car, farm, power tools etc, poor circulation due to smoking or diabetes. Sailors with diabetes are very susceptible to infections and they tend to have …
Disability Awareness
August, 1998
Contents
What is a Disability
2
Description of Common Disabilities
1 Acquired Brain Injury
3
2 Amputations
7
3 Asthma
8
5 Cerebral Palsy
10
6 Diabetes
12
7 Epilepsy
15
8 Hearing Impaired
17
9 Heart Disease
19
10 Intellectual Disability
20
11 Multiple Sclerosis
22
12 Paraplegia Quadriplegia
25
13 Spina Bifida
26
14 Vision Impairment
29
15 Acknowledgements
What is a disability ?
One in every ten people in Australia has a disability This means that the
chances are high that you will have contact with at least one person with a
disability every day The disability may or may not be obvious to you
The disability can be of a physical, mental or intellectual nature, or a
combination of one or more and caused by genetic, medical or an accident
No two people have a disability that is exactly the same At first glance
or without knowing very much about disabilities, it is quite easy to assume
that everybody with cerebral palsy is affected the same way or that all
quadriplegics have to use electric wheelchairs This is not the case
Everyone is affected in varying degrees,
some more seriously than others
To further confuse you, everyone with a disability learns to cope with it
in different ways; some better than others Therefore, one person may be
far more independent than the other person,even though they both may have a
very similar disability
The following material is included with the aim of facilitating personal
interaction between people It is not a detailed analysis of particular
disabilities and as with any material you may read on specific impairments,
should only be regarded as guidelines - as there will always be individual
variation in impairments, disabilities, preferences Details of specific
impairments are not relevant to social interactions if the person with a
disability wishes to talk to you about his/her disability she/he will
1 ACQUIRED BRAIN INJURY
What is an acquired brain injury ABI ?
An acquired brain injury is a loss of brain function as a result of damage
to the brain which occurs after birth It refers to injuries to the brain
caused by trauma such as from an external force, which may result in
unconsciousness or a diminished or altered state of consciousness
Causes
The term Traumatic Brain Injury TBI refers to
those injuries to the brain
caused by an external force This may result from -
Conditions which may result in damage to the brain Acquired Brain Injury
include -
Motor Accidents
Sporting Accident
Assault
Tumour
Stroke
Infection
Substance abuse
Medical mistake
Accidents
The term Acquired Brain Injury ABI encompasses all injuries which occur
to the brain after birth
How long does it last?
The effects of ABI can be temporary or permanent The period of
rehabilitation and the outcome of a brain injury will vary from person to
person depending on the degree of damage that has occurred and the area or
part of the brain affected For this reason, some people who acquire a
brain injury may incur multiple disabilities It should be stressed that
people with ABI differ considerably from people with an intellectual
disability People with brain injuries usually retain their intellectual
abilities but may have difficulty controlling, co-ordinating and
communicating their thoughts and actions
Training techniques
An injury to the brain can result in partial or total impairments of
cognitive, physical and/or sensory function Whilst recovery from physical
conditions might
indicate minimal impairment of athlete, there is often a
change in the behavioural and emotional functioning as a person adapts to
the changes in their life For this reason, ABI is often referred to as
the hidden disability
Instructions
A person with ABI usually retains their intellectual capacity after their
injury, however, depending on the area of the brain which has been
affected, there may be a problem in learning new skills because of the
difficulty in processing information Also, a person often has a problem in
recognising their own limitations due to lack of insight as a result of
damage to the frontal lobes
With regards to instruction the following guidelines are recommended:
Always talk slowly and clearly - do not provide too much information in
any one session
Break down task into components
Be prepared to repeat procedures the following session
Use of visual aids both during lessons and on the boat if possible ie
use of picture cards and visual cues
Ensure written material is in large type wherever possible in font 14
plus etc as people with ABI often have difficulty reading written
material
Ensure that sailor keeps a diary for planning,
including training
sessions and race schedules
CHARACTERISTICS
Physical sensory
Physical considerations may include:
an increased degree of spasticity,
poor co-ordination and mobility,
muscle weakness and
susceptibility to fatigue
Often a person might experience a loss of sensory function, such as a
decrease in visual acuity
Cognitive
Cognitive factors will vary for each individual but problems can occur
with:
spatial orientation
motivation
judgement
memory loss
difficulty in transferring information
Each coach will need to determine the amount of information that can be
processed by an athlete, including the capacity of short and long term
memory
Other considerations
In some instances, people with ABI might often exhibit inappropriate social
behaviour Whilst this is minimal, it is an aspect of brain injury which
people should be aware, to ensure minimum offence to others, especially
considering the social aspect of sailing
MEDICAL CONSIDERATIONS
Always attain a medical report or assessment of an individual including
medication requirements and medical approval for participation in proposed
activities Consult with individual, doctor and
parent or carer to
identify any issues, problem areas, medication etc
Epilepsy
People with ABI are more likely to develop epilepsy after their injury For
this reason, it is essential that coaches, carers etc have an awareness of
epilepsy and a knowledge of how to treat epileptic seizures
Fatigue
A person with ABI is very susceptible to fatigue Once a person is fatigued
they are more susceptible to accidents, bouts of frustration, become easily
stressed and therefore more likely to exhibit negative or inappropriate
behaviour
For this reason, the following guidelines should be implemented to
facilitate an easier learning experience for both instructor and trainee
Plan information or training sessions early in the day
Keep sessions short as concentration if often a problem and to minimise
onset of fatigue
Ensure appropriate rest periods are programmed into training schedules
If racing, be prepared to change and distribute responsibilities within
the crew
Frustration
A person with ABI will often remember all the activities they could perform
prior to their accident
Do not always presume that a person is capable of performing a task
independently It is often the case
that the person will not be able to
acknowledge initially that they are unable to perform certain tasks - the
lack of insight is a common issue for people with ABI
Always provide encouragement and positive reinforcement at all times
Motivation
People with ABI tend to exhibit a lack of motivation on many occasions To
address this issue, contact person prior to the day, on the day and as
transport is often an issue, arrange transport with someone at set times to
ensure opportunity for participation sailing or training day
OTHER GUIDELINES
Always consult with carers prior to beginning an activity Apart from
safety, this will try and eliminate situations where the trainee will be
uncomfortable and become stressed As ABI is a hidden disability,
sometimes, the disability is only apparent where there is an inability to
cope in stressful situations
People with ABI wish to live independent and would like to treated as an
individual, be involved and integrated into the club or community wherever
possible
IMPLICATIONS FOR SAILING
Balance can often be a problem - this should be taken into consideration,
especially when on larger boats
Vision - Always check to see if there are
any vision problems - people
with ABI have problems with visual acuity
Depending on the degree of injury , it may be necessary to use modified
equipment eg electronic controls etc
2 PEOPLE WITH AMPUTATIONS
For our purposes amputees will include people born with one or more limbs
missing as well as people with acquired amputations Amputations may be
of a single limb, they may be double amputations or more The position of
the amputation is important A person with an above the knee amputation
will be more disabled than someone with a below the knee amputation
Causes
The causes of amputations may include accidents eg car, farm, power tools
etc, poor circulation due to smoking or diabetes Cancer, infections,
gangrene are all causes of amputations Drugs taken during pregnancy may
lead to children being born without limbs
IMPLICATIONS FOR SAILING
Equipment may need to be adapted to suit the person
The instructor should always be on the side of the sound limb
There may be difficulty with balance while sailing
3 ASTHMA
Asthma means difficulty in breathing It is caused by the narrowing of
the small breathing tubes in the lungs This narrowing is due to
the
tightening of the muscle in the walls of the tubes, the swelling of their
lining and the increased production of mucus
Cause
The actual cause of asthma is unknown however a great deal is known about
things that can trigger an attack Attacks may be brought on by many
factors No two people are alike and it can be very difficult to identify
the actual cause of a particular attack Below is a list of possible
triggers for asthma attacks:
Allergens eg grass, pollens, house dust mite, pet fur etc
Sudden changes in temperature
Dry hot winds
Some people may be sensitive to certain types of food eg preservatives
FIRST AID
Recognising an Asthma Attack
Early signs of an attack
Breathing becomes more difficult and a wheezing sound develops
Breathing is rapid, sometimes with a gasp
Person becomes distressed, pale and sweaty with a rapid pulse
What to do during an Acute Asthma Attack
During an attack the person needs quiet surroundings, clean air and
treatment
Acute attacks need early treatment, the longer you wait the more difficult
it is for medication to work
The persons medications should be readily available with instructions
as to the dose and the order they
must be taken in Generally inhaled
beta-agonists are the fastest working
If no medication is available seek medical attention immediately In an
emergency, pharmacists can supply medication
During the attack, if the initial booster dose of medication is helping to
control symptoms, continue medication every 4-6 hours
IMPLICATIONS FOR SAILING
There is no reason why a person with asthma should not be fully involved in
sailing as long as they have their condition under control
If stimuli for attacks is known to be climatic and the sailor and
organisers are aware of the possibility of an attack in certain weather
conditions then medication can be taken sensibly, participation can be
complete
Organisers should be aware of medication and correct procedure during an
attack and ensure the person has filled out an information sheet about
their medications
Sailors, organisers rescue boat assistants should be aware of a common
signal given for immediate assistance required
4 CEREBRAL PALSY
Cerebral Palsy is the result of an injury to part of the brain before it
has finished developing It is non-progressive, it doesnt get worse This
injury affects parts of the brain that control
and co-ordinate the muscles
which move the body Therefore people with cerebral palsy have
difficulties with movement and posture
GENERAL INFORMATION
There are three main types of cerebral palsy:
1 Spasticity - These people find that when they try to move, certain
muscles contract and go stiff Then the muscles suddenly release These
people also have abnormal posture and poor hand function with a certain
amount of sensory loss
2 Athetosis - People with athetosis have their movements hindered by
lots of unintentional, uncontrollable extra movements These actions tend
to increase with excitement or nervousness Athetosis generally affects
the whole body but one side may be more affected
3 Ataxia - Usually people with ataxia have a degree of spasticity or
athetosis as well These people have difficulty in walking or moving
steadily They have trouble making controlled movements with their hands
and feet so they appear clumsy and uncoordinated
Difficulties Associated with Cerebral Palsy
Some people with cerebral palsy may also have an intellectual disability
However it is important to realise that many people have normal or above
normal intelligence, this is most
likely with athetoids Cerebral palsy
may also be associated with vision or hearing loss and epilepsy
People with Cerebral Palsy may not have perfect control over the muscles of
their mouth and throat so that speaking and eating may be difficult Some
may have trouble controlling their facial expressions The brain injury
which causes cerebral palsy does not get worse as the person gets older
However the effects of the cerebral palsy on the person will change over
the years
Causes
There are many possible causes of cerebral palsy The most significant
aspect is that the damage occurs to the brain before it has fully
developed This may happen if the birth is premature, prolonged or
difficult Sometimes the damage occurs in early childhood through brain
infections meningitis or through actual brain injury of the sort that may
be sustained in a car accident Cerebral palsy is not inherited It is
extremely rare for there to be more than one case in a family
IMPLICATIONS FOR SAILING
Many people with cerebral palsy will need lifting in and out of boats
Sailors with CP may tire easily
Poor circulation means they will get cold quickly and therefore shouldnt
be out on the water
too long and will need appropriate clothes in cold
weather
Sailors with CP often have difficulty with control of limbs and are prone
to bumps and bruising It is highly recommended that these sailors keep
their feet at all times covered to avoid injury
5 DIABETES
Diabetes is a disorder of the system which regulates the amount of sugar in
the blood Diabetics risk long term complications due to high blood
glucose These complications may affect eyes, kidneys, and nerves
Arteries, especially those supplying the heart, brain and legs may also be
affected Often blindness and amputations are due to diabetes Diabetes
is an inherited disease A person who has a family history of the disorder
has the tendency to develop it carry it on to their off spring
There are two types of diabetes
Insulin Dependent Diabetes This type is most common in children or young
adults These people produce little or no insulin The treatment is daily
insulin injections, diet and exercise
Non Insulin Dependent Diabetes This generally affects middle aged or
elderly people These diabetics are able to produce some insulin, they
dont need insulin injections Diet alone or diet and tablets may be
the
treatment used
Causes
It is caused by a failure of the pancreas to produce a sufficient supply of
the hormone Insulin Insulin allows the sugar to leave the blood and enter
the body cells to fuel them Without insulin the sugar in the blood rises
far beyond normal
DIABETIC REACTIONS
There are two possible reactions from which diabetics may suffer Insulin
Reactionand Diabetic Coma
1 Insulin Reaction
This is the most common complication of diabetes and is due to a drop in
the blood sugar level
Cause of Insulin Reaction:
Delaying/missing meals
Delaying/missing afternoon or morning tea
Insulin injected was more than needed dose
Unusual strenuous exercise
Emotional shock
Alcohol
Choice of injection site eg changing from abdomen to leg
Injecting insulin into a muscle or blood vessel, this can increase the
blood insulin level rapidly
Symptoms
sweaty cold clammy
pale
trembling
headache
dizziness
dilated widened pupils
blurred vision intense hunger
unusual behaviour eg bad temper
poor co-ordination
staggering walk
convulsion
coma
Symptoms depend on the severity of the reaction The signs vary between
people A diabetic should know his warning symptoms
2 Diabetic Coma -
Ketosis
Ketosis is a serious complication due to insufficient insulin
Causes
Omission of a dose of insulin
Insufficient insulin in dose
Infections eg flu
Gastric upset
Neglect of diet
Injury
Severe injury
Excessive alcohol consumption
Symptoms
heavy urine glucose
ketones in the urine
thirst
frequent urination
hunger
fatigue
blurred vision
deep rapid breathing
vomiting
coma - if untreated death
Treatment
Give drinks sweetened with 2 full tablespoons of sugar or glucose
If dramatic recovery occurs it is an Insulin Reaction - give more sugar
every 15 minutes for an hour
If it is Ketosis giving sugar will not harm them but you must SEEK
URGENT MEDICAL ATTENTION if recovery isnt obvious
If unconscious put the person in the coma position and SEEK MEDICATION
ATTENTION IMMEDIATELY
Diet
It is important that diabetics are very conscious of their diet for a
number of reasons Diet can help to control the blood glucose level and
diabetics need to maintain a desirable body weight
Important points about diet:
Meals and snacks should be eaten at approximately the same time every day
Meals must not be missed
Meals should be planned to provide an even food intake
Added sugars
should be limited, alternative sugars are advised
Foods which contain a high amount of sugar should be avoided
Alcohol should be had in moderation Alcohol is high in kilojoules and it
may react adversely with some medications
IMPLICATIONS FOR SAILING
Unusual amounts of exercise or excitement may require the adjustment of
treatment or an insulin reaction may occur
Sensory impairment reduces the diabetics perception of pain, injuries may
go unnoticed or be perceived as minor
Sailors with diabetes are very susceptible to infections and they tend to
have poor healing capacities Infections through cuts, blisters etc
should be avoided As their skin is so sensitive it may be useful to wear
and socks Circulatory restrictions should also be avoided Tight wet
suits may not be suitable
Sunburn can cause infections, it also affects blood sugar levels
Sailors may desire privacy when testing their sugar level or when
administering injections
Organisers should be aware that diabetics cannot miss or delay meals
Insulin needs to be kept in a cool place, preferably a refrigerator Fast
acting sugars eg lollies and orange juice should be readily available in
case of an insulin reaction
6
EPILEPSY
Epilepsy is a disorder which takes the form of recurring seizures A
seizure or convulsion is a sudden excessive discharge of electrical energy
in the brain Epilepsy affects people of all levels of intelligence and
from all age groups Approximately one person in every hundred has some
form of epilepsy Generally seizures can be controlled by medication
Cause
Often the reason for an individuals epilepsy is not known However,
possible causes are stroke, head trauma, lack of oxygen in the brain, brain
infections, birth damage, pre-natal infections
TYPES OF SEIZURE
1 Grand Mal seizures
Seizure usually lasts for less than five minutes and usually the person
will sleep for half an hour or more afterwards After 1-2 hours the person
should be completely recovered with no memory of the seizure
2 Temporal Lobe seizures
These seizures differ from Grand Mal Seizures in that the whole brain is
not necessarily involved in the increase in electrical energy An aura or
premonition up to a day before may warn the person of the seizure to come
This can take the form of nausea, headache, strange smells or tastes,
auditory hallucinations, fear Attacks can involve a great range
of
confused, inappropriate behaviour eg lip smacking, running around in
circles, accompanied by a vacant look and an inability to respond to
directions The seizures usually last from 5-15 minutes
3 Petit Mal seizures
Usually only children up to 15 years of age have this form of epilepsy
These seizures usually involve:
Sudden staring, blinking,
Loss of consciousness that lasts less than 30 seconds the person being
unaware of the seizure
TREATMENT FOR GRAND MAL SEIZURES
1 Keep calm
1 Roll the person on to their front with their head turned to one side If
the convulsions are very violent wait until they slow down before turning
the person over
1 Only move the person if they are in physical danger - it is better to
move objects from around them so they have nothing to injure themselves
on
1 NEVER put anything in the persons mouth - you may break teeth or have
fingers bitten
1 Let the seizure run its course - you cant stop it
1 Watch the person for signs of breathing
1 Offer support and reassurance when the person regains consciousness, he
may be confused and embarrassed A change of clothes may be needed
1 Help the person to a place close by where he can rest or
sleep for a
while to recover from the seizure
If the seizure goes for more than 10 minutes or another seizure begins -
get medical help
IMPLICATIONS FOR SAILING
Strict precautions must be taken if a person is known to have epileptic
seizures If a seizure were to occur whilst sailing the biggest danger
would be that of the person falling out of the boat and drowning
The person must be closely watched at all times when involved in water
activities
The person must have medical permission to participate in any activity
involving water
It is important that the person fill out an information sheet on his
epilepsy so organisers understand the condition and can take appropriate
action in the event of a seizure
If a seizure occurs the sailor should not continue sailing for the rest of
that day, even if they appear to have made a full recovery
7 HEARING IMPAIRMENT
CLASSIFICATION
Hearing loss is categorized by its severity
Mild hearing impairment
speech is normal
conversation is easy
has difficulty hearing distant noises
Moderate hearing loss
speech is impaired
has difficulty hearing normal conversation
Severe hearing loss
cannot participate in conversations although
he/she may catch the
occasional word
hearing aids are helpful
Profoundly deaf
cannot use hearing to help communication
hearing aid may help but it is limited in its ability to permit normal
speech
CAUSES
The cause of approximately 50 of hearing loss is unknown however common
causes include:
Ear infections
Genetically inherited conditions
Noise pollution
Intra-uterine infections during pregnancy eg rubella
Birth trauma
POINTS TO NOTE
Hearing aids
Amplify sounds they dont clarify them much Background sounds also get
amplified and this makes it difficult for the person to isolate sounds So
background noises should be kept to a minimum Continuous loud sounds may
cause headaches
Lip reading
Try to be on the same level as the person you are speaking to as it is
difficult to look up or down at a person and read their lips Poor
lighting also makes lip reading hard The hearing impaired persons back
should be towards the sun Lengthy conversations should be kept to a
minimum to avoid confusion People who talk quickly, move their head or
smile when they speak may be difficult to lip read Beards and moustaches
can make lip reading difficult Lip reading is tiring so the person
may
not be as good at understanding late at night
INSTRUCTION TECHNIQUES
When giving instructions in the presence of persons with hearing impairment
the following points are important for effective communication:
Be sure you have the persons attention so they can ascertain the whole
message
See and be seen Position yourself where you can be seen face on, at close
range and in good light The person needs to be able to lip read and see
your facial expression
Hand gestures and facial expressions help make the meaning clear However,
keep hands away from the face
Avoid background noise
Speak naturally and clearly
Keep instructions short and simple - dont use unnecessary words or long
sentences
Check that you have been understood
Rephrase the message if it is not understood
Encourage other members of the team to learn to communicate
Instructors should be precise and uncomplicated with signals
Aim to give all the necessary instructions before the activity has begun,
using visual aids and demonstrations where possible
Use demonstration as the most important cue
Consider environmental conditions ie wind and sun
During the activity, signs such as the wave of a nag, flick of
lights, or a
tap on the shoulder may be required if the person is unable to hear a
whistle
Use standard movements/body language which hearing impaired people
understand
Be patient
GENERAL
If you have difficulty being understood either through lip reading or a
hearing aid repeat what you have said in a different way - change the
phrases you used If there is still a problem, write it down There is a
danger of social isolation because of difficulty in participating in
conversations so efforts must be made to include a hearing impaired person
A profoundly deaf person may be hesitant when speaking as he is unable to
hear his own voice to know if it is loud or soft
IMPLICATIONS FOR SAILING
It may be easier for a hearing impaired person to understand instructions
and explanations if visual cues are used eg maps, charts, labels on
equipment, etc
It is essential that visual signals between instructor and hearing impaired
person and clearly understood
9 HEART DISEASE
Generally, there is no reason why people with heart disease should not
participate in sailing In fact, being physically fit is thought to
improve ones resistance to heart disease The issue at hand is the
work
intensity and the ability of the individual to copy with the physical
stress
HEART ATTACK
Sudden and complete oxygen shortage to the heart muscle causes tissue
damage and if it is not relieved some of the heart muscle dies This is a
heart attack
The warning signs:
Squeezing, discomfort or pain in the centre of the chest or behind the
breast-bone lasting more than 10-15 minutes
Pain spreading to the shoulders, neck or arms
These may be accompanied by:
Sweating, shortness of breath
A sick feeling in the stomach
Far too many Australians die each year because they failed to recognise a
heard attack Modern medical treatments for heart attack can save lives
and prevent serious heart damage
Dont waste vital moments
1 Dial 000
2 Ask for ambulance service
3 Report a possible heart attack
4 In an ambulance is not rapidly available, ask somebody to drive you to
hospital
Sudden pain or discomfort in the chest can be frightening It is natural
for all involved to hope it is something else - like indigestion, or a
pulled chest muscle - and delay taking action It is heart attack, every
minute counts in getting to hospital
STROKE
Stroke is an
interruption of the blood supply to the brain Symptoms
depend on the part of the brain affected They can include headache,
unconsciousness, weakness or numbness on one side of the body, impaired
speech and partial loss of sight Onset of symptoms is usually sudden
IMPLICATIONS FOR SAILING
Sailor will become fatigued readily and requires frequent rest periods
If a person with a heart condition collapses, get medical help immediately
10 INTELLECTUAL DISABILITY
Intellectual disability is present from birth or early childhood, or occurs
during the developmental period conception to 18 years Special
education, training and adequate support and medical treatment can help
lessen its effects, but it is not curable However, most people with
intellectual disabilities are capable, with assistance, of learning about
new situations and adapting to them People with intellectual
disabilities experience things which make us all human, but they learn and
develop intellectually at a slower rate that average
Three factors in combination determine whether or not a person has an
intellectual disability
1 Significantly below average intelligence
2 Shortcomings in everyday life
skills
3 Disability appears in the developmental period
CAUSES
Brain injury due to lack of oxygen at birth
Brain injury during or after birth
Disorders of metabolism, growth or nutrition
Chromosome abnormalities
Extreme prematurity
Poor diet and inadequate health care
Drug misuse during pregnancy included excessive consumption of alcohol and
smoking
INSTRUCTION
An instructor needs to be aware of some common denominators amongst the
population of people with an intellectual disability Any one individual
may not display all of the following characteristics, but rather, some of
these to varying degrees:
Inability to think in abstract terms
Lack of decision making ability
Poor short term memory
Learning difficulties and generally few literacy/numeracy skills
Poor co-ordination and mobility skills often due to lack of appropriate
opportunity
Inconsistent concentration spans
An instructor should be recognise that:
People with intellectual disabilities may range from borderline to profound
in their impairment
A number of physical disabilities are often aligned with intellectual
disabilities
Often where there is no accompanying physical disability, this is some
delay in
physical development The sailor may take longer to master
physical skills
Patience and understanding are needed
People with an intellectual disability like other people, express
frustration and anger Because they so often find it difficult to do this
verbally, it often takes the physical form eg clenched fists, foot
stamping, withdrawal, tears, sitting down and refusing to get up Their
frustration need not be feared, rather, they should be recognised, accepted
and channelled into appropriate actions
Those involved with instructions sailors with an intellectual disability
should consider the following points:
Make all sessions fun and enjoyable
The level of expectation is crucial Generally not enough is expected of
people with intellectual disabilities both physically and socially
The greatest area of difficulty and frustration for both instructor and
sailors is communication Keep verbal instructions basic and brief Be
clear, precise, deliberate and sequential, then reinforce your message
When demonstrating an activity be clear and participate so the person has
visual examples to model the performance on
Dont presume a nod or shake of the head means the person has
understood
your instruction Seek understanding of the instruction from the person
People with an intellectual disability learn more by doing than looking and
listening When teaching new skills move the sailors through the desired
motion
Be specific in praise and encouragement
Break down skills into small teaching components, ensuring each part is
learned fully before progressing Review and repeat skills, and drill in
many different ways and situation Then reinforce Remember also that
reinforcement should be spontaneous and immediate
Be prepared to teach basic skills Many people sailors will not have had
the opportunity to learn or understand these skills
Keep practice time on specific activities short to avoid loss of
concentration and boredom Be sure to vary your activities and drills
Dont assume that these sailors will automatically know the inherent
etiquette of sailing Etiquette should be taught and practised regularly
Observe and talk with the person to become familiar with his/her individual
physical and intellectual abilities
Activities and techniques can then be developed to provide challenges to
meet individual needs
People with an intellectual disability may
have little or no understanding
of correct clothing
As for any instruction session, introduce new activities early in practice
sessions before the individual becomes tired and vary the tempo of training
to reduce the fatigue factor Also, motivate with appropriate devices,
positive feedback, points, individual recognition
Encourage the sailor to compete, above all, against personal performances
IMPLICATIONS FOR SAILING
Many sailors with intellectual disabilities will be fully mobile It is
imperative to ascertain level of water safety skill they have and if
necessary the sailor may need to wear a life jacket continually whilst at
the sailing venue
While sailing a person with an intellectual disability may become fearful
and react in an unexpected manner These sailors should be monitored
closely until their level of confidence is ascertained
On the other hand, a sailor with an intellectual disability may show no
concern for their own personal safety or the safety of others Again
initial close monitoring should be instigated
11 MULTIPLE SCLEROSIS
GENERAL
Multiple Sclerosis, or MS, is a disease affecting the central nervous
system in the brain and spinal cord It is the
most common chronic
neurological condition amount young adults MS has no standard pattern of
symptoms The type and severity of its symptoms depend on the parts of the
central nervous system affected MS can present as either a remitting or a
progressive course
The remitting course is characterised by attacks or exacerbations of
symptoms In the beginning, the average interval between attacks is two
years However, it may vary and some people can experience long remissions
even up to 20 years, while other can experience more frequent bouts At
least two-thirds of the people who have MS start off with the remitting
course Of those, about 60 later develop a slowly progressive course
The progressive course, which is more common later in life, is
characterised by the symptoms steadily becoming worse In some cases,
earlier bouts may have been too trivial to notice In very rare cases, MS
can present at any age as a severely progressive course from the outset
SYMPTOMS
Symptoms of MS vary greatly from person to person - from time to time in
the same person It should be noted that many people who have MS have an
increase of symptoms during hot weather
Symptoms might
include:
Loss of co-ordination
Extreme fatigue or unusual tired feeling
Numbness or pins and needles
Loss of bladder or bowel control
Staggering or loss of balance
Dragging of feet
Eye trouble
Speech difficulties
Shaking of hands
IMPLICATIONS FOR SAILING
Because symptoms can vary so greatly it would be unwise to presume that
each person with MS should be treated the same Nevertheless all safety
precautions should be practised and as with all disabled people, ask them
the best way to approach any situation
These sailors may be more prone to hyperthermia and heat exhaustion
Reduced sensation in limbs may lead to injuries of the feet and therefore
it is advisable to have feet covered while sailing
12 PARAPLEGIA AND QUADRIPLEGIA
Paraplegia
Is defined as paralysis of the lower limbs and part or whole of the trunk -
usually a result of an injury to the back
Quadriplegia
Is paralysis of all four limbs and the trunk - usually a result of an
injury to the neck
CAUSES
The major causes of spinal cord injury are:
Motor vehicle accidents
Diving accidents
Falls
Football accidents
The majority of accident victims are young males aged 17 to 25 years
Human factors such as risk
taking and other careless or dangerous behaviour
predominate in spinal accidents
CLASSIFICATION
Description of impairment using international sporting classification
according to level of injury
Quadriplegia
CLASS 1A - Weak hand and upper arm muscles
CLASS 1B - Arm and wrist muscles functioning but fingers unable to grasp
CLASS 1C - Arm and wrist muscles functioning, fingers able to grasp but
inability to spread the fingers and close them
Paraplegia
CLASS 2 - Impaired balance in sitting position
CLASS 3 - Good balance in sitting position
CLASS 4 - Thigh muscles not functioning
CLASS 5 - Thigh muscles functioning but hip, knee and ankle muscles not
functioning or not functioning optimally
CLASS 6 - The same as in Class 5 but functioning to a greater degree
IMPLICATIONS FOR SAILING
Depending on the level of disability, most people with quadriplegia and
paraplegia will need assistance with lifting
Quadriplegics unused to physical exercise with tire easily
These sailors may be more prone to hyperthermia and heat exhaustion
The paralysed areas of the body are usually insensitive to heat, cold or
pain and will have reduced circulation
These areas need to be protected
from hard surfaces by cushioning and other protective clothing It is
important for quadriplegics and paraplegics to have their feet protected at
all times
The sailor may experience difficulty with balance whilst sitting in a boat,
depending on level of disability
13 SPINA BIFIDA
The term Spina Bifida refers to a group of conditions in which there is
failure of development of structures around the spinal cord In the usual
situation the lower part of the spine is involved The severity of the
condition varies considerably from person to person, with some being
minimally affected and other having multiple severe problems The lower
part of the spinal cord controls voluntary bladder and bowel function and
most people with spina Bifida have problems in these areas Usually with
medical and surgical treatment, appropriate appliances and personal care
these can be overcome, however occasional leakage of urine and faeces does
occur There may also be associated renal tract damage, and renal
infections which cause periodic illness
Spina bifida is associated with an additional malformation at the base of
the brain which causes obstruction to the
circulation of fluids in the
interconnected cavities which normally occur within the brain This
results in increased pressure and expansion of these cavities - or
hydrocephalus
In general the average IQ of people with spina bifida is below that of
comparable groups - slightly more so for those with shunts However the
average IQ is within the normal range
CAUSES
The cause is partly genetic and partly environmental Families with one
child with spina bifida have an increased risk of having spina bifida in
further children There is an increased risk in the offspring of people
with spina bifida Smaller risks apply to close relatives Other known
facts such as social class, seasonal and geographical variations point to
environmental factors Many possibilities including vitamin deficiency
have also been postulated but not proven There is no evidence linking
drugs taken during pregnancy with spina bifida
IMPLICATIONS FOR SAILING
General the persons lower limbs are fragile and therefore more likely to
fracture or suffer soft tissue damage These areas need to be protected
from hard surfaces by cushioning and other protective clothing It is
important for these sailors to
have their feet protected at all times
Care must be taken not to press or bump on the valve of the shunt which
controls hydrocephalus This valve is under the skin behind the ear -
beware of booms
If a urinary bag is worn, it should be emptied every 3-4 hours and before
any physical activity
14 VISION IMPAIRMENT
Blindness or vision impairment does not necessarily mean that the person
cannot see anything No more than 5 of blind people are completely
unable to see Most can see some light A legally blind person is someone
who cannot see, with visual aides, at 6 metres, what person with normal
vision can see at 60 metres, or if the width of a persons vision is 20
degrees or less
CAUSES
There are many possible causes of vision impairment:
4 Diabetes
5 Cataracts
6 Glaucoma
7 Aging
8 Prenatal infections
9 Eye malformations
10 Trauma - eg car accident
11 Infections
12 Tumours
13 Oxygen treatment after birth
Communicating with a person with vision impairment
Speak distinctly and directly towards the person
Dont speak louder than you normally do
Say something that announces your presence or intention to leave
Identify yourself when you approach a VI
person and introduce any people
with you
When speaking to a VI person address him by name or touch so he knows you
are talking to him
Speak naturally, dont worry about using words like look and see
Be specific with directions ie direct him to the left from his position
instead of saying over there
Unobtrusively explain what is happening when in public
Talk to the person you are guiding and give directions to avoid
difficulties
Never take a persons arm and put him in front of you Hold your arm to
your side, so he can take it and walk 1/2 a pace behind you
Dont leave a VI person alone in the middle of a room Make sure he has
contact with something eg a table
Dont completely fill glasses or cups
Discreetly tell a VI person if his clothes are dirty or untidy
Return objects to correct places so the VI person can find them easily
A half open door or any unusual object left where a VI person may walk can
be very dangerous
Warn a VI person to any possible dangers eg wet floors
INSTRUCTION TECHNIQUES
The instructor must be articulate and willing to give the fullest
description of technique and correction of poor technique Use key words
to assist
Sometimes it may help if the
person feels the instructor performing a
particular movement or the instructor moves the person through the
movement
Dont grab their arms unexpectedly If you are going to touch the person
tell them first where and what you are going to do
Constantly correct style manually - do NOT push or prod those being
instructed
Demand an accepted technique irrespective of the disability - adaption to
techniques must be carefully evaluated to fall within an accepted limit -
poor compromises inevitably lead to low standards of performance and
injury
Familiarise the person with obstacles in the area describe obstacles in
their direct path of travel, let them feel the area and five them time to
explore the area
Use other participants to assist with guidance and direction
A buddy system may be helpful
Give VI people constant feedback on the progress of an activity which may
be naturally observed by people with vision
Acoustic signalling may be required in some activities to aid in direction
and/or distance Instructors should also develop cue/key words, eg
communicating direction by referring to the hands of a clock
Develop a good level of spatial awareness
Work in a well lit area Shadows and
dark areas may be dangerous and will
reduce visibility
GENERAL NOTES
When in the company of a Vision Impaired person:
If he wishes to sit, put his hand on the back of the chair
Let the VI person take YOUR arm This allows him to walk one step behind
you and judge which way you are turning When you come to a step, pause
and say whether it is a step up or down
Approaching public transport or steps, place the VI persons hand on the
handrail
Do not be afraid to offer assistance to a VI person who is travelling
alone It is then up to him to say whether or not he needs assistance
Direct questions for a VI person to him and not to his companion
Use his name at the beginning or at the end of a sentence He will then
know that you are speaking directly to him
Always leave a door open or closed, never ajar
If entertaining a VI person, ask him if he would like any of his food cut
up
There is no need to tell him what type of food you are serving or where it
is positioned on his plate He will ask all he needs to know It is most
important not to make a fuss
Hand him his drink, he can then place it where he can find it easily A VI
smoker will appreciate not having to ask for an
ashtray
IMPLICATIONS FOR SAILING
A sailor with VI should be aware of the location of the water, direction
and location of facilities and have assistance until he becomes familiar
with the area
Audible aids will assist the VI sailor with direction and distance of buoys
and other craft and countdown for race starts
15 ACKNOWLEDGMENTS
Alison Smith Victorian Water Skiers Association -
Disabled Division
Julia Owens NSW Sports Council for the Disabled
Copyright : Subject to written application for permission to copy
material from Sailability NSW
Source:endhomelessness.org
