As part of the Therapeutic Recreation (TR) for Special Population course, I was tasks to simulate four disabilities to experience a range of disability simulations, develop empathy and appreciation for the lived experience of individuals with a disability, to reflect on my own pre-existing values and belief systems regarding individuals with a disability, and to reflect upon the requirements of recreation therapy service delivery for groups of people and individuals with a disability. I thought how hard can this be.
As the Director of Recreation Therapy and Volunteer Services in a nursing home, I have plenty f experience working with people who have a disability. I had to chose a disability with the following areas: behavioral health, geriatrics, developmental disabilities, and physical medicine/ rehabilitation. I was apprehensive about this exercise as I did not want to trivialize the experience of what it means to be living with a disability. Nevertheless, I thought this would be a simple task and is to complete. However, I soon realized it would be emotionally challenging and more difficult than I anticipated.
The first challenge I faced was choosing four disabilities to simulate. There are more than 39 disabilities listed in Porter’s textbook. Which one do I feel comfortable with? Do I have the resources to do the simulation? How do I do this without offending anyone? Am I capable of doing the simulation? I decided simulate something that I was familiar; Cerebrovascular (Stroke) and Visual Impairments and Blindness. As for the other two disability simulations, I decided to step out of my comfort zone and learn more about the Autism Disorder and the Schizophrenia Disorder.
I performed the four disability simulations; each lasting for a period of one hour. I faced several challenges in completing the imulations. During the simulations, my preconceived notions about serving individuals with a disability was also tested. I may not have gained an accurate insight what it is like to live with a disability; however, I did gain a greater awareness of key areas that affect a person’s leisure experience. Simulating a disability will make therapeutic recreation (TR) professionals better at the job they do.
Cerebrovascular Disease (CVA) – is better known as a stroke and occurs when there is either a blockage or rupture of a blood vessel that carries oxygen and nutrients to the brain. There are approximately 800 000 Americans suffer from a stroke each year and on average, every 40 seconds, someone will experience a stroke. Within the vascular system, one or more of the following are the primary factors that cause an cerebrovascular incident: 1. Thrombosis: a blood clot that develops in the brain and blocks the blood flow. 2. Embolism: a blood clot that stems somewhere else in the vascular system and travels to the brain and blocks the blood flow. . Hemorrhage: bleeding in the brain that is caused by a blood vessel rupturing. The primary areas affected by a stroke are an individual’s: a. Motor functions b. Sensory functions C. Cognitive functions d. Language functions e. Visual functions Stroke Simulation: I simulated having a stroke on my left side at work and outside my work place. Our rehabilitation assistant secured a properly fitted wheelchair (w/c) for the exercise. I did the following two simulations:
1. Thirty minutes in the building: a. First 5 minutes in the chair: felt comfortable with no issues b. Last 25 minutes: tired, left shoulder hurting. Used railings to make it easier to move. Felt frustrated that I could not maneuver the chair through doorways. 2. Thirty minutes outside he building a. Immediately frustrated, more difficult to maneuver the w/c, difficult going up the slightest hill, staff ask if I wanted help, I refused, felt embarrassed. Yoga is a wonderful TR intervention that can help improve flexibility and muscle tone. Yoga programs can easily be adapted and implemented for individual who experienced a CVA. (Bastille, 2004) Autism Spectrum Disorder (ASD) – is a neurodevelopmental disorder.
It is the fastest growing developmental disability in the US. One in 70 boys is diagnosed with Autism compared to one in 315 girls. The etiology of ASD is unknown; however, the ollowing areas of research may help explaining ASD: a. Genetics b. Neurological structure and development c. Environmental factors Autism spectrum disorder affects an individual’s social interaction and an individual’s ability to accept and adapt to changes in the environment. Autism Simulation: Most difficult and emotionally challenging simulation to do.
I used an IPad and the internet to do the following four simulation on Autism: 1. Twenty minutes watching the five videos on sensory stimulation at work. Very informative and experienced sadness for one of the individuals in the video. 2. Twenty minutes at my home simulating a sensory overload. Watched a hockey game while playing load music in the background. Felt frustrated and annoyed due to load noise. 3. Twenty minutes walking in the shopping mall while listening to a podcast. Tried to focus on everything around me. Felt disorientated, could not concentrate, and difficult remembering things. LEGO therapy is a good TR intervention for children with autism.
LEGO therapy is a group exercise that is designed to motivate children to work together by building with LEGO blocks in pairs or small groups. The intervention is designed to reduce aladaptive behaviours and increase peer socialization. (Owens, 2008) Schizophrenia Disorder – is a mental disorder with lasting challenges. It is diagnosed by: 1. Having two or more of the following symptoms: a. Delusions b. Hallucinations c. Disorder thinking and speech d. Motor behaviour e. Negative Symptoms 2. At least one of them must be delusions, hallucinations, or disorganized speech. 3. The symptoms must be present for a minimum of six months.
4. Noticeable changes in the ability work, interact with others, carry out self care, or perform in other important life areas. (Porter, 2015) Schizophrenia typically begins in early adulthood; between the ages of 15 and 25. Men develop schizophrenia slightly earlier than women. Most males become ill between 16 and 25 years old, most females develop symptoms several years later. The average age of onset is 18 in men and 25 in women. (Schizophrenia Facts and Statistics, n. d. ) There is no known cause for schizophrenia; however, researchers believe a combination between genetics and the individual’s environment can trigger the disorder.
Schizophrenia affects: 1. Cognitive 2. Emotional Functioning 3. Social Functioning (Porter, 2015) Schizophrenia Simulation: For the simulations, I used a photocopied a script with specific questions and downloaded an audio of voices that imitated audio hallucinations. 1. Fifteen minutes watching a television program while listening to the audio hallucinations. Felt irritable, lacked concentration, focus more on voices than show, and felt frightened by voices. 2. Fifteen minutes socializing my two teenage daughters while my wife whisper in my ear the script of questions. Experienced the same irritations and fearful emotions.
3. Fifteen minutes texting on the phone while my listening to the audio allucinations. Wasn’t as irritated or afraid. Felt in control of situation. 4. Fifteen minutes walking while listening to the audio voices. Felt less annoyed, less fearful and could focus on my surrounding. Video games is an excellent TR intervention as they can be used to positive symptoms especially delusions. It also helps improve involuntary movement. (Han, 2007) Visual Impairments and Blindness (VIB) – visual impairment is difficult to defined. Two most common criteria used to define VIB are visual acuity and visual field. 1. Visual acuity – sharpness of vision.
Measured by the ability to see small details from a given distance from a set standard. For instance, 20/20 vision normal vision, can see small details from 20 feet away. 2. Visual Field (degrees of peripheral vision) – tells how a person sees from one side to another and from up and down. (Porter, 2015) VIB is one of the most common causes of a disability in the United States. The following are potential causes for VIB: 1. Ocular VIB – a diseases or condition that affects the eye. A few examples include refractive errors, age-related macular degeneration, cataract, diabetic retinopathy, and glaucoma. Cortical (injury or structural differences in the brain) VIB – affects mainly seeing functions. However, secondary and comorbid conditions such as depression, diabetes, hearing impairment, stroke, falls, and cognitive decline. (Porter, 2015) Visual Impairment Simulation – Required the least preparation and materials.
1. Fifteen minutes at work station blindfolded. Felt challenged but confident. 2. Fifteen minutes blindfolded in staff meeting. Felt unfocused, difficult to concentrate, felt comfortable hearing my name during conversation.
3. Fifteen minutes at home trying to do chores around the house. I felt comfortable and more confident in my own surrounding. 4. Fifteen minutes at local park with my family. Felt uncomfortable and unsure of my surroundings. Individual with VIB would benefit from physical activity. This is a great TR intervention as it improves one’s quality of life and overall satisfaction. (Kamelska, 2015) The simulations help me a better awareness of challenges that a person with a disability might face. However, I do not feel I experienced a good representation of the real-life of an individual with a disability. I could emphasize more if I could emerge myself in the activity with people living with a disability.
It was very difficult to simulate a mental health disability. Spending time with individuals with a mental illness would be more beneficial than simulating the disorder. I felt more comfortable simulating the physical disabilities such as a stroke and being visually impaired. The resources to create these simulations were easy to obtain. As for the other two disability simulations, I was uncomfortable and at times felt scared simulating the autism and schizophrenia disorders.
I gained insight in three key areas that I feel will make me a better TR professional: 1. Environment Awareness: The little things matter just as much as the big things. The lighting in the room, the noise level, and even the layout of the room can affect a person’s leisure experience. Being able to determine what the client prefers can make a positive difference in their leisure experience. 2. Adaptive Equipment: Have the proper wheelchair to help create more independence or providing headphones to decrease noise levels can have a positive affect the way an individual experience. 3. Support System: Having someone say your name or stand beside you can motivate you to take part in leisure experiences.
There are many leisure services available for individuals with disabilities. “The Playbook”, a collaboration between parents of children with disabilities and the Halifax Regional Municipality Community Recreation Services Department, is a resource guide that list leisure opportunities for those with people disabilities within Nova Scotia. Conclusion I will not pretend that this exercise has given me a greater understanding of what it is like to live with a disability: however, I was surprised that I felt sadness and that I was fearful at times during the simulations.
This gave me a reminder that there are emotions do consider when working with any individual. Having a physical or mental disability can have a substantial effect upon a person’s ability and desire to participate in leisure activities. Simulating a disability can be challenging and difficult to perform. It may also not provide an accurate sense of what a person with disability goes through. By simulating a disability TR professionals can gain a sense of awareness of barriers a person with a disability face. Addressing these barriers, will help the TR professional provide better services to their clients.
