Glossary of Terms

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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A

A1C
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.

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

Abscess
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.

Abstain
To refrain from doing something or to not participate.

Abuse
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.

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

Accessible
Adaptations to buildings, other physical locations, and equipment so that people with disabilities may use them. Example: an "accessible van" means that there is a wheelchair lift and handrails so people 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)

Accidents
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.

Accommodation
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.

Accountable
Required to explain an action or decision. Being responsible for something.

Accuracy
Something that is free from error.

Acquiescence
To agree with others without protest. To be compliant.

Acronym
A word that is formed from the initial letters of other words. The letters might be used in place of the words. For example, activities of daily living may be referred to as “ADLs.”

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.

Action
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
Listening to fully understand what is being said. Listeners pay attention. They avoid distractions. They may ask questions for clarity. They wait to share reactions until the message is completely understood.

Active shooter
Someone who is using a gun to shoot at and/or harm people in shared or public spaces.

Active support
A way of providing assistance to people so that they are engaged in all aspects of their own life.

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

Acupuncture
A traditional Chinese health practice. A practitioner uses special needles. They prick spots on the body.

Acupuncturists
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.

Adaptation
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.

Adaptive equipment
Any tool, device, or machine that is used to help with daily living or work tasks.

Adrenaline
A hormone released during times of stress. It may cause rapid heartbeat or breathing. It may create discomfort or anxiety.

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.

Advance Care Planning
A process that allows a person to share what’s important to them about the medical care they want. This can be done in preparation for the potential loss of the ability to make decisions about health care and legal matters. Advance care planning should be done when a person can still communicate and make their own decisions about their care.

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 Directive
Legal documents that describe your wishes if you are unable. They go into effect if you are alive but cannot communicate. See Advance Heath Care Directive.

Advance Health Care Directive
A legal document that describes your health care and end of life wishes. It identifies who can make decisions for you if you cannot communicate. See related terms: Power of Attorney, Advance Health Care Directive, and Living Will.

Adverse Reaction
Serious problems from medication use. These can be permanent or life-threatening. They may come on suddenly. They may develop over time.

Advocacy
The act of being an advocate. Speaking up for yourself or others. This may be done to improve a situation. It may be done to get what is wanted, needed, or what is fair. (See advocate.)

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.

Affect
To influence (verb). Expression of feeling or emotion through one’s body (noun).

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

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

Aftershock
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.

Ageism
refers to the negative attitudes and discrimination toward the elderly.

Agitated
A state of nervous excitement; being restless or not calm.

Agoraphobia
An anxiety disorder. It includes severe fear in common situations. People feel fearful or trapped. They may avoid things like standing in lines or riding in an airplane.

Agranulocytosis
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.

Agreeableness
A person’s ability to be highly cooperative, friendly, and easygoing. It is one of the Big Five personality traits. Agreeableness includes how accommodating people are, and their level of self-sacrifice. People high in this trait have a high regard for others. They are often friendly and empathic. People low in this trait are manipulative and have little interest in others. They may be uncooperative and unfriendly.

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.

Aid
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. These can also be referred to as Speech Generating Devices (SGDs) or Voice Output Communication Aids (VOCAs).

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.

Akathesia
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.

Akinesia
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. They 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.

Alignment
To bring something into line, or to make straight.

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

Allergy
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).

Allergies
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).

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

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

Alternative format
A format that is different from the standard. This could include large print, braille, audio, or digital formats, among others.

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.)

American descendants of slaves
People in US society who descended from African slaves.

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.

Anal
Area of and around the anus.

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

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

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

Anchor
A person, thing, or thought that gives support and stability.

Animal assisted therapy
Use of animals in therapy sessions.

Anesthesia
Medication used to create a loss of sensation in the body. It can affect all or only part of the body. This can be with or without loss of consciousness.

Aneurysm
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.

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

Antecedent
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.

Anticonvulsant
A drug that is used to prevent or stop seizures.

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).

Antipsychotic
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.

Anus
The opening through which bowel movements are passed.

Anxiety
A feeling that causes distress or uneasiness.

Anxiety Disorder
A category of mental health conditions. These disorders can include symptoms of excessive, irrational fear or dread. The feelings are out of proportion to the situation. Anxiety may be focused on a specific item, situation, or person. Or it may be more general. There are several types of anxiety disorders. People living with anxiety disorders may have co-occurring conditions. They sometimes have a history of trauma. This can make diagnosis and treatment complex. However, it is still beneficial. Panic disorder, post-traumatic stress disorder, social phobia, agoraphobia, and obsessive-compulsive disorder are some examples of anxiety disorders.

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

Applicant
Someone who applies for a job.

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 community-based advocacy organization advocating for and serving people with intellectual and developmental disabilities and their families. 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.

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

Arthritis
a condition of painful inflammation and stiffness of the joints.

ASHA
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.

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

Asperger’s syndrome
An outdated diagnosis to refer to a subset of people with autism spectrum disorder. It is no longer used as a diagnostic term.

Aspirations
Something a person hopes to achieve.

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

Assertiveness
Directly stating your needs without being hostile or passive.

Assessments
Tools or processes used to evaluate.

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.

Association
A relationship between two or more things. A legal entity with a membership that share a common interest.

Asthma
A condition in which a person's lungs will suddenly narrow. This causes difficulty in breathing. This is commonly called "having an asthma attack."

Astigmatism
An imperfection in the curvature of an eye’s cornea or lens. It causes the person to have blurry vision for items near and far.

Ataxic
the loss of muscle control.

Athetoid
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.

Attainable
Can be achieved or accomplished. When related to SMART goals, this term refers to goals that are realistic and achievable. Goals can still be challenging and often are.

Attendant
A person in a hospital or other medical type setting that cares directly for a person'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)
This is a difference in brain functioning that creates difficulties in modern living. It is first noticeable in childhood. It continues to affect many adults. People with ADHD may struggle in many areas of life. These include completing certain tasks and planning ahead. They also include managing frustrations and processing information. The causes of ADHD are still not fully known. Symptoms vary. Identification, treatment, and coaching can be very useful to life success and good mental health for people with ADHD.

Attitudes
A way of thinking or feeling about something

Attitudes of leavers
This is what former workers think about the place they worked and their former job.

Attributes
The qualities that describe something.

Auditory
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 where the manager controls the flow of information. They direct the type and amount of decision-making and input that they want to have with others. They do this to maintain power over others.

Authority
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.

Authority figures
People who have authority over others. They may be seen as having higher status in a group. These may include informal or community authorities such as parents, elders, or community leaders. Formal authorities may include police officers, judges, or social workers.

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.

Autism
see autism spectrum disorder

Autism Spectrum Disorder (ASD)
ASD is a psychiatric label. People diagnosed with ASD must experience symptoms during childhood. They must have difficulties in two main areas. These are: 1. communication and social interactions, and 2. restricted interests and repetitive behaviors. These must affect the person in a significant way. They must also persist over time. They must be likely to last for life. They must not be because of other conditions or experiences. Autism is known as a “spectrum” disorder. There is wide variation in the type and severity of symptoms. ASD occurs in all ethnic, racial, and economic groups. Some people with ASD may also meet the criteria for a developmental disability. ASD often co-occurs with other conditions. Some of these include intellectual disability, anxiety, and attention-deficit/hyperactivity disorder. Treatments and services can improve a person’s ability to engage comfortably and effectively in life activities.

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.

Autonomy
Determining one’s own path in life. Making one’s own decisions.

Autopsy
An examination of a deceased person to figure out their cause of death.

Aversive
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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B

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.

Background checks
A formal process to check past behaviors. This is done to ensure a person is qualified or legally allowed to perform certain roles.

Bacteria
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.

Bacterial
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.

Barriers
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)

Baseline
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.

Behavior
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 analyst
Professionals who work with individuals to identify the communicative intent of challenging behavior and learn behavior that meets these needs in ways that are safer and more accepted.

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 specialist
A professional who seeks to understand what people are trying to communicate with their behavior. They often work with people who behave in ways that are seen as challenging. They help those who provide support to understand what may be meant by the behavior. They support people to find different ways to express themselves.

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
Questions that focus on asking people to describe situations they have experienced and how they handled them. This should include details about the situation, what they did, and what happened as a result. These types of question are useful in interviews. They provide specific details about how a person handles situation and not just their stated value set.

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

Belonging
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.

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

Benzodiazepine
A drug that may be used to calm or sedate a person. They may be used for a variety of purposes. Some include treating anxiety or reducing seizure activity. They may support better sleep. These medications are also commonly abused. They need to be carefully monitored.

Best Practices
New or emerging trends in the design of services or supports. These are often viewed as an improvement over the way things have been done in the past.

Bereavement
The feeling of grief and mourning after a death.

Beta-blocker
A drug used to reduce blood pressure. They can also be used to reduce anxiety.

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

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

Big Five personality traits
A personality theory that states there are five basic traits: openness, conscientiousness, extraversion, agreeableness, and neuroticism. (Also known by the acronym OCEAN.) The idea is that each person falls somewhere in a range between the two extremes for each of these five traits.

Biographical questions
Questions that ask people for information about themselves. This may include things such as educational experiences. It may include credentials for specific competencies. These questions also ask for information about special awards. It may ask about recognition and achievements. This type of information can be verified by checking documentation and references.

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.

Black, Indigenous, and/or people of color (BIPOC)
A broad term for people who collectively do not typically experience racial equity in the US.

Blepharitis
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.

Blizzard
A severe snowstorm. It can disrupt travel and affect power and other systems.

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:
http://www.osha-slc.gov/needle 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 transfer
When a person is given or exposed to blood from storage or another person.

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
Informal communication with our bodies. Examples of this include facial expressions, eye contact, or postures. These vary across cultures. Family experiences and position in a social group affect this. For example, in the same culture, one person may lower their eyes when angry; another may stare. This can be based on gender, age, or other factors. In another culture, eye contact when angry might be different. People are not always aware of their body language. This can cause problems with understanding each other.

Booster
Something that enhances or supports.

Botox
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.

Bowel Movement
The act of expelling food and nutrients that pass through your digestive tract. Also referred to as stool.

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.

Brainstorming
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.

Breach
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.

Brittle
Easily broken.

Browser
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.

Bunions
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).

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

Burnout
When a person has lost interest in an activity either because it’s too demanding or they are bored.

Business acumen
The ability to make sound business decisions. Knowledge about key areas of business functioning.

Business advisory council
A group of volunteers who help to provide business insight to a support agency.

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.

Business goals
Goals that are focused on growth, purpose, and stability of a business.

Business network group
A group that supports business to be more inclusive of people with disabilities.

Business practices
The ways in which a business structures itself and approaches core functions.

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C

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

Cancer
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
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.

Capacity
Being able to produce, perform, or support something.

Capitation
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.

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

Carbohydrates
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.

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

Cardiovascular system
The blood, heart, and blood vessels. It controls the circulation of blood, oxygen, and nutrients in the body.

Care Circle
A group of people who provide support to someone when they need help, such as during serious illness and the end of life. The people in a care circle also support each other.

Caregiver plan
A plan for the health and well-being of the caregiver.

Caretaker
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.

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

Catastrophes
A very large disaster.

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

Centers for Disease Control and Prevention (CDC)
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.

Certification
A way of validating ability or education. Certification may be formal. It may be recognized as valuable in a field. It may be required for some roles. It may also be less formal. For instance, recognized only internally to one organization.

Chief Executive Officer (CEO)
A common title for the leader of an organization. They usually hold the highest position in a company.

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

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)
A neurological disorder that is caused by a brain injury or malformation while the child’s brain is developing. Cerebral palsy affects body movement, muscle control, tone and coordination. There are different types of cerebral palsy which may affect each person differently. The person may have sensory limitations including hearing and vision impairments. It may cause cognitive impairment. People with cerebral palsy often have some difficulties with speech. Symptoms are usually evident before age 2 and may appear as early as three months of age. Symptoms may increase in later years due to issues related to aging.

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

Certified peer specialist (CPS)
A person with lived experience who is trained as a peer to support others in a service system. Many are recovering from mental illness and/or addiction. This person is formally trained and certified to support other people who are recovering. There are many types of certifications.

Cervix
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.

Chaining
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.

Chaplain
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.

Challenges
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.

Chemotherapy
Powerful drug treatment used to destroy or kill cancer cells.

Champion
A person who promotes, advocates, or defends a mission or cause.

Chief executive officer (CEO)
A common title for the leader of an organization. They usually hold the highest position in a company.

Child Molestation
Deliberate exposure of a minor to sexual activity.

Chlamydia
A sexually transmitted disease.

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

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

Cholesterol
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.

Chiropractors
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.

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

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

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

Citizenship
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
Questions that are used to follow up on a person’s answer when it is too general or needs more explanation.

Classification
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.

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

Climate
The conditions in an area. Sometimes they are geographic. These may have to do with weather and terrain. Other times they are social. These may have to do with attitudes, expectations, or opinions.

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

Clinical professional
A licensed professional in a health field. Sometimes called a clinician.

Close-ended questions
Questions that are used when the possible answers are known or can be reasonably guessed. Respondents select from a series of choices when giving their answer. There is no option to elaborate or explain.

Co-advocacy
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.

Co-occurring conditions
Having two or more diagnosable conditions at the same time. For example, a person may be diagnosed with autism, anxiety, and diabetes. Some conditions used to be called dual diagnosis or dual disorders. These are no longer the preferred terms.

Coaching
Supporting others to self-reflect for the purpose of growth and enhanced skill.

Code of Ethics for Direct Support Professionals
Recognized guidelines for direct support professionals to use when faced with situations that require ethical decision-making. See the NADSP Code of Ethics.

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

Cognitive
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.

Cognitive enhancement therapy (CET)
An evidence-based treatment for people who have schizophrenia. It improves attention and memory. It improves the ability to organize thoughts.

Cold call
A call, email, or visit to someone without having a prior lead or contact with them. For example, this may be done when looking for a job.

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.

Collaborative and Proactive Solutions (CPS)
A non-punitive approach to help children behave better. It was developed by Dr. Ross Greene. It focuses on helping children and adults to identify and share concerns. They learn to collaborate to solve these concerns.

Collectivistic culture
A culture that emphasizes relationships and family. It may be oriented toward status or community. People focus on their roles and status within the community or family when deciding what to do. They may seek the input of others when making choices.

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.

Combating Autism Act of 2006
An act of the US Congress that was signed into law by President George W. Bush on December 19, 2006. It authorized money for research, screening, and interventions for autism.

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

Committee work plan
A plan that guides the work of a committee.

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.

Communication
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 device
A tool used to help express a message or meaning. They may be used when a person has a hard time expressing what they mean. This includes electronic devices. It also includes picture books and boards, as well as other basic tools.

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.

Communities of color
The collective experiences of Black, Indigenous, and/or people of color (BIPOC). This may refer to groups with which people identify. The term can be non-preferred if it implies that all members have the same experiences or beliefs when they do not.

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.

Community
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
A community's ability to welcome and support people.

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 Emergency Response Team (CERT)
A federal program that supports local efforts to respond to disasters. Volunteers are trained. They can take actions before professional responders can arrive. They also work with professionals.

Community Inclusion
A concept that reflects the practice of sharing in community life. This involves at least four factors. The first is a physical presence. This means people live in a typical place (house, apartment, etc.). They do not live in places such as an institution or a nursing home. The second aspect is cultural integration. This means people participate in locally valued lifestyles and roles. For example, they work on a farm in a rural community. The third factor is connection to others beyond paid as supporters. These connections include relationships like friends, coworkers, neighbors, or spouses. The fourth is being able to self-determine one’s schedule and lifestyle. (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.

Community Programs
Programs available to anyone. They may be free or have a fee. For example, this includes story time at a public library or dance lessons at a community center.  

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 stewardship
Being accountable for the use of community resources. Caring for or providing service to the community.

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.

Conflict management
Using strategies to increase positive outcomes from conflict.

Co-Morbidity
The presence of one or more additional disorders co-occurring with a primary condition.

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.

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

Competencies
The knowledge, skills, and attitudes needed to perform well on the job.

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

Competency assessment
Methods of identifying if employees have the ability to perform as needed.

Competency Based Training
An approach to training. It ensures that training includes demonstration of the actual job skills needed for the job.

Competency-based job descriptions
Writing job descriptions to make clear the knowledge, skills, and attitudes needed to perform duties.

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.

Competitive integrated employment (CIE)
Work done by people with disabilities paid at or above minimum wage at the usual rate for that type of work. The work is done at businesses where people can interact with others who don’t have disabilities. People can get the same benefits and training as others in similar jobs get.

Competitive wage
A wage that is equal to or above the market rate for a given job, area, or industry.

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

Compliance-based
Focused on complying with rules and regulations.

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

Complementary and alternative treatments
A medical product or practice that is used with (complementary) or instead of (alternative) standard medical care.

Components
Parts of a larger set of things.

Components of the Direct Support Profession
The established body of knowledge and skills for the direct support profession. This also includes credentialing, certification options, and a code of ethics.

Comprehensive assessment
Methods of identifying if employees have the ability to perform as needed.

Compulsion
A behavior that a person feels driven to perform. They will do so even when the action may be harmful. People with compulsions may recognize these behaviors as unreasonable. They still may not be able to stop.

Computation Date
This is a date when numbers are computed to get a figure. (An example would be the date December 31st being the final date for computing the annual turnover rates of a calendar year.)

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

Concussion
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 outline a plan of correction for an employee. These list what the consequences will be for failing to improve. These documents also include a plan for timelines. They include the resources that will be used. They also include a plan of support for review and improvement.

Confidential
Something entrusted with private information and the confidence of another.

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

Confronting
This is a style of performance coaching that uses a direct approach. It is used after counseling has not resolved a work-related problem. In this approach the behavior is clearly described. The coach or supervisor explains why it is not meeting expectations. Expected behavior is also described. A clear outcome for not changes is described. Confronting may be 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.

Conscientiousness
A person’s ability to manage themselves to meet the needs of others and the situation. It is one of the Big Five personality traits. Conscientiousness includes being willing to organize oneself to achieve important goals. People with this trait often have good control over impulses. They are self-disciplined and reliable. They pay attention and enjoy structure and preparation. People low in this trait procrastinate and are disorganized, which makes it harder to achieve important goals. They may have a dislike for structure or schedules.

Continuity of operations plan (COOP)
A plan that identifies key operations of a business. It describes how they will keep going in emergencies. (See also: Employer emergency plan.)

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.

Consequence
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.

Conservator
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.

Conservatorship
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.

Context
The circumstances in which an event occurs.

Constipation
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
This 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 and specific. It also must be useful and timely. It should be given with the intention of helping the person you are giving the feedback to. It focuses on the behavior or statement rather than the person. It is given in a respectful manner. One suggestion is to ask the person if they want your feedback before offering it. You can also ask in what areas they want the feedback. You can also ask how they would like to be given the feedback.

Consumer
A term sometimes used to describe a person receiving services. This term is meant to be respectful. However, it is no longer the preferred language to refer to a person receiving services.

Consumer Advocacy
A movement started by Ralph Nader to fight for the rights of those who purchased good and services. The word "consumer" is no longer preferred language to refer to a person receiving services. However, this is a historical reference. It is still used in this context.

Consumer-directed
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. The word "consumer" is no longer preferred language to refer to a person receiving services. However, this word is still used by some agencies.

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

Contagious

A disease that spreads to others easily.

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

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

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

Contemporary
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.")

Contingent/Contingency
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.

Controversial
Giving rise or likely to give rise to public disagreement.

Controversy
A dispute about things that are important to people.

Conventional Medical Care
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 person'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.

Collectivistic culture
A culture that emphasizes relationships and family. It may be oriented toward status or community. People focus on their roles and status within the community or family when deciding what to do. They may seek the input of others when making choices.

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

Coronavirus disease (COVID)
An infectious disease. It is caused by the SARS-CoV-2 virus. This disease caused a pandemic.

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.

Corrections
The system that is responsible for incarceration, parole, or probation.

Correlated
Closely tied to, or having an effect on, something else.

Cost to Benefit Ratio of Intervention
This is the balance of expected outcome to effort or the cost of doing something. It is a way of measuring whether effort is worthwhile.

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

Counseling
Giving advice or direction. Paid counseling comes from trained professionals. Informal counseling comes from personal relationships. Supervisors can engage counseling at work. This can be used informally. It can also be part of a formal process of working with employees that are not performing well enough.

Counter-clockwise
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.

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

Credentialing
The process of establishing qualifications. Validation of qualifications.

Credit-bearing
Education that provides credits. These are recognized by others.

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.

Crisis
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.

Criteria
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
The ability to reflect on information in ways that lead to better outcomes. It includes planning for problems.

Cross-Functional/Project Teams
Teams that are made up of individuals who work on a specific project. This may be a part of or in addition to their normal duties. These teams are often limited by time. Their tasks are also more narrowly defined. These are sometimes called "tissue paper" committees.

Cross-training
Learning to perform jobs that are not yours at work. Engaging in fitness activities that train the body in different ways.

Crude separation rate
The number of staff leaving employment in a period of time. There is no distinction made about why they left (for example, fired, quit, etc.).

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

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

Cultural
  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 awareness
Being mindful of your own culture and how it may be different or similar to others. Recognizing each person comes with their own culture and worldview and most of this is unseen.

Cultural capital
The power and influence a person has by being part of, or welcomed by, 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. This is related to the concept of privilege.

Cultural competence
Recognition of the influence of culture and background on behavior and beliefs. It includes valuing diversity. It includes an ongoing commitment to gaining knowledge of and appreciation of culture. It includes being aware of one’s own beliefs, values, and traditions. It respects those of others. It recognizes all expressions are culturally-bound, even one's own. It includes the recognition that each person is a unique individual that may or may not affiliate or be able to recognize or speak of cultural differences. It includes the ability to support people in a context that resonates with their culture.

Cultural Context
The values, beliefs, experiences, and cultures that influences a person.

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 humility
Avoiding centering one’s own culture and worldview in interactions with others. Not seeing your own culture as superior to others. Providing services to others in ways that work for their cultural context rather than your own.

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.

Cultural Responsiveness
Recognizing each person has a unique lens to interpret life. Engaging them appropriately in that context.

Culturally-appropriate
Culturally appropriate means things make sense to people supported based on their unique worldviews. This takes into account many things such as language, resources, relationships, and experiences.

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 respectful
Being culturally respectful means acknowledging that each person has unique cultural needs. It includes having methods of assessing these needs. It includes being able to support people in ways that are meaningful and appropriate from their view.

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.

Culture
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.

Customized employment
A process that helps people find jobs through a relationship between an employee and employer that is tailored to meet the needs of both. It may also include self-employment.

Cuticle
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.

Cutting
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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D

Data elements
A defined unit of information. These are used to support analysis of an issue.

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
A Medical Assistance (MA) waiver program that is used by many states to fund services for people with intellectual and/or developmental disabilities. It may be referred to as the ID Waiver in some states. It is a federally supported funding stream. (See HCBS.)

debriefing
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.

Decentralized
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.

Decontamination
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.

Deficiency
A lack of something that is needed.

Dehydration
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.

Deinstitutionalization
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.

Delegation
The assignment of tasks to others.

Delusions
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).

Dementia
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.

Demographics
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.

Density
How compact or crowded something is.

Dental
Related to teeth or dentistry.

Dentures
False Teeth

Depilatories
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.

Depression
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
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.

Dermatologist
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
Things humans are expected to be able to do or experience in their bodies and minds at certain ages.

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.

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

Diagnosis
The process of assessing and labeling a condition. A medical label for an illness or disorder.

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

Diagnostic criteria
A set of guidelines for making a diagnosis.

Diagnostic and Statistical Manual of Mental Disorders (DSM)
A handbook used by mental health professionals that lists different categories of diagnosis for brain disorders and mental illnesses.

Diagnostic Manual-Intellectual Disability (DM-ID-2)
A specialized manual. It helps clinicians more accurately diagnose mental health conditions for people with intellectual disabilities.

Diagnostic process
The steps of completing a diagnosis.

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.

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

Dietitian
A professional who specializes in food, diet, and nutrition.

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

Digestive tract
The parts of the body that process food.

Digital presence
The online activity of a brand, person, or company. This includes actions or being mentioned in social media. It includes websites and online reviews. This presence can affect reputations.

Dignity
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.

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

Direct assessment of performance
Measuring performance through direct observation. This can be a simulation. It can be during an actual event.

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)
A person who assists people with disabilities to lead self-directed lives. A DSP helps people with necessary tasks to keep them healthy and engaged with their communities.

Disability
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. They make up a micro culture in the US. Living with disabilities is a distinct and valuable way of life. Disability culture does not frame people with disabilities as victims or burdens. But part of the culture is a common history of oppression and resilience. Disability justice activists offer people without disabilities an alternative vision of life and society that is inclusive of all.

Disengage
Withdraw from a situation or group. Detach emotionally.

Dissociation
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.

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

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

Discrimination
Treating someone unfairly due to traits they cannot control. This includes things like race, religion, gender, age, disability, etc. Protected groups are those that employers are legally bound to recognize as at risk for discrimination. There are practices that may violate federal and state fair employment practice. The first is called disparate treatment. This means that an employer treats people in one group less favorably than others. The second category is the use of policies or practices that have disparate impact on groups. This includes the use of tests and selection criteria that negatively impact opportunities. It also refers to policies and practices that impact people negatively. The third category is failure to make reasonable accommodations. This includes discriminating against applicants or employees based on disabilities or religious beliefs.

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

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

Disinfectant
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.

Disparity
A big difference between things.

Dispersed
Spread out over a wide area.

Displaced worker
An employee who has lost their job due to the employer closing or moving.

Dissociation
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.

Diverse
Meaningful differences in a group or set.

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

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

Do Not resuscitate
Do Not resuscitate order (DNR) A do-not-resuscitate order, or DNR order is a medical order written by a doctor. It instructs health care providers not to do cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating.

Documenting
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 that are the basis for judging actions and establishing public traditions and narratives. Usually the dominant culture is so much a part of a society’s perspective that it is “invisible” to members of the macro culture. Behaviors that are contrary to the perspective of the dominant culture are usually considered inappropriate or wrong, even when they are not harmful. Harmful actions on the part of the dominant culture are ignored or allowed, as long as they only affect micro cultures.

Douches
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.

Dopamine
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 when a baby has one extra chromosome in each of their millions of cells. Instead of 46, they have 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.

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.

Drought
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.

DSP
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.

Duration
How long something lasts.

Dwarfism
A genetic abnormality resulting in short stature

Dyskinesia
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 their fingers together. They may blink or pucker their lips repetitively. Early onset of this disorder from medication is usually reversible. (See Tardive Dyskinesia.)

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

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

Dystonia
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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E

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.

Earthquake
A shaking, trembling, or other movement of the earth.

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

Economies
The resources of a location or group. This can include money and assets. It can include measures of productivity.

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

Education system
The system of public and/or private school systems. This includes the laws, polices, public funding, resource allocation, and administrative tasks related to education.

Educational eligibility determination
A process of deciding if a student qualifies for special education services.

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.

Elders
A community leader by virtue of age and experience.

Electrode
A device that carries electrical currents.

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.

Electrolysis
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.

Eliminate
Stop the use of something. Get rid of something.

Elopement
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.

Elusive
Difficult to define, describe, capture, or understand.

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

Embed
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.

Emergency
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. It contains essential items needed to shelter in place for three or more days without access to electricity, water, or transportation. Kits used when you have to leave an area are often called “go bags.”

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 plan that helps people know what to do before, during, and after an emergency.

Emergency response services
The local professionals who are first to respond to emergencies. These may include the police, fire fighters, and paramedics. You often reach them by dialing 911 on your phone. (See also: First responders.)

Emergency response team
A local group that organizes itself to respond to emergencies. This may be a private group or community group. It often has a specific focus. One example is planning for an emergency in a school or business. It may also be sponsored by local government (such as a mayor’s office). These teams work with emergency response professionals to create a plan around situations they are concerned about.

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
Access to new information or opportunities for employees. These activities lead to some form of growth that is meaningful to the employee. They are chosen by the employee but must also be valued by the employer.

Employee Engagement
The level of commitment an employee feels toward their job and the company where they work.

Employee performance
How well an employee meets their employer’s standards for a position.

Employee satisfaction survey
A survey of employees’ perspectives. This often focuses on the influence of employer’s practices and policies on an employee’s satisfaction at work.

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

Employment reference
A contact who can confirm a part of an applicant’s employment record.

Employer
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 for emergencies developed by an employer. It covers all types of emergencies. It covers all services and employees. (See also: Continuity of operations plan (COOP).)

Employer Empowerment
When an employer gives their employees the authority to improve the quality of their own work lives. Employees can use their talents and creativity to meet responsibilities. This often improves the quality of work.

Empower
The knowledge, means, and ability to do things for oneself.

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.

Emotional regulation
Managing emotions in healthy and effective ways.

Employer Assistance and Resource Network (EARN)
A network that helps employers to build work settings that include people with disabilities. They provide many online tools for employers.

Empowerment
Giving someone the power or the authority to act on their own behalf or for someone else.

Enclave
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).

Endemic
When a disease occurs in a predictable way.

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).

English language learners
Someone who is working to learn English.

Entry-level
A position with the lowest level of skill and knowledge needed in that job class.

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.)

Epidemic
A disease that spreads quickly and affects many people. However, it stays in a contained region.

Epidemiologist
Scientists who study the spread and control of diseases.

Epilepsy
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.

Equitable
Everyone has what they need to succeed.

Equity
A term that applies to unequal and unfair disadvantages or advantages for some in society. (See Social Equity). Or a term that indicates how much value is owned in a material item. This might mean equity in a home, a car or stock shares, etc.

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

Escalate/Escalation
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
Job tasks or duties that a person must be able to do when working on the job. For example, an essential job function could be "Must be able to legally and safely drive a car."

Essential Lifestyle Planning (ELP)
A person-centered tool that helps discover and define what is important to the person in everyday life. It also addresses what others need to know and do so that those things are present when they experience issues with health and safety. This tool includes guided questions, exercises and activities to aid the discovery process.

Essential worker
A person with a job that is needed for the basic functions of society.

Estrogen
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
Guidelines that help people avoid actions that harm or disrespect others.

Ethical Practice
Practices that protect and respect others.

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

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

Ethnicity
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.

Eugenics
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.

Evacuate
To leave an area.

Evaluation
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.

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.

Evidence
Information or items that help make clear what has happened.

Evidence-based
A thoughtful integration of the best available evidence combined with clinical expertise.

Evidence-based practices (EBP)
A practice that has a body of scientific evidence that shows that it is effective. This may apply to an intervention or instructional program, as well.

Exception
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.

Executive function
A set of mental processes needed for the cognitive control of behavior. It includes working memory and flexible thinking. It also includes self-control. These skills are used to help plan, focus, and manage daily life successfully.

Exercise
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 interview
A conversation or survey with an employee that has resigned. The focus is to help the employer learn more about why employees choose to leave.

Exit Type
A record of whether an employee quit or was fired. This is used to find 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
Questions that ask a person to describe the jobs or other experiences they have had. This includes questions about what types of position they held, what their job duties were, and how long they worked in a position.

Exploitation
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.

Explosion
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.

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.

Extinction
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
Motivation that is created outside of the individual. This includes things such as money, rewards, or recognition.

Extraversion
A person who enjoys being outgoing or social. It is one of the Big Five personality traits. It includes being assertive and expressive. People with high levels of this trait are talkative and enjoy being the center of attention. They are energized by interacting with others. People low in this trait are introverts and prefer solitude. Introverts don’t like small talk and have a longer processing time before speaking.

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

F
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.

Facilitator
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.

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

Fair Housing Act
A federal law that prohibits discrimination in housing.

Falsification
When something is changed in order to deceive someone else.

Family
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 Educational Rights and Privacy Act (FERPA)
A federal law that protects the privacy of educational records. It ensures people access to their own records. They also have a right to request changes for accuracy.

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 and Medical Leave Act (FMLA)
A federal law that protects employee jobs in certain situations.

Family norms
The unique behaviors and actions that are expected in a family. They provide guidance on how individuals are expected to behave within and outside of the home. An example of this is the length of time an adult lives with their parents. Another example is the different meaning that being “on time” might have.

Family of choice
People who provide ongoing support to someone but are not biologically related (or connected through adoption or legal ties). They are connected through chosen bonds.

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
Family-centered support takes into account a person’s social context. It includes the most important people in a person’s life. It does this in ways preferred by the individual and these important others. It acknowledges that family may also want or need support. Family-centered support includes both “family of choice” (important people with no legal ties) as well as legal family members.

Fatigue
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.

Fee-For-Service
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 person—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.

Feedback
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 condition that can be caused when a woman drinks alcohol during her pregnancy. It affects the central nervous system and causes health conditions that are present at birth. These can include intellectual and/or developmental disabilities, poor motor skills, poor eye-hand coordination, and behavioral and/or learning issues. See also Fetal Alcohol Spectrum Disorder (FASD).

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.

Financial plan
A plan outlining financial goals. It may be part of an overall business plan.

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

Flatten the curve (of disease)
A public health strategy to slow the spread of pandemic illness. The goal is to give medical and social systems time to respond.

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

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

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

Fluoride
An element that helps to protect teeth from bacteria.

Flushed
A reddish blush on the face.

Focus Groups
Groups that involve bringing specific people together to inform others about important issues. Focus groups are usually structured around a set of issues or questions. The questions are used to gain the information the group needs. The group uses someone to guide the discussion.

Foster care
A situation in which for a period of time a child lives with and is cared for by people who are not the child's parents

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.

Freedom
(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.

Frequency
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.

Friction
The rubbing of one thing against another.

Friends
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.

Frontline supervisors (FLSs)
Frontline supervisors (FLS) directly supervise direct support professionals (DSPs). They also often manage services provided to people with disabilities. FLSs roles vary. They may hire/fire DSPs. They may train them. They may also work closely with people to plan and organize their services.

Frontline workers
People who do the work.

Frostbite
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. Those hours are divided by 40 hours to give the FTE for positions.

Function
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
Forms of communication that let people to meet their basic needs, including social needs.

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.

Fungal
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
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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G

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.

Gastrointestinal
Related to the stomach and intestines

Gastroenterologist
A medical professional who specializes in the body system that includes 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.

Gatekeepers
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.

Gay
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.

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

Gender-nonconforming
People who do not follow common or expected gender roles.

Generalization
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.

General Educational Development Test (GED)
A high school equivalency diploma.

Generator
A machine that produces energy. It can be used as an electrical power source.

Generic
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.

Genetic(s)
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.

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

Gender-nonconforming
People who do not follow common or expected gender roles.

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

Gerontologist
The study of aging. This includes older adults and the aging process.

Gestational diabetes
Occurs during pregnancy. This condition occurs when the hormones made by the placenta prevent the body from using insulin effectively. Glucose builds up in the blood instead of being absorbed by the cells.

Gestation
The time between conception and birth.

Gestures
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.

Gingivitis

Giardisis
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.

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

Glucose
Sugar

Glycemic index (GI)
Classification system that measures the effect that certain foods have on blood glucose, when compared to a set standard.

Go bag
A personalized emergency kit. It contains essentials a person needs if they must leave their home due to an emergency. It often has items for at least three days. This can include medications, money, food, water, clothing, and comfort items.

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.

Grooming
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.

Guardian
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.

Guardianship
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.

Guidelines
Criteria for how things should be done.

Gums
Pink tissue that surrounds the teeth in the mouth.

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

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Hallucination
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, where managers do not check in frequently. They believe people do best when they set their own direction and make their own decisions. This may or may not be a good approach for a situation.

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.

HBV
Hepatitis B Virus.

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

Health
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.

Healthcare 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 Insurance Portability and Accountability Act (HIPAA)
A federal act. It defines how entities must protect a person's right to privacy. It provides control over personal health information. Workers or employers that do not follow HIPAA laws can be punished. It can lead to lawsuits and fines or loss of employment.

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
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.

Herbal
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.

Herbalist
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.

High-tech
Technology that is complex or relatively new. It may include electronic devices. It may use digital applications. It usually has more than basic features.

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

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

HIV
See Human immunodeficiency virus (HIV).

Hmong
The language spoken by some people in parts of Southeast Asia. A member of a Southeast Asian ethnic group.

Holistic Approach
Viewing the person as a whole, especially in human services and health care. In the past, people were seen only for their diagnosis, history, or needs. This failed to see the whole person in the context of their social network, preferences, and gifts. It resulted in narrow and ineffective support. Practitioners in most fields now consider all aspects of the individual's personality and life. This includes culture, beliefs, strengths, existing supports, and preferences.

Home and Community-Based Services (HCBS)
A federal funding stream through the Medicaid program that provide opportunities for with intellectual or developmental disabilities to receive services in their own home or in the community rather than institutions or other isolated environments. Most states use these funds as an alternative to funds available through the Intermediate Care Facility for Individuals with Intellectual Disabilities program (ICF/IID) because the funds can be used more flexibly to meet individual needs.

Home and Community-Based Services (HCBS) Settings Final Rule
A federal rule that applies to Medicaid HCBS. It supports full access to the benefits of community living. It makes sure people are able to receive services in the most integrated settings.

Home and Community-Based Waiver
A federal funding stream through the Medicaid program that provides opportunities for with intellectual or developmental disabilities to receive services in their own home or in the community rather than institutions or other isolated environments. Most states use these funds as an alternative to funds available through the Intermediate Care Facility for Individuals with Intellectual Disabilities program (ICF/IID) program because the funds can be used more flexibly to meet individual needs. (See also Home and Community Based Services).

Homosexuality
Sexual behavior or attraction between people of the same sex.

Hormonal
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.

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

Hospice
Comprehensive comfort care given to a person after curative treatments for their illness or disease have been stopped. Hospice is provided for a person with a terminal illness whose doctor believes they have 6 months or less to live.

Hospice Care
Care that is typically provided to a person at the end of their life, when their life expectancy is likely to be six months or less. Hospice care can be provided in a person’s own home or in a hospice facility. Hospice care helps to support the person’s family and helps with the person’s physical, emotional, social and spiritual needs during their end of life.

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

HR (Human Resources) system data
A system that includes all the information an organization keeps about its employees. These systems often have data for calculating turnover rates.

Human immunodeficiency virus (HIV)
A bloodborne pathogen. It is passed by sharing certain bodily fluids. Untreated, this virus causes AIDS (acquired immunodeficiency syndrome). It can lead to serious illness and death. Current research indicates that the virus stays in a carrier for life. However, treatment is available and can help. Steps can be taken to protect others from being exposed.

Human resources (HR) professionals
An employee who focuses on employee policy and practice. They ensure employment laws are followed. They may also define employee development activities. They may review and manage benefits.

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 Services
A broad range of paid supports. These are meant to help people manage challenging life circumstances.

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.

Humility
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.

Hurricane
A severe and destructive storm. They most often begin over the western Atlantic Ocean. They are usually accompanied by rain, thunder, and lightning. They start over the water and can move to land.

Hurricane Katrina
One of the biggest natural disasters in the US. Hurricane Katrina happened in August of 2005. It hit Louisiana and Mississippi first but affected many states. There were more than 1,833 deaths as part of this storm.

Hydrated
Drinking the right amount of fluids, especially water.

Hydration
drinking the right amount of fluids, especially water.

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

Hyperglycemia
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.

Hypertension
High blood pressure.

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

Hyperventilation
Overly rapid breathing. This is usually brought on by stress or anxiety. It can cause dizziness and lightheadedness.

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

Hypomania
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.

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

Hypothesis
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.

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

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Icebreakers
Simple and fun activities that are done at the beginning of a meeting. They help the participants feel more comfortable and at ease.

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

ICF/IID
Intermediate Care Facilities for Individuals with Intellectual Disabilities. A federal funding source for services to people with intellectual disabilities, which was the first federal program targeted to monitor residential services for people with intellectual disabilities. ICFs/IID 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 there. They are guided by federal regulations.

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

Identity-first language
Language that places a disability-related term before the person in a phrase. Some people with disabilities prefer to use identity-first language. They see their disability as a part of who they are. For example, “A deaf person,” or, “An autistic person.” Not all people agree with the use of identity-first language. See also person-first language.

Identity theft
A crime where information that identifies a person is used without their permission. Examples of this include a person’s name, social security number, or credit card number.

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

Idiot
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.

Idiosyncratic
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.

IEP/IPP/IHP/ISP
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.

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

Image campaign
A plan for enhancing the image of a person, profession, brand, or entity.

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

Immigrant workers
People who have moved and work in another country.

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.

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

Immunization
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.

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

Impairment
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.

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

Implicit
Hidden or not conscious. Implied but not directly stated.

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.

Incest
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.

Incidents
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.

Inclusion
Being a valued part of communities that matter to you. Being able to access common, public environments. Being able to participate as an equal.

Inclusive
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.

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

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

Identity-first language
Language that places a disability-related term before the person in a phrase. Some people with disabilities prefer to use identity-first language. They see their disability as a part of who they are. For example, “A deaf person,” or, “An autistic person.” Not all people agree with the use of identity-first language. See also person-first language.

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. (The word “consumer” is no longer preferred language to refer to a person receiving services. However, it is still used by some agencies.) 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.

Indigenous
When capitalized, this term refers to the first persons to live in a region. Also called First Nations people. In the US, these communities include Native Americans, Alaska Natives, and members of tribal nations. When not capitalized, this refers to something that first appeared in a place. For example, indigenous plants of the rainforest.

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

Individualism
A focus on individuals over community or family.

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.

Individualized Education Plan (IEP)
A plan that explains how educational needs will be met for a student in a special education program. The plan represents the legal agreements.

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.

Individuals with Disabilities Education Act (IDEA)
A US law enacted in 1974. It requires a free public education for children with disabilities who are eligible. States and public agencies provide early intervention and special education based on this law.

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)
See IEP/IPP/IHP/ISP

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.

Individualized Education Plan (IEP)
A plan that explains how educational needs will be met for a student in a special education program. The plan represents the legal agreements.

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.

Individualistic culture
A culture that is oriented around individuals. Autonomy is valued. People believe that individuals should be able to make their own choices.

Industry
A distinct group of businesses.

Inequities
The differences or disadvantages that people face due to things they don’t control. Common inequities may be related to race, gender, or ability.

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, bacteria, or other microbe that can cause illness.

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 process of passing infection from one host to the next.

Infertility
The inability to reproduce or to have children.

Influence
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.

Informational interview
A meeting with a person who works in a job, field, or company you want to learn more about.

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.

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

Inherited
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.

Insomnia
The inability of sleeping.

Inside source
An inside source for finding new employees is one that knows the company’s culture and can answer questions about the job. Usually these are current or recent employees.

Institution
Large public or private residential program in which 16 or more people with intellectual and/or developmental disabilities live. Institutions are most often part of state-run hospitals or treatment centers and usually comply with the Intermediate Care Facility for Individuals with Developmental Disabilities (ICF/IID) standards set by the federal government. Institutions were once the only place where people with intellectual or developmental disabilities could receive residential supports. In many states, they are now the place of last resort for residential placement.

Institutional bias
The expression of valuing of one culture over others. This is expressed in the practices and policies of a system, community, or organization.

Insulin
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.

Integrated/Integration
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.

Integrated care
Care that ensures all medical and social services used by a person are coordinated. They are integrated around the person’s unique goals.

Integrity
Behaving the same in different situations.

Intellectual or developmental disability (IDD)
See intellectual disability (ID) and developmental disability (DD).

Intellectual Disability
Intellectual disability is a permanent condition of the brain. It is identified by three characteristics. The first is major difficulty in intellectual activities such as thinking, remembering and learning new things. The second characteristic is major difficulty when compared with people of one's own age in the skills of daily community living, such as communicating with other people, taking care of one's self or one's home, or performing other types of expected activities. The third characteristic is that these difficulties were first noticed while the person was still in the developmental period (it could be under the age of 18, or 21, depending on the criteria being used).

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

Intentionally
Doing something on purpose.

Intensity
How strong something is.

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.

Intentional communities
Communities or groups made up of people who choose to live together. These may be based on traits (senior living apartments). They may be based on preferred ways of living (ecovillage). In the disability community, intentional communities may be based on a disability type or other traits. These are being watched to make sure the people who live in them have control and direction over this option. Critics are concerned they may exclude people from the community at large.

Interdependent
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.

Interdependence
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
Teams that assist in the development and implementation of program and support plans for human services recipients. They also include ongoing review of these plans. The team members all have different and changing roles within the team.

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

Interference
To get in the way of, or impede.

Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)
A federal funding source for services to people with intellectual disabilities, which was the first federal program targeted to monitor residential services for people with intellectual disabilities. ICFs/IID 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 there. They 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 focuses on a person’s relationships with others.

Intersectionality
A concept developed by Kimberlé Crenshaw. The increase in discrimination when marginalized identities intersect. For example, Black women as a group experience more discrimination than either Black men or white women do.

Intersecting Identities
A concept that all people come with a variety of identities. These impact their ability to engage and be included in society. Some identities carry privilege. Others are met with exclusion or marginalization. This is not the same as “intersectionality” (see definition).

Intervention
A specific action to improve or change a situation.

Internship
A short-term position supervised by a qualified employee. This position may be unpaid. It provides the learner with supervised work experience.

Intimacy/intimate
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.

Intimidating
To make another person feel fearful or timid.

Intervention Plan
A written plan that lists the steps to take to change something. For example, a plan to reduce turnover and improve the quality of direct support.

Interviews
A meeting to get information from people.

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

Intrinsic motivation
Being driven by internal rewards. For example, a person works hard because it makes them feel proud.

Intuition
A sense of what’s right without analysis of details.

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

Inventory of current employee skills
A review of skills that employees currently possess. This is often compared to the skills needed. It is sometimes called a “skill gaps analysis”.

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

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

Isolation
Being away from others. This may be voluntary or not.

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J

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

Jaundice
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 accommodation
An adjustment to a job or work setting that helps a person with a disability to do their job.

Job Accommodation Network (JAN)
A resource that helps employers include people with disabilities in their work settings. They have online tools to support job accommodations. Employers can also talk to consultants to learn more.

Job aids
Instructions or other job tools that help remind the employee how to do specific procedures.

Job analysis
An information gathering process that finds the essential job skills, knowledge and attitudes that are needed for a job. It includes determining the job functions. It provides performance levels and physical capabilities. It also defines the job expectations and requirements.

Job carving
Breaking a job into components. Dividing tasks so that individual employees can succeed.

Job class
A group of jobs with similar roles and responsibilities.

Job description
A written description of an employee’s role and duties.

Job description review
A review of the written description of an employee’s role and duties.

Job market
The number of jobs open to workers. The type of work and number of employees an employer needs to operate.

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.

Just-in-time (JIT)
Doing something at the time it is needed. JIT training is provided right before a trainee needs to apply the skills. Skills are more likely to be used and retained when training is JIT.

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

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K

Keratoconus
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.

Ketoacidosis
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.

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

Kidney failure
When the kidneys are unable to filter waste products from the blood.

Kin
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.

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

Knowledge Acquisition
The act of learning new things.

Knowledge, skills and attitudes (KSAs)
The key elements of competencies. The KSAs refers to the knowledge, skills and attitudes needed to perform a job or task well. Knowledge refers to the information needed to perform a skill. Skills are things people can do. Attitudes refer to the beliefs and values needed to want to perform a skill with quality and accuracy.

Kwanzaa
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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L

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

Language
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.

Lanyard
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.

Latency
How soon something occurs after an event.

Law
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.

Leaders
People who guide others toward a common goal.

Leadership
The act of guiding people toward a common goal.

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
A belief that personal actions won't change things based on past efforts that were 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
The things a person should learn in training or in learning programs.

LEAP® model
A shared decision-making approach. It was created by Dr. Xavier Amador. LEAP stands for Listen-Empathize-Agree-Partner. It helps people with serious mental illnesses identify what is important to them. It helps others find common ground with the person. From there, they can agree on actions that may facilitate wellness.

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

Leavers
A term related to workforce retention data. These are employees who left during a specified period.

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
Actions you can defend in court.

Legally defensible questions
Legally defensible questions are developed to assure all candidates are treated fairly. Questions are written so as to not to discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Legislation
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).

Legislature
The law-making body of government.

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.

Lens
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.

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

Leukoplakia
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.

LGBTQIA+
An abbreviation used to refer to the lesbian, gay, bisexual, transgender, queer, intersexed, asexual, pansexual, genderqueer, agender, and ally community. The plus recognizes that these aspects may change with time as communities become more aware and articulate.

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.

Licensure
A set of guidelines with the power of law that must be met in order to be licensed.

Licensed clinical social worker
A social worker who is licensed to diagnose and treat mental health conditions.

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.

Light therapy
Use of a special light. This light mimics aspects of natural outdoor light. It may help improve mental health conditions.

Lifestyle
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.

Linguistic
Consisting of or related to language.

Literacy
The ability to read.

Lithium
A medication that stabilizes moods. It is often used to treat bipolar disorder.

Litigation
Taking legal action.

Lived experience
Life experiences in circumstances that others may study or have influence over.

Living will
A document that gives medical professionals instructions on how the person wants to be cared for during the end of life. It commonly includes medical directives on what treatments they want or don’t want.

LTSS employers
Employers that hire people to provide long-term services and supports (LTSS).

LTSS leader
A person who works toward positive changes in long-term services and supports (LTSS). These can be designated leaders. People in these roles may serve on boards. They may be high-level employees in LTSS organizations. They can be professional advocates or policymakers. They can also be people with lived experiences or frontline professionals.

Long COVID
Continuing health issues after a COVID infection has passed.

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.

Low-tech
Technology that is designed to be as simple as possible. It may also refer to things that are out-of-date.

Lozenges
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 history, beliefs, customs, traditions, behaviors, and experiences of the largest cultural group with the most influence within a multicultural society. This is often also known as the dominant culture.

Macrosomia
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.

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

Maintenance
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.

Maltreatment
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.

Mammogram
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 long-term services and supports (MLTSS)
MLTSS refers to the delivery of LTSS through capitated Medicaid managed care programs. See long-term services and supports (LTSS). See managed care.

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.

Management
A role in an organization. Managers provide direction to others. They focus on completion of organizational goals.

Mandarin
The language spoken in parts of China and Taiwan.

Mandate
Something that is 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.

Mania
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. They may overspend, have reckless sexual contact, and excessively use drugs. The person may be unable to sleep for more than a few minutes at time or at all. They may have extreme feelings of wellbeing. A complete loss of contact with reality can occur and the person may become psychotic.

MAPS
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.

Marginalize
Treat someone or something as if they are not important or have no power.

Marketing
Activities that promote services, products, or brands in a positive way.

Marketing plan
A plan that outlines a marketing strategy and goals. It may be part of an overall business plan. See also, marketing.

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

Masturbation
Touching and stimulating of the genitals for sexual pleasure.

Measurable
Can be tracked or counted. When related to SMART goals, this term refers to goals that can answer questions such as: How much? How many? How will you know when it has been accomplished?

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 Directives
These are instructions on what kinds of medical care the person wants during the end of life. The person can refuse or accept certain kinds of life-sustaining medical care such as a breathing machine, dialysis, or tube feeding.

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 older people who use services. 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 people who use Medicare are mandated by the federal government. (Definition from http://cpmcnet.columbia.edu/texts/guide/toc/all.html ) 10-14-2002

Medicare
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.

Medicaid
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.

Meditation
A practice of focusing the mind. Meditation can bring a sense of calm and balance. There are various forms of meditation.

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

Membership
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.

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

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

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

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

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 and chemical health professional
    A professional who assists people who have mental health or substance use disorders.

    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 mental health condition that may affect a person's thoughts, mood, or behavior. The condition affects the way they function in life, but it may or may not be permanent. Some examples of mental illness include depression, anxiety disorders, schizophrenia, and eating disorders. There are some mental health conditions like depression that are extremely common and may be undiagnosed. With proper treatment and support, many people who have mental illness can lead productive lives. People who have intellectual or developmental disabilities and mental illness are sometimes labeled as having a "dual diagnosis."

    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.

    Mentoring
    Mentoring occurs when a more experienced person guides a less experienced person. This can be a formal or informal relationship.

    Metabolic
    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.

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

    Met expectations
    When what was expected matches what is experienced.

    Metric
    A system of measurement that can be tracked over time. This can include values like weight and height. It can also include measures such as turnover and vacancy.

    Microaggressions
    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.

    Microbe
    A very small organism or germ. They include bacteria and viruses.

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

    Mindfulness
    Being fully aware of something. Being present in the moment.

    Mild Intellectual Disability
    A term applied to individuals who have I.Q. score from about 54 to 70 and substantial difficulties in at least two areas of adaptive behavior. Those difficulties must first appear during the developmental period (before adulthood). Boys are more likely to be identified with mild intellectual disability than are girls. 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.

    Minimum standard
    The most basic set of expectations for a situation.

    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.

    Misrepresented
    Writing something that does not accurately portray what has happened.

    Mission-driven
    A person or organization that actively works toward achieving their stated mission.

    Mission, Vision, and Values
    The guiding principles of an organization. The mission is a statement of the organization's purpose. The vision is the future that will exist if the mission is successful. The values are the underlying beliefs that help guide daily decisions so that the mission and vision are possible.

    Mitigate
    Take action to reduce harmful outcomes.

    Mitigation
    Action that reduces harmful outcomes.

    MMR vaccine
    A vaccine that protects against measles, mumps, and rubella. It is typically given during childhood. It may be need to be given again for a small group of adults.

    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.

    Mobility
    The capacity to move.

    Modeling
    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.

    Molestation
    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).

    Modification
    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.

    Monogamous
    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.

    Moron
    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.

    Motivation
    The driver of action. Motivation may be internal or external.

    Motivational interviewing (MI)
    A person-centered approach. It was developed by Stephen Rollnick and William R. Miller. MI helps people identify motivation. They explore ambivalence. They are supported to act on their own motivation for change.

    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.

    Mucous membrane
    A lining that covers organs of the body. It also lines some internal cavities.

    Multiculturalism
    The presence and acceptance of people from many different cultural or ethnic groups in a single society or group.

    Multidisciplinary team
    A group of medical and/or social service professionals from different backgrounds who work together. These teams always include the person. They sometimes include other chosen supporters (family, partner, friend, advocate, etc.). The purpose of the team is to use unique views to support the person’s best outcomes.

    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.

    Mutate
    A change in the nature of something.

    Mutually voluntary
    All people involved have agreed to participate.

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

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    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.

    The National Alliance for Direct Support Professionals (NADSP)
    The National Alliance for Direct Support Professionals (NADSP) is a national organization. They work to enhance the status, quality, and compensation of DSPs.

    The NADSP Code of Ethics
    A guide published by the NADSP. It is intended to help DSPs see common challenges in support and respond in an ethical way. See The National Alliance on Direct Support Professionals (NADSP).

    The NADSP E-Badge Academy
    A program managed by the National Alliance for Direct Support Professionals (NADSP). People can earn electronic badges. Badges are validation of competence. Badges can be accumulated to achieve professional credential levels

    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.

    National credentialing
    Credentialing that is validated at a national level rather than locally.

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

    Natural immunity
    Antibodies often develop when a person is exposed to a disease. This may help the person not to get sick from the disease in the future.

    National Frontline Supervisor Competencies (NFSC)
    A set of core competencies. They are based on a nationally validated job analysis for frontline supervisors. They reflect best practices in supervision. They apply across long-term services and supports.

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

    Nearsightedness
    A common vision condition in which a person can see the objects close to them clearly. Objects far away are blurry. Also called myopia.

    Needs Assessment
    A review that defines what is available and what is needed to accomplish something.

    Negative
    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.

    Neglect
    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.

    Network
    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.

    Networking
    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.

    Neurodiversity
    Differences in the way individual brains function. 

    Neuroticism
    A person’s tendency to be negative or act in a manner associated with distress or dissatisfaction. It is one of the Big Five personality traits. Neuroticism is characterized by sadness, irritability, and emotional instability. People with this trait are stressed and easily upset. They may have dramatic shifts in mood and irritability. Low levels of this trait include being relaxed and emotionally stable. These people often deal with stress well.  

    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.

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

    Neurologist
    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.

    Neurologist
    A doctor who specializes in brain and nervous system disorders.

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

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

    Neurotypical
    A term used by some people (e.g., those within the autism community) to refer to people whose neurological development is typical.

    New hire bonus
    Money given to a new employee for accepting a position. Also called sign-on or hiring bonus.

    Niche recruitment
    Recruiting people from groups with shared traits or employment needs.

    Noncompliance
    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.

    Non-binary
    A term used when a person does not identify with only one or either of two genders (male or female). They are outside the gender binary.

    Non-directive
    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.

    Non-speaking
    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.

    Nonspecific
    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

    Non-speech
    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.

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

    Non-Standardized surveys
    Surveys that have not been tested for reliability or validity.

    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.

    Nonverbal communication
    Any way of communicating from one individual to the other that does not include speech. Examples: hand gestures, facial expressions.

    Norepinephrine
    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.

    Norepinephrine reuptake inhibitor (NRI)
    A drug that increases norepinephrine in the brain. It may be used to treat mental health conditions.

    Normalization
    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.

    Norms
    The scores or answers given by typical respondents. For example, a job satisfaction survey may show how direct support professionals typically reply.

    Notarize
    When a document is signed by a person (a notary) to make it a legal and binding document.

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

    Nursing
    When a baby drinks mother’s milk from the breast.

    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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    O

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

    Objective
    Facts that are not affected by personal bias or personal feelings.

    Obligation
    Something owed or agreed to.

    Observed
    When a person sees something occur.

    Observable Measure of Performance
    A behavior you can see that tells you how well a person can do something.

    Observation
    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. http://www.osha.gov/

    Occupational safety
    Safety at work. Focused on preventing injuries and incidents while at work.

    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.

    Official transcripts
    A record of academic progress. This must be provided by an educational institution. They must use a secure process.

    Ombudsman
    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. http://www.ltcombudsman.org/

    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 http://www.hhs.gov/ocr/olmintro.htm

    Omission
    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
    Using an employee’s actual work to assess how well they are performing.

    Onboarding
    Structured processes to help new employees be successful. These help employees contribute as soon as possible. They also help them connect to others and feel comfortable in their new position.

    Oncologists
    A doctor who specializes in cancer treatments.

    One-page description
    A person-centered, one-page description used for a specific purpose. It highlights what is most important to a person. It includes their strengths and what others like and/or admire about them. It describes how to best support them. It is unique to the individual. The information is shared from their perspective.

    Ongoing support
    Support that has been provided for a long time. The type or amount of support may vary but it is usually expected to continue at some level.

    Open-ended questions
    Questions that cannot 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.

    Open-minded
    Being open to new ways of thinking or understanding.

    Openness
    A person’s willingness to be open-minded and flexible in a situation. It is one of the Big Five personality traits. Openness includes being insightful and having a variety of interests. People with this trait are often creative and open to trying new things. They may also think abstractly about concepts. People with low levels of this trait don’t like change or new ideas.

    Operational Definition
    An operational definition describes the meaning of a concept by showing how the concept is measured and applied in a particular setting. It gives a precise meaning to a word that can be understood by two or more people. It defines how a word or phrase is used when it is applied in a specific context. This means that a word may have different meanings when used in different situations. It should also clarify the procedures used to measure and apply a concept. Other people must be able to repeat the procedures.

    Opportunity
    A situation or circumstance that allows a person to do something positive or enriching for him/herself.

    Opthamologist
    A physician who specializes in the diagnostic and treatment of all conditions relation to the eyes.

    Optometrist
    A professional who specializes in eye care and vision.

    Oral
    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.

    Organization commitment survey
    A survey of employees’ perspectives. This often focuses on how committed employees feel to an employer. It often seeks to identify what influences employee commitment.

    Orientation practices
    Ways of welcoming new hires. Helping employees get adjusted to new jobs.

    Originators
    The people who started something.

    Orthodontist
    A dental surgeon who specializes in straightening teeth and oral surgery.

    Orthopedic surgery
    Surgery involving the bones or muscles.

    Orthotic
    A support, brace, splint, or other device used externally to support or align a body part.

    Osteoarthritis
    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.

    Osteoporosis
    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.

    Outbreak (of disease)
    A small, regional occurrence of more cases than expected of a disease.

    Outcome
    The result or consequence of something.

    Outreach
    Efforts to increase community awareness of services. The purpose is to ensure people who need these services are aware of them.

    Outside (External) Agencies
    Agencies that are not connected to the agency that provides supports, such as Adult or Child Protection agencies.

    Outside source
    An outside source for finding new employees is one that cannot credibly answer questions about jobs or the company. This is usually because they are static sources such as job posting.

    Overtime.
    Time worked past a maximum that is set for an employee role. These hours are often paid at a higher rate than base pay.

    Over-the-counter medication.
    A medication that is purchased without prescription.

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    P

    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.

    Pairing
    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
    Care given to those with a serious disease or at the end of life. This type of care treats disease symptoms and helps people navigate the various difficulties related to the disease or the end of their life.

    Panic attack
    A sudden sense of intense fear when there is no real danger. Panic attacks can be very frightening. People might fear they are losing control, having a heart attack, or even dying.

    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.

    Pandemic
    A disease that is serious and quickly spreads worldwide.

    Pap Smear
    A test of the woman's cervix to check for cancer.

    Paradigm
    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.

    Paranoia
    Exaggerated suspiciousness. Irrational or delusional thoughts of fear or anxiousness.

    Paraphrasing
    Restating something in your own words.

    Paraprofessional/s
    Another name for direct support professional. Most often used to describe people in direct service roles in educational settings.

    Parasites
    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.

    Participant
    A person who participates in something. Often a term used to indicate that the person receives direct or indirect services or supports.

    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. In some places this may be called "self-directed" or “consumer-directed" supports. (The word "consumer" is no longer preferred language to refer to a person receiving services. However, it is still used by some agencies.)

    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. See also: consumer-directed. (The word "consumer" is no longer preferred language to refer to a person receiving services. However, it is still used by some agencies.)

    Participant Observation
    A process for carefully watching a given situation, sharing the results with others and learning together to make changes.

    Participation
    Engaging with others, having a wide variety of relationships being known and knowing others, being part of the event--not just an observer.

    Participatory management
    A management style. It is designed to empower employees. It allows them to participate in and take ownership of organizational decisions.

    Partnership
    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.

    Paternalism
    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.

    PATH
    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.

    Pathogen
    anything that can cause a disease (especially micro-organisms such as bacteria, virus or fungus).

    Pediatrician
    A licensed health care practitioner who works with infants and children and their specialized diseases and conditions.

    Peer
    A person who is designated as equal to another by some status.

    Peer mentoring
    Use of peers within a work setting to mentor other employees in similar positions. Mentors may focus primarily on social aspects. Or they may be more skills-based.

    Peer support
    Support from a person who has a similar background or experiences as you. See also peer support group.

    Peer Support Group
    People of approximately equal social status who have reciprocal relationships; friends, colleagues or others who have common bonds.

    Penis
    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.

    Pension
    A payment made to a person on a regular basis (usually a fixed sum) after the person's retirement from employment.

    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.

    Perception
    How a person understands something or interprets something.

    Performance appraisal
    Review of an employee’s job performance.

    Performance coaching
    Coaching is a supervisory approach. It supports employee to self-reflect. This can be used to improve performance.

    Performance indicators
    Benchmarks (points of reference) or measures of performance in a work setting, that help clarify which duties an employee can perform and which they may need more training or support to be able to achieve.

    Performance management
    Ongoing assessment of and support for job performance.

    Performance reviews
    Formal evaluations of job performance. These are usually in writing and signed by an employee and supervisor.

    Peri-anal
    The area of the body between the genitals and the anus, including the anus.

    Pericardial Fluid
    The fluid that surrounds the human heart.

    Perimenopause
    The stage prior to menopause (see menopause).

    Perineal
    Relating to the perineum, which is the area between the anus and genitals.

    Perineum
    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.

    Periodontitis
    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.

    Perseveration
    Continually repeating a thought or an action such as getting stuck on a topic.

    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.

    Person-Centered
    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 plans
    A plan developed through a self-directed and voluntary process. It helps people express and explore their strengths, gifts, needs, and desires. People decide who helps them plan. They decide with whom they will share the information on the plan.

    Person-centered practices
    Practices that support a holistic and person-driven approach to services and supports. This includes knowing what is important to people, as well as for them. These practices elicit strengths as well as needs. They support individual preferences and goals as the basis for organizing supports. They include system reform when needed. This may include changes to things like policies, funding, professional training and standards, and community accessibility.

    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.

    Person- or People-First Language
    Language that places the person before a condition or label in a sentence. It is meant to be respectful and distinguish the person from being identified by ability or condition. For example, “A person with diabetes,” not, “A diabetic.” Not all people agree with the use of person-first language. See also identify-first language.

    Personal assistance
    One person assisting another with tasks individuals normally would perform for themselves if they did not have a disability.

    Personal care attendant
    A person who assists others with daily living tasks. These positions may also be called personal care assistant, home health aide, homemaker, caregiver, or companion.

    Personal career profile
    A short description of who you are, what your values are, and the type of work that represents the best fit for your skills.

    Personal culture
    The accumulation of personal experiences and choices that lead to a person's understanding of appropriate behavior and lifestyle.

    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.

    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)

    Personal reference
    A contact provided who can speak to a person’s character.

    Personal style inventory
    A self-assessment tool. It can show information about social traits, attitudes, and motivations. It can show strengths and weaknesses. It can help to find jobs that are a good fit.

    Personality traits
    A person’s actions, attitudes, or behaviors, that help to define their character.

    Presumed competency
    To assume a person has the capacity to think, learn, and understand regardless of appearances. An assumption that people are inherently capable. They may, however; need the right supports and systems to help them succeed.

    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.

    Pharmacist
    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.

    Phlebitis
    The inflammation of a vein.

    Phobia
    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
    What a person is able to do physically. Often this references a requirement for a job. For example, a physical capability for the job might 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 people. 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.

    Pica
    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

    Piety
    Showing devotion or reverence to God.

    Pilot program
    An initial, small scale program. It is used to assess costs, benefits, and possible barriers. It is used to see if a project is feasible on a large scale.

    Plaque
    A layer of bacteria on the teeth that causes tooth decay and gum disease.

    Pleural Fluid
    The fluid that surrounds the human lungs.

    Pneumococcal
    A bacteria that causes respiratory disease, often pneumonia.

    Pneumonia
    An infection in the lung often caused by a bacteria or virus.

    Podiatrists
    A professional who specializes in treating the foot or feet.

    Pointing
    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").

    Poisonous
    An element of a plant or substance that may cause or may be capable of causing death or illness if taken into the body.

    Policies
    The way things are handled.

    Policymaker
    A person who develops and implements public policy.

    Polio
    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.

    Polypharmacy
    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.

    Portability
    The ability to carry something with you. Portability of training means that the training you completed for one employer can cover requirements at another job.

    Portfolio
    A collection of work by an individual that is placed in an organized manner that demonstrates the person's abilities and talents.

    Positive
    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 Behavior Support
    Strategies that use behavioral science to improve a person’s quality of life. This approach considers behavior as communication. It analyzes persistent but unclear behavior to understand what need it is meeting for the person. It helps people find other ways of getting their needs met when their current choices are harmful or disruptive. It does so in a person-centered way.

    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
    See Generator.

    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.

    Pre-diabetes
    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.

    Pre-teaching
    Introducing concepts or skills before doing them.

    Precautions
    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.

    Predisposition
    An increased likelihood that something will happen given a set of circumstances.

    Preferred employer
    An employer with a reputation for being a good place to work.

    Preferred Provider Organizations
    People 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.

    Preferences
    Things that one prefers or likes best.

    Pregnancy
    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.

    Prejudice
    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
    Getting ready.

    Presbycusis
    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.

    Presbyopia
    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.

    Presence
    Participating in all settings where people without disabilities are present, including classrooms, board rooms, businesses, neighborhoods, and community events.

    Pressure sore
    Damage to skin and underlying tissue as a result of prolonged pressure on the skin.

    Prevalence
    The percentage of a population that has a condition at a given time.

    Preventive care
    Care that aims to stop something from happening. This may include routine health screenings.

    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.

    Privacy
    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.

    PRN
    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.

    Proactive
    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
    Questions that are used to gain more information or details.

    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.

    Procedures
    Standard ways in which a situation is handled.

    Profession
    Work that requires special training to acquire the skills, knowledge and ethical principles of the occupation.

    Professional
    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.

    Professionalism
    Acting in line with professional standards and ethics.

    Professional code of ethics
    Guidelines for members of professional groups. These are meant to protect people who use these professional services. They can also help protect the professional and the broader community.

    Professional development
    Activities related to improving skills and knowledge. These are based on what is important to individual employees.

    Professional Standard
    An expected practice by professionals working in a field.

    Profound Intellectual Disability
    A classification when a person’s I.Q. score is estimated between 0 and about 20. There are a wide number of skills among people at the high and low ends of the profound intellectual disability range, but all people within this range have major limitations in all areas of adaptive behavior. Most people with profound intellectual disability are identified as having major disabilities in their first year of life. They often also experience significant physical and health conditions.

    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
    This is a process for managing employees who are underperforming. It is clarifying expectations in a formal way. Expectations are written and shared verbally to ensure the employee understands. This process makes clear what the consequences are for continued performance concerns. It also clarifies what support will be given to the employee. There may be many or a few steps to this. The process continues until the employee is performing as expected or let go.

    Promiscuous
    Having sex with different people in a short period of time.

    Promising practices
    Practices that have shown some successful outcomes and measurable results. However, there is not yet enough research to show they could be effective on a large scale.

    Promotion
    Being hired into a position with more responsibility. These positions typically also have higher pay.

    Prompting
    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 development
    Activities related to improving skills and knowledge. These are based on what is important to individual employees.

    Professional Practice
    Working in a manner that is effective, skilled, organized, and demonstrates commitment to the chosen work.
    v

    Prostate
    A gland that is located at the end of the man's urethra.

    Protected class
    A group of people protected from employment discrimination. This is based on characteristics such as religion or age.

    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: http://www.protectionandadvocacy.com/

    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 Factors
    Characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor's impact. Protective factors may be seen as positive countering events. Some risk and protective factors are fixed: they don't change over time.

    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.

    Proximity
    The location of one thing to another. A characteristic of a positive social relationship: being physically close enough to be friends.

    Proxy
    A person who has legal authority to represent someone else. For example, a healthcare proxy expresses a person’s wishes about their care and is able to make healthcare decisions for them.

    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.

    Psychiatrist
    A doctor who specializes in mental and emotional problems.

    Psychoeducation
    A movement in mental health focusing on educating people who use services about their mental health condition. Psychoeducation provides accurate and realistic education about the disease, symptoms, treatment, and reality.

    Psychological
    Anything related to an individual's mind or emotions.

    Things that have to do with the mind such as thoughts, feelings, and moods.

    Psychologist
    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.

    Psychological safety
    A sense of being safe to express oneself without negative consequences.

    Psychopharmacologist
    Medical doctors who have studied the use of medications for treating mental health conditions. This includes any physician or psychiatrist who treats people with psychotropic medication. They have knowledge of the effects of drugs that may be used to treat mental health conditions. They have an understanding of drug interactions and possible side effects.

    Psychosis
    A severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality.

    Psychotherapy
    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.

    Psychiatric advance directive (PAD)
    A legal document. It outlines preferences for mental health treatment in an emergency. Not all states recognize PADs. In those states, people can use a general health care directive.

    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 (or psychotropics)
    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.

    Puberty
    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.

    Public aid
    Government sponsored assistance program. Examples of public aid include access to affordable housing or nutritional assistance.

    Public health crisis
    When the health of large part of a community is being seriously harmed or is at risk.

    Public health department
    Governmental office. They are responsible for improving the health of the community. They do this by developing regulations. They also enforce regulations. This is often done through licensing. They develop public policy. They define best practices. They also support research and education on public health matters.

    Public service announcement
    A form of messaging intended to raise public awareness of an issue.

    Punisher
    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.

    Punishment
    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).

    Pupil
    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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    Q

    QR code
    A specially designed square image in print that contains data. When scanned by a QR code reader, a link to information such as a website appears.

    Quackery
    False promises of medical expertise or medical benefits. A person who practices quackery is referred to as a quack.

    Qualified Intellectual Disability Professional (QIDP)
    A designation that generally requires a support professional to meet specific criteria. First, the person must have a Bachelor degree in a human service-related field. Second, they must have at least one year of experience working directly with people with intellectual and/or developmental disabilities. Each state applies the federal ICF/IID regulations differently for this role

    Qualified Mental Retardation Professional (QMRP)
    This term is no longer used. Pursuant to Rosa’s Law, all references to Mental Retardation are changed to Intellectual Disability. See Qualified Intellectual Disability Professional (QIDP).

    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.

    Quantify
    To measure or to make measureable. To express the value of something in a numbers.

    Quarantine
    To be required stay away from others in order to contain illnesses.

     

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    R

    Race
    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.

    Radiologist
    A doctor that specializes in taking and interpreting X-rays. These are pictures of the inside of the body.

    Railings
    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.

    Rape
    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.

    Reasonable accommodation
    Any change to an employment practice that gives a person with a disability equal opportunity or helps them do the core tasks of a job. This can include changes to an application or hiring process. It can include making changes to a job or the way it is done. It can include changes to a work setting. An accommodation is considered reasonable if it does not create an undue hardship for the employer or a direct threat to self or others.

    Receptive language
    Understanding or comprehension of spoken, written, or sign language.

    Receiver
    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.

    Recognition
    A strategy for acknowledging DSPs and other employees for doing their jobs well. It can highlight special accomplishments. It is a way to celebrate employees’ years of service. It can also be used to thank people who share creative ideas.

    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
    Healing and repair after loss.

    Recovery
    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.

    Recovery-oriented
    Focusing on people regaining skills, abilities, and roles they previously had or developing new ways of achieving life satisfaction.

    Recruiter
    A person whose role is to find applicants for open job positions.

    Recruitment
    Finding new workers. Finding new people for a cause or effort.

    Recruitment and hiring bonuses effectiveness analysis
    An assessment of whether or not recruitment or hiring bonuses offered by an employer increase retention or recruitment success. It looks at the new hires who left during the first six or twelve months. It compares the number of new hires who left who earned a bonus to the number who did not earn a bonus.

    Recruitment source cost-benefit analysis
    This is an analysis of recruitment sources effectiveness. It has several parts. First, it looks at the proportion of applicants who heard about the job from each source. Second, it examines the proportion of people actually hired who heard about the job from each source. Third, it looks at how long recruits from each source remained in their jobs. This helps identify which sources produced the most qualified and good match applicants.

    Recruitment card
    A small card that people who are interested in positions can take with them. These have information about the employer.

    Red Cross
    An organization that provides relief services. They help during disasters. They also help to prepare for emergencies.

    Reference
    A source of information.

    Referral bonus
    Money given to a current employee for referring a successful new hire.

    Refrigeration
    The act or process of cooling a substance to make it frozen or cold. A way to preserve items.

    Regional recruitment consortia
    A consortia is a group of organizations that work together. This type of consortia works to increase the interest of potential employees in their field.

    Registries
    A system that keeps information about people. Some are required (such as sex offender registries). Others are voluntary (such as emergency response registries). They can be used by responders in an emergency to meet people’s unique needs.

    Regulated
    Kept in control. Entities or procedures for which there are regulations.

    Regulation
    A description of standards related to rules or laws. These are developed by governmental agencies.

    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 model
    An orientation to delivering supports to people with disabilities or other service needs that focuses on correcting the identified problem or deficiency.

    Rehearsing
    Practicing something until you can do it well.

    Reimbursement
    Money given to compensate for past expenses.

    Reinforcement
    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.

    Reinforcer
    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.

    Relational
    Connections between things or people.

    Relationship
    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.

    Relevant
    Things that matter or are important. This can be subjective. When related to SMART goals, this term refers to goals that are identified as worthwhile by the person for whom the goal is being written.

    Reliability
    This is the extent to which a test produces results that can be replicated. This is assessed in a variety of ways. For example, the same person can complete the test more than once. It can also be tested by having two different people respond to the items referring to the same subject.

    Reliable
    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.

    Remedy
    Something that is done or taken to cure a condition or illness.

    Remedial
    Doing something to correct a problem.

    Remote
    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).

    Reporting
    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.

    Reprisal
    Take action against someone because of their behavior.

    Reputation
    Characteristics by which someone (or an organizations) is known. These may or may not be based in fact.

    Respect
    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."

    Respiratory
    Related to breathing and the use of oxygen in the body.

    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.

    Respiratory tract
    The parts of the body that help with breathing.

    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.

    Respiratory therapist
    A professional who specializes in the treatment of the heart and lung (cardiopulmonary) system. For example, they help with treating asthma or pneumonia.

    Responding
    What is done when something happens.

    Response rate
    This is the number of people who complete a survey out of the total number of people who were asked to complete it.

    Responsibility
    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.

    Retention
    Keeping or holding on to something.

    Retention basics
    A core set of data related to workforce. This includes employee turnover and vacancy rates. It also includes key tenure groups.

    Retention bonus
    Money given to employees who have stayed for a period of time.

    Restraint
    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

    Retina
    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.

    Retinopathy
    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.

    Retirement
    The time in a person’s life when they start to reduce or stop their paid work. This typically happens in older age.

    Retirement plan
    Plans meant to help people save and invest money to sustain them during retirement.

    Reverse 911
    A public alert system. This system uses registries of phone numbers tied to a location to send messages. They send voice or text messages about emergencies and what to do.

    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.

    Rewards
    Something given to another person. These are meant to encourage them or acknowledge them. Examples of rewards can include praise, money, or a gift.

    Right
    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.

    Risk
    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.

    Ritual
    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.

    Robbery
    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.

    Role-Play
    To assume or represent in a drama.

    Rotary
    A network of service clubs that help to address local and global concerns.

    Route
    A path or road for travel.

    Routine
    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
    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.

    Rubric
    A guide that places performance in a category.

    Rule
    A set of expectations. Administrative rules are a set of expectations developed by government agencies. These have to be followed like a law.

    Rule of Thumb
    A general guide on how to do something.

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    S

    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.

    Safety net
    A safeguard against a possible hardship or misfortune.

    Salmonella
    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
    A strategy about who should be asked to participate in assessments. This is a balance between resources and information needed. You want to ask enough people make sure you get a reliable sample. However, you need not ask every person to participate.

    Satiation
    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
    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.

    Scope of practice
    The services that a qualified health professional is knowledgeable in and skilled to perform. This is often defined by a license or certification.

    Screening
    A review of information for a purpose of deciding next steps.

    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.

    Screen reader
    A software program that helps people who are blind or have low vision to read text on a computer or phone screen. It does this with a synthesized voice or braille display.

    Score guide
    A guide that provides a score for specific criteria.

    Scrotum
    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.

    Seclusion
    Isolating people from activities, things, and/or other people. Seclusion for the purpose of punishment is not preferred. In many situations, it is illegal. It is sometimes allowed for safety.

    Second opinion
    Seeking advice from more than one expert on the same issue.

    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.).

    Section 504 Plan
    This is part of the US Rehabilitation Act. It prohibits discrimination against people with disabilities in certain public programs.

    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.

    Sedentary
    Lacking exercise or activity.

    Segregated
    An environment where only people with a certain label or defining characteristic work, live, or play.

    Segregation
    A separation from others. This may be due to social policy or community norms. It may also be a response to containing illnesses.

    Seizure Disorder
    A disorder that includes seizures.

    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.

    Selection
    Choosing from options.

    Selection team
    Using two or more people to help make selection decisions in a hiring process.

    Selection strategy
    A method that helps to identify the best applicant for a job.

    Self Abuse
    Behavior that is injurious to one's self: physical, mentally, emotionally, psychologically, spiritually, financially, etc.

    Self-Administer
    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.

    Self-Advocacy
    The act of standing up and speaking out for oneself.

    Self-Advocate
    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-awareness
    The ability to recognize what drives your actions and thoughts.

    Self Care
    Practices that support one’s health and well-being. Some examples of self-care include getting enough sleep or exercising. It could also include spending time with friends and listening to music. It can include taking time to clean your environment or pay your bills.

    Self-care skills
    Skills related to taking care of oneself. (See Self-care)

    Self-Determination
    Deciding for oneself how to live.

    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
    Self-direction is a right that adults have regardless of ability. Self-direction is the expression of what is important to a person. Some people may need support to do this. They may need help to understand what options they have and the potential outcomes of actions. They may need support to identify and balance what really matters to them or how to advocate for themselves.

    Self-Directed/High Performance Teams
    A team that has the authority to make decisions. These are decision that would typically be made by management.

    Self-Esteem
    A confidence and satisfaction in oneself.

    Self-employment
    A type of work in which a person is not an employee of another business. They could have their own business or be a contractor who provides services to other businesses.

    Self-evaluating and/or opinion questions
    Questions that ask the person what they think about something. This gives information about the person’s likes and dislikes. It also gives information about their strengths and weaknesses. These questions give information about what a person's goals, values, and philosophies are.

    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-Isolation
    To keep oneself separate from others. When used in reference to pandemics, it means to voluntarily keep yourself apart from others in an effort to slow or stop the spread of a pandemic illness.

    Self-management
    The ability to effectively manage aspects of one’s life. This can apply to thoughts and feelings. It can apply to actions and choices, as well as other areas of life. See self-regulate.

    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.

    Self-reflection
    Assessing your own thoughts, feelings and/or behavior.

    Self-regulate
    The ability to manage your behavior, thoughts, and emotions in a way that is productive or useful.

    Self-respect
    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.

    Seminal
    A critical or highly influential event, publication or research that forms the foundation of future related work .

    Seminar
    An intensive study group, or specialized conference.

    Sender
    The communication partner who is transmitting the message.

    Sensory
    Information processed by the physical senses. This includes sights, sounds, smells, textures, and so on.

    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.

    Serious Illness
    A condition with a high risk of death, such as heart disease or kidney failure. It often limits a person’s quality of life and daily functioning by restricting eating, bathing, dressing, toileting, transferring, or walking. This type of illness often causes stress and a greater need for health care. Serious illness raises questions about planning for the future and a person’s end of life wishes.

    Serotonin
    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.

    Service
    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 Providers
    People or agencies that provide needed services. Disability service providers specifically meet the needs of people with disabilities. These needs are not typically met in other ways in the community.

    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.

    Service system
    The set of services, processes, and professionals available to people with support needs.

    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.

    Severity
    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.

    Shaping
    Prompting and rewarding behaviors that are more like the desired behavior at each step, with the desired outcome being to teach a new behavior.

    Shared decision-making
    An approach where professionals or other people work with a person to support self-direction based on informed choice.

    Shelter
    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.

    Shock
    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 group of hereditary blood disorders.

    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.

    Sigmoidoscopy
    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
    Asking questions of a person that seeks information about actions they will take in certain situations. These help to understand a person's values and beliefs. They help to understand a person's ethics and attitudes.

    Skill
    An ability that usually requires instruction and practice in order to achieve.

    Skill Gaps
    The difference between skills an employee needs and the skills they currently have.

    Skilled Questioning
    Skilled Questioning is the art of asking questions to get good information from someone.

    Slang
    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.

    Sleep-Wake Cycle
    The pattern of time throughout a 24-hour day that is spent awake or asleep. For a person, 16 hours of their sleep-wake cycle is usually spent awake (during the day) and eight hours asleep (during the night).

    SMART goal
    Goals are things people want to accomplish. SMART is an acronym that is used to make sure goals are written in a useful way. It stands for: Specific, Measurable, Attainable, Relevant, and Time-Limited.

    Small business ownership
    A privately owned business that has fewer employees and earns less revenue than larger companies. These limits vary based on the type of business.

    Smegma
    Dead skin and oils that collect under the foreskin and can cause infection if it builds up.

    Sobriety
    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 Concept
    An idea that has been created and accepted by the people in a society Class distinctions are a social construct.

    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 determinants of health (SDOH)
    Social, economic and environmental aspects of a person’s life that affect their health and wellbeing.

    Social Distancing
    Social distancing measures are taken to restrict when and where people can gather to stop or slow the spread of infectious diseases. Social distancing measures include limiting large groups of people coming together, closing buildings and canceling events.

    Social Equity
    A recognition of unfair differences between social groups. There are excessive barriers to fair treatment, access, opportunity, and advancement for some. A focus on equity tries to identify unfair barriers. It seeks to eliminate them. It supports the inclusion of everyone in the benefits of society.

    Social media
    Technology applications for sharing information. They can be loaded onto phones, tablets, or computers. They allow people to share things such as comments, music, or photos. They also allow users to react to what others have shared.

    Social Isolation
    When an individual is kept from interacting with others (peers, family, etc.) because of his/her individual differences.

    Social model of disability
    Identifies systemic barriers, derogatory attitudes, and social exclusion which make it difficult or impossible for individuals with impairments to reach their valued goals.

    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
    A socially accepted set of behaviors that people adopt when they are in certain positions. Examples of social roles include parent, friend, employee, board member, and so on.

    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 http://ssa.gov/ 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.

    Social Story
    A story that illustrates a social situation and possible outcomes. It is used as a teaching tool. It can be useful for people who need time to process an event. It helps people think about or practice handling a situation. This can be done before or after an actual event.

    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.

    Spastic
    (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.

    Special education services
    No cost services to children with disabilities in schools. Qualification is based on a definition in federal law. (See the Individuals with Disabilities Education Act.)

    Specific
    Detailed and to the point. When related to SMART goals, this term refers to goals that are clear, simple, and make sense for the person.

    Speech
    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.

    Sputum
    The substance that a human coughs up after coughing or choking.

    Staff competence
    This is a measure of whether the staff member can perform the tasks required of them on the job.

    Staff satisfaction
    This is the opinion an employee has about the organization. This includes how they feel about different 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.

    Stakeholders
    People who are affected by something and who can affect it.

    Standard occupational classification
    A designation by the US Bureau of Labor Statistics. It defines a job for the purposes of tracking trends.

    Standard of living
    The level of wealth, resources, and/or necessities available to a person.

    Standardized surveys
    A survey that has been tested for reliability and validity. The norms have been set.

    Standardized testing
    A test that is designed to assess and rank individuals in a fair way. These must be conducted and scored in a prescribed way. While standardized testing is used to ensure impartiality, there is concern that they still contain biases.

    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.

    Stayers
    A term related to workforce retention data. These are employees who are working for the employer on the date of calculation.

    Stereotype
    the belief that because some individual members of a group have certain characteristics or traits, all members of the group have them.

    Stereotyping
    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.

    Sterilization
    Medical procedures or interventions that prevent a person from being able to reproduce (i.e father or bear children).

    Stigma
    The negative way others view a person because of their difference that isn’t culturally valued. Stigma can have a profound effect on a person’s ability to make friends because it can reduce others’ interest or desire to interact with the person.

    Stimulant
    A drug that is used to increase attention, alertness, and energy. This is a common treatment for attention-deficit/hyperactivity disorder (ADHD).

    Stimuli
    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.

    Stipends
    A type of financial support. This is typically given for completing certain tasks.

    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's direction supports and is connected to the organization's goals.

    Strategic plan
    A description of what an organization wants to do in the future. It also describes the strategies that will be used to do this. It may be part of an overall business plan.

    Strengths
    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.

    Stress
    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.

    Stroke
    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.

    Stretch opportunities
    Taking on tasks or projects that require learning and growth to accomplish.

    Structure
    A constructed building.

    Structured observation
    Watching a situation for a specific purpose and with a plan.

    Structural
    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 behavioral interviewing
    An interviewing style that asks questions about an individual’s past behavior in a situation. It aims to predict future behavior. It may be called “behavioral-based interviewing.” For example, “Tell me about a time you disagreed with a coworker. What was the disagreement and how did you handle it?”

    Structured questions
    A set of standard questions. These are used to easily compare responses between people.

    Subjective
    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.

    Substance Abuse Recovery
    A process of change through which people improve their health and wellness. It includes living self-directed lives and striving to reach their full potential.

    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.

    Sudoku
    A game where numbers are arranged in certain patterns.

    Suicide
    Taking one's own life. Intentionally killing oneself. Usually this is a result of untreated or unresponsive depression or similar mental health condition. .

    Sugaring
    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.

    Supervision practices
    The ways in which supervisors guide and manage employees.

    Summarizing
    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 http://ssa.gov/ 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 http://ssa.gov/pgm/getservices-change.htm. Another resource you may find helpful is the online benefits planning Estimators found at http://www.db101.org/. This can help a person prepare for changes in work or benefits, or to learn how benefits rules apply to the person.

    Support
    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 group
    A group of people with similar life experiences. The group may be led by professionals or peers. It offers people a chance to process their experiences in a safe environment with others who are more likely to understand as a result of having shared experiences. See peer support.

    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 documents outlining the details of supports, services, activities, methods, and resources needed for a person with disabilities to achieve their goals. These goals are based on a person's dreams and preferences. The plan details who is responsible to provide supports. It also explains how, when, and where supports will be provided. A person and their support team develop the plan using a person-centered approach.

    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 decision Making
    An emerging best practice. This is an alternative to guardianship. People have support from others to ensure they understand choices. They maintain all legal rights.

    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
    Sets of questions that are asked to find additional information about a topic. Survey questions can be close-ended or open-ended.

    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.

    Symbol
    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.

    Symptoms
    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.

    Syndromes
    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.

    Systemic barriers
    Broad-reaching views or structures in a society that result in social inequities. These are often unrecognized by those who benefit from them.

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    T

    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.

    Targeted marketing
    Messaging with a specific audience in mind.

    Targeted recruitment strategy
    An effort to find new workers by focusing on a specific group in the workforce. Examples of this might include students at a local college, working parents, or immigrants.

    Tartar
    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.

    TASH
    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.

    Task board
    A visual representation of work or tasks that need to be completed.

    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.

    Tax incentive
    A government tax benefit for employers that take certain actions. This could include giving them funds to offset the cost of making changes at a work site to increase access for people.

    Tay-Sachs
    A hereditary disease in which an enzyme is lacking in a person's body. It causes progressive deterioration of nerve cells. This affects the person’s mental and physical abilities. It can also cause seizures, blindness, and death at a young age.

    Team Charter
    A statement that sets the direction for a team. It could include the team's mission or purpose. It may include specific and measurable goals the team commits to achieve. It could also include any desired products.

    Teamwork assessment
    An evaluation of how well a team works and operates together.

    Technical knowledge
    Knowledge connected to specific skills that are not general. For example, these may be how to complete a therapy. They could be related to positioning. It could be related to fixing a flat tire or installing software.

    Telemedicine
    Meet with a medical practitioner or therapist via video or online chat.

    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.

    Temporary-to-hire
    People who complete the work of employees. They are hired (either directly or through an agency) for a limited period of time. The purpose is to understand if they are ready for the role or to ensure there is sufficient funding to maintain them.

    Temporary workers
    Short term employees. They may be directly employed. They may also be employed by a service that provides temporary workers.

    Tenure
    The length of time a person has been employed by their current employer.

    Tenure of leavers
    The percentage of people who remained in their jobs for a certain amount of time before leaving the job.

    Tenure of stayers
    The average time employees have stayed on the job. It is usually measured in months or years.

    Terminology
    The set of words that includes ideas and definitions that have specific meanings and uses for professionals working in a field.

    Terrorist
    The use of violence and threats to intimidate or coerce, especially for political purposes.

    Thalamus
    The part of the brain involved in processing sensory information and regulating wakefulness.

    Thalassemia
    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.

    The Centers for Medicaid and Medicare Services (CMS) Direct Service Workforce Core Competencies
    A set of core competencies. These are for frontline employees working in community long-term services and supports (LTSS).

    Theory of mind
    The ability to think about the mental states of both oneself and others. Mental states include things such as beliefs, emotions, intentions, and desires.

    Thunder
    A loud noise produced by the explosive expansion of air heated by a lightning discharge. Lightning produces thunder.

    Thunderstorm
    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.

    Tide
    The periodic rise and fall of the waters of the ocean and its inlets. The inflow and outflow.

    Tics
    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.

    Timely
    When something happens at the right time.

    Time-limited
    A specific amount of time. When related to SMART goals, this term refers to having a target date for achieving the goals.

    Time management
    Choices regarding schedules and effort.

    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.

    Tinnitus
    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.

    Token
    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.

    Tornado
    A destructive, funnel-shaped cloud with strong wind that travels over 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.

    Toxic
    Capable of causing injury or death, especially by chemical means. Poisonous.

    Toxic exposure
    Exposure to a toxic substance such as a chemical

    Toxins
    Things that can poison or harm you.

    Tradition
    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.

    Transitioned
    Adoption of the physical characteristics of a gender that is different from a person’s biological sex.

    Traditions
    Customs, beliefs, rituals or routines that are typically passed down from one generation to the next.

    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
    Assessing a job to identify the training needs of employees who will perform it.

    Training practices
    The ways in which training is selected and delivered to employees.

    Trajectory
    The path or track that a person or thing follows.

    Trans-fat
    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.

    Transgender
    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.

    Transitioned
    Adoption of the physical characteristics of a gender that is different from a person’s biological sex.

    Transition social worker
    A professional assigned to support a person who requires access to medical or social services during a life transition.

    Transportation
    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

    An injury or harm. This can be a physical injury. It can also be a psychological or spiritual injury.

    Trauma-informed
    See Trauma-informed care.

    Trauma-informed care
    A service approach that seeks to create environments that respect trauma experiences and support healing. It is focused on safety for everyone. This includes physical, psychological, and emotional safety. People maintain choice and control. This approach recognizes that trauma has deep effects on people. It can change thinking. It can affect responses. Communication can be harder. Trauma-informed care is applied in all settings. People who are interested can get clinical level trauma care.

    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.

    Triad
    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.

    Tricyclics
    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
    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

    Trust
    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.

    Tsunami
    A great sea wave produced especially by submarine earth movement or volcanic eruption

    Tuberculosis
    A disease which effects several parts of the body, but primarily attacks the lungs. This disease is spread through the air.

    Tuition Reimbursement
    A benefit that helps employees pay for some education costs.

    Turnover
    The loss of an employee in a position. See turnover rate.

    Turnover calculation
    It is a percentage of people who have left a position or employer. It is calculated by dividing the number of leavers during a time period of time by the average number of people who worked in those roles during the same time period. Turnover calculations need operational definitions. This ensures it is clear what is being measured.

    Turnover rate
    The percentage of turnover that exists in an organization

    Tweezing
    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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    U

    Ultraviolet
    Ultraviolet - Non-visible light that is harmful to eyes and skin in excessive amounts. It causes sunburn and long term exposure can cause cataracts.

    Unaided
    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.

    Undue hardship
    An action requiring significant difficulty or expense with respect to a request for a job accommodation. This must look at a number of factors. This includes the type and cost of the change in relation to the size and resources of the employer.

    Understanding
    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.

    Unethical
    Actions that are considered wrong or self-serving to the detriment of others. Actions that are in conflict with established moral or ethical codes.

    Union
    An organization made up of individual members who work towards a common cause or purpose.

    Unintelligible
    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.

    Unlicensed employee
    An employee who does not need a professional license to perform work.

    Unmet expectations
    When people expect things that do not happen.

    Unpredictable
    When something unexpected happens. It is often difficult to know exactly when challenging behaviors are going to occur, they are unpredictable.

    Unsheltered
    Without housing or shelter.

    Unusual or Major Incidents
    Infrequent but serious situations that lead to harm or injury or could have lead to harm or injury.

    Urethra
    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.

    Urgent-important matrix
    A tool used to sort tasks based on importance and urgency. It can help people decide what to do with each task.

    Upskilling
    Developing new skills. Usually this is for a specific need at work.

    US Bureau of Labor Statistics (BLS)
    The BLS is part of the Department of Labor. It measures and defines information related to jobs in the US. The information gathered is useful in supporting decision-making around workforce.

    Utilities
    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
    Job positions that are open or unfilled. An opening. Emptiness.

    Vacancy rate
    The percentage of positions that are open or unfilled. This is captured at a moment in time.

    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.

    Vagina
    The female opening for sexual intercourse. Monthly menstrual blood passes out of the body through this opening. Babies are born through this opening.

    Vaginal
    Related to the vagina in some way.

    Vaginal penetration
    A sex act involving insertion of the penis into the vagina.

    Validated
    Having a person’s feelings or opinions supported. This can also mean that something has been shown to be true. (For research purposes, see also validity.)

    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.

    Validity
    This is how well a test accurately measures what it is designed to measure. This is assessed in different 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 looking at whether scores on the test are correlated with scores on other tests that measure the same concept. It could also be tested by looking at whether scores relate to 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.

    Values
    Principles or standards which people use to guide them in daily life choices.

    Verbal
    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.

    Video modeling
    Using a video to show a learner a behavior or skill.

    Vigorously
    With physical energy and force.

    Viral
    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.

    Virus
    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.

    Viruses
    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.

    Vision
    The ability to see through the eyes.

    Vision board
    A mixture of images and words that represent a person’s goals. It is intended to serve as motivation.

    Visual support
    A graphic or picture that is used to communicate. Some examples include drawings, picture boards, and photos.

    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.

    Vocabulary
    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.

    Vocalization
    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

    Voluntary
    An action or decision made by a person freely and without force.

    Volunteer
    Offering to complete a job or task that is not required. Often this is without pay.

    Vulnerable
    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
    A comparison of the wages and benefits between people. This is often done between current employees and people in similar positions and locations. It can also compare people with similar levels of education and experience but in different industries. This can be used to check for differences that might lead to high turnover or recruitment problems.

    Wage compression
    When the increased skill and experience of workers does not lead to higher wages.

    Waiting
    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.

    Ward
    A person for whom a legal guardianor representative has been appointed.

    Waxing
    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.

    Wellness
    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.

    Wellness Recovery Action Plan ® (WRAP)
    Wellness Recovery Action Plan ® (WRAP) is a peer facilitated personally developed wellness plan. These plans are an evidence-based practice for mental health recovery when they are developed with fidelity. To learn more search the Copeland Center in your favorite search engine.

    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.

    Work sample
    A review of past work or direct observation of a person performing work for the purpose of assessment. This can be part of a selection process. It may also be used to assess the skills of current employees.

    Worker pool
    A group of potential employees that share a set of traits.

    Workforce challenges
    Issues in a workforce related to finding and keeping competent employees.

    Workforce crisis
    When the ability to provide services is at risk due to lack of competent workers.

    Workforce development (WD)
    Strategies to ensure enough workers are available in a field. They also ensure that workers can perform as needed.

    Workforce development board
    Teams that give local input to meet workforce development goals as outlined in state and federal law.

    Workforce development intervention
    A strategy used to find, train, and retain qualified workers.

    Workforce development plan
    A plan that helps to make sure there are enough skilled and qualified workers to meet a need. It may be part of an overall business plan.

    Work-life balance
    The impact of a job on a person’s overall life and well-being.

    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.

    Worldviews
    The unique lens a person uses to interpret life. It includes their culture as well as their experiences.

    Writing
    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.

    911
    Emergency phone number that works anywhere in the United States. This number can be called for any kind of emergency.

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