Questionnaire Text

Questionnaire form view entire document:  text  image

6. Type of disability

This person has limitation for:

Read all the options and circle the affirmative responses.

1 Moving, walking, or needs assistance
2 Using arms and hands
3 Is deaf or uses a hearing aid
4 Is mute
5 Is blind or only sees shadows
6 Has some retardation or mental deficiency
7 Has other physical or mental limitation.
_____Write the limitation.

8 Has no physical or mental limitation (Continue with number 8)

Questionnaire instructions view entire document:  text  image

6. Type of Disability

A disabled person is one who has some physical or mental limitation, which limits their ability to carry out activities in their house, school, or job, such as walking, dressing, bathing, reading, writing, hearing, etc.

This question obtains information from people who have long term or permanent disabilities or limitations.

Long term disabilities are those that exist for more than six months, or which are expected to last for at least that long.

[Depiction of this completed question on the enumeration form]

When a person has more than one limitation or disability, circle the codes of the affirmative responses. The following people can be considered to have disabilities:

[P. 68]

Those who cannot, or are limited in, moving or walking due to a partial or total lack of legs, or those who, having complete legs, cannot move them; they generally need help from other people, from a wheel chair, walkers, or an artificial foot or leg. This includes invalids, people with polio, people who have had one or both legs (or a portion of them) amputated, among others.

Those who cannot, or are limited in, using their arms or hands due to a partial or total lack of arms, hands, or fingers; or those people who, having both their arms, have lost the ability to move them, such that they cannot grab or move objects, push, throw, pull, dress, bathe, or perform other actions; those with one hand/arm are an example.

Those who cannot hear with one or both ears, those who only hear high pitched noises, or those who use any kind of hearing aid. For example, those who only hear with one ear, and those who only hear when they are spoken to very loudly.

Those who cannot speak. In this case, do not include babies who are not yet able to talk.

Those who are blind, those who see with only one eye, and those who only distinguish large shapes, or shadows.

People with mental retardation, who learn slowly, those who have Down syndrome, etc.

[Depiction of this completed question on the enumeration form, and a related drawing]

Any physical or mental disability or limitation other than the previous should be registered as it is reported to you, in the space write the disability.

If, after having read through the options, they report that the person does not have any disabilities, circle code 8 and go on to question 8. use of health services.