Physical Impairment: Definition, Types, Characteristics, Causes, Handling, etc
Physically disabled are individuals who have movement disorders caused by neuro-muscular or bone structure disorders that are congenital, diseased, or due to accidents. Among them are disabled individuals with cerebral palsy, amputation, polio, and paralysis (Anggara in Asrori, 2020, p. 81).
Meanwhile, according to Hallahan & Kauffman (in Sulthon, 2016, p. 23) quadriplegics are non-sensory physical limitations or health problems that interfere with learning at school, which requires training services, equipment, materials and special facilities.
Physically, sometimes quadriplegics are no different from people in general. People can know they are deaf when they speak, because they speak silently or in an unclear voice, or even don’t speak at all and they only use lip language or use sign language in communicating. However, for disabled people there are some people who look normal on the outside if the classification of a quadriplegic is carried in the heavy category which of course will be seen using a wheelchair or other mobility aids.
In addition, a quadriplegic is also defined as someone who has difficulty optimizing the function of the limbs as a result of injuries, diseases, deformed growths, and as a result the ability to perform certain body movements has decreased (Effendi in Asrori, 2020, p. 81).
It can be concluded that quadriplegic is a non-sensory physical disorder and limitation that can be caused by disease, virus, or congenital before or after birth so that it requires special services because it experiences certain limitations both during development and in everyday life.
Characteristics/Characteristics of the Physically Disabled
In general, the characteristics or characteristics of individuals with physical impairments are as follows.
Difficulty in movement (imperfect, inflexible, uncontrollable).
There are parts of the limbs that are incomplete.
There is an abnormality in the locomotion.
Fingers are stiff and unable to grip.
Difficulty standing, walking, sitting and showing abnormal body postures.
Hyperactive/unable to calm down (Geniofam in Asrori, 2020, p. 83).
Meanwhile, according to Murtie (2017, pp. 259-260) an understanding of children with physical disabilities can be known through their characteristics both physically and psychologically, which include the following.
One part of the body experiencing obstacles. For example, having weakness in the feet, hands, fingers, or other body parts.
Barriers to motor factors, when moving places, moving, walking, or not being able to control body coordination.
Lack of self-confidence because in conditions as mentioned in points 1 and 2 above, children with physical disabilities tend to close themselves off so that their potential is hampered.
Classification of the Physically Disabled
There are many classifications of quadriplegic based on certain conditions, such as: orthopedically handicapped (paradise due to bone and muscle disorders) and neurologically handicapped (paradise due to nervous disorders). According to Asrori (2020, p. 82) the classification of disabled people based on their level of disturbance is as follows.
Mild level of physical impairment
This classification is pure quadriplegic and mild combined quadriplegic. This type of physical disability generally experiences only a few mental disorders and their intelligence tends to be normal. This group is more due to limb-only abnormalities, such as paralysis, reduced limbs (stunting), and other physical disabilities.
Moderate level of disability
Individuals included in this classification are quadriplegics due to congenital defects, mild cerebral palsy, and mild polio. This group experienced tuna due to cerebral palsy (mental) which was accompanied by a decrease in memory when it did not get far below normal.
Severe level of disability
This classification is the result of severe cerebral palsy and hereditary due to infection. In general, children affected by this disability at their level of intelligence belong to the debilitated, imbecile, and idiot class. Based on the various definitions above, it can be concluded that a disabled child is a child who experiences various types of physical disorders caused by factors from birth or illness and injury, resulting in difficulties in optimizing the function of the limbs.
Cerebral Palsy (Impossible due to Central Nervous Disorders)
Furthermore, quadriplegics can also be classified into cerebral palsy or quadriplegics caused by central nervous system disorders. Based on the level or degree of disturbance, cerebral palsy can be divided into the following types.
Cerebral palsy is a mild category, characterized by being able to walk without aids, speak clearly, and be able to help oneself;
Cerebral palsy is in the moderate category, characterized by the need for assistance with speaking, walking, self-care, and special tools such as braces;
Cerebral palsy is in the severe category, which has the characteristics of requiring permanent care in an ambulance, talking, and self-help (Karyana & Widati, 2013, p. 34).
Meanwhile, based on the location of brain abnormalities and movement functions, cerebral palsly can be divided into several types below.
in the muscles there is partial or complete stiffness, spasms occur in the muscles due to stiff movements and can disappear when the state is still. As in sleep. Generally these spasms are severe when in a state of anger.
Athetoid dyskenesia, including athetosis (the patient shows uncontrolled movements).
with the characteristic of stiffness throughout the body, it becomes difficult to bend. The child experiences stiffness in the muscles accompanied by very slow and rough movements. The conditions of children like this greatly affect their daily activities.
the growing members always move on their own like small vibrations in the eyes, hands or on the head continuously.
has the characteristic of not experiencing spasms or stiffness, the muscles move easily, and sometimes there are uncontrollable movements beyond their ability. Movement can occur in the hands, feet, tongue, lips and eyes.
its characteristics include disturbed balance, unsteady gait, eyes and hands not functioning because they are not coordinated.
have abnormalities of two or more of the types mentioned above (Karyana & Widati, 2013, pp. 34-35).
Physical Impairment due to Skeletal and Muscle Disorders
Abnormalities of the muscular and skeletal systems in children with physical impairment are classified into the following groups.
an infection located in the spinal cord due to the polio virus which causes paralysis and is permanent. Polio children are divided into: (a) Spinal type, neck muscles, chest septum, paralyzed hands and feet; (b) Bulbair type, characterized by respiratory problems in the motor function of one or more peripheral nerves resulting in paralysis; (c) Bulbispinalis type, a combination of spinal and bulbar types.
the child has a fever, decreased consciousness, tremors, and sometimes has seizures. This paralysis is withered in nature, does not cause interference with intelligence or sense organs. This disorder results in muscles that become small (atrophy) due to damage to nerve cells, joints experience stiffness (contractors), limbs experience shortening, curvature of the spine to one side, like the letter S (scoliosis), experiencing bending outward or to the side deep on the sole of the foot, dislocation (a joint that is outside of its seat), the knee bounces back (genu recorvatum).
As a result of this disease, muscle development is not perfect because it is paralyzed with a progressive and symmetrical nature, and can be due to heredity.
namely spinal abnormalities characterized by the opening of one or three vertebrae and during the development process they are not closed again. So that the nerves are disturbed and can cause paralysis, hydrocephalus excessive fluid production causes enlargement of the head. So that disability occurs (Karyana & Widati, 2013, pp. 35-37).
Individuals with disabilities will face obstacles in carrying out their daily activities. The obstacles experienced by disabled people are as follows.
The occurrence of control of various parts of the body by the brain. This can affect the senses of sight, hearing, language, and movement. This is a Barrier in sensory factors.
Intelligence is below average, because children lack confidence in learning. This is a bottleneck in the cognition factor.
Experiencing obstacles in thinking about things properly. Because there is one thing that is in the brain so that the physical abnormality becomes quadriplegic.
Barriers in terms of emotional and social. The feeling of lack of confidence in children with physical impairment affects their emotions and social relationships with other people. Feelings that often arise include shame, inferiority, low self-esteem, and sensitivity. So if someone approaches the child often rejects that person.
Children with physical impairment in developing self-concept and self-actualization are lacking. Cognitively, disabled children are the same as other normal children, but their lack of self-confidence, inferiority and so on makes their potential less developed (Murtie, 2017, p. 260).
Impact of Disability
Through the characteristics of children with physical impairment can influence in terms of the ability to adapt to the environment which tends to be passive. In this case the behavior of children with physical impairment is influenced by the type and degree of their offspring. Other impacts can also be known from several aspects including academic aspects, social aspects, and health aspects which will be explained according to Atmaja (2018, p. 143) as follows.
Impact of academic aspects
The level of intelligence in children with physical disabilities who have abnormalities in the muscles and skeleton is normal, in this case children with disabilities who have abnormalities in the muscles and skeleton can learn with other normal children. Whereas in children with physical disabilities who have cerebral palsly disorders, their level of intelligence ranges from very low to very high. According to Hardman (in Karyana & Widat, 2013, p. 43) 45% of children cerebral palsy experience mental retardation, 35% have normal and above normal levels of intelligence, and the rest are slightly below average intelligence.
Emotional social impact
This impact is because a person with a quadriplegic feels that he has a disabled body, is useless, and even becomes a burden to other people, so that they spend the night studying, playing, and acting like other people. This child is also not accepted by parents and society, thus damaging the child’s personal development. Another thing is also regarding physical activities that cannot be carried out by children with physical disabilities which cause emotional problems such as being easily angry, easily offended, low self-esteem, frustrated, shy, difficult to get along with friends.
Physical and health impacts
The impact on children with physical disabilities apart from physical disabilities, also has other disorders, namely toothache, poor hearing, vision, speech disorders and so on. This disorder usually occurs in children with physical impairment of muscle and bone disorders. Meanwhile, people with physical impairment who have cerebral palsy will usually experience damage to the pyramidal and extrapymadial tracks whose function is to regulate the motor system. So they experience chaos, balance disorders, uncontrollable movements, and even have difficulty moving.
Factors Causing Physical Disabilities
There are several causes of physical disability, located in the brain tissue, spinal cord tissue, in the skeletal system. The occurrence of brain damage can occur before birth, at birth, and after birth which will be explained as follows.
Before birth (prenatal phase).
Damage occurs when the baby is still in the womb, damage is caused by: (a) when the mother is pregnant with a disease that attacks the brain of the baby she is carrying, for example infection, syphilis, rubella, and typhoid abdominolis; (b) circulation is disrupted, the umbilical cord is compressed, due to uterine abnormalities damaging the formation of nerves in the brain; (c) The baby in the womb is exposed to radiation. Direct radiation affects the central nervous system so that its structure and function are disrupted; (d) The mother experienced trauma (accident) while pregnant, resulting in disruption of the formation of the central nervous system.
Causes at birth (natal phase, natal elves).
The reasons for the damage to the baby’s brain when the baby is born include: (a) the birth process takes too long and the mother’s spine is small. So, the baby is deprived of oxygen, and causes disruption of the metabolic system in the baby’s brain, so, the central nervous system is damaged; (b) the brain’s nervous tissue in infants can be damaged due to the use of assistive devices in the form of pliers during difficult births; (c) Anesthesia is used by mothers during childbirth because the operation exceeds the dose. As a result, it affects the nervous system of the baby’s brain, the brain experiences abnormalities in its structure or function.
Causes after the birth process (postnatal phase).
The period of infancy after birth until brain development is considered complete, namely at the age of 5 years. The causes are defects after birth including: (a) Disease factors, such as meningitis (inflammation of the lining of the brain), encephalis (inflammation of the brain), influenza, diphtheria, partussis and others; (b) Accident factors, for example having a traffic accident, having been hit by a hard object, having fallen and been hit in the head; (c) Imperfect body or bone growth (Karyana & Widati, 2013, pp. 41-42).
Handling of the Physically Disabled
Dealing with disabled children requires special handling, in this case involving the people around them to handle them. The handling carried out for children with physical disabilities are as follows.
Parents need to realize and fully accept the child’s situation. Acceptance of the child’s condition is a positive energy from parents. By fully accepting, parents can realize that the imperfect condition that the child carries behind it has other potential. Here, parents who have children with disabilities are to explore this potential and accompany their children so that they can develop properly and in a focused manner.
Look for as much information as possible about matters relating to the handling of the body parts of children with limited movement. Through this awareness of seeking information, parents can have the facilities and infrastructure in caring for and accompanying children. Through this information, the risk can be minimized with various therapies. So that the limbs can function normally like other children.
Provide space for movement and schools that are suitable for children. Children with physical disabilities have the same mentality as normal children, so they can still go to public schools. It should be noted that parents must consider the facilities and mentality of their children so that they can be effective and grow well at school. However, sometimes children feel inferior if they are sent to public schools. However, public schools that support inclusive principles can be an excellent option.
Stimulation of children’s abilities in the fields they like and are good at. After knowing the potential that exists within a quadriplegic child, then parents can stimulate their abilities so that the child’s self-confidence grows. And they easily develop themselves, and don’t focus too much on their own shortcomings (Murtie, 2017, p. 261).