Glossary

Characteristic of environments, tools, services and information that allows all people, including those with disabilities, to use them autonomously and without barriers. Accessibility is articulated in different dimensions: physical (removal of architectural barriers), sensory (aids for the blind and deaf), cognitive (simplified language), digital (websites and applications usable with assistive technologies).

Italian legislation (Law 104/1992 and subsequent amendments) establishes criteria and obligations to ensure accessibility in public and private spaces open to the public. Universal Design promotes the design of environments usable by everyone without the need for adaptations. Accessibility is a fundamental right and prerequisite for the social, work and educational inclusion of people with disabilities.

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Physical obstacles present in buildings and urban spaces that prevent or limit the mobility and accessibility of people with motor, sensory or cognitive disabilities. They include: steps without alternative ramps, narrow doors, absence of elevators, uneven paths, non-equipped bathrooms, non-inclusive signage.

Italian DM 236/1989 defines technical parameters for the removal of architectural barriers. Regulations provide specific criteria for: minimum width of passages (90 cm), ramp gradient (maximum 8%), maneuvering spaces for wheelchairs, stair lifts and lifting platforms. Barrier removal is mandatory in new public buildings and incentivized in existing buildings through tax deductions. The removal of architectural barriers is essential to ensure autonomy, safety and dignity for people with disabilities.

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Person who provides continuous assistance to a family member or acquaintance who is not self-sufficient due to disability, chronic illness, old age or other disabling conditions. The caregiver can be formal (paid professional) or informal (family member, friend, volunteer).

In Italy, about 7 million people perform informal caregiving activities, often with significant impacts on work, social life and psychophysical health. Law 104/1992 recognizes some rights for family caregivers, such as paid work leave. Caregivers need support through: specific training, self-help groups, respite care services, psychological counseling. Caregiver burden can cause stress, anxiety, depression and health problems. It is essential to recognize the social and economic value of caregiving and ensure adequate support.

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Group of permanent disorders of movement and posture development, caused by non-progressive lesions of the developing brain (fetal, perinatal period or first years of life). Main cause of childhood motor disability, with prevalence of 2-3 cases per 1000 live births. Causes: perinatal asphyxia, prematurity, cerebral hemorrhages, infections, traumas, malformations.

Classification by distribution: hemiplegia (one side), diplegia (predominantly lower limbs), tetraplegia (all four limbs). By motor type: spastic (muscle hypertonia), dyskinetic (involuntary movements), ataxic (balance and coordination disorders), mixed. Manifestations: motor development delay, posture disorders, difficult or absent walking. Frequent associated disorders: epilepsy, cognitive deficits, sensory disorders, feeding and language difficulties. Multidisciplinary treatment: physiotherapy, occupational therapy, speech therapy, orthopedics, functional neurosurgery, drugs (antispastics, botulinum toxin). Early and continuous intervention improves functional outcomes and quality of life.

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Medical specialization that deals with prevention, diagnosis, treatment and rehabilitation of neurological, neuropsychological and psychiatric disorders of developmental age (0-18 years). Areas of competence: neurodevelopmental disorders (autism, ADHD, intellectual disability), epilepsy, infantile cerebral palsy, specific learning disorders (SLD), language disorders, motor deficits, psychiatric disorders (anxiety, depression, eating disorders), genetic syndromes with neurological involvement.

The child neuropsychiatrist coordinates a multidisciplinary team: psychologists, speech therapists, physiotherapists, occupational therapists, educators. Diagnostic tools: neuropsychological assessment, EEG, neuroimaging, genetic tests. Interventions: pharmacological therapies, cognitive and motor rehabilitation, psychological support, parent training. ASL territorial services offer free child neuropsychiatry. Early diagnosis is crucial to: activate timely interventions, certifications for school support (Law 104/1992, Law 170/2010), personalized rehabilitation projects. Continuous follow-up monitors evolution and adapts treatments.

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Condition of those who have lasting physical, mental, intellectual or sensory impairments which, in interaction with environmental and social barriers, may hinder full and effective participation in society on an equal basis. The UN Convention on the Rights of Persons with Disabilities (2006) adopts a bio-psycho-social model that recognizes the interaction between health conditions and contextual factors.

The ICF (International Classification of Functioning) classifies disability considering: body functions and structures, personal activities, social participation, environmental and personal factors. Main types include: motor disabilities, sensory (visual, hearing), intellectual, psychiatric, multiple. In Italy, Law 104/1992 protects the rights of people with disabilities ensuring social, educational and work integration. The modern approach emphasizes residual capacities, self-determination and quality of life rather than limitations.

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Chronic neurological disorder characterized by recurrent epileptic seizures due to abnormal electrical discharges in the brain. Seizures manifest with variable symptoms: convulsions, loss of consciousness, involuntary movements, sensory alterations. Generalized seizures (involving both cerebral hemispheres) and focal seizures (originating in a specific area) are distinguished.

Epilepsy affects about 50 million people worldwide and can occur at any age, with peaks in childhood and after 60 years. Causes include: brain injuries, genetic predisposition, infections, tumors, stroke. Diagnosis is based on medical history, EEG and neuroimaging. The main treatment is antiepileptic drugs, effective in 70% of cases. In drug-resistant cases, surgery, ketogenic diet, vagus nerve stimulation are evaluated. Most people with controlled epilepsy can lead a normal life with adequate support.

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Hereditary genetic disease caused by mutation of the FMR1 gene on the X chromosome, represents the most common hereditary genetic cause of intellectual disability. Prevalence: 1:4000 males, 1:8000 females. X-linked transmission: males more severely affected (only one X chromosome), females often less symptomatic (second X chromosome partially compensates).

Clinical characteristics: mild-severe intellectual disability, language delay, behavioral disorders (hyperactivity, anxiety, repetitive behaviors, poor eye contact), autistic traits (30% meet DSM autism criteria), facial dysmorphisms (elongated face, prominent ears, macroorchidism in males post-puberty). Variable symptoms, especially in females. Diagnosis: molecular genetic test (FMR1 gene analysis), recommended with family history or compatible symptoms. No specific cure exists. Symptomatic treatment: early educational interventions, speech therapy, behavioral therapy, drugs for ADHD/anxiety, family support. Genetic counseling fundamental for families: recurrence risk, prenatal diagnosis, informed reproductive choices.

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Term traditionally used to indicate the social disadvantage and limitations that a person experiences due to an impairment, in relation to the environmental and social context. The World Health Organization (WHO) has progressively abandoned this term in favor of "disability" and "participation," recognizing that limitations derive from the interaction between health conditions and contextual barriers, not from the person themselves.

The ICF (2001) replaced the deficit-centric model with a bio-psycho-social approach. In Italy, Law 104/1992 still uses the term "handicap" in the legal formulation to define rights and protections. Contemporary language prefers "person with disability" instead of "handicapped," emphasizing the person before the condition (people-first language). This terminological evolution reflects a cultural change: from a medical-care vision to a social model of rights, autonomy and inclusion.

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Partial or total reduction of hearing ability that can affect one ear (unilateral) or both (bilateral). Classification by severity: mild (20-40 dB), moderate (40-70 dB), severe (70-90 dB), profound (>90 dB). By location: conductive (outer/middle ear, often correctable), sensorineural (inner ear/auditory nerve, permanent), mixed.

Causes: congenital (genetic, prenatal infections), acquired (otitis, acoustic trauma, ototoxic drugs, presbycusis, diseases). Significant impact on: language development in children, communication, learning, social relationships, safety, mental health (isolation, depression). Diagnosis: tonal and vocal audiometry, impedance testing, auditory evoked potentials, neonatal screening. Treatment: hearing aids, cochlear implants (profound hearing loss), speech therapy rehabilitation, psychological support. Alternative communication: sign language, lip reading, subtitles. Early diagnosis and intervention essential, especially in pediatric age, to prevent language and cognitive delays.

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Process that ensures full and effective participation of people with disabilities in all areas of social life, on an equal basis and without discrimination. Inclusion goes beyond integration: it does not limit itself to inserting the person into existing contexts, but modifies contexts to make them accessible and welcoming for all.

Fundamental principles: recognition of differences as value, universal accessibility, self-determination, active participation. Areas of inclusion: school (personalized teaching, support teachers), work (targeted placement, reasonable accommodations), society (removal of barriers, awareness raising). The UN Convention (2006) affirms the right to inclusion in all sectors. In Italy, legislation promotes school inclusion (Law 104/1992, Legislative Decree 66/2017) and work inclusion (Law 68/1999). Inclusion requires cultural change, investments, training, collaboration between services. It is a collective responsibility to create societies that value diversity and ensure equal opportunities.

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Standardized measure of cognitive abilities obtained through psychometric tests that evaluate different skills: logical reasoning, verbal comprehension, working memory, processing speed, visual-spatial abilities. The average IQ of the population is 100 with standard deviation 15. WHO classification: IQ >130 very superior, 120-129 superior, 110-119 high average, 90-109 average, 80-89 low average, 70-79 borderline, <70 intellectual disability.

Main tests: WAIS (adults), WISC (children 6-16 years), WPPSI (preschool age). Intellectual disability is diagnosed with IQ <70 accompanied by deficits in adaptive functioning. Criticisms of IQ: does not measure all intelligences (emotional, social, creative), influenced by cultural, educational, emotional factors. Should not be used in isolation but integrated with comprehensive clinical assessment. IQ is not fixed: it can vary with educational interventions, stimulation, environmental conditions. Important to avoid labeling and focus on developmental potential.

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Set of services and interventions aimed at the employment of people with disabilities, through professional orientation, training, matching with companies and continuous support. Job placement for people with disabilities is based on principles of skills enhancement, path personalization and support for both the worker and the employer.

Main phases: skills and aspirations assessment, skills balance, professional orientation, targeted training, opportunity search, initial tutoring, job coaching, placement monitoring. In Italy, Law 68/1999 provides for mandatory targeted placement: companies with more than 15 employees must reserve quotas (7-15%) for people with disabilities. Tools: agreements, training internships, tax incentives. Services provided by: employment centers, type B social cooperatives, accredited entities. Success elements: analysis of compatible tasks, workplace adaptation, colleague training, cultural mediation. Effective job placement promotes economic autonomy, self-esteem, social inclusion.

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Rehabilitation method based on therapeutic movement to recover or maintain motor functions compromised by pathologies, traumas or surgical interventions. It includes active exercises (performed autonomously by the patient), assisted (with therapist help) and passive (mobilization performed by the therapist). Objectives: recovery of joint mobility, muscle strength, coordination, balance, motor pattern.

Main techniques: joint mobilization, stretching, muscle strengthening, proprioceptive re-education, gait re-education, breathing exercises. Indications: neurological pathologies (stroke, Parkinson, spinal cord injuries), orthopedic (fractures, prostheses), rheumatological (arthritis), respiratory. For people with permanent disabilities, kinesitherapy maintains residual functions, prevents complications (contractures, bedsores, osteoporosis), preserves autonomy. Programs are personalized evaluating: type and degree of disability, age, functional objectives, motivation. Kinesitherapy integrates with other rehabilitation disciplines: speech therapy, occupational therapy, neuropsychology.

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Alteration of normal walking characterized by asymmetric or irregular gait, caused by musculoskeletal, neurological or painful dysfunctions. Classification: antalgic (due to pain, with reduced load on painful limb), Trendelenburg (gluteus medius deficit, pelvis drops on opposite side), from limb length discrepancy (compensated with knee flexion or equinus), neurological (from strength deficit, spasticity, ataxia), psychogenic.

Common causes: trauma, arthritis, hip dysplasia, limb length difference, neurological pathologies (stroke, cerebral palsy), congenital malformations, amputations, muscle pathologies. Assessment: gait observation, joint examination, neurological assessment, radiographs, computerized gait analysis. Treatment depends on cause: pain therapy, physiotherapy, insoles or lifts, orthoses, corrective surgery, prostheses. In permanent disability, objective is: compensate for deficit, prevent secondary complications (scoliosis, contralateral arthrosis, contractures), maximize walking autonomy with or without aids.

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Branch of medicine that studies genetic diseases, their diagnosis, management and prevention. It deals with pathologies caused by DNA alterations, both hereditary and de novo. Main areas: genetic counseling (reproductive risk assessment), prenatal and neonatal diagnosis, genetic testing, experimental gene therapies.

Genetic diseases include: chromosomopathies (e.g., Down syndrome), monogenic diseases (cystic fibrosis, muscular dystrophy), multifactorial diseases (predispositions to tumors, diabetes). Diagnostic technologies: karyotype, FISH, array-CGH, genetic sequencing (NGS). Genetic counseling provides information on: probability of transmission, clinical implications, reproductive options, psychological support. Predictive genetic tests allow identification of risks (e.g., BRCA mutations for tumors). Relevant ethical aspects: informed consent, genetic privacy, discrimination. Medical genetics is crucial for early diagnosis, personalized management and prevention in at-risk families.

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Systematic and comprehensive process of evaluating health conditions, functionality, autonomy and care needs of people with disabilities or frailty, particularly elderly. Conducted by multidisciplinary team (doctor, nurse, physiotherapist, social worker, psychologist) through validated scales.

Dimensions evaluated: clinical (pathologies, therapies, symptoms), functional (daily activities autonomy - ADL, IADL), cognitive (memory, orientation - MMSE, neuropsychological tests), affective (depression, anxiety - GDS), nutritional (MNA), social (family support, housing, economic resources), environmental (architectural barriers, home safety). Tools: ADL scales (Activities of Daily Living), IADL (Instrumental ADL), Barthel Index, FIM. Outcomes: frailty profile, individualized care plan (ICP), identification of necessary resources, access to services (home care, nursing homes, day centers). MDA is an essential tool for intervention appropriateness, care continuity, complication prevention. Periodic re-evaluations monitor evolution and adapt interventions.

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Chronic autoimmune disease of the central nervous system in which the immune system attacks myelin (protective sheath of nerve fibers) causing inflammation, demyelination and progressive neurodegeneration. In Italy it affects about 130,000 people, predominantly women (2:1 ratio), with typical onset between 20-40 years.

Clinical forms: relapsing-remitting (85% at onset, with attacks alternating with remissions), secondary progressive (evolution from previous form), primary progressive (15%, gradual worsening from the beginning). Variable symptoms: visual, sensory disorders (tingling, paresthesia), motor (weakness, spasticity), balance, fatigue, bladder, cognitive disorders, pain. Diagnosis: magnetic resonance, liquor examination, evoked potentials. Treatment: immunomodulating/immunosuppressive drugs to slow progression, symptom management, multidisciplinary rehabilitation. Variable prognosis: some patients maintain good functionality, others develop progressive disability. Psychological support and patient associations (AISM) fundamental for disease management.

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Health discipline that deals with the prevention, treatment and rehabilitation of patients with pathologies or dysfunctions in the motor, neuromotor, visceral and cognitive area through physical, manual and instrumental therapies. Main objectives: functional recovery, pain reduction, prevention of complications, improvement of quality of life.

Techniques include: manual therapy, therapeutic exercise, postural re-education, physical therapies (electrotherapy, ultrasound, laser), water therapies. Areas of intervention: orthopedics and traumatology, neurology, cardiology, pulmonology, geriatrics, pediatrics. For people with disabilities, physiotherapy is essential to maintain or recover motor autonomy, prevent deformities and contractures, manage chronic pain. The physiotherapist develops individualized programs evaluating residual capacities and functional objectives. In Italy it is a regulated health profession (DM 741/1994) with mandatory three-year degree.

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Condition of those who have permanent or temporary difficulties in movements and walking, which limit autonomous access to places, services and transport. It can derive from: motor disabilities (paraplegia, hemiplegia, amputations), chronic pathologies (arthritis, heart disease), sensory deficits (blindness), old age, severe obesity, pregnancy, temporary traumas.

Reduced mobility significantly impacts: personal autonomy, social participation, access to work and education, quality of life. Necessary interventions: removal of architectural barriers, accessible transport (platforms, ramps, reserved seats), mobility aids (wheelchairs, walkers, canes), assistive technologies (stair lifts, platform lifts), tactile signage. European regulations recognize specific rights: EC Regulation 1107/2006 for air transport, EU Regulation 1300/2014 for rail transport. In Italy, DPR 503/1996 defines accessibility standards. Disability badge (Law 104/1992) allows parking in reserved areas. Autonomous mobility is a prerequisite for social and work inclusion.

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Global and continuous process aimed at enabling people with disabilities to reach and maintain the best possible functional level from a physical, sensory, intellectual, psychological and social point of view. The WHO defines rehabilitation as a set of interventions to optimize functioning and reduce disability in people with health conditions.

Multidisciplinary approach involves: physiatrists, physiotherapists, occupational therapists, speech therapists, psychologists, nurses, social workers. Objectives: maximize autonomy, prevent secondary complications, improve quality of life, promote social and work reintegration. Areas of intervention: motor (strength, mobility, balance), cognitive (memory, attention, executive functions), communicative (language, swallowing), psychological (adaptation, self-esteem), social (relationships, participation). Rehabilitation settings: acute hospital, intensive rehabilitation, outpatient, home. Rehabilitation is a fundamental right guaranteed by the NHS. Individualized rehabilitation plan defines objectives, interventions, times, results verification.

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Dental branch that deals with the prevention and treatment of oral health in patients with physical, sensory, intellectual disabilities or complex pathologies that make access to traditional dental care difficult. Includes: patients with intellectual disabilities, autism spectrum disorders, cerebral palsy, genetic syndromes, neurological diseases, psychiatric disorders.

Specific problems: poor oral hygiene, malocclusions, bruxism, drugs that alter oral health, collaboration difficulties. Therapeutic approaches: gradual desensitization, facilitated communication, behavioral aids, conscious sedation or general anesthesia for complex interventions. In Italy, public projects: DAMA (Disabled Advanced Medical Assistance) and TOBIA provide dental care in hospital settings. Specialized private centers offer: accessible environments, trained staff, adapted equipment, personalized protocols. Special dentistry requires: advanced clinical skills, relational sensitivity, collaboration with caregivers, coordination with health teams. Prevention is a priority to avoid invasive interventions.

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Health discipline that deals with the prevention, assessment and treatment of communication, language, voice, swallowing and oral function disorders. The speech therapist intervenes on: language disorders (aphasia, developmental delays), articulation (dysarthria, dyslalia), fluency (stuttering), voice (dysphonia), swallowing (dysphagia), communication (pragmatic disorders).

Areas of intervention: developmental age (language delays, learning disorders), adults (post-stroke aphasia, professional dysphonia), elderly (dysphagia, dementia), complex disabilities (autism, cerebral palsy, genetic syndromes). Techniques: articulatory exercises, language stimulation, myofunctional therapy, augmentative alternative communication (AAC), family counseling. For people with disabilities, speech therapy is essential to: develop functional communication, manage dysphagia (risk of aspiration pneumonia), improve quality of life. Regulated health profession (DM 742/1994) with three-year degree. The speech therapist works in a multidisciplinary team with neurologists, physiatrists, child neuropsychiatrists.

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Partial or total paralysis of all four limbs (upper and lower) and trunk, caused by spinal cord injury at cervical level. Also called quadriplegia. Lesion level determines extent of paralysis and residual functions: high lesions (C1-C4) also compromise autonomous breathing requiring assisted ventilation, mid-high lesions (C5-C6) allow shoulder movement and partial arm control, low lesions (C7-C8) allow greater use of upper limbs.

Main causes: trauma (traffic accidents, diving, falls), diseases (spinal tumors, myelitis), vascular. Complications: respiratory failure, bladder and bowel disorders, pressure ulcers, spasticity, neuropathic pain, thrombosis, osteoporosis, sexual dysfunctions. Treatment: acute phase (stabilization, surgery), early intensive rehabilitation, aids (electric wheelchairs, home automation, communicators), complication management, psychological support. Advanced assistive technologies: exoskeletons, brain-computer interfaces, functional electrical stimulation. Objective: maximize residual autonomy and quality of life.

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Standardized test for intelligence assessment in adults and adolescents (from 16 years old), developed by David Wechsler. Currently in use version WAIS-IV (2008). Evaluates different cognitive abilities through 15 subtests grouped into 4 main indices: Verbal Comprehension (verbal reasoning, acquired knowledge), Perceptual Reasoning (visual-spatial problem-solving, fluid reasoning), Working Memory (attention, concentration, mental manipulation of information), Processing Speed (speed of visual information processing).

Provides: Total IQ (FSIQ), scores for each index, detailed cognitive profile. Individual administration by qualified psychologists, duration 60-90 minutes. Used for: intellectual disability diagnosis, neurological assessment, school/professional orientation, certifications for educational support. Interpretation considers not only IQ but also discrepancies between indices, strengths/weaknesses, contextual factors. Standardized on Italian population with specific norms. Limitations: influenced by culture, education, motivation; does not measure emotional or creative intelligence.

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Term indicating the onset of dementia before age 65, also called early-onset dementia. Represents 2-10% of all dementia cases. Main causes: early Alzheimer's disease (30-40%), frontotemporal dementia (20%), vascular dementia, Lewy body dementia, alcohol-related, genetic diseases (Huntington, prions), repeated head trauma, HIV, B12 deficiency.

Peculiarities compared to senile dementia: often late diagnosis (symptoms attributed to stress, depression), greater social and work impact (people still professionally active), economic problems (income loss, mortgages), minor children or young adults, still young partners. Initial symptoms: personality changes, work difficulties, behavioral disorders (more evident than memory disorders). Diagnosis: neuropsychological assessment, neuroimaging (MRI, PET), genetic tests if family history. Management: specific drugs (limited effectiveness), psychosocial support, specific groups for young patients, family support, future planning (legal, economic aspects). Dedicated services needed for different needs than elderly.

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