Health and Social Care is a big thriving sector at current times. With the raised awareness among people regarding the care of people with specific needs, this sector is now greatly developed and the services are also much more supporting and effective. Nonetheless, this sector relentlessly works on further improvement of the facilities, services, strategies, etc provided to the people with specific needs.
Normality is considered to be such series or traits of thoughts, behavior, etc that is consistent with the usual and accepted standards. According to Emile Durkheim, French sociologist, behaviors were social facts that are present in the majority. Any exception to that behavior indicates pathology. (Durkheim)
Models of Normality
Now, there are a number of models regarding normality. Among them is the “Mental Health Model of Normality” (Jahoda, 1958)
According to this model, there are several criteria to determine what constitute normal psychological health. Deviation from these criteria would mean that the health of an individual is “abnormal”.
The criteria as follows:
- “The absence of mental illness”
- “Realistic self perception and contact with reality”
- “A strong sense of identity and positive self-esteem”
- “Autonomy and independence”
- “Ability to maintain healthy interpersonal relationships”
- “Ability to cope with stressful situations’
- “capacity for personal growth and self-actualization” (Jahoda, 1958)
The Disability Discrimination Act (DDA) defines a disabled person as “someone who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities.” (The Disability Discrimination Act (DDA))
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Disability is considered to be the state where a person is significantly impaired, compared to general people. Disability might refer to physical as well as mental impairment. Physical refers to the impairment of body organs like legs, hands, etc. whereas mental disability refers to the lack of the ability of thinking properly, including all sorts of mental activities.
When a person is feeling unwell in one or more aspects in case of health, then it is considered to be illness. It is considered to take place because of some sort of disease or sickness.
Behavior related to users of health and social care services
Behavior refers to the way one behaves, acts, or conducts, especially while communicating with other people. A healthy person usually has a very consistent behavior that suits the environment and circumstances. But when a person is not healthy, either physically or mentally, his/her behavior shows inconsistency.
Perceptions of Specific Needs and Gradual Changes
Disability and people with specific needs had received much ignorance throughout history. People with specific needs were outcasted in most of the societies. They are ignored and left to fend for themselves, whereas they didn’t have the minimum capacity to do the basics of their lives in most cases. In most of the cases, the disabled ended up without financial support and thus suffer throughout their lives. In extreme cases, they would either take up begging, or die for lack of care.
In 2011, when World Health Organization (WHO) estimated more than 1 billion people worldwide with a disability, that was a shock for the world. It meant that 15% of the entire population lived with a disability. And when compared with the situation in UK, it meant out of 10 people, 1 suffered from disability of some sort. (World Report on Disability, 2011)
Even then, no universal reaction was obtained. But the perception of the people varies based on the geographical location, time, culture, etc. For example, the Europeans and Americans are much more serious about the issue; whereas in some parts of Asia and Africa, this issue is still widely neglected.
The popular view on people with specific needs changed mostly in the last few years. Before that the people with specific needs were looked down upon weak tragic victims who need care and pity. But now they are perceived with a more positive outlook.
Various rights, allowances, etc are being sanctioned for them. Besides people are starting to take them as human potential which can be utilized in the development of human society. Services for the people with specific needs are developing drastically, and experiments and trials are taking place for more improved services and cures.
Impact of Social Policy, Practice, Legislation and Culture
Social policies and practices impact greatly on the availability of services. For example, a region with very low awareness regarding the people with specific needs would no doubt be a place with lack of services. The mentality of helping a person in need might help in bringing about the importance of services for people with specific needs in the light. But then again, the economic situation of the country would be a great factor in the availability and quality of services for people with specific needs.
The legislation of a country is also responsible. The laws, bills, etc passed in favor and to aid the people with disabilities speak a lot about the overall situation of services available in the country. For example, UK, USA, etc have strived for various rights of the disabled. But Bangladesh or India doesn’t have that many bills passed for the disabled. Consequently, there aren’t very improved services present for the people with specific needs.
The culture of a region or country is highly responsible in this respect. In some countries, a helping tendency towards people in need exists. Whereas, there are still communities where disabled people are still considered to be possessed by spirits, or gods, and thus should be left alone. But again, some communities consider people with disabilities as ones being possessed by evil spirits. They are tortured, outcasted and left to fend for their own.
Need For Care Needs in Organizations
Organizations that work with people having specific needs should have facilities of care needs for the employees having specific needs. Though it might be expensive, but this is a basic necessity and the people concerned might need special attention anytime.
Besides, having facilities for care needs would encourage the people with specific needs to work there. Because what might be a small factor for the organization, might actually be a basic need for the employee with specific needs.
So, organizations which employ people with specific needs should make sure that minimum facilities of services are kept for the employees with specific needs.
Current systems and services available
Various sorts of improved systems and services are available now-a-days for the patients with specific needs.
Services for the visually impaired:
- Guide dogs
- White cane
- Text-to-speech translators
- Talking books
- Large font books
Services for the hearing-impaired:
- Hearing aids
- Special telecommunication devices
- Closed captions on television
- Sign language interpreting
- Video relay services
Besides, a number of services are present there for the autistic, mental disabilities, etc. these services come under various names. They all are dedicated towards the improvement of the patient and a smooth lifestyle for them.
Examples of Services Available
- Mencap: This organization has worked for people in my community. They are a charity foundation, helping people with learning disabilities.
- National Autistic Society: They have mainly worked with the people with autism in my community. They focus not only on the patients, but also on their families, and try to make sure their rights are ensured.
- Disability Law Service: They provide and help with legal information and advice for disabled people and their families, as well as, carers.
- HFT- Family Carer Support Service: They work for the disabled by providing help and support to the carers of the people with specific needs.
Approaches and Intervention Techniques
During my work as a service provider to children with learning disabilities, I had noticed that their biggest trouble was with word recognition and reading comprehension skills.
I had tried to go with the scholars, who say “Traditionally, one-on-one reading instruction has been considered optimal for students with LD. Yet we found that students with LD who received reading instruction in small groups (e.g., in a resource room) experienced a greater increase in skills than did students who had individual instruction.” (Swanson)
According to Dr. Swanson, these few things are present at the heart of good reading intervention program:
- Guided practice
- Independent practice
- Daily reviews
- Statements of an instructional objective
- Formative evaluations
I have tried to follow all these intervention methods while teaching the children with learning disabilities.
Besides, some common approaches that are widely considered to be the best approaches as a service provider were taken by me.
The above mentioned approaches and interventions have proved to be of great advantage while teaching the children with learning disabilities.
Direct instruction was the most effective in improving word recognition. This can also be used in a group of learners, so one-to-one basis is not necessary and is thus much more effective. In case of improving reading comprehensions, a mixture of direct instruction and strategy instruction works the best. Strategy instruction basically refers to look out for patterns in words, key passages and main idea of each passage. This combination can be really time efficient when the tasks are broken down into short ones, and approached step by step. So far a good amount of improvement is being seen in the children.
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There is no particular limitation in this case, except that the complete model needs both the service provider and the service receiver to be persistent, which might not turn out to be as easy as it sounds. In case of children with learning disabilities, learning is already the hardest things to them. To persuade them to work hard for learning is the biggest challenge to this set of interventions.
Need for Development and Support of these Patients
The people in need of specific needs are a part of our race, and our society. Thus, it is a duty on our part to aid them in ways them need. Besides, they are a huge percentage of our workforce. If they can be educated, trained and groomed up properly, they can contribute to the society, even the economy, by a considerable amount.
Here comes the part where the services and facilities for them become important. They can contribute in the society for sure, but, they cannot be left completely unattended and on their own. If they are provided with the right kind of services, according to their needs, they can take care of the rest. But if they are not provided with the right kind of facilities, they would not be able to work. In this way, they would create barriers in the focus of others around him or her. This would result in a higher reduction of labor, since someone else’s work is being impeded as well.
Besides, in today’s world, the services for the people with specific needs have improved manifold, and is still on their way to perfection. So there is no need to have the perception that the patients would not do well, on their own. So, the services and care for people with specific needs is just not necessary, but also mandatory to some extent.
According to a study conducted on different aspects of challenging behavior, (Klass, Guskin, Thomas, Ritchie, & Pohl, 1995) “Challenging behavior” is defined as any behavior that
- interferes and hampers with children’s learning, development, and growth
- is harmful to the specific child, other children, or adults around the child
- puts a child at high exposure to risk for later social problems or associated school failure
During my work, I have come across people with challenging behaviors. Some of the characteristics are presented, based on my experiences:
- Self-injurious behavior: Patients having this behavior can commit activities such as hitting, biting, head butting, scratching, etc.
- Aggressive Behavior: Screaming, scratching others, punching, kicking, etc
- Sexualized Behavior: groping or public masturbation
- Property-directed Behavior: stealing, throwing objects, etc
- Stereotyped behaviors: repetitive rocking, etc
These characteristics pose threats to not only the patient, but also on the people around them and their carers or service providers.
Impact of Challenging Behavior
Challenging behavior puts the patient and his or her family at risk. During carrying out the services to be provided, the service-providers are also at risk of injuries. Besides, the emotional stress in handling the people with challenging behavior is great. In this state, the inclination of the health workers to work in this particular field decreases by a huge extent. This is one big challenge for this sector.
Besides, the people with challenging behavior require more attention and work from all the people around him or her, doubtless, the service provider. This also turns this particular service into a more expensive one. This service is also more diversified, and requires a constant attention.
All these factors pose a great challenge on the overall health and social care sector.
Strategies for Challenging Behavior
Challenging Behavior requires a great deal of attention from the service providers, and it is the most important to create stable and simple strategies for the patients, these strategies have to be in accordance with the needs, characteristics, nature of the patient. Thus strategy used for one might not work best for another patient.
A few common strategies necessary for providing service to people with challenging behavior are analyzed below:
- Setting Clear Boundaries: Boundaries and ground rules have to be set at the very beginning so that the patient understands what the limitations are. The rules have to be very basic and should be communicated in a way that the patient can easily understand and communicate. For example, the patient can be explained that the few basic orders – eat, go to sleep, play, etc are not just orders, or requests, but are obligations. And so a reminder means just a reminder and that the patient has to do it anyway.
- Rewards and sanctions: Rewards are very effective, they encourage the patients as well as help them to understand the rules straight, for example, if the patient is presented with something he or she likes every time he or she does something right, the patient will have a clearer idea of the rules, and what is appreciated.
- Time Out: In order to keep the patient disciplined and to bring them into discipline, they should be explained that there’s a fixed time for everything. So, when they should be reminded that time is out for a particular activity, they should oblige because that is the way things should be done, and that is the normal way for everything.
Apart from these, there are a number of other techniques, approaches, etc that are being taken for effectively providing service to people with challenging behavior.
Health services are a huge sector in the modern times. Though it is challenging, the service providers should keep in mind the noble cause they are working for- aiding the people who have specific needs, and the promise would drive them
- Durkheim, E. Rules of the Sociological Method.
- Jahoda. (1958).
- Klass, Guskin, Thomas, Ritchie, & Pohl. (1995).
- Swanson, D. L.
- The Disability Discrimination Act (DDA).
- (2011). World Report on Disability. World Health Organization.
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