Unicorn Roots

Holistic help for the disabled community

recent posts

about

  • Assistive Technology, Part 2

    Access

    Assistive Technology (AT) can take many forms: high-tech, low-tech, products, systems, and services. In fact, most people who use ATs regularly use more than one type, which shows just how important integration and integrative services are. More than 2.5 billion people worldwide use AT, and that number is expected to reach 3.5 billion by 2050. However, in many parts of the world, the majority of people who need the independence that AT provides have no access to the technology that could help improve their hearing, vision, mobility, self-care, cognition, communication, and much more. Greater access could help not only AT users; it could improve the well-being and inclusion of communities, enabling greater participation in the political, economic, and social life (World Health Organization, 2024).

    Most people will need some form of AT as they age, and the majority of AT users are seniors, disabled people, and those with long-term health conditions. However, AT has the potential to help everyone. Research shows that early access to appropriate AT can support language and communication development, improve access to education and employment, help prevent secondary complications, and support a greater sense of independence and safety. Still, the gaps in access globally are shocking. Nearly 80 million people require a wheelchair, while only up 35% of them have access to one. Around 1.5 billion people are deaf or hard of hearing, but fewer than 10% have access to a hearing aid (World Health Organization, 2024).

    It’s easy to assume that these numbers are disproportionate solely because of costs, and funding is certainly a factor. But other barriers play a significant role as well. A general lack of awareness, issues with physical access, limited product range, procurement challenges, workforce issues, and inadequate policy-making are just a few examples. The 2030 Agenda for Sustainable Development emphasizes universal health coverage (UHC) as a path toward universal access to health services, including the rights established by the Convention on the Rights of Persons with Disabilities. In 2022, the WHO and UNICEF Global Report on Assistive Technology provided recommendations for governments and stakeholders to work towards universal AT access for all. Examples of these recommendations include improving AT access across development sectors, involving AT users and their families in development processes, increasing public awareness to combat stigma, investing in data-driven policy, and supporting research and innovation (World Health Organization, 2024).

    To better understand what specific ATs are needed for any given group, it’s important to understand how different disabilities affect those living with them. Understanding this can help us understand what types of AT will benefit which individuals. This is where classification and categorization systems are truly valuable.

    The International Classification of Functioning, Disability, and Health (ICF) defines disability as encompassing activity limitations, impairments, and restrictions in participation. The purpose of AT is to decrease these limitations while promoting participation in society. As I covered in part 1, AT helps by aiding body structure and function, activity performance, and environmental modifications. Some options require insurance, prescriptions, or detailed documentation, while other options are readily available, such as touch lamps and electric toothbrushes. Some AT options may also require services to help with specialized customization, maintenance, and repair. Because the effects of an individual’s disability can also change with their environment, ideally, AT should be considered part of an adaptable environment rather than a standalone solution (Gray et al., n.d.).

    AT classification systems, such as the National Classification System for Assistive Technology Devices and Services used in the US and the International Organization for Standardization (ISO) and ICF-based classifications used internationally, organize AT into classes and subclasses for ease of access. The US system divides AT into classes, including architectural elements, sensory elements, computers, controls, independent living, mobility, orthotics and prosthetics, recreation and leisure, and modified furnishings, each with a unique numeric code. Europe uses a similar ISO-9999 and 3-tiered system. Both systems support efficient information retrieval, inventory management, and appropriate acquisition. These systems also specify hard technologies (tangible devices that can be assembled), soft technologies (human decision-making elements), as well as strategy and training materials. Within these systems, AT that requires specific skill is classified as a tool requiring additional soft technology, while AT that does not require specific skill is classified as an appliance (Gray et al., n.d.).

    Unsurprisingly, the majority of AT users are seniors relying on low-tech supportive appliances like walkers, canes, and glasses. Children and young adults more commonly use AT tools such as braces, prosthetics, and adaptive keyboards. However, mobility aids are the most widely used AT category. All of this classification and categorization also helps to determine costs and payment systems. Payment may be made in full or in part by individuals and families, or by insurance, rehabilitation centers, employers, veterans organizations, charities, or other third parties. Some AT can even be donated or loaned. In some US jurisdictions, businesses may be offered tax deductions for making their buildings fully accessible (Gray et al., n.d.).

    Two key tools used for measuring AT effectiveness are the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) and the Psychosocial Impact of Assistive Devices Scale (PIADS) questionnaires. Both of these questionnaires collect data on AT benefits and user satisfaction using criteria such as environment, expectations, perceptions, psychological factors, adaptability, competence, self-esteem, and specific AT characteristics. While some important factors like changes in satisfaction, self-esteem, adaptability, safety, and continued competence haven’t been adequately studied, current evidence shows that AT users have seen significant improvement in their ability to complete ADLs and in their overall quality of life (Gray et al., n.d.).

    It’s also easy to see how AT advancement is closely connected to overall technological advancement and the growth of the internet. This relationship has made it easier for disabled people to access AT and paved the way for new innovations. At the same time, the rise in graphics-rich and audio-dependent content has contributed to existing challenges that AT was initially created to help prevent (Gray et al., n.d.).

    References

    World Health Organization (2024). Assistive Technology. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/assistive-technology

    Cook, A.M. (n.d.). Assistive Technology. Britannica. https://www.britannica.com/science/assistive-technology

  • Assistive Technology, Part 1

    Definitions

    When I was younger, I used to wonder why none of the characters in fantasy stories and period dramas ever seemed to need glasses or wheelchairs. It seemed strange to me that disabled characters were virtually nonexistent. Of course, these stories were fiction, and I now know more about history and artistic licence. But representation matters. So what changed? The continued expansion of Assistive Technologies has played a major role in the growing visibility of the disabled community.

    Assistive Technology (AT) is an umbrella term for products, systems, and services designed to help those with disabilities and health conditions complete activities of daily living (ADLs) that would otherwise be difficult or impossible. This may include physical devices like shower chairs, canes, or prescription footwear; digital services and software like speech recognition or screen readers; and even widely available features like curb cutouts, accessible bathrooms, elevators, and widened hallways. While most ATs are designed specifically for those with disabilities, many can benefit everyone. For example, curb cuts help wheelchair users and people pushing strollers. ATs also help people with arthritis, amyotrophic lateral sclerosis (ALS), Attention Deficit Hyperactivity Disorder (ADHD), autism, vision and hearing loss, Ehlers-Danlos Syndrome (EDS), and many other conditions with ADLs like bathing and dressing, eating, communication, learning and remembering, symptom management, and much more (Office of Disability Services, 2026; World Health Organization, 2024; Cleveland Clinic, 2025).

    At their core, ATs are intended to promote independence and accessibility. They address a wide range of needs, including communication, mobility, vision and hearing loss, learning and cognitive disabilities, neurodiversity, and dexterity and fine motor skills. Many ATs are also very versatile, and more are created every day. For example, augmentative and alternative communication (AAC), mouth sticks, eye-tracking devices, and other speech-generating tools are typically used for communication needs, but they can also support mobility, learning, and cognitive needs. ATs such as adapted keyboards and joysticks, typically used to support mobility needs, can also support cognitive needs. AT systems and services like screen magnification and high-contrast displays, screen readers, audiobooks, captioning software, visual and haptic alerts, speech-to-text (STT) and text-to-speech (TTS) tools, as well as products like assistive listening and note-taking devices, can all support many needs (Office of Disability Services, 2026).

    Other ATs are designed for more specialized needs. Braille displays, hearing aids, and cochlear implants are largely unhelpful for those without vision and/or hearing loss. Similarly, wheelchairs, canes, and some highly specialized devices are primarily designed for those with mobility disabilities. On the other hand, some readily available tools, such as noise-canceling headphones, white noise apps, organizational apps, memory aids, and daily routine aids, can be especially helpful for those with learning and cognitive disabilities, even though they are simple conveniences to most people. In fact, Princeton University’s ODS site maintains a list of AT options organized by need, linked in the references below (Office of Disability Services, 2026).

    When considering all the ADLs that may need to be accommodated for, the list continues. Fall detection devices, vibrating alarms, grab bars, reaching and dressing aids, ramps, shower seats, ergonomic utensils, stair lifts, collapsible stools, eyeglasses, fidget toys, and that’s just the beginning. AT devices can be high-tech, like a touchscreen communication device, or low-tech, like a cardboard communication board. They can be physical hardware, like prosthetics, or computer hardware, like specialized keyboards. Some AT can include special software. Some can be found easily and independently, while others need to be carefully chosen by a team of professionals or consultants. This is partly because some AT requires a prescription, even when it’s covered by insurance or a government program. Cost and coverage are often significant barriers, as they often depend on the device or system, the reason or reasons that it is needed, the individual’s insurance coverage, and even the disabled individual’s employer (Cleveland Clinic, 2025; ATiA, 2026).

    Portability can also be an issue, making rental services a practical choice for some. Luckily, there are organizations like ATiA whose members can help their clients connect with AT providers. Online message boards and social media can also be a great place to start looking for information or to find less specialized AT (Cleveland Clinic, 2025; ATiA, 2026).

    Finally, when talking about AT, it’s important to acknowledge the ableism that often accompanies it. As with any form of discrimination, the discrimination against those with a disability is not always intentional, and it can come from within the disabled community as well. The modern concept of ableism, which likely emerged in the 1960s and 1970s, can be seen in almost every setting, personal, societal, cultural, and institutional. It can manifest in the unnecessary labeling and altered expectations of an innocent peer, or in more obvious judgments rooted in eugenics-based thinking. In almost every case, these judgments are based on what is perceived as “normal” (Britannica Editors, 2025).

    References

    Office of Disability Services (2026). Assistive Technology. Princeton University. https://ods.princeton.edu/assistive-technology

    Cleveland Clinic (2025). Assistive Technology. Health Library. https://my.clevelandclinic.org/health/articles/assistive-technology

    ATiA (2026). What is AT?. Assistive Technology Industry Association. https://www.atia.org/home/at-resources/what-is-at/

    World Health Organization (2024). Assistive Technology. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/assistive-technology

    Britannica Editors (2025). Ableism. Encyclopedia Britannica. https://www.britannica.com/topic/ableism

  • Service Animals, Part 3

    Service Animals, Part 3

    Part 3: Legallities

    In “Service Animals, Part 2,” I explained what a service animal was. Of course, legal definitions and legalities in general are often more complex than they appear. Generally, any establishment open to the public must allow service dogs to accompany their handlers, even where there’s a no pets policy. In the US, service dogs are not required to be certified or trained by a professional, nor are they required to wear a harness, vest, or tag to identify them as a service dog (US Department of Justice, n.d.).

    I also mentioned briefly in “Service Animals, Part 2,” that a service animal is generally a dog. However, miniature horses — typically up to three feet tall and weighing up to 100 pounds — may also qualify where reasonable. If the horse is house-broken, under the handler’s control, and the facility can accommodate the horse’s general type and size without compromising legitimate safety requirements, it is considered a reasonable service animal (US Department of Justice, 2020). For time and clarity, though, I’ll continue to focus on service dogs.

    Legally speaking, a service dog is one specifically trained to help their disabled handler with tasks directly related to their disability. While service dogs may also provide comfort and emotional support, these skills are not considered service dog tasks. Other working dogs, such as facility dogs, therapy dogs, and Emotional Support Animals (ESAs), provide comfort and emotional support primarily to non-disabled individuals. Though these dogs are often highly trained, they are still considered pets. For example, facility dogs are trained to assist professionals working in healthcare, rehabilitation centers, criminal justice settings, and similar establishments. Therapy dogs are certified to visit and comfort certain therapy patients. ESAs, while not specially trained, help to comfort and calm their handlers. However, these working dogs are only allowed where pets are and where their specific jobs take them (Canine Companions, 2026).

    To identify service dogs, establishments may ask a handler whether their dog is required due to their disability and what specific tasks the dog has been trained to perform. However, regardless of the handler’s response to this, they can not ask for proof of this disability or of the service dog’s qualifications. If the dog can not be kept under reasonable control, or if the service dog’s presence will fundamentally alter the nature of goods, services, programs, or activities provided, those in charge are allowed to refuse entry or service, or ask the handler to remove their service dog. For example, a sterile hospital setting may require the removal of a service dog. If a service dog must be removed, the handler must be provided with an alternative opportunity to receive their goods or services without their service dog (US Department of Justice, n.d.; US Department of Justice, 2020).

    Legally speaking, service animals are not pets, as their tasks directly relate to their handlers’ disabilities. For this reason, service dog handlers are not required to answer questions about their disability, documentation, proof of necessary accommodations, or to demonstrate their service dog’s training. They can’t be segregated, given lower-quality service, or charged more solely because of their service dog. A business can charge handlers for damages that they or their service dog cause, if other non-disabled customers would also be charged for damages. However, if a service dog handler needs alternative accommodations, the business is not responsible for the service dog’s care or supervision (US Department of Justice, 2020).

    To add to this, a customer or employee’s allergies and/or fear of dogs is not considered a valid reason to deny a service dog handler access to goods and services. These fears and allergies will not fundamentally alter the nature of goods or services provided. This means that if someone is allergic to pet dander, the business must accommodate both the disabled handler and the allergic customer separately (US Department of Justice, 2020).

    It’s important to note here that rules and regulations are often updated as needs evolve. For instance, the most recent update of the Americans with Disabilities Act (ADA) Title II and Title III regulations, published by the US Department of Justice (DOJ) in September 2010, modified specific requirements for the regulation of public and commercial accommodations, including the 2010 Standards for Accessible Design (2010 Standards). That said, state and local laws may differ from federal regulations. So it’s important to check your state attorney general’s office for all applicable laws (US Department of Justice, 2020).

    Regardless of these local and federal variations, all housing, schools, emergency shelters, and businesses must comply with ADA regulations. State and local governments may also require licensing and vaccination for service dogs, but only if these conditions apply to all dogs. They can not require specific service dog certifications or registrations, or discriminate against service dogs based on breed. Notably, airplanes are not subject to ADA’s regulations. Instead, they are required to comply with the Air Carrier Access Act. Similarly, the Equal Employment Opportunity Commission (EEOC) is responsible for enforcing ADA regulations in employment settings (US Department of Justice, n.d.). Simply put, if your well-behaved service dog helps you manage your disability, you can take them with you.

    References

    Canine Companions (2026). Know the Differences: Service Dogs, Emotional Support Animals, and More. Canine Companions. https://canine.org/service-dogs/service-dog-month/service-dog-differences/

    US Department of Justice (n.d.). Service Animals. ADA.gov. https://www.ada.gov/topics/service-animals/

    US Department of Justice (2020). ADA Requirements: Service Animals. ADA.gov. https://www.ada.gov/resources/service-animals-2010-requirements/#miniature-horses

  • Service Animals, Part 2

    Service Animals, Part 2

    Part 2: Job Titles

    Dogs have been working with people for a very long time, far longer than they’ve been our pets, and with good reason. They can sense things that we just can’t. In fact, dogs have around 300 million olfactory receptors in their noses, compared to humans, who have around six million. And that’s just their nose! The first known guide dogs were working with people in the first century AD, and standardized guide dog training began in the 18th century (Mueller, 2025). However, this is just one job that a service dog can do.

    A service animal may be a miniature horse in some special situations, but these situations are very rare. For this reason, this article will focus on service dogs. Regardless of terminology, service dogs are specially trained to help with tasks that their handlers struggle to perform independently. For example, mobility service dogs may press access buttons or brace an unsteady handler. Guide dogs identify and maneuver around obstacles using a specialized harness. Hearing dogs alert their deaf handlers to specific sounds and lead them to safety when necessary. Medical alert dogs detect significant hormonal changes or the presence of dangerous allergens. Some alert dogs are even trained to get help when necessary (US Service Animals, 2023).

    The Americans with Disabilities Act (ADA) defines a service dog as “any guide dog, signal dog, or other dog that has been trained to provide assistance to an individual with a disability” (Stull, 2025a). Unfortunately, service dogs are often confused with therapy dogs and emotional support animals (ESAs). While these types of assistance dogs definitely play important roles, they have distinctly different job descriptions. It’s often easier to distinguish service dogs from therapy dogs and ESAs when you understand the variety of jobs that service dogs can do. These jobs can include guiding, hearing, mobility tasks, medical alert, psychiatric, or a combination of these.

    In the US alone, there are more than 500,000 working service dogs. All of these service dogs are legally allowed to enter any public space, even where pets are not allowed. While guide dogs are the most widely known type of service dog, even their jobs are not as simple as some may think. They do more than just take their blind or visually impaired handlers from point A to point B. These amazing dogs stop at curbs to alert their handler to a crossing, avoid obstacles that could harm their handler, and actively ignore potentially dangerous commands (a technique called “selective disobedience”). They are generally trained for around a year to a year and a half, beginning with puppy raisers who work on basic obedience training and socialization. After this, the dogs move on to be trained by professional guide dog trainers before they’re paired with their handler. Finally, the dog and their new handler work together in a 2-4 week training program (Mueller, 2025; Stull, 2025a).

    Similarly, hearing ear dogs are raised like guide dogs. However, these dogs are trained to alert their deaf and hard-of-hearing handlers to specific sounds (e.g., oncoming cars, alarms, door bells, and knocking) and lead them to or away when necessary. Once paired with their new handler, they work on a 2-4 week training program that may also include additional, specialized alert skills (Stull, 2025a; Mueller, 2025).

    Mobility assistance is another important type of service dog job. These dogs can help pull a wheelchair over uneven or challenging terrain, or help handlers with less well-known mobility disabilities like arthritis, Cerebral Palsy, muscular dystrophy, spinal cord injuries, and more. Their tasks can also include retrieving items that their handler drops, helping to open and close doors, pushing access buttons, and providing physical support to a handler with difficulty balancing, using stairs, and/or moving between sitting and standing (Stull, 2025a; Mueller, 2025).

    Seizure response dogs are a type of medical assistance dog trained to remain with their handler during a seizure and to alert or retrieve help if needed. In contrast, seizure alert dogs are trained to alert their handler to chemical changes that precede a seizure, allowing their handler get to a safe place before the seizure occurs. While there’s no conclusive proof as to how seizure alert dogs do it, there is significant evidence supporting their effectiveness (Stull, 2025a; Mueller, 2025).

    Other alert dogs, such as allergy detection and diabetic alert dogs, are also trained to alert their handlers to the presence of allergens or to changes in insulin levels that could be fatal if not handled appropriately. However, contrary to popular belief, alert dogs cannot be trained to recognize the scent they alert to. These dogs are chosen and trained for their jobs because of their innate ability to detect these scents (Stull, 2025a).

    Psychiatric service dogs are actually a category of medical assistance dogs trained to help their handlers with mental health conditions such as PTSD, OCD, severe social anxiety, self-harm, autism spectrum disorder (ASD), and more. These dogs can be trained to walk ahead of their handler, turn lights on in a new room, interrupt an anxiety or panic attack, create a physical barrier to distance known triggers, or even alert their handler in a way that creates an excuse to leave. Autism support dogs, one type of psychiatric service dog, also help their handlers (often children) navigate difficult social settings, prevent eloping, mediate the symptoms of sensory overload, and provide companionship when others can’t. However, one common misconception is that psychiatric service dogs and ESAs are the same. The major difference here is that emotional support isn’t a disability task. In fact, ESAs don’t need any specialized training (Stull, 2025a; Mueller, 2025; US Service Animals, 2023).

    Clearly, service dogs can do a lot. This is exactly why it’s so important to differentiate between the different categories of assistance animals. While there is no clear definition of “assistance animal,” a common consensus seems to define this term as an umbrella term including all service animals, therapy animals, and emotional support animals. So, it’s important to clearly differentiate between the other two categories as well.

    According to the ADA, an ESA (also called an emotional support dog or ESD) is “an animal [which] provides companionship, relieves loneliness, and sometimes helps with depression, anxiety, or certain phobias, but do not have special training to perform tasks that assist people with disabilities.” ESAs are pets and are not permitted into places that don’t already allow pets without a letter from a medical or mental health provider. However, it’s also important to remember that no matter the certification or qualification, an aggressive dog can be denied entry or asked to leave any establishment. That said, service dogs are the only type of assistance animal with full access to public areas (Stull, 2025b).

    Therapy dogs (and sometimes other animals) are pets whose handler brings them somewhere to offer therapeutic care to others. These dogs have to be certified nationally, locally, or occasionally through the facilities providing animal therapy. There are three main types of therapy dogs: therapeutic visitation dogs, animal-assisted therapy dogs, and facility therapy dogs. Therapeutic visitation dogs are part of a team visiting hospitals, retirement facilities, and similar facilities in order to lift spirits and/or distract the patients receiving treatment. Animal-assisted therapy dogs work with health professionals in facilities like rehabilitation centers to help with injury recovery or heightened anxiety levels, allowing patients to relax and open up more. Facility therapy dogs typically live where they work with the residents, in places like nursing homes. They can be trained to comfort residents, alert staff when needed, and perform other related tasks (Stull, 2025b).

    All in all, dogs are amazing. Service dogs, ESAs, and therapy dogs do amazing jobs that are as varied as the disabilities and conditions that they help their humans with. However, it’s important to remember to respect these assistance dog teams. Wanting to bring your dog everywhere isn’t a reason to pretend that they’re a service dog. And most importantly, ask before you pet that adorable puppy; they may be working.

    References

    Mueller, L. (2025). 8 Types of Service Dogs and What They Do. Title of source. https://www.thesprucepets.com/types-of-service-dogs-4587180

    Stull, E. (2025a). The 10 Most Common Types of Service Dogs. The Academy of Pet Careers. https://www.theacademyofpetcareers.com/blog/10-types-of-service-dogs/

    Stull, E. (2025b). Therapy Dogs vs Emotional Support Dogs: What is the difference?. The Academy of Pet Careers. https://www.theacademyofpetcareers.com/blog/therapy-dogs-vs-emotional-support-dogs/

    US Service Animals (2023). The Different Types of Service Animals & How They Can Help. US Service Animals. https://usserviceanimals.org/blog/types-of-service-animals/

  • Service Animals, Part 1

    Service Animals, Part 1

    First Hand Experience

    Service dogs are incredible companions capable of handling a wide variety of jobs. If you’ve spent time on social media or watched the news, you’ve likely heard stories about the great work that these dogs can do. While most people are pretty familiar with guide dogs, service dogs’ abilities extend far beyond this. 

    As a handler currently working with my third service dog, I can confidently say that their help is wholly transformative. My first service dog lacked formal training and would be considered an assistance dog or an emotional support animal (ESA) today. However, 20 years ago, federal laws and California state regulations regarding these classifications were far more vague than they are today.

    When I adopted Xander in 2005, I was struggling with severe anxiety and found it very challenging to navigate busy or crowded places. I had heard that all I needed to do to bring my 21-pound Shiba Inu mix with me was to register him as a California Assistance Dog, specifying, when asked, that he was my psychiatric service dog (Thompson, 2018). This was almost a decade before I received my formal diagnoses, and I was determined to appear “normal”. Despite the effort, my anxiety made masking my insecurities nearly impossible without Xander’s help.

    After Xander passed away from congestive heart failure in 2014, I felt the detachment and anxiety returning in a very visceral way. I’d just learned about Asperger’s Syndrome (ASD level 1 or ASD-1), and I was beginning to see the connections in my own life (Health Essentials, 2024). I knew that I would need to find a fully qualified service dog to pick up the other end of the leash. Thankfully, with the help of my family and a few local connections, I adopted and trained Billie. I then went through the grueling process of obtaining formal diagnoses for both ASD and epilepsy. I could now proudly adjust to life with new insight and a furry sidekick to keep me safe.

    Now at 13 years old, Billie is retired and helping to train her little sister to take over her duties. Since receiving my two primary diagnoses and becoming a service dog handler, I’ve gained a much deeper appreciation for these hard-working companions and the jobs they do. I’ve met fellow service dog handlers and shared experiences with them, both positive and negative. I’ll do my best to keep these next few posts as professional as possible. Though I am autistic, and this is a “special interest” of mine. So I may get a little carried away from time to time.

    References

    Health Essentials (2024). Asperger’s vs Autism: What’s the Difference?. https://health.clevelandclinic.org/aspergers-vs-autism

    Thompson, J. (2018). How to Apply for a California Assistance Dog Tag. Legal Beagle. https://legalbeagle.com/5313646-apply-california-assistance-dog-tag.html

  • The 5 Senses, Part 4

    Come again?

    Echolalia, also known as echophrasia, is the involuntary repeating of words or phrases. It’s commonly seen in young children who are still learning to speak and in individuals on the autism spectrum. However, like most health conditions, echolalia can take several forms. The condition can be immediate or delayed, communicative or semi-communicative, mitigated or unmitigated, and ambient or echoing approval. With communicative echolalia, the repeated phrase clearly contributes to the conversation. In cases of mitigated echolalia, the tone and/or pitch of the repeated phrase is different from its original delivery. Finally, ambient echolalia is a word or phrase that’s repeated from the surrounding environment, while echoing approval is spoken as a tonal response to its original delivery (Cleveland Clinic, 2023, Echolalia).

    Often, people assume that this condition is simply a symptom of Autism Spectrum Disorder (ASD). There is indeed a strong correlation; approximately 75% of those with ASD have some form of echolalia, which usually fades by age three. However, its main cause is unknown. It’s also seen in those with ADHD, aphasia, head injury, dementia, developmental delays, encephalitis, Tourette’s syndrome, stroke, schizophrenia, stress and anxiety, and other related conditions. For this reason, some medical professionals have suggested that there’s a potential link to a type of frontal lobe dysfunction that affects conscious thoughts, movements, and memory. Theoretically, this dysfunction could lead to a significant imbalance of dopamine, affecting brain-body communication. Alternatively, the improper mirror neuron function and/or processing issues may change how the body responds to stimuli (Cleveland Clinic, 2023, Echolalia).

    While the main cause of echolalia remains unknown, therapy to identify potential causes and other relevant details of an individual’s case may improve communication. Medication, psychological counseling, and consultations with neurodevelopment specialists may also help in some cases. However, without some intervention, individuals can experience significant anger, stress, delayed learning, isolation, trouble forming relationships, depression, and/or anxiety (Cleveland Clinic, 2023, Echolalia).

    It’s also important to seek medical help for your loved one if they are a child reverting to echolalia, or an adult with no history of echolalia, suddenly developing it. For allies, friends, or family members of someone with the condition, observing how the repeated phrases are expressed and paying attention to specific words or phrases that are repeated can be highly beneficial. Trying to correct or interrupt the individual may make things more difficult for them (Cleveland Clinic, 2023, Echolalia). 

    A good example of this might sound something like the following:

    “Would you like some tea?”

    “Like some tea?”

    Instead of repeating yourself or criticizing them, try rephrasing what you said.

    “I’m going to make myself some tea. Would you like some?”

    Similar to echolalia, echopraxia (also known as echokinesis or echomotism) is the involuntary mimicking of physical and/or facial movements. Unlike voluntary imitation, which can be helpful when learning a new skill, echopraxia is entirely involuntary. It can manifest as simple actions like grimacing when someone else tastes a sour flavor, or as more complex actions, such as copying someone’s walk (Cleveland Clinic, 2024, Echopraxia).

    Echopraxia is a symptom of brain dysfunction, movement disorders, and psychiatric conditions. Diagnosis often involves asking the individual to respond to verbal commands while watching another person’s movements. If the individual has a strong compulsion to mimic the movements before or instead of responding to the verbal commands, they may have echopraxia. Like echolalia, its main cause is also unknown and is likely a symptom caused by frontal lobe and/or mirror neuron issues. It is more commonly seen in those with ASD, catatonia, epilepsy, schizophrenia, and Tourette’s syndrome. Currently, there is no single treatment or prevention method. However, identifying the underlying cause and addressing this with psychotherapy, cognitive behavioral therapy (CBT), and/or medication may be beneficial. It’s crucial to seek treatment for echopraxia, as the condition can lead to physical injury if untreated (Cleveland Clinic, 2024, Echopraxia).

    References

    Cleveland Clinic (2023). Echolalia. Health Library. https://my.clevelandclinic.org/health/symptoms/echolalia

    Cleveland Clinic (2024). Echopraxia. Health Library. https://my.clevelandclinic.org/health/symptoms/echopraxia

  • The 5 Senses, Part 3

    Pardon the Interruption

    Sensory processing disorder (SPD), also known as sensory integration dysfunction, affects how individuals with the disorder interpret sensory information from any or many senses. This often makes it difficult for the individual to respond appropriately to sensory stimuli. Because of this, sounds or textures can become irritating or even painful (Khalid, 2025).

    The misinterpretation or incomplete processing of sensory stimuli seen in SPD may also make it difficult for the individual to filter sounds, smells, and other sensory information the way a typical person would, making it more difficult to distinguish what is important. When exposed to too much unfiltered sensory input, this individual will often become overstimulated and overwhelmed. Everyone reading this is likely familiar with the most common signs of SPD. These common signs include an intolerance to bright lights and/or loud noises, an aversion to certain textures, increased distractibility by background noise, an aversion to sudden touch, and a decreased sense of spatial awareness (Rutgers-New Brunswick, 2025).

    Some of these SPD symptoms, such as hypersensitivity, are often confused with those of Autism Spectrum Disorder (ASD). However, it’s important to note the three main subtypes of SPD, distinguishing the condition from ASD itself. These subtypes are known as sensory modulation disorder, sensory-based motor disorder, and sensory discrimination disorder (Hawthorn, 2024).

    The most common symptom of sensory modulation disorder is an individual’s decreased ability to regulate their responses to sensory input, leading to overreactions or under-reactions to certain sensory input, and a potential craving for additional sensory input. Sensory-based motor disorder, on the other hand, primarily affects balance and spatial awareness. This decreased awareness can lead to increased difficulty in processing body movements (Hawthorn, 2024).

    The third subtype, sensory discrimination disorder, is often seen when an individual has difficulty interpreting sensations. This can lead to a decreased ability to distinguish between certain letters, such as M and N, or to determine when there is an urge to use the bathroom. Unsurprisingly, recent studies have shown that between 90% and 95% of those with an ASD diagnosis also experience SPD. In the United States, around 1 in 45 adults and 1 in 54 children are diagnosed with ASD, while around 1 in 6 US children are diagnosed with severe SPD (Hawthorn, 2024). While the medical community continues to debate whether SPD is its own diagnosis or simply a key diagnostic symptom of various neurodiversities, it’s important to see this as a clear example of the relationship between correlation and causation.

    References

    Hawthorn, A. (2024). It’s not Autism, It’s Sensory Processing Disorder. Psychology Today. https://www.psychologytoday.com/us/blog/the-sensory-revolution/202012/its-not-autism-its-sensory-processing-disorder 

    Khalid, E. (2025). Sensory Disabilities — Type, Effects, and Treatment. NuPrisma. https://nuprisma.com/sensory-disabilities-types-effects-and-treatment/

    Rutgers-New Brunswick (2025). Sensory Disabilities. Department of Kinesiology and Health. https://kines.rutgers.edu/dshw/disabilities/sensory/1061-sensory-disabilities

  • The 5 Senses, Part 2

    It’s Complicated

    Starting with a popular topic these days, let’s jump right in with autism. Autism Spectrum Disorder (ASD) is a complex, lifelong developmental disorder characterized by a wide range of social, communication, and behavioral difficulties and differences. These differences affect how those of us on the spectrum interact with our surroundings and other people. It is estimated that around 2% of US adults have ASD, with males being around four times more likely than females to receive an official diagnosis. Officially, the CDC states that around 1 in 54 US children have an ASD diagnosis. Though some may claim that “certain children recover from ASD,” autism is a lifelong condition, and individuals often continue to experience significant sensory sensitivities (Khalid, 2025). It’s also important to note that there are very few reliable statistics on ASD in relation to queer identities. Most of the studies that I’ve found refer to their subjects’ natal sex, rather than their gender identity.

    Another familiar topic in the realm of disability is blindness. Defining vision loss and blindness is more complicated than many people realize. To be considered legally blind, an individual must have vision that prevents them from seeing clearly beyond six meters, translating to roughly 20/200 vision in US terms. Alternatively, a person may be considered legally blind if their field of vision is less than 20º in diameter, even if their central vision is perfectly intact. This vision loss may be congenital, progressive, and/or the result of illness or injury. Some examples can include a physical difference in the eye, macular degeneration, diabetes, or many other conditions may lead to illness, injury, or a progressive condition. Although vision loss can occur at any age, those over 65 are more likely to experience it (Khalid, 2025).

    A common misconception is that blindness is an all-or-nothing disability. While it is true that blind and visually impaired individuals may need mobility aids, such as guide dogs and/or white canes, blindness does not necessarily mean that there’s a complete absence of vision. Low vision simply means that the individual’s visual impairment significantly interferes with daily activities. Some people may use large print, others may be able to see images at a distance or in their direct line of sight. Even the causes of vision loss are as diverse as their effects, ranging from uncorrected refractive issues to macular degeneration, glaucoma, trachoma, and many more (Rutgers-New Brunswick, 2025).

    As with blindness, deafness is also not an all-or-nothing disability. There are several different types of hearing loss, each with different causes. Conductive hearing loss occurs when sounds are physically prevented from passing through the outer and/or middle ear to the inner ear, and it’s often treatable with medicine and/or surgery. Sensorineural hearing loss is caused by a malfunction in the structures of the inner ear or in the nerves that process sound. A combination of these types of hearing loss is called mixed hearing loss. Going deeper, auditory neuropathy spectrum disorder is a type of hearing loss caused by damage to the inner ear and/or internal nerves, preventing the brain from processing sound. It’s also important to remember that hearing loss can have many causes. Congenital hearing loss alone can result from certain infections during pregnancy, low birth weight, birth asphyxia (or lack of oxygen at birth), misuse of drugs or medications, and many other factors (Rutgers-New Brunswick, 2025).

    It’s also important to remember certain cultural factors here. The terms hearing loss and deafness can also refer to any significant reduction in hearing. Many deaf people use a sign language to communicate, while others use lip reading either as their main method of communication or in addition to a sign language like American Sign Language (ASL). Like vision loss, an individual may be born deaf, or their hearing loss may be acquired. This hearing loss may also be progressive or non-progressive (Khalid, 2025).

    Unless you or someone you know is Deaf, you may also be unfamiliar with the difference between, and the importance of capitalizing the “D” here. The importance lies in matters of identity and community. When written with a lowercase “d”, deaf generally refers to hearing loss as an audiological or medical concept. This is a clinical term focusing on the diagnosis of conditions on a wide range of hearing impairments from mild to profound. Most often, you will hear and see this term used outside the Deaf community, or when specifically referring to a physical inability to hear (AccessiBe Inc., 2025).

    In contrast, Deaf with a capital “D” generally refers to a cultural or personal identity, or to the Deaf community itself. This includes the experiences, social norms, and shared sign languages existing within the community. It also includes the clinical deafness of individuals. But it’s important to remember the added sense of community, identity, and pride that the capitalization of a letter brings with it (AccessiBe Inc., 2025). Even hearing people can appreciate the resilience and anonymity that this simple change in grammar carries.

    It’s also important to remember that the choice of which spelling to use is often deeply personal to the individual experiencing deafness. The distinction is important wherever inclusivity is important, just like personal pronouns. Simply put, the lowercase “deaf” should be used when talking about the medical or general aspects of limited hearing, while the uppercase “Deaf” should be used when talking about cultural or community-centered aspects. It’s also important to remember that outside of a strictly clinical setting, “hearing impaired” is a deficiency. The terms “hard of hearing” and deaf are more neutral, much like “developmentally disabled” and neurodivergent (AccessiBe Inc., 2025). For example, my grandpa became deaf and started wearing hearing aids, while Deaf celebrity Nyle DiMarco grew up in the Deaf community. When in doubt, ask politely.

    References

    AccessiBe Inc. (2025). Deaf vs. deaf. accessiBe. https://accessibe.com/glossary/deaf-vs-deaf

    Khalid, E. (2025). Sensory Disabilities — Type, Effects, and Treatment. NuPrisma. https://nuprisma.com/sensory-disabilities-types-effects-and-treatment/

    Rutgers-New Brunswick (2025). Sensory Disabilities. Department of Kinesiology and Health. https://kines.rutgers.edu/dshw/disabilities/sensory/1061-sensory-disabilities

  • The 5 Senses, Part 1

    But you don’t look disabled

    Sensory disabilities are as complicated as our senses are. Most people are familiar with deafness and blindness. However, many people are less familiar with conditions like anosmia, congenital insensitivity to pain (CIP), hypoesthesia, hyperesthesia, hyperacusis, photophobia, auditory processing disorder (APD), or sensory processing disorder (SPD). This means that an individual with one of these conditions may have an increased or decreased sensitivity to different types of sensory input, such as touch, sound, visual input, or even smell and taste (Cleveland Clinic, 2023; NORD, 2025; Merriam-Webster, 2026).

    In my case, my ASD-1 (formerly Asperger’s syndrome) makes it more difficult for me to process verbal communication and certain types of physical contact quickly. In elementary school, my parents were told that I had an auditory processing deficit (formerly a layman’s term for what is now APD). However, I would also scratch tags and buttons off clothing and flinch when someone suddenly touched me. Decades later, I was diagnosed with ASD-1, and it was suggested that my previous informal diagnosis of APD may actually be SPD, not uncommon in those of us labeled as high-functioning autistic.

    A sensory disability can be defined as an impairment of one or more of the 5 senses: smell, sight, taste, hearing, and/or touch. Surprisingly, the most common sensory disability is related to taste impairment. Sensory disabilities are often genetic, but can also be caused by illness or injury. They are also most common in seniors, mostly affecting their quality of life. In fact, deaf-blindness, a sensory disability involving the loss or significant impairment of both hearing and vision, is often seen in older adults with dementia. To add to this, one-third of seniors with vision loss also have symptoms of depression and loneliness. However, one in six kids has at least one sensory disability that inhibits their daily life and learning. These disabilities can also affect learning and performance in school. Though they can’t be cured, symptoms can be treated and managed with therapies like sensory integration, occupational therapy, and physical therapy. Service dogs trained to aid those with sensory disabilities can also help by retrieving items, guiding, providing emotional regulation and stability (both physically and psychologically), alerting to oncoming seizures, providing direct companionship and a sense of security, and many more services (Khalid, 2025). 

    At its core, a sensory disability is a neurological condition that in some way prevents the brain’s processing of sensory info in a typical manner. This includes vision and hearing loss. However, it also includes conditions like Autism Spectrum Disorder (ASD) and Sensory Processing Disorder (SPD). Symptoms and signs of ASD can include some difficulties with communication, behavioral challenges, social interaction, and typical learning methods. Assistance needs vary significantly depending on the individual. An autistic person may lack the instinct to point to things of interest, and they may not readily follow another’s gestures. This disinterest in social interaction may lead to trouble relating to others, self-isolation, avoiding eye contact, trouble expressing emotions, showing empathy in a typical way, and echolalia (Cleveland Clinic, 2023; Rutgers-New Brunswick, 2025).

    References

    Cleveland Clinic (2023). Echolalia. Health Library. https://my.clevelandclinic.org/health/symptoms/echolalia

    Khalid, E. (2025). Sensory Disabilities — Type, Effects, and Treatment. NuPrisma. https://nuprisma.com/sensory-disabilities-types-effects-and-treatment/

    Merriam-Webster (2026). Medical Dictionary. Medical Dictionary. https://www.merriam-webster.com/medical

    NORD (2025). Congenital Insensitivity to Pain (CIP). National Organization of Rare Disorders. https://rarediseases.org/rare-diseases/congenital-insensitivity-to-pain-cip/

    Rutgers-New Brunswick (2025). Sensory Disabilities. Department of Kinesiology and Health. https://kines.rutgers.edu/dshw/disabilities/sensory/1061-sensory-disabilities

  • Mobility Disabilities: It’s a Bit Complicated

    When most people hear the phrase “mobility disability,” the first image that comes to mind is typically someone in a wheelchair or forearm crutches. But this image only represents a small portion of people with mobility disabilities. Many people don’t consider those with temporary mobility conditions, progressive disabilities, or disabilities with fluctuating symptoms. However, this lack of awareness isn’t too surprising, given our society’s depiction of mobility and disability.

    What “Mobility Disability” Means

    The easiest way to define mobility disability is to first define mobility. Simply put, mobility is the “ability to move purposefully as you go through your day.” This ability depends on stamina, strength, balance, coordination, flexibility, and range of motion. When any of these areas are impaired, or there is a significant disability here, everyday tasks like getting in and out of bed, showering, or carrying groceries, become harder (Marshall, 2022).

    Between 12% and 14% of Americans have some form of mobility impairment, and nearly half of all US seniors experience some mobility loss. Yet many people don’t really give mobility a second thought until a lack of it becomes impossible to ignore. Though even these facts and definitions don’t fully explain the complexity of this category of disabilities. Mobility exists on a complicated spectrum. Some disabilities are inherited, while others are acquired. Many neurological conditions and disabilities are also mobility disabilities or can lead to them (Marshall, 2022; Rung, 2024; Taylor & Stanton, 2020). For example:

    • Parkinson’s disease is the progressive degeneration of the brain’s basal ganglia, reducing motor coordination. 
    • Cerebral Palsy (CP), resulting from the temporary loss of oxygen to a developing brain, is a non-progressive loss of muscle control and can potentially lead to seizures, spasms, intellectual disabilities, decreased physical sensation and perception, impaired speech, and/or vision and hearing impairments.
    • Multiple Sclerosis (MS) is the result of the immune system attacking the myelin sheaths on nerve fibers, leading to degenerative paralysis, blindness, deafness, and/or mental deterioration.
    • Huntington’s disease is an inherited disease that causes physical and psychological deterioration, loss of motor function, muscle spasms, personality changes, and more.
    • Polio, also known as poliomyelitis, is a highly infectious virus that attacks motor neurons, preventing necessary nerve impulses from reaching the appropriate parts of the body. This can lead to anything from decreased motor function in the limbs to full-body paralysis.

    These are only a few examples of mobility disabilities and conditions that we know of (Taylor & Stanton, 2020).

    Treatment & Management Options

    Because mobility disabilities vary so widely, treatment and management options must be tailored to the individual’s needs. Each condition, whether temporary or permanent, will come with its own set of symptoms and treatment options. Some of these treatment options may include the following:

    • Surgery
    • Mobility aids
    • Prosthetics
    • Sensory aids
    • Physical rehabilitation
    • Retraining at home
    • Exercise plans
    • Allopathic medications
    • Seizure prevention methods
    • Specialized therapies
    • Follow-up care for complications
    • Special education plans
    • Service animals
    • Support services from a trained professional 
    • Combinations of the above

    (Sherrell, 2024)

    Some conditions will require significant home, work, and school accommodations like grab bars, accessible parking, ramps, joysticks and/or trackballs, accessible tech, and more (Rung, 2024). It’s helpful to note that with some inherited disabilities, genetic testing may be available to help prevent or prepare for the onset of a heritable condition (Taylor & Stanton, 2020). However, people with mobility disabilities aren’t always the only ones who need to remember to manage their health challenges.

    Caregivers can also put their own health at risk due to the high levels of stress, lost wages, and other requirements. For this reason, support groups and other healthcare maintenance should be considered for caregivers. Gender biases, discrepancies, and social stigmas may also be factors in these situations. Women are less likely to receive adequate support for chronic disabilities and are more likely to be institutionalized than their male counterparts. Children with chronic disabilities can also develop a range of psychological challenges, such as depression, low self-esteem, jealousy, and guilt, which may stem from a belief that they’re being punished or left out. Physical exercise and therapy can help a lot with these feelings when they occur in both adults and children (Taylor & Stanton, 2020).

    Common Allopathic Approaches

    There’s no doubt that exercise is important, even when it’s challenging. For those with mobility disabilities, guidelines recommend 150 minutes of moderate aerobic exercise per week, with strength and balance training twice a week. However, doing anything that increases the heart rate will be beneficial to some degree (Marshall, 2022).

    Using specific mobility aids often makes exercise possible for those with mobility disabilities. These aids include:

    • Standard canes and quad-canes to provide stability and support for the lower limbs
    • Forearm, Lofstrand, and platform crutches, which are most commonly used by those with more long-term disabilities, place the forearm into a plastic or metal cuff with a hand grip below to offer more support and greater weight distribution
    • Walkers (or zimmer frames), rollators, and manual or electric wheelchairs often provide similar support to those with limited or no mobility in their lower body
    • White canes help those with significant vision loss sense their surroundings in place of visible cues, while also making others aware of this need
    • Underarm (axillary) crutches and knee walkers, most commonly used by those with short-term injuries in much the same way as forearm crutches while the body heals
    • Service animals may also be trained to perform mobility, guiding, and/or alerting tasks for those with mobility disabilities

    (Leonard, 2017)

    Yes, And…

    Long-term or permanent mobility disabilities often require specific home modifications, including ramps, stair lifts, handrails, and other accessibility features. At the same time, these changes and modifications can also benefit abled-bodied people and those with fewer accessibility needs. Those with conditions like arthritis, diabetes, heart and lung issues, visual impairments, and those like myself with developmental disabilities and epilepsy can all benefit here. However, it’s also important to remember that improper use of mobility aids can risk other injuries like crutch paralysis from excessive pressure on the nerves in the armpit. This is why it’s important to learn about the proper use of each device and modification before using them on your own (Leonard, 2017).

    For businesses and rental properties, taking small steps to make everything more accessible can make a big difference. Ramps and automatic doors, widened hallways and doors with low or ramp-like thresholds, grab bars in bathrooms, and adding a few lower or more accessible facilities can help people with all types of mobility disabilities. Adjustable desks, chairs, and other equipment, coupled with accessible technology, can also help in work and school environments (Sherrell, 2024).

    It’s also important to remember that negative emotions can exacerbate poor health, mimic poor health, and even hide symptoms. This is why it’s so important to consider the influence of mental health when building a treatment plan or making changes in your environment. Making a solid effort to increase positive emotions wherever possible can boost immune and physical health, which helps to boost overall resilience (Taylor & Stanton, 2020). 

    Unfortunately, many people come to believe that their condition was caused or triggered by a potentially avoidable or stressful situation, often leading them to blame family and friends, including themselves. Learning to adapt and potentially gain new skills may be necessary to maintain independence and keep working. In some cases, this may be the only way to keep vital medical insurance current. Some people with newly acquired disabilities or diagnoses may also find that others start to treat them differently. Where others used to treat them as equals, infantilization and casual disregard may become more noticeable. Micro-aggressions and casual jokes may start to become apparent. Luckily, many forms of therapy can help considerably with recovery and learning to cope with this new way of approaching daily life (Taylor & Stanton, 2020).

    Herbal Options

    Mistletoe Viscum album 

    Mistletoe is a parasitic plant that grows on the branches of certain trees. Generally considered poisonous and potentially deadly, the right dosages administered by a professional can help the cardiovascular and immune systems. In the correct dosages, mistletoe can be useful for conditions like Postural Orthostatic Tachycardia Syndrome (POTS) or Rheumatoid Arthritis (RA), which affect blood pressure or immune function (Petersen, 2013).

    Olive Olea europaea 

    Olive can be used in its many forms, both internally and externally, for its anti-inflammatory, antimicrobial, hypoglycemic, and immune-boosting qualities. It can be used as integrative medicine for immune disorders, digestive issues, skin conditions, and many other conditions and complications associated with mobility disabilities. However, olive should not be used where gallstones are present (Petersen, 2013). That said, I have personally found that olive oil makes a fantastic carrier oil, lending its benefits to other preparations while simultaneously acting as a delivery method for medicinal preparations.

    Hawthorn Crataegus spp.

    Hawthorn is actually a genus of small trees and bushes, with a few key species being medicinally beneficial. Generally taken orally, hawthorn can act as a cardiotonic, vasodilator, anti-inflammatory, antiviral and antibacterial, antispasmodic, diuretic, and sedative. To name just a few of the many conditions it has helped with, it has been used internally for congestive heart failure, conditions affecting circulation, arrhythmia, hypo- and hypertension, gastrointestinal conditions, as well as topically for boils, sores, and ulcers. However, some contraindications can include nausea, gastrointestinal issues, sweating, and fatigue. It can also interact with some medications and is not safe to use during pregnancy (Petersen, 2013).

    Many other herbs can also help with symptoms such as dry skin, bruises, sores, muscle soreness, and others common in those with mobility disabilities. A licensed herbalist or naturopath can help determine what is appropriate and safe, tailoring an herbal regimen specifically to their client’s needs. However, when speaking with your practitioner, it’s often helpful to specify what your goals are and what other treatments and medications you are currently using. It may not be easy, but holistic healing is possible.

    References:

    Leonard, J. (2017). What Types of Mobility Aids Are Available?. Medical News Today. https://www.medicalnewstoday.com/articles/318463

    Marshall, M. (2022). Mobility. Harvard Health Publishing. https://www.health.harvard.edu/topics/mobility

    NORD (2021). Ehlers Danlos Syndrome. National Organization of Rare Disorders. https://rarediseases.org/rare-diseases/ehlers-danlos-syndrome/

    Petersen, D. (2013). Herbal Materia Medica I. Herb 302. Portland, OR: American College of Healthcare Sciences.

    Rung, R. (2024). Mobility Disability and Benefits. Healthline. https://www.healthline.com/health/what-is-considered-a-mobility-disability

    Sherrell, Z. (2024). Mobility Disabilities List. Medical News Today. https://www.medicalnewstoday.com/articles/mobility-disabilities-list

    Taylor, S. & Stanton, A.L. (2020). Chapter 10. Health Psychology (11th ed). McGraw Hill. ISBN: 9781260253900