Glossary of Terms



A form of hemoglobin used to test blood sugars over a period of time.

ABCs of Behavior
An easy method for remembering the order of behavioral components: Antecedent, Behavior, Consequence.

An injury that may include a scrape, a scratch, a scuff, a graze or a cut to the individual's skin.

A collection of pus around an infection.

Absorb, absorption
When liquids soak into a tissue they are absorbed. Some medications are delivered into the body by allowing them to soak into the skin or other body tissues.

To refrain from doing something or to not participate.

The intentional infliction of injury, unreasonable confinement, intimidation,or punishment aimed at another, with resulting physical harm, pain, or mental anguish.
This term is one that is commonly defined very specifically by state laws or regulations. You must be familiar with your state definitions. States that have specifically provided links to definitions or information regarding this term through special CDS customizations content include: PA, KS, MN.

Being able to get something. Getting services easily enough so the person is encouraged to do so rather than give up and go away.

When facilities have been adapted so that persons with physical or mental handicaps may be able to use them. Example: an "accessible van" means that there is a wheel chair lift and handrails so that persons with disabilities may be able to get in and out of the van.

Accident/incident Report
See definition for Incident/Accident report.

Accidental Exposure
A non-intentional contact with another person's blood or other bodily fluid(s)

Unplanned events or mishaps that we usually try to avoid and that may or may not cause injury, such as a car accident, slipping and falling, or tripping over something.

This is usually a change that helps a student work around his or her disability. It includes tools and techniques that help students keep up with a standard workload that is the same as their peers. An example might be a child that cannot hear. He or she may be provided with a sign language interpreter during class.

Something that is free from error.

To agree with others without protest. To be compliant.

Assertive Community Treatment (ACT)
Assertive Community Treatment (ACT) is a model of mental health care. ACT services are available to a person with serious mental health conditions as needed and on a regular basis in the community. Members of an ACT team are multidisciplinary and provide service ranging from medication management to rehabilitation support. ACT is a promising model that improves outcomes for people. It is recognized as an evidenced based practice by SAMHSA; however, it is not widely available.

A movement or series of movements which convey meaning; may be intentional or unintentional, e.g. jumping up and down is an action that may convey excitement.

Action Plan
One of many terms being used for creating a plan for people receiving services that is based on their abilities, strengths and personal desires or goals. These plans are created by support teams or circles of support (the people who know the person best and who the person would like to have participate in planning), and professionals who are only invited at the request of the rest of the support team. Action plans are more and more being used to replace previous deficit based planning (see IEP/IPP/IHP/ISP).

Action Plan
Specific planned things or actions you know to do during an emergency.

Active ingredients
The ingredients in a medication with known medicinal effects.

Active Listening
  1. A technique used to become fully involved in the communication process in which the listener works to understand the message, feeling and meaning of the other person communicating.
  2. It involves sensing, understanding, evaluating and responding. An active listener has an open mind and hears out the speaker, making a point of trying to understand the position of the speaker. Active listening includes verbal (saying things like mm-hmm," and okay" ) and nonverbal cues (such as nodding, appropriate eye contact, and attentive posture).

Activities of Daily Living (ADLs)
Everyday tasks such as brushing teeth, hair care, personal hygiene, communication.

A person who uses acupuncture to heal or improve health.

Acute health conditions
are those that need immediate attention, are temporary, and from which individuals usually recover, such as colds and flu, or can begin as needing immediate attention and may lead to long-term care, such as a heart attack or a stroke.

Acute-on Chronic health conditions
are those where a sudden presentation of a problem (e.g. pain or decrease in function) that stems from a long-term condition (e.g. arthritis or diabetes). For example, sudden joint pain from a long-standing health condition of arthritis.

Any type of change to the way you would traditionally carry out instruction and assessment. There are two kinds of adaptations. This includes accommodations and modifications.

Adaptive behavior
Adaptive behavior is functional behavior. Adaptive behavior is shown by being able to take care of yourself. For example, being able to groom and dress yourself. It is shown by completing daily tasks and interactions in effective and expected ways. For example, being able to ask for things you want or respond to other's requests. Standards of adaptive behavior are adjusted for age. They are also adjusted for culture differences.

Adult Daily Living Skills (ADLS)
Everyday tasks such as brushing teeth, hair care, personal hygiene, communication.

Adult Protection Agency
An agency designated in a state to investigate reports of potential maltreatment to adults. Mandated reporters need to know where to report.

Advanced Cultural Competence
Beliefs and actions that put a high value on diversity. People and institutions that fall on this part of the continuum are able to quickly identify situations that are influenced by culture. They have many resources for understanding culture. They have good ability to build on current knowledge and share it. Many times individuals at this level take on leadership and human resource development roles as a consultant or within an organization.

Advance Health Care Directive
This refers to a legal document that names who is a person's Power of Attorney. That is the most important function of this document. See related terms: Power of Attorney, Advance Health Care Directive, and Living Will.

Adverse Reaction
Life threatening or permanent damage caused by use of psychotropic medications. This may include a serious drug allergy.

The act of being an advocate. Speaking up for yourself or others to improve a situation and get what is wanted or needed, or what is fair. See advocate.

A person who speaks up and is active in working toward equal rights, opportunities, and respect for another person or groups of people. Advocates can be paid or unpaid. Also see Arc National and Self-advocacy.

Being associated with something. Being linked to a social group. Choosing to be linked to a social group.

Affiliation is how much a person relates to his or her life circumstances.

refers to the negative attitudes and discrimination toward the elderly.

A condition in which white blood cell counts fall below safe levels. This condition can be caused by many factors. Use of antipsychotics can cause the condition. People who take clozapine are at increased risk. Signs of this condition include fever, sore throat, bleeding or cough. These are signs of infection. Immediate medical attention is needed for this condition.

Agreements of cooperation
  1. This is a plan between companies about how they will help each other during an emergency. For example, an organization may use a certain supplier of goods. That supplier may not be able to deliver the goods due to an emergency. The organization has an agreement with an alternate company to supply similar goods.
  2. For purposes of emergency preparedness, this is a formal agreement between two parties such as two service provider organizations or between a provider and a government agency that describes how each entity will help the other out during times of emergency. This document should be prepared and signed during non-emergency times.

An object or device used to assist.

Aided communication
A physical object used to send or receive messages. Aided communication approaches include the use of actual objects, communication boards with photographs or symbols, or "high tech" voice output devices that "speak" for the person.

AIDS (Acquired Immune Deficiency Syndrome)
A (currently) incurable and fatal disease cause by infection from the human immunodeficiency virus (HIV).

Airway Obstruction
Blocking of the passages or breathing tubes that carry air (oxygen) to the lungs.

This is a movement disorder. It can be a side effect of antipsychotic medication. It involves physical agitation. A person may pace or fidget and appear restless or nervous. It can be mild to very serious feelings of sensitivity. It can be mistaken for agitation caused by the treatment of psychosis. Caution must be taken not to over medicate the person as a response.

This is a movement disorder. It can be a side effect of antipsychotic medication. It involves a slowing or stiffening of movement. A person may sit still for long periods of time. He or she may appear stiff or clumsy when moving. This could also be a sign of Parkinson's disease.

Alcohol Based Disposable Hand Wipes
The alcohol in the wipes kills the germs. The wipes can be found in most supermarkets and drug stores.

To bring something into line, or to make straight.

A substance that causes an allergic reaction in some people. The substance could be a chemical, perfume, food, medicine, dust, smoke or bacteria.

A negative reaction to foreign substances by the body's immune system. These substances that might trigger an allergic reaction are called allergens (e.g., dust mites, pollen, mold, dander, food).

A negative reaction to foreign substances by the body's immune system. These substances that might trigger an allergic reaction are called allergens (e.g., dust mites, pollen, mold, dander, food).

A strong, abnormal reaction to something like plant pollens, dust, foods. Common allergy symptoms may include sneezing, itching, and skin rashes.

A choice or the opportunity to choose among several possibilities. Something other than what you currently have.

Alternative Medicine
Medical treatments that are not a part of conventional medicine such as acupuncture, meditation and herbs.

Alternative Therapy
Alternative therapies are those that are not considered to be traditional or conventional medical practices.

Alzheimer's Disease
Alzheimer's disease is the most common form of dementia among older people. It involves the parts of the brain that control thought, memory, and language. The disease usually begins after age 60, and risk goes up with age. There is some indication that people with certain disabilities, Down Syndrome being one of them, are at increased risk for onset at an earlier age. Alzheimer's disease is not a normal part of aging and currently there is no cure.

Ambiguous loss
A person experiences a loss that is private or not easy to define. It is the loss of dreams and hopes as much as the tangible loss that affects the person. Some examples may include miscarriage, loss of an important relationship, having to move from your home, or receiving a diagnosis of a mental illness.

American Sign Language (ASL)
The linguistic system of manual symbols used by the Deaf in the United States. (See also the definition for sign language.)

Americans with Disabilities Act (1990)
This law supports the rights of people with disabilities and prohibits discrimination against them. ADA also requires employers and public services to make reasonable efforts to allow people with disabilities to participate in the activities of normal community life.

Amniotic Fluid
The fluid that surrounds a fetus in a woman's uterus.

Area of and around the anus.

Anal penetration
A sex act involving insertion of the penis into the anus.

A person from whom one is descended. A person from whom one has inherited biological traits and cultural traditions.

Something that happens before a behavior that helps us gain insight into why the behavior occurs.

A small earthquake or tremor that follows a major earthquake. Aftershocks usually originate at or near the focus of the main earthquakes they follow and can continue for days or months. They usually decrease in magnitude and frequency with time.

An abnormal swelling or bulging of a blood vessel in the body.

Annual meeting
A yearly gathering of a supported individual and his or her support team. During the meeting they discuss the needs of the individual. A service plan is then developed for the upcoming year.

An eating disorder in which a person believes they are overweight even when they are thin, and they begin to starve themselves.

Events that occur before the behavior. Antecedents may or may not influence a behavior. When behavioral responses to antecedents are linked to desired consequences, these antecedents can serve as a signal to the person to engage in certain types of behavior (called discriminative antecedents). Once this relationship is learned, the person may continue to engage in the behavior following the antecedent, even if the behavior is no longer reinforced.

Antecedent Manipulation
Changing the environment so that the antecedents and setting events that predict the challenging behavior are avoided, and antecedents that predict the desired behavior are present.

Antibiotic ointment
A first aid cream used to prevent or eliminate infection by applying it to the individual's wound or injury.

Antidepressant medication
A psychiatric medication, prescribed by a doctor or psychiatrist, used to treat depression. Can take several forms including: selective serotonin reuptake inhibitors (SSRIs), tricyclics and monoamine oxidase inhibitors (MAOIs).

Used to treat symptoms of a psychotic illness such as schizophrenia or certain stages of bipolar disorder.

Antisocial Personality Disorder
A serious mental health disorder that involves a lack of respect for authority and the rights of others. A person living with this disorder may be physically aggressive, commit crimes against people and property, and show no remorse or guilt for his or her actions.

The opening through which bowel movements are passed.

A feeling that causes distress or uneasiness.

Anxiety Disorders
A category of mental disorders with the common symptoms of excessive, irrational fear or dread. People living with anxiety disorders frequently have a co-occurring disorder which can make diagnosis and treatment complicated. Panic disorder, post-traumatic stress disorder, social phobia, agoraphobia, and obsessive-compulsive disorder are examples of anxiety disorders.

Anxiety Disorder
A condition in which a person feels more anxious in a situation than would be expected. The increased anxiety is chronic or extreme and interferes with the person's ability to function. Anxiety disorders take different forms. They may be focused on a specific item, situation, or person. They may be more general. There are several types of anxiety disorders.

Difficulty with or loss of ability in speaking and understanding speech.

Applied Behavior Analysis
A field of study that: 1) uses the science and technology of behaviorism, 2) as it applies to behaviors thought to be voluntary, 3) and uses the technology to change or understand socially important problems or issues.

Arc National
A national advocacy group for people with mental retardation. There are also many State and local Arc chapters throughout the United States. In some states the local Arcs are also providers of residential and vocational services.

Deliberately lighting a fire for the purpose of damaging property or gaining attention.

a condition of painful inflammation and stiffness of the joints.

The American Speech-Language-Hearing Association is the professional, scientific and credentialing association for more than 118,000 members and affiliates who are audiologists, speech-language pathologists, and speech, language, and hearing scientists.

An Administrative Service Organization, a non-risk bearing entity that is hired to perform fiscal,
legal, & administrative tasks in a managed care system.

the inhaling of foreign matter into the respiratory tract such as food or other gastric substances.

Tools or processes that one uses to identify a person's strengths and needs or to identify the potential barriers in an environment. There are a number of formal assessment tools available. Informal assessments usually take place in daily interactions with people as a way to ensure that supports meet individual and situational needs. Select environments or arrange for success, as much as possible, in all situations.

Personal property or items of value owned by a person that have substantial value (e.g. cash, home, car, life insurance).

Directly stating your needs without being hostile or passive.

Assistive technology (AT)
Includes devices and services. An AT device is any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities. An AT service is any service that directly assists an individual in selecting, obtaining, or using an AT device. (Technology-Related Assistance for Individuals with Disabilities Act Amendments of 1994, PL 103-218).

Assistive technology device
Any item, piece of equipment, product or system, either purchased, created, modified, or customized, that is used to increase, maintain or improve functional capabilities of an individual. Simple pieces of assistive technology include spoons or forks with larger handles which make them easier to grip. Complex pieces of assistive technology include complex computerized communication devices.

A chronic condition in which a person's lungs get narrow causing difficulty in breathing and wheezing. Asthma is typically discussed in terms of "having an asthma attack."

the loss of muscle control.

involuntary, slow, writhing movements.

Athlete's Foot
A skin disease found on the foot caused by a fungus. It causes itching, burning, inflammation and scaling of the skin. It is contagious.

At Risk
The state of being in danger or likely to experience harm. Specific characteristics of an individual where he or she may require safety steps or actions to be taken to prevent unnecessary accidents, injuries, abuse, or other potential for serious harm.

A person in a hospital or other medical type setting that cares directly for a patient's physical needs. Historical term for direct support staff working in an institutional setting.

Attending skills
Demonstrating that you are interested and involved in what another person is talking about by leaning slightly forward, maintaining eye contact, and keeping both feet on the floor and arms uncrossed.

Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is estimated to affect 3 to 5 percent of all children. It is more common in boys than girls. ADHD can continue into adolescence and adulthood. People with ADHD can have trouble sitting still, planning ahead, and finishing tasks. They can be distracted by unimportant sights and sounds or unaware of what's going on around them. The causes of ADHD are still unknown and the symptoms can temporarily disappear for a few minutes or even an entire day. Because the symptoms can be disruptive and appear or disappear, many people with ADHD have difficulty in their relationships with others and in completing responsibilities at work, school, or home. These problems can cause diminished self-esteem and additional problems.

Attitudes of leavers:
Attitudes of leavers is the opinion employees who have been fired or who have quit their jobs have about the organization as a whole and about various parts of their job.

Related to the ear and the ability to hear.

Augmentative and alternative communication (AAC)
All forms of communication that enhance or supplement speech and writing. These forms sometimes replace "natural" speech production altogether. Different forms of AAC involve using communication boards, manual gestures or signs, and/or computers or other devices to communicate.

Authoritarian Style of Management:
An approach to managing an organization which is characterized by the manager controlling the flow, type, and amount of information, decision making, and input, that he or she wants to have with supervisors, Direct Support Professionals, and others as a way to maintain power.

The person or entity that has power. In a self-determined approach--the person with a disability and his/her supporters who have the power to change services, allocate or distribute funds for services.

Authorization Form
A written document that, when completed, provides authorization for confidential information to be released or given to another person or entity outside of an organization for an expressed reason.

Authorization to Release Information Form
This is a document that gives permission for information to be shared with others OUTSIDE of the service provider organization. For example when an individual is being referred for another service or when the agency or individual is part of a research project. To document authorization, you would use an authorization form.

see autism spectrum disorder

Autism-Spectrum disorder
Autism spectrum disorder (ASD) is a developmental disability that is caused by differences in how the brain functions. People with ASD may communicate, interact, behave, and learn in different ways. Signs of ASD begin during early childhood and usually last throughout a person’s life (1). ASD includes former diagnoses of autistic disorder, pervasive developmental disorder, not otherwise specified (PDD-NOS), and Asperger disorder. These diagnoses were collapsed into the single category of ASD in 2013.

Autoimmune disorder
A disease where the body's own defenses (immune system) attack the body's cells. These types of diseases can occur in various systems of the body. Treatment is usually a medication that suppresses the body's immune response so it does not attack itself.

Something that is aversive, is something that a person does not like or wants to avoid. Aversive procedures or techniques are those that use the presentation of something unpleasant to the person after he or she exhibits a behavior, with the desired effect being the stopping or discouraging the person from engaging in the behavior. Aversives are the actual products, events, or things that are presented to the person or brought into the environment to discourage or stop the behavior. Caution! Many forms of aversive procedures or techniques are prohibited by law. Any aversives that cause significant discomfort or harm (physical or psychological) are either prohibited or tightly monitored and controlled.

Aversive Procedures
see Aversive Punishment

Aversive Punishment
(sometimes called Aversive Procedures) Adding something to the environment in response to a behavior that decreases the likelihood that a person will engage in the behavior, such as slapping someone's hand when they reach for something. Caution! Aversive punishment is usually not allowed and should never be used in the absence of a carefully developed and reviewed behavior support plan and only when the challenging behaviors are extremely serious and all alternatives have been tried and have failed.

Avian or Bird Flu
Influenza (flu) viruses that have adapted to birds. Birds can "host" or carry the influenza virus.

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Baby Boomer
A person who was born in the United States between the years 1946 and 1964; the generation in which a large number of people were born after World War II.

Bacteria (plural) or Bacterium (singular) are microscopic single celled organisms or germs. They do not have a nucleus enclosed in a membrane, nor other internal structures. They are among the most common life form on earth. Most bacteria are useful and necessary, however some bacteria can cause diseases in plants, animals and humans.

Related to bacteria, which is a type of germ that causes infection and is spread by contact with contaminated surfaces and can also be airborne (though less frequently). Bacterial infections include staff infections and pneumonia.

Physical, emotional, or intellectual things which may get in the way of a person doing something that he or she would like to do. (see also Social & Cultural Barriers and Environmental & Physical Barriers)

  1. The starting point by which progress will be judged. In behavioral support plans or individual support plans there should be a baseline of behavioral activity or daily living skills so that, once teaching methods and other interventions are put into place, it is easy to tell if the person is learning new skills or decreasing the number and severity of challenging behaviors.
  2. A beginning measure against which progress can be compared

Basic Cultural Competence
Beliefs and actions that value diversity. People and institutions that fall on this part of the continuum welcome the chance to learn from people from different cultures. They often recognize when problems stem from cultural differences. They have a basic ability to work with people of varying cultures. They have skills and resources for dealing with some situations. They may find other situations more difficult.

Beck Depression Inventory
Created by Dr. Aaron T. Beck, this is a 21-question multiple-choice self-report inventory that is one of the most widely used instruments for measuring the severity of depression. The most current version of the questionnaire is designed for individuals aged 13 and over and is composed of items relating to depression symptoms such as hopelessness and irritability, cognitions such as guilt or feelings of being punished, as well as physical symptoms such as fatigue, weight loss, and lack of interest in sex.

Something someone does that is both measurable and observable. Behavior can be influenced by consequences and relevant antecedents. Something is measurable when you can count it or express it in numbers. It is observable when you can see it, hear it, or otherwise use your senses to monitor when it happens.

Behavior Intervention Plans
See Behavior Support Plans

Behavior Management Plans
See Behavior Support Plans

Behavior Protocols
Behavioral guidelines for individuals that specifically state what staff should do when particular behaviors occur. Behavior protocols are often used for challenging behaviors.

Behavior Support Plans
Plans developed to let support people (staff, family, friends and others) know how best to identify, track, prevent, and respond to an individual's challenging behaviors. These plans should have an emphasis on teaching new more appropriate skills for communicating needs. These may also known as behavior management plans, or behavior intervention plans, however, the term support is meaningful and may be evidence that the plan has an emphasis on positive behavior support as opposed to simply "managing" behaviors.

Behavioral Chain/Chaining
A behavioral chain is a series of of steps of individual behaviors that, when put together in sequence, lead to the completion of a whole task. Chaining is teaching two or more steps of the chain, in sequence.

Behavioral Questions
Ask participants to describe specific situations they have already experienced and how they handled them. They probe for details about the situation, what the person did in the situation, and what happened as a result.

A school of psychology that focuses on the effects of antecedents and consequences on observable and measurable aspects of behaviors.

A very strong feeling that a person feels when they are valued by others, when others call just to talk or invite him or her to go to a party or "hang out" at the mall.

A set standard that is used as a point of comparison.

New or emerging trends in the design of services or supports, often viewed as an improvement on the way things have been done in the past.

A preference or inclination towards something that prevents one from looking at the overall situation with objectivity. Bias is a form of prejudice.

A person who believes their own culture is superior to others. This person may or may not recognize differences as a part of culture.

Biographical questions
Ask the candidate for information about themselves such as educational experiences, credentials that acknowledge specific competencies, special awards, recognition, and achievements. You can verify responses to this type of information through documentation and reference checking.

Bipolar Disorder
A mood disorder in which the person can swing from depression to emotional highs. The frequency and symptoms are variable from person to person, with some being more often depressed, and differences in how often the moods cycle.

Bipolar Affective Disorder
A mood disorder in which the person can swing from depression to emotional highs. The frequency and symptoms are variable from person to person, with some being more often depressed, and differences in how often the moods cycle.

Black box warning
A black box warning is used by the US Food and Drug Administration to indicate that side effects of the medication can be very serious and even life-threatening.

Blepharitis is an infection that makes the eyelids red and itchy. Medications and special cleansing solutions can be used to treat this condition. If it is not treated, blepharitris can result in keratoconus. This is a disease of the cornea.

A long severe snowstorm with high winds

Bloodborne Pathogens
A disease causing microorganisms that are present in human blood. Two bloodborne pathogens that are of a central focus of occupational safety due to their potential to be fatal or lead to serious health problems include hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

Bloodborne Pathogens Standard
A federal standard for occupational safety that helps workers and employers understand how to prevent the transmission of bloodborne pathogens that can lead to illness and death. To view the standards you can visit the following website: sticks/needlesticks-regtxtrev.html

Blood glucose
The amount of sugar level found in the blood stream.

Blood Pressure
The force of the heart as it pumps blood through the arteries and other blood vessels to the rest of the body.

Blood Sugar Problems
An elevated level of the sugar glucose in the blood.

Blood type incompatibility
Blood type describes a person's blood according to the types of substances in the cells. The most common groups of blood types are ABO and Rhesus (Rh factor). Blood type incompatibility occurs when the blood type of the mother differs from the blood type of a fetus. ABO blood type incompatibility results when the blood type of the fetus, or developing child, differs from the blood type of the mother.

Bodily Fluids
(Also known as body fluids) Fluid that is contained in the human body utilized to maintain life and functioning.

Body language
A way to communicate without saying any words such as our facial expressions or the pace of our speech. This is an informal way to communicate. The same body mannerisms do not always convey the same message within cultures or families. An example might be, one person lowers their eyes when angry, while another may stare. Body language is usually a combination of culturally trained responses and individual responses. For instance, cultures usually share some common patterns. An example of this is how close to stand next to someone when talking (i.e., personal space). Even though people might be aware of the gestures they use, they usually are not aware of their body language. Men and women will often learn different body languages, even if they are from the same family.

A brand name for a drug containing the botulinum toxin. This toxin paralyzes muscles. It is often used for cosmetic treatments. It is also used for cerebral palsy to reduce spasticity.

Borderline Personality Disorder (BPD)
A serious mental illness characterized by difficulty in regulating emotions, volatile relationships, rapid and frequent moods swings, and an unstable sense of self. BPD responds well to treatment. Evidence suggests it is a biologically influenced mental illness like anxiety, depression and other major mental illnesses.

Brain Injury (BI)
Brain Injury is any injury cause to the brain that damages parts of the brain. It is estimated that 5.3 million Americans are currently living with a BI-related disability. The effects from brain injury can be mild to severe but often causing changes in a person's personality and abilities. Short term memory is often affected.

Brain malformation
Brain malformation is a condition where the brain of a developing fetus stops growing or slows down. The reason this happens is often unknown. However, genetics, toxins, or injury to the fetus are some of the known causes. This condition results in permanent damage to the brain.

A process used to generate ideas free of judgment. Works best with a group of individuals trying to solve a problem. An activity used by a facilitator of a work group that helps generate new or original ideas and approaches. In brainstorming people quickly generate ideas without analyzing their feasibility. There are no comments other than clarifying questions during this period. After brain storming is done, groups typically spend some time reviewing ideas for possibilities.

To break an agreement or to go against an understanding between people.

Under the Health Insurance Portability and Accountability Act (HIPAA) Breach Notification Rule, a breach is when Protected Health Information (PHI) is shared with an unauthorized person and there is a risk to the security or privacy of the PHI that was shared.

Breach Notification Rule
The Breach Notification Rule is a rule under the Health Insurance Portability and Accountability Act (HIPAA). It outlines steps for businesses and covered entities to take when they suspect a breach of Protected Health Information (PHI) has occurred.

Breaching Confidentiality
This means you have disclosed, shared, or otherwise given private information to another party who is not authorized to see, hear, or read the information.

Breakthrough Seizure
This is a seizure that occurs despite a person's use of medication to prevent seizure activity. These can be more dangerous than other seizures. This is because they are often not expected. Some causes include missed or incorrect dosage of medication, switching medicines, interactions with an other medicine, exhaustion, stress, alcohol and drug use, menstruation, acute illness, and malnutrition.

Easily broken.

The software that provides reads text and images off of the World Wide Web.

Buccal Medication
This is a medication meant to be dissolved in the space between the gum and the cheek near the back of the mouth.

A swelling on the first joint of the big toe that is often painful with red, calloused skin (the big toe tends to point toward the second toe and this causes a bump to appear on the outside edge of the toe).

The crime of either entering a building as a trespasser with the intention of committing theft, rape, grievous bodily harm, or damage.

When a person has lost interest in an activity either because it is too demanding or he or she is bored.

Business Associates
These are entities that receive protected health information. This includes workers such as contractors and subcontractors. A business associate performs functions, activities or services on behalf of covered entities that involve use of or disclosure of personal health information (PHI). The rules have been modified to clarify that business associates may "create, receive, maintain, or transmit" PHI. It clarifies that entities only store PHI also are business associates.

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A way to measure the energy that you get from food.

A disease in which the body's cells grow incorrectly and cause serious illness. A term for diseases in which abnormal cells multiply without control. Cancer cells can invade nearby tissues and can spread through the bloodstream and lymphatic system to other parts of the body.

Candidiasis is a fungal infection that is also know as thrush. This most often occurs in very young children and older adults who wear dentures. Good oral hygiene is essential to treating this, but prescription medication may also be necessary.

Canker Sores
Canker sores are small ulcers inside the mouth. They are not contagious and usually recur. The exact cause of canker sores is not known. Canker sores can heal on their own, but can also be treated with over the counter medications. Spicy and acidic foods can often irritate and further inflame canker sores.

The physical ability, strength, mental ability and resources the family has available to them to help them deal with a family member with a disability in a healthy or effective manner.

A method of service financing in managed care systems where the payer pays a fixed amount of money per person to a managing intermediary to deliver a set of services, whether or not each person who has been paid for uses the services.

List of allowable services, or standards used to determine what services can be provided in managed care systems.

Foods that are made up of sugars and starches such as bread, pasta, rice, candy, and baked goods.

Carbon monoxide
An odorless, poisonous gas that results as a malfunction of gas-using appliances such as a furnace or water heater. This gas can kill and is very dangerous.

A doctor who specializes in the care and treatment of the heart.

As a direct support professional you do something for the person, you take care of tasks or issues. For example, you provide transportation or cook meals.

Case management or care coordination
A person who helps the person receiving services understand his or her options and benefits regarding services. In many cases, the case manager is a professional that is assigned through local government. Emerging models of case management or service coordination include other types of professionals who are hired by the service recipient, or in some case, parents or families. Depending on the state and local government and the funding for their services, case managers may have different types of authority and responsibility. In some cases they may be closely connected to their caseload and even serving in place of guardians for people under state guardianship. In other cases, they may be less involved in the person's day-to-day or have a time-limited connection with the person and be focused only on finding appropriate services.

Case rate
The dollar amount that the payer pays per "user" to the managing entity in managed care. Case rates are keyed to people who actually receive/use services. Capitation rates are keyed to an entire services group.

Case Study
A case study is a detailed description of a single person, program or situation that is used to learn about or analyze a larger group or concept.

Cash and counseling
Describes recent innovative service arrangements in managed care for elderly Americans, where cash is paid directly to the individual needing assistance and the individual receives counseling from a paid professional to: set benefit levels, hire and fire, manage, assist the individual to find resources and monitor quality.

A clouding of the lens of the eye making vision poor.

A very large disaster.

A breakdown of the tooth caused by bacteria, tooth decay or holes in the teeth caused by acid from the plaque bacteria.

Center for disease control and prevention
This is a government agency responsible for control and suppression of infectious diseases.

Celiac Disease
: An autoimmune disease that occurs in the small intestine when the body is not able digest gluten, often found in wheat products.


Centers for Independent Living
Centers for Independent Living are organizations run by and for individuals with disabilities in local communities across the country. Founded by Ed Roberts these centers provide an array of supports and services to help individuals live and work in the community of their own choosing.

Central Nervous System
consists of the brain and spinal cord engaged in a complex network of sending and receiving messages throughout the body.

Cerebral Palsy (CP)
Cerebral Palsy (CP) is a brain condition that results in difficulty with controlling body movements and posture. It is permanent but does not worsen with time. (Symptoms may increase in later years due to issues related to aging.) There are different ways in which CP may affect a person. The person may have hearing or vision impairments. Many people with CP have difficulties with speech. People with CP may also have intellectual disabilities.

Cerebral Spinal Fluid
This is a fluid that surrounds the human brain and spinal cord.

the lower, narrow part of the uterus (womb). The uterus, a hollow, pear-shaped organ, is locked in a woman's lower abdomen, between the bladder and the rectum. The cervix forms the canal that opens into the vagina, which leads to the outside of the body.

A task is a series of behaviors performed in order. This order is the behavioral chain. Chaining is a way of teaching that breaks the task into small steps that a person can perform with prompts or guidance. Reinforcement is given as needed for each step or small sequence to get the person to perform it independently. New steps in the chain are added as the person learns to complete the others well. The sequence or portions of it are taught in order until the person can complete the whole task with one initial prompt. (For example, when told: It's time to do the dishes," the person is able to get up, find all materials, and complete all tasks, until the dishes are done.) Forward chaining is when the steps of the task are taught in order from the beginning. Another option is backward chaining. This is a way of teaching in which the final steps of the sequence are taught first. Each step is added working back to the initial action needed for the task. Backward chaining can be helpful because reinforcement is always given for the final step of the whole task.

A religious leader, such as a rabbi, imam, or pastor, who serve a group of people not able to attend religious services. One example of where a chaplain would serve would at a hospital.

Barriers and difficulties a person may face when living with a disability. The barrier or difficulty may be related to the nature of the person's disability, to societal attitudes toward disability or to limitations upon the resources available for support.

Challenging Behavior
Behavior that is harmful to self or others, is consistently or extremely disruptive, results in serious or repeated property destruction or consistently interferes with the achievement of personal goals. Sometimes called: problem behaviors, undesired behaviors, or socially inappropriate behaviors.

Chemical Dependency
A physical or mental addiction to drugs and/or alcohol. Chemical dependency is a disease. It can be fatal without treatment.

Powerful drug treatment used to destroy or kill cancer cells.

Child Molestation
Deliberate exposure of a minor to sexual activity.

A sexually transmitted disease.

The freedom to pick among several options. To make a decision when faced with one or more possibilities.

Airway obstruction, due to airway becoming blocked due to a solid object, fluids, or the back of the tongue.

A soft, waxy substance that is present in all parts of the body including the nervous system, skin, muscles, liver, intestines, and heart. It is made by the body and absorbed from animal products in the diet.

A type of therapy based on the manipulation of the spine and other parts of the body.

Chronic Disability
A chronic disability is one that is of long or indefinite length. When people have a serious injury, they may become disabled. They may have a "severe" disability that limits what they can do independently. But if their injury is one that heals in a normal length of time, without leaving them with permanent impairments, the injury did not cause a chronic disability.

Chronic Health Condition
An illness or situation that lasts a long time, is ongoing, or continuous

Circle of Support
The people who are close to a person, who believe in the person's capacities and best possible life, and who create a social and support network around the person that can be depended upon in a time of need.

The movement of blood through the circulatory system of the body. This system includes the heart, lungs, veins, and arteries.

Use of related words to describe an idea or word that a person cannot remember

The partial removal of the foreskin of the penis by surgical procedure.

When a person has a status within a shared governance (such as a nation), where the governance owes certain protections and privileges to the person (for example, protection under the law, the right to vote, etc.) and in return the person has duties and obligations to the governance (for example, the payment of taxes, following the laws, etc.).

Civil Right
The rights of personal liberty for people who are citizens of the United States. These rights are guaranteed in the US Constitution, by congressional acts and by state constitutions.

Civil Rights Movement
Civil Rights Movement: a primarily nonviolent struggle to bring full civil rights under the law to all Americans. The American Civil Rights movement has been made up of many movements, though it most often refers to the struggles between 1945 and 1970 to end discrimination against African Americans and to end racial segregation, especially in the U.S. South.

Civil Rights (legal)
The set of conditions and privileges that a person is guaranteed by the Constitution, such as the right to free speech the right to vote, etc.

Clarifying questions
Are used to follow-up on the candidate's answers when they are too general or need more explanation.

Grouping things by shared characteristics. Classification in developmental disabilities places people into categories according to different disability related characteristics for a number of purposes.

The purposes include:

  1. determining eligibility for services,
  2. authorizing different types of services,
  3. authorizing different amounts of services, or
  4. assigning people to different programs.

Something that is easy to understand, straightforward and without complication.

Clinical diagnosis
A diagnosis completed by a licensed practitioner in a health related field.

Close-ended questions
Are used when the possible answers are known or can be reasonably guessed. Respondents select from a series of choices in giving their answer.

Co-advocacy is when people advocate together. It is a process of speaking up for and working to get equal rights for yourself and others. It means working for equal opportunities and respect for yourself and others.

Is a style of performance coaching that consists of showing and telling the direct support professional how to do their job. Coaching encourages the direct support professional to do the best they possibly can. Coaching helps direct support professionals participate in and contribute to their organizations. Coaching encourages direct support professionals to improve already satisfactory skills through regular feedback and to ask for specific advice on what to do and how to do it.

Code of Ethics for Direct Support Professionals
A body of principles, values, and guidelines developed and endorsed by the National Alliance for Direct Support Professionals. These guidelines are intended to assist direct support practitioners in making thoughtful and appropriate decisions when facing ethical dilemmas and in acting ethically on the job. They are a body of guidelines that direct support professionals have identified as important to the provision of high quality direct support and to the overall well-being of the people they support.

Lure, trick, or manipulate someone to do something. An action or decision that is forced and not made freely.

Related to the ability to think.

Cognitive abilities
Abilities related to thought processes, including memory, organization, planning, adaptive behavior, and knowledge.

Cognitive Behavioral Therapy
A form of skill based therapy that helps people recognize distorted or inaccurate thoughts that lead to anxiety, anger or depression and replace them with more accurate thoughts that empower.

Cold Sores
Cold sores are also known as fever blisters and Herpes simplex. They are groups of painful, fluid-filled blisters. Cold sores are contagious and often recur. Cold sores often heal by themselves within approximately one week. They can also be treated with prescription medications.

Cold Sores
Cold sores are also known as fever blisters and Herpes simplex. They are groups of painful, fluid-filled blisters. Cold sores are contagious and often recur. Cold sores often heal by themselves within approximately one week. They can also be treated with prescription medications.

colorectal cancer
a cancer of the colon or rectum (bodily parts in the digestive system) that occurs when tumors form in the lining of the large intestine. It is more common in people over the age of 50, and therefore regular screenings (such as colonoscopy) for elders are critical. Symptoms are similar to those of constipation.

Refers to a thing or material that can easily catch fire and burn.

Common Era
The Common Era refers to the time since the birth of Jesus, whose life and teachings are the foundation of the Christian church.

A process of sharing information which requires both the sender and the receiver of a message to mutually agree on that message. The quality of the communication depends on both parties understanding and interpreting the same message. Communication is not only speaking words to someone but also listening, attending to body language, decoding meaning, explaining, questioning, and clarifying the information being exchanged.

Communication breakdown
An instance where a message is not successfully communicated, due to one or both partners' problems in comprehension and/or production of the message.

Communication impairments
An inability to convey messages appropriately either verbally or non-verbally.

Communication or Speech Therapy Assessment
This is done when a person has difficulty communicating. It is done to find out or diagnose what is causing communication problems and to suggest therapy or treatment to help the person communicate better.

Communication Plan
A plan spells out how emergency information is communicated before, during and after an emergency has happened. For individuals, it specifically details how the individual communicates and what impact stressful situations have on effective communication, how to best communicate emergency information to individuals, information on an alternate way to communicate, and a list of whom to call in emergencies. For companies, the plan is very specific about who to call during emergencies and an alternate plan and should specifically state people's names and contact information, including phone numbers where they can be reached, addresses, and e-mail addresses. The communication plan should also talk about how you can communicate an emergency to the manager or other people in charge.

Communication repair
Steps taken by one or both communication partners to fix a situation where it is clear that the receiver has not understood the intended message.

A group of people that are connected to each other socially, through a common need, experience, mission, culture, vision, and/or values.

Community Access
As a member of a community, being able to fully use and enjoy all that the community has to offer.

Community Bridge-Building
Strategies for helping communities become more inclusive for people with developmental disabilities in general. Nurturing and supporting a specific connection between an individual with a disability and others in the community.

Community Capacity
The ability of a community to welcome and share community resources with diverse populations, including people with developmental disabilities.

Community-based employment
This term refers to the traditional type of employment, where individuals are employed and paid by the company which hired them. Additionally, the work takes place in the actual work setting and is performed independently or with the support of co-workers and/or support staff.

Community Connections
Contacts and relationships with people in naturally occurring communities such as neighborhoods, places of work, and public facilities. Many people with developmental disabilities lack real contact with other members of the community and are therefore at risk of isolation, and also miss out on the benefits of having allies, advocates, and friends with various resources, backgrounds, and abilities.

Community Inclusion
A concept that reflects the practice of sharing in community life involving at least these four aspects (1) physical presence where the individual actually lives in a typical community setting (house, apartment etc.) vs. an isolated setting such as an institution or a nursing home, (2) cultural integration where the individual exhibits locally valued lifestyles and roles (e.g., farm hand in a rural community; condominium or home owner; church or association member), (3) connections to others who are not paid as supporters. These connections include a variety of reciprocal relationships like friend, coworker, neighbor, spouse, etc.) and (4) self-determination. (see community integration, self-determination).

Community Integration
A concept of having people with disabilities live, work and recreate in the same places as people without disabilities. Being physically present in naturally occurring communities. Community integration is one part of community inclusion, in which people with disabilities interact in meaningful ways with people without disabilities, such as developing friendships, participating as coworkers, participating as members of community associations and boards, and being good neighbors. Community integration is an essential ingredient to inclusion, however, sometimes additional supports are needed to assist people with developmental disabilities fully participate as members of their communities. See community inclusion.

Community Participation
Spending time participating in community life, such as supporting local businesses, joining and participating in local clubs or associations, volunteering for community projects or activities, and using the community doctors and dentists for your health care.

Communication boards
Communication boards are devices upon which letters, words, or pictures or symbols might be displayed. The individual may use the communication board to express him or herself to another person.

Communication book
is a tool used to convey important information between different parties supporting individuals with disabilities. These are not specific to staff teams.

Community Resources
Events, activities, people, places, services, memberships, groups, etc. available to people of a community that help enrich and add quality to life.

Community Support Skill Standards (CSSS)
Skill and knowledge guidelines for the direct support role developed as a national collaborative effort in involving direct support professionals, service participants, families, employers and policy makers in human services. The standards describe direct service in contemporary and professional manner and are useful in developing educational and training curriculum or for other human resource applications.

The existence of more than one physical or mental disorder/condition simultaneously. One condition may or may not affect the other. Also can be referred to as co-occurring disorders.

Co-occurring Conditions
Experiencing more than one medical, developmental, mental health, or substance use condition at the same time. The conditions may not affect the person equally.

Being recognized for strengths, contributing, having opportunities to learn more.

The identified skills and behaviors the Direct Support Professionals needs to demonstrate on the job at a specific level of performance in order to meet job expectations.

The mental ability to understand the general effect of a transaction or document.

Competency Based Training
Is a comprehensive approach to training that aligns job skills and work expectations with job descriptions and performance evaluations as well as with the mission, vision and values of the employer.

Competing behaviors
Behaviors that keep a person from engaging in a challenging behavior because it is impossible to do the challenging behavior at the same time as the competing behavior (for example, sitting down and standing up).

Competitive Employment
Typical employment in which a person is placed in a job and requires no additional support or supervision other than that which is typically provided by that employer.

Compensatory Strategies
Actions or behaviors that compensate for a loss of physical, emotional, or cognitive functioning.

Additional health related issues that can stem from another condition such as pandemic flu.

Parts of a larger set of things.

Components of the Direct Support Profession
Three major elements of the profession of direct support are 1) skills (derived from the Community Support Skill Standards (CSSS) and relevant local criteria) 2) knowledge (derived from the CSSS, the College of Direct Support and other relevant resources and materials); and 3) ethics (derived from the Code of Ethics for Direct Support Professionals developed by the National Alliance for Direct Support Professionals).

Comprehensive assessment
Strategies for helping communities become more inclusive for people with developmental disabilities in general. Nurturing and supporting a specific connection between an individual with a disability and others in the community.

Computation Date
Last date of the time period of interest (for example December 31 for computing annual turnover rates of a calendar year).

When something is expressed in as few words as possible, while still maintaining the quality and meaning of the information.

An injury to an organ, often the brain, that is caused by a blow to or jarring of organ and results in a temporary or permanent loss of functioning.

Conference statements
Formal written documents regarding poor performance that outlines a plan of correction, consequences for failure to improve, timelines, resources, and support for review and improvement.

Something entrusted with private information and the confidence of another.

The responsibility of a service provider to regard as private any information that passes between themselves and a client, unless this information poses a threat to the safety of the client or another individual or group.

Is a style of performance coaching that uses a problem solving approach but goes beyond counseling when the work related problem is not resolved to the frontline supervisor's satisfaction. The frontline supervisor discusses with the direct support professional specifically what behavior is occurring and why it is not meeting performance standards. Then tells the direct support professional what will happen if their performance does not improve. Confronting is often used as part of a disciplinary process.

Congregate settings
Places and settings that people live, work, or recreate where they are grouped together and have to share space and resources with others, for example, a group home, an institution, a nursing home, a supported work environment where several people share the same job, or work closely.

A continuity of operation planning document for companies and organizations to use during emergencies. This plan helps keep the company running even during times of emergencies.

Consent Form
A written document that, when completed, provides authorization for confidential information to be released or given to another person or entity within an organization for an expressed reason.

Something that happens after the behavior, as a result of the behavior, that influences the likelihood that the behavior will happen again in the future. Consequences can be things that occur naturally, or things that are planned and provided by DSPs or others to enhance or decrease the likelihood of future behavior. Also see Reinforcer and Punisher.

Consequence management
Using consequences to change behavior. Ensuring that desired behaviors are reinforced and challenging behaviors are not reinforced, or when appropriate, are punished.

A person in a legally defined role of protector. Similar to a guardian, a conservator oversees the decisions of another person who is unable to make decisions based on an accurate assessment of risk and benefits, and therefore, could be at risk of harm or exploitation. Conservators usually have narrowly defined areas which they oversee, such as finances or major medical decisions.

The condition that exists when an individual is legally appointed in a limited way, to assist a person who is incapable of understanding the risks and benefits of a situation, in making important decisions. See conservator.

a condition that occurs when a person's bowel movements become difficult or less frequent. There is a range of causes, symptoms, and treatments for this condition.

Constructive feedback
Provides the speaker with an understanding of how you perceived the statement and how that statement is affecting you. Constructive feedback needs to be descriptive, specific, usable, timely, and given with the intention of helping, not hurting, the receiver. Constructive feedback focuses on the behavior or statement rather than the person, and is provided in a respectful manner. One suggestion is to preface your feedback by asking the person if she or he wants feedback, in what areas she or he wants feedback, and how he or she would like to receive the feedback.

A term often used to describe a person with a developmental disability who receives some type of services from a government or private agency. A consumer of services. This term is used in place of "client" to put the emphasis on the person as someone who uses services rather than someone who has a problem which needs professional help. This term is meant to be respectful, however, like any label is can be overused or otherwise misused, and may be an offensive term to some people.

Consumer Advocacy
A movement started by Ralph Nader to fight for the rights of those who purchased good and services.

When the person (or family, in the case of children) receiving supports makes the decisions regarding when, where, how and by whom he or she will receive those supports.

Contact Lenses
Thin lenses fitting over the eye to correct vision.


A disease that spreads to others easily.

When something is made impure or unsuitable by contact or mixture with something that is unclean.

The presence of a substance which is undesirable which mixes with another existing substance.

Something that becomes unusable or impure. In health, this means that something has germs on it that can cause illness.

Meaning either 1) current or modern, part of the standard of our time (such as, "contemporary models of support'), or, 2) being of the same time frame (such as, "John Wilkes Booth was a contemporary of President Lincoln.")

In behavior support, contingent means that a behavior must be displayed before a consequence will be delivered. The delivery of consequence is dependent on the display of the behavior. Contingencies are consequences that are a planned or natural result of engaging in a behavior. Natural contingencies, are those that happen directly as a result of the behavior and do not rely on other people to deliver them or are commonly delivered by others in that situation.

Contingent responding
A communication strategy that entails having the communication partner wait until the person with a disability communicates in some way, before the partner replies or acts in accordance with the message sent by the person with a disability. Contingent responding involves acknowledging and responding to the meaning (the WHAT) of the message but not necessarily the form (the HOW) of the message.

Continuation of Medicare Coverage
Is an employment support provided to people accessing Social Security Disability Insurance (SSDI) and Medicare. It allows people that no longer qualify due to earning over the benefit limit to maintain their medical coverage. This benefit is provided for the 93 months, or 7 years and 9 months.

Continuous Cycle
An ongoing process that moves through stages but never stops.

Controlled substances
Drugs that are carefully monitored and tracked by the federal Drug Enforcement Agency (DEA) because of their potential for abuse or risk. Both legal and illegal drugs can fall into this category.

Giving rise or likely to give rise to public disagreement.

Conventional Medical Care
- is what most people think of when they think of health care providers. These are the professional licensed to provide medical care, in other words the doctors, nurses, hospitals and other licensed medical practitioners. Medical doctors can be divided into four broad categories which are: General practitioners, internists, family practitioners, pediatricians, and gynecologists (female health). Within each of these, there are many specialists depending on the patient's needs. Other conventional health care providers may include nurses, nurse practitioners, nutritionist, speech, occupational, and physical therapists, mental health professionals, ophthalmologist, optometrists, and hearing specialist.

Conversation (the art of)
The ability to communicate clearly with others through verbal, non-verbal and active listening skills.

CPR (cardiopulmonary resuscitation)
An emergency procedure in which the heart and lungs are made to work by manually compressing the chest overlying the heart and forcing air into the lungs. CPR is used to maintain circulation when the heart stops pumping, usually because of disease, drugs, or trauma (cardiac arrest, apnea, etc.)

Coexisting Conditions
When two or more disabilities or conditions are diagnosed for one person. Usually one condition or disability is defined as the primary or main cause for the disability and the other being secondary.

Coronary Arteries
Blood vessels that carry oxygen to the heart muscle.

Coronary heart disease
A disease caused when there is a build up of plaque or fatty tissue in the arteries to the heart. When the plaque builds up to the point that the arteries become stiff and blocked, the heart muscle does not get enough oxygen to do its job and the result can lead to a heart attack, if not treated. Another term for heart attack is atheroclerosis.

Cost to Benefit Ratio of Intervention
An intervention needs to effectively meet the challenge however, it must do it in a cost effective way. For instance, offering a starting salary of $50,000.00 a year may greatly reduce turnover and vacancy, but it is usually not possible given resources.

A system where a person is fined" for displaying certain behaviors. Most often used in token programs.

Is a style of performance coaching based on personal observations from a more objective point of view. It is often used in a problem solving model where a direct support professional has come to the frontline supervisor with a particular problem looking for advice on how to resolve the issue. The frontline supervisor takes on the role of a sounding board listening and outlining solutions or options. Keep counseling sessions" to work related issues and avoid personal issues.

A direction opposite to that of the normal rotation of the hands of a clock. Not clockwise.

Covered Entity:
These are defined in the HIPAA rules as 1) health plans, 2) health care clearinghouses, and 3) health care providers. These entities electronically transmit health information based on standards set by the Department of Health and Human Services (HHS). These businesses must comply to HIPAA. They always have at least two things in common. First, they use protected health information (PHI) in conducting services. Second, they transmit protected health information (PHI) electronically. This is often for billing purposes.

when a muscle or group of muscles spasm involuntarily and cause sudden and severe pain.

Creative Thinking
A strategy used to generate original ideas that involves the combining of ideas into a new idea that solves a problem. Can be done individually or in a group.

Criminal Law
Legal actions and laws involving crime and punishment as opposed to civil law which has to do with citizen's rights.

A period, situation, or event where things are uncertain and traumatic. It is time where an issue reaches a critical point. Immediate action is required to prevent further damage, disaster, or injury.

Crisis intervention
Strategies for respectfully, effectively, and safely, interrupting dangerous or extremely disruptive behaviors. A secondary goal in crisis intervention is to resolve the crisis in ways that assist the person to be more likely to exhibit desired behaviors in the future and less likely to engage in the challenging behavior.

Goals, markers, or indicators that are listed, to help people understand what to look for in something (such as a support plan, or a goal).

Critical incidents
Situations that arise that are unusual or serious. An example is a vulnerable person getting lost. Medication errors or a behavioral crisis may be a critical incident. Guided review of these situations can be helpful learning experiences.

Critical thinking
Is the ability to examine and question the validity of information. It helps you identify problems, solutions and evaluate outcomes based on the facts set forth in a logical argument.

Cross-Functional/Project Teams
These teams are made up of selected individuals who work on a specific project as a part of or in addition to their normal duties. These teams are often limited by time, and their tasks are more narrowly defined.

Verbal, visual, or physical reminders and supports to help the person understand or remember how to perform a skill.

To grow, tend and foster relationships or memberships which include educating and encouraging the growth of skills that improve the support network.

  1. Having to do with culture.
  2. A person being knowledgeable, appreciative, and sensitive to a group's beliefs, values, traditions, expressions, ethnicity, culture, and race.

Cultural Affiliation
Attributes, beliefs, experiences, and traditions that bond a group of people to each other (for example, youth culture, disability culture, religion, ethnicity, urban culture, etc.) A person may have multiple groups with which he or she is culturally affiliated.

Cultural capital
The power and influence a person has by being part of the macro (dominant) culture. The more people are able to "fit in" with the dominant culture, the easier it is for them to be successful.

Cultural Destructiveness
Beliefs and actions that are harmful toward other cultures. People and institutions that fall on this part of the continuum often do not recognize culture. They may believe that people from other cultures are abnormal or dangerous. They may deny the civil or human rights of people from other cultures.

Cultural guides
A person from another culture who is willing to help you learn about their culture. They may also help you to learn about barriers to services due to culture. They recognize that within their own culture there are differences in views, beliefs, customs, celebrations, and rituals.

Cultural Heritage
The culture which one has inherited from one's ancestors. One may or may not choose to embrace one's cultural heritage as one's cultural identity.

Cultural Identity
The social or cultural identity of an individual or group can include race & ethnicity, religion, the rules and rituals of a group, social class and financial resources, and/or personal history (like where one grew up, what school one attended, city or country living.)

Cultural Inattention
Beliefs and actions that deny differences in cultural values. People and institutions that fall along this point on the continuum do not recognize the hidden parts of culture. They believe, deep down, all people are the same. They do not look for the unique or different qualities in each person. They do not recognize that people may want to be treated differently, yet they do not intentionally harm others or prefer one group over another.

Cultural Incapacity
Beliefs and actions that act as benign neglect" toward other cultures. People and institutions that fall on this part of the continuum often do not recognize culture. Or they may believe that their culture is better than others. However, they do not intentionally harm others.

Cultural Lens:
The way culture influences your understanding of what is happening and why it is happening.

Culturally Competent
A person being knowledgeable, appreciative, and sensitive to a group's beliefs, values, traditions, expressions, ethnicity, culture, and race.

Cultural Competence Continuum
A method of looking at a person's level of cultural competence from the least culturally competent to the most.

Culturally Competent Supports:
The ability to go beyond an awareness that there are different cultural perspectives to actually having a number of sophisticated methods for assessing respecting each person's individual cultural preference. Culturally competent supports include respecting and infusing preferred cultural preferences into each person's individual supports.

Culturally sensitive
Being aware of the influences that culture can have on various aspects of service delivery and having a capacity to adapt services and supports to meet the needs of an individual in the context of his or her culture.

Cultural Norms
Expectations and behaviors of the group including how to act, what to wear, rituals and routines, etc.

Cultural Pre-Competence
Beliefs and actions that recognize differences in cultural views. People and institutions that fall on this part of the continuum are beginning to recognize when situations are influenced by culture. They may value diversity. However, they do not know how to handle cultural conflicts. Or, they may not know where to find reliable resources to help them deal with conflicts. In addition, they support basic protections of and foster growth among different groups.

The beliefs, arts, celebrations, social organizations, and other products of human thought and activity expressed by a particular community at a particular time. Also see Personal Culture. This includes the behaviors and beliefs characteristic of a particular social, ethnic, or age group. It is the sum total of ways of living built up by a group of human beings and transmitted from one generation to another.

Custodial Care
A form of care that provides for basic health and safety needs but does not concern itself with personal skill or development if the service participant.

This is a small semi-circle of skin attached at the back of a nail. It can be gently pushed back to groom the nail.

A kind of self injury that involves inflicting cuts or scratches on the body. Self injury is an attempt to deal with powerful negative emotions such as anger or frustration.

Cystic Fibrosis
A hereditary disease which results in thick mucus affecting a person's pancreas, lungs, and digestive system.

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Day Training Programs
Day training programs are programs to help adults with developmental disabilities gain social, recreational self-care and work-related skills. Because most adults want to work and earn money, more and more day training programs are including work activities for which people are paid. More importantly large numbers of people who would have once been in day training programs are today in supported employment.

DD Waiver
This is sometimes referred to as the ID Waiver. It is a federally supported funding stream. It used by many states to fund services for people with intellectual or developmental disabilities. (See HCBS.)

a conversation with a person who just experienced a stressful or traumatic event (for example: a direct support professional speaking with her supervisor about the death of a person supported). The purpose of the conversation is to relieve feelings of stress and trauma by informing other people about the experience, validating the person's feelings, and allowing the person to talk about his or her experience.

Spread out, not in one place. Residential services for people with developmental disabilities have become more decentralized since institutions have been replaced by many small group homes in a variety of communities. This trend toward decentralization will continue as more people are supported in their own homes and with individual vocational supports.

An action that takes away the thing that makes something unusable or impure. In health, this means cleaning surfaces and rooms to take away the harmful germs.


Declaration of Sentiments
Declaration of Sentiments: a document signed in 1848 by 68 women and 32 men, delegates to the first women's rights convention, in Seneca Falls, New York. The principal author of the Declaration of Rights and Sentiments was Elizabeth Cady Stanton. This document, following the form of the United States Declaration of Independence, formed a basis for attaining the civil, social, political, and religious rights of women.

A lack of something that is needed.

the body is lacking fluid and essential elements called electrolytes which help to regulate the body. Symptoms of dehydration are: thirst, infrequent urination, dry skin, fatigue, lightheadedness, and dark colored urine.

A process to reduce the number of people living in institutions by moving the people living in them to places in the community where they can live or by preventing new placements of people in these institutions.

Delayed echolalia
Repeating or echoing of a word, phrase, or verbal utterances after some time delay or time lapse.

The assignment of tasks to others.

Fixed beliefs that are not based on reality. They can be unrealistic and bizarre, but they can also have realistic themes. For example; "the police are watching me, they drove by my house." The police may have driven by the person's house (reality), but are not watching the person (delusion).

Emotional disturbance and confusion caused by a brain disorder. Condition of deteriotation in a person's mental ability, affecting areas such as memory, reasoning, and emotional functioning.

Dementia with Lewy Bodies
A condition of progressive cognitive decline, combined with three additional defining features: (1) fluctuations in alertness and attention, (2) recurrent visual hallucinations, and (3) motor symptoms similar to Parkinson's disease, such as rigidity and the loss of spontaneous movement; caused by the build up of Lewy bodies (bits of protein) inside areas of the brain that control memory and motor skills.

Percentages and real numbers that are useful in describing populations and understanding trends. For example, the percentage of people with disabilities between the ages of 25-40 who are employed full-time compared to the percentage of people without disabilities between the ages of 25-40 who are employed part-time.

How compact or crowded something is.

Related to teeth or dentistry.

False Teeth

Lotions, creams and gels that chemically dissolve the hair near the root are called depilatories. This method can irritate the skin, and the product should always be tested in an inconspicuous area before using. This can be used on small areas of facial hair or larger areas such as removing leg hair. Be sure to purchase the product that is made for the particular area you applying it to.

A mental disorder and medical condition which is characterized by persistent and ongoing feelings of sadness, lack of drive, a depressed mood, and/or a loss of pleasure in activities. These issues can affect a person's personal, family, work, school, and social life. Serious depression can be life threatening and affects a person both mentally and physically. Depression is considered a mood disorder.

Deprivation means to be without something that is either necessary or preferred. Deprivation procedures are those that use the withdrawal of something the person likes or needs, after he or she exhibits a challenging behavior, and with the desired effect of stopping or discouraging the person from engaging in the behavior. Caution! Many forms of deprivation procedures or techniques are prohibited by law. Any deprivation techniques that cause significant discomfort or harm (physical or psychological), or keep people from basic human needs such as water, food, rest, freedom of movement, and contact with others or their own personal possessions, are either prohibited or tightly monitored and controlled. Deprivation can also be a setting event that is useful in increasing the effectiveness of certain reinforcers. For instance, if food is being used as a reinforcer, being hungry may increase the reinforcing value of the food. While depriving people of food in order to increase its effectiveness as a reinforcer would not be allowed, timing the use of food as a reinforcer with naturally occurring states of deprivation (for example, right before a planned meal) can increase its effectiveness.

Deprivation Punishment
(sometimes called Restrictive Procedures) Taking something away from the environment in response to a behavior that decreases the likelihood that a person will engage in the behaviors, such as removing someone's dinner plate when he or she throws food. Caution! Restrictive procedures are usually not allowed and should never be used in the absence of a carefully developed and reviewed behavior support plan and only when the challenging behaviors are extremely serious and all alternatives have been tried and failed.

Medical Professional that deals with the skin.

Developmental Disability(ies)
A federally defined term to help identify who is eligible for funding or services, which is: A severe, chronic disability of an individual 5 years of age or older that: is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the individual attains age 22; is likely to continue indefinitely; and results in substantial functional limitation in three or more of the following areas of major life activity: 1) self-care; 2) receptive and expressive language; 3) learning; 4) mobility; 5) self-direction; 6) capacity for independent living; 7) economic self-sufficiency; and 8) reflects a need for a combination and sequence of supports and service that are likely to be lifelong in duration. When this term is applied to children 5 or under, it means the high probability that the person will meet this definition after 5 years of age.

Developmental Milestones
different stages of the normal process of growth.

Developmental Period
Developmental period refers to the period of life prior to adulthood. This distinction separates intellectual and developmental disability from disabilities caused by conditions that occur later in life (e.g., strokes, brain injuries, Alzheimer's disease and so forth). Exactly how the developmental period is operationally defined varies from one definition to another, but all agree on the range between 18 years and 22 years.

Developmentally Appropriate
Suited to both the age and skill level of the learner.

A disease caused by the body's abnormal insulin production. A condition when the body cannot handle glucose because of reduced insulin.

Diagnostic Assessment
A clinical assessment completed by a qualified medical or mental health professional.

Diagnostic and Statistical Manual of Mental Disorders (DSM)-5
The handbook used by mental health professionals to assist in the diagnosis of psychological disorders. The DSM-5 provides detailed descriptions of behaviors, symptoms, history, and additional criteria for the diagnosis of psychological disorders. The manual also provides a way to organize information. It is the system used for insurance reimbursement.

loose and watery bowel movements which occur more than three times in a day, can cause dehydration.

the process of breaking down food in the stomach and intestines into substances that can be used by the body.

Dialectical behavioral therapy
Dialectical Behavioral Therapy (DBT). A therapy that helps people who live with frequent emotional distress. It supports them to work toward a life they feel is worth living. It uses group work. There is also time with an individual therapist. The therapy helps people gain skills. Skills include distress tolerance and mindfulness. They also include emotional regulation and interpersonal effectiveness.

The quality or state of being worthy of esteem or respect. While everyone should be treated with dignity, many people with disabilities are not treated with dignity, due to their physical, cognitive, behavioral, or financial circumstances.

Dignity of Risk
An idea first introduced by Robert Perske in the early 1970s that there is an inherent dignity in trying new things even when those attempts may result in failure. It is the fundamental argument against protectionism and paternalism toward people with disabilities. Dignity of risk should not be confused with recklessness or lack of caution or adequate planning.

A communicative message such as an order or instruction that is meant to direct the communication partner's behavior; a response is required.

Direct deposit
Payment is deposited directly into a person's bank account.

Direct Support Ethics
The values and principles used in providing the highest quality support and care.

Direct Support Professional (DSP)
An individual who assists individuals with developmental disabilities to lead self-directed lives and to contribute to their communities; and encourages attitudes and behaviors that enhance inclusion in their communities. DSPs provide supports in a variety of settings to people with a variety of types of disabilities.

Disability is a physical, intellectual and/or emotional (including: areas like social interactions, or mental health) condition(s) that limits a person's daily activities or abilities in some way. (Different state and federal rules, regulations and laws have different definitions for disability. The medical and mental health community also defines disability based on different diagnosis.)

Disability Culture
People with disabilities have forged a group identity. Disability Culture does not frame people with disabilities as victims. Part of disability culture is a common history of oppression and a common bond of resilience. This term establishes a life with disabilities as a distinct and valuable way of life. It offers non-disabled people with an alternative vision of life and society. More information on disability culture

An apparent separation of a person's thoughts and feelings from their body. A sense of being disconnected from what is happening in the here and now.

A large scale emergency that impacts many people and much property.

The act or process of making sensitive information known to others.

  1. Treating someone differently or worse because of a certain trait or characteristic they present.
  2. Three categories of employer behavior or practice may violate federal and state fair employment practice: disparate treatment (when an employer treats some people less favorably than others because of their race, color, religion, sex, national origin, disability or other protected characteristic; the use of policies or practices that have disparate impacts (the use of test, policies, selection criteria or oher practices that have an adverse impoace on employment opportunities of a protected group); and failure to make mandated reasonable accomodations (discriminating against applicants or employees based on disabilities, or religious beliefs or practices; Definition from Roehling, M.V., Campion, J.E., & Arvey, R.D. (1999). Unfair discrimination issues. In R.W. Eder and M.M. Harris (Eds.). The employment interview handbook. Thousand Oaks: Sage Publications, pp. 49-67).

Being unfair to someone based on prejudicial idea about a person's characteristics. For example race, age, sex, religion, or disability.

To destroy the germs on surfaces, clothing, and wounds by cleaning.

A product that can be used to kill germs on surfaces.

Discrimination Training
Teaching someone to link and a behavior he or she already knows how to perform, to an appropriate antecedent. (For example, standing up and leaving the room, when a fire alarm sounds.)

Disenfranchised grief
When there are no easy, public way to express grief. Grief that cannot be expressed and supported tends to linger and grow.

Dissociation is a psychological symptom. It may be a feeling of being "unreal" or disconnected from oneself. In some people, the person may actually lose contact with what is happening. He or she may continue to act, speak, or move but have no conscious memory of these actions later. In others, the person may feel outside themselves as if he or she is watching themselves from a distance.

Diversity can be found in a group of people whose members differ in such things as age, race, or beliefs.

Providing a written or electronic record of an action, event, item, issue, or thought that is important or meaningful.

To write down information in a standard way usually on forms provided by the support agency.

Domestic violence
An act of violence or abuse against a person living in one's household, especially a member of one's immediate family.

Dominant Culture
In multicultural societies, the cultural practices which are the basis for judging actions and establishing public traditions. Usually the dominate culture is so much a part of the societies' perspective that it is "invisible." Behaviors which are contrary to the perspective of the dominate culture are usually considered inappropriate or wrong, even when they are not harmful.

Products sold to clean the internal vaginal area. These are generally not recommended and should only be used with the recommendation of a medical professional.

One of three brain chemicals believed to be linked to depression when they are imbalanced. The others are serotonin and norepinephrine. People living with schizophrenia often have high levels of dopamine, which affects emotions and motivation.

Down Syndrome
Down syndrome occurs in a baby has one extra chromosome in each of his or her millions of cells. Instead of 46, he has 47. In Down syndrome it is the number-21 chromosome that does not separate properly. This is referred to as Trisomy 21, which is another term for Down syndrome. Over six thousand babies with Down syndrome are born in the United States every year and thousands more in other countries. It occurs in boys and girls evenly. It is one of the most common birth defects, occurring in all races, ethnic groups, socio-economic classes and nationalities. Because chromosomes and the genetic material they carry play a large part in determining a child's characteristics, this extra chromosome will affect his or her life. His or her appearance may be a bit different from other children's, he or she may have some unique medical problems, and he or she will likely have some degree of mental retardation, although the severity of any of these problems varies tremendously from child to child.

Dravet's Syndrome
This is also called severe myoclonic epilepsy of infancy (SMEI). It is a severe form of epilepsy that appears during the first year of life with frequent febrile seizures.

A long period of abnormally low rainfall that can last up to several years.

Dry Eyes
Dry eye is a condition that occurs when a person does not make enough tears. Symptoms are scratchy, irritated eyes. Dry eyes can be treated with ointments or artificial tears. If it is not treated, dry eyes can result in keratoconus. This is a disease of the cornea.

Direct support professional.

Dual Diagnosis
An old term used to describe having two disorders that cause significant impairment. It was often used to describe having both a mental illness and chemical dependency. It was also used to describe having both an intellectual disability and a mental illness.

Durable medical equipment
This is medical equipment used to aid individuals in everyday life. Examples include wheel chairs, walkers, canes, oxygen tanks, nebulizers, CPAP, and catheters.

How long something lasts.

A genetic abnormality resulting in short stature

This is a movement disorder. It can be a side effect of antipsychotic medication. It involves abnormal and involuntary movements of the body. It may affect many different parts of the body. The person may roll his or her fingers together. He or she may blink or pucker their lips repetitively. Early onset of this disorder from medication is usually reversible. (See Tardive Dyskinesia.)

the same as Athetoid Cerebral Palsy and is characterized by the same involuntary body movements.

A specific learning disability that affects a person's ability to read.

This is a movement disorder. It can be a side effect of antipsychotic medication. It is an involuntary spasm of muscles. It can be painful. It can cause the person to contort into unusual positions. Sometimes this is visible. But sometimes a person has this and does not know why.

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Ear Canal
The tube connecting the outside of the ear to the inside of the head.

Early Intervention
Strategies and interventions in the early developmental period from birth to 5 years of age.

A shaking or trembling of the earth that is volcanic or tectonic in origin

Eating Disorders
Bulimia or anorexia - self manipulated to vomit and/or regurgitate food intake to avoid weight gain. Both are potentially life threatening.

Repeating or echoing of a word, phrase, or verbal utterances.

Effective Communication
The transfer of comprehensive and accurate information from one person to another that results in the best outcomes for the person receiving supports.

Electroconvulsive Therapy (ECT)
This is used to treat some mental illnesses. It is a medical procedure during which small amounts of electric current are passed through the brain that triggers a brief seizure. ECT is sometimes used with people that have severe depression when other treatments have not been effective.

Electroconvulsive treatments (ECT)
Electrically induced seizures under the supervision of a physician used to treat severe forms of depression or psychosis.

Electroencephalography (EEG)
A medical instrument and testing process that detects brain waves and seizure activity. Medical practitioners often use this test in the process of diagnosing a person with the medical condition of epilepsy.

A method of hair removal. Electrolysis can only be done by a trained professional. It is the process of using an electric current to destroy hair at the root. A small needle is placed into the skin where the hair exits the skin to burn the hair follicle. This method can be painful, expensive, and time-consuming. It has long lasting results though it may take a few treatments to remove all of the hair. This method is typically used on smaller areas of hair.

Stop the use of something. Get rid of something.

When someone who is not able to be unsupervised leaves the area without supervision and without the knowledge of the person supervising. This may or may not be deliberate.

Difficult to define, describe, capture, or understand.

An individual who was previously under another's guardianship but is now released to his or her own legal guardianship.

To integrate into the whole. In teaching, to take separate objectives or goals and teach them in the context of a whole activity. For example, to teach the recognition of common community signs during a neighborhood walk, rather than sitting at a table and reviewing flash cards with pictures of the signs on them.

An event that requires immediate response because it could be dangerous to people.

Emergency Booklet
A booklet that contains information about an individual that has personal contact information, how the person communicates, emergency contact information, alternate emergency contacts, medical information, medications and pharmacy phone number(s), and special medical conditions, health and safety concerns, service animals (if appropriate), pets, likes and dislikes, and any other relevant information that would help emergency workers and first responders during an emergency.

Emergency fact sheet
A paper that contains medical, dietary, equipment, and communication needs that would be considered necessary and important to the individual's well-being and health. Important numbers such as Medical Assistance, case manager, personal emergency contacts, a medical physician, and other critical contact information should be included. If the person has a service animal there should be appropriate identification. Identification may include cards or documentation from a medical doctor that the person is using the animal for his or her disability.

Emergency kit
A kit for emergencies that contains survival items for three days. This includes water, non-perishable food, a weather radio, flashlight and batteries, whistle, dust mask, first aid kit, moist towelettes, garbage bags, a wrench or pliers, can opener for canned food, matches, local maps, and blankets. Individual kits should contain a change of clothing, sturdy shoes, a copy of the emergency book, and any other important items critical to the survival of the individual.

Emergency Management Officials
Emergency Management People who are trained in managing emergencies. This may include fire fighters, police, emergency medical technicians, and other first responders who are first on an emergency scene. It also includes people who manage first responders.

Emergency PLAN
An emergency plan outlines the steps to take in response to a crisis, man-made or natural, when it disrupts operations, threatens life, or creates major damage.

Emergency Planning Team
The group of employees who writes and distributes the emergency plan for the organization.

Emergency Preparedness
Getting ready for different kinds of emergencies.


Emergency Preparedness Plan
A written document for emergencies that contains information on preparing, responding, and recovering from emergencies. It also contains information on lessening the danger of an emergency. This is known as mitigation.

Emergency Response Team
The police, fire department, paramedics, hospital emergency room members, etc. that are trained to respond to an accident, injury, or emergency situation.

Emotional lability
A more rapid mood shift or extremes of mood than the average person.

Employee assistance program (EAP)
This is a service for employees. EAPs help employees with any issue affecting their work. Confidential counselors are available. Issues can be work related such as coworker conflict. They can also be personal problems. Some types of problems include assistance with substance abuse, housing, or relationships with family members.

Employee development
Is a training strategy that includes a written listing of long range goals and short term goals. These career goals define action steps or plans needed to achieve these goals. Employee development plans need to set realistic expectations.

The action of seeking to understand another person's feelings or experiences. Recognizing that actions and situations affect others beside yourself.

An employer is someone who hires workers to do a job. An employer can be an individual or an entity like a business. An employer is responsible for hiring, firing, supervising, training, scheduling, and determining wages of workers.

Employer Emergency Plan
A plan a company has that provides detailed information on how to keep the company going during emergencies. These plans should include the following components: Communication plan for before, during, and after an emergency, evacuation plan, transportation plan, shelter plan, staff roles and responsibilities during and after an emergency, identification and tracking of staff and individuals during and after an emergency, and a Continuity of Operations Plan (COOP). A COOP should include the following: a list of critical operations, a business flow chart, emergency payroll information, planning for safe and secure records, and agreements with backup suppliers of goods and services.

Employer Empowerment
In comparison to individual and team empowerment, employer empowerment is creating the culture and climate within an employment setting or organization that invests in all the employees the authority and responsibility to use their talents, creativity, compassion, and work to improve the quality of their own work lives as well as the lives of the persons for whom they support, and to encourage and support all other employees to do the same.

Emotional Dysregulation
The inability to mange emotions in healthy or effective ways. It may include those with extreme moods or rapid mood swings. It may include those with a poor ability to control impulses. It may also include those who are confused or overwhelmed.

The act or art of investing someone with power or the authority to act on one's own behalf or in someone's absence.

A type of supported employment option where groups of people with disabilities work together in a community setting. These groups typically vary in size from 2-15 people. This type of supported employment is advantageous for people who may not be able to work consistently enough to maintain a daily job. The disadvantages are that the group situation makes social contact with workers without disabilities less likely and that the person can be stigmatized (e.g., seen as one of "those" workers with disabilities, as opposed to a natural and productive contributor in the workplace).

Enforcement Rule
The Enforcement Rule is a rule under the Health Insurance Portability and Accountability Act (HIPAA). This rule outlines consequences for people and organizations that violate HIPAA laws and compromise the safety of Protected Health Information (PHI).

Environmental Conditions
Things that are in the immediate surroundings.

Environmental Controls
Method of reducing exposure to pathogens by creating environments where accidental exposure is less likely to happen. Environmental controls include using proper and routine cleaning procedures, proper labeling and storage of hazardous materials, developing procedures for potentially hazardous situations, and adapting the environment so that it is easy to avoid exposure (e.g., having sharps containers located near where sharps are used.)

A disease breakout which effects many people all at one time.

Scientists who study the spread and control of diseases.

A neurological disorder which affects about 1% of the population in which people experience seizures. Seizures are a very sudden attack on the nerve cells in the brain caused by electrical dysfunction or disturbances resulting in unconsciousness or violent movement (a neurological disorder).

  1. Partial seizures occur in a specific part of the brain. That is why they are called partial. The seizure varies greatly based on what part of the brain is affected.
    1. Simple partial - called a focal or Jacksonian seizure and usually affects one side of the body or a particular limb. It is characterized by a tingling, stiffening and or jerking movement of that part of the body. There is no loss of consciousness and the individual usually can resume the activity they were doing before the seizure began.
    2. Complex partial - often referred to as a temporal lobe or psychomotor seizure. The individual suddenly stops an activity, appears dazed, and engages in some type of motor activity like smacking their lips or pulling on their clothing. When the seizure activity ends, they appear confused and are often irritable without any memory of the seizure activity.
  2. Generalized seizures - affect the entire brain and are classified as Tonic-Clonic or Absence seizures. This is the most familiar and recognizable type of seizure.
    1. Tonic-Clonic seizures - once referred to as "grand mal" seizures, they affect the whole brain. These are characterized by a loss of consciousness followed by a stiffening and then jerking of the body. Breathing may be affected, urine or bowel accidents may occur and confusion and tiredness are common after having this type of seizure.
    2. Absence seizures - once called "petit mal" and are characterized by brief loss of consciousness along with a facial tic, oral movements, or eye fluttering. The individual usually resumes activities as if nothing has happened when the seizure activity is over. It is common for these types of seizures to go unnoticed because they are so subtle and brief.
  3. Status Epileptuicus - when a person has repeated seizures one right after another that do not stop or respond to usual medical treatments. Although this condition is rare it can be life threatening due to possible loss of oxygen to the brain. Consider contacting medical emergency personnel for this type of seizure.

Erectile Dysfunction (ED)
A man's inability to maintain an erection during sexual activity or intercourse.

When something gets more intense or frequent.

Escherichia coli/E.coli
A common bacteria that has many different strains. Contact with some of these strains cause food poisoning in people.

Essential Functions
Of the job are tasks or duties that the person must be able to do when working on the job. For example, if the job requires a person to drive the company vehicle during their shift, an essential job function would be "Must be able to legally and safely drive a car."

A substance in the body that helps in the development of female sexual characteristics.

Eternal Child
When an adult with disabilities is "treated like a child," and prevented from making choices, contributing, and taking risks that are an expected part of adult life. (see also Paternalism)

Ethical Dilemma
A situation in which the correct path is unclear or confusing, and a direct support professional is faced with conflicting obligations, and he or she needs to make the best choice possible. Due to the nature of direct support work, DSPs face ethical dilemmas frequently. A strong sense of values and mission, helps to make these choices and decisions easier.

Ethical Guidelines
Procedures that are based on accepted values of good practice. Also see the National Alliance Code of Ethics for Direct Support Professionals.

Ethical Practice
The process of following an accepted code of ethics when making decisions and performing activities and duties. Performing direct support work in accordance with accepted principles or values of good practice. Also see the National Alliance Code of Ethics for Direct Support Professionals.

Ethics or Values
The principles that an individual or group consider most important, and that influence individual or group behavior.

Of or relating to a sizable group of people sharing a common and distinctive racial, national, religious, linguistic, or cultural heritage.

A person's ethnic character, background, or affiliation.

Etiquette and Rituals
Culturally shared patterns and customs around communication. These "rules" or guidelines help people communicate more easily in everyday situations. Greetings, such as a handshake, are communication customs. Saying "Hello" when answering the phone is another example.

The science of using techniques to improve the genes of a human population in a manner similar to that which is used when breeding animals, by only letting the people with the best genes bear children. Of great debate is not only the ethical basis for the whole philosophy, but also, which genes are considered the best. The Eugenics Movement was at its height in the United States in the early 1900s. The Nazis of Germany were also proponents of eugenics believing that the genes for light skin, blue eyes, blond hair, and height were among the best" genes in the population.

Eugenics Period
Period spanning approximately 1920 to 1950 when scientific principles were misused in an attempt to prevent birth of people with disabilities. The unethical application of science of genetics led to forced sterilization, institutional segregation, the prevention of marriage and other human rights abuses of people with disabilities.0

To leave an area either on foot or by some other means.

A systematic process used to identify a person's strengths, diagnosis, needs, challenges that can include personal, medical, physical, social, emotional, behavior, familial and educational information.

Information or items that help make clear what has happened.

Evidenced Based
A thoughtful integration of the best available evidence combined with clinical expertise.

A case in which a rule does not need to be followed.

Executive Branch
This governmental branch is headed by the President and makes laws official. The Vice President and other government officials are part of the executive branch.

Physical activity that develops and maintains physical fitness. It includes aerobic exercise, such as running or walking that keeps the heart and lungs working well and weight training that increases strength.

Exit Date
The last day a person worked for the organization.

Exit Type
Record of whether an employee quit or was fired (used in developing a baseline of workforce challenges).

Expedited reinstatement
Is an employment support provided to people accessing Social Security Disability Insurance (SSDI) and Medicare. It allows recipients to restart benefits if they lose them and become eligible for them again. This can occur any time in the six years after losing them. In addition, they may be eligible for provisional benefits during the time their re-eligibility is being determined.

Experiential questions
Ask the person to describe the extent, type and nature of jobs or other experiences they have had (e.g., what types of position they held, what their job duties were, how long they worked in a position).

Using the resources or possessions of a child or vulnerable adult for the personal benefit, profit or gain of persons other than the vulnerable adult or child. To take advantage of a person that you have power over in a selfish or unethical manner.
This term is one that is commonly defined very specifically by state laws or regulations. You must be familiar with your state definitions. States that have specifically provided links to definitions or information regarding this term through special CDS customizations content include: PA, KS, MN.

A violent blowing apart or bursting caused by energy released from a very fast chemical reaction, a nuclear reaction, or the escape of gases under pressure.

Exposure Control Plan
Each employer that has employees with occupational exposure to blood or other potentially infectious body fluids and any body fluid visibly contaminated with blood must establish a written Exposure Control Plan designed to eliminate or minimize employee exposure.

Expressive language
Use of spoken, written, or gestural symbols, in rule-governed arrangements, to convey meaning.

Evacuation Plan
A plan that outlines when and how to leave from a place of danger to a place of greater safety.

Evacuation Route
A path to take to escape from a dangerous thing.

Extended period of eligibility
Is an employment support provided to people accessing Social Security Disability Insurance (SSDI) and Medicare. It allows recipients that have used up their Trial Work Period the opportunity to receive benefits. For those that wish to earn more than substantial gainful activity (SGA), they can still receive benefits if their earning fall below SGA. If benefits need to restart, they do not need to complete a new application. This can happen as many times as needed during the 36 months after the Trial Work Period. For those that do not want to earn more than SGA, it allows them to maintain their benefits.

Extensive Support
Extensive support is part of a disability classification system. (Published by the American Association on Intellectual and Developmental Disabilities, AAIDD). It refers to persons who need ongoing support for most life activities. These individuals can do some things on their own. However, they will always need support from others.

External Antecedents
Antecedents that are caused by something in the environment or by the way in which supports are provided, such as loud noises or asking someone to do something.

No longer reinforcing a behavior that was previously reinforced, with the expected result of reducing the occurrence of the behavior. Usually extinction is thought of something that happens as part of a plan to reduce challenging behaviors, but extinction can apply to desired behaviors, if there is not enough reinforcement for the behavior over time.

Extrinsic motivation
Something created outside the individual, such as money, rewards, or recognition, that compels a person to do good work.

Eye contact
A nonverbal, visual connection between two people, with each looking into the eyes of the other.

Eye gaze
Looking at people and objects that are of interest; indicates the direction or focus of attention.

Eye Movement Desensitization and Reprocessing (EMDR)
EMDR was developed in 1989 and has been used to treat people with Post-Traumatic Stress Disorder (PTSD).

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F stands for Fahrenheit. It is a way to measure water temperature. In the United States, temperature is measured in Fahrenheit. In many other countries, temperature is measured in centigrade. In the United States, human temperature is measured in Fahrenheit. Normal body temperature is usually 98.6 degrees Fahrenheit. This is often written as 98.6° F.

Facial expression
A form of nonverbal communication resulting from one or more movements or positions of the muscles of the face, closely connected to emotions; may be voluntary or involuntary.

Face Mask
In health, a face mask is worn across the nose and mouth to help prevent the spread of illness.

As a direct support professional you support the person to do things for themselves or you assist them in finding someone else to help them with it.

Reducing the frequency or changing the timing of prompts while teaching, so that eventually the person does not need the prompts.

When something is changed in order to deceive someone else.

A group of two or more people related by birth, marriage, adoption, or emotional ties. It includes relatives and / or other significantly important people who provide psychological, emotional, and spiritual support for a person they are close to. Family does not need to be a blood relative to be an integral part of a person's life.

Family FOCUS:
A short way to describe a process that helps DSPs identify the Family who the person receiving supports wants to relate to; the Organizations and affiliations important to these people; the Culture and lifestyles shared in the family; the Uniting and supportive activities the DSP can employ; and, the Steps for implementing these activities.

Family Medical Leave Act
A federal law enacted in 1993 that provides up to 12 weeks of unpaid leave for an employee without fear of losing his/her job. Conditions that qualify for FMLA: a serious health condition that makes the employee unable to perform his or her job, to care for a sick family member, or to care for a new child (including by birth, adoption or foster care )

Family of Origin
The family members you are related through blood or adoption (either formal or informal) and who have known you since childhood, typically, your parents, grandparents, and siblings, and extended family members related by birth, like aunts, uncles, and cousins. Romantic partners and your own children are not part of your family of origin.

Family support
Describes service programs for families who provide support at home for children, and sometimes adults, with developmental disabilities. Within a family "centered" or "driven" context, the programs make use of structured services, natural supports, and often cash assistance to: (a) make it possible for families to keep their family member at home, (b) assure that the person with disabilities receives needed services at home, (c) enhance the capacity of families to provide supports at home, and (d) realize some cost savings related to promoting care at home over out-of-home options.

Family System
A group of people who act and react with each other as members together and independently in a complex structure known as a family.

Family-centered Support
When professionals see families as capable of making informed choices and decisions that leads to improvements in family functioning and quality of life.

A feeling of tiredness that people often experience when ill.

Febrile Seizure
A non-epileptic seizure that occurs during childhood and is triggered by a fever, usually over 102 degrees Fahrenheit. This seizure is not related to any other brain or spinal cord injury. Febrile seizures can be mild with symptoms of stiffening limbs or eye rolling. They can also be strong where there are contractions of the whole body. The child may moan, cry, fall, or pass urine. These seizures are most often short lasting (less than 10 minutes) and do not require medical attention. Bringing the child's fever down is an important step in prevention.

Federal Insurance Contribution Act (FICA) taxes
A specific U.S. tax taken out of the pay check of every working citizen. The contribution go toward paying for the Social Security program.

This type of coverage generally assumes that the medical provider (usually a doctor or hospital) will be paid a fee for each service rendered to the patient—you or a family member covered under your policy. With fee-for-service insurance, you go to the doctor of your choice and you or your doctor or hospital submits a claim to your insurance company for reimbursement. You will only receive reimbursement for "covered" medical expenses, the ones listed in your benefits summary

Is a respectful and supportive exchange or discussion about work performance between a frontline supervisor and direct support professional. It includes direct and clear communication about how the employee is meeting or not meeting expectations.

Fetal Alcohol Syndrome (FAS)
a disorder that is caused when a woman drinks when she is pregnant. It affects the central nervous system and causes birth defects such as mental retardation, poor motor skills, poor eye-hand coordination, behavioral and learning problems.

Financial management services
These services include making financial transactions within participant-directed support programs on behalf of participants. This often involves paying workers that individuals employ, deducting payroll taxes, facilitating the purchase of items, and tracking expenses against the individualized budget. States will often arrange to provide these administrative services on behalf of participants. A state may obtain services from an outside contracted agency or may provide the services within the public agency.

First Responders
Trained professionals who are first on an emergency scene to offer assistance.

A rising and overflowing of a body of water especially onto normally dry land.

A soft silk or cotton material that is drawn between two teeth to clear bacteria and food particles.

The appropriateness of the speed at which the person completes a task. Fluency is achieved when the rate is appropriate to the situation.

An element that helps to protect teeth from bacteria.

A reddish blush on the face.


Focus Groups
Focus groups involve brining a specific group of people together for the specific purpose of informing others about important issues. Focus groups are usually structured around a set of issues or questions about which information is needed. A facilitator is used to guide the discussion.

A reddish blush on the face.

Focus Groups
Focus groups involve brining a specific group of people together for the specific purpose of informing others about important issues. Focus groups are usually structured around a set of issues or questions about which information is needed. A facilitator is used to guide the discussion.

Forced commitment
A legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a hospital (inpatient) or in the community (outpatient).

Formative Experience
An experience that happens when one is a child and has a profound impact on how one develops (especially regarding emotional growth) into an adult individual.

Fragile X syndrome
Fragile X syndrome is the most common inherited form of intellectual disability. It occurs in about 1 in 3600 males and 1 in 4000-6000 females. Males with Fragile X syndrome are more likely to have significant intellectual disability, as well as some of the following physical or behavioral characteristics: enlarged ears, long face, attention deficit disorder, speech disturbances, hand biting, hand flapping, poor eye contact and unusual responses to sensory stimulation.

(In a self-determined service approach) The right of a service participant and his/her supporters to make the decisions about the direction of his/her life and the supports needed to achieve his/her goals, dreams, and aspirations.

The number of times something happens. A characteristic of a positive social relationship would include reasonably high frequency: seeing or interacting with each other often enough to establish a real relationship.

The rubbing of one thing against another.

Non-related people you know who you like and trust. These are people who are close to you, to whom you hold in special regard. Friends can be people you know from work, school, or other social groups or gatherings. Friends can be people you hang out with but it is important to remember that friendship is a reciprocal relationship. This means you are there to help and support them and he or she is available to help and support you. Sometimes family members can be considered friends as well.

Injury or destruction of skin and underlying tissue. Most often that of the nose, ears, fingers, or toes. This results from prolonged exposure to freezing or subfreezing temperatures.

Full Guardianship
With full guardianship, the guardian is allowed to make both personal and financial decisions on behalf of the ward.

Full-time equivalent (FTE)
A full-time equivalent is 40 hours per week of scheduled hours of work by one or more employees. It is calculated by adding up the budgeted scheduled hours per week and dividing by 40 hours which will give you full-time equivalent positions.

The purpose something serves. What is does. In applied behavior analysis, the two basic functions of challenging behaviors are considered to be 1) to obtain something desirable; and 2) to avoid something that is undesirable.

Functional Academics
Functional academics are the minimal levels of reading, math or other academic skills needed to function with independence in age-typical daily activities in one's community.

Functional Analysis
Methods and strategies to further test a hypothesis statement generated through the functional assessment process. The functional analysis process is one in which the variables (events or circumstances) thought to promote or maintain the behavior are presented in a setting where events and environments can be carefully controlled and observed, in order to gather information about the effect of these variables on the behavior.

Functional Assessment
Methods and strategies used in the person's daily environment that help us understand the antecedent(s) that predict challenging behaviors and the consequences that maintain challenging behaviors. Using a definition of the behavior that is observable and measurable, functional assessment seeks to discover the function the behavior serves (that is, what the person obtains or avoids) by looking at: 1) When, where, and with whom are the behaviors are most and least likely to occur; and 2) What consequences maintain these behaviors. The results of a functional assessment are used to develop a hypothesis statement, which in turn is used to develop a behavior support plan. The hypothesis statement can be further tested through functional analysis if needed.

Functional communication
Communication skills that are useful in enabling individuals with disabilities to participate productively in interactions with other people. Functional communication includes the abilities to communicate for a variety of purposes relevant to the person's life experiences, use a variety of communication modes to accomplish these purposes effectively, and initiate, maintain, and terminate social interactions. Functional communication is communication that occurs in every day, "real life" or "natural" settings; results in real consequences; and includes "spontaneous" communication.

Functional equivalence
Also see replacement behaviors. When two different behaviors serve the same function. Finding more appropriate behaviors that are functionally equivalent to challenging behaviors, and teaching and reinforcing these new behaviors, is one strategy for creating lasting change in a person's behavior. If the functionally equivalent behavior is connected to a function that is appropriate to the environment, teaching the more socially appropriate behavior may be the final goal of intervention. At other times, it is a step in the process for reducing challenging behaviors while other skills will continue to be taught.

Functional skills
The skills a person needs to do the ordinary tasks of day to day life. Functional skills may be an ability to read, open a door without assistance, or cook a meal.

Funding Systems
"Funding systems" is a term used to describe how federal, state and local monies are provided to pay for the services people with developmental disabilities receive. These public monies may be paid directly to an individual or family so they can buy what they need. Public monies can also be paid directly to an organization or individual for services they utilize has or will provide to person with developmental disabilities. Many people with developmental disabilities receive help that comes through both kinds of funding.

Related to fungus, which is a type of infection that is spread by direct contact with fungal spores on a surface such as public shower floor. An example of a fungal infection is athlete's foot.

Fungi (plural) or fungus (singular) are a diverse group of plantlike spore-forming organism that live by decomposing and absorbing organic material. They can be single or multi-celled organisms. They are neither plant nor animal. They include molds, mildews, smut, rusts, and yeasts. Some fungi are helpful; consider edible mushrooms or yeast used in bread making. Other fungi are harmful even deadly. Still some fungi cause diseases in humans, plants and animals.

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Gang activity
A gang is a group of two or more people who commit illegal acts. Gang activity includes, but is not limited to wearing, using, or distributing, displaying, or selling any clothing, jewelry, emblem, or badge that evidences or promotes gang affiliation.

gastric juice
an acidic fluid produced in the stomach that destroys bacteria and helps in the digestive process; also referred to as gastric acid.

Referring to the stomach and intestines.

Gastrostomy tube
Is a feeding device inserted directly into a person's stomach through the abdominal wall. It is used to provide nutritional supplements when a person has difficulty swallowing.

People or agencies that are between a person and other people or services. Sometimes gatekeepers are helpful because they provide a helpful screening service for the person, sometimes they are barriers to the person living his or her own life.

Gatekeeping or primary care case management
A single practitioner in a managed care system, who is responsible for determining the quality and mix of services a recipient needs and receives.

A term used to describe one's homosexual orientation. While gay applies is some contexts to all homosexual people, the term lesbian is used exclusively to describe gay women. Sometimes gay is used to refer only to men.

Gay and Lesbian Rights Movement
Movement of the late 1960s and early to mid 1970s by radical lesbian, gay, bisexual, and transgender people fighting for acceptance and pride in one's identity. Lesbians and gays were urged to "come out", publicly revealing their sexuality to family, friends and colleagues as a form of activism, and to counter shame with gay pride.

Gel Sanitizers
Hand cleaner with alcohol that doesn't need water to work. These sanitizers kill the germs on hands. This product can be found in most supermarkets and drug stores.

General infection control procedures
Daily procedures that direct support professionals should use to reduce the transfer of infectious agents. These procedures include hand washing, proper handling of potentially infections materials (raw foods, personal use items), cleaning of personal items and common areas, and the use of personal protective barriers when needed.

A word used to identify the sex of a person, being male or female.

Being able to apply a skill or knowledge to a variety of situations. Many people with developmental disabilities have difficulty with generalization. It is best to support skills in the place they will use the skill.

Generalized Anxiety Disorder (GAD)
An anxiety disorder characterized by unwarranted yet continual worrying about everyday life and activities. People living with GAD may also have physical symptoms such as headaches and sleep disorders.

A machine that produces electrical energy to run equipment.

Not specific to people with disabilities. Resources available to all people regardless of ability such as parks, swimming classes at the local YMCA, or professionals like doctors/dentists.

Characteristics, attributes, or health conditions that are a result of a persons' genes. Genes are passed from parents to children as part of the biological process. The study of how a person's characteristics and its consequences for health are passed on from parents to children.

Genetic Counseling
The affecting of information and discussion about specific areas (such as the probability of a couple having a child or the possibility of developing a certain disease) that result from genetic and hereditary conditions.

Genetic disorders
Genetic disorders are disorders of the genes or chromosomes. Genetic disorders can be passed down from one's parents. Sickle Cell Anemia and Cystic Fibrosis are examples of genetic disorders that are inherited, or passed down from one's parents. Genetic disorders can occur during conception or growth of a new baby. These types are not inherited. Down Syndrome is an example of a genetic disorder that is not inherited.

The study of how a person's characteristics and its consequences for health are passed on from parents to children.

A person's external sexual organs and the area of the body where the sexual organs are.

a professional who focuses on issues and needs of older adults and/or aging populations.

Gestational diabetes
Occurs in someone that is pregnant who has not previously had diabetes. This is often a temporary state that is brought on by pregnancy.

Informal body movements that have meaning. An example is waving good-bye. These are usually culturally shared. Usually both men and women use the same or similar gestures.


An illness caused by a parasite called Giardia intestinalis. It lives in soil, food and water. It may also be on surfaces contaminated with waste. A person can become infected if he or she swallows the parasite. This infects the intestines. It can cause diarrhea and other symptoms.

A disease of the eye in which pressure builds within the eye and causes damage.


Graduated guidance
A the fading of physical prompts by gradually decreasing the amount of pressure during the procedure or the length of time the person is touched.

Graduated Risk Opportunities
The opportunity to experience small amounts of risk in order to develop the skill and knowledge necessary to make better judgments about larger risks. For instance, many young adults go on group dates and supervised dates before they go on individual dates as a way to provide graduated risk taking.

Personal care activities that people perform to look their best and present a certain image to others.

Ground Rules
A set of rules put together by a work team. These rules are meant to create shared norms around communication in the team.

Group dynamic
The interaction between members of a group.

Group Home
A home, usually in a community setting, which has 2 or more people with disabilities living in it and receiving services. These homes can range in size from 2 people to 15 people and can be publicly or privately owned and operated. Also see: congregate care setting.

Group Living Arrangement
A residential service model where paid staff provide daily living support for 2 to 15 people and can be publicly or privately owned.

A legal relationship with another, where one person (the guardian) is legally appointed to overseeing the decisions of another, due to the other's inability to fully understand the risks and benefits of his or her decisions. Guardianship usually covers a broad range of areas such as finances, medical and behavioral interventions, and choices regarding health and daily living. The consequences of guardianship and authority of guardians does vary depending on the state in which guardianship is obtained. (i.e., what rights the person retains versus the areas the guardian has authority over). In addition, guardianship is a legal method for ensuring that people maintain the ability to express their rights and not as a vehicle for limiting or denying rights.

The condition that exists when an individual is legally appointed to assist a person who is incapable of understanding the risks and benefits of a situation, in making most important decisions. Also see: conservatorship and guardian.

Pink tissue that surrounds the teeth in the mouth.

A licensed health care practitioner who works with sexual health, and hygiene of women.

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The perception or feeling, which can be visual, auditory,or sensory that a persons feels or knows to be real but is not based in reality. A hallucination is very real to the person experiencing it, but cannot not be seen or felt by others.

Hands Off Style of Management
In this style of management, no one is in control" or nobody is making the decisions. The primary belief of this approach is that the manager needs to be uninvolved with supervisors and Direct Support staff. Everyone can and must set their own direction, make their own decisions, and get their work done on their own.

Hand fidgets
Small items people can manipulate with their hands to help a person focus or relieve anxety.

Hate crimes
A crime, usually violent, motivated by prejudice or intolerance toward a member of a gender, racial, religious, or social group.

Hazardous Materials
Materials are designated as "hazardous materials" when they pose a significant risk to people or property. This could include things like used disposable gloves or a used needle in the direct support setting.

Hepatitis B Virus.

A person familiar with traditional methods of healing within a culture who may or may not have western medical training.

The general state of one's physical body and mind. Good health is often defined as the absence of illness or injury. Poor health, on the other hand, means the presence of a physical or psychological disease, illness, or malfunction of the person's physical or mental state.

Health Assessments
a document outlining the health of an individual including a health history and results of physical exams and lab work.

Health Care Providers
Physicians, dentists, nurses, nurse practitioners, physician assistants, dental hygienists, physical/occupational/speech language therapists, behavioral health specialists, and all other health care specialists. A person who is trained and licensed to give health care. See also health professional.

Health Condition
These are health concerns or characteristics of a person's health. For example, heart or lung problems would most likely be considered as health characteristics that put people at higher risk for pandemic flu.

Health Information:
According to HIPAA, this is general information about a person's diagnosis, treatment plan, services received, and how services are paid for. This information can be exchanged orally, electronically, and in writing.

Health Insurance
This kind of insurance is most often offered by employers to employees, the kind that covers medical bills, surgery, and hospital expenses.

Health Maintenance Organizations (HMO)
charge a single monthly or annual fee that covers all medical expenses, from routine and emergency care to hospitalization. Many also charge a small "co-payment," usually about $5-15 for each visit to the doctor.

Health Professionals
People who are trained and certified to care for individuals' health related needs, examples include nurses, doctors, physical therapists, nutritionists, and paramedics.

Healthy Life
The active process of making choices about diet, exercise, and they way you live your life to make you feel good, to have energy to do what you can to prevent illness and to live longer. The belief that an individual can and will influence their own health.

Healthy Lifestyles
All the behaviors associated with living life and maintaining and improving your health.

Hearing impairment
A condition where a person has difficulty hearing with their ears. The condition may range from mild (needing no hearing aid) to severe, where a person is not able to hear any sound.

Heart attack
Damage to an area of heart muscle that is deprived of oxygen. This is usually due to blockage of a diseased coronary artery. It is typically accompanied by chest pain radiating down one or both arms. The severity of the attack varies with the extent and location of the damage.

Heart Disease
a broad term used to describe a range of diseases that affect the heart, which includes diseases of the blood vessels (such as coronary artery disease), heart rhythm problems (such as arrhythmia), heart infections, and heart defects that a person is born with (such as congenital heart defects).

Heat Stroke
A severe and dangerous condition cause by prolonged exposure to heat.

Hepatitis is disease of inflammation of the liver commonly caused by a virus. There are several types of hepatitis, the three most common in American are: Hepatitis A (HAV), Hepatitis B (HBV), and Hepatitis C (HCV). The severity of the disease increases from Hepatitis A, which does not cause liver damage and almost always goes away after several weeks, to Hepatitis B which often becomes chronic (keeps coming back) to Hepatitis C which can result in permanent damage to the liver and possibly liver cancer.

Hepatitis B virus (HBV)
A bloodborne pathogen that can cause serious illness and death. Some people who become infected will be lifelong carriers of the disease and have the potential to infect others even when the carrier no longer has symptoms.

A preparation made of natural substances that are found in herbs and plants. These preparations are thought to cure or prevent poor health by those that use them.

A person who is knowledgeable about the curative and properties of herbs.

High Blood Pressure
A health condition, also known as hypertension, caused when the pressure of blood flow against the artery is too strong.

High risk
A category that describes those who might more easily catch a particular kind of illness.

  1. The Health Insurance Portability and Accountability Act (HIPAA) requires that you maintain the privacy of each person's personal health information.
  2. This is a federal act that defines a person's right to privacy for health related information. Individual health information must be kept private. PHI is health information transmitted or maintained in any form or medium that: identifies or could be used to identify an individual; is created or received by a healthcare provider, health plan, employer or healthcare clearinghouse; and relates to the past, present or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present or future payment for the provision of healthcare to an individual.
  3. Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that covered entities must follow, due the type of health information they use and how they use it. The law presents national standards to protect privacy and security of protected health information (PHI). It does this by defining boundaries to how people can share PHI verbally and in writing, as well as how they can share it electronically. If this law is not followed, civil and criminal punishments can be incurred. These punishments can include up to 10 years in prison and/or fines up to $1.5 million for a single agency.

The part of the brain associated with consolidating memories and emotional memory.

Hire Date
Date an employee was hired or started their position.

Human immunodeficiency Virus (HIV)

Holistic Approach
Handling or dealing with a person as a whole, rather than focusing on only specific parts of the individual such as diagnosis, history, or needs. In the past, in human services and health care, people were seen and understood primarily through the lens of their diagnoses, deficiencies, or needs. This narrow and "deficiency-based" approach failed to consider the whole person in the context of his or her social network, preferences, and gifts, and resulted in narrow and ineffective support or interventions. Practitioners in most fields are now striving to understand and support people through consideration of all aspects of the individual's personalities and lives, including individual culture, beliefs, strengths, existing supports, and preferences.

Home and Community Based Services
A federal funding stream through the Medicaid program. It is used to fund long-term services and supports outside of institutions.

Home and Community-Based Waiver
(See Home and Community Based Services). When HCBS were developed, they included a waiver to the institutional regulations.

Sexual behavior or attraction between people of the same sex.

Anything that is affected or caused by the stimulating action of natural, body-made substances.

Hormone Replacement Therapy
A medical approach of artificially replacing female hormones during menopause.

A product of living cells that circulates in body fluid and that yields specific actions in the body at a distance from its origin

An approach to end of life care that is based on respect for the dying process. A team works together to provide the most comfortable care for the last six months of a person's life.

The living creature that illness-causing organisms or agents enter in order to multiply and spread.

HR System Data
HR system data includes all the information an organization maintains on computers or hard copies that describe employee characteristics (age, gender, race/ethnicity), job status (hire date, current position, supervisor, termination date, reason for termination), wage and benefit information, schedule, and other information needed to administer the programs of the organization and respond to regulatory requirements. Often, HR system data is a rich source of information for computing retention basics, and useful for coordinating other assessments.


Human immunodeficiency virus (HIV)
A bloodborne pathogen that can lead to serious illness and death. Current research indicates that carriers are lifelong and can go for a long time without symptoms even when they are capable of infecting others. This virus is what cause AIDS (Acquired Immune Deficiency Syndrome).

Human Right
Rights that belong to all people. Examples are freedom from unlawful imprisonment, torture, and execution.

Human Rights
Conditions and privileges to which people are entitled to as the natural result of being human.

Human Rights Committee
A group of people who come together within an agency to review situations in which a person's rights are being restricted and to ensure that all possible steps are being taken to remove and reduce restrictions.

The attribute of accurately understanding one's strengths and weakness. Being able to share this with others without covering the weaknesses.

Huntington's Disease
A genetic brain disorder that attacks the body's functioning and breaks the body down, eventually resulting in death.

A tropical cyclone with winds of 74 miles (119 kilometers) per hour or greater that occurs especially in the western Atlantic, that is usually accompanied by rain, thunder, and lightning, and that sometimes moves into temperate latitudes.

Drinking the right amount of fluids, especially water.

drinking the right amount of fluids, especially water.

Personal care activities that keep people clean and help to maintain overall well-being.

A condition where the body has too much sugar (glucose) in the blood stream. If high blood sugar occurs over a long period of time, it can cause organ damage.

An abnormally high body temperature usually resulting from infection, overheating, certain drugs and medications, or head injury. This is also called heat stroke.

A condition where the body does not have enough sugar (glucose) in the blood stream.

A state in bipolar disorder where a person experiences mild symptoms of mania. The person is generally oriented to reality. However, he or she may have increased energy, excessive feelings of well-being, rapid speech, and less need for sleep.

A severe and dangerous condition caused by prolonged exposure to cold that causes the body's temperature to go down to dangerous levels.

A theory that explains a set of facts and that can be further tested. A hypothesis statement regarding challenging behaviors is a summary statement that defines the problem behavior(s) and identifies: the events that reliably predict the occurrence and nonoccurrence of the behavior; the consequences that maintain the problem behavior; and the function of the behavior. A hypothesis statement would be the outcome of formal functional assessment procedures. While not every hypothesis statement needs to be developed through a formal functional assessment process, all behavior support plans should contain a well-thought-out hypothesis statement.

A condition that reduces the thyroid glands production of hormones that results in a loss of energy.

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Simple, fun activities that are done at the beginning of a meeting to help the participants to feel comfortable and at ease. An activity used by trainers or facilitators. This is meant to get an unfamiliar group warmed up and ready to work together.

Ice storm
A storm in which falling rain freezes on contact.

Intermediate Care Facility for People with Intellectual Disabilities. These are institutions for people with ID.

Identification and tracking
A way to identify and keep track of individuals and staff members during and after an emergency.

Statements that have meaning within a culture yet are not clear when directly translated into another language or to people of other cultures.

The word idiot originally comes from the Greek word 'idios,' meaning "a private person." It then came to refer to one who lacked professional knowledge, and later to one who was ignorant, or ill-informed. In the later writings of the Greeks, idiot was used to refer specifically to persons with perceived mental disabilities. In the early 1900s, the word idiot came to refer to a person with very severe intellectual disability who was considered "mentally equivalent" to a child of three years of age. Today, this word is offensive and not used by professionals.

Unique to an individual; non-standard. For example, unusual gestures used by an individual to indicate a specific meaning that is understood by only familiar communication partners.

Individual Educational/Program/Habilitation/Service Plan. Individualized plans. A set of assessments, goals, strategies, and actions developed for a specific person receiving services. Traditionally the plan has been developed by a team of people involved in the person's life such as paid professionals, direct support professional, family members, and the individual receiving services. Goals focus on developing skills and achieving outcomes desired by the individual. In most states there are specific rules and regulations that require the plans and their specific content. Also see: support plans.

The state or fact of being ignorant; lack of knowledge, learning, information, etc.

Immediate echolalia
Repeating or echoing of a word, phrase, or verbal utterances immediately after hearing it.

Immune system
A system within the human body that protects the body from diseases, injuries, and illnesses. It is a group of biological responses that help the body identify foreign invaders that may cause harm to the body. The body then responds by attacking these foreign invaders.

A person's resistance to disease or illness that makes it harder to get sick.

Methods of creating immunity to diseases through the introduction of substances that cause an immunity to develop in the body without making the person ill.

Is a way to make a person or animal resistant to a particular disease, usually through a vaccination or inoculation to the disease.

A disturbance affecting the normal performance of major body organs or parts. For example, a visual impairment is a disturbance of the normal performance of the eyes.

A bacterial infection of the skin, most commonly found in skin that has been injured or has compromised health.

In-home services
Services provided in a person's home.

Inaccessible accommodations
Anything in the environment that creates a barrier to people who want to participate in activities there, such as movie theaters or planes without seats that are large enough for a person to sit comfortably in them, allergens in the air, poor sound systems that makes it difficult to hear, lack of translation of materials to other languages, no parking spaces available, etc.

Inactive ingredient
Substances in a medication that are not known to have a medicinal effect.

Sexual contact between persons who are closely related by blood or adoption and when this contact is illegal or forbidden by custom or law.

Incident/Accident Report Form
A form usually provided by the support agency that is used to provide necessary details about an incident or accident.

Actions or events that are uncommon and may be important to document due to harm or the possibility that harm could come from the action, such as a person leaving a supervised area without telling anyone, a person having an unexpected seizure, or a person acting very upset when he or she is usually calm.

Incitement to Act
Telling or asking someone else to act in an abusive manner or to take matters into their own hands. Causing someone to act in a certain way that is detrimental to themselves or others, through deliberate actions.

See community inclusion.

Accepting, open to and including people with different needs and backgrounds.

Inclusive relationships
Relationships that include people from various backgrounds and experiences including relationships between people with and without developmental disabilities.

The inability of a person to make or carry out important decisions regarding his or her affairs.

Physically unable to control your bladder and/or bowel movements.

Independent Living
Independent living means having the opportunity to control one's own life and make one's own decisions, perhaps even to fail, but to do so with access to the services and supports needed to live the life one chooses.

Independent Living Movement
The Independent Living Movement was founded by people with disabilities. It is tied closely to other civil rights struggles of the 1950s and 1960s, including the African American civil rights movement, Women's Liberation, and Consumer Advocacy. People with disabilities felt that the problems that were keeping them and others from being active, included and productive members in society are more often due to social attitudes, discrimination, and architectural barriers than because of their actual physical or mental difficulties. The first Independent Living Center (ILC) was created in Berkeley, California the early 1970s. It soon became a model for other centers. Today there are hundreds of ILCs and satellite programs. They provide advocacy, peer counseling, assistance with publicly funded services, transportation, adaptive equipment (e.g., with buying or repairing wheelchairs), and accessible housing. They refer to other organizations or professionals and generally do whatever they can so that individuals with disabilities can live as independently as possible. All participants in the Independent Living Movement, whether through ILCs or as individuals, share a belief that people with disabilities must control their own lives and become a proud and organized force for removing the physical and social barriers to full inclusion of people with disabilities.

pain or discomfort felt in the stomach because of difficulty digesting food.

Individualized Budget
This refers to the amount of money that is made available for a person to spend on his or her participant-directed supports. It is an annual or other regular estimate of how much funding the person can receive through a Medicaid program such as Home and Community-Based Services. It is based on the person's assessed support needs. Rules for individualized budgets vary by state.

Individual Education Plan
An Individual Education Plan (IEP) is a written plan that outlines how a child's education and related needs will be met. It includes learning goals for the child and lists the services the school will provide for the child.

Individual emergency plan
A plan that has detailed information for supporting an individual before, during, and after an emergency takes place. This plan should be made with the individual and his or her support team and should provide information specific to the individual. This includes: communication, staff roles and responsibilities, specialized supports, evacuation, transportation, shelter, and identification and tracking of the individual both during and after emergencies.

Individual Risk
Risks that are specific to the person and include physical and mental status as well as personality, preferences, and other individual traits.

Individual Program Plan (IPP)

Individual Risk Management Plan
Plans that are developed by a the person and his or her support team to help DSPs know what special risks the person may experience due to his or her specific needs and how to support the person in reducing risk.

Individual Safety Plan
Plans that are developed by a the person and his or her support team to help DSPs know what special risks the person may experience due to his or her specific needs and how to support the person in reducing risk.

Individual Support Plan
The Individual Support Plan (ISP) provides details about what is most important to an individual with a disability so that everyone involved in supporting that individual can focus on those areas. Developed through a Person Centered Planning Process (PCP), the ISP collects information concerning personal preferences, dreams and wishes, medical history/current medical concerns, and communication preferences

Individualized Budget
This refers to the amount of money that is made available for a person to spend on his or her participant-directed supports.It is an annual or other regular estimate of how much funding the person can receive through a Medicaid program such as Home and Community-Based Services. It is based on the person's assessed support needs. Rules for individualized budgets vary by state.

Individually Identifiable Health Information:
According to HIPAA, this is health information that is linked to a specific person, thereby identifying whose information it is. The information can be stand alone, where a person can be identified merely by the health information. For example, a treatment plan with an individual's name on it directly links a person to the information. Even if obvious identifiers are removed, a person can still be linked to health information. For example, if a treatment plan does not have a name on it but has a home telephone number of an individual; one could still determine whose information it is by making a telephone call and inquiring.

Individuals with Disabilities Education Act (IDEA):
This law was originally called the Education of all Handicapped Children Act of 1975. It stated that no school-aged child could be denied a "free appropriate public education." Students with disabilities must be taught in the "least restrictive environment." The law set up the Individualized Education Plan (IEP) as a way for parents and students to have more control over their own education.

Infection Control
Efforts made to prevent and stop the spread of viruses and infections that can be transmitted from one person to another.


Infectious Agent
A virus, bacterium, germ, fungus, or other infectious entity.

Infectious Disease
A disease that is caused by an organism or agent that invades and lives off of a vulnerable living host and that can be passed from one host to another.

Infectious Disease Cycle
The cycle of how infection is passed form one host to the next.

The inability to reproduce or to have children.

The ability to persuade or change the choices or decisions of others. When something has an effect on something else.

Influenza or Flu
A viral infection in which the lungs and breathing tract get inflamed. Symptoms include fever, chills, muscle ache, and wanting to lie down.

Informed choice
A choice that is based on knowledge and understanding of the possible consequences of making that choice without any coercion.

Informed Consent
Making a choice with accurate and thorough knowledge of options and potential consequences.

Informed Disclosure Model
A model of decision making for direct support professionals confronted with issues of confidentiality and privacy. Steps include: 1) be respectful of the person requesting the information, 2) seek additional information and consult with a supervisor when necessary, 3) consult with the person using supports, 4) encourage the person using supports to speak for him/herself, and 5) answer the request in a timely matter.

This is a medication that needs to be inhaled into the lungs.

A person receives a characteristic from one's parent or ancestor.

Injuries of Unknown Origin
Any injury that was not directly observed to happen and when the cause of the injury cannot be accurately reported by the person.

The inability of sleeping.

An organized residence in which people with disabilities and similar conditions live together. Institutions are most often part of state-run hospitals or nursing homes. They must comply with federal and state standards. People who live in institutions are often physically and socially isolated from the rest of the community. Institutions were once the only place where people with disabilities could receive publically funded support for daily living. They are not preferred options today.

Institutional bias
The valuing of one culture more than others. This is expressed in the practices and policies of a community.

A hormone that is made in the pancreas. Insulin helps the body store and use sugar (glucose) for energy. Diabetes occurs when the body does not produce enough insulin. To treat diabetes, insulin is often injected into a person's body. Sometimes pills are all that is needed to stimulate the pancreas to make more insulin.

Intact Work Teams
Operational, ongoing work teams of coworkers that report to a supervisor or manager. In many cases, the supervisor is the designated team leader. These teams work with management to plan, form, and correct their own work. Members join and leave the team on an ongoing basis.

A setting where people of all abilities and backgrounds work, live, or play together. Although the concepts behind integration assumed that by being in the same place at the same time people would naturally begin to associate with each other, integration of environments does not always naturally lead to acceptance of each other. Also see community integration and community inclusion.

A person's ability to follow a strict set of moral and ethical rules.

Intellectual Disability
Intellectual disability is a permanent condition of the brain. It is identified by three aspects. 1) difficulty in activities such as thinking, remembering and learning new things; 2) difficulty when compared with people of one's own age with expected activities such as self-care or communication; 3) onset of difficulties when in the developmental period (under the age 18, or 21). People with ID have more difficulty than average when learning. However, like all people, they do grow and learn. Correct support can enhance this capacity.

Intelligence quotient or I.Q.
Intelligence quotient. The numerical measure of a person's intelligence as measured by standardized tests and administered by a trained professional, often used in definitions of mental retardation.

The strength or force of something.

Intentional Act of Aggression
An act where someone means to hurt or frighten another individual.

Intentional communication
Any deliberate act (motor or vocal, symbolic or non-symbolic) that is intended to transmit information and/or influence the communication partner.

Objects, people, or ideas that overlap and depend on each other for success. In a simple example, people who grow food to earn money and people who eat food to stay alive are interdependent. Each needs the other.

A relationship in which two or more people mutually benefit from a connection with each other and have mutual regard for and respect and trust in each other.

Interdisciplinary/Support Teams
These teams assist in the development, implementation, and ongoing review of program and support plans for human service recipients. Team members have various roles within the employing entity and in the consumer's life.

Wanting something. A characteristic of a positive social relationship (i.e., wanting to be friends, wanting to spend time together).

To get in the way of, or impede.

Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR)
A federal funding source for funding services to people with developmental disabilities, which was the first federal program targeted to monitor residential services to people with mental retardation. ICFs/MR are congregate care settings that range in size from 4 people living in a community home to several hundred living together (including units in state institutions). These programs require 24 hour supervision of the people who live in them and are guided by federal regulations.

Intermittent Support
Intermittent support is part of a disability classification system. (Published by the American Association on Intellectual and Developmental Disabilities, AAIDD). It refers to people with milder intellectual disabilities. People have good ability to take care of themselves, with access to reliable support.

Internal Antecedents
Antecedent that are internal to the person and usually can not be observed by someone else, such as physical pain or feeling sad.

Interpersonal therapy
A form of therapy that helps people improve their relationships and feelings of self-worth.

A depth of feelings for each other that goes beyond casual acquaintance. Knowing about each other, sharing with each other, and feeling close to each other.

To make another person feel fearful or timid.

Intervention Plan
A comprehensive written document that outlines the action steps you will take to reduce turnover and improve the retention of high quality direct support professionals including the identification of the people responsible for these steps and defined timelines for completion of each step.

Interviews gather information verbally from one or more respondents. Interviews can be highly structured, with a set group of questions that will be asked of all respondents in the same way or less structured, with the questions varying depending on the answers given to previous questions, or depending on the characteristics of the people being interviewed.

With regard to the area inside the skull or the interior of the head

Intrinsic motivation
A self-imposed internal motivating force that compels a person to do good work.

Invading Agent
A virus, bacterium, fungus, or other infectious agent that makes its way into a living host.

Individual Risk Management Plan - A four-part process to assess an individual's risk potential.

Unimportant or unrelated to what is being explored, reviewed, discussed, or thought about. Not relevant.

Being kept away from people and other things. Isolation can be a specific term that is used for what is known as "time-out" practices where people were taken away from everyone and everything and left alone in a stark, barren room for a period of time. This use of "isolation" is typically not allowed anymore. Isolation can also simply be the experience of not being accepted by others or part of what is going on due to barriers and stigma. Isolation is experienced by many people with developmental disabilities.

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Words related to a certain field of interest and that are not meaningful to most people outside of that field.

A condition common in infants where the liver is not processing bilirubin adequately. Bilirubin is a substance produced when red blood cells get old. It often causes skin to turn yellow. Jaundice is usually harmless, but can cause brain damage in some cases.

Jim Crow Laws
Jim Crow Laws: state and local laws enacted in the Southern and border states of the United States and enforced between 1876 and 1965. They mandated "separate but equal" status for black or African Americans.

Job Aides
Written or picture instructions or other on site tools that help remind the employee of how to implement specific procedures, or complete specific tasks. These are especially important with difficult or infrequently used yet important skills.

Job analysis
A job analysis is an information gathering process that identifies essential job skills, knowledge and attitudes required of the person doing the job. It includes identification of essential functions, performance levels and physical capabilities as well as job expectations and requirements.

Job carving
A strategy used by employers to look at all aspects of a job, work site, and work team. With this strategy, the supervisor and/or the work team consider what modifications to the job expectations, tasks, and responsibilities can be made to accommodate the different strengths of applicants for the position and still assure that all job requirements are met either by the direct support professional hired or by the work team at the job site.

Judicial Branch
This governmental branch oversees the court systems. The Supreme Court heads the judicial branch, and rules whether or not something is permitted under the Constitution.

Juvenile Diabetes
A disease caused by the body's abnormal insulin production that starts in childhood.

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Keratoconus is a progressive thinning of the cornea that can cause nearsightedness and moderate to severe distortion in a person's vision. It can also cause astigmatism. Eyeglasses can correct nearsightedness and mild astigmatism.

Occurs as the cells start to use alternative sources of fuel in order to keep functioning. Using these fuels (proteins and fats) results in the production of excess acids. The acids in the cells disturb the body's acid levels and can accumulate to the point of being life threatening.

Toxic acids produced by the body when the body is not making enough insulin.

Relatives or family members. This is often culturally and personally defined, for example, some people consider family and kin to be only a small network of people closely related by blood, other people have a broader definition that includes people related by marriage or other affiliations,as well as by blood.

A family relationship or other close relationship in which people are closely bonded to each other

Knowledge Acquisition
The act of learning new things.

An African-American cultural holiday conceived and developed by Dr. Maulana Ron Karenga, was first celebrated on December 26, 1966. Kwanzaa is traditionally celebrated from December 26 through January 1, with each day focused on Nguzo Saba, or the seven principles. Derived from the Swahili phrase "matunda ya kwanza" which means "first fruits", Kwanzaa is rooted in the first harvest celebrations practiced in various cultures in Africa. Kwanzaa seeks to enforce a connectedness to African cultural identity, provide a focal point for the gathering of African peoples, and to reflect upon the Nguzo Saba, or the seven principles, that have sustained Africans.

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The outer parts of the female genitals consisting of two sets of folds that cover the urethra and vagina.

Language is a set of words or symbols used as a structured way to communicate and express one's thoughts. It has structure and is often unique to a culture, ethnic group or country. An example would be French" is spoken in France.

A cord or necklace that is worn around the neck or can be attached to a shoe or other article of clothing. It is typically used to attach a set of keys or identification.

Laser Treatments
A method of hair removal. Laser treatments can only be done by a trained professional and can be expensive. Laser treatments do not last long initially, but after a few treatments the effects can last up to six months. There are side effects with laser treatments, so this method should be thoroughly examined as an option before pursuing.

Late Entry
An item that is documented much after an event or situation occurred; a way to identify documentation that occurred in an untimely manner.

A rule of conduct or action or a binding custom or practice of a community that is prescribed and recognized as binding by a controlling authority (e.g., police, judges) - and is enforceable.

Lead Poisoning
A chemical element present in a person's body at high levels making the person ill.

Leak Proof
A container that prohibits seepage or the release of substance in any way.

Learned helplessness
An understanding that one cannot control one's environment based on experience that efforts to exert control are ineffective.

Learner Goals or Objectives
Descriptions of what a learner should know and understand after completing a learning experiences, usually written in objective and measurable statements.

Learning Disabilities
An inability or difficulty in achieving specific skills such as reading, writing or mathematics. This may mean someone has difficulty using or remembering what they have learned because their attention span is too short or they have difficulty in remembering or processing the information.

Learning Objectives
Describe what the direct support professional knows and is able to demonstrate on the job in clear, observable and measurable terms after participating in training.

Least Restrictive Environment
A clause in Individual's with Disabilities Education Act which mandates that children receive education in the least restrictive settings possible.

Legal representative
Someone who is appointed by law to provide consent for another, or someone hired to represent the person in court. Also see guardian, conservator, power of attorney, and surrogate decision maker.

Legal Right to Privacy
The principle that individuals have a right to maintain a personal identity that is different and separate from one's public identity.

Legal Rights
Conditions and privileges accorded to people by law.

Legally defensible
Questions are developed to assure all candidates are treated fairly and are not discriminated against due to age, religion, ethnic origin, etc.

The exercise of making laws that can be enforced because they were promulgated or enacted by an official body of power within a country, state, or other entity (e.g., city council, state legislature, Congress).

Legislative Branch
The branch of the government that is responsible for making laws in Congress. The two houses of Congress are the Senate and the House of Representatives.

Lennox-Gastaut Syndrome
This is a difficult form of epilepsy to treat. It most often appears between the second and sixth year of life. It is characterized by frequent and different seizure types. It is often accompanied by a developmental delay, psychological, and behavioral problems.

In anatomy, the crystalline lens is a transparent elastic structure behind the iris, which focuses light onto the retina of the eye. It helps the eye change to focus on objects at various distances.

A woman who is romantically and sexually attracted only to other women.

Leukoplakia is a whitish patch that can form on the inside of the mouth, gums and on the tongue. There are a number of reasons that Leukoplakia can occur. If symptoms of leukoplakia occur the person should seek medical attention, as it can potentially progress to cancer.

Life Cycle Stages
Developmental stages that all families experience over the course of a lifetime. These stages are determined by the human development of family members, as well as social expectations and rituals. Rites of passage, such as birthdays, weddings, and funerals tend to reinforce and draw attention to these life cycle stages.

Life Expectancy
the average number of years a person is expected to live at a specific age. For example, the life expectancy of a person born in 2006 is 77 years. The life expectancy of a person currently age 65 is another 15 years.

Lifelong learning
A concept that learning is important and possible at all stages of life and for all people.

The way in which one chooses to live ones life, including where and when one works, lives, and plays.

Limited Guardianship
A limited guardianship that allows the guardian to make decisions in certain areas authorized by the Court. The ward retains the right to make decisions in all other areas. Examples might include areas of decision-making such as where to live, what services s/he receives or medical treatment.

Limited Support
Limited support is part of a disability classification system. (Published by the American Association on Intellectual and Developmental Disabilities, AAIDD). It refers to people who receive support rarely. This may be on a time limited basis. It may be for specific activities. For example people may receive 10 hours of support a week. Activities may include things like shopping, money management, meal planning, and cooking skills.

Consisting of or related to language.

The ability to read.

A lawsuit against the employer in criminal or civil court.

Living will
This document indicates a person's preferences for end-of-life care. This document does not have to be followed by medical personnel.

Long term services and supports
Ongoing, long-term supervision or assistance given to a person with disabilities to help the individual complete daily living activities (e.g., eating, dressing, bathing, communicating, keeping a job, taking prescribed medications), learn new skills, maintain a general sense of safety and well-being, or otherwise pursue a normal daily life rhythm. Such assistance typically excludes medical interventions due to injury or illness.

Long-term Care Ombudsman
This is a mandated advocacy organization. It is for people who live in long-term care. This includes places like nursing homes, group homes, and board and care. People who feel their civil, legal, or resident rights have been violated can contact the ombudsman for support. Others who have concerns about quality of care in LTC facilities may also report to an ombudsman. Some events must be reported to an ombudsman as determined by state law such as death and serious injuries.

Low Density Lipoprotein (LDL) cholesterol
This is considered bad" cholesterol. It means a person has low-density lipoproteins. Lipoproteins are a combination of fats (lipids) and proteins in the blood responsible for carrying cholesterol from the liver to the tissues in the body.

This is a medication meant to be fully dissolved in the mouth. Usually the medication is meant to affect the tissues in the mouth and the throat.

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Macro culture
The overall shared beliefs, customs, traditions, behaviors, and experiences of a large group and groups with the most influence within the group. This is often also known as the dominant culture.

A condition known as big baby syndrome. It is also called LGA (large for gestational age) meaning the baby is bigger than average. A baby with Macrosomia is in the 90th percentile for gestational age.

Macular Degeneration
Age-related macular degeneration, or AMD, is a medical condition. It usually affects older adults. It results in a loss of vision in the center of the visual field. This is caused by damage to the retina. The condition occurs in "dry" and "wet" forms. It is a major cause of blindness and visual impairment in older adults over the age of 50 years. This condition can make it difficult to read or recognize faces. Sometimes enough peripheral vision remains to allow for other activities of daily life.

Being able to perform a skill or task, over time, without additional teaching.

To maintain or keep up.

Major Depression
A mental disorder that interferes with a person's ability to participate in daily life. Symptoms include intense feelings of sadness, hopelessness, and/or worthlessness that do not go away. Signs of major depression include losing interest in things that were important, changes in eating and sleeping habits, problems concentrating, and thoughts of suicide.

Major Depressive Disorder
A form of depression. It generally occurs for a specific period of time and may occur in episodes throughout a person's lifetime. Effects are significant. These effects can impair a person's ability to function and/or cause significant distress.

Male menopause
This term is sometimes used to describe decreasing testosterone hormone levels in men who are aging. Female menopause is a very different situation, because sex hormone changes in men tend to occur more gradually.

An act, behavior or failure to act of a family member or professional care provider that causes harm or is considered inhumane treatment of a vulnerable child or adult. Often this is referred to as abuse, neglect, verbal abuse, exploitation, caretaker misconduct, sexual abuse, and sexual exploitation.

An x-ray of the breast used to detect breast cancer.

Managed care
Various strategies that seek to maximize the value of services by controlling their cost and use, promoting their quality and measure performance to ensure cost effectiveness.

Managed care intermediary
The organization in a managed care system which links the payer and the service providers or recipients.

Managed Care Organization (MCO)
The risk-bearing entity which receives a fixed payment to assure that a set of recipients get all the services they need as specified in the managed care plan; it does not directly provide any services.

Managed Risk
Situations that include risks that are well understood and are within limits.

Managed Service Organization (MSO)
Like a Managed Care Organization (see definition) except that it is a network of service provider organizations, and does directly provide services.

Something that is mandatory or required by law.

Mandated Reporting
Reporting any act that is suspected to be potential abuse, neglect, or exploitation of a person who is vulnerable (a child or adult with special needs) that is required by law because of the professional role of the reporter. In many states direct support professionals are mandated reporters.

A state in bipolar disorder where a person experiences a great increase in activity and energy. The person becomes disconnected from reality and there are consequences for actions. He or she may over spend, have reckless sexual contact, and engage in excessive use of drugs. The person may be unable to sleep for more than a few minutes at time or at all. He or she may have extreme feelings of well-being. A complete loss of contact with reality can occur and the person may become psychotic.

used to be an acronym but now is simply known as MAPS. It is a person-centered planning method developed for people at risk for social isolation. It was developed by John O'Brien, Marsha Forest, Jack Pearpoint, Judith Snow, and David Hasbury.

Massage therapists
A trained person who uses massage techniques to cure others or improve health.

Touching and stimulating of the genitals for sexual pleasure.

Mechanical Restraint
Any form of restraint used in the management of challenging behaviors in which the person can be left alone and he or she remains restrained (such as tying someone's arms to a bed or chair, use of straight jackets, helmets, bed rails, etc.). Mechanical restraints used for the purpose of controlling behaviors are typically discouraged and should never be used in the absence of a carefully developed and reviewed behavior support plan, only when the challenging behaviors are extremely serious and all alternatives have been tried and failed, and only by people who are trained in the proper and safe use of such restraints. The use of mechanical restraints should be frequently reviewed and the person should be supported in other ways to reduce the need for restraint. The use of mechanical supports (splints, helmets, straps, etc.) for the purpose of increasing a person's freedom, independence, and health in a way where the person has free choice to use the mechanical support, would usually not be considered restraint.

Medical or Clinical Records
Written documents that describe in detail an individual's medical, psychiatric or other related conditions and progress related to such conditions. Such records often contain details of family history and other highly personal and private information.

Medical Model
Emerging from the growing knowledge about the human body during the Renaissance period, the Medical Model views disabilities as a human weakness or "medical misfortune." Services were often geared toward returning the person to "health" or making him or her more "normal."

Medical Practice
Any type of care that includes methods of healing or preventing injury or illness.

Medical Restraint
See Psychotropic.

Medically Fragile
A person who has health conditions that make him or her more susceptible to illness and serious medical complications and therefore, typical activities or actions may be more of a risk to the person than they would be to someone without these medical issues.

Medicare and Medicaid
Federally subsidized health care plans that were established by Congress in the 1960s to help provide health care for citizens 65 and over, and those least able to afford medical insurance on their own. Medicare provides about 40 percent of the cost of acute care for elderly patients. Medicaid programs provide medical assistance to the poor and unemployed who meet the eligibility requirements, which vary greatly from state to state, while benefits for Medicare patients are mandated by the federal government. (definition from ) 10-14-2002

Is a commonly used federal entitlement program in the United States. It is provided to all people that receive Social Security Disability Insurance. Medicare is four part health program that provides insurance coverage. Part A provide hospital and skilled nursing coverage. Part B provides outpatient and medical equipment coverage. Part C provides users the option to select their provider and Part D provides prescription drug coverage.

Is a needs-based medical assistance program in the United States. It provides medical coverage for people with little income and few resources. People that qualify for Supplemental Security Income also qualify for Medicaid. It is a joint federal and state program.

Medication Administration Record (MAR)
A record kept to help people track when medications were taken.

a hormone produced in the body that regulates the sleep-wake cycle by chemically causing drowsiness and lowering body temperature.

When a person is an active participant in an ongoing group such as: church choir, Kiwani's organization, basketball team, book club, etc.

Memory book
A tool such as a notebook, palm pilot, or other electronic device used to record important information It is supposed to serve the role of memory for a person with a brain injury.

Inflammation in the brain area typically caused by a bacterial infection or a virus

The time in a woman's life when menstruation ceases and fertility is ending.

A woman's menstruation, commonly called her "period."

Relating to the care of blood that is passed as part of a woman's reproductive cycle (menstruation).

  • A woman's body discharges bloody matter each moth during the years of fertility.
  • A normal function of the reproductive cycle in women. During the monthly cycle a lining of blood and tissue develops on the inside of the uterus to supply energy to a fertilized egg. If no egg is fertilized this lining sheds in the form of menstrual bleeding through the vagina.
  • Mental Health
    The well being of a person's mind, thoughts, and emotional state.

    Mental Health Professional
    A person licensed or certified to provide mental health services. This is include includes psychiatrists, psychologists, psychiatric social workers, psychiatric nurses, peer counselors, and mental health counselors.

    Mental Illness
    A condition of the mind or brain that seriously affects a person's thoughts, feelings and behavior. These conditions can affect a person’s ability to function on a daily basis. They may include extreme moods or fluctuations. Onset can occur at any point in life, depending on the condition. They vary in intensity. Most mental illnesses respond to treatment and lifestyle changes. However, they are chronic conditions that may have to be managed indefinitely once they occur. Mental health disorders are extremely common and often undiagnosed.

    Mental Retardation
    This term is no longer used. Please see: Intellectual Disability.

    Mental or Intellectual Well-Being
    A state of feeling productive, adapting to change and coping with things that go wrong. It is being able to think, use your memory and creativity. It is about sharing ideas, dealing with others and learning.

    Chemical and biological processes that are always taking place in the body and are necessary for life.

    Metabolic Disorders
    Disorders that interfere with the body's ability to use, produce, or store energy.

    Processes in the body that are necessary for maintaining life. An example of a metabolic process is digestion.

    Occurs when an experienced direct support professional (DSP), regardless of age or current job function, helps someone with less direct support knowledge and skill to reflect on current practices, culture and values, and to expand, refine and build new skills.

    Met expectations
    One reason new staff leave their jobs is because they are not what they expected. A new hire survey can be used to measure the extent to which the job matches the expectations new employees had when they were hired.

    Behaviors or statements that may appear to be benign or not very harmful but actually disparage or demean people based on traits they cannot control. (For example, gender, age, skin color or other physical or mental attributes.) Examples include: no access to a building for people who use wheelchairs; using the words “retarded” or “need to take your meds” to belittle yourself or someone else; a store clerk following and closely observing a person of color as if they might steal.

    Micro culture
    The overall shared beliefs, customs, traditions, behaviors, and experiences of a small group that is different than the macro culture.

    Mild Intellectual Disability or Mild Mental Retardation)
    A term applied to individuals who have I.Q. score from about 54 to 70, substantial difficulties in at least 2 areas of adaptive behavior, with those difficulties first evident in developmental period, that is before adulthood. Males are more likely to be identified with mild intellectual disability than are females. Children are identified much more often than adults.

    Minimum Necessary Requirement:
    The HIPAA standard under the Privacy Rule that requires authorized people sharing protected health information (PHI) with other authorized people to limit their communications to only the information needed to get the work done or to meet the specific information specified in the consent form or business associate agreement. In other words, limit the information exchange to the minimum necessary.

    Minority Model
    During the human rights struggles of the 1960's and 1970's, the Minority Model emerged which thought that the challenges people with disabilities faced were due in part to discrimination and prejudices. Its main focus is to help people identify their goals and provide resources to help them overcome barriers to those goals.

    Writing something that does not accurately portray what has happened.

    Mission, Vision, and Values
    The guiding principles of an organization. The mission is a statement of the organizations purpose. The vision is an image or picture of the future that will exist if the mission is successful. The values are the underlying or supportive perspectives that help guide daily decisions so that the mission and vision are possible.

    (in relation to emergency preparedness): To make a situation more safe and lessening the danger by actions taken before the emergency happens.

    (in relation to emergency preparedness): The process and activities associated with reducing danger in emergency situations.

    Mnemonic devices
    These are learning aids that help with memory and recall. These can be phrases, rhymes, strings of letters or number, or symbols. An example would be a picture of a snake in the shape of an "S" to help the learner remember the sound "S" makes.

    The capacity to move.

    Demonstrating how to do something. Modeling is often combined with verbal or written instructions to ensure important steps are understood.
    Use of communication strategies by the non-disabled communication partner, to demonstrate the use of those strategies in ongoing communication to the person with disabilities. In particular, it is important to model "special" forms of communication like communication boards and voice output devices, as well as signs and gestures.

    Moderate Intellectual Disability
    A classification applied to people with an I.Q. score of about 40 to 54. About .2% to .25% of all people have moderate intellectual disability. People with moderate intellectual disabilities usually have substantial adaptive behavior problems in several areas. Most are first diagnosed in the preschool years. Although complete independence is not usually achieved, people with moderate intellectual disability often learn important self-care, domestic, work and other skills.

    Any act of sexual harassment or touching that is unwanted by an individual or is forbidden because of the nature of the relationship or characteristics of the individuals involved (e.g., sexual contact between a child and an adult even if the child is willing).

    This usually means a change in what is being taught. It can also be a change to what is expected from a student. It reduces the size and difficulty of a student's workload. An example might be giving a student more time to turn in a project than the rest of the students in class.

    Monoamine oxidase inhibitors (MAOIs)
    A type of antidepressant medication used to treat depression. MAOI's are powerful drugs which should be used as a last resort after other medications or treatments have been tried unsuccessfully.

    Having one mate or romantic relationship at a time.

    Moral Model
    A dominant belief in early Western history that believed disabilities were a "special gift" or "punishment" from God. Depending upon how one viewed the disability, one could either suffer persecution and harm or be given kindness and charity.

    The word moron comes from the Greek moros, meaning "stupid." The term was used to refer more to foolish rather than ignorant behavior. In the early 1900s, the word moron was used to categorize persons with mild intellectual disability who were considered "mentally equivalent" as an adult to a child between 8 and 12 years of age. Today, this word is offensive and not used by professionals.

    Morse code
    A way of sending information over telegraphic lines. Invented by Samuel Morse in the 1890's, it is a standardized sequences of short and long elements often called "dits" and "dahs". These "dits" and "dahs" represent letters, numerals, punctuation and special characters of the alphabet.

    This is that inner excitement and energy that drives employees to do well in their job, accomplish great things, and go beyond what is expected.

    Movement Disorders
    These are common side effects of antipsychotic medication. These disorders can be mildly annoying or they may be very disturbing. These effects usually show up early on in treatment. The most common of these movement disorders are Akinesia, Dystonia, Akathesia, Dyskinesia and Tardive Dyskinesia.

    Muscle spasticity
    A condition in which a muscle is hyperactive; it becomes rigid and maintains a muscle contraction or spasm.

    Musculoskeletal System
    the organ system made up of bones and muscles that provide form, support, stability, and movement to the human body.

    Mutually voluntary
    All people involved have agreed to participate.

    a commonly held belief that has been proven not to be true.

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    The National Alliance for Direct Support Professionals (NADSP)
    This national organization is a coalition of organizations that works to improve the quality of human service support by making the direct support workforce stronger.The mission of the NADSP is to promote the development of a highly competent human services workforce which supports individuals in achieving their life goals."

    Narcissistic Personality Disorder
    A mental health disorder characterized by an exaggerated sense of self-importance and need for recognition and admiration. A person living with this disorder may look down on others, but often have a fragile self-esteem.

    National Alliance for Direct Support Professional Code of Ethics
    See code of ethics for direct support professionals.

    National Alliance for Direct Support Professionals
    The NADSP is a voluntary coalition of organizations and individuals from the fields of mental health, developmental disabilities, child welfare, education, and other human services, whose mission is to promote the development of a highly competent human services workforce which supports individuals in achieving their life goals. For more information go to the website:

    National Alliance on Mental Illness (NAMI)
    A national advocacy organization with state and local chapters that provides advocacy, support, training, and education on mental illness.

    Natural disasters and weather related emergencies
    Emergencies that come from different types of weather. Earthquakes and floods are examples of natural disasters.

    Naturally-occurring gestures
    The use of hand movements and body movements (including facial expressions) by many communicators, including communicators with and without disabilities. Naturally-occurring gestures are NOT universal, but are widely understood within a culture. Naturally-occurring gestures are often used "unconsciously" to emphasize or clarify a message.

    Natural Supports
    Supports which naturally occur in all people's lives. Some examples include, a friend who helps paint your house, a neighbor who picks up your mail when you are out of town, a coworker who picks up your paycheck when you are sick, the family member who introduces you to a potential new employer.

    Needs Assessment
    Structured review of a situation in which the gap between what is available and what is necessary to accomplish something is identified.

    In the context of understanding the consequences to behavior (reinforcement and punishment), negative means removing something from the environment and can apply to both the types of consequences. In common language, it means something bad or undesirable. Be careful not to confuse the two definitions.

    Negative Reinforcement
    Taking something out the environment that makes it more likely that a behavior will occur, such as turning off the radio when someone asks.

    The failure to provide goods or care that is needed for a person's physical and/or mental health to the extent that his or her well-being is impaired or threatened.
    This term is one that is commonly defined very specifically by state laws or regulations. You must be familiar with your state definitions. States that have specifically provided links to definitions or information regarding this term through special CDS customizations content include: PA, KS, MN.

    Nervous System
    The body system that includes the brain, spinal cord, and nerves that send and receive messages throughout the body.

    A group whose members are connected at various points and that together create a defined whole that has more strength, resources, and abilities than any one member alone.

    In managed care: A group of service providers assembled by an Managed Care Organization or who come together independently to increase their competitiveness and to assure a clientele. The providers share responsibility for the network's smooth performance. Often service recipients are limited to using providers in the network, or have to pay additional costs to use an out-of-network provider.

    A process in which social contacts are identified for the purpose of gathering information and creating opportunities. Networking can be very helpful in job hunting, dating, and finding companions with similar interests. Networking can also be a general approach and ongoing process for getting to know the resources and people who might be helpful in various situations. For example, a professional job developer would be wise to see every meeting with a potential employer or community member as a networking" opportunity.

    Neuroleptic Malignant Syndrome
    This is a life-threatening syndrome. It can occur after taking an antipsychotic. Symptoms include sudden high fever and sweating. They also include changes in blood pressure and muscle stiffness. A person needs immediate medical attention if this syndrome is suspected.

    Having to do with the central nervous system. The central nervous system includes the brain, the spinal cord, and nerves.

    A doctor who specializes in brain and nervous system disorders.

    Neurological disorder
    A disorder that affects the central and/or peripheral nervous system. This includes nerve roots, the brain, spinal cord, cranial nerves, autonomic nervous system, neuromuscular junction, and muscles.

    A doctor who specializes in brain and nervous system disorders.

    A type of psychologist that is specifically trained to assess cognitive or thinking ability.

    A doctor that specializes in operations focusing on the brain and central nervous system.

    Have a normally functioning brain in terms of the way in which information is processed. A term used within the autism community to refer to people whose neurological development is normal.

    This occurs when a person chooses not to take medication and/or participate in treatment as prescribed by a medical practitioner.

    Non-controlled drugs
    Drugs that the federal Drug Enforcement Agency (DEA) do not monitor or track due to a low likelihood of abuse or risk to the user.

    Spoken input designed to give or share information with the communication partner, rather than to direct his or her behavior.

    Non-intentional communication
    Any unconscious or involuntary act (motor or vocal, symbolic or non-symbolic) that serves to communicate an individual's internal state or meaning to another person, even though the individual is not aware of the act and does not anticipate that it will have an effect on the other person.

    A term used to describe individuals who do not use speech as a communication mode, either because they cannot produce speech, sustain speech, or have speech that is so unintelligible that they cannot be understood by even familiar communication partners.

    Non-verbal communication
    A process of communication that uses wordless messages. Messages are instead communicated through gesture; body language or posture; facial expression and eye contact.

    Something that may be produced by a variety of conditions. Challenging behaviors are not categorically the result of any specific cause but rather can be produced by a variety of conditions

    Ways of communicating that do not use speech, includes sign language, facial expression, eye gaze, gestures, communication devices, picture boards, and other approaches. Sometimes referred to as "nonverbal" communication.

    Unusual gestures used by an individual to indicate a specific meaning that is understood by only familiar communication partners.

    Non-Standardized surveys
    Instruments that have not been tested for reliability or validity or for which norms have not been established.

    Non-symbolic communication
    Communication in which the message is conveyed solely through direct physical action, indicative gestures, facial expression, and/or vocal intonation other than speech.

    Non-verbal Communication
    Any way of communicating from one individual to the other that does not include speech. Examples: hand gestures, facial expressions.

    A hormone that works with adrenaline to create the "flight or fight" response to stress. One of three brain chemicals believed to be linked to depression when imbalanced. The others are serotonin and dopamine.

    A social commitment; a process to assist people with disabilities to experience patterns of life and conditions of everyday living that are as close as possible to the regular circumstances and ways of life of society.

    A standardized test will have information about what the scores or answers given by typical respondents. For example, a standardized job satisfaction survey may provide information about how direct support professionals in supports for persons with disabilities in the United States typically reply to the survey items.

    Any substance that is necessary to support the life and growth of an individual, including a variety of sustaining foods and water.

    Nurse practitioners or nurse midwives
    Nurses with specialized degrees that allow them to practice more advanced medicine than a traditional RN, including prescribing some medications.

    Nutritional Supplement
    Vitamins, minerals, and other substances, like protein or fiber, that people take to ensure good balance in their daily diet.

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    Excessively overweight by 20% or more of a person's recommended body weight.

    Facts that are not affected by personal bias or personal feelings.

    Something owed or agreed to.

    When a person sees something occur.

    What a person sees when they watch something occurs. A way to watch what is going on in the environment.

    Obsessive Compulsive Disorder (OCD)
    An anxiety disorder. People living with OCD experience upsetting thoughts or obsessions and cope with these thoughts by performing rituals or compulsions.

    Occupational Safety and Health Administration (OSHA)
    A federal agency under the Department of Labor that was created in 1971 to ensure safe and healthful workplaces in America.

    Occupational therapist
    Therapist that are knowledgeable about finding ways for people with disabilities to perform basic activities of daily living.

    A licensed professionals who support people with injuries or disabilities to improve their ability to perform necessary tasks in school, living, and job settings.

    Occupational Therapy
    A treatment using specific adaptations, assistive devices, and lifestyle adaptations. It is designed to help a person perform activities of daily living as independently as possible. Therapeutic activities include improving the ability to walk, eat, drink, dress, and other personal cares or activities. In the beginning, consultations should be with a trained professional called an occupational therapist.

    This is a person designated to investigate complaints and suggest solutions. Long-term care ombudsman's offices were designated by the federal government in the US. Certain acts and situations must be reported to this office if a person lives in a long term care facility.

    Olmstead Decision
    An anti-discrimination lawsuit (Olmstead v. L.C., 1999) based on the ADA which was won by two women with disabilities in Georgia. The U.S. Supreme Court decided that using institutional care in place of community based supports for people who could benefit from community based supports was a discriminatory practice. This lawsuit could have a long-reaching impact on the service delivery system and could potentially call into question our standard practice of institutionalizing or re-institutionalizing people with challenging behaviors who could benefit from community services. To learn more about Olmstead and the ADA, go to a site maintained by the Health and Human Services Office of Civil Rights at


    The act of not doing important actions, or the failure to say or record an important item. The failure to act or document risks to service participant's health, safety, or well-being is considered a type of neglect.

    On the Job Assessment
    An evaluation of a person's ability to perform his or her work related responsibilities and duties. Assessment may be very focused (e.g., testing a person's ability to perform specific tasks as part of a performance review) or more general, for example, a thorough assessment identifying the person's strengths (tasks or performance that they are good at, assets), weaknesses (tasks or performance that the person may need more training and direction in, deficits), and preferences, (task that the person enjoys and would like to do more of or learn more about) in the workplace, in general, as part of exploring potential employment options.

    A doctor who specializes in cancer treatments.

    Open-ended questions
    These are questions that can not be answered with a simple yes" or no" response. They require the person to explain, discuss or give more detail in order to answer the questions being asked.

    Operational Definition
    An operational definition is used when what you want to define cannot be seen. Operational definitions are agreed upon by people. They tell us what we should look for, when we are trying to describe the things we cannot see. For example, an intellectual disability is something we cannot see. Since it cannot be seen, professionals use tests. The tests look at skills in reasoning, remembering, and doing certain things. The results of the tests tell us if peoples' skills fall into a category or not. Operational definitions help make sure that classifications are reliable.

    A situation or circumstance that allows a person to do something positive or enriching for him/herself.

    A physician who specializes in the diagnostic and treatment of all conditions relation to the eyes.

    A professional who specializes in eye care and vision.

    Of or relating to the mouth.

    Oral Medication
    This is medication taken through the mouth that is generally a liquid or pill and that is meant to be absorbed in the digestive system.

    Oral penetration
    A sex act involving insertion of the penis into the mouth area.

    Oral Piercing
    Pierced areas of the mouth, such as a pierced tongue, pierced lip, etc.

    The people who started something.

    A dental surgeon who specializes in straightening teeth and oral surgery.

    Orthopedic surgery
    Surgery involving the bones or muscles.

    A support, brace, splint, or other device used externally to support or align a body part.

    A type of arthritis that involves a breakdown of joint cartilage, the part of the joint that cushions the ends of bones. When cartilage wears away, bones rub together causing pain and loss of movement.

    a medical condition in which the bones become brittle and fragile from loss of tissue; a common condition among older adults which typically is a result of hormonal changes or deficiency of calcium or vitamin D.

    The actual achievement of something (as opposed to the process of trying to achieve it). Outcome-based support services takes the emphasis off the particular method or process of trying to achieve goals, and measures success in the achievement of actual benefits to the person being supported.

    Outside (External) Agencies
    Agencies that are not connected to the agency that provides supports, such as Adult or Child Protection agencies.

    Over-the-counter medication.
    A medication that is purchased without prescription.

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    Paid Service Relationships
    Relationships in which it is one person's paid job to interact with another. These relationships typically have a very specific purpose, roles, and boundaries. Because of the defined purpose of the relationship, it is not necessarily important that the people involved in these relationships share the same values, beliefs, or interests. Despite the generally limited commitment to each other, people who develop relationships with paid service providers experience benefits. For example, a regular customer at a restaurant, bar, or store, can often expect to be treated better than a new customer.

    Paid Staff
    People who are hired to provide specific types of support to a person(s) with a disability. Direct Support Professionals are always considered paid staff.

    In behavioral support, this is the process of combining primary reinforcers with events or objects that could be secondary reinforcers, for the purpose of establishing the event or object as a reinforcer. For example, combining a sip of juice (assuming the person is reinforced by the juice) with a gentle touch on the hand, in the hopes that the gentle touch will eventually become an effective reinforcer for the person.

    Palliative care
    To help relieve pain and symptoms without curing the illness. Pain medications or extra oxygen could be used to make a person more comfortable.

    Panic Disorder
    An anxiety disorder characterized by panic attacks. Panic attacks consist of an overwhelming fear or terror that is accompanied by physical symptoms such as sweating, dizziness, chest pain, and a racing heartbeat. Panic disorder is a chronic, debilitating condition that can have a devastating impact on a person's family, work, and social life.

    Infectious disease that spreads across large amounts of people in a geographic region or regions.

    Pap Smear
    A test of the woman's cervix to check for cancer.

    A way of viewing things. A filter of beliefs through which we assess, understand, organized, and make judgments about things that happen or other information. In services to people with developmental disabilities our services paradigms in this century have moved from the "care model" where the emphasis was on daily care, to the "medical model" where the emphasis is on "fixing" people, to the current understanding of the "community support model", where the emphasis is on providing needed resources and supports to help people achieve a satisfactory life in communities they choose.

    Exaggerated suspiciousness. Irrational or delusional thoughts of fear or anxiousness.

    Is telling the speaker in your own words the main points of what was said. This clarifies the message. The speaker may agree or disagree with how his or her words have been interpreted, and may use the opportunity to further express the idea. This ensures that information has been received and understood. Some examples of paraphrasing may begin, Do you mean...?" or What I hear you saying is..."

    Another name for direct support professional. Most often used to describe people in direct service roles in educational settings.

    An organism that lives in or on another organism and uses it as a host. It thrives by getting its nutrients at the host's expense.

    Parking lots
    A technique group facilitators use to capture important ideas that are not part of the formal agenda. These ideas may take the group to far off track if discussed at this point. However, they need to be captured and not forgotten. By putting the ideas in the 'Parking lot' the idea is maintained for later, but the group can move on.

    Parkinson's Disease
    A motor system disorder caused by the loss of dopamine-producing brain cells. The four primary symptoms are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. This may cause difficulty in walking, talking, or completing other simple tasks. This typically affects people over the age of 50.

    A person who participates in something. Often a term used to indicate that the person receives direct or indirect services or supports. Also see: consumer.

    Participant-directed supports
    A service option in which people with disabilities and elders, their families, or their allies manage and direct their own services and supports. This can also be referred to as "self-directed" or consumer-directed" supports.

    Participant-driven managed supports
    A variety of strategies for administering systems to increase their effectiveness and efficiency, while maintaining a commitment to community integration and self- determination for people with developmental disabilities. Also see: consumer directed.

    Participant Observation
    A process for carefully watching a given situation, sharing the results with others and learning together to make changes.

    Engaging with others, having a wide variety of relationships being known and knowing others, being part of the event--not just an observer.

    People working together cooperatively to achieve a common goal for the individual being supported. Partners honors the strengths, cultures, traditions and expertise that each party bring to the relationship.

    A policy or practice of treating people as if they were children, that is, providing for their needs without giving them rights or responsibilities. Also see: "Eternal Child" relationship.

    stands for Planning Alternative Tomorrows with Hope. It is a method of person-centered planning that helps groups be focused on goals. It can be helpful with groups that are stuck. It was developed by Jack Pearpoint, John O'Brien, and Marsha Forest.

    anything that can cause a disease (especially micro-organisms such as bacteria, virus or fungus).

    A licensed health care practitioner who works with infants and children and their specialized diseases and conditions.

    Peer Support Group
    People of approximately equal social status who have reciprocal relationships; friends, colleagues or others who have common bonds.

    a payment made to a person on a regular basis (usually a fixed sum) after the person's retirement from employment.

    Persistent depressive disorder (Dysthymia)
    A form of depression, which lasts longer but has milder symptoms than major depression. Persistent depressive disorder (Dysthymia) is a more chronic condition, which must occur for at least two years.

    Personal Digital Assistant (PDA)
    A handheld electronic device used to keep track of appointments and addresses. Most typically, PDA's are usually cell phones called "smart phones" that can perform a number of organizing tasks.

    The primary sexual organ for a male. Some males will be circumcised and others will not. Circumcision means that the foreskin on the penis has been partially removed, usually when the person is a child.

    People-first language
    Respectful forms of address which avoid labeling or describing an individual in terms of a diagnosis or other attributes or characteristics. In all forms of communication, including spoken and written communications the person precedes his/her attributes. (for example: The person with mental retardation. NOT- the mentally retarded person.)

    peptic ulcers
    open sores that develop on the inside lining of the esophagus, stomach or the small intestine, which typically results in abdominal pain. These may be caused by a bacterial infection or some medications. Also called stomach ulcers.

    Perceived Risk
    The amount of risk that individuals feel an activity has. Perceived risk may or may not be closely related to real risk.

    How a person understands something or interprets something.

    Performance coaching
    Is a training strategy that will help direct support professionals meet or exceed job expectations. It involves one or more of the following styles: counseling, mentoring, confronting and coaching employees to improve work behaviors. It can be used to teach new skills, reinforce current skills and to expand career opportunities.

    Performance indicators
    Specific occurrences, including service results, to be measured to determine the success of service quality.

    Benchmarks (points of reference) or measures of performance in a work setting, that help clarify which duties an employee can perform and which he or she may need more training or support to be able to achieve.

    Performance reviews
    Formal written evaluation document of job performance that give the direct support professional feedback about how well they are doing on the job as well as identifying areas that need improvement, timelines, resources, and support for improvement.

    The area of the body between the genitals and the anus, including the anus.

    Pericardial Fluid
    The fluid that surrounds the human heart.

    The stage prior to menopause (see menopause).

    Relating to the perineum, which is the area between the anus and genitals.

    The skin and area between the scrotum and the anus on a man and between the vaginal opening and the anus on a woman.

    Periodontal Disease
    Disease of the soft tissue surrounding the teeth and jaw bone.

    A serious gum disease caused by poor oral hygiene. The symptoms include inflamed, bleeding gums, loose teeth, and mouth pain. Professional dental treatment should be sought if any of these symptoms occur. Preventive care and treatment can reverse some of the problems caused by this disease. Without treatment and daily oral hygiene the condition will get worse.

    Peritoneal Fluid
    The fluid which surrounds the human intestines.

    Continually repeating a thought or an action such as getting stuck on a topic.

    An approach to supports and services that looks at a person's unique strengths, needs and personal goals as a basis for determining how to identify services and supports.

    Person-Centered Approaches
    An approach to supports and services that looks at a person's unique strengths, needs and personal goals as a basis for determining how to identify services and supports.

    Person-centered planning
    A planning process which looks at the person's strengths, needs and desires. There are formalized processes for person centered planning such as Essential Lifestyle Planning, MAPS, PATH and Personal Futures Planning. There are also informal ways of gathering information and listening to a person to learn what they want regarding services and supports. This planning process results in an action plan that is developed to help the person achieve his or her goals.

    Person-centered support
    An approach to supports and services that looks at a person's unique strengths, needs and personal goals as a basis for determining how to identify services and supports.

    Personal assistance
    One person assisting another with tasks individuals normally would perform for themselves if they did not have a disability.

    Personal culture
    The accumulation of personal experiences and choices that lead to a person's understanding of appropriate behavior and lifestyle.

    Personal effectiveness
    A person's capacity to take actions that lead to positive results. This requires the ability to accurately assess situations. It requires the ability to think about others. With the vision or big picture in mind, the person identifies the most important things that are likely to have a positive influence the outcome. He or she works on the ones that are in his or her control.

    Personal Factors
    These factors are the traits that a person has that can influence his or her work experience. These factors may be similar from one person to another, or they may be different. A few personal work factors include one's social skills, motor skills, and problem solving skills. Personal work factors are important to consider when developing a career plan.

    Personal Futures Planning (PFP)
    is a person-centered planning method developed by Beth Mount. It is primarily for adults. It uses the foundation of the five accomplishments identified by O'Brien and Lyle O'Brien to envision a positive future: Community participation and presence, valued social roles, and experience with choice, and contribution. PFP is based on the values of seeing people as whole, with both needs and capacities. It rejects defining a person by the methods and terms of the system.

    Personal Goals
    A person's desires, wishes, or goals for him or her self, which may include relationships, activities, vocations, and other opportunities or experiences.

    Personal Protective Equipment (PPE)
    Refers to any clothing or equipment used to reduce employee exposure to hazards in the workplace. This creates a protective barrier and reduces the risk of exposure on the job. (See also Protective Barriers)

    Pervasive Developmental Disorder (PDD)
    The broad diagnostic category which refers to a group of disorders defined by delays in the development of communication and social skills.

    Pervasive Support
    Pervasive support is part of a disability classification system. (Published by the American Association on Intellectual and Developmental Disabilities, AAIDD). It refers to people who need constant direct support in all their life activities.

    Petty cash
    This is a small amount of cash money that is accessible to designated people so they can make small purchases. These purchases must be documented and receipts must be kept.

    A licensed health care provider who is trained to gather and package (dispense) medications and other treatments as they are prescribed by health care providers.

    Phenylketonuria (PKU)
    A genetic disorder that prevents the normal use of protein food. The disease can be screened at birth and successfully prevented by diet modification. In this disorder the body has difficulty breaking down certain types of food. In the United States, one baby out of every 10,000-15,000 is born with PKU. People with PKU need to follow special diets. If they do not follow their diets serious damage to their bodies can occur, causing many problems, including problems with learning and intellectual development.

    An intense and irrational fear of a particular thing or situation. When the fear interferes with a person's functioning, it is recognized as an anxiety disorder.

    Physical abilities
    Related to the ability to move and control one's body.

    Physical capabilities
    Are the physical requirements or physical demands placed on a person doing the job. For example, if the job requires the direct support professional to lift 50 pounds of weight frequently during their shift, a physical capability for the job would be "Must be able to lift 50 pounds."

    Physical Abuse
    Any act of violence, force, or rough treatment done knowingly, recklessly or intentionally whether or not actual physical injury results.
    This term is one that is commonly defined very specifically by state laws or regulations. You must be familiar with your state definitions. States that have specifically provided links to definitions or information regarding this term through special CDS customizations content include: PA, KS, MN.

    Physical Injury
    Injury to someone's physical body such as: broken bones, scratches, cuts, bruises, etc.

    Physical Restraint
    Any time the staff restricts a person's movement, either mechanically or with their own body, through holds, "escorts," and the like. Physically assisting someone (to learn a new skill) or minor, temporary physical interventions, such as blocking people from touching something dangerous and then explaining the danger to them is not considered a physical restraint. (Although frequent and repetitive use of even minor and temporary procedures may be considered restraint due to the restraining effect on the person's life.)

    Physical therapist
    A health care practitioner who is knowledgeable in methods of speeding up recovery or enhancing strength and flexibility after an injury.

    Physical Therapy
    A treatment using specific exercises and physical activity to help improve muscle coordination, strength, and mobility for patients. It also includes activities like how to properly use and select mobility and postural equipment. In the beginning, these exercises must be designed by a professional called a physical therapist. They are based on the specific needs of the individual.

    Physical Well-Being
    The state of health that is maintained by the choices we make about how we live our lives. The choices are related to exercise, nutrition, rest and sleep, stress management, management of injury and illness, and the uses of treatments and prescription drugs.

    A condition where a person eats items that are not edible and may be harmful such as dirt, paper, chemicals or cigarette butts.

    Picture Communication Book
    A method of communication sometimes used by people who do not speak. Contains words and phrases commonly used by the person.0

    Showing devotion or reverence to God.

    A layer of bacteria on the teeth that causes tooth decay and gum disease.

    Pleural Fluid
    The fluid that surrounds the human lungs.

    A bacteria that causes respiratory disease, often pneumonia.

    An infection in the lung often caused by a bacteria or virus.

    The use of a body part to refer to a present person, object, or location of interest. Usually involves the isolated index finger, but may be accomplished through eye gaze ("eye pointing").

    An element of a plant or substance that may cause or may be capable of causing death or illness if taken into the body.

    The way things are handled.

    Polio myletis is an acute infectious disease most often affecting children. It is caused by a virus that attacks the gray matter of the spinal cord and can cause paralysis in its victims.

    Political rights
    Political rights are related to civil rights. They allow people to exercise democratic control over governmental powers and public policy. This includes freedom of expression, freedom of association, the right to run for office, and the right to vote.

    Using more than one medication at the same time. This practice can cause an increased risk for side effects, interactions, and errors. In some cases it can achieve better outcomes (e.g., bipolar disorder)

    Population Risk
    Risks that are associated with societal expectations and perceptions of people based on their circumstances.

    The ability to carry something with you. Portability of training means that training that is meaningful to one employer will be equally meaningful to the next.

    A collection of work by an individual that is placed in an organized manner that demonstrates the person's abilities and talents.

    In the context of understanding the consequences to behavior (reinforcement and punishment), positive means adding something to the environment and can apply to both the types of consequences. In common language, it means something good or desirable. Be careful not to confuse the two definitions.

    Positive Behavioral Supports
    The use of ongoing methods of support that prevent or diminish the use of challenging behaviors, through emphasis on quality of life, person-centered supports, and the proactive teaching of skills for success.

    Positive Behavior Support Plans
    a written plan outlining how staff are to interact with someone who communicates using challenging behaviors. The plan identifies target behaviors and suggests ways direct support professionals can mimimize these by using strategies that emphasize quality of life, person-centered supports, and the proactive teaching of skills for success.

    Positive Reinforcement
    Adding something to the environment that makes it more likely that a behavior will occur, such as telling someone they did a good job.

    Postpartum Depression
    A form of depression which can occur after the birth of a child. Can occur in both men and women, but more often women. Adoptive parents can also experience this type of depression. This can be quite serious and often requires treatment.

    Postpartum psychosis
    This is much rarer and more serious than postpartum depression. The symptoms of postpartum psychosis can include loss of reality, hallucinations, and/or delusions. It can also include suicidal or aggressive thoughts. Professional treatment is needed immediately.

    Post-traumatic Stress Disorder (PTSD)

    An anxiety disorder that is triggered by a horrific or traumatic event. People living with post-traumatic stress disorder relive the terrible experience, sometimes through flashbacks, and often in nightmares. People may have physical symptoms such as headaches and insomnia. Cognitive behavior therapy is considered to be the most effective kind of treatment for this disorder.

    An anxiety disorder characterized by a terrifying physical or emotional event (trauma) causing the person who survived the event to have persistent, frightening thoughts and memories or flashbacks of the ordeal. Symptoms can include nightmares, flashbacks, sweating, rapid heart rate, outbursts of anger, sleeplessness, and more.

    Power of Attorney
    One party gives to another party the authority to make any number of decisions on his or her behalf. The person granting the power of attorney must be mentally competent to enter into the contract and the power of attorney remains in effect if the individual becomes mentally incapacitated. Power of Attorney also refers to a document that prepares for the end of life stage. People who are independent and have made their own decisions as an adult choose one person to make decisions. This one person has the power to make decisions when the person supported is no longer able to make decisions.

    Power generation
    A way to produce electricity to operate machines and other things that require electricity.

    Power generator
    A machine that generates electrical current to run equipment that requires electrical power.

    Power outage
    No electricity due to no power supply..

    Prader Willi
    a genetic disorder of chromosome 15, which impacts the physical, cognitive, emotional and behavioral aspects of a person's life. A major medical concern with this syndrome is the issue of voracious overeating that often leads to extreme obesity, which can be life threatening.

    Occurs when sugar levels in the blood are higher than normal, but not high enough to diagnose Type 2 diabetes. There may be things a person can do to prevent getting type 2 diabetes.

    An action taken that helps to protect against something not wanted. It could also mean steps taken during and after an illness that will prevent or stop the illness from spreading or causing illness to happen again. In health, an example of a precaution to prevent spread of illness is frequent hand washing.

    An increased likelihood that something will happen given a set of circumstances.

    Preferred Provider Organizations
    Patients enrolled in a Preferred Provider Organization (PPO) can select their own doctor from a list of "preferred" physicians and hospitals that are members of the group.

    Things that one prefers or likes best.

    Pregnancy is a condition where a woman is going to have a baby. Pregnancy occurs after the male sperm unites with the female egg and results in conception of a baby.

    A negative judgment or opinion regarding the value of a person, thing, or experience, formed beforehand without knowledge or facts, or formed as a result of insufficient experiences. Prejudice against people is usually based on easily observable characteristics or circumstances, often out of the person's control, such as poverty, race, gender, or disability.

    Premenstrual Syndrome (PMS)
    A set of emotional and physical symptoms women experience at different phases of their menstrual cycle (will vary by the individual). For some women these symptoms interfere with their daily lives.

    Preparing (in relationship to emergency preparedness)
    A plan of action before a disaster strikes

    A medical condition that frequently occurs among older people, and results in the inability to hear certain sounds. Consequently, speech may not sound clear and may be difficult to understand. People may confuse similar words like "pat' for "bat" and "dinner" for "thinner." Presbycusis is more common among young adults.

    A vision impairment of farsightedness that is caused by loss of elasticity of the lens of the eye, which typically occurs in middle and older age. People experiencing this condition typically use reading glasses.

    Prescription Medication
    A medication for which you need a medical professional's written approval to purchase and to take legally. Not all medical professionals can write prescriptions.

    Participating in all settings where people without disabilities are present, including classrooms, board rooms, businesses, neighborhoods, and community events.

    Trying to stop something before it happens.

    Primary Emotion
    The first emotion felt in a situation, for example, fear, sadness, or disappointment. A person under stress or with emotional regulation problems may replace this emotion with anger.

    Primary language
    The first language the person learned. The one he or she uses to communicate with family.

    Primary reinforcers
    Reinforcers that do not require learning in order to be effective because there is a biological drive behind them. Examples include: food, drink, relief from pain, sleep, etc. For people who have not learned to be motivated by social events (such as a smile or praise in response to a behavior) it may be necessary to use primary reinforcers. However, it is desirable to find or develop secondary reinforcers because primary reinforcers are things that people should have access to without needing to earn" them and because of their use may not be practical or may add to stigma.

    Primary Relationships
    The most important relationships a person has.

    The right to be left alone, the condition where confidential information about an individual is not made known to others.

    Privacy officer
    A privacy officer is an employee at a covered entity who is responsible for developing and implementing all required policies and procedures under the HIPAA rules.

    Privacy Right Notice
    A form used to let the people you support understand their right to privacy.

    Privacy Rule
    The Privacy Rule is a rule under the Health Insurance Portability and Accountability Act (HIPAA). This rule sets national standards for how Protected Health Information (PHI) in any format can be used and shared safely between professionals, including DSPs. It also allows people to understand and control how their PHI is disclosed.

    Medical shorthand for "as needed," meaning a medication or treatment that is approved and available to the person at any point when he or she needs it.

    Consistently planning for and responding to daily events in a manner that sets the stage for success and achievement of goals. Anticipating and intervening prior to a problem. Making changes in support strategies to prevent challenging behaviors.

    Probing questions
    are used to follow-up on the candidate's answers where more information and details are needed.

    Problem routines
    Times or situations where a person frequently displays challenging behaviors. Identifying the times and situations that challenging behaviors are most likely to happen (problem routines), and then carefully observing the behavior to identify the relevant antecedents and maintaining consequences to the behavior, helps to identify the function of the behavior and provide information for a well-developed hypothesis statement regarding the behavior.

    Problem Solving Model
    A systematic approach that identifies a solution and a plan for solving problems using the following steps:
    1. Identify the problem;
    2. Think solutions;
    3. Evaluate options;
    4. Create a plan;
    5. Implement the plan;
    6. Assess outcome;
    7. Modify plan as needed.

    Standard ways in which a situation is handled.

    Work that requires special training to acquire the skills, knowledge and ethical principles of the occupation.

    Being a qualified individual in a field that requires considerable training, experiences, and specialization. Having the qualities that are connect with trained and skilled people, such as effectiveness, knowledge, organization, competence, and ethical understanding and practice.

    Professional Standard
    An expected practice by professionals working in a field.

    Profound Intellectual Disability or Profound Mental Retardation
    An older classification applied to people based on IQ scores. People with this label have IQ scores below 20. They often need significant physical and social support.

    Program Analysis of Service Systems (PASS)
    A method of evaluating services through the lens of normalization principles.

    Programs, or Program Plans
    A written document or plan that identifies specific goals and objectives that when implemented are designed to assist someone in achieving something they want or learning a new skill.

    Progress Notes
    are an official record of a direct support professional's contact with the person being supported. Entries are usually focused on the goals and objectives set forth in the Individual Support Plan. They function as a communication tool between support team members.

    Progress Reports
    a summary of progress made on individual goals as outlined in an individual support plan using measurable data collected over a specified period of time (e.g. monthly, quarterly, annually, etc.)

    Progressive discipline
    Is a strategy to use when dealing with repeated poor performance. It is a series of increasingly more formal responses by a supervisor that encourages employee performance improvement.

    Having sex with different people in a short period of time.

    Verbal, visual, or physical reminders and supports to help the person understand or remember how to perform a skill, over and above a discriminative stimulus (which is a naturally occurring prompt in the situation).

    Professional Practice
    Working in a manner that is effective, skilled, organized, and demonstrates commitment to the chosen work.

    A gland that is located at the end of the man's urethra.

    Protected Health Information (PHI)
    Is defined by HIPAA as any individually identifiable health information. This includes Social Security number, all diagnoses, treatment history, services provided and service eligibility.

    Protection and Advocacy
    The Protection and Advocacy (P&A) System and Client Assistance Programs (CAP) are a nationwide network of congressionally mandated, legally-based disability rights agencies. P&As maintain a presence in facilities that care for people with disabilities, where they monitor, investigate and attempt to remedy adverse conditions. Website:

    Protective Barriers
    Items used when taking precautions against being exposed to potentially infectious agents to create a barrier between the infectious agent and others. Protective barriers should be provided by your place of employment and can include, latex or rubber gloves, aprons, goggles or masks, as well as other necessary items. Usually these items are single use and need to be thrown away after each exposure incident.

    Protective Service Agency (Protective Services):
    The county or state agency, which investigates the reports of abuse, neglect, and injury to individuals that rely on others for care and are considered vulnerable. Often adult and child protective agencies are separate.

    Providing interesting new objects
    Objects in the environment that are interesting, new or unusual, and that promote shared focus and turn-taking.

    The location of one thing to another. A characteristic of a positive social relationship: being physically close enough to be friends.

    Psychiatric Social Worker
    A person with a degree in social work who has additional training and/or experience working with people living with serious mental illness.

    A doctor who specializes in mental and emotional problems.

    A movement in mental health focusing on educating consumers or patients about their mental health condition. Pyschoeducation provides accurate and realistic education about the disease, symptoms, treatment, and reality.

    Anything related to an individual's mind or emotions.

    Things that have to do with the mind such as thoughts, feelings, and moods.

    A professional with a specialty in the science of the mind, behavior, and emotions. A psychologist will usually have a PhD and is licensed in most states.

    Psychological Abuse
    Acts, which may inflict emotional harm, invoke fear and/or humiliate, intimidate, degrade or demean an individual.
    This term is one that is commonly defined very specifically by state laws or regulations. You must be familiar with your state definitions. States that have specifically provided links to definitions or information regarding this term through special CDS customizations content include: PA, KS, MN.

    A severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality.

    This is also known as talk therapy. It is a process used in treating mental illness that focuses on communication between the person living with the mental illness and a therapist. Psychotherapy is often used as a broad term to include a variety of different techniques.

    Psychotic Depression
    A less common form of depression in which a person may experience symptoms of a major depression along with psychosis. These may include hallucinations or delusions. Psychotic depression is serious and requires immediate treatment.

    Psychotropic Medication
    A medication that alters a person's moods, thoughts, or behavior. These are sometimes called "psychotropics." These medications are used in the treatment of mental illness or mental health problems. A misuse of these medications is to alter behavior when there is no treatable mental health condition. This is called "medical restraint." Medical restraint is usually not allowed. When used there must be a proper plan in place. This plan includes the following 3 components. Use these only when other positive behavior support methods have not worked. Use these only when behaviors are extreme, dangerous, or are a barrier to a person's quality of life. Use these only in conjunction with a plan to support learning new behavior. Some drugs have a psychotropic effect but are given for other medical purposes. An example of a medical purpose could be controlling high blood pressure. Psychotropics are meant to treat symptoms of a diagnosed mental illness. These uses are not considered medical restraints.

    The time in the life a person when a child's body turns into the body of an adult. It is the time of growth and development of sexual characteristics caused by hormones.

    Any event, action, activity or object that when consistently used as a consequence to a behavior, decreases the likelihood of that behavior occurring in the future.

    The relationship between a behavior and a consequence, in which the presentation of the consequence decreases the likelihood that a behavior will occur again in the future. Punishment can be positive (something is added to the environment) or negative (something is taken out of the environment).

    The dark circular opening in the center of the eye, which changes in size to regulate the amount of light that reaches the retina.

    Purchasing Alliance
    A formal pact or union of service recipients in a managed care system, where they act cooperatively to purchase or acquire needed services or supports from potential providers.

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    False promises of medical expertise or medical benefits. A person who practices quackery is referred to as a quack.

    Qualified Intellectual Disability Professional (QIDP)
    (Also called Qualified Developmental Disability Professional). A position defined by the federal ICF/ID regulations. It requires a four year degree in a human services field and a minimum of two years’ experience working with people with ID. The regulations require that a QIDP review and approve any programs developed for people receiving services.

    Quality Assurance
    This term is generally used to refer to the complex web of regulations and standards, that have been determined to define quality, as well as the licensing and certification processes that enforce them. The focus of these programs is changing to include quality of life outcomes and quality assurance programs are starting to include expectations for quality improvement. Within managed care environments this means an organized set of activities intended systematically to ensure minimal safety of service recipients and to foster performance improvements.

    Quality of Life
    The sum of a person's overall life experience. In general, people are thought to have a high quality of life if their basic needs, such as food, shelter, and safety are met, along with opportunities for growth, choice, new experiences, and development and maintenance of personal relationships. A poor quality of life is one in which basic needs are not met, or people are isolated, lonely, bored, or frustrated on a regular basis.

    Strict isolation to prevent the spread of contagious disease.


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    A race is a group of people who have shared physical and genetic traits. These similarities can include skin color, eye color and shape, hair texture, blood type, or other hereditary qualities.

    A doctor that specializes in taking and interpreting X-rays. These are pictures of the inside of the body.

    Support bars that are made up of horizontal and vertical support material used to create a protective barrier or supportive aid along sidewalks, yards, pools, walls, stairways, shower stalls, etc.

    The crime of forcing a person to submit to unwanted sexual relations, or of engaging in sexual activity with someone who can not resist such as a young child, or an adult who has serious physical or cognitive disabilities.

    Rape Kit
    A set of items used by medical personnel for gathering and preserving physical evidence of a sexual assault. The collected evidence for a case concerning sexual assault.

    Real Risk
    The amount of risk that can reasonably be expected given the experiences of all people who engage in an activity.

    Realistic Job Preview (RJP)
    Any method an employer uses to help a prospective employee get a balanced picture of the positive and negative aspects of work he or she will be doing as well as the organizational climate prior to the offer of a position.

    Receptive language
    Understanding or comprehension of spoken, written, or sign language.

    The communication partner to whom the message is transmitted by the sender.

    Reciprocal or Reciprocity:
    A relationship in which there is a give and take, that is, the both people in the relationship feel that they are both giving something to the other person, and getting something from the other person.

    Is a strategy for acknowledging DSPs and other employees.for a job well done, for special accomplishments, for years of service, for sharing creative ideas and for completing other notable activities.

    Recommended dose
    The amount of a medication that the person taking the medication is instructed to use by a health professional or the company that makes the medication. The recommended dose is written on the bottle or box that holds the medication. Using more than the recommended dose can cause serious health problems.

    Recovering (in relationship to emergency preparedness)
    Actions that help restore things back to normal or as close to normal as possible.

    When referring to mental illness, recovery is an individually defined process that guides the development of new skills, attitudes, and goals that will support the individual to live a meaningful life in the community.

    Focusing on people regaining skills, abilities, and roles they previously had or developing new ways of achieving life satisfaction.

    The act or process of cooling a substance to make it frozen or cold. A way to preserve items.

    A system of voluntary registration of people who might need extra help during an emergency situation.

    Recruitment and hiring bonuses effectiveness analysis
    This is an assessment of whether recruitment or hiring bonuses offered by an employer increase retention or recruitment success. The basic analysis examines the percent of new hires who left during the first six or twelve months for those who did earn a bonus compared to the percent of new hires who left who did not earn a bonus.

    Recruitment source cost-benefit analysis
    This is an analysis of which recruitment sources were most effective. It has several parts. First, it examines the proportion of applicants who heard about the job from each source. Second, it examines the proportion of new hires who heard about the job from each source (to see which sources produced the most qualified applicants). Third, it examines how long recruits from each source remained in their jobs (e.g., the proportion who stayed six months or twelve months)

    Rehabilitation Act of 1973
    This law was designed to prevent discrimination on the basis of disability. This applied to any program or activity that received federal funding.

    Rehabilitative service model0
    An orientation to delivering supports to people with disabilities or other service needs that focuses on correcting the identified problem or deficiency.

    Practicing something until you can do it well.

    The relationship between a behavior and a consequence, in which the presentation of the consequence increases the likelihood that a behavior will occur again in the future. Reinforcement can be positive (something is added to the environment) or negative (something is removed from the environment)

    Reinforcement schedule
    A plan for how often and how soon to deliver reinforcers after a person displays a desirable behavior.

    Any event, action, activity or object that when consistently used as a consequence for a behavior, increases the likelihood of that behavior occurring in the future.

    Related Injuries
    Injuries that are related to something else. Injuries that are the product or consequence of precautionary steps not being followed.

    The way people become connected with one another and get along. These connections are created and maintained through a set of behaviors or skills such as, good communication, acceptance of differences, good listening skills, kindness, common courtesies, flexibility and problem solving, etc.

    Relationship Map
    A drawing of a person's relationships.

    Release of Information Forms
    a document signed by the individual or their legal decision maker that specifies what information about the person and his or her supports can be shared with other parties. These are time limited and outline specifically what information can be share, with whom, and for what reason.

    The extent to which the test produces results that can be replicated. This is tested a variety of ways such as by having the same person complete the test more than once, or by having two different people respond to the items referring to the same subject.

    Something that is the same each time. Operational definitions, tests and procedures for assessing developmental disabilities or other conditions are said to be reliable if they come up with the same general conclusions when the same individual is evaluated by two different people or at two different times.

    Religious Affiliation
    Being connected to a spiritual group or religious ideology.

    Something that is done or taken to cure a condition or illness.

    Far away or isolated.

    Replacement Behaviors
    Specific appropriate behaviors that have the same function as challenging behaviors. These behaviors are meant to replace the challenging behavior by teaching an appropriate alternative for communicating and having a need met. Also see functional equivalence. Replacement behaviors may also be called: replacement skills, positive alternative behaviors, competing behaviors, or desired behaviors.

    Reportable Accident or Incident
    Accidents and incidents that need to be reported as described in agency policies or as mandated by local, state, or federal rules and regulations. Usually these reports are required in order to track and understand problems and issues so that steps can be taken to protect people from harm. Some examples of reportable accidents or incidents include: deaths, accidents or incidents of a serious nature, injuries of unknown origin, suspected abuse or neglect, or unusual situations (e.g., a fire, even if no one was hurt).

    Telling or notifying the appropriate people about an incident or accident. People to report to may include a supervisor, the individual's family members, a guardian, a social worker, protective service personnel, emergency response team members, or others. You may be required to report both verbally and on a written report and will usually have to do so as soon as possible after the incident.

    Representative or Protective Payee
    A person who is appointed to manage Social Security, Veterans' Administration, Railroad Retirement, food stamps or other state or federal benefits or entitlement program payments on behalf of an individual.

    Take action against someone because of their behavior.

    An attitude shown towards another person. It is an open-minded understanding and regard for the rights, values, beliefs and cultural traditions of another. Respect is something you show and give to others. It is often shown through culturally sensitive common courtesies and behaviors.

    Respect and Valued Roles
    Being seen as a person--as well as a person with a disability, being valued by others, not being seen as out of the norm or as a "curiosity."

    the lungs and other organs that control breathing and the body's intake and distribution of oxygen and elimination of carbon dioxide.

    Respiratory Droplets
    These come from sneezing and coughing. These droplets contain virus germs if someone is infected with the flu or a cold. The droplets can infect another person or sometimes even an animal.

    Respite Care
    For family's who have an individual with a developmental disability living at home, the state pays for a certain number of hours a month for someone outside of the family to take care of their family member so that they make take a break, have a small vacation, or get some errands done.

    Respite services
    Services that give family or other caregivers a break from caregiving duties.

    Responding (in relationship to emergency preparedness)
    Actions that are taken when an emergency happens.

    Response rate
    The percentage of people who complete a survey out of the total number of people who are asked to complete a survey.

    An obligation or duty for which one is in charge of seeing through.
    (In a self determined service approach): The person with a disability and his/her supporters have control of the funding and selection of supports and also bear the responsibility for budgeting, planning, evaluating, and covering additional costs.

    Any method for restricting a person's movement or behavior. For more information see medical restraints, mechanical restraints, and physical restraints.

    Restrictions/Restrictive Procedures
    Restrictions are limits on access to items, environments, people, choices, or freedoms. Restrictive procedures are any procedures that restrict access to items, environments, people, choices, or freedoms, to which people would normally have access, or to which they have rights. Restrictive procedures are sometimes used in response to challenging behaviors. Aversive and deprivation procedures can be restrictions, but restrictions can also include procedures that are in place to prevent behavior from happening in the first place. Caution! People with developmental disabilities have the same rights as people without disabilities, therefore, restrictions cannot be made without taking measures to understand the affect on rights and protecting rights. Restrictive procedures should not be planned as the only or as permanent interventions for challenging behaviors.

    Restrictive Procedures
    see Deprivation Punishment

    A layer at the back of the eyeball containing cells that respond to light and pass nerve impulses to the brain to form visual images.

    A condition of the eye in which the retina is damaged either by the blood vessels in the retina leaking or by the blood vessels being blocked. This condition can occur often in people who are diabetic and in premature infants.

    Review committees
    Committees sometimes at an agency level, sometimes at a state level, that are empowered to review, comment, and ask for revisions on the content of policies, behavior support plans, and other other issues that have to do with the rights of people being supported. Common types of committees are human rights committees, surrogate decision making committees, or behavior management committees.

    The ability to act, or not act, in a certain way or to compel someone to do or not to do a particular thing that is protected by law. Rights come from many sources including: the U.S. Constitution, state constitutions, legislation, court decisions, contracts, regulations, rules etc.

    RIGHT Decision Model
    An approach to solving ethical dilemmas where each letter of the word RIGHT signifies a step in the process. The steps are:
    1. Recognize the dilemma
    2. Identify points of view
    3. Gather information and resources
    4. Have a plan
    5. Take action

    Rights Violation
    An action that denies or prevents the person from making the decision themselves; restricts their choices or access to their belongings or otherwise infringes upon their human rights.

    Unknown or understood parts of a situation that may be harmful. The possibility or likelihood that loss or damage will occur.

    Risk Management
    Making choices that make necessary risk less likely to be harmful. For example, wearing a helmet while riding a motorcycle.

    Risk Management Plans
    See Individual Risk Management Plan.

    A ceremonial act or custom; any act or event which is practiced on a regular basis. Rituals can be religious, but they do not need to be, a person may have a ritual of exercising every morning, or going out to dinner with the same group of people every Friday.

    A usually unnecessary behavior that a person feels compelled to engage in when given a certain set of circumstances, for example, repeated rubbing of his or her palms after shaking hands with someone.

    Taking the property of another from his or her person or in his or her immediate presence, against his or her will, by violence or intimidation.

    Robert Perske
    Internationally known for his work on behalf of people with disabilities. In 1968 he received a Rosemary Dybwad International Award, which provided him the opportunity to travel throughout Sweden and Denmark and study attitudes toward people with disabilities. He has received awards on behalf of his work for people with developmental disabilities and has contributed to reports to US presidents, regarding supports to people with developmental disabilities.

    Role Model
    Someone that a person can look to for guidance and advice; someone that has done something in an admirable way such that other people may look at his or her actions as a model to guide their own actions. Someone, who by virtue of his or her status (for example movie stars, famous musicians, politicians, and sports figures), is looked to as a person to imitate. Direct support professionals are often role models for the people they support and as such should demonstrate positive characteristics in their professional life.

    To assume or represent in a drama.

    A path or road for travel.

    An ordinary sequence of events; an activity that is usual and predictable. Routines are the things people do as part of their daily activities, like getting ready to go to work, preparing a meal, calling a friend on the phone, playing cards, etc.

    Rubella is a virus commonly known as German Measles. It usually is a mild respiratory illness. Rubella is dangerous to pregnant women and their fetuses. If a pregnant woman gets Rubella, she can pass it to her fetus. Children born to mothers with rubella often have a variety of birth defects.

    Rule of Thumb
    A general guide on how to do something.

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    Safety Check
    Precautionary steps of inspecting, examining or reviewing procedures, protocols, rules, tasks, or environments to prevent accidents or injuries from happening.

    Safety Mats
    Mats or rugs with rubber backing that are used to help prevent slippage, falls, and/or unnecessary accidents/injuries.

    A type of bacteria that passes from animals and people to other animals and people and causes diarrhea in people. It is the most frequently reported cause of food-borne illnesses in people.

    Sampling Strategy
    Is a decisions about who should be asked to participate in assessments. This is a balance between resources and information needed. You want to ask enough people to ensure you get a good representation. However, you need not ask every person to participate.

    When the person has had too much of a reinforcer, making it less desirable, and therefore less reinforcing (or even aversive!)

    Schizoaffective Disorder
    A serious brain disorder that includes signs and symptoms of both schizophrenia, such as hallucinations and delusions, and a mood disorder, such as mania or depression.

    Schizophrenia a disease of the brain that has a biological basis. An estimated one percent to one and a half percent of the U.S. population are diagnosed with it over the course of their lives. While there is no known cure for schizophrenia, it is treatable disease. The symptoms include thought disorder, delusions, and hallucinations.

    A way of testing or measuring something to look for early signs of health problems.

    Screening Documents
    are forms complete to assess a person with a disability evaluate the level of care needed. Depending on the funding source for services these assessments help to qualify individuals for services.

    The area at the base of the penis that contains the testes. This may more commonly be called the "balls.

    Seasonal Affective Disorder (SAD)
    A type of mood disorder in which a person's mood is affected by reduced sunlight. A person may experience a depressed mood or depressive symptoms when the season turns to winter. Mild forms may not require treatment.

    Seasonal Flu
    Respiratory illness that can be transmitted from one person to another. Most people have some immunity or resistance. A vaccine is available.

    Secondary Condition
    A condition in addition to a disability. This can include things like pain, depression, and a greater risk for certain illnesses.

    Secondary reinforcers
    Reinforcers that a person has learned to find valuable. Secondary reinforcers are diverse and can include special events, interactions, privileges, recognition, items, etc., (for example, going to an amusement park, listening some favorite music, someone saying thank-you" or you did a great job", tokens, badges, trading cards, etc.).

    Security Rule
    The Security Rule is a rule under the Health Insurance Portability and Accountability Act (HIPAA). This rule sets a national standard for how Protected Health Information (PHI) can be shared safely in electronic formats. This rule outlines administrative, physical, and technical safeguards that organizations must use to protect electronic PHI.

    Lacking exercise or activity.

    An environment where only people with a certain label or defining characteristic work, live, or play.

    Imposing social separation based on ethnic, class, racial or ability differences.

    Seizure Disorder
    A disorder that includes seizures.

    A sudden attack on the nerve cells in the brain by too much electrical activity in the brain, resulting symptoms such as uncontrollable twitching, blackouts, snorting, foaming at the mouth, blinking, or other symptoms. These symptoms will vary from person to person and also each time the person seizures. Many different things can cause seizure disorders, but the most common causes are brain injury, epilepsy, and high fever. While seizures can be scary to witness, they are rarely life-threatening. Staying calm and making the person comfortable by supporting him or her as needed and moving dangerous objects out of reach, can help prevent injury during a seizure.

    Selective Dorsal Rhizotomy
    A surgery that involves cutting the nerves to reduce spasticity in children who have cerebral palsy.

    Selective Serotonin Uptake Inhibitors (SSRI)
    A more common form of antidepressant medication used to treat depression or others disorders. SSRI's affect the levels of serotonin in the brain.

    Self Abuse
    Behavior that is injurious to one's self: physical, mentally, emotionally, psychologically, spiritually, financially, etc.

    A person who has the ability to take their own medications, herbals, and nutritional supplements in a safe and effective manner after successfully completing a prescribed set of training information and demonstration of behaviors and attitudes related to medications.

    The act of standing up and speaking out for oneself.

    A person with a developmental disability who is active in standing up and speaking out for his or her own rights or for the the rights of all people with developmental disabilities.

    Self Care Skills
    The basic ways that people take care of themselves and their hygiene.

    The attitudes and skills needed to take control over and responsibility for one's own life, and to make choices without undue external influence. Self-determination includes the ability to make things happen in one's life by applying problem-solving and decision-making skills, while understanding when assistance is needed.

    Self-Determining Adult:
    A person over 18 who acts as the principal decision-maker in his/her own life, especially around choices regarding lifestyle, occupation, and social interaction. While all people with developmental disabilities have the capacity to be self-determining adults in some capacity, very few are provided the opportunities or experiences necessary to do so.

    Self-directed learning
    Learning that is directed by the learner. It may be completely independent or guided by an instructor or mentor. Motivation to learn is higher in self-directed learning than traditional instructor-led learning.

    Self-direction refers to the ability of people to lead themselves in age-typical ways in carrying out age-typical activities. A limitation is self-direction means that a person needs unusually great amounts of assistance, supervision and reminders from others to perform the activities that are typically performed by someone of the person's age or cannot perform those activities at all.

    Self-Directed/High Performance Teams
    Although this type of team has been uncommon at the direct-support level, it is now becoming more prominent in the field as the roles of DSPs change. These teams work to create an environment that empowers employees to contribute to the improvement of services by giving them the authority to improve the work itself. This results in more satisfying jobs that offer employees greater challenge, variety, and opportunity for enhancement.

    A confidence and satisfaction in oneself.

    Self-evaluating and/or opinion questions
    Ask the candidate what they think about a certain topic thus revealing information about likes, dislikes, strengths and weaknesses as well as information about goals, values, and philosophies.

    Self-Injurious Behaviors
    (SIB) behaviors that are harmful to oneself, including deliberate self-injury, such as hitting oneself, or behaviors that indirectly cause injury or harm, such as repeatedly rubbing an area of skin until it bleeds.

    Self Medicate
    When a person uses conventional or unconventional methods to treat a disease, disorder, or symptoms. The method may or may not be advised by a doctor; the person uses the method because it feels good. Commonly used to express when a person uses alcohol or drugs to mask symptoms of mental illness rather than receive sanctioned treatment.

    Having healthy well rounded self-esteem and confidence in ones abilities.

    Self-Stimulation or Stereotypic Behaviors
    These are repetitive, sometimes odd-looking behaviors that people engage in such as rapid flapping of hands, sniffing objects inappropriately, pacing, spinning, or rocking. They can become challenging behaviors when they are harmful or limit the person's ability to obtain or maintain a high quality of life.

    Semi-independent Living Services (SLS)
    A funded support program for people with disabilities. This program provides a few hours of services each week.

    A critical or highly influential event, publication or research that forms the foundation of future related work .

    An intensive study group, or specialized conference.

    The communication partner who is transmitting the message.

    Sensory abilities
    Related to use hearing, sight, smell, touch, and taste to perceive and interpret stimuli.

    Sensory Impairments
    Sensory impairments exist when people have substantially below average abilities to see, hear, taste and feel. The sensory impairments that are most common and of greatest concern are those in which people have major vision and hearing difficulties that cannot be corrected with eyeglasses or hearing aids.

    A brain chemical that acts as a neurotransmitter by sending messages across synapses from one neuron to another. Low levels of serotonin are thought to be associated with depression.

    Serotonin-norepinephrine reuptake inhibitors (SNRIs)
    A type of antidepressant medication used to treat depression and other disorder. SNRI's affect serotonin and norepinephrine in the brain.

    A paid support to a person who needs it, such as transportation, homemaking, job assistance.

    Service Animal
    An animal that is necessary for assisting an individual in activities of daily living.

    Service coordination
    Service coordination is a way of assisting people disabilities and their families through choices in meeting support needs by explaining what services the person qualifies for. See also Case management.

    Service Evaluation
    a written document summarizing the services and supports provided to an individual with disabilities and the outcomes of those services and supports.

    Service Recipient Rights
    The rights of a person receiving services. Not all services provide a rights statement, however, some do. The purpose of these rights is to clearly identify, prior to a service arrangement, what rights are maintain and how, during the period of services, so that the person receiving services understands his or her rights and how to make a complaint, if needed. An example would be "resident rights" in long-term care facilities. Some regulations for services require a statement of rights for service recipients, others do not.

    Service Relationships
    Someone who is paid or volunteers to provide a service to a person.

    Service plan
    An agreement or contract between a supported individual and his or her support team. The plan outlines services that will be provided for the individual. These are based on his or her needs for safety and support. The service plan may be referred to by different names. This will depend on the support setting. A service plan may be called an Individual Educational, Program, Habilitation, or Service Plan (IEP/IPP/IHP/ISP). Please refer to the entry IEP/IPP/IHP/ISP for further information.

    Service substitution
    A process requiring the use of a lower cost but equally effective service in place of a higher cost one, most often used in managed care systems.

    Setting Event
    Events, situations, or experiences that influence the likelihood that challenging behaviors will occur in response to a stimulus. The presence of setting events will make challenging behaviors more likely to occur. These events can be social, environmental, or physical events (for example, being asked to sit next to someone who is disliked, being in a room that smells of paint fumes, being tired.). Setting events can be present at the time the behavior occurs, although they may or may not be obvious (for example, having a headache or being in an unfamiliar place, may make a person more likely to feel frustrated and therefore, more likely to engage in challenging behaviors). They can also be things that occur earlier or in another environment but still have an effect on the behaviors (for example, being late for the bus and feeling rushed earlier in the day, may leave a person feeling irritated or worried and lead to undesirable behaviors).

    Severe Disability
    A severe disability is one that makes it very difficult for an individual to perform activities that are typical for a person of the individual's own age. Usually severe disabilities need to be accommodated by providing special equipment of devices, by redesigning the physical or intellectual demands of the activity, or by providing assistance with the activity.

    Severe Intellectual Disability
    People identified as having severe intellectual disability have IQ scores from about 20 to about 35. They also have substantial limitations in all areas of adaptive behavior. People with severe intellectual disability are usually identified in first two years of life and their disability is identified continuously throughout life. Language is usually limited; understanding is often better than speaking. Physical disabilities and seizure disorders are also common.

    The intensity or seriousness of something that occurs.

    Sex Education
    Education related to sexual activity and feelings, sexual anatomy, safer sex practices, rights and responsibilities of sexual behavior and legal versus illegal sexual activity and other important areas regarding sexuality and its expression.

    Sexual Abuse
    Any sexual activity that takes place when a person is vulnerable due to being under the age of consent, physically or mentally unable to defend his or herself, or unable to understand and give informed consent regarding sexual activities, and when another person or persons who are not equally vulnerable, take advantage of the vulnerability to engage in sexual behavior with the vulnerable person. In addition, acts that restrict the rights of sexual expression, identity, or reproduction.
    This term is one that is commonly defined very specifically by state laws or regulations. You must be familiar with your state definitions. States that have specifically provided links to definitions or information regarding this term through special CDS customizations content include: PA, KS, MN.

    Sexual Assault
    Any form of sexual contact without voluntary consent.


    Sexual Development
    The growth and changing of an adolescent's body including sexual organs and characteristics such as body hair, impulses, and awareness.

    Sexual Expression
    Behaviors that allows a person to express his or her sexuality. Positive expressions of individual sexuality will vary depending on the person, but some examples include wearing certain types of clothing, methods of grooming such as wearing make-up or cologne, or actions such as holding hands with a partner.

    Sexual Intercourse
    Genital contact, especially the insertion of the penis into the vagina followed by orgasm.

    Sexuality (Human)
    The various states human beings express and show their sexual desires, interests, and preferences.

    Sexually Transmitted Infections
    A disease that is given from one person to another person through contact with sexual organs or sexual fluids.

    Sexually Transmitted Disease
    A disease that is given from one person to another person through contact with sexual organs or sexual fluids.

    Prompting and rewarding behaviors that are more like the desired behavior at each step, with the desired outcome being to teach a new behavior.

    A place to stay for a short time until the disaster or emergency is over.

    Shelter in place
    To stay in a place during an emergency until help arrives. Usually there is a designated spot in a building that everyone knows about where people gather until they receive help to evacuate the building.

    Shelter Plan
    A plan that outlines where to go for cover or protection during an emergency.

    Sheltered work
    A work setting in which only people with disabilities work. Also see: sheltered workshop.

    Sheltered Workshop
    A place where paid work and work-like activities and recreational activities are available to people with developmental disabilities. Work available at a a sheltered workshop often pays below a competitive wage and does not provide opportunities for people to meet and get to know members of the community without disabilities as coworkers and employers.

    the failure of the cardiovascular system to keep adequate blood circulating to vital organs. May be caused by loss of body fluids, severe injuries, burns, heart attack, stroke, and allergic reactions.

    Sick Visits
    A visit to a health care professional when a person is experiencing symptoms of illness.

    Sickle Cell Anemia
    A chronic and often fatal disease where malformed red blood cells result in pain, fever, yellow skin color and open leg sores affecting people of central African heritage.

    Side Effects
    1. the adverse conditions sometimes caused by a drug working within the body system(s). (for example, fever, itching, bowel changes, confusion, etc.)

    2. undesirable effects of taking a medication that are different than the intended positive effects for which the medication was given. Common side effects include dizziness, headache and upset stomach.

    A medical procedure that uses a flexible lighted instrument to inspect the colon for potential diseases and abnormalities of the intestines.

    Sign of illness
    Visible (something you notice) that would tell you someone is sick or not feeling well. It can include things like bruises, swelling, rashes, excessive sweating, etc.

    Sign language
    A formal language and system of communication in which signs made with hands and facial expressions convey meaning. American Sign Language is the most common form of sign language used in the United States. Sign language is its own language and not a direct translation of spoken English.

    Situational questions
    Ask the candidate for information about actions they will take by choosing between equally desirable and undesirable actions in various situations and to get at the person's values, ethics, beliefs and attitudes.

    An ability that usually requires instruction and practice in order to achieve.

    Skill Gaps
    The difference between what an employee needs to know to perform their job effectively and what skills they currently have.

    Skilled Questioning
    Skilled Questioning is the art of asking questions to get good information from someone.

    Informal words that have meaning to certain groups. The meaning of these words is not understood by people outside the group. Some are not real words. Others have a different formal meaning.

    Sleep Apnea
    A disruption of breathing resulting from obstruction of the air waves.

    Dead skin and oils that collect under the foreskin and can cause infection if it builds up.

    The act of staying sober.

    Social Anxiety Disorder
    An anxiety disorder characterized by symptoms of extreme stress in situations that require interacting with others. People living with this disorder may appear to be afraid when introduced to people and may go to great lengths to avoid social situations.

    Social Class
    The distinctive economic and cultural group that a person identifies with.

    Social Control
    Refers to societal processes that regulate individual and group behavior. This can lead to conformity and compliance to the informal or formal rules of a given society, state, or social group. It involves internalization of norms and values, and the experiences of external sanctions, such as positive or negative consequences of behavior.

    Social Disruption
    The interruption or stopping of services and social gatherings.

    Social Isolation:
    When an individual is kept from interacting with others (peers, family, etc.) because of his/her individual differences.

    Social Model of Disability
    This was born out of the 1960 Disability Rights Movement. It views disabilities from a societal perspective. It recognizes that some people have physical or mental conditions or impairments. While these conditions may affect how a person functions, these do not cause the disability. Rather, it is the societal barriers that create the disability for the person. It is also these barriers that negatively affect the person's quality of life. It supports equality for people with disabilities by removing barriers and making community and services more accessible.

    Social Networks
    All the people who know a person.

    Social norms
    Unwritten social expectations or social rules that most people pick up on automatically during social development. Social norms are culturally relevant meaning that different cultures and families have different social norms.

    Social rights
    Social rights are the rights a person has based on permissions or entitlements agreed to by the society he or she is a member of. These agreements may or may not be written into laws and include things like the right to have a job of one's choosing, a home, and adequate healthcare, etc.

    Social Roles
    The roles that people participate in when they have social interactions. People with developmental disabilities typically have had very few opportunities to participate in valued social roles where they are looked up to and seen as capable, competent, and valued contributors to the interaction.

    Social routine
    A usual, predictable interaction between familiar communication partners where the goal of the activity is to maintain the interaction.

    Social Security Disability Insurance (SSDI)
    Is a widely used federal entitlement program in the United States. It provides a monthly cash payment to people with disabilities. To be eligible a person (or their parent or spouse) must have paid into the Social Security system for enough time. They must also have a qualifying disability and be unable to meet substantial gainful activity (SGA). In 2009, a person earning below $980 a month was not meeting SGA. SSDI continues to provide cash payment until a person is able to reach SGA or their disability improves. For people with vision impairment, the amount of work to be consider substantial gainful activity was $1,640 in 2009. The amount of money a person receives depends on how much they (or their parents or spouse) have paid into the system.

    Social Security Retirement Insurance Benefits:
    A type of financial assistance provided by the U.S. Social Security Administration to older adults. To qualify for this benefit program, a person must meet all of the following requirements: (1) Have earned enough Social Security credits through earning income and paying taxes, and (2) Be at least age 62 throughout the first month of entitlement. Visit for more information.

    Social Services
    Government or private services available to people in need of extra support in order to function and thrive. This may include mental health services, residential services, day activity services, vocational placement, rehabilitation services, etc.

    Any activity that is social in nature, interacting with others.

    Social/Emotional Well-Being
    A state of getting along with others in a comfortable manner. It is about feeling good about yourself and your importance to others.

    (spasticity) stiff muscles.

    Specialized supports
    This includes anything an individual needs to function in life. Examples include communication boards, and service animals. It includes special information that is critical to know about an individual such as an anxiety attack protocol and durable medical equipment.

    Special transport
    Transportation that is equipped to accommodate individuals who use durable medical equipment that would not be accommodated on regular transportation.

    Special diet
    A diet for a person who can only eat certain foods due to a diagnosed medical condition.

    Special Education
    Special education refers to a special modification of the normal curriculum and/or instruction methods in schools to respond to specific needs of students with disabilities.

    The oral expression of language.

    Speech-language pathologist
    An allied health professional who works with the full range of human communication and its disorders. This includes the evaluation, diagnosis, and treatment of speech and language disorders. In addition, because of the relationship of the oral mechanism to speech production, the speech-language pathologist may also address swallowing disorders. These individuals may be known as speech therapists or "SLPs".

    Speech Language Pathologist or Therapist
    A licensed professional whose primary job duties include assessment, diagnosis, and treatment of communication issues such as speech problems and language disorders. Also referred to as speech therapists.

    Speech Therapy
    A treatment designed to help someone improve communication with others. Therapeutic activities include improvement in speaking, language skills, oral motor skills, and swallowing skills. It also includes activities like learning sign language or using augmented communication devices. Treatments are developed and designed by a trained professional called a speech therapist.

    Spina Bifida
    a congenital physical disability in which part of the spinal cord is exposed through a gap in the backbone.

    Spiritual Well-Being
    A state of being where a person has purpose and meaning. It is finding ways to be in touch with what you value and discovering what is important to you. It is feeling good about what you are doing.

    Spoken languages
    A formal system of communication in which words and sounds are used to convey meaning. English is the primary language spoken in the United States. There are many other languages spoken by Americans. Spanish is the second most common language spoke in the United States. American English is slightly different than British English. Within the United States, there are local differences. Some words are pronounced differently. Other words are used differently. African American Language (sometimes called Black English) is a type of English spoken by some African-Americans.

    The substance that a human coughs up after coughing or choking.

    Staff competence
    Staff competence is a measure of whether the staff member can perform the tasks required of them on the job.

    Staff satisfaction
    Staff satisfaction is the opinion a specific employee has about the organization as a whole and about various parts of their job.

    Staff communication log (or book)
    is a tool using written documentation (handwritten, hardcopy or electronic) to convey important information between staff team and across shifts.

    People who are invested in something (for example, because it has a direct impact on their life, because they paid for it, or because they responsible for making it happen) and who can affect it.

    Standardized surveys
    A standardized instrument is one that has been tested for reliability and validity and for which norms have been established.

    Staff roles and responsibilities
    The plan specifically outlines duties that staff members have to do their job. In the case of emergencies, it clearly states what is expected of the DSP during and after various types of emergencies.

    Staph Infections
    (Short for staphlococcus) is a common bacteria often found living on human skin which are usually harmless until they enter the body through a cut or break in the skin and causes a pus-producing infection.

    Stakeholder Involvement
    Including the individual, his or her support team including family members, and others who are important to the person in the planning process. In emergency planning for individuals this would mean including the individual and his or her close family and/or friends in creating the person's emergency plan.

    the belief that because some individual members of a group have certain characteristics or traits, all members of the group have them.

    Stereotyping is believing things about a group of people based on how some people in that group look, dress, talk, or act. Stereotyping can limit or even block a person's ability to understand and appreciate others.

    Medical procedures or interventions that prevent a person from being able to reproduce (i.e father or bear children).

    The negative way others view a person because of his/her difference that are not culturally valued. Stigma can have a profound effect on a person's ability to make friends because it can reduce other's interest or desire in interacting with the person.

    Something that causes a response.

    Stimulus (singular)/Stimuli(plural)
    Events or objects that are present in the environment or internally, that can have an effect on a person's behavior. These include things that are sensed (smelled, heard, seen, felt, tasted), as well as interactions and situations (for example, being approached by someone or being yelled at) that have been consistently linked to certain consequences and, therefore, have an effect on behavior.

    Stop, Drop & Roll:
    Steps to take when someone you support is in danger: STOP: Intervene to stop immediate harm. Make sure the person is safe; DROP: Drop the urgency once the person is safe. Don't make hasty decisions or recommendations; ROLL: Roll together all the personal resources the person has. Make sure the people who care about the person have the opportunity to help.

    Also a method for teaching fire safety that is useful for helping people understand how to put out a fire which is on his or her clothing or hair by immediately stopping, dropping to the ground, and rolling on the fire until it is smothered. This method helps contain the fire quickly by depriving it of oxygen, whereas running to seek help will often cause the fire to grow swiftly and cause more harm.

    Storm surge
    An abnormal rise in the level of the sea along a coast caused by the onshore winds of a severe cyclone.

    Straight-line Winds
    Very strong winds that produce damage.

    Strategic Alignment
    How a team charter supports and is connected to the organization's mission and vision.

    Attributes, skills, conditions, abilities, knowledge, available supports or other circumstances or entities that improve the ability of an individual to lead a satisfactory lifestyle.

    Strengths-Based Planning
    A method of planning that emphasizes building on strengths when planning for needed supports rather than focusing on deficits or challenges. Strength based planning is usually more effective in producing results because of increased motivation on the part of the person being supported.

    A state in which there are changes in a person's body which can include a more rapid heartbeat and breathing, perspiration, and more focused attention in response to environmental or psychological factors. Stress can be caused by a variety of factors including physical exertion, perceived danger, extreme difficulty, pressure, or strain. While stress can be a positive force in achievement and safety, high levels of stress can be damaging to a person's ability to think and react appropriately and prolonged stress can cause physical and emotional damage.

    A sudden loss of brain function caused by a blockage or rupture of a blood vessel to the brain. Characterized by loss of muscular control, loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain.

    A constructed building.

    Having to do with a building and it's parts. This includes the plumbing, electrical, and heating and cooling, as well as the materials that make up the building.

    Structured questions
    Are planned and organized before you interview. These are the list of questions that are intended to yield responses that will help you make a judgement about the candidate's ability to meet specific job requirements and work expectations or how the individual will fit in" with the work team. Each candidate would answer the same set of structured questions during the interview so you can more easily and efficiently compare one candidate with another.

    Information that is affected by personal bias, feelings, values and beliefs.

    Sublingual Medication
    This is a medication that enters the system through membranes in the mouth and need to be dissolved under the tongue.

    Substance use disorders
    This is when people misuse things like alcohol and drugs on a regular basis. Often people do this to handle feelings and thoughts that are painful.

    Substance Abuse
    Using drugs, alcohol, or another substance in excess or inappropriately. Substance abuse can result in an impairment in one's ability to meet responsibilities, interact with other people, and engage in behavior than can hurt the person or others. A person may be addicted to a substance. Or the person may use the substance to cope with problems or issues.

    Substantial gainful activity (SGA)
    Refers to the specific dollar amount that the federal government uses as a determination point for Social Security Disability Insurance (SSDI) and Medicare, and Supplemental Security Income (SSI) and Medicaid. In 2009, for people with vision impairment, the amount of work to be consider substantial gainful activity was $1,640. For people with other disabilities, the SGA level was $980 per month.For SSDI and Medicare, SGA is the point at which benefits may be affected. For example, they may be cut off. For SSI and Medicaid, SGA is a point used to determine eligibility.

    Substantial limitations
    The Americans with Disabilities Act (ADA) defines "substantial limitation" as "significantly restricted as to the condition, manner, or duration under which a person can perform a particular major life activity as compared to the condition, manner, or duration under which the average person of the same age/grade level in the general population can perform the same major life activity." Interpretations of this vary. However, in general a person must be unable to do things that would be expected. Or they may have a lot more trouble than doing things than would be expected. This limitation may be at home, school, or at work. It may be in a variety of areas from physical to mental abilities. Accommodations can often improve the situation and help the person participate effectively.

    A game where numbers are arranged in certain patterns.

    Taking one's own life. Intentionally killing oneself. Usually this is a result of untreated or unresponsive depression or similar mental health condition. .

    A method of hair removal. Sugaring is a process that is similar to waxing. Sugar is applied to skin and rolled off with the hands. This process removes hair for up to two months and can be less painful and irritating than waxing. This is most often done in a salon.

    Summarizing is the process of briefly restating the main ideas concerning an issue being discussed. This summary would include essential points while omitting unimportant details.

    Supplemental Needs Trusts (SNT)
    Trust funds that are funded through an individual account. These can help with housing payments and other expenses not covered by government funds. Extra funds will go back to the state after the person passes away.

    Supplemental Trusts (ST)
    Trust funds that are funded through other people's accounts. Creating a trust fund is taking a more active role in planning for the future. This provides funding for expenses not covered by government programs. Extra money can be donated to a person or an organization after the person passes away.

    Supplemental Security Income (SSI)
    A type of financial assistance provided by the U.S. Social Security Administration to people with disabilities based on financial need. It is designed to help citizens who are aging and/or have disabilities, who have little or no income. It provides cash to meet basic needs for food, clothing, and shelter. Visit for more information. Understanding government benefits and navigating the Social Security system can be challenging. To make sure that you have the most accurate, updated information regarding a person's social security benefits, please go to Another resource you may find helpful is the online benefits planning Estimators found at This can help a person prepare for changes in work or benefits, or to learn how benefits rules apply to the person.

    Assistance, encouragement, emotional help, guidance. Assistance from others that a person needs in order to maintain best health, stay connected to others, maintain employment, or otherwise participate in the activities of life. Supports can be formal or informal and paid or unpaid. Paid supports are sometimes called "Services."

    Support Broker
    This is a professional who can help a person to develop and implement an individualized plan for participant direction. The support broker's primary function is to help a person build connections with people or organizations that can provide supports. This involves assisting with paperwork and planning based on the individualized budget. This also involves acting as a liaison between the person and financial management services.

    Support coordination
    A paid service that includes coordinating professional services and community resources that a person needs to achieve desired goals.

    Support Network
    Support networks are defined as family, friends, paid supporters and other people who play a role in providing everyday or support to an individual. These are people who have give and take relationships with one another and together they serve as a source strength for the person with a disability.

    Support plans
    Support plans are written documentation outlining the details of supports, services, activities, methods and resources needed for an individual with disabilities to achieve individual goals. These goals are based on a person's dreams and preferences. The plan details who is responsible to provide supports. It also delineates how, when, and where supports will be provided. A person's individual support team and/or network along with the person develop the plan using a person-centered approach develop the support plans.

    Support Team
    The group of people who help the individual organize and maintain his or her supports, both paid and unpaid. Core members of the team are typically the individual, involved family members, friends, and advocates, direct support professionals, and other professionals who have regular contact or responsibilities regarding the person's support. Support teams can grow or shrink in number and meet at various intervals depending on the person's needs. Other members, such as specialized professionals, may join the support team for a limited time as an advisor.

    Supported employment
    Describes services to help individuals with disabilities to find and keep a paid job in a regular community business (not counting employment in sheltered workshops or similar service environments). Paid staff can: (a) work with the individual to determine the type of job preferred, (b) find appropriate employment, (c) work with the employer to modify the job, apply assistive technology, or otherwise assure that the individual can perform the job, (d) provide support to the individual on the job or to his or her coworkers, and (e) monitor quality and provide support as needed.

    Supported living
    A residential service model which is based on the provision of only those supports which the person needs. Tailoring services to meet individual needs.

    Surrogate decision maker
    People or committees, who are not legal guardians or conservators, but who are sanctioned by law to make a decision in the place of a person who does not have the capacity to make an informed decision on his or her own. State laws vary regarding the types of decisions that the surrogate can make. Most often used for consent for medical treatment and interventions, many states do not allow surrogate decisions makers to consent to restrictive procedures such as may be found in some behavior support plans.

    Surveys are sets of questions that are asked of employees or others that seek information about attitudes, opinions, characteristics, suggestions and other topics. Survey questions can be close-ended (providing the possible answers and having the respondent select from the list) or open-ended (providing the question and having the respondent answer using his or her own words).

    Swallowing difficulties
    There are a large number of possible swallowing problems related to cerebral palsy. There may be difficulties closing lips, moving tongue to control food during chewing, or to push food from the front to the back of the mouth.

    Words, pictures, or items that "stand for" the things or concepts they represent. Symbols vary from very concrete (a red cup that stands for Bobby's own cup or a photograph of a cup that stands for "cup") to abstract (the printed word, "cup").

    Symbolic communication
    Communication in which the message is conveyed through symbols that are distanced from the thing(s) they represent.

    These are observable characteristics. They include things such as sensations and changes in behavior or mood that are out of the ordinary. These are an indication there may be something wrong with a person's physical or mental health.

    Symptoms of illness
    Something someone tells you about what they are feeling or experiencing such as high temperature, feeling sick to your stomach, weakness, or being very tired, etc.

    Syndromes are conditions with a specific set of health related characteristics that define the condition such as Tourette Syndrome or Fragile X.

    Synovial Fluid
    The fluid surrounding the human joints, where separate bones connect.

    System-centered planning
    is a method of planning that is designed to meet the requirements of regulations. It usually is a list of interventions and goals. These are organized around what is wrong with the person. The goal is to improve functioning and achieve independence (or minimized dependence on support from others). The plan is achieved when the person enhances his or her functional skills to the level identified on the plan.

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    Tardive Dyskinesia (TD)
    This is a movement disorder. It can be a side effect of antipsychotic medication. A person will exhibit unusual or abnormal movement. It may include blinking or grimacing. It may include twisting and rolling of the tongue. Fingers, legs, and arms may also be affected. This disorder can become permanent. Early identification of symptoms is important. Reduction or discontinuation of the medication may stop or reduce symptoms if done early enough.

    Tardive Dyskinesia
    This is a movement disorder. It can be a side effect of antipsychotic medication. A person will exhibit unusual or abnormal movement. It may include blinking or grimacing. It may include twisting and rolling of the tongue. Fingers, legs, and arms may also be affected. This disorder can become permanent. Early identification of symptoms is important. Reduction or discontinuation of the medication may stop or reduce symptoms if done early enough.

    Targeted Behaviors
    The specific challenging behaviors that are being tracked so that a change in their frequency or intensity can be noted and behaviors support plans or interventions adjusted accordingly based on the data.

    A hard yellowish substance that develops on the gumline and edges of teeth when plaque is allowed to build up on teeth. Tartar makes teeth look yellow, but it also creates pockets where bacteria and food can collect. This can increase dental health problems. Tartar control toothpaste will not remove tartar. Daily brushing and flossing will reduce or prevent tatar build-up.

    A national membership association of professionals, families, and individuals with disabilities who are concerned with the education, employment, and self-determination of individuals with significant disabilities.

    Task analysis
    Breaking down a complex skill, behavior, or activity into individual steps.

    Tax-ID number
    A number given to an organization that provides publicly funded services. This number allows the service to not pay taxes on certain purchases. It is restricted to purchases for the services and cannot be used for personal purchases.

    A hereditary disease in which an enzyme is lacking in a person's body which causes mental retardation, seizures, blindness and death at a young age.

    Team Charter
    A statement that sets a direction for the team, clarifies its purpose and specifies what it intends to accomplish. It could include the team's mission or purpose, specific and measurable goals the team commits to achieve, and the desired end product.

    Technical knowledge
    Questions ask the candidate about what they know about technical subject areas such as the ability to use computers and software or how to complete a task with or without a set of instructions.

    Temporary Guardianship
    A temporary guardianship expires on a set date, usually within a few weeks to a few months of the time it takes effect. It is rarely used for people who have a disability that permanently affects their ability to make decisions. It is more often used when a person is temporarily incapacitated.

    Tenure of stayers describes the average amount of time employees have stayed on the job. It is usually measured in months or years. Tenure of leavers is a specific form of tenure.

    Tenure of leavers can be described as the proportion of people who remained in their jobs for a certain amount of time before leaving (for example the percent who leave before completing 6 months of employment).

    The set of words that includes ideas and definitions that have specific meanings and uses for professionals working in a field.

    The use of violence and threats to intimidate or coerce, especially for political purposes.

    The part of the brain involved in processing sensory information and regulating wakefulness.

    An inherited form of anemia, which is a condition where red blood cells are not reproduced in the body as they are supposed to be.

    A loud noise produced by the explosive expansion of air heated by a lightning discharge. Lightning produces thunder.

    A form of turbulent weather characterized by the presence of lightning and its acoustic effect on the Earth's atmosphere known as thunder.

    thyroid gland
    a large gland in the neck that produces hormones to regulate the body's metabolism.

    Ticket to Work Program
    Is a voluntary, federal program allowing individuals using Social Security and/or Supplemental Security Income (SSI) to receive employment supports. The program allows individuals to chose a support provider that best meets their support needs. These providers are then paid based on an individual meeting certain employment milestones, which assist the individual in reducing their dependence on Social Security or SSI.

    The periodic rise and fall of the waters of the ocean and its inlets. The inflow and outflow.

    A persistent trait of character or behavior demonstrated by such things as repetitive phrases, sudden and jerky movement of the head, arms, and other body parts.

    Time delay
    A fading procedure where the form of the prompt remains the same (verbal, visual, physical), but there is a longer time before it is given to allow the person to engage in a behavior without prompts.

    When something happens at the right time.

    Time Out
    A behavior intervention that includes taking someone out of the current situation in order to stop the challenging behavior or temporarily limiting access to reinforcers in the environment. In many cases this will be the short-term (minutes) restriction of a desired item, or the short-term removal of the person from the environment. This practice should only be used in emergencies or when developed as part of an approved behavior control plan.

    Time Stamps
    A way to denote the exact date and time at which an event, incident, or situation occurs. A common format for time of day will use HH:MM with AM or PM indicator at the end. Dates commonly use MM/DD/YYYY formats.

    A medical condition that frequently occurs among older people, and causes a person to hear a buzzing, swishing, tingling, or clicking sound even though there is no such sound in the environment. It can result from earwax, damage to the inner ear, or high or low blood pressure, and it may be aggravated by stress and tiredness. Tinnitus is hard to treat and difficult to diagnose in people with intellectual and developmental disabilities who may have difficulty explaining the symptoms.

    Something, such as a poker chip, a check mark, or a sticker, that can be exchanged for something else.

    Tooth Decay
    The breaking down or rotting of a tooth enamel, cavities or holes in the teeth caused by acid from the plaque bacteria.

    A violent destructive whirling wind accompanied by a funnel-shaped cloud that progresses in a narrow path over the land.

    Tornado warning
    This is issued when a tornado has been spotted in the area.

    Tornado watch
    This is issued when weather conditions are favorable for severe thunderstorms to produce tornadoes in and close to the watch area.

    Total task presentation
    teaching someone to perform all of the steps in a task in the right order.

    Tourette Syndrome
    a neurobehavioral condition that is often visible through sudden, jerky, and often dramatic behaviors that are typically considered "inappropriate". These behaviors include involuntary movements and sounds, as well as compulsive rituals and behaviors.

    Capable of causing injury or death, especially by chemical means. Poisonous.

    Toxic exposure
    Exposure to a toxic substance such as a chemical

    Things that can poison you or harm you. These can be breathed or eaten. Some can be absorbed through the skin. Common toxins in our environment include: lead, nicotine, mercury. Substances that are not toxic to a woman may be toxic or harmful to an unborn baby she is carrying. These may include alcohol, medications, and street drugs. In addition, toxins like mercury may have a minimal effect on the woman in small doses, but cause damage to an unborn child.

    Something that is done because it has been done before, and carries with it emotional or psychological significance to the participants. The passing down of culture from generation to generation. A custom that has been passed on to one from one's ancestors or has developed over time.

    Traditional Medicine
    Ways of protecting and restoring health that existed before the arrival of modern medicine. As the term implies, these approaches to health belong to the culture and heritage of each country, and have been handed down from generation to generation. In general, traditional systems have had to meet the needs of the local communities for many centuries.

    Training needs assessment
    This is an assessment of a group of employees to identify high priority training needs. This uses competency assessments to identify skill gaps that need to be addressed.

    Trans fat is a man-made fatty acid created by a process called hydrogenation. This stabilizes certain oils and prevents them from spoiling at room temperature. Trans fats can be harmful to the heart and have been linked to some cancers. Trans fats can be found in foods like margarine and processed fried and fast foods.

    A person who feels the biological sex they were born into is not correct or does not match with the way he or she identifies as. Includes transsexuals, cross-dressers, drag kings, drag queens, etc.

    A means to move from one location to another. Examples includes cars, buses, helicopters, trains, and bicycles.

    Transportation plan
    A plan that includes cars, vans, buses, or any other mode of moving that moves people away from an emergency to a safe place. This includes walking. Various roads or routes should be part of the transportation plan. The plan should include alternate routes. The plan should take into account who will be transported and what their specific accessibility needs might be. It should also consider any durable medical equipment or other specialized needs the individual would needs that need to be accommodated while in the vehicle.


    Trauma is an injury or event that causes harm to a person or harm to a person's body.

    A physical, emotional or psychological injury. This can result in long-term consequences that are physical, emotional, or psychological in nature. Trauma can come in a variety of forms but is more often a result of some sort of violence, threats, or injury made to or witnessed by a person.

    Trauma-Informed Care
    Trauma informed care is based on several principles. The first being acknowledgement of the very high rates of trauma in people seeking services. Another being that trauma can create symptoms and behaviors that mimic or interact with those of other disorders. Another being that aspects of how services are delivered can increase trauma or support healing. With these principles in mind, trauma informed care seeks to create service and treatment environments that respect people's histories and support healing. These efforts are applied universally. They are combined with specific outreach and clinical support to those with significant trauma needs.

    Traumatic Brain Injury (TBI)
    Traumatic Brain Injury is any injury cause to the brain that damages parts of the brain. It is estimated that 5.3 million Americans are currently living with a TBI-related disability. The effects from traumatic brain injury can be mild to severe but often causing changes in a person's personality and abilities. Short term memory is often affected.

    Treatment Administration Record (TAR)
    A record kept to help people track when medical treatment is given.

    Three elements related in some way.

    Triad of Challenges
    Group of three challenges observed in people with autism.

    Trial Work Period (TWP)
    Is an employment support provided to people accessing Social Security Disability Insurance (SSDI) and Medicare. It allows recipients the opportunity to test their ability to work and earn as much as possible. During this time a person can earn as much as they want and they will not lose their benefits. As of 2009, a trial work month is any month a person earns over $700 or works over 80 hours at their own business. Ultimately, a person can have nine trial work months in a five year period.

    A type of antidepressant medication which affects neurotransmitters in the brain.

    Triggering Events
    Events that occur before a challenging behavior that may cause the behavior to occur.

    Triglycerides are how most fat is stored in the body. Body fat is almost entirely made up of triglycerides. Fats are mostly transported in the blood in this form as well. Triglycerides can come from fat we eat or fat which is made in the body from carbohydrates.

    Tropical storm
    A tropical cyclone with strong winds of over 39 miles (63 kilometers) per hour but less than hurricane intensity

    An approach to engaging people in human services that recognized the profound effect of trauma on a person’s ability to function and communicate. It promotes universal approaches physical, psychological, and emotional safety of both providers and survivors. These approaches support people in maintain positive control in the support environment. It connects people to clinical level support for trauma when they feel they would benefit.

    A trait where one believes in the honesty, integrity and reliability of others. In a relationship trust is shown by having confidence in the other person's words and deeds. Trust is something you earn by doing what you say you will do and is based on past experiences.

    A great sea wave produced especially by submarine earth movement or volcanic eruption

    A disease which effects several parts of the body, but primarily attacks the lungs. This disease is spread through the air.

    A method of counting the number of staff leaving employment and is referred to as the crude separation rate or percentage that describes the number of people who have left employment during a specified time period at the worksite divided by the average number of people who worked at the site during the same time period.

    A method of hair removal. Plucking hair with a tweezers is a way to remove one or only a few hairs at a time. This method is most frequently used to remove hair around a person's eyebrows or the stray hair on the chin or upper lip. It is a clean, effective and safe way to remove hair at the root.

    Type 1 diabetes
    Occurs when the body does not produce any insulin. Type 1 diabetes usually, but not always, is diagnosed in children or young adults. Type 1 diabetes was previously called juvenile diabetes.

    Type 2 Diabetes
    1. This is a mild form of diabetes, a disease in which a person's insulin levels are not managed properly by their own body, which does not have symptoms or require medication.

    2. Occurs when the body does not use insulin that is produced by the body. This is most commonly diagnosed in adults and often occurs as people get older. Type 2 diabetes was previously called adult-onset diabetes.

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    Ultraviolet - Non-visible light that is harmful to eyes and skin in excessive amounts. It causes sunburn and long term exposure can cause cataracts.

    Describes the use of symbols and signals for communication that require no external device or item for sending or receiving messages. Unaided communication approaches use body parts (e.g. the face or hands) to enhance meaning and improve the effectiveness of communication. Unaided approaches include sign language, naturally-occurring gestures, actions, and eye gaze.

    Having an appreciation for a set of circumstances without passing judgment about the people or circumstances involved. Understanding is shown when you take the time to learn about the facts and details of a particular situation and remain unbiased and professional in your encounters with the family support network.

    Actions that are considered wrong or self-serving to the detriment of others. Actions that are in conflict with established moral or ethical codes.

    Difficult to understand; poorly expressed.

    Universal Design
    Universal Design is the design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.

    Universal Precautions
    A standard set of procedures designed to protect individuals from coming into contact with contaminated blood or bodily fluids. Because anyone can be a carrier of these diseases and symptoms do not have to occur for a person to be contagious, universal precautions greatly reduce the chances of exposure because they require that all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.

    Universal Risk
    1) Universal risk --Risks that apply to everyone, regardless of ability, personality, or status.

    Universal safety standards
    Standards of behavior regarding safety that apply to everyone, such as requiring all passengers in a car to wear a safety belt.

    University Affiliated Program
    Programs at institutions of higher education designed to learn about (research) and share information (dissemination & training) about the best possible services that will support people with developmental disabilities to achieve independence, productivity and community integration. These programs are authorized under the Developmental Disabilities Assistance Bill of Rights Act and are now called University Centers for Excellence in Developmental Disabilities Education (UCE).

    University Centers for Excellence in Developmental Disabilities Education (UCE)
    See University Affiliated Program.

    When something unexpected happens. It is often difficult to know exactly when challenging behaviors are going to occur, they are unpredictable.

    Unusual or Major Incidents:
    Infrequent but serious situations that lead to harm or injury or could have lead to harm or injury.

    The tube through which urine passes to leave the body.

    Urinary Tract
    Area of and around the body parts in which urine passes as it is released.

    Electrical and/or natural gas, found in both residential and commercial buildings.

    Utilization review
    Evaluation by an outside party of the appropriateness, necessity, and/or efficiency of a given service for an eligible recipient.

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    Vacancy rate
    The proportion of positions that are open or unfilled on a specific date.

    Vaccine or vaccination
    The process of administering weakened or dead pathogens to a healthy person. This promotes the person's immunity against a pathogen such as the flu. This is administered as a shot (or injection), but can often be administered in other forms such as a nasal spray.

    The female opening for sexual intercourse. Monthly menstrual blood passes out of the body through this opening. Babies are born through this opening.

    Area of and around the vagina or female genitals.

    Vaginal penetration
    A sex act involving insertion of the penis into the vagina.

    Valid Assessment
    A valid assessment is an assessment that actually measures what is trying to measure. Assessments are not valid when they are not completed the way they should be. For example a problem in validity happens when people cannot understand the language in which the test is written or when they have not had the chance to learn the words or concepts in the assessment.

    The extent to which the test accurately measures the concept it is designed to measure. This is tested in a variety of ways. For example, subject matter experts might review it to see if the items are accurate measures of the concept. Validity may also be tested by examining whether scores on the test are correlated with scores on other tests that measure the same concept or by examining whether scores are correlated with other outcomes.

    Valued Roles
    Roles that are perceived as having social value by others, such as being able to contribute financially or in other ways to positive causes and betterment of community, family or organizations. Many people with disabilities are shut out of valued roles due to inaccessibility of accommodations, service barriers, and stigma.

    Principles or standards which people use to guide them in daily life choices.

    Commonly used to describe people who have functional use of speech; may also refer to cognitive ability related to symbol use.

    Verbal Abuse
    Any communication that diminishes a person's dignity or self-worth or cause the person emotional anguish or pain.
    This term is one that is commonly defined very specifically by state laws or regulations. You must be familiar with your state definitions. States that have specifically provided links to definitions or information regarding this term through special CDS customizations content include: PA, KS, MN.

    Verbal Report
    Telling someone what happened.

    With physical energy and force.

    Related to virus, which is a type of germ that causes infection and is spread through the air and by touching contaminated surfaces such as doorknobs, another persons' hand, and countertops. Viruses include the common cold and flu.

    A very small thing that enters a human or plant cell and multiplies. Viruses cannot be seem with the human eye. In humans, the virus enters a cell in the body and multiples very quickly, causing a person to get sick.

    Any one of a number of simple infectious agents that cause disease in living things. Viruses need to be in a living host to replicate and are typically not considered to be living themselves.

    The ability to see through the eyes.

    Vision impairment
    is a condition where a person has difficulty seeing with their eyes. The condition may range from mild (needing only corrective glasses) to severe, where a person cannot see at all.

    a set or body of words from a particular language. These words must be known to each communication partner for effective communication to take place.

    Vocal inflection
    Vocal inflection is combination of pitch, cadence, volumn, speed, starts and pauses in someone's voice as they speak. It is the modulation of words during speech or how a person alters or varies the sound of what they are saying.

    Vocabulary selection
    The selection of words (or phrases) to be included on an individual's communication device or signs to be taught to a person who uses an AAC approach. Selection should be based on several factors including context, partner, and relevant topics.

    The use of non-word utterances that convey intentional or non-intentional meaning. Vocalizations include attempts at speech, as well as utterances such as "ooh," "aaah," etc.

    Vocational rehabilitation counselor
    A licensed professional who supports individuals with conditions such as disabilities, physical injuries, substance abuse issues, and mental illness in finding and keeping meaningful employment.

    Vocational Rehabilitation Services (VR)
    State agencies that provide employment-related services, support, and/or funding to assist individuals with disabilities with work preparation, attainment, and maintenance.

    Volcanic eruption
    The sudden occurrence of a violent discharge of steam and volcanic material

    An action or decision made by a person freely and without force.

    People who are often solicited by an agency to provide a certain type of support. The agency takes responsibility to coordinate their schedule, accepts liability for their actions and usually provides volunteer orientation and training programs. Sometimes other organizations (churches, clubs, etc.), use volunteers to conduct some of their charitable programs.

    At risk for injury or harm. Unable to defend or care for oneself.

    Vulnerable Adults
    Persons 18 years of age or older who: are a resident of a facility; receive licensed services from a home care provider or personal care assistant provider; or regardless of residence or if any service is received, have physical or mental infirmity or other physical, mental or emotional dysfunction, that impairs the individual's ability to provide adequately for his or her own care without assistance, including the provision of food, shelter, clothing, health care or supervision, and/or because of the dysfunction or infirmity and need for assistance, the individual has an impaired ability to protect him/herself from maltreatment.

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    Wage/benefit market analysis
    This is an analysis that compares the wages and benefits offered by a particular organization to wages and benefits offered by direct competitors in the same geographic region, and to wages and benefits offered to persons with similar educational and experiential backgrounds in other types of organizations or companies. The purpose is to check whether significant discrepancies exist that might contribute to relatively high turnover or recruitment difficulties.

    A strategy used to enhance communication by allowing the person with a disability time to understand the message, process the response that may be required, formulate and produce a message. Sometimes called "expectant time delay", this strategy requires the communication partner to act as if she expects the person with a disability to respond. The communication partner should refrain from repeating the question or providing other cues or prompts until a set period of time (e.g. a count of "5") has elapsed to make sure the person with a disability has had a chance to respond.

    Waiver (The)
    A formal set aside of certain regulations for a specific purpose. Also see: The Home and Community Based Waiver.

    A person for whom a legal guardianor representative has been appointed.

    A method of hair removal. A warm strip of wax with a strip of cloth over it is placed on the skin. Once it cools and hardens the cloth is pulled back to remove the hair at the root. This method is often used for larger areas of hair to be removed. This process should not be done by a direct support professional.

    Being aware of all the things it takes to live a healthy life and then making choices to reach the goal of living a healthy life style.

    Wind Chill
    A combination of wind speed and air temperature that feels cooler than the actual temperature on the skin.

    Wind Chill factor
    A phenomenon that makes us feel colder in winter than the air temperature really is.

    Women's Rights Movement
    Women's Rights Movement: the struggle for the freedoms inherently possessed by women and girls of all ages which may be ignored or suppressed by law, custom, and behavior in a particular society.

    Work Factors
    These are the many aspects that are specific to a job. They can influence a person's success on the job. These factors may be similar from one job to the next, or they may be different. For example, a few work factors include the work tasks of a job, when and where the work is done, level of supervision afforded on the job, and the amount of social interaction allowed on the job. Work factors are important to consider when developing a career plan.

    Working Relationship
    The state of connectedness, affiliation or association between direct support professionals, the people they support, frontline supervisors, families and support networks which describe the interdependency or connectivity between these groups who must work together to provide support to individuals with disabilities.

    WRAP Plan
    A self-directed plan developed by a person with serious mental illness that is designed to ensure they have plans in place in case symptoms become difficult to manage independantly.

    The production of meaningful letters or other graphic symbols that can be read by others.

    Written language
    Formal systems of communication in which written symbols are combined to convey meaning. English is both a spoken and a written language.

    Emergency phone number that works anywhere in the United States. This number can be called for any kind of emergency.

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