6. If the person is noted in questions 4 and 5 of the List of Occupants, ask:
What type of physical or mental impediment do you have?
(Mark the most severe)
[] 1 Blind
[] 2 Deaf
[] 3 Mental retardation
[] 4 Cerebral paralysis
[] 5 Permanent physical disability
[] 6 Other
[] 7 None
Question Number 6: What type of physical or mental impediment do you have?
Mark with an "X" a single box agreeing with the response of the person. Remember that this question is asked only to the persons who declared to have some impediment in the list of occupants. If the person does not have an impediment mark circle 7 (none).
[Below the text is a picture of a filled out question.]
Consider as:
Blind: a person who has no vision or sees very little (visual weaknesses) an impediment that cannot be normalized with the use of glasses, treatments or other optical aids. Include persons who are blind from birth, blind by sickness like glaucoma, "toxoplasmosis", and diverse infections, and those blind by accident (hit in the eye, diverse injuries, etc.).
Deaf: a person who does not hear or talk and communicates through signs but with normal intelligence.
Mental Retardation: a person who has a below normal intellectual capacity. The characteristics are shown through a low performance in school, problems with adaptation and behavior, and retardation in mental and social development. A typical case is a "mongoloid" [Down's syndrome] person.
Cerebral Paralysis: a person who cannot move because of an injury or pain in the brain. Generally, there is an aural, visual, mental or language problem.
Permanent Physical Disability: includes paraplegics who are paralyzed in the lower extremities of their bodies and quadriplegics who are persons paralyzed in the upper and lower extremities of their bodies. This condition could have happened from sickness or accident.
Other: Mark this circle in the case of a person who is mute, autistic or suffers from dementia.