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

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

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

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

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
A change or adjustment to a job or work environment that makes it so that a qualified person with a disability can do the job and enjoy its benefits equal to employees without disabilities.

Accuracy
Something that is free from error.

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).

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

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

Activities of Daily Living (ADL)
Commonly referred to as ADL�s, these are the basic tasks of everyday life, such as eating, bathing, dressing, toileting, and transferring.

Active Range of Motion
Commonly referred to as ADL�s, these are the basic tasks of everyday life, such as eating, bathing, dressing, toileting, and transferring.

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.

Adaptive
Able to be adjusted or modified to suit specific needs, requirements, or conditions.

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.

Addiction
Something that happens to a person when he or she has no control over physical and mental cravings for a substance.

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

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.

Adult Protective Services (APS)
Adult Protective Services is an agency that helps to prevent, detect, or resolve the abuse of adults. The names of this agency may vary from state to state, but each state has one with workers who are specifically trained to handle reports of any kind of abuse.

Adverse Reaction
A dangerous or unexpected reaction from a drug.

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

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.

Aerobic
Aerobic activities are activities that cause the heart and lungs to work faster.

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 smaller earthquake following the main, larger earthquake.

Aging
The accumulation of changes in an organism over time. Aging in humans refers to a process of physical, psychological, and social change.

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.

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.

Alcoholic cardiomyopathy
A condition caused by long-term alcohol use that weakens the heart muscle and prevents it from efficiently pumping blood. This condition can lead to heart failure

Alcoholism
Alcoholism is a disease where a person becomes dependent on alcohol. Alcoholics are unable to control their drinking, experience withdrawal symptoms when they try to stop drinking, and develop a tolerance and need more alcohol to feel the same effect that it initially gave them.

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

Allergen
Something that causes an allergic reaction. Common allergens in the home are mold and dust. Common allergens outside the home are flowers, grass, trees, and air pollution.

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 physical reaction such as itchy eyes, problems with breathing, or seizure, that can range from mild to life-threatening when in contact with foods, medicines, plants, or other things in the environment.

Alphabet Board
This is a board that is used to communicate, with the most basic one having ‘Yes/No’ and numbers on it so that someone can spell out what they want to say or to answer ‘Yes’ or ‘No’ to a question. There are other boards that have the letters of the alphabet placed as if they were on a keyboard (along with a ‘space’ bar), as well as others that list the vowels down a column on the far left side.

Alternate Format
Information that is not in a printed format with the words at a certain size. Examples include information on audio tape, in Braille, or on electronic text.

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

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

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, Downs 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.

Ambulation
To walk about or move from place to place.

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

Americans with Disabilities Act (ADA)
An Act passed in 1990 providing civil rights to people with disabilities. The Act said that it was illegal to discriminate against people with disabilities in employment, transportation, public services, public accommodations, and telecommunications.

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

Anaphylaxis
A severe allergic reaction that can become life-threatening.

Anal
Area of and around 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.

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

Angina
Angina is when a person experiences chest pain or discomfort. It’s usually a symptom of coronary heart disease.
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.

Antibiotics
Drugs that are used to prevent and treat bacterial infections by killing the bacteria or keeping them from spreading.

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

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

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

Anus
The opening through which bowel movements are passed.

Anxiety
A state of distress, uneasiness, uncertainty, or apprehension caused by an impending or anticipated future event.

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

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

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

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

Arrhythmia
Irregular heart beats.

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

Arteriovenous Fistula
A connection between the vein and an artery. A surgeon connects an artery to a vein. This is created so the vein can become larger and stronger. People who use dialysis may have this procedure.

Arteriovenous Graft
A graft is small tube that connects the vein to the artery. A surgeon inserts a tube so the vein can become larger and stronger. People who use dialysis may have this procedure.

Arthritis
Painful swelling and stiffness of the joints in the body and in the surrounding muscles and tendons.

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.

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

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.

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.

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

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.

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

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

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

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

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

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.

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

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

Autonomic Dysreflexia
A condition that occurs when there is an extreme response in the autonomic nervous system due to stimulation. It can result in a medical emergency where high blood pressure can cause a stroke.

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.

Ayurvedic
A medical system that originated in India thousands of years ago. This type of health care system is still used in India today. Ayurvedic medicine includes concepts of health and disease that promote the use of herbs and special diets.

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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.

Bacterium (plural of Bacteria)
A type of germ that causes infection. It is spread by contact with contaminated surfaces and through the air (though this occurs less frequently). Bacterial infections include 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
  1. The starting point by which progress will be judged. In behavioral support plans or individual support plans there should be a baseline of behavioral activity or daily living skills so that, once teaching methods and other interventions are put into place, it is easy to tell if the person is learning new skills or decreasing the number and severity of challenging behaviors.
  2. A beginning measure against which progress can be compared

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

Bathing
Washing or immersion of something, especially the body, in water, steam, etc., for cleansing.

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 Intervention Plans
See Behavior Support Plans

Behavior Management Plans
See Behavior Support Plans

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

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

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

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.

Benign
Not harmful.

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

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.

Binge Drinking
Drinking alcohol to the point where a person's blood alcohol concentration is 0.08% or more. Usually, this might be 5 drinks within 2 hours for men and 4 drinks for women.

Biofeedback
A technique where one is trained to control certain body functions which are usually involuntary. This can include functions such as heart rate, blood pressure, and muscle tension.

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

Bipolar 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.

Bioterrorism
Terrorism that involves the use and release of toxic biological agents.

Blackout
After drinking, a period of time when the person can’t remember events that happened.

Bladder
The sac in humans where urine is collected before it is emptied from the body.

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 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
Fluid that is contained in the human body utilized to maintain life and functioning.

Body Mass Index (BMI)
A way to screen a person for overweight or obesity. BMI is calculated using a person’s weight and height. The BMI number then falls into one of four categories from ‘underweight’ to ‘obesity. A higher BMI means more body fat.

Body Mechanics
Body mechanics refers to using the correct muscles to complete tasks safely and efficiently, without causing strain or injury. Posture and positioning are important aspects of body mechanics.

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

Body System
A collection of organs and body parts joined to serve a common function.

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.

Boundaries
Boundary: Boundaries set the limits in the relationship between two people. Boundaries can be both physical and emotional.

Bowel
The intestines.

Bowel Dysfunction
Problems with the frequency, consistency, and/or ability to control bowel movements.

Bowel Program
A program of activities to help the person have bowel movements on a regular basis. This is usually done at a specific time everyday so the person�s body becomes used to the program. Suppositories or enemas may be used in a bowel program to produce a bowel movement.

Braille
A system of writing for people who are blind that is composed of raised dots that can be read by touch. Each group of dots represents a letter or number.

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.

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.

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

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.

Bronchitis
When the tubes that carry air to the lungs, called bronchial tubes, get inflamed.
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.

Bulimia
an eating disorder in which a person over eats and then makes themselves throw up to get the food back out of their body in order to remain thin or to loose weight.

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

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

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.

Captioning
Subtitles and text that appears on a TV screen or in a video window. This is so that Deaf or hard-of-hearing individuals can read what is being said on the screen.

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

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

Cardiovascular Disease
A group of diseases that affect the heart and blood vessels.

Cardiovascular System
A body system consisting of the heart, blood and blood vessels. This system distributes blood, nutrients, gases, and hormones to and from cells in the body. This helps to fight diseases and stabilizes body temperature and pH to maintain life.

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.

Catheter
A tube that is inserted into a body cavity to allow for drainage of that cavity.

Cavities
A breakdown or decay of the tooth caused by bacteria. Cavities are caused by acids in the mouth, which are a form of bacteria. Tooth or ear pain can be a sign of serious cavities and infection.

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

Cell
A unit of life at the smallest level in living things. An organism is made up of cells.

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

Centers for Independent Living
A Center for Independent Living (CIL) is a consumer controlled, community based, cross disability, non-residential private nonprofit agency that is designed and operated within a local community by individuals with disabilities. A CIL provides an array of independent living services including information and referral, independent living skills training, individual and systems advocacy, and peer counseling (Section 702 of the Rehabilitation Act of 1973, as amended).

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 type of developmental disability resulting from damage to the brain, which results in loss of control over voluntary muscle movement in the body. There are different types of Cerebral Palsy which may affect a person differently. The person may have sensory limitations including hearing and vision impairments. People with Cerebral Palsy often have difficulties with speech. Cerebral Palsy is sometimes combined with mental retardation but not always. Symptoms are usually evident before age 2 and in severe cases may appear as early as three months.

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

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.

Central Venous Catheter
A catheter that is inserted into the largest vein in a person’s chest, allowing for repeated injections or blood draws over a long period of time.

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.

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 attack
The deliberate use and release of hazardous substances to harm people and the environment. This is a form of terrorism.

Chemical dependency
This is when someone has an addiction to a substance or a chemical. The person's body craves it and he or she will have trouble avoiding the substance. Alcohol and crack are two examples of substances that can be addictive.

Chemotherapy
A treatment that uses powerful medications to kill cancer cells. Powerful drug treatment used to destroy or kill cancer cells.

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 diseases
See Chronic Health Condition: An illness or health condition that lasts a long time, is ongoing, or continuous.

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.

Chronic Kidney Disease (also known as Chronic Kidney Failure)
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
Are used to follow-up on the candidate's answers when they are too general or need 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.

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

Closed-captioning
Subtitles that appear on a TV screen so that a viewer can read what is being said on TV.

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

Co-advocacy
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.

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

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

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.

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.

Colonoscopy
A test that looks inside a person's colon and rectum. A doctor uses a tube that goes up the rectum and looks for any growths or abnormalities.

Colostomy
A surgical procedure that leaves a patient with a hole in the abdomen. This allows feces to exit the body from the colon to the opening in the abdomen.

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

Common Cold
caused by a virus that invades the body and can last a week or even two. There are over 100 kinds of cold viruses and people typically get more than one cold per year. Cold viruses live inside of a person's nose and can only spread from direct germ contact within the nose.

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.

Communicable Diseases (also known as Infectious Disease)
A disease that is spread from one person to another through people, body fluids, animals, insects, surfaces, foods, or air.

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

Communication and Picture Boards
This type of communication board has words on it so that a person can just point to certain words when communicating. Pictures on a communication board can be grouped into colored areas on the board, or they can be separate boards entirely.

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 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.

Communication Tablet
A picture communication tablet is an electronic device that shows small pictures, and the user can point to a picture to communicate. Each picture also has a word that describes it. Many picture tablets also have the capability to ‘talk’ out loud.
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
The ability of a community to welcome and share community resources with diverse populations, including people with developmental disabilities.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complementary Health Approaches
Non-conventional medical and health practices that are used along with conventional health practices. This typically includes natural products (such as herbs and probiotics) and mind and body practices (such as yoga, meditation, and chiropractic care).

Components
Parts of a larger set of things.

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

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

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

Concise
When something is expressed in as few of words as possible, while maintaining the quality 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 outlines a plan of correction, consequences for failure to improve, timelines, resources, and support for review and improvement.

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

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

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

Congestive Heart Failure
A type of cardiovascular disease where the heart has a hard time pumping enough blood through the body. Over time, the heart gets weaker and as a result fluid can build up in parts of the body, include the legs, ankles, feet, abdomen, neck, and liver. Congestive heart failure can also cause shortness of breath and fatigue.

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.

Consent
To give permission.

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.

Constipation
Having a bowel movement fewer than three times a week. With constipation, stools are hard, dry, small, and difficult or painful to eliminate. Constipation is a symptom of bowel dysfunction, not a disease.

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

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

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

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.

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

Contagious
A disease that spreads to others easily. Avian (or Bird) Flu: A flu virus that is 'carried' by birds. This means birds "host" (or carry) the flu virus and can pass it on.

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

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.

Contractures
A shortening of a muscle in response to a stress exerted on that muscle, such as a spasm.

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.

Convention
A legal agreement.

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

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

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

Coronary heart disease
A disease affecting the coronary arteries in the heart. Coronary arteries bring oxygen-rich blood into the heart muscle. When a person has coronary heart disease, this means the coronary arteries are narrowed and blocked.

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

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

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

Covered Entity:
Refers to businesses that must comply to HIPAA. These businesses always have at least two things in common. First, they use protected health information (PHI) in conducting services. Secondly they transmit protected health information (PHI) electronically, often times for billing purposes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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.

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

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

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.

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.

Deep Breathing
A relaxation exercise that helps to reduce tension and slow things down in the body using controlled breathing.

Defecate
When the body gets rid of solid wastes.

Defensive Driving
This refers to things you can do to stay safe and avoid dangerous situations while driving. This includes reacting to an unsafe situation such as a speeding car or a slippery road.

Defensive Walking
Ways in which a person can identify unsafe pedestrian situations and ways to stay as safe as possible.

Deficiency
A lack of something that is needed.

Dehydration
When your body does not have as much water or body fluids as it should.

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.

Delirium
A syndrome where people may experience confusion, hallucinations, and have difficulty paying attention.

Delusions
Fixed beliefs that are note 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.

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
different stages of the normal process of growth.

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

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

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

Diabetic Eye Disease:
This is when diabetes and too much glucose causes damage to various parts of the eyes. It can result in loss of vision and complete blindness.

Diagnosis:
The identification of a disease or health condition by a doctor.

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.

Dialysis
A type of treatment that is used when the kidneys are no longer able to function. Dialysis can do some of the things that kidneys are supposed to do including removing wastes and fluids from the body, balancing chemical levels in the blood, and helping to control blood pressure.

Diarrhea
Loose, watery stools. Chronic diarrhea can lead to dehydration and can be particularly dangerous in children and the elderly.

Diet
The foods eaten by a particular person or group.

Digestive System
A body system consisting of the salivary glands, esophagus, stomach, small intestine, and large intestine. This system breaks down food into smaller components so they can be absorbed in the blood stream.

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

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

Disability Rights Movement
A movement by and for people with disabilities seeking equal opportunities and civil rights. People with disabilities were seeking complete integration and equal opportunities in their communities including work, school, and social activities.

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

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

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

Disparities
Big differences.

Disposable Briefs (also known as Incontinence Pads)
Underpants that are thrown away after they have been soiled once.

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 record of an action, event, item, issue, or thought that is important or meaningful.

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

Domestic Violence:
Behaviors such as emotional or physical abuse used by one person in a relationship to control the other. This can take place between married and non-married partners, people who are dating, living together or family family members. Examples of domestic violence are not limited to the following: physical assault, intimidation, sexual abuse, coercion, stalking, harassment and neglect.

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

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.

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

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

Dressing
To put clothing on.

Drought
A very long period of low rainfall, often resulting in a shortage of water.

DSP
Direct support professional.

Dual diagnosis
Having more than one diagnosis or disability

Durable Medical Equipment (DME)
Durable medical equipment is commonly referred to as 'DME.' DME is medical equipment that is durable, or long-lasting, used in the home, and prescribed for a medical reason. DME includes equipment such as walkers, wheelchairs, commode/toilet chairs, hospital beds, canes, and crutches.

Durable Power of Attorney
A document that allows you to give authority to another person to make financial or legal decisions and financial transactions on your behalf.

Duration
How long something lasts.

Dwarfism
A genetic abnormality resulting in short stature

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

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

Dysthymia
A form of depression which lasts longer but has milder symptoms than major depression. Dysthymia is a more chronic condition which must occur for at least two years.

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

E. coli
A foodborne illness that is often caused by raw or undercooked beef, unpasteurized fruit juices or milk, and fresh produce.

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

Earthquake
A sudden, rapid shaking of the earth. This is caused by pressure from large plates of rock below the surface 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.

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

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

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

Electroconvulsive Therapy (ETC)
A biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient.

Electrocution
Being harmed or killed by electricity.

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

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

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

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

Emergency Preparedness
A set of activities to help make sure a person or community can be prepared for and respond to an emergency to help prevent injury, loss of life, and property damage.

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

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

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

Emphysema
A long term progressive disease of the lung that primarily causes shortness of breath.

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

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

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

Empathy
Being able to identify with and understand the feelings, thoughts, experiences, or attitudes of another. expectations.

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

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).

Endocrine System
A body system that consists of glands. It produces chemicals throughout the body called hormones such as the pituitary, thyroid, and adrenal glands. It is also an information system that regulates many functions of the body such as mood, growth and development, tissue function, and metabolism.

Enema
A liquid treatment injected into the rectum to help a person have a bowel movement.

Energy
The capacity for activity or exertion of power.

Enteral Nutrition
More commonly known as ‘tube feeding,’ this is a way to deliver nutrients directly to a person’s stomach, bypassing their mouth.

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.)

Enzymes
Various proteins capable of producing certain chemical changes in organisms such as digestion.

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

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.

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

Ergonomic
The design of the work setting such as furniture, equipment, and the body to help position the worker in a way that will lessen the possibility of injury when performing work tasks.

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

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

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

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

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.0

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.

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

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.

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

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

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

Exploitation
Using another person or that person's resources illegally for your own purposes.
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.

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

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

Evacuation Route
A path to take to escape from danger. This could be an emergency or natural disaster, such as an earthquake or hurricane.

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 according to the disability classification system of the AAMR refers to persons who receive regular ongoing support across a range of life activities. These individuals can do some things on their own, but they always have access to people who can help them.

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

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

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

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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.

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.

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

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

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

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

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

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.

Fecal incontinence
When a person has a hard time controlling his or her bowels. This causes feces to leak or total loss of control.

Feces
The waste that the bowels get rid of after food has been digested.

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 patient�you or a family member covered under your policy. With fee-for-service insurance, you go to the doctor of your choice and you or your doctor or hospital submits a claim to your insurance company for reimbursement. You will only receive reimbursement for "covered" medical expenses, the ones listed in your benefits summary

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

Financial Management Services (also known as Fiscal Intermediary)
Also known by other names, financial management services help people manage their finances and the administrative documentation and requirements related to the employment of a home care worker.

Fiscal Intermediary (also known as Financial Management Services)
Also known by other names, a fiscal intermediary helps people manage their finances and the administrative documentation and requirements related to the employment of a home care worker.

Fistula
See Arteriovenous Fistula

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

Flu
A respiratory illness that can be transmitted from one person to another. Most people have some resistance to the flu. A vaccine is available.

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.

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

Foodborne Illness
Another name for food poisoning. Foodborne illness is usually caused by bacteria and viruses in food that has been contaminated from unsanitary or improper handling, cleaning, packaging, storage, or cooking.

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.

Frostbite
In very cold weather, the injury or destruction of the skin and underlying tissue. Most often the areas affected are the nose, ears, fingers, or toes. Frostbite results from prolonged exposure to freezing or subfreezing temperatures.

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

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

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

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

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

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

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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Gait Belt
A device used to transfer people from one position to another. The gait belt is worn around the person being transferred.

Gastrointestinal
Referring to the stomach and intestines.

A flexible tube that is placed in the stomach through a small opening in the abdomen. Fluids, medications, and liquid food can be delivered through the g-tube.

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.

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 Identity
A person’s own experience with how they perceive their own gender. This may or may not be the same as their birth sex.

Generalization
Being able to apply a skill or knowledge to a variety of different situations. Many people with mental retardation have difficulty with generalization. This means the best place for them to learn a skill is in the place they will use the skills, for instance being trained in job tasks at the actual job or learning homemaking skills in their own homes.

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.

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

Germs
A microorganism that produces disease.

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

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
The mildest form of periodontal disease. This disease involves the gums and can result in a person losing his or her teeth. The disease is caused by a bacterium that is in plaque, a substance that forms on your teeth. Gingivitis is an early form of gum disease that is usually not painful. Symptoms include red, swollen or soft gums that bleed easily. If left without treatment and care, more serious gum disease (such as periodontitis) can occur.

Glands
Glands are organs in the body that produces certain chemical substances (like insulin or hormones) that are released into the body.

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

Glucose
A type of sugar in the blood. Glucose is a major source of energy for the body's cells.

God-parent
A person who agrees to support a child’s religious development.

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.

Graft
See Arteriovenous Graft

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.

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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H1N1
A flu virus found in humans that was originally found in the lungs of pigs. In 2009 there was a H1N1 pandemic as this virus spread and affected people around the world.

Hallucination

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

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

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 overall physical, mental, and social well being of a person.

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

Health Condition
A set of symptoms about a specific area of health that, if left untreated, can lead to a person becoming ill.

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

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

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

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

Health Risk
Something that can affect a person's health because of his or her chronic disease. For example, people who do not treat high blood pressure are at risk for getting a stroke.

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
A heart attack is also called a myocardial infarction. It occurs when blood flow is completely blocked in the heart. A heart attack can cause permanent damage to the heart.

Heart Disease

Heart Failure
See Congestive Heart Failure. When the heart cannot pump flood throughout the body normally, fluid can build up in the lungs and lower legs. A person with congestive heart failure can also have shortness of breath and swollen abdomen, feet, legs and ankles.

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

Heat wave
A very long period of very hot weather.

Hemodialysis
A procedure where a machine filters wastes, salts, and fluid from a person�s bloodstream when his or her kidneys are no longer healthy enough to do this work. It is one of the most common types of dialysis that people with kidney failure have. There are other types of dialysis.

Hemorrhagic Stroke
A stroke caused by sudden bleeding in the brain from a ruptured artery.

Hemorrhoids
A condition in which the veins around the anus become swollen and inflamed. This can be caused by straining during a bowel movement, chronic constipation or diarrhea, pregnancy, anal intercourse, or aging.

Hepatitis
A disease of the liver causing it to become inflamed. The two most common types that health care workers and home care providers are most at risk for are Hepatitis B and Hepatitis C. Both are communicable diseases.

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.

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

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

Human Immunodeficiency Virus (HIV)
A virus that leads to AIDS or Acquired Immunodeficiency Syndrome. AIDS is a condition in humans where the immune system fails and leaves the body vulnerable to other life-threatening infections. HIV is a communicable virus.

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

Home and Community Based Services
A variety of services which are funded through the federal Medicaid Home and Community Based Waiver program. HCBS unlike ICF/MR funding is a less regulated and more flexible pot of money which can help fund services provided in a number of settings including small agency run group homes, family homes, and a person's own home or apartment. How these funds are used and their availably are defined by each state's agreement with the Federal program.

Home and Community-Based Waiver
A federal funding stream through the Medicaid program, that can be used to fund a variety of service to people with various needs, including people with developmental disabilities. Many states use these funds as an alternative to funds available through the Intermediate Care Facility for People with Mental Retardation (ICF/MR) program because the funds can be used more flexibly to meet individual needs.

Home Care Agency
A home care agency can be a for-profit or non-profit business. A person or family caregiver can find a paid home care provider through home care agencies. The services a home care agency can provide can be personal care, homemaker, or chore services. The agency also may provide a case manager. The case manager oversees the situation of the person and the provider.

Home Care Provider
A person who helps a person with a disability, chronic illness, cognitive impairment, or are older to live in his or her own home by providing assistance with personal care activities.

Home Health Agency
Home Health Agency: A home health agency will provide home health services that Medicare and Medicaid will pay for. Licensed professionals (nurses, physical therapists, doctors, and social workers) provide these services. These agencies also may provide some homemaker and chore services. Home Health Agencies provide more supervision and control of the services they provide.

Homeopathy
Homeopathy is a medical system that was developed in Germany over 200 years ago. Treatments used in homeopathy are unique for each person who uses them, meaning two people with the same health issue may receive different homeopathic treatments. These treatments typically come from plants, minerals, or animals and are then formulated into ointments, gels, tablets, or creams.

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 chemical substance secreted by an endocrine gland or group of endocrine cells. This acts to control or regulate specific physiological processes, including growth, metabolism, and reproduction.

Housing Voucher
A federal housing program that helps low-income families, older adults, or people with disabilities afford rental housing, whereby the government helps to pay for some of the costs of the rent.

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

Hoyer Lift
Hoyer Lift (see Mechanical or Manual Lift): An assistive device that allows people to be transferred between a bed and chair to another place by using a sling under the body and a hydraulic lift.

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

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

HPV: See Human Papillomavirus
A sexually transmitted disease that can be from one of over a hundred viruses. HPV is a major cause of cervical cancer. People with HPV may not have symptoms for years.

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

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

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

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

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

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.

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

Hypersexuality
An increased interest in sex.

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 temperatures. Hypothermia 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.

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

ICF/ID
Intermediate Care Facility for People with Intellectual Disabilities (formerly called the ICF/MR program).

ICF/MR
Intermediate Care Facility for People with Mental Retardation

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.

Ileostomy
A surgical procedure that leaves a patient with a whole in the abdomen, allowing feces to exit the body from the small intestine to the opening in the abdomen.

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

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

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.

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.

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

Implicit Bias
Assumptions, biases, and stereotypes that are made unconsciously or unintentionally.

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
See community inclusion.

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.

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 Philosophy
The independent living philosophy emphasizes self-direction and believes that people with disabilities are the experts on their own needs. Because of this, they should be the ones who make decisions about their daily life, services, and care.

Independent Living Movement

Independent Providers (IP)
Independent providers are caregivers who are hired by and work directly for the person with a disability or an older adult. An IP is not part of any other organization but may have a relationship with an Intermediate Service organization (ISO). An IP may or may not have any caregiver training or home care experience.

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

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

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

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

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

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

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

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

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
The flu is a disease caused by the influenza virus. It is different than a common cold since it is caused by a specific virus. The flu can effect you suddenly and easily transmitted to other people through germs spread through coughing, sneezing, or after a person with the flu has touched a surface with germs on their hands and then another person comes in contact with that same surface.

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
Difficulty getting asleep or staying asleep.

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

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

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.

Insulin Resistance
Insulin is a hormone produced in the pancreas to help turn sugars in the bloodstream into energy. Insulin resistance is when the body does not respond to the insulin. The pancreas has to produce more insulin so that the body can get energy from sugars.

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.

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

Intrathecal Pump
An intrathecal pump is an implanted pain pump that delivers medication directly to the spinal cord. The pump is surgically implanted in the abdomen and connected to a catheter. This catheter leads directly to the fluid in the spinal cord. Delivering medicine this way can block the nerves sending pain signals to the brain. With an implanted pain pump, pain relief can come more quickly and efficiently than with oral medications. It can also give a person more control over when and how much pain medication they need.

Skin (Integumentary) System
A body system that consists of skin, nail and hair. This system provides a barrier to the body, regulates temperature, detects pain and sensation, and protects tissues deep inside the body.

Intellectual Disability
Intellectual disability or mental retardation 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 (under the age 18, or 21).

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

Intensity
The strength or force of something.

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

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

Intentionally
Deliberately or on purpose.

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

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

Intermediate Service Organization (ISO)
Intermediate Service Organization (ISO): An ISO is an organization that might screen independent home care providers or have a home care provider worker registry.

Intermittent Catheterization
When a bladder is drained several times a day by inserting a small rubber or plastic tube. The tube does not stay in the bladder between catheterizations.

Intermittent Support
Intermittent support according to the disability classification system of the AAMR refers to persons who only receive support when needed and usually just at special times in other lives. In most cases these are individuals with relatively mild intellectual disabilities and relatively fewer or less substantial limitations in adaptive behavior. For example, people may have received job training and placement assistance, but once prepared and in a job, they manage the demands of their lives independently, with or without occasional assistance as needed.

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

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

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

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

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

Intravenous (IV) Catheter
A type of catheter that goes into a vein so a person can have numerous injections over a period of time without repeatedly getting pricked by a needle. This also helps to keep the person’s veins from getting damaged.

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

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

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

Iron Lung
A large airtight metal box, or tank, that works as a respirator. A person’s body, except their head, is slid into the iron lung, which then uses negative air pressure to pull air into and out of the lungs. It was commonly used with polio survivors who were unable to breathe on their own.

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

Ischemic Stroke
A stroke that happens when oxygen-rick blood flow to the brain is blocked.

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

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

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

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

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

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

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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.

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.

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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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.

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.

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.

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

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

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

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

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

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

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

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

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

Legal Rights
Conditions and privileges accorded to people by law.

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

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).

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.

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.

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.

lewy bodies
Lewy bodies: Lewy bodies are small, abnormal structures inside the brain. They disrupt the way the brain functions and cause neurons to die. A person can have dementia with Lewy bodies and experience symptoms similar to those from Alzheimer's and Parkinson's disease.

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

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

Lift Cushion or Chair
A powered lifting mechanism that pushes the entire chair up from the base, allowing the user to easily move to a standing position.

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 according to the disability classification system of the AAMR refers to persons who only receive support on a time limited basis or for specific activities in which help is needed. For example people may receive 10 hours of support a week from a direct support professional to help them with shopping, money management, meal planning, and improving cooking skills.

Listeria
A foodborne illness that is often caused by raw or undercooked meats, unpasteurized milk, soft cheeses, and ready-to-eat meats and hot dogs.

Literacy
The ability to read.

Litigation
A lawsuit against the employer in criminal or civil court.

Long-term Care Insurance
This is a type of private insurance in which a monthly premium is paid to help cover the costs of long-term care. This type of insurance usually covers care that is not covered by a person’s health insurance, Medicaid, or Medicare.

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.

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.

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.

Lumen
The tubes of a central venous catheter that dangle outside of the person’s body.

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

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.

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

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.

Malignant
A malignant tumor can invade and destroy parts of the body. A malignant tumor can spread to other parts of the body as well.

Malnutrition
A condition that occurs when the body does not get enough nutrients, the right kind of nutrients, or the nutrients the body is getting are imbalanced.

Maltreatment
An act, behavior, or failure to act by a family member or professional care provider that causes harm to 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, or 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 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.

Mandate
Something that is mandatory or required by law.

Mandated Reporter
People who are legally required to report any maltreatment they see or suspect to the appropriate authorities or protective service agency, such as Child Protective Services or Adult Protective Services. Every state and different agencies will identify different people who are mandated reporters.

Mandated Reporting
Reporting any act that is suspected to be potential abuse, neglect, or exploitation of a person who is vulnerable (a child, adult with disabilities, or older adult) that is required by law because of the professional role of the reporter. In many states direct support professionals and home care workers 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. He or she may over spend, have reckless sexual contact, and engage in excessive use of drugs. The person may be unable to sleep for more than a few minutes at time or at all. He or she may have extreme feelings of well-being. A complete loss of contact with reality can occur and the person may become psychotic.

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.

Massage
A body-based practice where the muscles and other soft tissues of the body are worked on by licensed massage therapists using their hands and fingers. Massage can help the person feel better, relax, get rid of pain, and reduce muscle tension. There are many different types of massage, all of which use different techniques.

Mass Transit
Mass transit are transportation services that are designed for the general public. This includes buses, trains, and subways.

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.

MCI
Mild Cognitive Impairment (MCI): People with MCI have mild problems with thinking and memory. MCI is more than just being forgetful, but it's also not quite dementia. Unlike with dementia, these problems do not interfere with everyday activities and people with MCI are often aware of their symptoms.

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

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

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

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

Medical Restraint
See Psychotropic.

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

Medicare and Medicaid
Federally subsidized health care plans that were established by Congress in the 1960s to help provide health care for citizens 65 and over, and those least able to afford medical insurance on their own. Medicare provides about 40 percent of the cost of acute care for elderly patients. Medicaid programs provide medical assistance to the poor and unemployed who meet the eligibility requirements, which vary greatly from state to state, while benefits for Medicare patients are mandated by the federal government. (definition from 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
The United States federal health insurance program for low-income individuals, families, and people with disabilities. It is funded jointly by the states and federal government, but is managed and administered by each state individually.

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

Meditation
A type of mind and body practice where a person focuses their attention to reach a calm and relaxed state. Meditation can help a person cope with sickness or improve their health and well-being. It can also be used as a part of yoga.

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 Health
    The well being of a person's mind, thoughts, and emotional state.

    Mental Health Professional
    A broad category of professionals who treat and support individuals with mental health issues. They can include: psychiatrists, clinical psychologists, social workers, psychiatric nurses, counselors. States vary in their regulation and accreditation of these professionals.

    Mental Illness
    A disease of the mind or brain that seriously affects a person's thoughts, emotions, personality, behavior and ability to function, and may include extreme moods, such as excessive sadness or anxiety. Sometimes referred to as mental disorders. People with known mental health needs caused by mental illness are often stigmatized and excluded by other members of the community, however, some mental health disorders like depression are extremely common and often undiagnosed. With proper treatment and support, most people with mental illnesses can lead productive and satisfactory lives. People who have mental retardation and metal illness are sometimes labeled as having a "dual diagnosis."

    Mental Retardation
    A disability that is present prior to the age 18, in which the person has an IQ level below average for his or her same age peers, and in which there are significant limitations in the person's ability to understand and process information. People with mental retardation are each unique, with very different needs and abilities, even if they have the same IQ. Many people with mental retardation can live satisfactory lives with intermittent support from others. Other people with mental retardation, need significant daily assistance.

    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.

    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.

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

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

    Micro-aggression
    Ongoing, subtle, dismissive, stereotypical, or negative comments or messages directed towards and experienced by people of a particular group that is seen as "less than" others based on personal traits or experiences they cannot change. These groups can include people of different ages, races, abilities, genders, and sexual orientations or identifications, among others.

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

    Migraine
    Chronic and severe headaches that cause significant pain, lasting from many hours to even days.

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

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

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

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

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

    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).

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

    Morbidly Obese
    Being over 40% of a person’s recommended body weight.

    Mucus
    A slippery, watery substance that keeps some organs and body cavities, such as the lungs and nose, moist. Mucus helps to keep these organs from drying out and getting infected.

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

    Musculoskeletal Disorders
    An injury affecting the musculoskeletal system. This system refers to muscles, tendons, ligaments, nerves, joints, cartilage, bones, or blood vessels in the arms, legs, or back. These disorders are injuries that are caused or aggravated by work tasks such as lifting, pushing, and pulling.

    Musculoskeletal System
    A body system that consists of bones, skeletal muscles, cardiac muscles, and smooth muscles. This system provides strength, posture, movement, and heat for the body to keep warm.

    Mutually voluntary
    All people involved have agreed to participate.

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

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

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

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

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

    Naturopathy
    Naturopathy is a medical system that combines conventional medicine and some of the health care approaches that were popular in Europe in the 19th century. Naturopathy may involve dietary supplements, lifestyle changes, herbs, homeopathy, body-based practices, and exercise therapy.

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

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

    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.

    Not giving someone attention or respect and not taking care of his or her needs. This includes ignoring a person or treating a person as unworthy.

    Neurons
    Nerve cells in the brain.

    Nerve Block Injection
    A body system that consists of the brain, spinal cord, and nerves. This system sends signals between different parts of the body, telling the body what to do.

    Nervous System
    A body system that consists of the brain, spinal cord, and nerves. This system sends signals between different parts of the body, telling the body what to do.

    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.

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

    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.

    Neurons
    Nerve cells in the brain that send messages to one another and from the brain to the rest of the body.

    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.

    Neurotransmitters
    Chemicals produced in the brain that carry messages telling the body what to do and feel. Depending on the type and the amount of neurotransmitter, these chemicals can either intensify or minimize your body's responses, your feelings, and your mood.

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

    Nicotine
    An addictive drug found in tobacco products. Nicotine stimulates the body and causes an increase in blood pressure, heart rate, and respiration rate.

    Non-Communicable Diseases
    Diseases that are not infectious, but rather may be the result of genes, lifestyles factors, or the environment.

    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-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.

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

    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
    Instruments that have not been tested for reliability or validity or for which norms have not been established.

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

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

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

    Norepinephrine
    A neurotransmitter and a hormone that operates in the brain and throughout the human body.

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

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

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

    Nutrient
    Substances that a person must get through their diet so that their body can function, survive, and grow. Nutrients are not made by the body. The six essential nutrients are proteins, carbohydrates, fats, vitamins, minerals, and water.

    Nutrition
    The provision of food and other nutrients to support life, growth, and tissue replacement in living organisms, mostly humans.

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

    Nutritionist
    A person who is an expert in nutrition.

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    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.

    Observation
    What a person sees when they watch something occurs. A way to watch what is going on in the environment.

    Occupational Health
    The promotion and maintenance of the health, safety, and well being of workers.

    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 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.

    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
    An evaluation of a person's ability to perform his or her work related responsibilities and duties. Assessment may be very focused (e.g., testing a person's ability to perform specific tasks as part of a performance review) or more general, for example, a thorough assessment identifying the person's strengths (tasks or performance that they are good at, assets), weaknesses (tasks or performance that the person may need more training and direction in, deficits), and preferences, (task that the person enjoys and would like to do more of or learn more about) in the workplace, in general, as part of exploring potential employment options.

    Oncologists
    A doctor who specializes in cancer treatments.

    Open-ended questions
    These are questions that can not be answered with a simple yes" or no" response. They require the person to explain, discuss or give more detail in order to answer the questions being asked.

    Operational Definition
    An operational definition is used when what you want to define cannot be seen. Operational definitions are agreed upon by people. They tell us what we should look for, when we are trying to describe the things we cannot see. For example, an intellectual disability is something we cannot see. Since it cannot be seen, professionals use tests. The tests look at skills in reasoning, remembering, and doing certain things. The results of the tests tell us if peoples' skills fall into a category or not. Operational definitions help make sure that classifications are reliable.

    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.

    Outcome
    The actual achievement of something (as opposed to the process of trying to achieve it). Outcome-based support services takes the emphasis off the particular method or process of trying to achieve goals, and measures success in the achievement of actual benefits to the person being supported.

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

    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 Piercing
    Pierced areas of the mouth, such as a pierced tongue, pierced lip, etc.

    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 condition with fragile and weak bones.

    Ostomy
    An opening in the abdomen that removes solid waste or urine.

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

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    Paid Service Relationships
    Relationships in which it is one person's paid job to interact with another. These relationships typically have a very specific purpose, roles, and boundaries. Because of the defined purpose of the relationship, it is not necessarily important that the people involved in these relationships share the same values, beliefs, or interests. Despite the generally limited commitment to each other, people who develop relationships with paid service providers experience benefits. For example, a regular customer at a restaurant, bar, or store, can often expect to be treated better than a new customer.

    Paid Staff
    People who are hired to provide specific types of support to a person(s) with a disability. Direct Support Professionals are always considered paid staff.

    Pain
    An unpleasant sensation as a result of tissue damage, injury, illness, or disorder.

    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.

    Pancreas
    An organ in the body that secretes insulin. This is a kind of hormone to control blood sugar and other juices that aid in digestion.

    Pancreatitis
    An inflammation of the pancreas that prevents it from digesting properly.

    Pandemic
    An infectious disease that spreads among large numbers of people in or across geographic regions.

    Pantiliners
    Pantiliners are thinner versions of pads. Pantiliners are worn to catch overflow of tampons during heavy periods or on light flow days when pads are not necessary. They can also be used in-between bleeding to absorb discharge or when menstruation starts unexpectedly.

    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.

    Paramedical Services
    Health-related tasks that are prescribed by a doctor. Home care providers who provide paramedical services usually require some training by a health care professional or the person he or she works for.

    Paranoia
    An unrealistic fear, suspicion, or distrust.

    Paraphrasing
    Is telling the speaker in your own words the main points of what was said. This clarifies the message. The speaker may agree or disagree with how his or her words have been interpreted, and may use the opportunity to further express the idea. This ensures that information has been received and understood. Some examples of paraphrasing may begin, Do you mean...?" or What I hear you saying is..."

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

    Paratransit
    Paratransit services are an alternative to mass transit. Paratransit services are scheduled ahead of time and take a person door to door, to and from a specific location. A van or taxi might be used in paratransit services.

    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.

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

    Participant-driven managed supports
    A variety of strategies for administering systems to increase their effectiveness and efficiency, while maintaining a commitment to community integration and self- determination for people with developmental disabilities. Also see: consumer directed.

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

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

    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.

    Passive Range of Motion
    Another person or equipment moves a person's joint through the range of motion with no effort from the patient.

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

    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.

    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.

    People-first language
    Respectful forms of address which avoid labeling or describing an individual in terms of a diagnosis or other attributes or characteristics. In all forms of communication, including spoken and written communications the person precedes his/her attributes. (for example: The person with mental retardation. NOT- the mentally retarded person.)

    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 coaching
    Is a training strategy that will help direct support professionals meet or exceed job expectations. It involves one or more of the following styles: counseling, mentoring, confronting and coaching employees to improve work behaviors. It can be used to teach new skills, reinforce current skills and to expand career opportunities.

    Performance indicators
    Specific occurrences, including service results, to be measured to determine the success of service quality.

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

    Performance reviews
    Formal written evaluation document of job performance that give the direct support professional feedback about how well they are doing on the job as well as identifying areas that need improvement, timelines, resources, and support for improvement.

    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.

    Perishable
    Something that is likely to spoil quickly.

    Peritoneal Fluid
    The fluid which surrounds the human intestines.

    Peritoneal Dialysis
    A process used when the kidneys are no longer able to function, whereby the lining of the stomach, or peritoneum, is used to filter a person’s blood with the help of a dialysis solution.

    Peritoneum
    The lining of a person’s stomach.

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

    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 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)

    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.

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

    Personal Care
    People or devices that assist a person with a physical, sensory, mental, or cognitive disability with tasks that the person would perform for himself or herself if he or she did not have a disability.

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

    Personal 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.

    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 according to the disability classification system of the AAMR refers to persons who receive highly intense, 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.

    Physical abilities
    Related to the ability to move and control one's body.

    Physical Activity
    Any activity that uses energy and gets your body moving.

    Physical capabilities
    Are the physical requirements or physical demands placed on a person doing the job. For example, if the job requires the direct support professional to lift 50 pounds of weight frequently during their shift, a physical capability for the job would be "Must be able to lift 50 pounds."

    Physical Abuse
    Any act of violence, force, or rough treatment done knowingly, recklessly or intentionally whether or not actual physical injury results.
    This term is one that is commonly defined very specifically by state laws or regulations. You must be familiar with your state definitions. States that have specifically provided links to definitions or information regarding this term through special CDS customizations content include: PA, KS, MN.

    Physical Disability
    As defined by the Americans with Disabilities Act (ADA) of 1990, a disability is a physical or mental impairment that substantially limits one or more major life activities. A physical disability, according to the ADA definition, would therefore be caused by a physical impairment. This definition follows what is known as the �Medical Model� of disability in that disability is caused by a health condition, implying that it requires medical care and treatment. Another definition of physical disability is based on the �Social Model� of disability. The Social Model of Disability views disability as being a social construct, caused by environmental circumstances, or existing barriers in the environment that prevents the full integration of people with disabilities into society.

    Physical Exam
    This is usually part of a regular preventive checkup with a health care provider. During a physical exam a health care provider might take vital signs; measure the height of a person; weigh the person; check their hearing, reflexes, and vision; check certain body parts by looking at, touching, and feeling various parts of the person’s body; order lab tests such as a blood sample or x-ray; and give shots such as the flu, pneumonia, or vaccinations.

    Physical Injury
    Injury to someone's physical body such as: broken bones, scratches, cuts, bruises, etc.

    Physical Restraint
    Any time the staff restricts a person's movement, either mechanically or with their own body, through holds, "escorts," and the like. Physically assisting someone (to learn a new skill) or minor, temporary physical interventions, such as blocking people from touching something dangerous and then explaining the danger to them is not considered a physical restraint. (Although frequent and repetitive use of even minor and temporary procedures may be considered restraint due to the restraining effect on the person's life.)

    Physical therapist
    A health care practitioner who is knowledgeable in methods of speeding up recovery or enhancing strength and flexibility after an injury.

    Physical Therapy
    A treatment using specific exercises and physical activity to help improve muscle coordination, strength, and mobility for patients. It also includes activities like how to properly use and select mobility and postural equipment. In the beginning, these exercises must be designed by a professional called a physical therapist. They are based on the specific needs of the individual.

    Physical Well-Being
    The state of health that is maintained by the choices we make about how we live our lives. The choices are related to exercise, nutrition, rest and sleep, stress management, management of injury and illness, and the uses of treatments and prescription drugs.

    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.

    Plaque
    A layer of bacteria on the teeth that causes tooth decay and gum disease. Plaque is an invisible bacterium that lives in the mouth all the time. When sugar from food is in the mouth, plaque produces acid. This acid eats away at the teeth and can cause cavities.

    plaques
    Plaques are abnormal clusters of protein that build up between nerve cells.

    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.

    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").

    Policies
    The way things are handled.

    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)

    Pollen
    An airborne allergen that is carried in the wind. Pollen is a major cause of seasonal allergies.

    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 training that is meaningful to one employer will be equally meaningful to the next.

    Port
    A thin catheter attached to a small plastic or metal reservoir. Ports are inserted completely underneath the skin during a surgical procedure and are usually placed in the chest or upper arm. A special needle goes through the skin and into the reservoir when a port is used. Medicine is then injected into the port through the catheter and flows directly into the bloodstream.

    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 Behavioral Supports
    The use of ongoing methods of support that prevent or diminish the use of challenging behaviors, through emphasis on quality of life, person-centered supports, and the proactive teaching of skills for success.

    Positive 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)
    A form of an anxiety disorder that occurs after a traumatic event. A trauma is an experience the person cannot control and where there is extreme fear. After the incident the person may re-experience the feelings of the trauma without reason. They may also experience chronic low level agitation and anxiety, restlessness, or sleep problems. These may be punctuated by other more serious symptoms.

    Power generator
    This is a piece of equipment that is usually powered by gas and can provide (or generate) electricity. Generators are often portable and can be used in an emergency, if the power in a house or building is lost.

    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.

    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.

    Precautions
    Taking action IN ADVANCE to stop a possible danger.

    Predisposition
    An increased risk, tendency, or susceptibility of having a disease or other condition.

    Preferred Provider Organizations
    Patients enrolled in a Preferred Provider Organization (PPO) can select their own doctor from a list of "preferred" physicians and hospitals that are members of the group.

    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 (in relationship to emergency preparedness)
    Making a plan of action before a disaster or emergency strikes.

    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
    A skin wound that develops due to poor blood supply to an area of the body. They commonly form when a person stays in one position for too long, limiting blood flow to the skin. If the skin does not have enough blood supply it will begin to die and form a pressure sore.

    Preventative
    Trying to stop something before it happens.

    Primary Care
    The most basic of healthcare services that are received from a primary care doctor. This would include routine checkups, screenings, blood draws, and other routine tests.

    Primary Care Doctor
    Primary care doctor: This is usually the first doctor that a person sees when he or she needs health care. Primary care doctors can diagnose and treat patients, but might also refer a patient to another doctor who specializes in diagnosis and treatment in specific areas.

    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.

    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.

    Privacy Right Notice
    A form used to let the people you support understand their right to privacy.

    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
    are used to follow-up on the candidate's answers where more information and details are needed.

    Probiotics
    Live microorganisms that are present in certain foods or dietary supplements. They are similar to the good bacteria found in the human gut. Probiotics are often referred to as “friendly bacteria.”

    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.

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

    Profound Intellectual Disability or Profound Mental Retardation
    a classification applied to people with IQ scores between 0 and about 20. There is a wide distribution of skills among people at the high and low ends of the profound disability range, but all individuals within this range have major limitations in all areas of adaptive behavior. Most persons with profound intellectual disability are identified as having major disabilities in their first year of life. Significant physical and health conditions are also very common.

    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 Note
    The official, written, ongoing record of the progress that an individual is making toward achieving the identified goal(s) documented in his or her Individual Recovery Plan. Progress notes are generally recorded in the individual's personal file and record the successes and challenges the individual experiences in the pursuit of his or her goals.

    Progressive discipline
    Is a strategy to use when dealing with repeated poor performance. It is a series of increasingly more formal responses by a supervisor that encourages employee performance improvement.

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

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

    Protected Health Information (PHI)
    Is defined by HIPAA as any individually identifiable health information. This includes Social Security number, all diagnoses, treatment history, services provided and service eligibility.

    Protection and Advocacy
    The Protection and Advocacy (P&A) System and Client Assistance Programs (CAP) are a nationwide network of congressionally mandated, legally-based disability rights agencies. P&As maintain a presence in facilities that care for people with disabilities, where they monitor, investigate and attempt to remedy adverse conditions. Website: 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 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.

    Psychiatrist
    A doctor who specializes in mental and emotional problems.

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

    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.

    Psychosis
    A state in which a person is not connected with reality. A person may experience hallucinations, delusions, or other things that are not based in reality. A person may have a disorganized thought pattern and not make sense to others.

    Psychotherapy
    Intervention used by mental health professionals to assist individuals in working through various problems or issues, using relational and interpersonal techniques.

    Psychotic Depression
    A less common form of depression in which a person may experience symptoms of a major depression along with psychosis. These may include hallucinations or delusions. Psychotic depression is serious and requires immediate treatment.

    Psychotropic
    (sometimes called Medical Restraint) A medication given specifically to alter behavior. Use of psychotropics is considered the equivalent of physical restraint and the same procedures to ensure it is used properly including; using them only when other positive methods are not effective; when behaviors are extreme, dangerous, or are a barrier to quality of life; and only in conjunction with a properly developed and approved behavior support plan. Drugs that have a psychotropic effect but are given for other medical purposes (such as controlling high blood pressure or seizures) 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.

    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).

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

    Qualified Mental Retardation Professional (QMRP)
    A position defined by the federal ICF/MR regulations that requires a four year degree in a human services field and a minimum of 2 years experience working with people who have mental retardation or related conditions. The ICF/MR regulations require that a QMRP review and approve any programs developed for people receiving services.

    Quality Assurance
    This term is generally used to refer to the complex web of regulations and standards, that have been determined to define quality, as well as the licensing and certification processes that enforce them. The focus of these programs is changing to include quality of life outcomes and quality assurance programs are starting to include expectations for quality improvement. Within managed care environments this means an organized set of activities intended systematically to ensure minimal safety of service recipients and to foster performance improvements.

    Quality of Life
    The sum of a person's overall life experience. In general, people are thought to have a high quality of life if their basic needs, such as food, shelter, and safety are met, along with opportunities for growth, choice, new experiences, and development and maintenance of personal relationships. A poor quality of life is one in which basic needs are not met, or people are isolated, lonely, bored, or frustrated on a regular basis.

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    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.

    Radiation
    A treatment that uses radiation beams aimed at a certain area of the body to kill cancer cells.

    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.

    Range of Motion
    The normal amount that joints can move in one direction.

    Range of Motion Exercises
    Exercises that stretch muscles and joints and improve their flexibility.

    Ratify
    To make official and legally binding.

    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.

    Real Risk
    The amount of risk that can reasonably be expected, given the experiences of all people who engage in the activity.

    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
    Is a strategy for acknowledging DSPs and other employees.for a job well done, for special accomplishments, for years of service, for sharing creative ideas and for completing other notable activities.

    Recommended dose
    The amount of a medication that the person taking the medication is instructed to use by a health professional or the company that makes the medication. The recommended dose is written on the bottle or box that holds the medication. Using more than the recommended dose can cause serious health problems.

    Recovering (in relationship to emergency preparedness)
    The actions that help restore things back to normal or as close to normal as possible.

    Recruitment and hiring bonuses effectiveness analysis
    This is an assessment of whether recruitment or hiring bonuses offered by an employer increase retention or recruitment success. The basic analysis examines the percent of new hires who left during the first six or twelve months for those who did earn a bonus compared to the percent of new hires who left who did not earn a bonus.

    Recruitment source cost-benefit analysis
    This is an analysis of which recruitment sources were most effective. It has several parts. First, it examines the proportion of applicants who heard about the job from each source. Second, it examines the proportion of new hires who heard about the job from each source (to see which sources produced the most qualified applicants). Third, it examines how long recruits from each source remained in their jobs (e.g., the proportion who stayed six months or twelve months)

    Refrigeration
    In the mental health community, recovery emphasizes that all individuals living with mental health problems can get better and that it is important in working with them to focus on their hopes for the future and their strengths for realizing their goals. Recovery is defined as a process, an individual journey that involves the rekindling of hope, belief in one's self, choice/self-determination, the compassionate support of others, making meaning and finding purpose in one's life, and participating fully in valued roles in communities of choice.

    Registry
    An official list or record. An emergency registry, such as a shelter or transportation registry, refers to a list of those people who might need extra help during an emergency. These individuals have voluntarily signed up on the registry.

    Rehabilitation
    Activities to help a person maximize his or her skills or strength that may have been affected by an injury, disability, or chronic disease.

    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.

    Rehabilitation Center
    A center dedicated to restoring physical functioning and capacity through various forms of therapy.

    Rehabilitative service model0
    An orientation to delivering supports to people with disabilities or other service needs that focuses on correcting the identified problem or deficiency.

    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.

    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.

    Reliability
    The extent to which the test produces results that can be replicated. This is tested a variety of ways such as by having the same person complete the test more than once, or by having two different people respond to the items referring to the same subject.

    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.

    Reminiscence therapy
    A fancy word meaning 'remembering things from the past.' Reminiscence therapy is a way to help a person deal with memory loss. It uses a variety of ways to remember the past, including music, photos, videos, or stories. These things can help a caregiver start a pleasant, comforting conversation with the person who has dementia.

    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.

    Reproductive System
    A body system that consists of male and female sexual organs such as the penis, prostate, breasts, and ovaries. This body system serves the purpose of reproduction.

    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 System
    : A body system that consists of the lungs, trachea and nose. This system allows oxygen in the body and carbon dioxide out of the body.

    Resignation
    Voluntarily giving up a position or job.

    Respite Care
    For family's who have an individual with a developmental disability living at home, the state pays for a certain number of hours a month for someone outside of the family to take care of their family member so that they make take a break, have a small vacation, or get some errands done.

    Respite services
    Services that give family or other caregivers a break from caregiving duties.

    Responding (in relationship to emergency preparedness)
    The actions that are taken when an emergency or disaster happens.

    Response rate
    The percentage of people who complete a survey out of the total number of people who are asked to complete a survey.

    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.

    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
    The thin lining in the eyeball which contains several layers. It is very delicate and sensitive to light. The retina connects the optic nerve to the brain, which allows us to process what we are seeing.

    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.

    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.

    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 Factor
    Something that increases your changes of getting a chronic disease. There are many types of risk factors. Some are ones a person can control, like habits and behavior, and others that a person cannot change.

    Risk Management
    Making choices that make necessary risk less likely to be harmful. For example, wearing a helmet while riding a motorcycle.

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

    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.

    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.

    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.

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

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    Safety Check
    Precautionary steps of inspecting, examining or reviewing procedures, protocols, rules, tasks, or environments to prevent accidents or injuries from happening.

    Safety Hazard
    Something that can cause harm or damage to a person while at work.

    Safety Mats
    Mats or rugs with rubber backing that are used to help prevent slippage, falls, and/or unnecessary accidents/injuries.

    Saliva
    A clear liquid produced by glands in the mouth. Saliva helps people break down, swallow, and digest food, as well as helps to keep teeth healthy.

    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
    Is a decisions about who should be asked to participate in assessments. This is a balance between resources and information needed. You want to ask enough people to ensure you get a good representation. However, you need not ask every person to participate.

    Sanitary Napkins (also called pads)
    These are also known as sanitary napkins. An absorbent pad or cloth used by a woman when she is bleeding from the vagina. Most often sanitary napkins are used when a woman is menstruating, recovering from vaginal surgery, or bleeding after giving birth. Sanitary pads are secured to the crotch of women’s underwear with adhesive. Pads need to be changed at least every 4-6 hours or more frequently as needed.

    Sanitize
    To clean or sterilize an object or area by removing dirt or germs.

    Satiation
    When the person has had too much of a reinforcer, making it less desirable, and therefore less reinforcing (or even aversive!)

    Schizoaffective Disorder
    When a person meets the criteria for both schizophrenia and a mood disorder.

    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.

    Screenings
    A way of testing or measuring something to look for early signs of health problems.

    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.

    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.).

    Secondhand Smoke
    Smoke that comes from the burning end of a tobacco product (like a cigarette) or the smoke that is exhaled by a person who is smoking.

    Sedentary
    Lacking exercise or activity.

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

    Segregation
    Imposing social separation based on ethnic, class, racial or ability differences.

    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.

    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 Care Skills
    The basic ways that people take care of themselves and their hygiene.

    Self-Determination
    The attitudes and skills needed to take control over and responsibility for one's own life, and to make choices without undue external influence. Self-determination includes the ability to make things happen in one's life by applying problem-solving and decision-making skills, while understanding when assistance is needed.

    Self-Determining Adult:
    A person over 18 who acts as the principal decision-maker in his/her own life, especially around choices regarding lifestyle, occupation, and social interaction. While all people with developmental disabilities have the capacity to be self-determining adults in some capacity, very few are provided the opportunities or experiences necessary to do so.

    Self-Direction
    Self-direction refers to the opportunity for people to plan and live a lifestyle of their own choosing, with the support of others as necessary. Also called Participant Direction or Consumer Direction.

    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-Directed/High Performance Teams
    Although this type of team has been uncommon at the direct-support level, it is now becoming more prominent in the field as the roles of DSPs change. These teams work to create an environment that empowers employees to contribute to the improvement of services by giving them the authority to improve the work itself. This results in more satisfying jobs that offer employees greater challenge, variety, and opportunity for enhancement.

    Self-Esteem
    A confidence and satisfaction in oneself.

    Self-evaluating and/or opinion questions
    Ask the candidate what they think about a certain topic thus revealing information about likes, dislikes, strengths and weaknesses as well as information about goals, values, and philosophies.

    Self-Injurious Behaviors
    (SIB) behaviors that are harmful to oneself, including deliberate self-injury, such as hitting oneself, or behaviors that indirectly cause injury or harm, such as repeatedly rubbing an area of skin until it bleeds.

    Self Medicate
    When a person uses conventional or unconventional methods to treat a disease, disorder, or symptoms. The method may or may not be advised by a doctor; the person uses the method because it feels good. Commonly used to express when a person uses alcohol or drugs to mask symptoms of mental illness rather than receive sanctioned treatment.

    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 program for people with mental retardation who have minimal support needs and can live for the most part independently with a few hours of services each week from paid staff.

    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.

    Senile
    Showing decreased mental function. Short-term memory loss is often associated with being senile.

    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.

    Serotonin
    A neurotransmitter in the brain that affects mood. Levels can be too high or too low.

    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 Recipient Rights
    The rights of a person receiving services. Not all services provide a rights statement, however, some do. The purpose of these rights is to clearly identify, prior to a service arrangement, what rights are maintain and how, during the period of services, so that the person receiving services understands his or her rights and how to make a complaint, if needed. An example would be "resident rights" in long-term care facilities. Some regulations for services require a statement of rights for service recipients, others do not.

    Service Relationships
    Someone who is paid or volunteers to provide a service to a person.

    Service plan
    An agreement or contract between a supported individual and his or her support team. The plan outlines services that will be provided for the individual. These are based on his or her needs for safety and support. The service plan may be referred to by different names. This will depend on the support setting. A service plan may be called an Individual Educational, Program, Habilitation, or Service Plan (IEP/IPP/IHP/ISP). Please refer to the entry IEP/IPP/IHP/ISP for further information.

    Service substitution
    A process requiring the use of a lower cost but equally effective service in place of a higher cost one, most often used in managed care systems.

    Setting Event
    Events, situations, or experiences that influence the likelihood that challenging behaviors will occur in response to a stimulus. The presence of setting events will make challenging behaviors more likely to occur. These events can be social, environmental, or physical events (for example, being asked to sit next to someone who is disliked, being in a room that smells of paint fumes, being tired.). Setting events can be present at the time the behavior occurs, although they may or may not be obvious (for example, having a headache or being in an unfamiliar place, may make a person more likely to feel frustrated and therefore, more likely to engage in challenging behaviors). They can also be things that occur earlier or in another environment but still have an effect on the behaviors (for example, being late for the bus and feeling rushed earlier in the day, may leave a person feeling irritated or worried and lead to undesirable behaviors).

    Severe Disability
    A severe disability is one that makes it very difficult for an individual to perform activities that are typical for a person of the individual's own age. Usually severe disabilities need to be accommodated by providing special equipment of devices, by redesigning the physical or intellectual demands of the activity, or by providing assistance with the activity.

    Severe Intellectual Disability
    People identified as having severe intellectual disability have IQ scores from about 20 to about 35. They also have substantial limitations in all areas of adaptive behavior. People with severe intellectual disability are usually identified in first two years of life and their disability is identified continuously throughout life. Language is usually limited; understanding is often better than speaking. Physical disabilities and seizure disorders are also common.

    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 Development
    The growth and changing of an adolescent's body including sexual organs and characteristics such as body hair, impulses, and awareness.

    Sexual disinhibition
    The loss of sexual inhibitions. This means that a person no longer feels self-conscious about sex and is much more relaxed about it.

    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.

    Sexuality (Human)
    The various states human beings express and show their sexual desires, interests, and preferences.

    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.

    Sheltered work
    A work setting in which only people with mental retardation and other 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 chronic and often fatal disease where malformed red blood cells result in pain, fever, yellow skin color and open leg sores affecting people of central African heritage.

    Side Effects
    1. the adverse conditions sometimes caused by a drug working within the body system(s). (for example, fever, itching, bowel changes, confusion, etc.)

    2. undesirable effects of taking a medication that are different than the intended positive effects for which the medication was given. Common side effects include dizziness, headache and upset stomach.

    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.

    Sign language language interpreter
    A person who can interpret the spoken word into sign language for Deaf or hard-of-hearing individuals, or can interpret sign language into spoken word for those who are not Deaf or hard-of-hearing. A sign language interpreter helps bridge the communication gap between the Deaf and hearing communities.

    Situational questions
    Ask the candidate for information about actions they will take by choosing between equally desirable and undesirable actions in various situations and to get at the person's values, ethics, beliefs and attitudes.

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

    Skill Gaps
    The difference between what an employee needs to know to perform their job effectively and what skills they currently have.

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

    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 sleep disorder characterized by short pauses in breathing during sleep.

    smartphones
    A cell phone that has more functionality than a standard phone. Smartphones have an operating system that allows it to access the Internet, send and receive Emails, and send and receive text messages, among other things.

    Smartphone Applications
    Smartphones have applications that a person can download and use as a form of AAC on their portable devices. Some phones also have settings that enable ‘Text to Speech.’ These applications and settings enable a smartphone or tablet to talk or communicate for the person using it. Picture communication boards can also be downloaded to a smartphone or tablet.

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

    Smoking Materials
    These are usually materials made out of tobacco processed for consumption by smoking. Common examples of smoking materials made of tobacco are cigars, cigarettes and shredded tobacco for pipe smoking.

    Sobriety
    The act of staying sober.

    Social Class
    The distinctive economic and cultural group that a person identifies with.

    Social Control
    Refers to societal processes that regulate individual and group behavior. This can lead to conformity and compliance to the informal or formal rules of a given society, state, or social group. It involves internalization of norms and values, and the experiences of external sanctions, such as positive or negative consequences of behavior.

    Social Disruption
    The interruption or stopping of services and social gatherings.

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

    Social Media
    Social media are interactive Internet-based programs meant to share information with large networks and communities of people. All social media information is shared online through the Internet.

    Social Model of Disability
    This model characterizes disability as something that does not need to be fixed or treated. Instead, disability is something that is experienced by people because there are barriers in the environment. These barriers, and not the disability, are what keep people from fully participating in their community. The barriers can be attitudinal, societal, or even physical barriers in the environment. An example is the lack of curb cuts for a wheelchair or walker.

    Social Networks
    All the people who know a person.

    Social norms
    Unwritten social expectations or social rules that most people pick up on automatically during social development. Social norms are culturally relevant meaning that different cultures and families have different social norms.

    Social rights
    Social rights are the rights a person has based on permissions or entitlements agreed to by the society he or she is a member of. These agreements may or may not be written into laws and include things like the right to have a job of one's choosing, a home, and adequate healthcare, etc.

    Social Roles
    The roles that people participate in when they have social interactions. People with developmental disabilities typically have had very few opportunities to participate in valued social roles where they are looked up to and seen as capable, competent, and valued contributors to the interaction.

    Social routine
    A usual, predictable interaction between familiar communication partners where the goal of the activity is to maintain the interaction.

    Social Security Disability Insurance (SSDI)
    Is a widely used federal entitlement program in the United States. It provides a monthly cash payment to people with disabilities. To be eligible a person (or their parent or spouse) must have paid into the Social Security system for enough time. They must also have a qualifying disability and be unable to meet substantial gainful activity (SGA). In 2009, a person earning below $980 a month was not meeting SGA. SSDI continues to provide cash payment until a person is able to reach SGA or their disability improves. For people with vision impairment, the amount of work to be consider substantial gainful activity was $1,640 in 2009. The amount of money a person receives depends on how much they (or their parents or spouse) have paid into the system.

    Social 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.

    Socialization
    Any activity that is social in nature, interacting with others.

    Social/Emotional Well-Being
    A state of getting along with others in a comfortable manner. It is about feeling good about yourself and your importance to others.

    Social Determinants of Health
    This refers to the conditions in which people are born, grow, live, work, play, and age. The social determinants of health affect a person’s health, functioning, quality of life, and risks.

    Spasm
    A sudden, involuntary contraction of a muscle or group of muscles. Spasms usually happen suddenly, resolve quickly, and can be quite painful.

    Spastic
    (spasticity) stiff muscles.

    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.

    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
    Spina Bifida literally means "split spine." Spina Bifida happens when a baby is in the womb and the spinal column does not close all of the way. Spina Bifida is the most common birth defect that disables people for life.

    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.

    Sports Massage
    A type of massage the combines Swedish massage techniques and deep tissue massage. This type of massage is used to release muscle tension and is commonly used by active or athletic people.

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

    State of Emergency
    When the local, state, or federal government declares that an area is in danger or has experienced a disaster and in response government operations are changed or suspended to address the danger or disaster and regain control of the area.

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

    Staff satisfaction
    Staff satisfaction is the opinion a specific employee has about the organization as a whole and about various parts of their job.

    Staff communication log (or book)
    is a tool using written documentation (handwritten, hardcopy or electronic) to convey important information between staff team and across shifts.

    Stakeholders
    People who are invested in something (for example, because it has a direct impact on their life, because they paid for it, or because they responsible for making it happen) and who can affect it.

    Standardized surveys
    A standardized instrument is one that has been tested for reliability and validity and for which norms have been established.

    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.

    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 his/her difference that are not culturally valued. Stigma can have a profound effect on a person's ability to make friends because it can reduce other's interest or desire in interacting with the person.

    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.

    Stoma
    An opening in the body.

    Stool
    Bowel movements.

    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. This is caused by the onshore winds of a severe hurricane.

    Straight-line Winds
    Very strong winds that produce damage.

    Strategic Alignment
    How a team charter supports and is connected to the organization's mission and vision.

    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 physically, mentally, or emotionally disruptive or upsetting response to something.

    Stroke
    A stroke occurs when there is a blockage of blood flow in the brain or bleeding in the brain. A stroke can affect a person's memory and emotions as well as the ability to think and move around.

    Structured questions
    Are planned and organized before you interview. These are the list of questions that are intended to yield responses that will help you make a judgement about the candidate's ability to meet specific job requirements and work expectations or how the individual will fit in" with the work team. Each candidate would answer the same set of structured questions during the interview so you can more easily and efficiently compare one candidate with another.

    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.

    Subsidized
    This is when the government has an agreement to help pay for an item or service. In this case, the government subsidy helps to pay for the rent of an accessible housing unit for people with disabilities.

    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 a substance for the wrong purpose. This is when a person uses a substance to the point of self-harm.

    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.

    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.

    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.

    Sundowning
    When a person becomes more restless or agitated later in the day – when the sun goes down.

    Supervise
    To watch over the job that another person does, including directing and monitoring their work.

    Supplemental Security Disability Income (SSDI)
    A type of monthly cash payment provided by the federal Social Security Administration for which people with disabilities may be eligible.

    Suprapubic Catheter
    A catheter that is inserted in the abdomen into the bladder rather than through the urethra.

    Supplemental Security Income (SSI)
    Is a needs-based cash assistance program in the United States. It provides income to people with little income and few resources. SSI is a joint federal and state program. Some states choose to supplement the federal dollars to provide added income. In 2009, the federal SSI payment for an individual, which is a base for all states, was $674. This amount is affected by the amount of monthly earned and unearned income a person has.

    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 coordination
    A paid service that includes coordinating professional services and community resources that a person needs to achieve desired goals.

    Support Network
    Support networks are defined as family, friends, paid supporters and other people who play a role in providing everyday or support to an individual. These are people who have give and take relationships with one another and together they serve as a source strength for the person with a disability.

    Support plans
    Support plans are written documentation outlining the details of supports, services, activities, methods and resources needed for an individual with disabilities to achieve individual goals. These goals are based on a person's dreams and preferences. The plan details who is responsible to provide supports. It also delineates how, when, and where supports will be provided. A person's individual support team and/or network along with the person develop the plan using a person-centered approach develop the support plans.

    Support Team
    A network of people who will help during an emergency. A support team can be made up of friends, neighbors, co-workers, home care providers and other people who care about the person.

    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.

    Suppository
    A medication that is inserted into the rectum to encourage a person have a bowel movement.

    Surgery
    Surgery is one way to remove cancer cells. The cancer cells or tumor are cut out of the body or removed in some way.

    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
    Surveys are sets of questions that are asked of employees or others that seek information about attitudes, opinions, characteristics, suggestions and other topics. Survey questions can be close-ended (providing the possible answers and having the respondent select from the list) or open-ended (providing the question and having the respondent answer using his or her own words).

    Swallowing difficulties
    There are a large number of possible swallowing problems related to cerebral palsy. There may be difficulties closing lips, moving tongue to control food during chewing, or to push food from the front to the back of the mouth.

    Swedish Massage
    A common type of massage using long strokes, kneading, and deep circular movements.

    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.

    Symptoms of illness
    Something someone tells you about what they are feeling or experiencing such as high temperature, feeling sick to your stomach, weakness, or being very tired, etc.

    Syndromes
    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.

    Systems Advocacy
    Systems advocacy is is an effort to change the policies, practices, organizations, and rules that affect people. Rather than changing and helping a person, systems advocacy changes organizations and entire systems.

    System-centered planning
    is a method of planning that is designed to meet the requirements of regulations. It usually is a list of interventions and goals. These are organized around what is wrong with the person. The goal is to improve functioning and achieve independence (or minimized dependence on support from others). The plan is achieved when the person enhances his or her functional skills to the level identified on the plan.

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    Tampons
    Tampons are a cotton tube that is inserted into the woman's vagina to absorb menstrual blood. They are inserted with an applicator tube and have a string attached to remove them. Tampons should be changed every 4-6 hours and should never be worn more than 8 hours. Tampons should ONLY be used when a woman is able to insert and remove it herself.

    Tardive Dyskinesia (TD)
    a variable combination of abnormal involuntary movements associated with the long-term use of anti psychotic agents.
    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.

    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.

    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.

    Tay-Sachs
    A hereditary disease in which an enzyme is lacking in a person's body which causes mental retardation, seizures, blindness and death at a young age.

    Team Charter
    A statement that sets a direction for the team, clarifies its purpose and specifies what it intends to accomplish. It could include the team's mission or purpose, specific and measurable goals the team commits to achieve, and the desired end product.

    Technical knowledge
    Questions ask the candidate about what they know about technical subject areas such as the ability to use computers and software or how to complete a task with or without a set of instructions.

    Telecommunications Device for the Deaf (TDDs)
    A communication device used by people who are deaf. Most often this is a teletypewriter, or TTY. A TTY has a keyboard and a visual display so that written messages can be seen while using a telephone. Often, a telecommunications relay service is used with a TTY.

    Temporary Guardianship
    A temporary guardianship expires on a set date, usually within a few weeks to a few months of the time it takes effect. It is rarely used for people who have a disability that permanently affects their ability to make decisions. It is more often used when a person is temporarily incapacitated.

    Tenure
    Tenure of stayers describes the average amount of time employees have stayed on the job. It is usually measured in months or years. Tenure of leavers is a specific form of tenure.

    Tenure of leavers can be described as the proportion of people who remained in their jobs for a certain amount of time before leaving (for example the percent who leave before completing 6 months of employment).

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

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

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

    Thrush
    See also Candidiasis.

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

    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.

    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.

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

    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 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.

    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 warning
    This is an advance warning issued when a tornado has been spotted in the area.

    Tornado watch
    This is issued when weather conditions are favorable for severe thunderstorms. These thunderstorms can produce tornadoes in and close to the area where the tornado watch is issued.

    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 you or harm you. These can be breathed or eaten. Some can be absorbed through the skin. Common toxins in our environment include: lead, nicotine, mercury. Substances that are not toxic to a woman may be toxic or harmful to an unborn baby she is carrying. These may include alcohol, medications, and street drugs. In addition, toxins like mercury may have a minimal effect on the woman in small doses, but cause damage to an unborn child.

    Traditional Chinese Medicine
    This is a type of medicine that originated in China thousands of years ago. People who practice this may use herbs and mind and body-based practices such as acupuncture to treat or prevent health problems.

    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.

    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.

    Tracheostomy
    An incision into the trachea (windpipe) that forms a temporary or permanent opening.

    Training needs assessment
    This is an assessment of a group of employees to identify high priority training needs. This uses competency assessments to identify skill gaps that need to be addressed.

    Transfer
    To move from one place or person to another.

    Transfer Board
    A board used to transfer a person from one place to another such as between a wheelchair to a bed.

    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.

    Trauma
    Trauma is an injury or event that causes harm to a person or harm to a person's body.

    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.

    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 large, high sea wave, or tidal wave, caused by an earthquake.

    TTY
    Text telephones that let people who are Deaf or hard-of-hearing type and read messages over the phone line.

    Tuberculosis (TB)
    A contagious bacterial infection that primarily affects the lungs. It is spread through the air when an infected person who has TB coughs, sneezes, or spits. TB is a communicable disease that can be caught by others.

    Tumor
    An abnormal growth of cells. There are many types of tumors depending on shape or how they grow. Some tumors are benign while others are malignant.

    Turnover
    A method of counting the number of staff leaving employment and is referred to as the crude separation rate or percentage that describes the number of people who have left employment during a specified time period at the worksite divided by the average number of people who worked at the site during the same time period.

    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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    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.

    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.

    Unintelligible
    Difficult to understand; poorly expressed.

    Universal Design
    The concept that good design should accessible, usable, and convenient for everyone regardless of their age, size, or ability. This includes things in the built environment (like parks and sidewalks), as well as products (like cars and computers) and services (like ridesharing and interior design) that are purchased. Universal design is good design for everyone.

    Universal Precautions (also known as �Standard Precautions)
    A standard set of procedures designed to protect individuals from coming into contact with contaminated blood or bodily fluids. Universal precautions greatly reduce the chance of exposure because they require that all human blood and certain human body fluids are treated as if known to be infectious for bloodborne pathogens. Universal precautions must be used every time there is a possibility of any body fluids being present.

    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.

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

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

    Urethra
    The tube through which urine passes to leave the body.

    Urinary Catheter
    A sterile tube inserted into the bladder to drain urine.

    Urinary System
    A body system that consists of the kidney, bladder, urethra. Also includes the penis in males. This body system produces, stores, and eliminates urine.

    Urinary Tract Infection (UTI)
    An infection in the urinary tract commonly caused by bacteria. Bladder infections are the most common type of UTI.

    Urinary Tract
    Area of and around the body parts in which urine passes as it is released.

    urinate
    When the body gets rid of urine.

    Urine
    Liquid waste produced by the kidneys, usually yellowish in color. Urine leaves the body through the urethra.

    Urostomy
    An opening in the body made for the urinary system. A urostomy is made in cases where the long-term drainage of urine through the bladder and urethra is not possible.

    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 rate
    The proportion of positions that are open or unfilled on a specific date.

    Vaccination
    Introducing a vaccine into the body to help it build immunity, or resistance, to certain diseases or viruses.

    Vaccine
    A shot or nasal spray that contains a small, safe amount of a virus or bacteria. This is given to a person so that his or her body can produce immunity, or resistance, to it. Most people who receive a vaccination do not become ill. If they are exposed to the virus or bacteria at a later time, a vaccine will usually keep the person from getting sick, or the person will experience a milder infection.

    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
    Area of and around the vagina or female genitals.

    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
    The extent to which the test accurately measures the concept it is designed to measure. This is tested in a variety of ways. For example, subject matter experts might review it to see if the items are accurate measures of the concept. Validity may also be tested by examining whether scores on the test are correlated with scores on other tests that measure the same concept or by examining whether scores are correlated with other outcomes.

    Valued Roles
    Roles that are perceived as having social value by others, such as being able to contribute financially or in other ways to positive causes and betterment of community, family or organizations. Many people with disabilities are shut out of valued roles due to inaccessibility of accommodations, service barriers, and stigma.

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

    Vascular dementia
    Vascular dementia is the second most common type of dementia. It's caused by a reduced flow of blood to the brain, which kills brain cells. A stroke or a series of strokes can cause vascular dementia. Over time, the damage from these strokes can cause memory loss or confusion in a person.

    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.

    Videophone
    A phone with a video display. This allows individuals who are Deaf or hard-of-hearing to see another person and communicate using American Sign Language.

    Vigorously
    With physical energy and force.

    Vital Signs
    Vital signs are measurements of some basic functions of the body. These measurements are usually taken by a health care provider during a regular preventive checkup. They include body temperature, blood pressure, pulse, and respiratory rate. Taking vital signs can help a health care provider identify if a person has a possible illness or health problem. What is considered normal is different for each person based on age, current health, disability, gender, and weight.

    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
    See Viruses.

    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 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.

    Visualization
    A relaxation exercise where a person breathes deeply and thinks about doing something calming or pleasant.

    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.

    Voice Output Device
    A voice output device is a device that can speak for the user if they can’t. These devices will have pictures, symbols, and a keyboard. The person identifies photos or uses a keyboard to type and then the device ‘talks’ for the person. Voice output devices speak whatever is typed into it, or can also respond or say phrases that are pre-programmed into it.

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

    Volunteers
    People who are often solicited by an agency to provide a certain type of support. The agency takes responsibility to coordinate their schedule, accepts liability for their actions and usually provides volunteer orientation and training programs. Sometimes other organizations (churches, clubs, etc.), use volunteers to conduct some of their charitable programs.

    Vulnerable
    More likely to be wounded or hurt.

    Vulnerable Adults
    Persons 18 years of age or older who: are a resident of a facility; receive licensed services from a home care provider or personal care assistant provider; or regardless of residence or if any service is received, have physical or mental infirmity or other physical, mental or emotional dysfunction, that impairs the individual's ability to provide adequately for his or her own care without assistance, including the provision of food, shelter, clothing, health care or supervision, and/or because of the dysfunction or infirmity and need for assistance, the individual has an impaired ability to protect him/herself from maltreatment.

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    Wage/benefit market analysis
    This is an analysis that compares the wages and benefits offered by a particular organization to wages and benefits offered by direct competitors in the same geographic region, and to wages and benefits offered to persons with similar educational and experiential backgrounds in other types of organizations or companies. The purpose is to check whether significant discrepancies exist that might contribute to relatively high turnover or recruitment difficulties.

    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.

    Walker
    A framed metal device with wheels that are geared to provide stability when walking.

    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.

    Weather radio
    A radio that broadcasts weather information and reports. A weather radio airs both normal and emergency weather information.

    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.

    Well Being
    A state of being satisfied with an individual�s health, quality of life, or overall wellness.

    Wheelchair
    A chair mounted on wheels for use by a person who cannot walk.

    Wind Chill
    A combination of wind speed and air temperature. On a person's skin, the wind chill feels cooler than the actual temperature outside.

    Wind chill factor
    A phenomenon that makes us feel colder than what the air temperature really is in cold weather.

    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 Agreement
    Work Agreement: This document describes what tasks the home care provider will do. It also outlines the responsibilities of the person who the home care provider works for. A work agreement should include things like the work schedule, requirements of the job, the pay rate and schedule, and any benefits that may be provided.

    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.

    Workers Compensation
    This is a program that can cover some costs of medical care and paid time off if you are injured on the job.

    Working Relationship
    The state of connectedness, affiliation or association between direct support professionals, the people they support, frontline supervisors, families and support networks which describe the interdependency or connectivity between these groups who must work together to provide support to individuals with disabilities.

    WRAP Plan
    A self-directed plan developed by a person with serious mental illness that is designed to ensure they have plans in place in case symptoms become difficult to manage independantly.

    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.

    Yoga
    A mind and body practice that traces its origins to ancient India. There are many different styles of yoga, all of which typically involve breathing exercises, placing the body in certain positions, and meditation or relaxation techniques. Meditation can be used as a part of yoga.

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