Academic journal article Health and Social Work

Promoting Good Health in Adolescents with Disabilities

Academic journal article Health and Social Work

Promoting Good Health in Adolescents with Disabilities

Article excerpt

To reap the full benefits of adult life, adolescents with developmental disabilities not only have to master self-sufficiency and independent living but also have to maintain good health. The necessity for their good health maintenance (Wallander & Siegel, 1995) has been underscored by recent attempts to implement the 1990 Individuals with Disabilities Education Act (IDEA) (P.L. 101476) and the Americans with Disabilities Act of 1990 (ADA) (P.L. 191-136). However, despite the documented service need (Lipkin, 1996), the U.S. Department of Health and Human Services has failed to allocate the national resources necessary for promoting the health and well-being of all youths with disabilities (Lollar, 1994).

As key players in the health care arena, social workers are familiar with the general concept of health promotion, but like others in U.S. society, they seem unsure what constitutes "good" health for adolescents and tend to view the concept of disability as the opposite of good health (Williams, 1994). Social workers and other professionals seem unsure whether to focus primarily on rehabilitation or habilitation and whether to include the prevention of secondary conditions (Dorval, 1994). The difficulty in conceptualizing good health for adolescents with developmental disabilities is further compounded by the varied etiology attributable to prenatal, perinatal, or postnatal factors and by the range of functional limitations in communication, self-care, learning, mobility, capacity for self-direction, independent living, and economic self-sufficiency.

To address this problem this article first explores the difficulties health professionals experience with the concepts of good health, rehabilitation versus habilitation, and assistance and independence for youths with developmental disabilities. Next, it considers the concepts of mobility, education and learning, family adjustment, social relationships and sexuality, and emotional adjustment to adolescence as major factors that may circumscribe individual health adjustment. Third, it discusses the context of adolescent health promotion. Last, in exploring implications for social work practice, the article develops a psychosocial approach that takes into account quality of life, prevention, and implementation.

ISSUES IN HEALTH PROMOTION

Concept of Good Health

For the general population, good health has been defined as both the absence of illness, injury, and disability and the presence of ability to achieve greater choice and control in life. By contrast, the health status of youths with developmental disabilities is defined by cognitive, emotional, or physical limitations or restrictions in life functioning. This singular focus on the presence of physical deficits contradicts the general concept of good health and fails to take empirical evidence into account. Such evidence documents that developmental disabilities are not static conditions throughout life (Bergman, 1994) and that good health is associated with a sense of personal well-being derived from the interplay of satisfaction in personal relationships, health, education, work, standard of living, community interaction, creative expression, and future prospects for growth and development and the absence of perceived stress (Lollar, 1994). These points are of critical importance in that the definitions of health and health problems affect the solutions sought. Thus, for youths with developmental disabilities, reconceptualizing health and well-being from the presence of physical deficits to the presence of social strengths directs attention to their capacity for self-direction in personal care, education, socialization, personal intimacy, and vocational choices.

Rehabilitation versus Habilitation

Rehabilitation aims to develop or restore functional capacity with a goal of independence. It advocates for consumer choice, empowerment, informed consent, and integration. …

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