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The Six Types of Disabilities to Be Assessed Under New Guidelines

The government, through the Ministry of Health, has developed new guidelines for conducting assessments and categorizing disabilities in the country.

Assessment of disability Kenya | © Unsplash

Disability guidelines Kenya (Unsplash)

The Disability Medical Assessment and Categorization Guidelines are the first of their kind in the country and aim to "provide a standard process, unified and consistent language, for conducting the assessment and categorization of persons with disabilities."

The guidelines, the first of their kind, have offered six categories (domains) for disability, in line with the International Classification of Functioning, Disability, and Health (ICF) model.

  • 1

    Physical Disabilities

    The guidelines define physical disabilities as conditions that affect a person's mobility, functional capacity, coordination, strength, limb length, and dexterity. Upon interaction with the environment, physical disabilities hinder full and effective social participation on an equal basis with others.

    The causes of these conditions include neurological, musculoskeletal, posttraumatic, or congenital disorders. The guidelines categorize physical disabilities into three:

    1. Neurological: Examples include cerebral palsy, congenital hip dislocation, acquired brain injuries, Erb's palsy, hemiplegia, hydrocephalus, klumpke's palsy, monoplegia, multiple sclerosis, muscular dystrophy, paraplegia, poliomyelitis, quadriplegia, spina bifida, and spinal cord injuries

    2. Musculoskeletal: Examples include amputation, arthritis, arthrogryposis, ankylosing spondylosis, congenital deformities, freeman sheldom syndrome, kyphoscoliosis, osteogenesis imperfecta, phocomelia/amelia, scoliosis, and kyphosis. 

    3. Other physical conditions: Includes permanent colostomy, dwarfism, and gigantism.

  • 2

    Visual Impairments

    According to the guidelines, visual impairment occurs when an eye condition affects the visual system and one or more of its functions and causes a decreased ability to see to the degree that causes problems not fixable by usual means, such as glasses, intraocular lenses, contact lenses, and surgery.

    Visual impairments are categorized into five: normal vision, mild visual impairment, moderate visual impairment, severe visual impairment, and blindness.

  • 3

    Hearing Impairment, Speech And Language Disability

    1. Hearing impairment: Any level or grade of hearing loss. Hearing loss refers to any reduction of or difficulties in hearing sounds. The guidelines identify three types of hearing loss-conductive hearing loss, sensorineural hearing loss (SNHL), and mixed hearing loss.

    2. Speech, Language, Communication, and Swallowing Impairments

    According to the assessment guidelines, disabilities in these categories may be congenital or acquired, stable, improving or progressive, and temporary or permanent. They include:

    • Speech impairments: Includes dysfluency/ stammering/stuttering and cluttering; voice difficulties such as aphonia (total voice loss, which can be temporary or permanent), dysphonia (partial voice loss); speech sound disorders such as articulation; and motor speech disorders such as dysarthria and Verbal Dyspraxia.

    • Language disorders: Refers to children and adults with language difficulties that create obstacles to communication or learning in everyday life. The disorders tend to be congenital in children and acquired in adults through a head injury, dementia, or stroke.

    Includes developmental language delay and disorder (DLD)/specific language impairment (SLI), congenital language disorder, and aphasia (acquired language disorder in adults).

    • Communication impairment: People with social communication disorder have prominent difficulties with using language for social purposes or pragmatics, for example, in conversation, story-telling, and figurative language, i.e., jokes and metaphors.

    Swallowing impairment-commonly known as dysphagia, it includes swallowing and drinking difficulties in infants, children, and adults.

  • 4

    Mental Health Disorders, Intellectual Disability, And Autism Spectrum Disorders

    Disabilities in this domain are divided into two categories:

    1. Mental health disorders: According to the assessment guidelines, these are disorders of the mind characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior. The disturbance reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.

    They include neuro-developmental disorders, Schizophrenia spectrum, other psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, and others such as trauma and stress-related disorders, somatic symptoms, and related disorders.

    1. Neuro-developmental disorder: Includes intellectual disability, Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder (ADHD), and Specific Learning Disorder.

  • 5

    Chronic Progressive Disorders

    The guidelines define chronic progressive disorders as health condition or disease that worsens over time, resulting in a general decline in health or function. They are characterized by:

    • A recurrence or deterioration pattern that is incurable. 

    • Poor prognosis that worsens with time.

    • Consequences that affect an individual's quality of life.

    • Persisting for at least 12 months-long term.

    • Substantially limits a person’s ability to perform essential functions or activities of daily living.

    They are divided into ten categories-cardiopulmonary/ cardiovascular, musculoskeletal, neurological, cancers/malignancies, gastrointestinal disorders, dermatological conditions, vascular conditions, genito – urinary, frailty, and HIV/AIDS & HIV-associated illnesses.

  • 6

    Maxillofacial Disabilities

    According to the assessment guidelines, maxillofacial disabilities are conditions related to the oral, dental, and maxillofacial structures, leading to considerable permanent loss of function and affecting the individual’s daily living and productivity.

    The disabilities are characterized by orofacial pain, infection, or pathological condition and lack of functional dentition affecting nutritional intake, growth, development, or participation in life activities.

    Examples include impairments affecting the teeth, jaws, temporomandibular joints, nerves, Soft tissues, and Salivary Glands.

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