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Tips for First Responders

Dear First Responder,

Whether you are a First Responder assisting in an emergency caused by a natural disaster or a terrorist attack, or you are a community volunteer providing assistance to people in need, you may encounter people with some type of disability. Some disabilities may be visually obvious. Other disabilities are more difficult to detect. In many cases, you can’t tell just by looking at the person whether they have a disability.

Supporting people with disabilities is easier if you remember they are “people first” and their disability is only a part of who they are. People with disabilities simply want to be treated with dignity and respect, just like anyone else. In supporting people with disabilities, take time to listen to what they are telling you either with their words or behaviors. It is always best to start by asking how you can help or assist.

Many first responders have requested quick, easy-to-use guidelines for assisting persons with disabilities. These tips sheets provide information about many types of disabilities and can be used during emergencies as well as during routine encounters. They are not meant to be comprehensive, but contain specific information that you can read quickly either before or while you are responding to an incident. In addition to the tips for responding to people, information about where to locate services for people is also provided.

If you would like more information about how to assist people with disabilities or have suggestions for future editions of this guide, please contact us.

The Oklahoma Developmental Disabilities Council gratefully acknowledges the following organizations for the initial creation and subsequent individualization of Tips for First Responders. Without their hard work, the customized Oklahoma version of Tips would not have been possible.

  • Center for Development and Disability, University of New Mexico
  • New Mexico Department of Health, Office of Emergency Management
  • American Association on Health and Disability
  • New Mexico Governor’s Commission on Disability
  • Research and Training Center on Independent Living
  • Texas Center for Disabilities Studies
  • Texas Developmental Disabilities Council


General Tips

General Tips:

(A) Always ask the person how you can best assist.
(B) Ask/Look for:
(1) An identification bracelet with special health information.
(2) Emergency contact information to reach the person’s family.
(3) Essential equipment and supplies (for example: wheelchair, walker, oxygen, batteries, communication devices [head pointers, alphabet boards, speech synthesizers, etc.]).
(4) Medication.
(5) Mobility aids (for example, wheelchair, cane, walker or an assistance or service animal).
(6) Special health instructions (for example, allergies).
(7) Special communication information (for example, the person might say [s]he is stressed, look confused, withdraw, start rubbing their hands together).
(8) Conditions that people might misinterpret (for example, someone might mistake Cerebral Palsy for drunkenness).
(9) Try to include the person in conversations with other people; don’t talk about a person in front of that person.
(10) If the person does not use words to speak, look for gestures or other behaviors that communicate what that person wants to express.
(11) Don’t assume that people do not understand just because they don’t use words to communicate.

  Tips for Seniors 

Seniors:

(A) Always ask the person how you can best assist them.
 (B) Some elderly persons may respond more slowly to a crisis and may not fully understand the extent of the emergency. Repeat questions and answers if necessary. Be patient! Taking time to listen carefully or to explain again may take less time then dealing with a confused person who may be less willing to cooperate.
 (C) Reassure the person that they will receive medical assistance without fear of being placed in a nursing home.
 (D) Older people may fear being removed from their homes - be sympathetic and understanding and explain that this relocation is temporary.
 (E) Before moving an elderly person, assess their ability to see and hear; adapt rescue techniques for sensory disabilities.
 (F) Persons with a hearing loss may appear disoriented and confused when all that is really "wrong" is that they can't hear you. Determine if the person has a hearing aid. If they do, is it available and working? If it isn't can you get a new battery to make it work?
 (G) If the person has vision loss, identify yourself and explain why you are there. Let the person hold your arm and then guide them to safety.
 (H) If possible, gather all medications before evacuating. Ask the person what medications they are taking and where their medications are stored. Most people keep all their medications in one location in their homes.
 (I) If the person has dementia, turn off emergency lights and sirens if possible. Identify yourself and explain why you are there. Speak slowly, using short words in a calm voice. Ask "yes" or "no" questions: repeat them if necessary. Maintain eye contact.
 (J) If you suspect the person has dementia or Alzheimer's, do not leave the person unattended.

 Senior Resources:
 DHS Aging Services Division, www.okdhs.org,
 Senior Info Line, 800-211-2116, toll-free statewide number linking older Oklahomans and their caregivers to assistance at the local level. Calls are automatically routed to the Area wide Aging Agency nearest to you.

Tips for People with Service Animals 

People with Service Animals

(A) Traditionally, the term "service animal" referred to seeing-eye dogs. However, today there are many other types of service animals.
 (B) Remember - A service animal is not a pet.
 (C) Do not touch or give the animal food or treats without the permission of the owner.
 (D) When a dog is wearing its harness, it is on duty. In the event you are asked to take the dog while assisting the individual, hold the leash and not the harness.
 (E) Plan to evacuate the animal with the owner. Do not separate them!
 (F) Service animals are not registered and there is no proof that the animal is a service animal. If the person tells you it is a service animal, treat it as such. However, if the animal is out of control or presents a threat to the individual or others, remove it from the site.
 (G) A person is not required to give you proof of a disability that requires a service animal. You must accept that he or she has a disability. If you have doubts, wait until you arrive at your destination and address the issues with the supervisor in charge.
 (H) The animal need not be specially trained as a service animal. People with psychiatric and emotional disabilities may have a companion animal. These are just as important to them as a service animal is to a person with a physical disability - please be understanding and treat the animals as a service animal.
 (I) A service animal must be in a harness or on a leash, but need not be muzzled.

 Service Animals Resources:
 Service/Support Animals Resources Delta Society, www.deltasociety.org

Tips for People with Mobility Issues 

(A) Always ask the person how you can help before attempting any assistance. Ever person and every disability is unique - even though it maybe important to evacuate the location where the person is, respect their independence to the extent possible. Don't make assumptions about the person's abilities. 

(B) Ask if they have limitations or problems that may affect their safety. 

(C) Some people may need assistance getting out of bed or out of a chair, but CAN then proceed without assistance. Ask! 

(D) Here are some other questions you may find helpful: 

"Are you able to stand or walk without the help of a mobility device like a cane, walker or a wheelchair?
"You might have to [stand] [walk] for quite awhile on your own. Will this be ok? Please be sure to tell someone if you think you need assistance."
"Do you have full use of your arms?" 

(E) When carrying the person, avoid putting pressure on his or her arms, legs, or chest. This may result in spasms, pain, and may even interfere with their ability to breathe. 

(F) Avoid the "fireman's carry." Use the one or two person carry techniques. 

(G) A person using a mobility device may be able to negotiate stairs independently. One hand is used to grasp the handrail while the other hand is used for the crutch or cane. Do not interfere with the person's movement unless asked to do so, or the nature of the emergency is such that absolute speed is the primary concern. If this is the case, tell the person what you'll need to do and why. 

(H) Ask if you can help by offering to carry the extra crutch. 

(I) If the stairs are crowded, act as a buffer and run interference for the person. 

(J) Tips when evacuating wheelchair users: 

(1) If the conversation will take more then a few minutes, sit down to speak to the person at eye level. 

(2) Wheelchair users are trained in special techniques to transfer from one chair to another. Depending on their upper body strength, they may be able to do much of the work themselves. 

(3) Ask before you assume you need to help, or what that help should be. 

(K) Carrying techniques for non-motorized wheelchair users: 

(1) The In-chair carry is the most desirable technique to use, if possible. 

(2) One-person assist: Grasp the pushing grips, if available; Stand one step above and behind the wheelchair; Tilt the wheelchair backward until a balance (fulcrum) is achieved; Keep your center of gravity low; Descend frontward; Let the back wheels gradually lower to the next step. 

(3) Two-person assist: Position the second rescuer to stand in front of the wheelchair and face the wheelchair; Stand one, two, or three steps down (depending on the height of the other rescuer); Grasp the frame of the wheelchair; Push into the wheelchair; Descend the stairs backward. 

(L) Things to remember about motorized wheelchairs: 

(1) Motorized wheelchairs may weigh up to 100 pounds unoccupied, and may be longer than manual wheelchairs. Lifting a motorized wheelchair and user up or down stairs requires two to four people. 

(2) People in motorized wheelchairs probably know their equipment much better than you do. Before lifting, ask about heavy chair parts that can be temporarily detached, how you should position yourselves, where you should grab hold, and what, if any, angle to tip the chair backward. 

(3) Turn the wheelchairs power off before lifting it. 

(4) Most people who use motorized wheelchairs have limited arm and hand motion. Ask if they have any special requirements for being transported down the stairs. 

Mobility Resources: Department of Rehabilitation Services, 800-845-8476 www.okrehab.org ABLE Tech, 888-885-5588 www.ok.gov/abletech

Tips for Supporting People with Autism

Tips for People with Autism

People with Autism

(A) Communication:
(1) Speak calmly - use direct, concrete phrases with no more than one or two steps, or write brief instructions on a pad if the person can read.
(2) Allow extra time for the person to respond.
(3) The person may repeat what you have said, repeat the same phrase over and over, talk about topics unrelated to the situation, or have an unusual or monotone voice. This is their attempt to communicate, and is not meant to irritate you or be disrespectful.
(4) Avoid using phrases that have more then one meaning such as "spread eagle" "knock it off" or "cut it out."
(5) Some people with autism don't show indications of pain - check for injuries.
(B) Social:
(1) The person may not understand typical social rules, so may be dressed oddly, invade your space, prefer to be farther away from you than typical, or not make eye contact.
(2) The person may also look at you at an odd angle, laugh or giggle inappropriately, or not seem to take the situation seriously. Do not interpret these behaviors as deceit or disrespect.
(3) Because of the lack of social understanding, person with autism spectrum disorders may display behaviors that are misinterpreted as evidence of drug abuse or psychosis, defiance or belligerence. Don't assume!
(4) Approach the person in a calm manner. Try not to appear threatening.
(C) Sensory and Behavior:
(1) If possible, turn off sirens, lights, and remove canine partners. Attempt to find a quiet location for the person, especially if you need to talk with them.
(2) Avoid touching the person, and if necessary, gesture or slowly guide the person. If the person is showing obsessive or repetitive behaviors, or is fixated on a topic or object, try to avoid stopping these behaviors or taking the object away from them, unless there is risk to self or others.
(3) Make sure that the person is away from potential hazards or dangers (busy streets, etc.) since they may not have a fear of danger.
(C) Autism Resources:
Oklahoma Department of Human Services, Developmental Disablities Services Divison www.okdhs.org
Oklahoma Autism Alliance, www.okautism.org
Oklahoma Autism Network, http://www.ah.ouhsc.edu/tolbert/OKAutism.asp

Tips for People who are Deaf or Hard of Hearing

People who are Deaf or Hard of Hearing

(A) There is a difference between hard of hearing and deaf. People who are hard of hearing vary in the extent of hearing loss they experience. Some have complete deafness, while others can hear almost normally with hearing aids.
(B) Hearing aids do not guarantee that the person can hear and understand speech. They increase volume, not necessarily clarity.
(C) If possible, flick the lights when entering an area or room to get their attention. Establish eye contact with the individual, not with the interpreter, if one is present.
(D) Use facial expressions and hand gestures (but not exaggerated) as visual cues.
(E) Check to see if you have been understood and repeat if necessary.
(F) Offer pencil and paper. Write slowly and let the individual read as you write.
(G) Written communication may be especially important if you are unable to understand the person's speech.
(H) Do not allow others to interrupt you while conveying the emergency information.
Be patient - the person my have difficulty understanding the urgency of your message.Provide the person with a flashlight to signal their location in the event they are separated from the rescue team. This will facilitate lip-reading or signing in the dark.
(I) While written communication should work for many people, others may not understand English well enough to understand written instructions. Keep instructions simple, in the present tense and use basic vocabulary.
(J) Hearing Resources: ABLE Tech, 888-885-5588, www.ok.gov/abletech

Tips for People who are Blind or have Low Vision

People who are Blind or have Low Vision

(A) There is a difference between low vision and blindness. Some people who are "legally blind" have some sight, and may see some shapes and contrasts, while others are totally blind.
(B) Announce your presence, speak out, and then enter the area.
(C) Don't be afraid to use words like "see," "look" or "blind."
(D) State the nature of the emergency and offer them your arm. As you walk, advise them of any obstacles. Offer assistance but let the person explain what help is needed.
(E) Do not grab or attempt to guide them without first asking them. Let the person grasp your arm or shoulder lightly for guidance.
(F) They may choose to walk slightly behind you to gauge your body's reactions to obstacles.
(G) Be sure to mention stairs, doorways, narrow passages, ramps, etc.
(H) When guiding someone to a seat, place the person's hand on the back of the chair.
(I) If leading several individuals who are blind or have low vision, ask them to guide the person behind them. Remember that you'll need to communicate any written information orally.
(J) When you have reached safety, orient the person to the location and ask if any further assistance is needed.
(K) If the person has a service animal, don't pet it unless the person says it is ok to do so. Service animals must be evacuated with the person.
(L) Visual Resources:
Oklahoma Library for the Blind and Physically Handicapped, www.library.state.ok.us, 800-523-0288
ABLE Tech, 888-885-5588, www.ok.gov/abletech

Tips for People with Cognitive Disabilities

People who have Cognitive Disabilities

(A) Say:
My name is... I'm here to help you, not hurt you.
I am a .... (name your job).
I am here because .... (explain the situation).
I look different from my picture on my badge because ..... (for example, if you are wearing protective equipment).
(B) Show:
Your picture identification badge (as you say that above).
That you are calm and competent.
(C) Give:
Extra time for the person to process what you are saying and to respond.
Respect for the dignity of the person as an equal and as an adult (example: speak directly to the person).
An arm to the person to hold as they walk. If needed, offer your elbow for balance.
If possible, quiet time to rest (as possible, to lower stress and fatigue).
(D) Use:
Short Sentences.
Simple, concrete words.
Accurate, honest information.
Pictures and objects to illustrate your words. Point to your ID picture as you say who you are, point to any protective equipment as you speak about it.
(E) Predict:
What will happen (simply and concretely)?
When events will happen (tie to common events in addition to numbers and time, for example, "By lunch time...." "By the time the sun goes down....".
How long this will last - when things will return to normal (if you know).
When the person can contact or rejoin loved ones (for example: calls to family, re-uniting pets).
(F) Ask for/Look for:
An identification bracelet with special health information.
Essential equipment and supplies (for example: wheelchair, walker, oxygen, batteries, communication devices [head pointers, alphabet boards, speech synthesizers, etc.]).
Medication.
Mobility aids (for example, assistance or service animals).
Refer to the section on People with Service Animals.
Special health instructions (for example: allergies).
Special communication information (for example, is the person using sign language).Contact Information.
Signs of stress and/or confusion (for example, the person might say he or she is stressed, look confused, withdraw or start rubbing their hands together).
Conditions that people might misinterpret (for example, someone might mistake Cerebral Palsy for drunkenness.
(G) Repeat:
Reassurances (for example, "You may feel afraid. That's OK. We're safe now."
Encouragement (for example, "Thanks for moving fast, you are doing great. Other people can look at you and know what to do."
Frequent updates on what's happening and what will happen next. Refer to what you predicted will happen, for example: "Just like I said before, we're getting into my car now. We'll go to .... now."
(H) Reduce:
Distractions. For example: lower volume of radio, use flashing lights on vehicle only when necessary.
(I) Explain:
Any written material (including signs) in everyday language.
Public address system announcements in simple language.
(J) Share:
The information you've learned about the person with other workers who'll be assisting the person.
(K)Cognitive Disabilities Resources
Oklahoma Department of Human Services, Developmental Disabilities Services Division, www.okdhs.org
Oklahoma Department of Human Services, Aging Services, www.okdhs.org
Center for Learning and Leadership, http://www.ouhsc.edu/thecenter/ 405-271-4500
Oklahoma Disability Law Center www.flash.net/~odlcokc 800-880-7755 Advocacy Legal Services
TARC www.ddadvocacy.net 800-688-8272

Tips for People with Mental Health Conditions

People who Mental Health Conditions

(A) You may not be able to tell if a person has a mental health condition until you have begun the evacuation procedure.
(B) If a person begins to exhibit unusual behavior, ask if they have any mental health issues of which you need to be aware. However, be aware that they may or may not tell you. If you suspect someone has a mental health issue, use the following tips to help you through the situation.
(C) In an emergency, the person may become confused. Speak slowly and in a normal calm tone.
(D) If the person becomes agitated, help them find a quiet corner away from the confusion.
(E) Keep your communication simple, clear and brief.
(F) If they are confused, don't give multiple commands - ask or state one thing at a time.
(G) Be empathetic - show that you have heard them and care about what they have told you. Be reassuring.
(H) If the person is delusional, don't argue with them or try to "talk them out of it". Just let them know you are there to help them.
(I) Ask if there is any medication they should take with them.
(J) Try to avoid interrupting a person who might be disoriented or rambling - just let them know that you have to move quickly.
(K) Don't talk down to them, yell or shout.
(L) Have a forward leaning body position - this shows interest and concern.
(M) Mental Health Resources:
Oklahoma Department of Mental Health and Substance Abuse Services, http://ok.gov/odmhsas/
National Alliance on Mental Illness, www.nami.org

Contact ODDC
2401 NW 23rd St, Ste. 74
Oklahoma City, OK 73107

405-521-4984
Fax: 405-521-4910
Email: staff@okddc.ok.gov

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Oklahoma Developmental Disabilities Council