Disability, SEN and Health Condition Awareness

According to Disability Wales, there is a distinct difference between how a ‘disability’ and ‘impairment’ should be defined.

Impairment: An injury, illness, or congenital condition that causes or is likely to cause a long-term effect on physical appearance and/or limitation of function within the individual that differs from the commonplace.

Disability: The loss or limitation of opportunities to take part in society on an equal level with others due to social and environmental barriers.

Disability Wales states that disabled people generally have fewer opportunities and a lower quality of life than non-disabled people. They state that there are two different ways of explaining what causes this disadvantage; the Medical Model of Disability and the Social Model of Disability.

The Medical Model of Disability: Disabled people not joining in society is seen as a direct result of having an impairment and not as the result of features of our society which can be changed. (This means that an individual’s health condition/impairment is labelled as the disability and is seen as the reason for disadvantages).

The Social Model of Disability: The Social Model of Disability makes the important difference between ‘impairment’ and ‘disability’. The impairments or person’s body are not the problem; social barriers are the main cause of the problems. These barriers include people’s attitudes to disability, and physical and organisational barriers. (This means that an individual’s impairment or health condition does not cause a disability, it’s the attitudes and limitations put in society that cause an individual to be disabled).

Some people (either consciously or subconsciously) will share the belief of the Medical Model which can (arguably) be seen as implemented within the above legal definition of disability; it’s the idea that someone is disabled by the health condition itself rather than by surrounding social and environmental factors. The condition itself is seen to be the reason for being unable to carry out “normal” day-to-day tasks. The Social Model, which states someone is only disabled when the impairment/condition is met with other inhibiting factors.

Examples of how the Medical and Social Models approach a situation differently are as follows:

The important thing to remember when encountering a ‘disability’, (irrespective of which model/definition you feel you align with), is that the individual is not the “problem”, they are not “defective”, they are not “not normal”, and they certainly don’t need “curing”. According to Disability Wales, the disabled person is often placed at the centre of the “problem” and the beliefs listed above are wrongly adopted.

Disabilities, special Educational Needs (SEN), and health conditions come in a wide variety of forms and we understand that every individual is different; each person will experience a health condition or disability differently and will be affected in varying ways. This means every person will have different needs and requirements that should be met in order to allow them to live a happy, healthy, and equal life. We strive to provide equitable support to enable all within our community to access equal opportunities; that’s why we deliver a vast array of support for students and staff which is tailored to each individual’s circumstances and their personal journey within education. 

Here at HoW College we believe everyone within our community should feel welcomed, valued, and included. However, to achieve this we need to all be on the same page and have an understanding of the needs our peers and colleagues can face. That’s why we’ve collated various sources of information below to try and help everyone learn more. Nevertheless, we would like to highlight that we acknowledge and accept that each person has a right to choose the way in which they are identified and would like their condition to be named/referred to; we must not simply assume or decide on someone’s behalf what is/is not acceptable. For this reason, the terminology and guidance we have shared below has been gathered form official medical, government and charitable organisations, but should simply act as a guideline. Each individual person has a right to choose which terminology they do/do not find acceptable, irrespective of what governing bodies may suggest.

What is included on this page is by no means extensive. However, we hope it will provide a good foundation for understanding SEN, disabilities, and health conditions, and will encourage those within our college community to learn more.

Impairment

(according to Disability Wales) - An injury, illness, or congenital condition that causes or is likely to cause a long-term effect on physical appearance and/or limitation of function within the individual that differs from the commonplace.

(Medical definition according to Cambridge Dictionary) - A deterioration in the functioning of a body part, organ, or system, that can be temporary or permanent and can result from the injury or disease.

Impediment

(according to Oxford Languages) - A hindrance or obstruction in doing something.

SEN Support

(according to Mencap) - Special Educational Needs Support; something schools and similar settings use to find and meet the needs of children with special educational needs (SEN). (This term is specific to educational and similar learning environments/settings).

(According to Headway.org) - an acquired brain injury (ABI) is an injury caused to the brain since birth. There are many possible causes, including a fall, a road accident, tumour and stroke. Traumatic brain injury (TBI) is an injury to the brain caused by a trauma to the head (head injury), and possible causes include road traffic accidents, assaults, falls and accidents at home or at work. The effects of a traumatic brain injury can be wide ranging and depend on a number of factors such as the type, location and severity of injury. Acquired brain injury covers all situations in which brain injury has occurred since birth, and includes traumatic brain injury as well as tumour, stroke, brain haemorrhage and encephalitis, to name a few.

According to Remploy, the impact of ABI can be temporary or permanent, and can affect people physically and/or emotionally. It can also affect their behaviour and ability to carry out tasks and process information. People with ABI may experience tiredness or lack stamina and might also find it difficult to concentrate.

(according to the NHS) - Aphasia is when a person has difficulty with their language or speech. It's usually caused by damage to the left side of the brain (for example, after a stroke). People with aphasia often have trouble with the 4 main ways people understand and use language. These are:

• reading
• listening
• speaking
• typing or writing

Speaking problems are perhaps the most obvious, and people with aphasia may make mistakes with the words they use. This could be sometimes using the wrong sounds in a word, choosing the wrong word, or putting words together incorrectly.

Although aphasia affects a person's ability to communicate, it doesn't affect their intelligence.

Aphasia can occur by itself or alongside other disorders, such as visual difficulties, mobility problems, limb weakness, and problems with memory or thinking skills. Common causes include:

• stroke (the most common cause of aphasia)
• severe head injury
• brain tumour
• progressive neurological conditions (conditions that cause the brain and nervous system to become damaged over time, such as dementia)

(According to the NHS) – is a common condition that causes pain and inflammation in a joint. Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis.

Osteoarthritis is the most common type of arthritis in the UK, and it can occur at any age as a result of an injury or be associated with other joint-related conditions, such as gout or rheumatoid arthritis. Osteoarthritis initially affects the smooth cartilage lining of the joint. This makes movement more difficult than usual, leading to pain and stiffness. Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder. This can cause swelling and the formation of bony spurs called osteophytes.

Rheumatoid arthritis often starts when a person is between 40 and 50 years old and women are three times more likely to be affected than men. In rheumatoid arthritis, the body's immune system targets affected joints, which leads to pain and swelling. The outer covering (synovium) of the joint is the first place affected. This can then spread across the joint, leading to further swelling and a change in the joint's shape. This may cause the bone and cartilage to break down. People with rheumatoid arthritis can also develop problems with other tissues and organs in their body.

(According to the NHS) – cerebral palsy is the name for a group of lifelong conditions that affect movement and co-ordination. It's caused by a problem with the brain and can happen if a baby's brain does not develop normally while they're in the womb or is damaged during or soon after birth. Causes of cerebral palsy include bleeding in the baby's brain or reduced blood and oxygen supply to their brain, an infection caught by the mother during pregnancy, the brain temporarily not getting enough oxygen (asphyxiation) during a difficult birth, meningitis or a serious head injury. However, in many cases, the exact cause is not clear. 

The symptoms of cerebral palsy are not usually obvious just after a baby is born. They normally become noticeable during the first two or three years of a child's life. Symptoms can vary significantly and can include:

• delays in reaching development milestones; for example, not sitting by 8 months or not walking by 18 months
• seeming too stiff or too floppy
• weak arms or legs
• fidgety, jerky or clumsy movements
• random, uncontrolled movements
• walking on tiptoes
• a range of other problems; such as swallowing difficulties, speaking problems, vision problems and learning disabilities

(According to the NHS) – the main symptom of chronic fatigue syndrome (also known as Myalgic Encephalomyelitis or CFS/ME), is feeling extremely tired and generally unwell. In addition, people with CFS/ME may have other symptoms, including:

• sleep problems
• muscle or joint pain
• headaches
• a sore throat or sore glands that are not swollen
• problems thinking, remembering or concentrating
• flu-like symptoms
• feeling dizzy or sick
• fast or irregular heartbeats (heart palpitations)

Most people find over exercising makes their symptoms worse and the severity of symptoms can vary from day to day, or even within a day. CFS/ME symptoms are similar to the symptoms of some other illnesses, so it's important to see a GP to get a correct diagnosis.

(According to NHS Inform) - chronic or persistent pain is pain that carries on for longer than 12 weeks despite medication or treatment. Although most people get back to normal after pain following an injury or operation, sometimes the pain carries on for longer or comes on without any history of an injury or operation.

According to Healthline, chronic pain is usually caused by an initial injury, such as a back sprain or pulled muscle, but can occur without reason. It’s believed that chronic pain can develop after nerves become damaged, and the nerve damage makes pain more intense and longer lasting. In these cases, treating the underlying injury may not resolve the chronic pain.

(According to the NHS) – an inherited condition that causes sticky mucus to build up in the lungs and digestive system. The build-up of sticky mucus in the lungs can cause breathing problems and increases the risk of lung infections. Over time, the lungs may stop working properly. Mucus also clogs the pancreas (the organ that helps with digestion), which stops enzymes reaching food in the gut and helping with digestion. This means most people with cystic fibrosis don't absorb nutrients from food properly and need to eat more calories to avoid malnutrition.

Symptoms usually start in early childhood and vary from child to child, but the condition gets slowly worse over time, with the lungs and digestive system becoming increasingly damaged. Treatments are available to help reduce the problems caused by the condition and make it easier to live with, but sadly life expectancy is shortened. Symptoms of cystic fibrosis include recurring chest infections, wheezing, coughing, shortness of breath and damage to the airways (bronchiectasis), difficulty putting on weight and growing, jaundice, diarrhoea, constipation, or sometimes a bowel obstruction in new-born babies (meconium ileus) – meaning surgery may be needed.

(according to the NHS) - epilepsy is a common condition that affects the brain and causes frequent seizures. Seizures are bursts of electrical activity in the brain that temporarily affect how it works and they can cause a wide range of symptoms. Epilepsy can start at any age, but usually starts either in childhood or in people over 60.

Seizures can affect people in different ways, depending on which part of the brain is involved. Possible symptoms include:

• uncontrollable jerking and shaking, called a "fit"
• losing awareness and staring blankly into space
• becoming stiff
• strange sensations, such as a "rising" feeling in the tummy, unusual smells or tastes, and a tingling feeling in your arms or legs
• collapsing
• passing out and not remembering what happened

You should see a GP if you think you might have had a seizure for the first time. This does not mean you have epilepsy, as a seizure can have several causes and sometimes they're just a one-off, but you should see a doctor to find out why it happened.

Remember, always call 999 for an ambulance if someone:

• is having a seizure for the first time
• has a seizure that lasts more than 5 minutes
• has lots of seizures in a row
• has breathing problems or has seriously injured themselves

(according to the NHS) – hearing loss can be temporary or permanent. It often comes on gradually as you get older, but it can sometimes happen suddenly. You should see a GP if you notice any problems with your hearing so you can find out the cause and get advice on treatment. Common signs include:

• difficulty hearing other people clearly, and misunderstanding what they say, especially in noisy places
• asking people to repeat themselves
• listening to music or watching television loudly
• having to concentrate hard to hear what other people are saying, which can be tiring or stressful

The signs can be slightly different if you only have hearing loss in one ear or if a young child has hearing loss.

According to the Royal Association for Deaf People (RAD), the word ‘deaf’ is an umbrella term used to describe people with all degrees of deafness. For profoundly Deaf people in the UK, British Sign Language (BSL) is usually their first or preferred language.  The capital ‘D’ is not a typing error – it is used to denote the pride that people have in their deafness. BSL users belong to a Deaf community that is very proud of its language, heritage and culture. Deaf people consider themselves a linguistic minority and not disabled; to the Deaf community, deafness is not a problem that needs to be fixed. Other correct terms RAD identify are “Deafblind” and “Deafened”. Deafened is used to describe people who become severely or profoundly deaf after learning to speak, and often happens as a result of illness or an accident. Becoming deafened in adult life is a life-changing event with far-reaching consequences, not only for the deafened person, but also for their friends and family.

(according to the NHS) – an amputation is the surgical removal of part of the body, such as an arm or leg. An amputation may be needed if:

• you have a severe infection in your limb
• your limb has been affected by gangrene (often as a result of peripheral arterial disease) 
• there's serious trauma to your limb, such as a crush or blast wound
• your limb is deformed and has limited movement and function

Most amputations involve removing a section of a limb rather than the entire limb. Once the section of the limb has been amputated, additional techniques can be used to help improve the function of the remaining part of the limb and reduce the risk of complications. Following an amputation, the rehabilitation process will begin and is tailored to the individual. This can be a long process and can involve “transfer techniques” to help an individual move around more easily, prosthetic limb use, and techniques to help maintain mobility and muscle strength.

(according to the NHS) – a migraine is usually a moderate or severe headache felt as a throbbing pain on one side of the head. Many people also have symptoms such as feeling sick, being sick and increased sensitivity to light or sound. A Migraine is a common health condition, affecting around 1 in every 5 women and around 1 in every 15 men, and they usually begin in early adulthood. There are several types of migraine, including:

• migraine with aura – where there are specific warning signs just before the migraine begins, such as seeing flashing lights
• migraine without aura – the most common type, where the migraine happens without the specific warning signs
• migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop

Some people have migraines frequently, up to several times a week. Other people only have a migraine occasionally. It's possible for years to pass between migraine attacks.

You should see a GP if you have frequent or severe migraine symptoms (on more than five days a month), even if they can be controlled with medicines, as you may benefit from preventative treatment.

You should call 999 for an ambulance immediately if you or someone you're with experiences:

• paralysis or weakness in one or both arms and/or one side of the face
• slurred or garbled speech
• a sudden agonising headache resulting in a severe pain unlike anything experienced before
• headache along with a high temperature (fever), stiff neck, mental confusion, seizures, double vision and a rash

(according to the NHS) – MND (also known as Amyotrophic lateral sclerosis or ALS in other countries), is an uncommon condition that affects the brain and nerves, and it causes weakness that gets worse gradually. Over time, moving around, swallowing and breathing get increasingly difficult, and treatments like a feeding tube or breathing air through a face mask may be needed. There's no cure for MND, but there are treatments to help reduce the impact it has on a person's daily life, and some people live with the condition for many years. However, MND can significantly shorten life expectancy and, unfortunately, eventually leads to death. Symptoms of motor neurone disease happen gradually and may not be obvious at first. Early symptoms can include:

• weakness in your ankle or leg – you might trip, or find it harder to climb stairs
• slurred speech, which may develop into difficulty swallowing some foods
• a weak grip – you might drop things, or find it hard to open jars or do up buttons
• muscle cramps and twitches
• weight loss – your arms or leg muscles may have become thinner over time
• difficulty stopping yourself from crying or laughing in inappropriate situations

Motor neurone disease is an uncommon condition that mainly affects people in their 60s and 70s, but it can affect adults of all ages. It's caused by a problem with cells in the brain and nerves called motor neurones; these cells gradually stop working overtime and it's not known why this happens. Having a close relative with motor neurone disease, or a related condition called frontotemporal dementia, can sometimes mean you're more likely to get it but in most cases it does not run in families.

(according to the NHS) – MS is a condition that can affect the brain and spinal cord, causing a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance. It's a lifelong condition that can sometimes cause serious disability, although it can occasionally be mild. In many cases, it's possible to treat symptoms; however, average life expectancy is slightly reduced for people with MS.

MS is most commonly diagnosed in people in their 20s and 30s, although it can develop at any age. It's about two to three times more common in women than men and MS is one of the most common causes of disability in younger adults. The main symptoms of MS include:

• fatigue
• difficulty walking
• vision problems, such as blurred vision
• problems controlling the bladder
• numbness or tingling in different parts of the body
• muscle stiffness and spasms
• problems with balance and co-ordination
• problems with thinking, learning and planning

Depending on the type of MS you have, your symptoms may come and go in phases or get steadily worse over time.

(according to the NHS) – the muscular dystrophies (MD) are a group of inherited genetic conditions that gradually cause the muscles to weaken, leading to an increasing level of disability. MD is a progressive condition, which means it gets worse over time; it often begins by affecting a particular group of muscles, before affecting the muscles more widely. Some types of MD eventually affect the heart, or the muscles used for breathing, at which point the condition becomes life-threatening. There's no cure for MD, but treatment can help to manage many of the symptoms.

Some of the more common types of MD include:

• Duchenne MD – one of the most common and severe forms, it usually affects boys in early childhood; people with the condition will usually only live into their 20s or 30s
• Myotonic dystrophy – a type of MD that can develop at any age; life expectancy isn't always affected, but people with a severe form of myotonic dystrophy may have shortened lives
• Facioscapulohumeral MD– a type of MD that can develop in childhood or adulthood; it progresses slowly and isn't usually life-threatening
• Becker MD – closely related to Duchenne MD, but it develops later in childhood and is less severe; life expectancy isn't usually affected as much
• Limb-girdle MD – a group of conditions that usually develop in late childhood or early adulthood; some variants can progress quickly and be life-threatening, whereas others develop slowly
• Oculopharyngeal MD – a type of MD that doesn't usually develop until a person is between 50 and 60 years old, and doesn't tend to affect life expectancy
• Emery-Dreifuss MD – a type of MD that develops in childhood or early adulthood; most people with this condition will live until at least middle age

(according to the World Health Organisation (WHO)) – musculoskeletal conditions comprise more than 150 conditions that affect the locomotor (movement) system of individuals. They range from those that arise suddenly and are short-lived, such as fractures, sprains and strains, to lifelong conditions associated with ongoing functioning limitations and disability. Musculoskeletal conditions are typically characterised by pain (often persistent) and limitations in mobility, dexterity and overall level of functioning, reducing people’s ability to work. Musculoskeletal conditions include conditions that affect:

• joints, such as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, ankylosing spondylitis
• bones, such as osteoporosis, osteopenia and associated fragility fractures, traumatic fractures
• muscles, such as sarcopenia
• the spine, such as back and neck pain
• multiple body areas or systems (such as regional and widespread pain disorders and inflammatory diseases)

(according to the NHS) – osteoporosis is a health condition that weakens bones, making them fragile and more likely to break. It develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a bone to break (fracture). The most common injuries in people with osteoporosis are a broken wrist, broken hip, and broken spinal bones (vertebrae). However, breaks can also happen in other bones, such as in the arm or pelvis. Sometimes a cough or sneeze can cause a broken rib or the partial collapse of one of the bones of the spine. Osteoporosis is not usually painful until a bone is broken, but broken bones in the spine are a common cause of long-term pain. Some factors that can increase the risk of developing osteoporosis include:

• high-dose steroid tablets for more than three months
• other medical conditions (such as inflammatory conditions, hormone-related conditions, or malabsorption problems)
• a family history of osteoporosis, particularly a hip fracture in a parent
• long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-oestrogen tablets that many women take after breast cancer
• having or having had an eating disorder such as anorexia or bulimia
• having a low body mass index (BMI)
• not exercising regularly
• heavy drinking and smoking

The stage before osteoporosis is called osteopenia. This is when a bone density scan shows you have lower bone density than the average for your age, but not low enough to be classed as osteoporosis. Osteopenia does not always lead to osteoporosis. It depends on many factors. If you have osteopenia, there are steps you can take to keep your bones healthy and reduce your risk of developing osteoporosis, just visit the NHS website for more information.

(according to the NHS) – the loss of the ability to move some or all of your body.

It can have lots of different causes, some of which can be serious. Depending on the cause, it may be temporary or permanent. The main symptom of paralysis is the inability to move part of your body, or not being able to move at all. It can start suddenly or gradually and sometimes it can come and go. Paralysis can affect any part of the body, including:

• the face
• the hands
• one arm or leg (monoplegia)
• one side of the body (hemiplegia)
• both legs (paraplegia)
• both arms and legs (tetraplegia or quadriplegia)

The affected part of your body may also be stiff (spastic paralysis), with occasional muscle spasms, floppy (flaccid paralysis), numb, painful or tingly.

(according to the NHS) – scoliosis is where the spine twists and curves to the side. It can affect people of any age, from babies to adults, but most often starts in children aged 10 to 15. Scoliosis can improve with treatment, but it is not usually a sign of anything serious and treatment is not always needed if it's mild. Signs of scoliosis include:

• a visibly curved spine
• leaning to one side
• uneven shoulders
• one shoulder or hip sticking out
• the ribs sticking out on one side
• clothes not fitting well

Some people with scoliosis may also have back pain although this is usually more common in adults with the condition. Many people will not need any treatment and only a small number will need to have surgery on their spine. Based on age, treatments can be as follows:

• Babies and toddlers may not need treatment as the curve might improve over time. A plaster cast or plastic brace may be fitted to their back to stop the curve getting worse as they grow.
• Older children may wear a back brace to stop the curve getting worse until they stop growing. Sometimes surgery may be needed to control the growth of the spine until an operation to straighten it can be done when they stop growing.
• Adults may need treatment to relieve pain, such as painkillers, spinal injections and, very occasionally, surgery.

Most people with scoliosis are able to live normal lives and can do most activities, including exercise and sports. The condition does not usually cause significant pain or any other health problems and tends to stay the same after you stop growing; however, those with scoliosis should see a GP if it gets any worse.

(according to Healthline) – speech disorders can affect the way a person creates sounds to form words. Speech disorders affect the vocal cords, muscles, nerves, and other structures within the throat, and causes may include:

• vocal cord damage
• brain damage
• muscle weakness
• respiratory weakness
• strokes
• polyps or nodules on the vocal cords
• vocal cord paralysis

Some of the most common speech disorders are stammering (stuttering), apraxia and dysarthria.

Apraxia is a motor speech disorder caused by damage to the parts of the brain related to speaking.

Dysarthria is a motor speech disorder in which the muscles of the mouth, face, or respiratory system may become weak or have difficulty moving. Some people with speech disorders are aware of what they would like to say but unable to articulate their thoughts. 

Stammering (according to the NHS) is when you repeat sounds or syllables – for example, saying "mu-mu-mu-mummy", when you make sounds longer – for example, "mmmmmmummy", and/or when a word gets stuck or does not come out at all. There are two main types of stammering; developmental stammering (the most common type of stammering that happens in early childhood when speech and language skills are developing quickly), and acquired or late-onset stammering (relatively rare and happens in older children and adults as a result of a head injury, stroke or progressive neurological conditions. It can also be caused by certain drugs, medicines, or psychological or emotional trauma).

(according to the NHS) – when a baby's spine and spinal cord does not develop properly in the womb, causing a gap in the spine. Spina bifida is a type of neural tube defect (the neural tube is the structure that eventually develops into the baby's brain and spinal cord). The neural tube starts to form in early pregnancy and closes about 4 weeks after conception. In spina bifida, part of the neural tube does not develop or close properly, leading to defects in the spinal cord and bones of the spine (vertebrae). It's not known what causes spina bifida, but a lack of folic acid before and in the early stages of pregnancy is a significant risk factor.

There are several different types of spina bifida, including:

Myelomeningocele – the most severe type of spina bifida; the baby's spinal canal remains open along several vertebrae in the back, allowing the spinal cord and protective membranes around it to push out and form a sac in the baby's back.

Meningocele – another serious type of spina bifida where the protective membranes around the spinal cord (meninges) push out through the spine; the spinal cord usually develops normally so surgery can often be used to remove the membranes without damaging the nerves.

Spina bifida occulta – the most common and mildest type of spina bifida. One or more vertebrae does not form properly, but the gap in the spine is very small; spina bifida occulta does not usually cause any problems and most people are unaware they have it.

Most people with spina bifida are able to have surgery to close the opening in the spine but the nervous system will usually already have been damaged. This can lead to problems such as:

• weakness or total paralysis of the legs
• bowel incontinence and urinary incontinence
• loss of skin sensation in the legs and around the bottom – the child is unable to feel hot or cold, which can lead to accidental injury

Many babies will have or develop hydrocephalus (a build-up of fluid on the brain), which can further damage the brain.

(according to the NHS) – a stroke is a serious life-threatening medical condition that happens when the blood supply to part of the brain is cut off. Strokes are a medical emergency and urgent treatment is essential; the sooner a person receives treatment for a stroke, the less damage is likely to happen. The main symptoms of stroke can be remembered with the word FAST:

Face – the face may have dropped on one side, the person may not be able to smile, or their mouth or eye may have dropped.

Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in one arm.

Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you're saying to them.

Time – it's time to dial 999 immediately if you see any of these signs or symptoms.

Like all organs, the brain needs the oxygen and nutrients provided by blood to function properly. If the supply of blood is restricted or stopped, brain cells begin to die. This can lead to brain injury, disability and possibly death. There are two main causes of strokes:

Ischaemic – where the blood supply is stopped because of a blood clot, accounting for 85% of all cases

Haemorrhagic – where a weakened blood vessel supplying the brain bursts

There's also a related condition called a transient ischaemic attack (TIA), where the blood supply to the brain is temporarily interrupted. This causes what's known as a mini stroke which can last a few minutes or persist up to 24 hours. TIAs should be treated urgently, as they're often a warning sign you're at risk of having a full stroke in the near future; you should always seek medical advice as soon as possible, even if your symptoms get better.

People who survive a stroke are often left with long-term problems caused by injury to their brain. Some people need a long period of rehabilitation before they can recover their former independence, while many never fully recover and need ongoing support after their stroke.

(according to the NHS) – a condition that causes a person to make involuntary sounds and movements called tics. The condition usually starts during childhood, but the tics and other symptoms often improve after several years and sometimes go away completely. People with Tourette's syndrome may also have OCD, ADHD or learning difficulties and whereas there's no cure for Tourette's syndrome, treatment can help manage symptoms.

Tics are the main symptom of Tourette's syndrome and people with the condition usually have a combination of physical and vocal tics. Examples of physical and vocal tics include:

• blinking
• eye rolling
• grimacing
• shoulder shrugging
• jerking of the head or limbs
• jumping
• twirling
• touching objects and other people
• grunting
• throat clearing
• whistling
• coughing
• tongue clicking
• animal sounds
• saying random words and phrases
• repeating a sound, word or phrase
• swearing (however this is rare and only affects about 1 in 10 people with Tourette's syndrome)

Tics are not usually harmful to a person's overall health, but physical tics, such as jerking of the head, can be painful. Tics can be worse on some days than others and they may be worse during periods of stress, anxiety, and tiredness.

(according to the NHS) – in the UK, there are almost 2 million people living with sight loss and of these, around 360,000 are registered as blind or partially sighted. Being told you have a visual impairment that can't be treated can be difficult to come to terms with. Some people go through a process similar to bereavement, where they experience a range of emotions including shock, anger, and denial, before eventually coming to accept their condition.

According to Sense UK, there are many different reasons why you might experience loss of vision. Some people are born blind/with some form of vision loss, and others develop conditions causing vision loss later on in life due to illness, accidents, or simply ageing. Vision loss can come in many forms; it can be a full or partial loss of sight, temporary or permanent, and it could affect one or both eyes. The different types of vision loss are as follows:

Congenital vision loss – This is when you are born blind or with a partial vision loss, some causes may be genetic, due to premature birth or infection during pregnancy such as rubella.

Acquired vision loss – This is a term used if a person experiences sight loss later in life. Anyone can lose vision at any time through illness, accident or as a result of ageing. We all experience a level of sight loss as we get older; this is considered a normal part of ageing. But sometimes the loss is more severe and can't be corrected as easily. There are many eye conditions that can develop with age such as macular degeneration, glaucoma, cataracts and diabetic retinopathy.

Mixed vision loss – People may have more than one type of vision loss and a congenital loss may be complicated by an acquired loss later in life.

(according to the NHS) - anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. Everyone has feelings of anxiety at some point in their life, but some people find it hard to control their worries. Their feelings of anxiety are more constant and can often affect their daily lives. Anxiety tends to be the main symptom of disorders such as panic disorders, phobias, post-traumatic stress disorder (PTSD), social anxiety disorder and general anxiety disorder (GAD).

GAD is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. GAD can cause both psychological (mental) and physical symptoms which can vary from person to person, but can include:

• feeling restless or worried
• having trouble concentrating or sleeping
• dizziness or heart palpitations

(according to the NHS) – a mental health condition that affects your moods, which can swing from one extreme to another. It used to be known as manic depression. People with bipolar disorder have episodes of depression (feeling very low and lethargic) and mania (feeling very high and overactive), and symptoms of the disorder depend on which mood you're experiencing. Unlike simple mood swings, each extreme episode of bipolar disorder can last for several weeks (or even longer).

(according to the NHS) – most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days. Depression affects people in different ways and can cause a wide variety of symptoms which range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety and there can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.

The symptoms of depression range from mild to severe; at its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living. Sometimes there's a trigger for depression like life-changing events, such as bereavement, losing your job or giving birth. People with a family history of depression are more likely to experience it themselves, but you can also become depressed for no obvious reason. It's important to seek help from a GP if you think you may be depressed.

(according to the NHS) – OCD is a common mental health condition where a person has obsessive thoughts and compulsive behaviours. OCD can be distressing and significantly interfere with your life, but treatment can help you keep it under control. If you have OCD, you'll usually experience frequent obsessive thoughts and compulsive behaviours.

An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease.

A compulsion is a repetitive behaviour or mental act that you feel you need to do to temporarily relieve the unpleasant feelings brought on by the obsessive thought.

For example, someone with an obsessive fear of being burgled may feel they need to check all the windows and doors are locked several times before they can leave their house.

(according to Mind UK) - Our personality is the collection of thoughts, feelings and behaviours that makes each of us the individuals we are. However, if you experience significant difficulties in how you relate to yourself and others and have problems coping day-to-day, you may receive a diagnosis of personality disorder.

You might be given a diagnosis of personality disorder if all of these apply:

• The way you think, feel and behave causes you significant problems in daily life. For example, you may feel unable to trust others or you may often feel abandoned, causing you or others distress in day-to-day relationships.
• You experience these problems across different aspects of your life. For example, you may struggle to start or keep friendships, to control your feelings and behaviour, or get on with people. There may be an intensity to your emotions that makes them feel frightening and overwhelming sometimes.
• These problems continue for a long time. These difficult patterns may have started when you were a child or teenager and can carry on into your life as an adult.
• These problems are not solely caused by a substance or a medical condition. For example, using drugs or medication can cause changes in people, as can the physical effects of experiences like head trauma.

You can only be diagnosed with a personality disorder by a mental health professional experienced in diagnosing and treating mental health problems, such as a psychiatrist or psychologist – not by your GP.

(according to Mind UK) – Post-traumatic stress disorder (PTSD) is a mental health problem you may develop after experiencing traumatic events. When you go through something you find traumatic it's understandable to experience some symptoms of PTSD afterwards, such as feeling numb or having trouble sleeping. This is sometimes described as an 'acute stress reaction'. Many people find that these symptoms disappear within a few weeks, but if your symptoms last for longer than a month, you might be given a diagnosis of PTSD. Your GP might refer you to a specialist before this if your symptoms are particularly severe.

PTSD may be described differently in some situations:

Delayed-onset PTSD – if your symptoms emerge more than six months after experiencing trauma, this might be described as 'delayed PTSD' or 'delayed-onset PTSD'.

Complex PTSD – if you experienced trauma at an early age or it lasted for a long time, you might be given a diagnosis of 'complex PTSD'.

Birth trauma – PTSD that develops after a traumatic experience of childbirth is also known as 'birth trauma'.

Secondary trauma - If you experience some PTSD symptoms while supporting someone close to you who's experienced trauma.

(according to the NHS) – schizophrenia is a severe long-term mental health condition. It causes a range of different psychological symptoms. Doctors often describe schizophrenia as a type of psychosis; this means the person may not always be able to distinguish their own thoughts and ideas from reality. Symptoms of schizophrenia include: 

• hallucinations – hearing or seeing things that do not exist outside of the mind
• delusions – unusual beliefs not based on reality
• muddled thoughts based on hallucinations or delusions
• losing interest in everyday activities
• not caring about your personal hygiene
• wanting to avoid people, including friends

Schizophrenia does not cause someone to be violent and people with schizophrenia do not have a split personality.

(according to the NHS) - Attention Deficit Hyperactivity Disorder (ADHD) is a condition that affects people's behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse. Symptoms can include inattentiveness (e.g. short attention span, forgetfulness, making silly mistakes), and hyperactivity and impulsiveness (e.g. unable to sit still, fidgeting, excessive talking).

(according to National Autistic Society UK) - Asperger syndrome was introduced to the world by British psychiatrist Lorna Wing in the 1980s. The term derives from a 1944 study by Austrian paediatrician Hans Asperger (new evidence about his problematic history has recently been revealed and provoked debate). Many people who appear to have Asperger syndrome are now being diagnosed with an ASD instead. Each person is different, and it is up to each individual how they choose to identify.

Some people with Asperger syndrome have mental health issues or other conditions like those with an autistic spectrum disorder, meaning they need different levels and types of support. People with Asperger syndrome see, hear and feel the world differently to other people. If you have Asperger syndrome, you have it for life – it is not an illness or disease and cannot be ‘cured’. Often people feel that Asperger syndrome is a fundamental aspect of their identity. People with Asperger syndrome don't have the learning disabilities that many autistic people have, but they may have specific learning difficulties. They may have fewer problems with speech but may still have difficulties with understanding and processing language.

(according to the NHS) – autism is a spectrum and refers to a condition that can come in many forms and affect each individual very differently; Some autistic people need little or no support, whereas others may need help from a parent or carer every day. Someone with an autism spectrum disorder may:

• find it hard to communicate and interact with other people
• find it hard to understand how other people think or feel
• find things like bright lights or loud noises overwhelming, stressful or uncomfortable
• get anxious or upset about unfamiliar situations and social events
• take longer to understand information
• do or think the same things over and over

Being autistic does not mean you have an illness or disease. It means your brain works in a different way from other people. It's something you're born with or first appears when you're very young and if you're autistic, you're autistic your whole life. Autism is not a medical condition with treatments or a "cure". But some people need support to help them with certain things.

(according the NHS) - Down's syndrome is when you're born with an extra chromosome. You usually get an extra chromosome by chance, because of a change in the sperm or egg before you're born, and this change does not happen because of anything anyone did before or during pregnancy.

People with Down's syndrome will have some level of learning disability meaning they'll have a range of abilities. Some people will be more independent and do things like get a job, whereas other people might need more regular care. But, like everyone, people with Down's syndrome have their own personalities, things they like and dislike, and things that make them who they are.

(according to the British Dyslexia Association) - dyscalculia is a specific and persistent difficulty in understanding numbers which can lead to a diverse range of difficulties with mathematics. It will be unexpected in relation to age, level of education and experience and occurs across all ages and abilities. It can occur singly but often co-occurs with other specific learning difficulties, mathematics anxiety, and medical conditions. A person with dyscalculia/mathematical learning difficulties may:

• find counting backwards difficult
• have a poor sense of number and estimation
• have difficulty in remembering ‘basic’ facts, despite many hours of practice/rote learning
• have no strategies to compensate for lack of recall, other than to use counting
• find difficulty in understanding place value and the role of zero in the Arabic/Hindu number system
• have no sense of whether any answers that are obtained are right or nearly right
• be slower to perform calculations (therefore, give fewer examples, rather than more time)
• forget mathematical procedures, especially as they become more complex, for example ‘long’ division; addition is often the default operation. The other operations are usually very poorly executed (or avoided altogether)
• avoid tasks that are perceived as difficult and likely to result in a wrong answer
• have weak mental arithmetic skills
• have high levels of mathematics anxiety

(according to the British Dyslexia Association) – Dyslexia is a learning difference which primarily affects reading and writing skills; however, it does not only affect these skills. Dyslexia is actually about information processing. Dyslexic people may have difficulty processing and remembering information they see and hear, which can affect learning and the acquisition of literacy skills. Dyslexia can also impact on other areas such as organisational skills. It is important to remember that there are positives to thinking differently. Many dyslexic people show strengths in areas such as reasoning and in visual and creative fields.

(according to the NHS) – Dyspraxia (also known as Developmental Co-ordination Disorder or DCD), is a condition affecting physical co-ordination. It causes a child to perform less well than expected in daily activities for their age and appear to move clumsily. DCD is thought to be around 3 or 4 times more common in boys than girls, and the condition sometimes runs in families.

Early developmental milestones of crawling, walking, self-feeding and dressing may be delayed in young children with DCD. Drawing, writing and performance in sports are also usually behind what is expected for their age. Although signs of the condition are present from an early age, children vary widely in their rate of development. This means a definite diagnosis of DCD does not usually happen until a child with the condition is 5 years old or more.

(according to the NHS) – a learning disability affects the way a person understands information and how they communicate. This means they can have difficulty understanding new or complex information, learning new skills, and coping independently.

A learning disability can be mild, moderate or severe; some people with a mild learning disability can talk easily and look after themselves but may need a bit longer than usual to learn new skills. Other people may not be able to communicate at all and have other disabilities as well. Some adults with a learning disability are able to live independently, while others need help with everyday tasks, such as washing and dressing, for their whole lives. It depends on the person's abilities and the level of care and support they receive. Children and young people with a learning disability may also have special educational needs (SEN).

A profound and multiple learning disability (PMLD) is when a person has a severe learning disability and other disabilities that significantly affect their ability to communicate and be independent. Someone with PMLD may have severe difficulties seeing, hearing, speaking and moving. They may have complex health and social care needs due to these or other conditions. People with PMLD need a carer or carers to help them with most areas of everyday life, such as eating, washing and going to the toilet. With support, many people can learn to communicate in different ways, be involved in decisions about themselves, do things they enjoy, and achieve more independence.

(according to the National Autistic Society) – Pathological Demand Avoidance (PDA) is a profile that describes those whose main characteristic is to avoid everyday demands and expectations to an extreme extent. PDA often (but not always) is accompanied by high levels of anxiety. 

The existence of PDA as a ‘diagnostic term’ and how it fits within the autism spectrum is widely debated. With limited evidence-based research there is no conclusive and agreed upon definition of PDA. What is generally agreed upon is what is often referred to as a PDA profile. People with a PDA profile can appear to have better social understanding and communication skills than some other autistic people and are often able to use this to their advantage. However, these apparent social abilities can often mask difficulty with processing and understanding communication and social situations. The distinctive features of a demand avoidant profile include: 

• resists and avoids the ordinary demands of life
• uses social strategies as part of avoidance, for example, distracting, giving excuses
• appears sociable, but lacks some understanding
• experiences excessive mood swings and impulsivity
• appears comfortable in role play and pretence
• displays obsessive behaviour that is often focused on other people. 

People with this profile can appear excessively controlling and dominating, especially when they feel anxious. However, they can also be confident and engaging when they feel secure and in control. It’s important to acknowledge that these people have a hidden disability.

• Name calling and deliberately using offensive terms such as ‘handicapped’, ‘spastic’, ‘retard’ and ‘invalid’
• Any form of physical and emotional abuse/harassment based on an individual’s health condition
• Telling someone there’s something wrong with them or that they are a problem/inconvenience; acting as though someone with a health condition needs to be cured
• Expressing the belief that someone with a health condition or disability is “not normal” and those with such conditions are not equal to those without
• Eugenics; (according to Britannica) the selection of desired heritable characteristics in order to improve future generations, typically in reference to humans. The stance is taken that only those with desirable hereditary traits should mate in order to strengthen human species, and that “breeding out” of disease and disabilities should take place as they are “undesirable” characteristics
• Deliberately hiring/befriending/dating someone with a disability or health condition for personal gain; this could be to meet legal/inclusivity requirements, or to look like a “nice person”. This is known as positive discrimination (the act of favouring people due to certain characteristics)
• Deliberately failing to make reasonable adjustments to accommodate for those with health conditions, impairments and disabilities; this can happen in work, education and in social settings
• Dismissing someone from their job for health condition/disability-based reasons such as needing extra time to attend medical appointments and needing extra support to carry out their job (such as wheelchair access, more seating to avoid standing for long periods of time, equipment to help with sight/hearing etc.). Likewise, not hiring an individual for these reasons is also unacceptable

• Using incorrect terminology; this can be due to naivety or ignorance surrounding disabilities, SEN and health conditions
• Failing to make reasonable adjustments to accommodate for those with health conditions, impairments and disabilities; this can occur when an individual/organisation haven’t encountered a certain condition before (e.g. not having a lift available or not having correct toilet facilities)
• Wanting to try and find a cure/solution to someone’s disability or condition. This can often be well-intended; however, this can still give the perception of thinking there’s something “wrong” with an individual based on societal standards of what’s “normal” and how someone should be. It’s often much kinder and more acceptable to simply directly ask an individual if there’s any way you can help and/or support them
• Assuming someone’s preferred method of communication, for example immediately assuming someone who is Deaf/has hearing loss will want to communicate via British Sign Language. Some utilise BSL, Sign Supported English (SSE), and/or lip reading; the important thing is to give the individual the choice and not just assume
• Assuming someone’s disabled/impaired/has a health condition based on appearance and/or how they communicate; this often becomes an issue as it makes the assumption on how someone should be identified and takes away the individual’s choice of identification. This also can be very offensive as it can give the impression that the individual is defined by their disability/condition; some people choose to define themselves this way as they are proud of who they are and see their condition as a big part of their identity, whereas others see it as only a small part of who they are and don’t wish for it to be their key defining characteristic. Again, the important thing is to give the individual the choice and not just assume
• Paying particular attention and offering proportionally more help to someone with a condition/disability, without being told extra support is required (this can occur in employment, education and socially). This can often come from a good place of wanting to offer support for someone; however, this can be incredibly offensive as it can challenge someone’s independence and ability, and on occasion, highlight someone’s condition more significantly without permission. This can as a result cause self-esteem issues

Discrimination or cases of inequality can be reported to one of your lecturers, any nearby member of staff, or to your College/school Welfare service. (HoW College Welfare Service Worcester and Malvern, welfarew&m@howcollege.ac.uk, and Redditch and Bromsgrove welfarer&b@howcollege.ac.uk).

According to Gov.uk, Employees should talk to their employer first to try and sort out the problem informally. If things cannot be sorted out informally, talk to Acas, Citizens Advice or a trade union representative.

Does it feel like the situation could get heated or violent very soon? Is someone in immediate danger? Do you need support right away? If so, call the Police on 999 or if you're deaf or hard of hearing, contact the Police textphone service using 18000.

Should you see/hear any form of health condition/disability-based inequality or discrimination within advertisement, online platforms or on TV, identify the responsible organisation (for example, the BBC) and follow their complaints procedure. Bodies such as Ofcom can also be utilised to report such behaviour.