The University of Iowa
Department of Counseling, Rehabilitation & Student Development
07C:247 Medical Aspects of Disability

Fall Semester, 2006 Instructor
T Th 10:55 a.m.-12:10 p.m. Noel Estrada-Hernández, Ph.D., C.R.C.
N218 Lindquist Center N366 Lindquist Center
Phone: 335-6426
FAX: 319/335-5291
e-mail: noel-estradahernandez@uiowa.edu

Required Texts:

* Falvo, D. R. (2005). Medical and psycho-social aspects of chronic illness and disability.
(3rd ed.). Gaithersburg, MD: Aspen.

* Gylys, B.A., & Wedding, M.E. (2005). Medical terminology systems: A body systems
approach (5th ed.). Philadelphia, PA: F.A. Davis Co.

Course-Pak available at Zephyr Copies, 124 E Washington St.

Other readings and handouts as assigned.

Recommended Texts:

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental
disorders IV-TR. Washington, DC: Author.

Angel, J. E. (Ed.). (2001). Physicians' desk reference. Oradell, NJ: Medical Economics
Co.

Barkow, R. (Ed.). (most recent). The Merck manual of diagnosis and therapy. Rahwey,
NJ: Merck, Sharp, & Dohme Research Laboratories.

Bowers, J. S. (1983). Psychopharmacology for non-medical therapists. Columbus,
OH: Psychology Publications.

Brodwin, M. G., Tellez, F., & Brodwin, S. K. (2002). Medical, psychosocial and
vocational aspects of disability (2nd ed.). Athens, GA: Elliot & Fitzpatrick.

Galvin, J.C., & Scherer, M.J. (1996). Evaluating, selecting, and using appropriate
assistive technology. Gaithersburg, MD: Aspen Publishers.

Gylys, B. A., & Wedding, M. E. (1990). Medical terminology: A systems approach.
Philadelphia, PA: F. A. Davis Co.

Maki, D.R., & Riggar, T.F. (1997(. Rehabilitation counseling: Profession and practice. New
York: Springer Publishing.

Shtasel, P. (1990). Medical tests and diagnostic procedures: A patient's guide to just
what the doctor ordered. New York: Harper & Row.

Stolov, W., & Clowers, M. (1981). Handbook of severe disability. Washington, DC:
U.S. Government Printing Office.

Thomas, C. L. (Ed.). (2005). Taber's cyclopedic medical dictionary (20th ed.). Philadelphia,
PA: F. A. Davis Co.

*These texts have been ordered by the University Bookstore.

Internet Resources
Both students and clients are increasingly turning to the Internet for information and ideas about managing the disabilities that confront them. Over 60 million Americans consulted the internet for health information in 2000, and of those who did 70% said that it influenced their health care decisions. There are increasingly sophisticated types of information and multimedia presentations available on the world wide web. However, the first question that all users should ask is “Is the Web site reputable?” Counselors have a new responsibility to educate themselves and their clients to be critical of on-line resources, and only to use those that hold good credentials to better assure their credibility. Even then, on-line resource information should be checked with the client’s physician or health care professional.

Users are urged to use at least the following criteria to evaluate the Web sites they visit:

1. Look for recent dates when browsing health articles.
2. Do not rely on just one Web site for advice or treatment information.
3. Look for Web sites that have medical experts who review their articles and information. Look for sites who belong to Health On the Net Foundation (www.hon.ch ) , an organization of medical Web sites that has a code of conduct and standards for information. See their Code of Conduct attached to this syllabus.
4. Steer clear of online doctors who promise treatment without an examination.
5. Sites that are affiliated with known universities, medical centers, or professional organizations are more likely to provide credible information.


Basic Course Objectives:
1. To develop a basic vocabulary of common medical terminology.

2. To be able to read and interpret standard medical reports.

3. To develop basic knowledge and understanding of human anatomy and physiology, especially the integration of body systems.

4. To develop a general understanding of the major chronic disabilities including their etiology, symptomology, diagnosis, prognosis, treatment, and maintenance strategies.

5. To be able to translate the medical aspects of disabling conditions to their functional limitations and residual capacities as a basis for rehabilitation planning.

6. To develop an awareness of the effects of pathology on the social, psychological, and vocational functioning of persons with disability, their families, and community.

7. To develop a working knowledge of the most common medical reference/resource books and the information they provide.

8. To develop a knowledge of the specialized resources available for persons with disability, with special emphasis on credible on-line resources.

Purposes of the Course:
This course is intended to equip the graduate student in vocational rehabilitation counseling with a working knowledge of disabilities. His/her need for medical information is for specific purposes: case finding, determination of eligibility (i.e., that the individual has a substantial and relatively stable physical, mental or emotional disability), determination of feasibility (i.e., that VR Services will lead to employment), arranging physical restoration services, counseling, planning, and a suitable vocational objective, training and selective job placement. The counselor must evaluate the functional limitations of a client's disability and initiate service to reduce the resulting handicap.

The vocational rehabilitation counselor is responsible for designing a "rehabilitation plan" and arranging for its implementation, including the purchase of medical services (examinations, hospitalization, therapy, surgery, prosthetics, etc.). In addition the counselor selects and coordinates a wide variety of services (prevocational evaluation, personal adjustment services, job training, etc.) leading towards the goal of remunerative employment for his client.

A rehabilitation counselor does not require a depth of knowledge in anatomy and physiology, as the counselor is not being prepared to medically diagnose or treat. The counselor's needs are not those of the physician, so it is unnecessary for him to have a broad knowledge of medicine. The counselor must, however, deal with certain practical problems arising out of a number of disabilities and relative effectively to medical and allied health professionals. A topical outline for the lectures and reading, covering what the counselor needs to know in his/her work, is suggested on page 3.

Disabilities to be covered are those which may ordinarily cause the individual to be eligible for vocational rehabilitation services (and about which special information by the counselor is important). Eligibility for state-federal rehabilitation services is based on: (a) the presence of a mental or physical disability and resulting limitation in activities, (b) a substantial handicap to employment, and (c) a reasonable expectation that vocational rehabilitation services will render the individual fit for remunerative employment.

It is the counselor's function: (a) to identify persons who may be eligible for vocational rehabilitation, (b) to arrange for general and special medical examinations, the reports of which he/she reviews to determine whether or not the individual is legally eligible, (c) to decide what services are indicated on the basis of his/her counseling contacts with the client and other information and considerations, (d) to arrange for the purchase of needed services, (e) to coordinate the entire rehabilitation procedure through continued counseling contacts with the client, and finally, (f) to assist this individual in finding and adjusting to suitable employment. The rehabilitation counselor, in helping the disabled client readjust or adjust vocationally, is concerned with all aspects of the problem, e.g., the psychological, educational, financial, social, and physical.

Alignment with CORE and CACREP Standards:
CORE Standards:

C.3 HUMAN GROWTH AND DEVELOPMENT

Students will demonstrate the ability to:

C.3.1 articulate a working knowledge of social, psychological, spiritual, and learning needs of
individuals at all developmental levels;

C.3.2 understand the concepts related to learning and personality development, gender and sexual
identity, addictive behavior and psychopathology, and the application of these concepts in
rehabilitation counseling practice;

C.8 RESEARCH AND PROGRAM EVALUATION

Students will demonstrate the ability to:

C.8.1 articulate current knowledge of the field;

C.8.2 analyze research articles in rehabilitation and related fields;

C.8.3 apply research literature to practice (e.g., to choose appropriate interventions, to plan
assessments, to implement meaningful program evaluation, to perform outcome analysis, to
conduct consumer satisfaction studies);

C.8.6 conduct a review of the rehabilitation literature on a given topic or case problem; and

C.8.7 apply knowledge or ethical, legal, and cultural issues in research and evaluation.

C.9 MEDICAL, FUNCTIONAL, AND ENVIRONMENTAL ASPECTS OF DISABILITY

Students will demonstrate the ability to:

C.9.1 explain basic medical aspects of the human body system and disabilities;

C.9.2 access resources for researching disability information;

C.9.3 explain functional capacity implications of medical and psychosocial information;

C.9.4 determine the need for assistive technology and the appropriate intervention resources;

C.9.5 apply working knowledge of the impact of disability on the individual, the family, and the
environment;

C.9.6 support consumer empowerment and advocacy as it relates to medical treatment;

C.9.7 utilize existing or acquired information about the existence, onset, severity, progression, and
expected duration of an individual’s disability; and

C.9.8 consult with medical professionals regarding functional capacities, prognosis, and treatment
plans for consumers.
CACREP Standards:
C.-Knowledge and Skill Requirements for Community Counselors
2-models, methods, and principles of program development and service delivery for a clientele based on assumptions of human and organizational development
3-effective strategies for promoting client understanding of and access to community resources
4-principles and models of biopsychosocial assessment, case conceptualization, theories of human development and concepts of normalcy and psychopathology leading to diagnoses and appropriate counseling plans

CACREP Standards for Community Counseling
C. Knowledge and Skill Requirement for Community Counselors
2-models, methods, and principles of program development and service delivery for a clientele based on assumptions of human organizational development, including prevention, implementation of support groups, peer facilitation training, parent education, career/occupational information and counseling, and encouragement of self-help
3-effective strategies for promoting client understanding of and access to community resources
4-principles and models of biopsychosocial assessment, case conceptualization, theories of human development and concepts of normalcy and psychopathology leading to diagnoses and appropriate counseling plans.

Administrative Policies
Accommodations: I would like to hear from anyone who has a disability that may require some modification of seating, testing, or other class requirements as soon as possible, so that appropriate arrangements may be made. Do not hesitate to see me before or after class.

Student Grievances: Procedures for filing student complaints are explained in Policies and Regulations Affecting Students. Copies are published every September as a supplement to the Daily Iowan and additional copies are available at the Campus Information Center in the Iowa Memorial Union (IMU). This information is also available on the University website: www.uiowa.edu by clicking on the “Current Students” link. It is your responsibility to be aware of these policies and regulations.

Plagiarism and Cheating: The collegiate policy on plagiarism and cheating is outlined in the Schedule of Courses and the Liberal Arts Bulletin. It is your responsibility to be aware of this policy. The penalty for the first offense is disciplinary probation until graduation. A second offense could result in suspension, and a third offense expulsion.

Respect for Diversity: It is the intent of the instructor to present material in a manner that is respectful of diversity: gender, sexuality, disabilities, age, socio-economic status, ethnicity (race, nation, or culture), race (physical characteristics transmitted by genes; body of people united by common history or nationality), and culture (beliefs, customs, arts, and institutions of society).

Cross Enrollments This course is given by the College of Education. This means that class policies on matters such as requirements, grading, and sanctions for academic dishonesty are governed by the College of Education. Students wishing to add or drop this course after the official deadline must receive the approval of the Dean of the College of Education. Details of the University policy of cross enrollments may be found at: http://www.uiowa.edu/~provost/deos/crossenroll.doc

COURSE REQUIREMENTS and GRADING:

1. Regular attendance and prompt arrival in class are required. Roll will not be taken, but quizzes begin promptly at 10:55 a.m. each class period. If you must miss a quiz, a make-up exam will not be given.

2. The points for this course are divided into thirds:
1/3= Best 15 quiz scores/Divided by 2 150 points
1/3= Mid-Term Examination 150 points
1/3=Final Examination 150 points

3. All quizzes will be in a multiple choice, true-false, or matching format. The mid-term and final will be similar in format to the quizzes.

4. The final examination will not be cumulative.

5. Grading: 90% - A
80% - B
70% - C



TOPICAL OUTLINE OF DISABILITIES

Prevalence and incidence data: by age, type or other pertinent grouping.

Description: signs and symptoms, common types, clinical classifications.

Cause: Hereditary, acquired and precipitating factors, brief overview of etiological processes.

Diagnosis: Examination procedures, laboratory tests and equipment, history and prior medical records, other diagnostic methods, prognosis, practical value and confidence level of diagnostic information, resources required (medical and paramedical specialists, facilities, time and costs).

Physical reconstruction, restoration and adaptation: methods and procedures (surgery, drug and other therapy or prosthetic devices), selection of patient and management, outcome success expectancy and remaining handicap, needed medical follow-up (why, how often and how long, who), resources required (medical staff, facilities, time and costs).

Related or concomitant impairments

Eligibility and feasibility for vocational rehabilitation: how the counselor can determine the severity, permanence, course and stability of the disability; functional limitation and abilities associated with the disability; expected functional outcome of physical restoration.

Vocational appraisal: disability related limitations, tolerances and hazards in physical activities and/or working conditions.

Legal considerations: reportability, driver license restrictions, workmen's compensation.

Psycho-social problems: somatopsychological characteristics, family and social factors, public attitudes and misconceptions, employer practices, educational considerations.

Rehabilitation counselor's role: case finding (where and how to identify), provision of information to the physician (case history, medical records, etc.), obtaining information and recommendations from the physician, the interdisciplinary team (communications, cooperative procedures, responsibilities), interpretation of medical information, special precautions (personal hygiene, professional restrictions, etc.).

The future: prevention efforts, medical research, community resources, trends in provision of service, how the rehabilitation counselor can keep up-to-date.

Other Information: specialized treatment centers and resources for rehabilitation, best sources of current information, patient/client support groups.

Summary