Arthritis and Related Disorders
Arthritis includes many disorders. Three types of arthritis commonly seen are osteoarthritis, rheumatoid arthritis, and Still's disease (juvenile rheumatoid arthritis). Osteoarthritis is the most common form of arthritis; many older people are affected to some degree. Symptoms include weakness and muscle spasms around a joint, fatigue, pain, deformity, and joints so unstable they may "give out." Osteoarthritis is the wearing out of a joint, caused by a disturbance in the mechanics of the joint leading to uneven distribution of weight on the joint's surfaces. The joints may be abnormally strained because of daily activities or occupational hazards. Dock workers may have osteoarthritis in their backs; assembly workers may have it in their fingers. The most commonly affected joints are those in the back, the hips, and the knees_all weight-bearing joints subjected to hard work. Flare-ups and remissions of the pain are common.

Rheumatoid arthritis is a chronic systemic disease. Joints become inflamed and bones thin, atrophied, and misshapen. In the early stages, the disease manifests itself as a migratory stiffness and swelling in various joints of the body. Deformities typify later stages. Still's disease is much like adult rheumatoid arthritis but strikes children between the ages of two and five and nine and 12. By the age of 16, most children outgrow the disease.

The cause of arthritis is unknown, and there is no cure. The disease affects more women than men but strikes adults of all ages. Often it worsens progressively. Pain may be relieved through physical therapy, application of heat, medications, joint replacement surgery, and even acupuncture and biofeedback.

Asthma
Asthma is a common medical disorder, often caused by an allergic reaction to something in the environment, food, or strenuous exercise. Many different irritating substances, including pollen, dust, or chlorine, may be responsible for the constriction of the air passages that is symptomatic of asthma.

A person who is asthmatic experiences tightness in the chest and wheezing that lead to shortness of breath. The person with asthma then is unable to take in air and expel it properly. If untreated, respiratory paralysis and even death may occur. Medications tend to neutralize the bronchial spasm and open up air passages to permit normal breathing. A person with asthma may need to avoid forced attempts at holding the breath.

Stress may be a factor in bringing on asthma. Exercise can be therapeutic for the person with asthma.

Cardiac Disease
Cardiac disease includes a number of congenital disorders and other diseases of the heart. Among common cardiac abnormalities are angina pectoris, or angina, a chronic condition of pain in the chest. Angina is usually brought on by exertion, emotion, a heavy meal, or sudden exposure to extreme cold.

Congenital heart disease, abnormalities that occur before birth, may be worsened by a change in activity level. Older persons with valvular heart or coronary artery disease also must be cautious not to strain their hearts. Tolerance for exercise can slowly be established and intensity of action as well as duration of the exercise can be increased progressively.

People living or working with heart patients should be thoroughly trained in cardiopulmonary resuscitation (CPR). Emergency numbers for medical assistance and hospital transportation should be close at hand. Any sign of chest pain, shortness of breath, cyanosis (a bluish color possibly indicating a decrease of oxygen content in the blood), or undue fatigue calls for immediate medical evaluation.

Cerebral Palsy
Cerebral Palsy is a neurological disorder resulting from damage to the brain before, during, or after birth. Cerebral palsy affects that portion of the brain which controls the muscles. Generally speaking, cerebral palsy is characterized by involuntary jerking movements, poor sense of balance, speech impairment, and spastic muscles. A small minority of people with cerebral palsy also have mental retardation.

There are three forms of cerebral palsy: spastic (where movement is stiff and difficult); athetoid (involuntary and uncontrolled movements); and ataxic (characterized by a disturbed sense of balance and depth perception). Some individuals have a combination of those forms.

It is estimated that between 750,000 and one million persons in the United States have cerebral palsy. Approximately 25,000 infants are born each year with the disorder.

People with cerebral palsy may or may not use wheelchairs, alternative communication systems such as computers or speech cards, technical aids for writing or other fine motor tasks, or personal assistance.

Cystic Fibrosis
Cystic fibrosis is a heredity disease that results in an abnormally thick mucus which clogs the lungs, obstructs their functions, and prevents the flow of certain pancreatic enzymes to the small intestine.

When cystic fibrosis was first reported in the 1930s, people with the disease usually died before the age of one year. With improvements in treatment, the average life expectancy of a person with cystic fibrosis is now 14 years. However, a large percentage of children with cystic fibrosis reach adulthood and function well. One in 1,000 children born in the United States has cystic fibrosis.

Diabetes
Diabetes is a condition in which the pancreas is unable to produce sufficient insulin, a hormone necessary to utilize the excess sugar in the blood. The person who is diabetic consequently has an excess of sugar in the blood that can lead to many complications, such as vascular disease, kidney disease, and blindness.

Diabetes is treated with a proper diet, an exercise program that aids in reducing excess weight, and, in severe cases, insulin to lower the excess blood sugar.

Diabetes ranks with heart disease and cancer as the three major diseases that kill. Diabetes afflicts millions of Americans. There are two types of diabetes: the first usually has its onset in childhood or young adulthood and requires life-long treatment. Its warning signs are frequent urination, unusual thirst, rapid weight loss, fatigue, nausea, and extreme hunger.

The majority of people who are diabetic have the second type, which most frequently strikes people over 40. Its warning signs may include those of the first type as well as excessive weight, blurred vision or a change in vision, tingling or numbness in the feet or legs, frequent skin rashes or infections, and slow healing cuts and bruises.

People with diabetes who take insulin either orally or by injection and may be subject to insulin shock brought on by exercise, an overdose of insulin, or too little food. Too much sugar in the blood and not enough insulin may result in a diabetic coma. People with diabetes are often encouraged to wear medic alert tags.

Symptoms of insulin shock include breathing deeply, sighing, and having dry and flushed skin. Breath may have an acetone odor. Since people with diabetes are slow to heal, they should take precautions to avoid skin abrasion and bruising.

Epilepsy
Epilepsy is the term used to cover 20 different kinds of seizure disorders. Epilepsy is characterized by sudden seizures due to abnormal electrical discharges of brain cells.

Seizures may consist of lapses of consciousness or only minor twitching movements, depending on the severity of the electrical discharge, the region where the disturbance originates and the nature of the stimulation to the brain. Types of seizures include grand mal, petite mal, and psychomotor seizure. An individual's seizure threshold may be influenced by many factors, such as emotional upsets, bodily discomfort, stress, hunger, fatigue, or changes in medication.

Epilepsy affects more Americans than cancer, tuberculosis, cerebral palsy, muscular dystrophy and multiple sclerosis combined. It is estimated that four million people in the United States (at least two percent of the population) have some form of epilepsy.

Most people with epilepsy lead active, productive lives. The kinds of activities in which a person with epilepsy participates depends in part, on how controlled are his or her seizures. People whose seizures are under control drive, work, go to school, travel, and participate in sports, physical activities and other areas of life. Anti-seizure medication may also have side effects that may determine the kinds of activities a person can participate in. The person who has epilepsy is the expert on his or her limitations and is the best source of information on how to provide assistance in the event of a seizure.

Hearing Impairment
Hearing impairments affect individuals of all ages. The degree of loss may be mild to severe. Each individual's adjustment to hearing loss is different, depending upon the degree and type of loss, the age of onset, and the individual. Some people with hearing impairment are able to be assisted with hearing aids. Other types of impairments are not affected by hearing aids.

People who are pre-lingually deaf are either born without hearing (congenitally deaf) or lose their hearing before the age of five years (adventitiously deaf). Both speech and language are affected to varying degrees. The person who is pre-lingually deaf communicates primarily through sign language, finger-spelling, and writing, but may possess enough speech and speech reading ability (lip reading) for basic social expression.

People who are post-lingually deaf are those who become profoundly deaf after the age of five years and, although possessing no hearing for practical purposes, have had normal hearing long enough to establish fairly well-developed speech and language patterns. While speech generally is affected, it becomes quite understandable once one is accustomed to the speech patterns.

People who are deafened are those who experienced hearing loss after completing their education, generally in their late teens or early 20s and upward. Such people usually have fairly comprehensible, nearly normal speech and language, but they need instruction to acquire useful speech reading.

People who are hard of hearing may have been born with a hearing loss or subsequently experienced a partial loss of hearing. While they have acquired speech normally through hearing and communicate by speaking, their speech may be affected; the voice may be too soft or too loud. They understand others by speech reading, by the use of a hearing aid, or by asking the speaker to raise his or her voice or enunciate more distinctly.

A person may consider himself or herself a member of the Deaf community. That is a group of people with a shared language, experience, and social norms. American Sign Language is the common language of the Deaf community. This is a manual language that has its own grammar, vocabulary and syntax. It is only a visual language; there is no written equivalent. American Sign Language, or ASL, is not related to English or any other spoken language. ASL is based on hand shape, position, and movements.

Manual or Signed English is a system of hand communication that uses signs and fingerspelling that approximates the word order and grammatical structure of spoken English. There are a number of variations of Signed English. Some variations follow English grammar very closely using specific tenses and word endings. Others only code certain word roots. Fingerspelling is a technique that has a hand shape for each letter of the English alphabet.

People with a hearing impairment may use a Telecommunication Device for the Deaf to communicate by telephone. This device is commonly known as a TTY (Text-typing Telephone) or a TDD (Telecommunications Device for the Deaf).

HIV/AIDS
Acquired Immune Deficiency Syndrome, (AIDS), is an advanced stage of an often fatal illness caused by Human Immunodeficiency Virus, (HIV). HIV attacks certain white blood cells which are part of the body's immune system. When the immune system is weakened by HIV, rare cancers and infections can invade the body, eventually leading to death.

Not everyone who is infected with HIV develops AIDS. Some people develop chronic symptoms which vary from mild to severe. Other people who are inflicted with HIV appear to be in good health. These people may be unaware of their infection because they have no symptoms.

However, all persons who are infected with HIV, from those with no symptoms to those with AIDS, are capable of infecting others under specific conditions. Others can become infected with HIV from direct contact with infected blood, semen or vaginal secretions.

Learning Disability
A learning disability is a disorder in one or more of the basic psychological processes involved in understanding or using language, spoken or written. Learning disabilities may affect ability to listen, speak, read, write, spell, or do mathematical calculations. The term includes such conditions as perceptual handicaps, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.

Social skills may also be affected by a learning disability. People who have learning disabilities sometimes find it difficult to understand others or to read non-verbal cues.

Most people who have a learning disability have average or above-average intelligence. With appropriate support, many people with learning disabilities can function fully and learn with accommodations such as audiotapes in the place of printed text.

Mental Illness
The terms mental illness and psychiatric illness or psychiatric disability describe a broad range of mental and emotional conditions that have recognizable symptoms and established modes of treatment. Mental illnesses are characterized by behavioral and psychological patterns which may interfere with a person's occupational, social, and daily functioning.

Mental illnesses typically are recurring, on-going conditions that do not follow a regular pattern of development and outcome. The intensity and duration of symptoms differ from person to person. Although the symptoms of mental illness often can be controlled effectively through medication and/or psychotherapy, or may even go into remission, the illness may continue to cause periodic episodes that require acute treatment. Mental illness encompasses schizophrenia, anxiety disorders, and depressive disorders.

Schizophrenia
Research has not yet determined whether schizophrenia is a single disorder or a group of related illnesses. The illness is highly complex, and few generalizations hold true for all people diagnosed with schizophrenia. Most people initially develop the symptoms between the ages of 15 and 25. Typically the illness is characterized by dissociated or fragmented thoughts and an inability to process information.

Anxiety Disorders
Panic disorder - the sudden onset of paralyzing terror or impending doom, with symptoms that closely resemble a heart attack. Phobias - excessive fear of particular objects (simple phobias), situations that expose a person to the possible judgment of others (social phobias), and situations where escape might be difficult (agoraphobia). Obsessive compulsive disorder - persistent distressing thoughts (obsessions) that a person attempts to alleviate by performing repetitive, intentional acts (compulsions), such as hand-washing. Post-traumatic stress disorder - a psychological syndrome characterized by specific symptoms that result from exposure to terrifying, life-threatening trauma, such as an act of violence, war or a natural disaster. Mental illness also encompasses several depressive disorders: they include manic-depressive illness, dysthymia, and seasonal affective disorder.

Mental Retardation
Mental retardation is a condition, often present before birth, in which normal development of the brain does not correspond with physical growth. For people with mental retardation, learning ability develops slower than average. Reasoning and judgment may also develop at a slower pace. For most people with mental retardation, it is not the ability to learn that is missing, but the speed and ease at which things are learned is slower. Some social skills may also be below their expected age level. Mental retardation may be the result of genetic factors, faulty prenatal care and nutrition, certain illnesses during pregnancy, or premature or traumatic childbirth. Accidents, poisoning or disease after birth can also cause mental retardation. In some cases, mental retardation can be traced to severe environmental deprivation. An estimated six million americans have mental retardation. The range of capabilities of people with mental retardation is probably greater than in any other disability group. And, mental retardation is a disability about which the general public has great apprehension and misunderstanding. People with mental retardation may be overprotected and discouraged from exploring the world or interacting with others. Often people with mental retardation have been limited to segregated services and programs. Many people with mental retardation are able to participate in activities with non-disabled people with appropriate support and adaptations. Others may require long-term structure and assistance. With more appropriate training and education, many people with mental retardation learn to become independent citizens, managing their own homes or apartments and money. Many hold non-skilled or semi-skilled jobs and are well-assimilated into the community.

Multiple Sclerosis
Multiple sclerosis is characterized by spots of degeneration that attack any part of the central nervous system, causing paralysis and sometimes blindness, deafness or mental changes. Early symptoms include numbness, double vision, dragging of the feet, loss of bladder or bowel control, speech difficulties, and extreme fatigue. Symptoms can disappear (called remission) and reappear (relapse) over a period of years, after which deterioration is steady. Approximately 250,000 Americans have multiple sclerosis. It attacks young adults (usually between 20 and 35 years old), primarily in temperate climates such as North America and Europe. Frequency is slightly higher in women than in men.

Muscular Dystrophy
Muscular dystrophy is a group of chronic muscle diseases, usually hereditary, in which muscle tissue is destroyed until the person is incapacitated. Various forms of muscular dystrophy affect specific muscle groups. Onset of the disease may be in childhood or adulthood. About 250,000 persons in the United States have muscular dystrophy. The disease generally appears in young children, but may be arrested for several years, then reappear.

Spina Bifida
Spina bifida is a congenital malformation where some of the vertebrae that normally cover the spinal cord fail to develop fully. This can be corrected with surgery, but spinal cord involvement may occur. This may result in varying degrees of neurological impairment, affecting strength and movement of the legs as well as bowel and bladder control. People with spina bifida may walk with aids such as crutches or may use wheelchairs. Until the 1940s, very few people born with this disability survived beyond infancy. However, treatments developed in recent years have drastically improved the outlook for persons with spina bifida. Not only are they able to live into adulthood, most individuals are able to pursue active, productive lives.

Spinal Cord Injury
Spinal Cord Injury is damage to the spinal cord through injury or accident which results in partial or complete paralysis. The spinal cord can be injured at any point along its approximate 17-inch length. Although each injury has its own characteristics, in general, the higher the point of injury, the higher the level and loss of function. The parts and functions which are located above the injury point will continue to function unimpaired.

Injury to the spinal cord is irreversible in that the cord is unable to regenerate or repair itself. In general terms, the effects of an injured spinal cord include paralysis, bowel and bladder dysfunction, impairment of sensation, susceptibility to urinary tract infection, and problems with skin integrity. Paralysis may not only affect motor control of certain parts of the body, but may also affect responses to external stimuli such as touch, temperature, pain, and sometimes even awareness of body position.

The most common kinds of spinal cord injury are paraplegia and quadriplegia. Paraplegia means paralysis of the legs, affecting both motion and sensation. Quadriplegia means a degree of paralysis in all four extremities (arms and legs). Weakness of the upper limbs may range from limited use to total paralysis, depending on the level of injury to the spinal cord. About 80% of all persons who experience spinal cord injury are young, active men between the ages of 18 and 30.

Short and/or Amputated Limbs
People with missing limbs are often referred to as amputees. A large number of amputations are the result of automobile, machinery or explosive accidents. Certain diseases such as diabetes, may necessitate amputations.

Some people are born with limbs that are short or formed differently than most people. People with short or missing limbs develop strategies for coping by using other limbs, such as writing or driving with the feet. Many also use prostheses or adaptive devices.

Some terms used to describe the location of an amputation are unilateral (one arm or leg), bilateral (two arms or legs), double (one arm and one leg), and multiple (more than two limbs).

Stroke
Stroke involves the destruction of brain substance that results from a rupture of a cerebral blood vessel, the occlusion of a cerebral blood vessel, or vascular insufficiency.

Hemiplegia (paralysis on one side of the body) and speech impairment are common effects of stroke. Emotional effects frequently experienced by people following a stroke are frustration, depression, and anger. While the majority of people experiencing strokes are age 50 and over, younger people also experience strokes.

Visual Impairment
People with visual impairments have a wide range of abilities and limitations. There are many kinds of visual impairments. People who are described as legally blind may be able to read large print and move about without mobility aids in many or all situations. They may be able to perceive light and darkness, and perhaps some colors. However, someone who is legally blind may not have any of these skills.

The vision of some individuals with impairments may be better one day than another, depending on fatigue and other factors. Environment can also influence an individual's visual abilities. He or she may be able to see better in certain lighting or other conditions.

Glare can be a major problem for some people. Glare usually results when too much light bounces off light-colored walls and floors, making it difficult or uncomfortable to navigate a long corridor or around a room. Low-light level conditions result in heavy shadows, making it difficult for some people to perceive hazards such as stairs or changes in floor surfaces.

Some people with congenital visual impairments (impairments present from birth) may have learned skills in reading braille and tactile orientation guides. However, people who have lost their sight later in life usually have visual memories of color, scale and concepts such as reflections that people who have been blind since birth do not have.

Visual impairment may result from disease, defective functioning of various parts of the eye, defects in the shape of the eye, congenital defects, irritation, injury; and accidents.

The leading causes of blindness, in order of incidence, are cataracts, glaucoma, diabetes, vascular disease, trauma, and heredity.