Multiple Views on Technology and Disability

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Multiple Views on Technology and Disability

• Patti Bahr
• Gillette Lifetime Specialty Healthcare
• Joan Breslin Larson
• Minnesota Department of Education

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• Competencies are attitudes, knowledge, and
  skills that health professionals, including
  rehabilitation specialists, must possess in order
  to deliver high quality care (Coursey, 1998).
  Competencies are attributes of individual
  providers, though it is unlikely that a single
  provider will have all of those necessary to
  treat all persons (Hartman, Young Forquer,
  2000). Having a general understanding of
  particular populations, however, is the first
  step in achieving this goal. (http//cirrie.buffal
  o.edu/monographs/mexico.pdf)

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Assistive Technology

• Devices used by persons with disabilities to
  increase, maintain or support independence
• The services to support the selection,
  acquisition or use of the devices.

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Assistive technology can be

• No or low tech (simple tools)
• Mid tech (some electronics, but generally lower
  in cost)
• High tech (includes high end technology such as
  computers and mobility devices)

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Technology Access for Students Varies by Race

• Teenagers who have access to home computers are 6
  to 8 percentage points more likely to graduate
  from high school than teens who lack access to a
  home computer, after controlling for individual,
  parental, and family characteristics.
• Only 50.6 percent of blacks and 48.7 percent of
  Latinos have access to home computers, compared
  with 74.6 percent of whites.
• Only 40.5 percent of blacks and 38.1 percent of
  Latinos have internet access at home, compared
  with 67.3 percent of whites.
• Asians have home-computer and internet-access
  rates that are slightly higher than white rates
  (77.7 and 70.3 percent, compared with 74.6 and
  67.3 percent).
• Among Latinos, Mexicans have the lowest home
  computer and internet access rates, followed by
  Central and South Americans. (http//www.econ.ucon
  n.edu/fairlie.pdf)

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Technology dedicated to unique cultural groups

• Voice output computers
• Limited alternate language algorithms
• Is possible to program alternate pronunciations
  in most programs
• Voice output devices
• Digitized
• Synthesized

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Considerations for digitized

• Any message, any language is possible as
  everything is recorded on the device
• Messages are limited to those recorded on the
  device

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Considerations for synthesized

• A limitless range of spontaneous messages are
  possible.
• There are a limited number of languages
  available. They are primarily limited to
  romance languages.
• There are a limited number of companies that make
  devices with alternate languages.

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• Demonstration of range of devices.

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Dominant culture view

• Disability is a physical phenomenon
• Disability is an individual phenomenon
• Disability is a chronic illness/condition
• Disability requires remediation/fixing

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Another view

• Disability is a spiritual phenomenon
• Disability is a group phenomenon (e.g. the family
  or society are causal factors)
• Disability is a time limited phenomenon
• Disability must be accepted, which affects
  whether the family seeks intervention.

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Assumptions for immigrant or minority groups

• Generally a sense of shame regarding the person
  with a disability.
• Will attempt to hide or cope at home with the
  issues with disability rather than ask for
  support.
• People from visible minority groups have more
  limited access to services than does the general
  population.

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Impacting factors

• Impact of length of time in the country
• Regional differences
• Impact of education, income, employment, etc.
• Religious belief

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Anglo

• You must be a special person
• So brave, so noble, so innocent, so stupid
• God knew what he was doing when he gave you this
  special child.
• You will always need care.
• Anglos are individualistic

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Hmong

• The disability was caused by the nab.
• A sin of an ancestor has caused the disability.
• A disability may- or may not- be viewed as a
  problem (epilepsy/Shamanism)

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Treatment concerns

• Typical Hmong treatment does not involve touching
  the body (certainly not internally)
• A loss of limb/body part (including surgical
  procedures or removing bone marrow) will prohibit
  the person from being reincarnated
• You have a set amount of blood to last a lifetime
• Anglos depend too much on technology.
• Items added to the body (botox injections,
  pacemakers) are concerns.

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When addressing treatment

• Hmong belong to clans and defer to elders,
  particularly men.
• Folk medicine will frequently be used in
  conjunction with traditional medicine
• Short term solutions rather than life long
  treatment

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Hispanic

• Social relationships important
• Family with hierarchy of authority
• Respeto, dignidad, confianza
• Will use folk healers and clergy in addition to
  health providers

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Russian

• Alternative medicine (mud baths, massage) is used
  alone or in conjunction with traditional
  medicine. Homeopathic regimes are preferred.
• It is typical that bad news be given to the
  family rather than the patient
• New treatments and procedures are desirable

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African American

• Vast diversity in education, economic status,
  religious belief, urbanization, etc.
• Despite this, Blackness is a common experience
• Many African Americans rely on community
  supports, particularly the church in dealing with
  disabilities.
• Perhaps a broader perceptions of developmental
  milestones than do educators.

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Somali

• Msp/St Paul has largest population of Somalis in
  US
• Families could only bring the number of children
  with them they could afford. Many families never
  succeed in bringing the entire family to the US.
• Most Somalis are Muslim
• Family is the ultimate source of personal
  security and identity
• Family honor and loyalty are paramount values

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• Whom are you from? (clan and family history)
• Parents/grandparents are the center of the
  extended family. They are arbiters and mediators.

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Native people

• Over 500 tribal groups identified by US
  government
• Enduring sense of pride in cultural heritage
• Belief of interrelatedness of body and spirit
• Reliance on extended community and kinship
  networks
• Time is not linear as it is for Anglos

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Many native people

• Do not have words for disabilities
• May assign names that describe condition
• Typically will rely on folk remedies
• May recognize the disability as being a gift of
  the gods

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Recommendations for cultural competency

• Ask about family names. Wives may not have the
  same name as husbands (Hmong and Anglo)
• Ask open questions, let the respondent self
  select rather than you choosing respondent
• Be aware that many individuals are hesitant to
  enter the system as they have a history of
  governmental abuse or may be illegals

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Trying to communicate

• Be aware that many cultures may say yes to
  indicate they are part of the conversation, but
  it does not indicate understanding or agreement.
  (Conversely, Russians will say no to indicate
  that they are part of the conversation.)
• Acknowledge that you are aware that you dont
  know much about their culture. Ask for patience
  and help. Communicate that you are trying to
  help.
• Use an interpreter
• Use a cultural broker

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So that I might be aware of and respect you
cultural beliefs

• What languages are spoken/understood in your
  home?
• Usual diet,special times of year for diet changes
• Beliefs and practices including special events
• Is there anything that your culture will prohibit

• Experiences with health care in home country
• Do you need to ask me anything
• Do you use traditional healthcare
• Who else needs to be part of our discussion

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Ultimately

• Be aware that all these guidelines are not
  concrete, that individuals will vary.

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Resources

• http//cirrie.buffalo.edu/mseries.htmlseries
• The Program for Multicultural Health at (734)
  998-9800, or the UMHS Interpreter Services at
  [phone]. (University of Michigan Health
  System)
• The Spirit Catches You and You Fall Down, Anne
  Fadiman
• MN. Department of Education Cultural/Diversity
  Specialist, special education Elizabeth Watkins
  http//education.state.mn.us/mde/Learning_Support/
  Special_Education/Evaluation_Program_Planning_Supp
  orts/Cultural_Linguistic_Diversity/index.html