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Open AccessArticle

The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan

1
Department of Natural Resources and Environmental Studies, National Dong Hwa University, Hualien 97401, Taiwan
2
Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City 97005, Taiwan
3
Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
4
Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
5
Department of Public Health, Tzu Chi University, Hualien City 97004, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(20), 7553; https://doi.org/10.3390/ijerph17207553
Received: 8 September 2020 / Revised: 4 October 2020 / Accepted: 13 October 2020 / Published: 17 October 2020
(This article belongs to the Special Issue Health Inequality and Spatially Distribution)
Developmental disability is likely to be lifelong in nature and to result in substantial activity and societal participation limitations. The performance of individuals is related to the environment, supports, and urbanization of living cities. Most of the surveys for people with disabilities have not discussed the relationship between the cognitive impairment properties and performance of participation and activities functioning, and most cognitive impairments are regarded as having similar performance. The location of residence in childhood is mainly influenced by parents and main caregivers, but the factors related to the preferences of adults with cognitive impairment in the location of residence are more complicated. Objective(s): The aim was to explore and compare the relationships of the urbanization degree of their living cities and the functioning performance of daily living in various domains among adults with intellectual disability (ID), autism, and concomitant communicative impairment (CCI). Method: The cross-sectional study was applied, and the data was collected face-to-face by professionals in all authorized hospitals in Taiwan. The participants were 5374 adults with ID (n = 4455), autism (n = 670), CCI (n = 110) and combination disabilities (n = 139) which were according to the International Statistical Classification of Diseases 9th Revision (ICD-9) from a total of 167,069 adults with disabilities from the Disability Eligibility System (DES) in Taiwan between July 2012 and October 2013. The authors used the World Health Organization Disability Assessment Schedule 2.0–36 item version of WHO (WHODAS 2.0-36 items) to measure performance and capability of daily living. Results and Conclusions: There were significant differences in age, gender, disabled severity, and the urbanization between all subgroups (p < 0.05). After adjusting the age of all participators, the degree of urbanization just significantly affected the functioning score distribution in domain 1: cognition for an adult with ID, autism, and CCI; in domain 2, mobility for an adult with CCI and combination disability; in domain 3, self-care; domain 4, independent domains for ID (p < 0.05). There were no significant differences between urbanization degree and functioning scores in all domains for adults with autism. All in all, only in groups with combination disability did we find that the worse the degree of impairment was, the lower the degree of urbanization of their place of residence was, and there was no such phenomenon in adults with autism and ID in our study. View Full-Text
Keywords: activity and participation functioning; developmental disabilities; performance; urbanization activity and participation functioning; developmental disabilities; performance; urbanization
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Lin, S.-W.; Chiu, T.-Y.; Liou, T.-H.; Yen, C.-F.; Chen, H.-G. The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan. Int. J. Environ. Res. Public Health 2020, 17, 7553.

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