she will interpret the lecture.
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