COMMON DISABILITIES IN THE JOB CORPS

POPULATION

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IntroductionIntroduction

Brief overview of the four major categories of impairment with an emphasis on the affective and cognitive areas.

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Common Impairment AreasCommon Impairment Areas

SensoryPhysicalCognitiveAffective

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Sensory ImpairmentsSensory Impairments

Blind/Visually ImpairedDeaf/Hearing Impaired

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Physical ImpairmentsPhysical Impairments

Cerebral PalsySpinal Cord InjuryHead InjuryAmputationMultiple SclerosisArthritisSeizure Disorders

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Cognitive ImpairmentsCognitive Impairments

Learning DisabilitiesAttention Deficit Hyperactivity DisorderMental RetardationTraumatic Brain InjuryRehabilitation from Substance Abuse

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Affective ImpairmentsAffective Impairments

Psychotic DisordersMood DisordersAnxiety DisordersPersonality Disorders

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What is the most common What is the most common disability among our Job disability among our Job

Corps population?Corps population?

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Learning Disabilities Learning Disabilities Definition-Education for All Handicapped Definition-Education for All Handicapped

Children Act of 1975Children Act of 1975

A disorder in one or more of the basic psychological processes involved in understanding or using language, spoken, or written, in which the disorder may manifest itself in an imperfect ability to listen, think, speak, read, write, spell or do mathematical calculations, despite at least average intelligence. The term does not include children who having learning problems which are primarily the result of visual, hearing, or motor disabilities; mental retardation; emotional disturbance;or of environmental, cultural, or economic disadvantage.

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Types of Learning DisabilitiesTypes of Learning Disabilities Dyslexia

– Problems reading, letter or word reversals, confused by pages crowded with print

Listening Comprehension– Able to hear words, but have difficulty understanding

their meaning when combined to express a complete thought. Trouble following spoken instructions

Expressive Language Disorders (spoken/written)– Written Expression– Motor difficulties. Difficulty learning to write. Poor

written expression. Avoids writing.– Difficulty putting thoughts into words. Refuses to

speak (usually to a group)

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Types of Learning Disabilities Types of Learning Disabilities (continued)(continued)

Mathematics– Problems doing Math despite given adequate

instruction. Math Skills Below Grade Level

Visual-perceptual/Visual Motor– Difficulty interpreting what is seen. Problems

copying designs;putting together puzzles.

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Types of Learning Disabilities Types of Learning Disabilities (continued)(continued)

Auditory Processing Disorders– Difficulty hearing the sounds within words. Focus

is on individual words not sentences. Poor speller. Memory

– Problems with short-term or long-term memory Abstract Reasoning, Organization, and

Problem Solving– Average or better cognitive skills. Difficulty

understanding the relationship among things (i.e. analogies)

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Examples of General Accommodations Examples of General Accommodations for Learning Disabilitiesfor Learning Disabilities

Taped Examinations Large Print Examinations Large Print Answer Sheets Transcribers Interpreters Taped Texts Videotaped Lectures Cassettes Prepared Notes

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Attention Deficit Hyperactivity Attention Deficit Hyperactivity Disorder (ADHD)Disorder (ADHD)

Persistent pattern of inattention or hyperactivity— impulsivity

More frequent in males (4:1) than females (9:1)

Symptoms tend to attenuate during late adolescence and adulthood

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ADHD Students in Job CorpsADHD Students in Job Corps

Inattention– Low frustration tolerance– Mind is somewhere else– Disorganized work habits

Hyperactivity– Feelings of restlessness– Difficulty engaging in sedentary activities

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Impulsivity– Fails to listen to directions– Interrupts others frequently– Engages in potentially dangerous activities

Behavioral– Impairments in the classroom and in the

dorms– Temper outbursts, frequent insistence that

requests be met, poor self- esteem

ADHD Students in Job CorpsADHD Students in Job Corps (continued)(continued)

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Examples of ADHD AccommodationsExamples of ADHD Accommodations

Minimize distractions during class Allow extra time to finish work Peer Assistance Short work periods Break long tasks into smaller ones Recommend training program of high interest

to student Praise appropriate behaviors - Reinforcement Pair oral assignments with written instruction Checklists Buddy System during unstructured time

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What are the most common What are the most common affective impairments among affective impairments among our Job Corps population?our Job Corps population?

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Mood DisordersMood Disorders

DepressionManiaBipolarSeasonal Affective Disorder

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Sadness, irritability, loss of pleasure or interest, appetite changes, sleep changes, psychomotor changes, fatigue

Onset—no particular age—highest in 25-44 age group

Gender differences—twice as common for adolescent and adult women than men

The lifetime risk for major depression is 10 -25% for women and 5 -12% for men

DepressionDepression

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Mood Disorders Hall of FameMood Disorders Hall of Fame

Barbara Bush

Ray Charles

Dick Clark

Robin Williams

Charles Dickens

Vincent Van Gogh

Joan Rivers

Ernest Hemingway

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Students with Depression Students with Depression in Job Corpsin Job Corps

Irritability in the dormsObsessive rumination—relationshipsFrequent visits to health services—

excessive worry over physical healthComplaints of pain (headaches, joint

pain, etc.)Alcohol useSuicide threats or attempt

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Accommodation SuggestionsAccommodation Suggestions

Acute stages of major depression, probably not appropriate for Job Corps.– MSWR or Medical Leave for Treatment

Students who are in remission or stabilized on medication are more appropriate– Adjust schedule to allow for treatment with CMHC

or off center– Adjust vocational/educational load to account for

low energy level

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Accommodation Suggestions Accommodation Suggestions (continued)(continued)

Depression– Encourage participation in recreational

activities– Develop support system– Monitor nutrition and personal care with

CMHC

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Personality DisordersPersonality DisordersWho Am I?Who Am I?

Conduct Disorder/Antisocial Personality Disorder

Borderline Personality Histrionic Personality Obsessive-Compulsive Personality Narcissistic Personality Several Others

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On Center—CharacteristicsOn Center—Characteristics

Conduct Disorder Before age 15

Little empathy

Blames others

Image of toughness

Aggressive style

Difficulty with GED

Antisocial Personality 18 or older

Lack of empathy

Superficial charm

Inflated ego

Excessively opinionated

Dysphoria

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Borderline PersonalityBorderline Personality

On Center—CharacteristicsOn Center—Characteristics Extreme attention seeking Manipulative—gaining the concern of staff

– Will share most intimate details easily Constant anger—recurring verbal fights

– When staff or friends are seen as neglectful, withholding, uncaring

Promiscuous behavior Sudden and dramatic shifts in their view of

others and Job Corps

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Histrionic PersonalityHistrionic Personality

Pervasive and excessive emotionality and attention seeking behavior

Center of attention Theatrical Sexually

provocative 2-3% of population

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On Center—CharacteristicsOn Center—Characteristics

Very Macho or Extremely FeminineRole of “Victim” or “Princess”Demands Constant Attention Becomes Bored Easily—Needs Novelty Initiates Job or Project—Loses Interest

FastCannot Delay GratificationDistorted Intimate Relationships

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Examples of Examples of AccommodationsAccommodations

Place in vocations with low interpersonal demands and low risk of injury to self and others

Provide frequent feedback to student about progress and how staff and other students view them

Place with supportive teachers/vocational instructors who are skilled at working with volatile students

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Anxiety DisordersAnxiety Disorders

Panic DisordersSpecific PhobiasAcute Stress DisorderPost-traumatic Stress DisorderGeneralized Anxiety

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Examples of Examples of AccommodationsAccommodations

Depending upon severity, medical leave or MSWR for treatment

Modifications in schedules for treatment with CMHC or off center

Vocational placement in areas that avoid the “feared situation/object – indoor work to avoid snakes, bugs – outdoor trade to avoid confined spaces

Identify areas of concerns and provide training, buddy system, alternative learning method, etc.

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Psychotic DisorderPsychotic Disorder

Most Common Form is Schizophrenia

Description of Schizophrenia– Emotional Turmoil – Overwhelming Confusion– Changes in Speech and Behavior– Loss of Reality Testing

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Students with Schizophrenia Students with Schizophrenia in Job Corpsin Job Corps

Can be abrupt or insidiousSocial withdrawalLoss of interest in class and workDeterioration in hygiene and groomingUnusual behavior—inappropriate affectAnger outbursts

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Examples of Examples of AccommodationsAccommodations

Most students in the acute stages of a psychotic disorder will need to be separated, however those with a history and stabilized on medication can be successful in Job Corps– Some of the ones listed for LD and ADHD– Monitoring of meds and general functioning by

the CMHC and center physician– RA to monitor self care– Recommend vocational trades of low risk –

business/computer

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Who Suffers from Cognitive and Who Suffers from Cognitive and Affective Impairments?Affective Impairments?

Approximately 1 out of 4 people will suffer some form of cognitive or affective impairment during their

lifetime.

American Psychiatric Association, 1998

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Where to Get More Where to Get More InformationInformation

Resource List in Packet