Glossary

Acquired:  That which appears after birth as a result of injury, disease, or learning.

Accessibility:  A term which refers to freedom for people with disabilities to equally participate in activities of daily life including employment, transportation, housing, health care, recreation and education without being limited or denied due to architectural and/or attitudinal barriers or discrimination.

Acute:  A term which refers to a disease or illness which is short and severe, not long and drawn out (chronic).

Advocacy Group: A general term describing a group or agency comprised of persons or organizations with similar goals, working together to bring to public attention, their views and the proposals they support in order to effect positive change.

AIDS (Acquired Immune Deficiency Syndrome) – As explained by information from the AIDS Institute of the New York State Department of Health, AIDS (Acquired Immune Deficiency Syndrome) causes the body to lose its natural defenses against disease. The body then becomes open to attack by a whole set of illnesses, ranging from mild infections to life-threatening conditions, which usually do not pose a threat to anyone whose immune system (see term for definition) is working normally. Some people with AIDS develop a rare form of pneumonia (Pneumo-cystis carini pneumonia) caused by an organism that has no ill effect on healthy people. Others develop Kaposi’s sarcoma, a cancer that affects the skin and lining of the blood vessels, and may spread throughout the body. Also, unusual bacterial and fungal infections are often found in persons who have AIDS. Symptoms may include one or more of the following: unexplained tiredness, combined with headache, dizziness or lightheadedness; continued fever or night sweats; weight loss of more than 10 pounds which is not due to dieting or increased physical activity ; swollen glands in the neck, armpits or groin ; heavy, dry cough that is not from smoking and has lasted too long to be a cold or flu; thrush (a thick whitish coating of the tongue or throat), which may be accompanied by a sore throat; shortness of breath; bruising more easily than normal; purple or discolored growths (patches) on the skin, possibly first seen on the ankles and legs, or the mucous membranes inside the mouth; unexplained bleeding from any body opening or from growths on the skin or mucous membranes.

Alzheimer’s Disease:  Alzheimer’s Disease is a progressive, degenerative disease that can cause memory loss, confusion, inability to make decisions, difficulty in speech and movement, inability to recognize even family members, loss of basic and learned skills and the ability to live independently. A characteristic of this disease is the death of neurons (nerve cells vital to the functioning of the brain) which significantly decreases the ability of the brain to relay messages and recall stored knowledge.

Amputee:  A term which refers to a person who has amputation, or the complete surgical removal of any limb (s) or part of a limb (s) from the body. This procedure is undertaken only when there is disease or damage beyond treatment or repair. Industrial and/or road accidents are the major causes of severe limb damage, but the necessity for amputation may occur as the result of such diseases and conditions as cancer, diabetes, gangrene (death of part of the tissues of the body usually as a result of direct injury or inadequate blood supply), frostbite (freezing of the skin and tissue due to exposure from extreme cold) and hardening of the arteries. An amputee may experience many post-operative symptoms including phantom limb pain (the feeling that the absent limb is still there and that it, or part of it, is painful). Among the methods used for adaptive/rehabilitative education is the use of a prosthesis — an artificial device (which may be electronic) to substitute for the missing part.

Amyotrophic Lateral Sclerosis: A degenerative nervous system disorder characterized by loss of motor neurons in the cerebral cortex, brainstem and spinal cord with resultant muscular atrophy, spasticity and weakness The weakness begins in the upper extremeties and often unilaterally. The first sign is often loss of control of fine motor movements in the hand. The disease has severe effects on respiration and deglutition.

Aphasia:  A medical term which means “loss of language”; it refers to all aspects of language loss, not only speech. People with aphasia often have difficulty with one or more of the following things: speaking, reading, writing, arithmetic, spelling, counting, telling time, understanding what is said, and recognizing objects. Two specific examples of aphasia are: expressive aphasia– a condition in which it is difficult or impossible to make one’s own thoughts or wants known to others; and receptive aphasia– a condition in which it is difficult or impossible to understand what others are trying to communicate.

Architectural Barriers:  This term refers to building design which limits usage by persons who are mobility-impaired. In order to move toward eliminating architectural barriers, New York State enacted Chapter 707 of the Laws of 1981, which created the State Fire Prevention and Building Code Council (within the Division of Housing and Community Renewal). The Council was charged with preparing a new State Uniform Fire Prevention and Building Code to be used by all municipalities within the State effective January 1, 1984 and amended in October, 1987. The Code contains provisions for the construction and maintenance of buildings including such structural elements as: space and fire safety requirements; plumbing, heating, electrical, ventilating and fire protection equipment; and facilities for persons who are physically handicapped and hearing impaired. Information on the establishment of specifications for accessibility including bathrooms, kitchens, and curb ramps can be found under “American National Standards Institute, Inc. ”

Arthritis:  Arthritis means inflammation of a joint, and generally refers to over 100 rheumatic diseases (a group of diseases which affect muscles, ligaments, tendons, joints, and other body parts) which have different symptoms, patterns and treatments. The most commonly recognized forms of diseases included under the umbrella term “arthritis” are:

• juvenile arthritis: forms of arthritis which differ from the kinds found in adults that may appear any time after birth, may be mild or serious, can change from day to day, and may include the symptoms of skin rash, fever, inflammation of the eyes, slowed growth, swelling of lymph nodes, fatigue, and swelling and pain in the muscles and joints;
• rheumatoid arthritis: an auto-immune disease in which the body’s immune system forms antibodies against itself and can involve chronic inflammation of joint membranes and tissues which may cause fatigue, weight loss, anemia, and stiffness and malformation of the joints in knees, hands and feet ;
• osteoarthritis: the most common form of arthritis, which involves the chronic breakdown of cartilage in the affected joints, such as fingers, hips, knees, spine and may result in painful bony growths in the finger joints;
• scleroderma (progressive systemic sclerosis)– meaning “hard skin”, a disease that may cause a thickening of the skin and problems with the blood vessels, joints, kidneys, lungs, digestive tract and bowels, and systemic lupus erythematosus (see “Lupus” for full definition).

Assistive Listening Devices: This term refers to personal (individual) acoustic communication equipment that could be made available in facilities such as public auditoriums to improve the transmission and auditory reception of sound for persons who are hearing impaired. Such equipment may include transmission of sound through an amplitude modulation signal (AM), a frequency modulation signal (FM), an audio induction loop (an antenna-type device which acts as a miniature transmitter/receiver) or an infrared light sound system (a system similar to an audio induction loop, but which uses infrared light to transmit and receive audio signals instead of electrical impulses). Legislation in New York State was passed in 1987 which requires that the Governor’s Press Room, the Senate and Assembly Chambers and the Hearing Rooms in the Legislative Office Building be equipped with assistive listening devices.

Asthma:  Asthma is a condition in which the air tubes (bronchial) of the lungs become narrowed by tightened muscles, mucus plugs, and swollen tissues causing difficulty in breathing. Many of the victims are young children. It accounts for about half of all chronic illness of childhood but can also affect adults. It may be caused by substances in the air to which an individual is sensitive, which causes an allergic reaction. Some of these substances are : pollens, molds, animal dander ; irritants like cigarette smoke, certain fragrances, etc. ; also certain food. It affects an estimated 6. 6 million persons throughout the United States (2. 7 million of whom are under 18 years old).

Ataxia: This is a rather uncommon type of Cerebral Palsy, varying between one to 15 per cent of the population of persons with CP. The person has a disturbed balance sense and has greatly decreased ability to maintain balance or coordination. The person may exhibit a high stepping gait and may stumble, lurch and fall easily. Nystagmus (involuntary rapid eye movement) and tremor of the head may be seen.

Athetosis: Athetosis is a type of Cerebral Palsy found in approximately 20 to 25 percent of children with CP. Purposeful movements are contorted and the person has abnormal posturing and uncoordinated jerky, uncontrollable, twisting movements of the extremities. The head is often drawn back with the mouth open. In trying to talk, the person may grimace. Ability to walk may vary according to circumstances, perhaps improving when the person is not anxious and is well rested.

Atlanto axial instability: Atlanto axial instability is a condition which affects 10 to 12 percent of individuals with Down syndrome. Common symptoms are: (1) neck pain; (2) head tilted and rotated; (3) progressive or transient weakness; (4) change in gait pattern; (5) increased clumsiness; (6) bowel or bladder incontinence; (7) hyperactive or spastic reflexes.  Treatment for this condition may include surgery. However, those individuals who are without symptoms may only need to have restrictions on some activities which flex and extend the neck such as tumbling, diving, etc. However, follow-up examinations and x-rays should be performed on a routine basis.

Autism: Autism can be defined as a bio-neurologically caused disorder of communication and behavior which can be present at birth or have its onset usually within the first 30 months of life. Autism occurs by itself or in association with other disorders which affect the functions of the brain such as viral infections, metabolic disturbances, and epilepsy. Characteristics of this developmental disability may include: slow development or lack of physical, social and learning skills, immature rhythms of speech, limited understanding of ideas, and use of words without attaching the usual meaning to them, abnormal responses tosensations such as sight, hearing, touch, pain, balance, smell, taste, the way a child holds his body, abnormal ways of relating to people, objects and events and repetitive movements such as rocking and spinning, head banging and hand twisting. Any one or a combination of these symptoms may be evident.

Blind and Visually Impaired See “Visually Impaired”

Cardiovascular Disease: A classification which encompasses a number of different problems of the heart and circulatory system such as high blood pressure (hypertension), hardening of the arteries (arteriosclerosis), coronary heart disease (disease of the veins or arteries of the heart), and rheumatic carditis (inflammation of the heart). These diseases may occur alone or in conjunction with other disabling conditions.

Cerebral Palsy: Cerebral Palsy is a neuromuscular disability resulting from damage to the central nervous system occurring before birth, at the time of birth, or during the early years of life. Manifestations of the condition range from mild motor coordination impairment to severe motor incapacity and sometimes, is associated with more extensive conditions which may include intellectual, sensory, behavioral and perceptual problems, often in combination. Also see Ataxia, Athetosis.

Chronic Bronchitis: Chronic Bronchitis is an inflammation of the lining of the tracho-bronchial tree which causes abnormal secretion of fluids and mucus and interferes with the function of cilia which helps cleanse the respiratory tract. Frequently, it causes coughing and spitting. Contributing factors are smoke and air pollution, certain allergens and infections. The term, chronic, is applied when coughing and spitting continue for long periods of time and return each year, generally lasting slightly longer with each occurrence. Cigarette smoking is a major contributing factor. It affects an estimated 13. 7 million persons each year throughout the United States.

Communication Disorder: A disorder in one or more of the processes of speech, hearing or language which interferes with the ability to speak, understand or use language. Such disorders may be developmental or acquired, may range from mild to severe, and may or may not be associated with a handicapping condition.

Community Residence (CR): A CR is a living situation in a single-family dwelling (or comparable structure) with common living areas (i.e. kitchen, living room) which offers persons who are disabled, shelter, meals, companionship and social and recreational activity in a homelike environment. A CR may be operated by a public, proprietary or voluntary non-profit agency, and funded through a variety of state, federal and local resources. Funding may be supplemented by resident contributions. Day-to-day operations, programming and long-term planning for the individuals living in the CR are the responsibility of the operating agency. Programs in the CR include instruction in activities for daily living. A primary daytime program outside the home must also be provided for every resident (see Day Treatment and Day Training for definitions) and can include a full range of medical and specialized therapeutic services; education programs; habilitation training; sheltered workshops and vocational training.

Cystic Fibrosis (CF): CF is an inherited disease of children, adolescents and young adults that affects the exocrine, or externally secreting, glands of the body. These glands discharge their secretions onto the skin (sweat glands), or into organs which connect to body openings, such as the lungs and intestines, either directly or through special ducts. In CF, the mucus-producing glands fail to produce normal, clear, free-flowing fluid. Instead, they secrete a thick, sticky mucus which tends to clog and block the ducts. This abnormal mucus accumulates in various parts of the body and interferes with vital functions, such as breathing and digestion. Cystic Fibrosis affects not only the mucus-secreting glands, but also the glands that produce sweat, as well as the salivary glands. As a result, the secretions of these glands usually contain an excessive amount of salt, resulting in a salty taste of the skin. Some of the other symptoms of CF which may at first be attributed to other conditions (i. e. chronic bronchitis, asthma, or a disorder of intestinal absorption called celiac disease) are: a lingering cough; wheezing; repeated respiratory infections (such as pneumonia or bronchitis); failure to grow or gain weight despite a good appetite; bowel movements that are frequent, bulky, and foul-smelling; pain in the abdomen ; and, rectal prolapse (protruding of the rectum caused by large bowel movements). Legislation was passed in 1987 that provides for the cost of health care of persons with cystic fibrosis over the age of 21. Public Health Law. Chapter 851.

Deaf and Hard of Hearing: A hearing disorder is a reduced sensitivity to sounds, reduced hearing levels and / or damage to the auditory system (ear, inner ear and connective nerves to the brain) which interferes with the ability to develop, understand, produce or maintain speech or language usage. Hearing disorders include two major classifications: hard of hearing — a mild to moderate reduction in the ability to hear which interferes with the ability to communicate; and deafness — a hearing loss that is so severe that with or without an assistive hearing device, a person cannot always depend upon hearing to communicate with others. There are many types, causes, and degrees of severity of hearing disorders, as well as involvement with other disabilities (i. e. blind-deaf). Kinds of deafness include: congenital deafness — deafness occurring at birth; nerve deafness or sensorineural hearing 1088 — results from damage to the delicate sensory nerves of the inner ear commonly occurring during the aging process and from sudden or extended exposure to loud noise; Meniere’s Disease — a disease of the inner ear which may include symptoms of fluctuating hearing loss, dizziness, tinnitus (ear noise including ringing, buzzing, clicking) and/or a feeling of fullness in the ear. One method used to help people with hearing impairments is the utilization of a hearing aid — a device which amplifies sound. There are basically four types of hearing aids: post auricular (ear level) which fits behind the person’s ear; “all-in-the-ear” which fits directly into the person’s ear canal; a body aid worn in a pocket on the person’s chest with a cord going to the ear; or, an eyeglass aid, which is connected to the eyeglasses. (For more information see Assistive Listening Devices and Sign Language.)

Deinstitutionalization: Refers to the discharge of people from institutions for the purpose of changing the manner in which treatment is provided from being solely an institutionally-based system to one of community-based treatment and support services.

Developmental Disabilities: Diabetes (Diabetes Mellitus) Diabetes Mellitus is a chronic metabolic disorder (metabolism is the process by which the body takes the food we eat and breaks it down into elements and compounds that the cells can use to build and repair tissue, and to produce energy to sustain life) which adversely affects the body’s ability to manufacture and utilize insulin, a hormone necessary for the conversion of food into energy. The body makes a substance called glucose from the sugars and starches [carbohydrates] that we eat. In order for the body to use glucose properly, it needs insulin. Insulin regulates the amount of glucose the body can use. If the glucose is not processed properly, too much remains in the blood stream, instead of being used by the cells to produce energy. The body is then starved of that energy. People who have diabetes are not able to produce enough insulin. There are two types of diabetes:

• Juvenile diabetes (Type I) the more severe form of the disease, can appear at any age, though most commonly from infancy to the late thirties. Juvenile diabetics must take daily insulin injections to stay alive.
• Maturity-onset diabetes (Type II) usually begins in the middle or later years. Treatment is usually through diet and weight control, although oral medication or insulin may be required in some cases.

Diabetes often leads to heart disease, stroke, kidney disease, gangrene, nerve damage and adult blindness. Symptoms of diabetes include: unusual thirst, frequent urination, abnormal hunger, sudden weight loss, skin disorders and infections, blurred vision, and unexplained weakness or fatigue.

Down Syndrome: Down Syndrome is a genetic birth defect which occurs in about one out of 800 births causing varying degrees of delayed development and effects all nationalities, ethnic and socio-economic groups. The individual with Down syndrome has an extra chromosome on the twenty-first chromosome thereby giving that person 47 instead of the normal 46 chromosomes. This condition may be associated with certain physical features, some degree of mental retardation and medical problems such as congenital heart disorders, low muscle tone and loose joints, hearing loss and susceptibility to respiratory infections. Individual mental abilities, behavior, and developmental progress vary considerably. Because of this great variability, it is crucial that each individual is evaluated for placement into a school or work situation on the basis of his or her own needs and skills rather than as a category of handicapping condition.

Dyslexia (or Learning Disabilities): A term used to describe those children and adults with average or above average measured intelligence who have severe difficulty in reading, writing and spelling. One of the more obvious characteristics of Dyslexia is severe difficulty in the identification (naming) of printed words or symbols which impairs all other aspects of reading, such as comprehension.

Emotionally Disturbed/Emotionally Handicapped: Educationally, according to Part 200 (Handicapped Children) of the Regulations of the Commissioner of Education, this term refers to a pupil who has an inability to learn which cannot be explained by intellectual, sensory or health factors, and who exhibits one or more of the following characteristics to a marked degree and over a long period of time: an inability to build or maintain satisfactory interpersonal relationships with peers and teachers; inappropriate types of behavior or feelings under normal circumstances; a generally pervasive mood of unhappiness or depression; or a tendency to develop physical symptoms or fears associated with personal or school problems. The term does not include socially maladjusted pupils unless it is determined that they are emotionally disturbed.

Emphysema: Emphasema is a non-revesible pulmonary disease causing extreme shortness of breath and eventual death. In this disease, the broncial tubes of the lungs become blocked with mucus plugs and infection, inhibiting passage of air into and out of the aveoli (air sacs). The disease is characterized by destruction of these sacs which lose their elasticity, swell and rupture thereby interfering with the exchange of oxygen and carbon dioxide in the breathing process. Emphysema affects more than 2 million persons throughout the United States and is third among diseases for which Social Security provides disability benefits. Cigarette smoking is a contributing factor.

Encephalitis: This term means “inflammation of the brain. ” There are many types, most of which are due to virus infections, and which can damage one or many parts of the brain. It can be a frequent cause of learning and behavior disorders because of the resultant brain dysfunctioning.

Epilepsy: Epilepsy is a common neurological condition which is sometimes called a seizure disorder. Although the cause is unknown in approximately half of the cases, some known causes include : problems before birth, such as infections, anoxia (lack of oxygen to the brain), and trauma (injury to the fetus) ; problems during birth, such as trauma, anoxia and infections ; head injuries; infectious diseases (meningitis, encephalitis, or brain abscess); toxic factors, such as lead or mercury poisoning; tumors of the brain ; inherited or degenerative diseases, such as phenylketonuria (PKU) (see term for definition); and strokes. Epilepsy is characterized by brief, temporary changes in the normal functioning of the brain’s electrical system. These brief malfunctions mean that more than the usual amount of electrical energy passes between cells. This sudden overload may stay in just one small area of thebrain, or it may swamp the whole system. The type of seizure activity indicates the area of the brain in which the overload occurs. The most common seizure types include:

• Absence seizure (petit mal): a few seconds of loss of consciousness, during which there may be staring, eye blinking or facial twitching;
• generalized tonic-clonic seizure (grand mal): Generalized convulsive seizure (effecting the whole body) lasting one to three minutes in which the person falls and becomes unconscious, the body stiffens, the muscles begin alternate periods of spasm and relaxation, the person may pass urine and/or bite the tongue or stop breathing, and when the person regains consciousness may be confused, sleepy, fatigued, have a headache, speech difficulty, or weakness of the limbs;
• complex partial seizure (psychomotor or temporal lobe): usually not remembered by the person afterwards and often characterized by purposeless activity. This seizure varies greatly from person to person with symptoms which may include a glassy stare, no or confused response, moving about aimlessly, lip-smacking or chewing motions, fidgeting with clothes, appearing drunk or drugged or psychotic, abnormalities in thinking, and unusual sensory perceptions.

Some people can experience a seizure and not have epilepsy. For example, many children have convulsions from fevers. Other types of seizures not classified as epilepsy include those caused by an imbalance of body fluids or chemicals or by alcohol or drug withdrawal. A single seizure does not mean the person has epilepsy.

Foster Care Home: A private home certified by an agency (i. e. Department of Children and Families) providing a family life experience for those who need care for a temporary or extended period.

Genetic Disorder and Hereditary Disorder: Terms which are sometimes used interchangeably to describe a disease or condition passed from parent to child, but not necessarily from generation to generation, which can be identified as an error in a chromosome (thread-like bodies into which a cell nucleus divides during the process which forms the fetus) which is the carrier of genes (the biological determiners of the characteristics a fetus will have) and which may result in birth defects, disabilities or syndromes such as hemophilia, Tay-Sachs Disease, and Down Syndrome. (See terms for definitions.)

Guardianship: Guardianship is a legal proceeding in the Court which designates a parent, relative, friend or an organization to act on behalf of an individual who is mentally retarded and unable to manage his or her personal affairs without assistance.  Guardianship enables parents to ensure that they or other designees of their choosing may act as an advocate with legal authority on behalf of their children in protecting their rights and fostering their quality of life. The process empowers a guardian to maximize all available resources for the benefit of the person who is mentally retarded.  In Florida, parents of persons who are mentally retarded are considered the natural guardians of their children, as with any other child, until such child’s eighteenth birthday (age of majority). After a person turns 18, he or she is deemed legally competent. Guardianship authorizes parents to exercise legal supervision of their children and provide them with lifetime protection even after they reach the age of 18.

Head Injury: Serious head injuries usually result in prolonged loss of consciousness or coma. While it may be brief, lasting only a few minutes, it may extend to days or weeks. If the period of coma is brief, recovery to full or nearly full function is likely ; but as time in coma lengthens, emergence to a fully alert state can take a long time. The result of head injury can be intellectual impairment, speech problems, behavioral disorders and related physical disabilities. Most head injuries are due to accidents, but similar problems can result from conditions such as encephalitis (see term for definition), lack of oxygen to the brain and cerebral hemorrhage.  A person who is head injured may experience a range of physical, cognitive, and/or psychosocial symptoms in varying degrees:

• Physical symptoms: aphasia, visual impairment, hearing impairment (see terms for definitions), physical disability (including orthopedic involvement), spasticity, hemiparesis (a slight paralysis or weakness of one half of the face or body), paraplegia, and seizures;
• Cognitive symptoms: deficits of short-term or long-term memory, perception, concentration, attention, planning and judgment, lack of foresight, decreased capacity for abstract thinking, difficulty in generalization, and spatial disorientation;
• Psychosocial (including behavioral and emotional) symptoms: fatigueability, euphoria, denial, egocentricity, lack of self-esteem, disinhibition, depression, sexual dysfunction, inability to cope, and agitation.

While any or all of these symptoms may occur in varying degrees, factors which effect the outcome of head injury include: age at the time of injury, location of the areas of brain dysfunction, severity of the brain damage and the length of coma, time lapse between the occurrence of injury and the initiation of treatment, pre-existing intellectual skills, pre-existing personality characteristics, type of environment since the injury, motivation for recovery, family members’ involvement, and rapid entry into a rehabilitation facility with programs for head injured persons.

Head Start: Head Start is a Federal project which provides a comprehensive child development program for income eligible preschool children between ages three and five and their families. Services offered to each child include educational programs, a parent program and social services. Health services, including medical, dental, nutritional and mental health care are also provided. The Head Start program has developed a national network of Resource Access Projects (RAP) which assist local Head Start professionals in the implementation of services children with handicapping conditions. RAP staff provide training and technical assistance in New York State, and work with schools and other agencies in facilitating the transition of these children from Head Start to local district programs. They also collaborate with the State Education Department and other agencies in developing plans for serving preschool children who are handicapped to ensure maximization of limited resources.

Hemiplegia: Paralysis on one side of the body, usually referred to as a stroke. It may be caused by damage to the brain (on the side opposite the affected side), occurring from thrombosis (a blood clot within the blood vessel), embolism (obstruction of a blood vessel by a solid body like fat globules or tumor cells) or cerebral hemorrhage, or, less commonly, from a head injury or brain tumor.

Hemophilia: A primarily hereditary life-long blood clotting disorder, which affects males almost exclusively, and is caused by the inactivity of one of the blood proteins necessary for clotting. A hemophiliac does not bleed faster than anyone else, but may bleed for a longer period of time due to the clotting problem. One of the major problems associated with this disorder is uncontrolled internal bleeding which can begin spontaneously without apparent cause. Over a period of time, bleeding into joints can cause permanent damage and chronic pain.

Hydrocephalus: Hydrocephalus, or “water on the brain, ” is a birth defect, the cause of which is not always clear. It can develop before birth in association with an infection, or begin at the time of birth as the result of a brain hemorrhage caused by birth trauma, or later in childhood as a complication of meningitis (infection of the cover of the brain). The so-called “water” is actually cerebrospinal fluid (a liquid which cushions and protects the brain and spinal cord from shock). The fluid is produced in the ventricles (cavities) of the brain, and normally flows through the ventricles, bathes the surfaces of the brain and spinal cord, and is absorbed into the bloodstream. In hydrocephalus, however, the fluid gets trapped in the ventricles and does not enter the bloodstream. The excess fluid causes the  ventricles to expand and the brain to become larger. As a result, pressure is exerted on the skull and the fontanels (a baby’s “soft spots”), and the head begins to grow. Unless relieved quickly, brain damage may result. It can cause mental retardation, blindness, seizures and motor impairment. Often, hydrocephalus can be treated by the surgical insertion of a shunt (a tube from the brain to another part of the body). This tube permits the fluid to be drained to another part of the body, where it is absorbed into the bloodstream.

Hyperactivity (Hyperkinetic Syndrome): Hyperactivity is often used interchangeably with the term “hyperkinesis. ” Hyperkinesis describes a condition in which the individual displays a high degree of physical activity which has no purpose, plus a significantly impaired attention span. The person is unable to control motion and/or attention. Many physicians have described hyperkinesis as a treatable illness characterized by involuntary behavior and learning problems in a child whose brain maturation is delayed.

Immune System: The immune system is the body’s basic defense against infection. In simple terms, it involves white blood cells, which contain antibodies or disease fighters, resisting foreign bodies or infection. Immunity can be innate (from inherited qualities) or it can be acquired actively or passively, naturally or artificially. Active immunity is acquired naturally during an infectious disease, or artificially by vaccination; passive immunity is acquired naturally when maternal antibody passes to the child through the placenta (organ developed in approximately the third month of pregnancy through which the fetus is supplied with nourishment and oxygen, and through which the fetus gets rid of its waste products) or in the milk, or artificially by administering immune sera (watery portions of blood remaining after coagulation) containing antibody. The immune system is usually beneficial because it protects the body, but sometimes the antibodies can be harmful such as in causing the body to reject a transplanted organ.

Incontinence: The inability to retain the evacuations of the bowels or bladder, or both, sometimes caused by a disorder of these organs, but more often by injuries to or diseases of the spinal cord and brain, including traumatic paraplegia and spina bifida. (See terms for definitions.)

Institutionalization: A term referring to the placement of a person in a non-community based residential care facility (i. e. Developmental Center) which houses and provides services for a large number of residents.

Intermediate Care Facility (ICF): A supervised living facility for people who are developmentally disabled, which provides additional health and rehabilitative services. Funded through Medicaid with a 50% federal share, the rest of the expenses are covered by matching state and county funds. Individuals in an ICF do not require the degree of care or treatment which a hospital or skilled nursing facility is designed to provide, but because of their mental or physical condition, they require care and services above the level of room and board.

Kidney Disease: Kidneys are organs responsible for filtering or cleansing the blood, and secreting waste from the body to the bladder in the form of urine. Kidney disease is a general term that includes diseases ranging from urinary tract infections, to kidney stones (a hardening of mineral salt around organic material found in the kidney), to more serious disorders such as polycystic kidney disease– a progressive hereditary disease in which cysts that increase in size form in the kidneys and may eventually cause kidney failure; nephrosis– a condition that causes the kidneys to remove too much protein from the blood as it is filtered through the kidneys, causing the kidneys to retain excess amounts of salt and fluid resulting in swelling around the eyes, abdomen, ankles and hands; and, chronic kidney failure–gradual and permanent loss of kidney function which allows harmful waste products and fluid to accumulate in the body resulting in growth stops or delays, elevation of blood pressure, fatigue and poor appetite.

Language Disorders: Language Disorders include, but are not limited to, impairment or deviant development of comprehensive and/or use of spoken, written and/or other symbol system (e. g. sign language, augmentative communication systems, etc. The disorder may involve (1) the form of language (phonologic, morphologic and syntactic systems), (2) the content of language (semantic) system and / or (3) the function of language in communication (pragmatic) system in any combination.

Learning Disabilities: In 1975, the Federal government defined learning disabilities in Public Law 94-142, The Education of All Handicapped Children Act, (see term for definition) as follows: “Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations. The term includes such conditions as perceptual handicaps, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. The term does not include children who have learning problems which are primarily the result of visual, hearing or motor handicaps, mental retardation, emotional disturbance or environmental, cultural, or economic disadvantage.” In 1981, the Rehabilitation Service Administration accepted learning disabilities in adults as a medically recognizable disability which enabled such individuals to receive job training services under the following definition: “Specific learning disabilities is a disorder in one or more of the central nervous system processes involving perceiving, understanding and/or using concepts through verbal (spoken or written language) or nonverbal means. This disorder manifests itself with difficulties in one or more of the following areas: attention, reasoning, memory, communicating, reading, writing, spelling, calculation, coordination, social competence, and emotional maturity. The resulting disorder must result in a substantial handicap to employment.” Although defined in these instances, each child, adolescent or adult with learning disabilities shows a different combination and severity of problems. Characteristics used in diagnosing learning disabilities include: short attention span, poor memory, difficulty following directions, inadequate ability to discriminate between and among letters, numerals, or sounds, poor reading ability, eye-hand coordination problems, difficulties with sequencing, disorganization and numerous other problems which may affect all of the sensory systems.

Least Restrictive Environment (LRE):  The concept of the least restrictive environment (LRE) is stated in Federal law (see “Public Law 94-142”) and implemented through efforts of states and local school districts. LRE assures the opportunity for each student with an educational handicap to receive programs and support services which consider each child on an individual basis. In other words, children should not be placed into a more segregated setting because that is the only place that the appropriate program exists or because of lack of space in public school buildings. A child should only be placed into a more restrictive setting when it is proven by the CSE that the child cannot benefit from being in an integrated environment.

Limited Mobility: A term which generally refers to the inability of an individual to move about easily because of a physical disability. This term also refers to the situation which exists due to the lack of accessible transportation systems and services which severely limits the ability of persons who are elderly and disabled to travel easily locally and statewide.

Long Term Care: A general term used to describe the services provided in any type of facility where individuals or patients stay for longer than 30 days at a time. A hospital is generally not a long term care facility.

Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease): Amyotrophic lateral sclerosis is a rapidly progressive neuromuscular disorder of adults resulting from degeneration of the motor nerves in the spinal cord and brain stem, and leading to atrophy (wasting away or shrinking) of the muscles controlled by these nerves in the hands, arms, feet, legs, and tongue. It can produce a combination of both flaccid (weakness, lack of control) and spastic (involuntary muscular contraction) paralysis which may cause difficulty in swallowing, speaking and breathing.

Lupus (Lupus Erythematosus): Lupus erythematosus, or Lupus as it is commonly known, is a chronic inflammatory disease affecting connective tissue. It may affect only the skin in some people; in others it may affect virtually any organ in the body, including the skin, joints, kidneys, brain, lungs, heart, blood and immune system. Lupus can be present in varying degrees of severity, from mild to severe. There are two main types of Lupus, depending on which part of the body is affected. The first type is called Discoid Lupus. It involves only the skin, usually on the face, neck, and sometimes the upper chest. It may cause raised, scaly areas of the skin. The second type of Lupus, usually more severe, is called Systemic Lupus. It involves the internal systems of the body and organs. A skin rash may be present in both types. It is not contagious nor is it thought to be hereditary. Since Systemic Lupus can affect any part of the body, there are a great variety of symptoms that can be present. The most commonly present symptoms are: fatigue, pain in the joints or chest, unexplained low-grade fever, red skin rash (often a butterfly shaped rash across the bridge of the nose and cheeks, frequently occurring after sun exposure), abnormal hair loss, and, blanching of ringers after exposure to cold.

Mainstreaming: A term, when used regarding special education (see term for definition), that refers to the integration of children with disabilities into programs and courses of study attended by their non-disabled peers. This may be done for purposes of academic and/or social reasons.

Medicaid: Medicaid (Medical Assistance Programs– Title XIX) is a federally-aided, state-operated and administered program, to provide physical and related health care services to persons with low incomes. Persons with disabilities may be eligible for Medicaid on the basis of their income. Eligibility is determined by the State program of public assistance (welfare) on the basis of broad federal guidelines, so there are geographic differences between eligibility requirements and types of services covered. Each state establishes its own eligibility requirements for Medicaid. Generally, persons may be eligible if they are receiving welfare or other public assistance benefits, or Supplemental Security Income (see term for definition), or are blind or disabled. Individuals with higher incomes may be eligible for Medicaid Supplemental Medical Care Assistance, or their children may be eligible if medical expenses exceed a given percentage of their annual income.

Medicare: A nationwide, federal health insurance program (Title XVIII) designed to serve everyone over 65 years of age and persons who are disabled under 65 years of age who have been entitled to receive Social Security disability benefits for a total of 24 months; or who need dialysis treatments or kidney transplant because of permanent kidney failure. The program is not based on income, but is available regardless of financial need. The Medicare program has two parts: Part A– hospital insurance at no cost that helps pay for care while in the hospital and for related health care services after leaving the hospital; and Part B– voluntary medical insurance at a monthly premium that helps pay doctor bills and other approved medical services.

Mental Illness: A term used to describe a chronic or intermittent disability which is associated with an impairment of one or more important areas of functioning such as social behavior, rational thinking, feeling or judgment. Symptoms and types of mental illness are varied from individual to individual, and may include neurological, biochemical, genetic and perhaps viral reasons, making diagnosis and treatment difficult. Mental illnesses include: neurosis– a functional disorder that can be in the form of anxiety, reactive depression, hysteria and obsession which arises as a result of stress and anxieties in the individual’s environment; psychosis– a mental illness arising in the mind itself (as opposed to neurosis in which the mind is affected by factors in the environment) which is so severe that it involves loss of contact with reality; and schizophrenia (see term for definition).

Mental Retardation: This term refers to subaverage general intellectual functioning (as defined by various tests which measure intelligence) in, or associated with, impairments in adaptive behavior (adjustment to everyday life), and manifested during the developmental period (birth to age 22). Persons with mental retardation are those who mature at a below average rate, and experience unusual difficulty in learning and social adjustment. Difficulties may occur in learning communication, social, academic, and vocational skills. The amount of difficulty experienced depends upon the person’s age, mental ability, and developmental stage. Persons who are Mildly retarded are in many respects quite similar to their typical peers. While still young their retardation is not readily apparent. Persons who are Moderately retarded are more obviously handicapped, and their retardation is usually apparent before school age. Persons Severely or profoundly retarded have obvious intellectual impairments and frequently have other handicaps such as cerebral palsy, epilepsy, blindness, or deafness. Mental retardation is not a disease, and although there are more than 250 specific identified causes, in most cases, the exact reason is unknown.

Multiple Handicap: Generally, this term refers to a person with two or more disabilities. In relation to education, “multiple handicapped” refers to a pupil with two or more handicapping conditions that result in multisensory or motor deficiencies and developmental lags in the cognitive, affective, or psychomotor areas, the combination of which cause educational problems that cannot be accommodated in a special education program solely for one of the impairments.

Multiple Sclerosis (MS): Multiple Sclerosis (meaning many scars) is a disease that affects the brain and the spinal cord. The brain sends messages through the spinal cord to the muscles throughout the body to tell the body what to do. When a person has MS, the covering (myelin) that protects the nerves in the brain and the spinal cord is scarred so that the message cannot always get through. Symptoms of MS vary greatly depending upon where the sclerosed patches are formed in the central nervous system, and might include eye trouble, speech problems, partial or complete paralysis of any part of the body, tingling sensation, poor coordination, unusual fatigue, and loss of bladder and bowel control.

Muscular Dystrophy: This term is used to designate a group of muscle-destroying disorders which vary in hereditary pattern, age of onset, initial muscles attacked, and rate of progression. These disorders include, but are not limited to :

• Duchenne Muscular Dystrophy (DMD): one of the most common and rapidly progressive forms of muscular dystrophy (a wasting away of the muscle tissue) which develops early, usually between ages 2 and 6, in the large muscles of the lower trunk and upper legs, and results in difficulty in walking and raising the arms above the head;
• Facio-Scapulo Humeral Dystrophy: a disease of slow progression, usually evident in the teen years, which begins in the muscles of the face (facio), shoulder (scapulo), and arms (humeral) and may sometimes result in involvement of the trunk and leg muscles; and,
• Myotonic Dystrophy: a disease which usually affects adults that is characterized by progressive weakness (dystrophy) and inability to relax muscles after contraction (myotonia) and which may include cataracts, diabetes (see term for definition), and personality changes.

Myasthenia Gravis: A chronic neuromuscular disease (see term for definition) characterized by intermittent muscular weakness of variable degree and duration. It can begin at any age, but most often appears among women in their 20’s and men over 40. Any muscles may be affected. Initially, those most commonly involved are muscles of eye movement, facial expression, and eyelid elevation. In mild cases, weakness may be limited to these muscles, and function is regained after rest. In more severe cases, the disease may later affect muscles of the limbs and of respiration, chewing and swallowing; strength may not improve even with prolonged rest.

Neurofibromatosis: Neurofibromatosis, also known as Von Recklinghausen’s disease, is a usually progressive genetic disorder characterized by the abnormal growth of body tissue, primarily nerve tissue. There are a variety of signs, including initially the appearance of light brown spots on the skin (called “cafe-au-lait” spots) and later the development of multiple tumors on or under the skin. Neurofibromatosis lesions (changes in body tissue) may occur in any part of the body. The tumors can lead to disfigurement, deafness, blindness, the dysfunction of many organs, deformity of limbs, learning disabilities, epilepsy, and mental retardation. John Merrick, a nineteenth-century Englishman whose life was depicted in the book, play, and film entitled “The Elephant Man, ” had an unusually severe form of the condition. Neurofibromatosis may be inherited from a parent who has the disorder, or it may result from a spontaneous change in the developing fetus.

Neuromuscular Diseases: This term refers to diseases which affect the nerves and muscles. These diseases include those of the peripheral nervous system (see Friedreich’ s Ataxia and Charcot-Marie-Tooth disease); metabolic diseases of the muscle which affect voluntary muscles and are characterized by inherited chemical deficiencies; diseases of the neuromuscular junction (see Myasthenia Gravis); spinal muscular atrophies which are characterized by degeneration of the motor nerve cells in the spinal cord (see “Lou Gehrig’s Disease” /Amyotrophic Lateral Sclerosis); and the muscle destroying disorders called muscular dystrophies (see Muscular Dystrophy).

Occupational Therapy: A skilled profession which assesses and treats persons who are physically, developmentally and / or emotionally disabled by using selected purposeful activities to promote development or return of function. Occupational therapists are trained to build or rehabilitate the basic skills involved in everyday living by developing treatment activities and by adapting materials to suit the special needs of the individual who is disabled. They focus on fine motor activities, especially the use of hands and fingers, on coordination of movement, and on self-help skills. Occupational therapists work in hospitals, rehabilitation centers, nursing homes, public and private schools and home health agencies. They also act as consultants to health care facilities, and an increasing number have private practices.

Paraplegia: A term meaning total or partial paralysis of both lower limbs. Paraplegia is caused by injury or disease involving the spinal cord. Below the level of the damage, there is locomotor paralysis and sensory loss. Bladder and bowel function may be affected.

Parkinson’s Disease: A chronic progressive nervous disease of later life that can result in tremor and weakness of resting muscles, and jerky movements. This disease involves the progressive loss of brain cells in an area of the brain called the basal ganglia (at the base of the brain) which is responsible for balancing the activity of opposing muscles; and a progressive deficiency of a chemical called dopamine, which transmits messages from muscle cells to the brain.

Phenylketonuria (PKU): An inherited disease that, if untreated, causes mental retardation. It affects the way the body is able to process the food it takes in– the child cannot metabolize part of the protein (phenylalanine), which then collects in the blood stream. The abnormal build-up of phenylalanine can prevent the brain from developing as it should.  Each newborn infant must be tested for PKU unless medically contraindicated, in which case, the tests shall be performed as soon as the medical condition of the infant permits such testing. When an infant is born outside of an institution, it becomes the duty of the person required by Section 4130 of the Public Health Law to register the birth of a child to ensure that the tests are administered not later than the 14th day of life unless medically contraindicated, in which case, the tests must be performed as soon as the medical condition of the infant permits testing.

Physical Therapy: A treatment done by physical means. Physical therapists are concerned with the promotion of health, with prevention of physical disabilities and with the rehabilitation of persons who are disabled by pain, disease or injury. Physical therapy involves the evaluation of patients and the treatment of same through the use of physically therapeutic measures as opposed to medicines, surgery or radiation.

Polio (Infantile Paralysis): Before vaccines were made available to the public in 1955, polio was a common disease caused by a virus which could result in partial or total paralysis as the virus attacked the nerves which send messages to the muscles and limbs. Although, due to the vaccine, polio is no longer a major health problem, individuals who had polio 30 or 40 years ago have recently found that muscles are becoming weaker and shrinking or atrophied (Post-Polio Muscle Atrophy) causing difficulty in breathing, and pain in muscles and joints.

Prader-Willi Syndrome: Prader-Willi syndrome is a birth defect of unknown origin; it is not inherited, nor is it caused by brain damage or prenatal trauma. A dysfunction of the central nervous system, this disorder develops in two stages, beginning with certain characteristics detectable during pregnancy. Infants display characteristics which may include: reduced movement in the womb, low birth weight, hypotonia (poor muscle tone), lack of ability to control head and limbs, weak cry, poor sucking reflex, poor appetite, ability to hold head erect, delay in sitting, walking, talking and mental retardation. Between the ages of 1 and 4, an uncontrollable appetite develops.  In adults, significant characteristics may include : short stature (average height of five feet); small, tapering, puffylooking hands and feet; lack of muscle tone; underdeveloped genitals or incomplete sexual development; strabismus (wandering or crossed eyes); stubbornness or temper tantrums; picking at sores or insect bites; and diminished sense of pain. Persons with Prader-Willi have an on-going need for multidisciplinary case management, including the following: nutritional services, pediatric or family medical services, endocrinological services, genetic counseling, psychological or psychiatric services, and occupational and physical therapy.

Quadriplegia/Tetraplegia: Paralysis of all four limbs, caused by traumatic injury or disease to the nerve cells of the spinal column in the neck. The most common causes of injury are diving accidents, falls, traffic accidents (where the head is thrown forward following deceleration of the body) and war injuries.

Reasonable Accommodation: A term which currently has no universally accepted legal definition, but which refers to adaptations made (particularly in the workplace) to enable a person with disabilities to more easily utilize equipment and materials. The ” reasonable” aspect is that special equipment, physical alterations, or environmental adjustments would be cost-effective, and requests for such would be tempered with the realization that the determination of the accommodations needed may require compromise between the requester and the provider. Reasonable accommodations could range from a ramp to an extended pointer to enable someone (i.e. a person who is quadriplegic) who uses his/her teeth to hold such an implement to have access to a typewriter or computer; from a Braille writer or voice synthesizer which translates printed symbols to voice for use by a person who is visually impaired, to more technical adaptations as needed to enable people with disabilities to pursue their chosen interests, including satisfying employment.

Rehabilitation: A planned program in which a person with a disability progresses towards or maintains the optimum degree of mental, physical, and emotional independence of which he / she is capable. In relation to disability, “rehabilitation” can refer to many areas including vocational rehabilitation–job skills or post-secondary school training towards the attainment of gainful employment; and physical rehabilitation– treatment to restore or maintain mobility, muscle tone, etc. by physical and mechanical means such as massage, regulated exercise, water, light, heat and electricity.

Respite Services: The provision of intermittent temporary substitute care for the purpose of providing relief to the parent, guardian or caregiver for a person with disabilities who has remained in the home. Respite care enables the caregiver to maintain the person in the home, while reducing the burden of continual care. Among the services which could be provided are: supervision , personal care (i. e. feeding, bathing), recreation , day programming and medical care. Respite care can range from a brief length of time (under 24 hours) to a few weeks, depending upon circumstances, and can take place in a variety of settings, including: in-home care– care in the home of the person; provider home care–provided in the home of the person caring for the person temporarily; community residence respite– overnight or daytime short-term care provided in a certified community residence which is either State or agency operated; free-standing respite– a home or apartment specifically established and funded to provide respite services as its primary function; and, developmental center respite– overnight or short-term care in beds set aside by the center for community use.

Schizophrenia: A psychiatric diagnosis of disturbance characterized by disorganization of an individual’s personality, often resulting in life long episodes of ill-health and hospitalization. Onset is commonly in youth or early adult life, and can be either sudden or develop so gradually that it is well established before becoming apparent. Characteristics of this illness can include hearing voices, hallucinations, talking to oneself, and loss of ability to solve the problems of everyday living. Schizophrenia is not a “split personality” but a disorder, whose cause is uncertain, which destroys rational thought.

Scoliosis: Scoliosis is the medical term for lateral, or side-to-side curvature of the spine. Normally, the spine curves slightly from front to back, but has no sideways curvature and appears perfectly straight when viewed from the back. In the person with scoliosis the spine also curves from side to side. It can be so mild that the curvature is hardly visible, or so severe that the spine begins to look like the letter S.

Seizure: A brief, temporary change in the normal functioning of the brain’s electrical system (which relays messages to and from the brain and body components) causing a more than usual amount of electrical energy to pass between cells. This sudden overload may be localized in the brain, or it may take over the whole system. The results can range from a few seconds of loss of consciousness, to a generalized convulsive seizure effecting the whole body (the person becomes unconscious and falls, the body stiffens, the muscles begin alternate periods of spasm and relaxation). For further information see ” Epilepsy”.

Sheltered Workshop: A term commonly associated with a facility offering a recognized program of vocational rehabilitation for persons with disabilities. The rehabilitation is accomplished through paid and unpaid employment in the workshop, competitive employment in the community, and sometimes by using therapeutic programs like Work Activities or Work Adjustment Training (programs designed to enhance or hone an individual’s basic work skills and ability to interact in a work situation with peers and management). The workshop serves clients who are independent in basic social situations, and are productive in a work setting.

Sign Language: A way of communicating words, ideas and feelings using one’s body, hands, arms and face. There are many forms of sign language which include:

• American Sign Language (ASL): a visual-gestural (movement of body and/or limbs) language with vocabulary and grammar different from standard English ;
• Signing Exact English (SEE): a system, which is a grammatical and word-for-word method than other forms of sign language, that was devised to help hearing impaired children primarily in an educational setting to learn standard English (i. e. usage and sentence structure) for reading, writing and self-expression; and,
• Fingerspelling: the use of 26 different handshapes to represent the letters of the alphabet to spell out words.

Skilled Nursing Facility (SNF): A facility or distinct part of an institution (e.g. hospital or nursing home), that is licensed to provide inpatient care for persons requiring skilled nursing services for a chronic disease or convalescence, over a prolonged period of time.

Social Security Disability Insurance (SSDI): Social Security Disability Insurance (SSDI) benefits may be paid to a worker who is disabled, under age 65 and his/her family when earnings are lost or reduced due to the worker’s disability. You may be considered “disabled” if you have a physical (including visual) or mental impairment which (1) prevents you from working, and (2) is expected to last for at least 12 months or to result in death; for the purpose of SSDI a person is considered “blind” with central visual acuity of 20/ 200 or less in the better eye with the use of corrective lenses or visual field reduction of 20 degrees or less. (See “Visual Impairments” for explanation.) Before a worker and his or her family can get benefits, the worker must have credit for a certain amount of work under Social Security. The exact amount of work credit needed depends on the worker’s age. Children 18 or older, who were disabled before age 22, also can receive monthly benefits when either parent becomes entitled to retirement payments or dies after having worked long enough under Social Security. A widow or widower who is disabled, or surviving divorced wife age 50 or older who is disabled, may be eligible for monthly survivors payments when a worker dies. For information on the specific criteria for eligibility, contact the local Social Security office.

Spasticity: Spasticity is the most common type of Cerebral Palsy. It is found in about 50 to 60% of cases, mostly with hemiplegia (paralysis of one side of the body) or less likely, with quadriplegia (total paralysis of the body from the neck down). The muscle tone is increased, and there is increased resistance to passive movement. When the muscles are stretched, as in attention to movement, there is an increased stretch reflect and the muscle contracts strongly, involuntarily and inaccurately.

Special Olympics: Special Olympics Games consist of competitions in track and field, swimming, gymnastics, basketball, volleyball, floor hockey, bowling, iceskating, soccer, frisbee disc, winter activities, wheelchair events and other sports. Another feature of the games is sports clinics in a variety of activities conducted by professional and amateur athletes. Local, area, sectional, and state games are scheduled throughout the year. State games are for Special Olympians who have qualified through local and area meets. Eligible participants are those individuals (8 and older) who have been assigned to programs for the persons who are mentally handicapped. Volunteers provide the manpower for Special Olympics. They come from schools, colleges, service clubs, parents ‘ groups, youth agencies, sports officials, coaches’ organizations and professional groups in education, special education, physical education and recreation.

Speech-Language Pathology: Speech language pathologists are concerned with the assessment and treatment of speech and language disorders in children and adults. They are best qualified to offer assistance to persons with communicative disorders. Services provided by speech-language pathologists include: Preventing, evaluating and treating disorders of verbal and written language, articulation, voice, fluency, mastication, deglutition, cognition/communication, auditory and/or visual processing and memory, and interactive communication. Determining the need for augmentative communication systems (sign language, gesture systems, communication boards, electronic automated devices, mechanical devices) ; selecting and developing the most effective and functional communication system; and, providing training in maximal utilization of the system selected. Speech disorders include, but are not limited to, difficulty with articulation, e. g. disturbances of vocal quality, pitch, loudness; fluency disorders, including stuttering, or other disruptions of spoken language, e. g. a disruption in the fluency of verbal expression which occur frequently or are marked in character and are not readily controllable. Speech disorders may reflect developmental delays or deficits, neuropathologies of many kinds, and/or reflect difficulties inherent in the child or adult’s environment. Speech and language problems are often found to co-exist together.

Spina Bifida: Spina bifida means cleft spine, which is an incomplete closure in the spinal column. The three types of spina bifida (from mild to severe) are:  Spina bifida occulta– there is an opening in one or more of the vertebrae (bones) of the spinal column without damage to the spinal cord ; Meningocele– the meninges, or protective covering around the spinal cord, have pushed out through the opening in the vertebrae in a sac called the “meningocele, ” but the spinal cord remains intact; Myelomeningocele– not only are there openings in the vertebrae, but the spinal cord itself does not close. It usually protrudes from the back. Most children born with an open spine also develop hydrocephalus (see term for definition). Another closely associated problem is Arnold-Chiari Syndrome, in which part of the lower brain may protrude downward into the spinal canal. Many people with spina bifida have some additional handicaps such as bladder and bowel dysfunction, paralysis of the legs or lack of sensation.

Stuttering: Stuttering is a speech disorder characterized by interruptions in the flow of speech. These disruptions in fluency present themselves primarily as repetitions, prolongations, hesitations, or blocks on the individual sound or word level. Although the exact cause of stuttering is unknown, current theories suggest organic, functional, and I or behavioral (causative) factors. Therapy and treatment of stuttering is conducted by a certified speech-language pathologist (see “Speech-Language Pathology” for definition).

Supplemental Security Income (SSI): Supplemental security income (SSI) makes monthly payments to persons who are aged, disabled, and / or blind who have limited income and resources (assets). To receive SSI payments on the basis of disability or blindness, you must meet the social security definition of ” disabled” or “blind”. You do not need any social security work credits to get SSI payments (see “Social Security Disability Insurance” for comparison). People may be eligible for SSI even if they have never worked. And, people who get SSI checks can also get Social Security checks, if they are eligible for both. Children who are disabled may qualify for SSI payments. To be eligible for SSI, you must have limited income and resources, be a resident of the U. S. or Northern Mariana Islands, and be either a U.S. citizen or a lawfully admitted immigrant.

Talking Books: A term referring to the audio tapes, discs and cassettes available at no cost from certain designated regional libraries throughout the State to persons who are visually impaired, blind, or physically disabled. Subject matters range from classics to recently released books, magazines and periodicals, to reference and information. These libraries also provide the equipment necessary to use these materials, and have many other services available. (See “Libraries for the Blind and Physically Handicapped” and “National Library Service for the Blind and Physically Handicapped” for more information.)

Telecommunications Devices for the Deaf (TDD’s): A telecommunication device for the deaf (TDD’s) is a technological device which enables persons with hearing and / or speech impairments to communicate over standard telephone lines. Descendants of the original teletypewriter device (TTY), TDDs permit users to type messages by phone instead of voicing them. Messages are received on a display screen at the receiving end and/or a printer which records the conversation on paper. To operate successfully, both the transmitting and receiving parties must have compatible TDDs.   To place a call, the user dials the telephone conventionally, places the telephone receiver on the TDD coupler (much like a computer modem), and observes the pattern of lights on the TDD monitor. The pattern signals whether the line is ringing, busy, or has been answered. When the telephone is answered by a TDD user on the receiving end, the caller simply types the message and awaits a response. Thus is conversation initiated.   Incoming TDD calls are signalled by a flashing signal light , e.g., a lamp which is activated by a visual alert system. Vibrators can also be used to alert users of an incoming call, e.g., vibrators worn on the wrist or placed under a mattress or pillow for those insensitive to light flashing when asleep. Innovations in TDD technology enable the user to choose between a variety of devices. Small portable TDDs are available with or without a printer as are sophisticated computerized devices with answering machine capability. A number of models enable users to bypass use of standard telephone equipment and dial directly from the keyboard.

Tourette Syndrome (TS): TS is a neurological disorder characterized by involuntary muscular movements (i. e. excessive blinking, sniffing, twisting and bending body), uncontrollable vocal sounds (i.e. cough, sniff, grunt, bark, shout), and inappropriate words (i.e. involuntary obscenities or repeating words of other people). These multiple tics (involuntary rapidly repeated movements) usually begin when a person is between ages 2 and 16. TS is thought to be caused by a chemical abnormality in the neurotransmitter system (chemicals which carry signals from cell to cell in the brain and along the nerves), by which the brain regulates movements and behavior.

Tuberous Sclerosis: Tuberous Sclerosis is a genetic disease characterized by one of its most common symptoms in its most severe form- – the hardening (sclerosis) of swellings (tubers) or tumors. Other symptoms may include one or more of the following : convulsive seizures, mental retardation, white skin spots, tumors, physical handicaps, hyperactivity, developmental delay, and certain skin rashes seen over the face and most prominently over the cheeks. The disease is highly variable in its pattern of progression and because of its multi-faceted character, is often confused with other disorders.

Visual Impairments (Blind and Visually Impaired): This term refers to a variety of conditions. Visual impairments include, but are not limited to:

• legal blindness: the inability to see no more at a distance of 20 feet than a person with normal sight can see at a distance of 200 feet;
• astigmatism: curvature of the outer, transparent part of the eyeball resulting in a distorted image;
• retinitis pigmentosa: a congenital degeneration of the pigmented layer of the retina (the innermost part of the eye which is responsible for the details, color and perspective of vision) that leads to a severe loss of peripheral vision (vision to the side while looking straight);
• farsightedness (hyperopia): a refractive error or defect in the curvature of the eye in which the focal point for light rays is behind the retina, resulting in the inability to see close objects clearly; and
• nearsightedness (myopia): a refractive error of the eye where the image of a distant object (more than 20 feet away) is formed in front of the retina and cannot be seen distinctly resulting in the inability to see distant objects clearly.

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