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• What are physical impairments?                
  
• Associated strengths
• Impact on Employability Skills and Attributes     
  
• Areas where ‘reasonable adjustments’ may be required
• General advice
• Resources/references

What are physical impairments?

Physical impairments can be caused by a range of medical conditions and/or trauma. Mobility can be affected by impairments such as arthritis, amputation and head or spinal cord injury and can create difficulties with stamina, co-ordination, endurance and movement. The impairment can be temporary or permanent; fluctuating, stable or degenerative; and may affect only some parts of the body or the whole of it.

People’s mobility can be affected in many ways and may necessitate the use of aids such as a wheelchairs or crutches. With acquired brain injury or stroke more subtle effects may present as loss of fine motor control (affecting the ability to write), poor balance or concentration. People with conditions such as cerebral palsy and/or stroke may have additional impairment of speech and/or vision.

Coordination and balance may be mildly or severely affected by some conditions, and movement may be impaired by muscle spasms, numbness or pain. As a result, writing and the manipulation of equipment may be difficult.

Some students with physical impairments, neurological conditions or acquired brain injury may also have perceptual difficulties. Students may have experienced barriers to learning that relate to negative perceptions of their impairment and low expectations of their abilities. They may have missed out on vital stages of learning during their early schooling, affecting language acquisition and the development of literacy, and may also missed out on work experience in their later educational experience.


Associated strengths

Although there are some impairments that may impact on peoples’ cognitive functioning as well as their physical abilities, many do not have any difficulties with learning. Do not assume that because someone has slurred speech, uses a wheelchair or has spasticity of the limbs that they have any difficulties with thought or learning.  Professor Stephen Hawkins is probably the most well known wheelchair user; he is noted for his contributions to the fields of cosmology and quantum gravity especially in the context of black holes. He has also achieved success with works of popular science in which he discusses his own theories and cosmology in general; these include the runaway best seller ‘A Brief History of Time’.


Conditions which are frequently associated with limited/poor mobility include:
 
Muscular Dystrophy -  a group of inherited disorders characterized by the deterioration and wasting of muscle fibres.  

Cerebral Palsy - A disorder usually occurring before or after birth that relates to bad coordination and involuntary movements of the muscles.

Hemiplegia- is the paralysis of one side of the body as a result of a stroke or traumatic brain injury and should not be confused with paraplegia or quadriplegia. With quadriplegia and paraplegia the brain is not affected. With hemiplegia, there may be an impairment of intellect, personality, speech or senses.

Multiple Sclerosis - A disorder of the nervous system that attacks the brain and spinal cord and causes deterioration of the nerve tissue. Usually associated with paralysis, muscle spasms, disorders of speech, and tremors of the hand.

Paralysis - Loosing feeling in certain parts of the body and not be able to move these parts of the body.

Paraplegic- the paralysis of the lower extremities and part or all of the trunk muscles. Usually there is a loss of sensation in paralysed limbs and other effects such as muscle spasms, pain and loss of bowel and bladder control.

Polio - A disease that kills nerve tissue in the spinal cord, which causes a high fever, paralysis of different muscles.

Quadriplegia- occurs when there is damage to the spinal cord in the Cervical Region. This will cause impairment to the hands and arms in addition to the effects of paraplegia.


Impact on Employability Skills and Attributes

Students with physical impairments may experience difficulties with one or more of the following abilities:

• Mobility
  
• Motor / Manual Dexterity
  
• Stamina
  

Although most people depend on the above abilities in the following employability skills, this does not mean that people who have physical impairments cannot possess these skills; rather, they may need reasonable adjustments to practice to enable them to develop or evidence the skills.  

Click below for further information about the effect of limited ability on each of the employability skills/attributes shown:

• Mobility and Practicals
  

• Motor-Manual Dexterity and Use of ICT
  
• Motor-Manual Dexterity and Information Literacy
  
• Motor-Manual Dexterity and Practicals
  
• Motor-Manual Dexterity and Written Communication
  

• Stamina and Practical Skills
  
• Stamina and Working Under Pressure

NB: The experience and characteristics of different impairments/conditions are highly variable between individuals. For this reason it is really important that you never make assumptions about what a person can or cannot do. Though someone may have significant difficulties, they may also have devised sophisticated means of compensating for these, so talk to the person concerned and make judgments only on an individual basis.
 
Areas where ‘reasonable adjustments may be required

Activities of daily living - People with impaired co-ordination and/or perception often find routine tasks such as driving, household chores, cooking and personal grooming difficult.

Stamina - Fatigue is common for many people with physical impairments. Accessing facilities which others take for granted, such as toilets, refectories, libraries, and lecture rooms may be difficult and/or take more time.

Handwriting - Those who have damage/impairments relating to the hands or arms in addition to mobility difficulties may have difficulty with handwriting; they may unable to write using a pen or have a slow writing speed.  Involuntary head movements may affect the ability to read standard-sized print. Some people may have difficulty manipulating resources in the learning environment; they may also have difficulty turning pages or using computers.


General advice

• Use the term ‘wheelchair user’ not ‘wheelchair bound’.
• Never push a person's wheelchair without their permission - offer help if you think it's required but don't impose it!
• When talking to a person who uses a wheelchair sit down (if possible) so that you are both on the same level.
• People who walk using sticks or crutches may appreciate help with carrying belongings or opening doors, but don’t assume that everyone needs your help. If in doubt, ask!
• Talk directly to the person using the wheelchair, not the person who is pushing it.
• Never invade a wheelchair user's personal space by leaning on their chair.
• Try to keep walkways, corridors and aisles free from obstructions - this makes things easier for everyone, not just for people with impaired mobility.
• When walking with a person who uses crutches or a wheelchair adjust your pace to match theirs.
• Don't feel embarrassed to use words like 'run', 'walk', 'jump' or 'dance' in front of a  wheelchair user- use your everyday language.
• Encourage the use of appropriate assistive technology e.g. an adapted keyboard or a computer with voice recognition software.

Resources/references

Reasonable adjustments for arthritis

Reasonable adjustments for back conditions

Reasonable adjustments for muscular dystrophy

Reasonable adjustments for leg impairments

Reasonable adjustments for wheelchair users