Disabilities, Volume 5, Issue 4 (December 2025) – 36 articles

The Réseau de transport de la Capitale (RTC), Quebec City’s public transportation provider, has launched a training program to enhance skills and self-efficacy for using the bus, including training for people with disabilities: “Service d’accompagnement en mobilité intégrée (SAMI)”. This pre-post study with a convergent mixed approach aimed to evaluate the influence of the SAMI program (P-SAMI) on transportation self-efficacy, mobility and satisfaction with the bus use among people with disabilities. The study also explored people with disabilities’ experiences and perceptions with the P-SAMI and bus use. The P-SAMI was delivered, and questionnaires and semi-structured interviews were completed before and after P-SAMI. Paired t-tests, Wilcoxon tests, and deductive thematic analyses were performed. Thirty-three participants (53.7 ± 14.9 years-of-age) showed statistically significant gains in transportation self-efficacy (p < 0.01) and satisfaction with bus use (p < 0.01), with no statistically significant differences in mobility (p > 0.05). Qualitative findings confirmed enhanced transportation self-efficacy and satisfaction with bus use, with participants reporting using buses to carry out some daily activities. The P-SAMI shows promise for improving transportation self-efficacy and satisfaction with using the bus, with the potential to enhance participation in daily activities. Controlled trials should be conducted in the future to test the effectiveness of transportation training for people with disabilities. Full article

The most prevalent chromosomal condition, Down syndrome (DS), is often linked to deficiencies in working memory, executive function, and visuospatial skills. Innovative approaches to promote cortical plasticity and improve cognitive development have been suggested, including play- and technology-based therapies like LEGO^®-based neurohabilitation. In this pre-experimental study, a 16-year-old adolescent with DS undertook 30 sessions of increasingly sophisticated LEGO^®-based therapy, covering everything from robotic assembly and programming to block creation. Before and after the session, a neuropsychological evaluation was carried out using the Rey complex figure, motor control, and five-digit tests. The reliable change index (RCI) was used to analyze changes in performance. Constructive praxis, processing speed, and overall efficiency all showed notable clinical improvements, especially in the copy score, total complexity, and total processing. These findings imply that LEGO^®-based neurohabilitation can provide significant gains in executive efficiency, visual–spatial abilities, and cognitive processing while offering a stimulating, developmentally appropriate therapy setting. Full article

We, five co-authors of this paper, came together for a three-day collective biography workshop to reflect on moments of recognition that have impacted our lives. We told our stories from lives lived with disability; we listened to each other’s stories and wrote and read them to each other with careful attention. In the discussions that followed, both during the workshop and during the following months of finalizing this paper, we explored the ways in which disability is made to matter and how. In that process, we each moved beyond our own singularity, our own particular memories of recognition and belonging, to a new, emergent understanding of our shared materiality and response-ability. Full article

Research on families with a child with Down syndrome (DS) focused primarily on the impact on parents, with less attention to siblings, yet typically developing siblings are particularly important for individuals with DS as they play a unique role in the family and often become their sibling with DS’s primary caregivers. One of the central aspects in sibling dynamics is acceptance, an area that has largely been ignored in research to date. The current study examined variables that predict typically developing siblings’ acceptance of their brother/sister with DS, focusing on the internal resources of optimism and sense of coherence (SOC), and the potential mediating role of social support and emotions towards the sibling. Functionality of the brother/sister with DS was explored as a moderating variable. Participants included 306 Israeli typically developing siblings (201 sisters, 105 brothers) ranging in age from 18 to 27 (M = 21.54, SD = 2.50). Participants reported their sibling’s independent functioning as higher or lower independence. The results showed that both social support and negative emotions towards the brother/sister mediated the relations between optimism and acceptance and SOC and acceptance. Functionality of the brother/sister with DS moderated these relations, such that acceptance was more strongly predicted by negative emotions when the sibling was low-functioning. The study’s findings emphasize the importance of social support and emotions as mediators between the personal resources of optimism and SOC, with functionality as a significant moderator. As individuals with DS have varying levels of functionality, it is necessary to take this variable into consideration and appropriately adapt support for typically developing siblings. Further, examining acceptance and how it may be predicted by personal resources lends itself to practical insights regarding supporting siblings and promoting sibling relationships. Full article

Manual wheelchair users with spinal cord injury (SCI) often experience upper-limb strain and pain due to repetitive propulsion. A detachable dual-propulsion add-on device has been developed to mitigate this issue by offering an alternative propulsion mechanism, but its user acceptability and practical benefits must be rigorously evaluated. This study will implement a structured mixed-methods usability assessment of the new device with 30 adult wheelchair users with SCI. The evaluation will combine quantitative surveys, objective task-based performance metrics, and qualitative interviews to capture a comprehensive picture of usability. We will conduct a single-arm mixed-methods protocol using a device-specific 45-item usability questionnaire and semi-structured interviews, followed by convergent triangulation to integrate quantitative scores and qualitative themes. Participants will use the dual-propulsion device in realistic scenarios and then complete a 45-item questionnaire covering effectiveness, efficiency, safety, comfort, and psychosocial satisfaction. In addition, semi-structured interviews will explore users’ experiences, perceived benefits, challenges, and suggestions. During a standardized mobility task course (doorway navigation, ramp ascent, threshold crossing, and 50 m level propulsion), objective performance indicators—including task completion time, task success/error rate, number of lever strokes, and self-selected speed—will be recorded as secondary usability outcomes. The use of both a standardized questionnaire and in-depth interviews will ensure both broad and nuanced assessment of the device’s usability. Data from the survey will be analyzed for usability scores across multiple domains, while interview transcripts will undergo thematic analysis to enrich and validate the quantitative findings. This protocol is expected to provide robust evidence of the device’s usability, inform iterative improvements in its design, and highlight the importance of structured usability evaluations for assistive technologies. Full article

Background: People with intellectual disabilities, in comparison to the general population, face multiple health inequalities and poor health outcomes. Service organisations for people with intellectual disabilities are one of the key players in ensuring that people with intellectual disabilities have access to adequate healthcare. Methods: A cross-sectional web-based survey was implemented from 8 to 22 April 2025, focusing on organisations providing services to people with intellectual disabilities, with a peak response rate of 9%. The survey comprised 29 questions, split into three sections: general information, experience, and opinions on cancer prevention policy. Results: A total of 29 organisations from 14 upper-middle- and high-income European countries participated. Approximately 20% (n = 6) of organisations reported the existence of a cancer prevention policy in their country designed to address the needs of people with intellectual disabilities, with most considering them inadequate. Overall, 86.2% of organisations identified tailoring cancer prevention policy for people with intellectual disabilities to be of major importance. Respondents identified national government/ministries (n = 26, 90%), organisations for people with intellectual disabilities (n = 24, 82.8%), and research entities (n = 23, 79.3%) as the responsible stakeholders for implementing policy changes. Conclusions: Respondents expressed strong support for tailored policies, alongside support for a pan-European approach. From a policy perspective, findings support the critical need for policymakers to prioritise cancer prevention strategies, improve coordination, and ensure training and co-production with organisations supporting people with intellectual disabilities. Full article

The study aimed to analyze the public sports policy of the State of Mato Grosso do Sul in the educational context and the inclusion of people with disabilities. This is a retrospective, qualitative, exploratory, and documentary longitudinal study, with analysis of documents that regulate sports policy for educational contexts in Mato Grosso do Sul between 2020 and 2024, using the documentary analysis technique. The existence of a macro program that anchors seven other programs/projects was evidenced, with a predominance of the sport-performance dimension (47.5%). No program or project explicitly aims to include people with disabilities in its objectives. One project was specifically designed with inclusion goals; however, it fails to effectively include individuals with disabilities. Another project targets individuals with disabilities, although it was not originally intended to do so. We concluded that the inclusion of people with disabilities is not contemplated, as they are only integrated into a single project. Full article

Background/Objectives: Cerebral palsy (CP) is a non-progressive, permanent syndrome of childhood, with approximately 80% of patients exhibiting spasticity. Untreated spasticity can cause pain, structural changes in bones, muscles, and nerves negatively impacting quality of life and functionality. Photobiomodulation (PBM) has demonstrated biological effects such as tissue regeneration, muscle relaxation, inflammation reduction, and pain relief. The objective of this pilot study is to evaluate the action of PBM on the spasticity of the medial and lateral right gastrocnemius muscles of children and adolescents with spastic cerebral palsy. Methods: This single-blinded, randomized, controlled trial evaluated PBM’s effect on gastrocnemius spasticity in children and adolescents with CP. The study presents pilot preliminary results from twelve children and adolescents (7–16 years) with spastic CP who were randomized into two groups: active PBM (850 nm, 100 mW, 1.5 J/point, 2 points, weekly for 8 weeks) or placebo (same protocol, device off). Both groups received standard rehabilitation exercises. Outcomes were assessed using the Modified Ashworth Scale (MAS), Pediatric Evaluation of Disability Inventory (PEDI), Gross Motor Function Classification System (GMFCS), and ankle range of motion before and after the intervention (8 weeks). Results: MAS and all outcomes improved significantly over time in both groups. No significant differences were found between groups for all outcomes. The PBM effect size on MAS improvement (ANOVA, Analysis of Vari, η² = 0.171) suggests modest but positive benefits. PBM did not worsen spasticity, and no adverse effects were reported. Conclusion: This study represents a pioneering effort in evaluating a safe PBM protocol for the spastics gastrocnemius in children and adolescents with CP. This protocol, used as an adjunct to physiotherapy, demonstrated no short-term adverse effects and no participant dropouts. Future studies should explore this PBM protocol in patients with less severe GMFCS levels, those with minimally preserved functionality, or those with contraindications to physiotherapeutic exercises. Full article

People with Down Syndrome often experience more barriers to achieving a good quality of life compared to people without disabilities. A lot of the existing research has focused on the views of parents and professionals, rather than directly including the voices and perspectives of people with Down Syndrome themselves. We wanted to find out how this might be done. At the 2024 World Down Syndrome Conference, over 140 adults with Down Syndrome came together at a one-day Forum to talk about their lives—aspects that are going well and what could be better. The goal was to hear directly from them. This article explains how the Forum was run so that others with Down Syndrome can use a similar process. We describe how Artificial Intelligence (AI) was used to assist the authors in organising and sharing the information from participants, such as grouping what people said into different themes and helping to create plain language reports. This process worked. Eight key themes were found that could help people to have a good life, such as having good relationships with family and friends; having a job; making personal choices; and being respected and included. The list was longer than previously reported in other studies. The Forum gave valuable insights and helped us think of new ideas for supporting people with Down Syndrome to speak up for themselves. Used thoughtfully, AI (Artificial Intelligence) could be a helpful tool in the future to help these people share their experiences and needs. More research is needed to understand how people with Down Syndrome can be more involved in making changes through advocacy projects where they take an active role. Full article

Disabled people face discrimination in healthcare settings, yet the compounding effects of intersectional identities remain underexplored. This project examines how different types of discrimination affect healthcare access and outcomes. We conducted a cross-sectional study of disability-based, race-based, gender-based, and sexuality-based discrimination using the 2022 National Survey on Health and Disability (NSHD; n = 2725) administered October 2021–January 2022. Measures used in this study include: (1) demographics; (2) types of discrimination; (3) unmet healthcare needs. Our sample was not nationally representative, as it consisted primarily of white, college-educated participants. Data were analyzed using summary statistics (STATA crosstab) among respondents with health insurance (n = 2566). Chi-squared tests were used to determine statistical significance. We fit logistic regression models for categorical responses (STATA logit), adjusting for participant characteristics. Some participants (41%; n = 2566) reported experiencing at least one form of discrimination, with 4.9% reporting race-, 15.08% gender-, 5.9% sexuality-, and 38.3% disability-based discrimination. Most participants (94%; n= 2412) reported at least one unmet healthcare need, from unmet prostheses (2.6%) to unmet dental care (34.8%). Compared with other care types, participants had the lowest odds ratio (OR = 0.38, p < 0.001) of having their preventive care or specialist care needs met. These findings highlight that discrimination contributes to disparities in particular areas of healthcare access and emphasizes a need for tailored interventions and additional research. Full article

Youth with disabilities face persistent disability-related discrimination (ableism) but research frequently overlooks the experiences of racially minoritized youth. The purpose of our study was to explore the experiences and perceived impact of discrimination among racially minoritized youth and young adults with disabilities. This qualitative study involved a sample of 15 youth and young adults with disabilities (mean age 22 years) identifying as racially minoritized. A descriptive inductive thematic analysis was applied to the interview data. Our findings highlighted the following themes: (1) types of discrimination (i.e., cultural and family-related ableism, racist ableism, and gendered/sexist ableism); (2) perceived impact of discrimination (i.e., social isolation, avoidance of unwelcoming and unsafe situations, impact on physical and mental health, decisions about identity disclosure, and a lack of access to resources and opportunities); and (3) positive coping strategies (i.e., inclusive and safe spaces, self-advocacy, and social and family supports). Full article

As digital technologies become increasingly integrated into daily life, individuals with intellectual disabilities face both opportunities and risks in virtual environments. Despite widespread internet access and frequent use of digital devices among the general population, many individuals with disabilities continue to experience significant barriers to digital participation. These include difficulties in using technological tools, limited access to devices at home, and challenges in navigating online environments safely and independently. This study investigates the cybersecurity knowledge, risk perception, and privacy practices of 28 university students with mild intellectual disabilities in Spain. Utilizing a validated, accessible self-assessment questionnaire, the research analyzes participants’ understanding of digital threats, self-protective behaviors, and gender-based differences in knowledge and decision-making. Results reveal a generally high awareness of online risks and appropriate use of privacy settings, though inconsistencies in password security and high social media usage persist. Female participants demonstrated slightly higher levels of theoretical knowledge. The findings underscore the urgent need for inclusive, accessible cybersecurity education tailored to cognitive diversity. Promoting digital autonomy and safety through targeted interventions can reduce the digital divide and foster full social participation. This research contributes to the broader discourse on digital inclusion and protection for individuals with disabilities in an increasingly connected world. Full article

Student mobility in Higher Education Institutions (HIEs) significantly contributes to students’ personal and academic development. However, participation of people with disabilities remains limited due to various barriers. This study explores the perceptions of students with disabilities regarding mobility within universities in southern Chile. A descriptive qualitative approach was used, and semi-structured interviews and a focus group with 15 undergraduate students with diverse types of disabilities were conducted. Data analysis was conducted using reflexive thematic analysis. The results revealed that students with disabilities prefer one-semester mobility experiences, typically near the end of their studies. Identified barriers include a lack of physical and digital accessibility, insufficient implementation of reasonable adjustments in the teaching-learning process, and poor coordination in mobility management between institutions. Additionally, specific requirements emerged depending on the type of disability, such as the need for sign language interpreters for deaf individuals and additional medical insurance, subsidies for personal assistants, or accessible transportation for those with reduced mobility. This study highlights the importance of adopting inclusive and proactive policies to facilitate student mobility for individuals with disabilities and promote an accessibility ecosystem that involves all institutional stakeholders. Full article

This study aimed to adapt and translate the Knowledge, Comfort, Approach and Attitude towards Sexuality Scale (KCAASS) for stroke rehabilitation clinicians who are Canadian French speakers and to determine its measurement properties. The KCAASS was adapted for stroke rehabilitation by three occupational therapists and translated into Canadian French using a back-translation process. After being pretested, the resulting KCAASS-Stroke-FrCan was disseminated to seven rehabilitation centers in Quebec, Canada. Exploratory factor analysis, Cronbach alphas, intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change (MDC) were computed. 199 clinicians participated. Factor analysis revealed a four-factor solution. Internal consistency for the total score (α = 0.942) and subscales “Knowledge” (α = 0.834), “Comfort” (α = 0.966), and “Approach” (α = 0.836) were very good, and critical for “Attitude” (α = 0.628). Test–retest reliability was very good (0.81; p < 0.001) for the total score, good for “Knowledge” (0.69; p < 0.001) and “Comfort” (0.74; p < 0.001), very good for “Approach” (0.82; p < 0.001), and poor for “Attitude” (0.37; p = 0.003). SEM and MDC were presented. The KCAASS-Stroke-FrCan showed good measurement properties to assess stroke rehabilitation clinicians’ training needs and educational interventions. Full article

Background: Spinal cord injury is a life-changing condition for individuals who have previously been independent in activities of daily living. Motor recovery prognosis for individuals with complete spinal cord lesion above thoracic level ten is poor after nine months of injury. Although the corticospinal tract is responsible for voluntary mobility functions such as walking, it is possible, through neuroplasticity, that involuntary lower limb movements can be trained. Methods: This case study discusses the use of multi-modal rehabilitation strategies, from weightbearing exercises using traditional manual-controlled exoskeleton to ambulation using advanced automotive exoskeleton. Results: The patient’s perspective showed themes that align with the World Health Organization’s International Classification of Functioning and Disability. In spinal cord injury, majority of concerns are in environmental and personal factors. This could be due to the perceived permanent disability in complete spinal cord lesion. The moderate-intensity two-hour intervention using traditional and advanced exoskeletons during physical rehabilitation showed that it was possible to stimulate deep sensations, and muscle pull and cramp for a patient diagnosed with complete spinal cord lesion. Conclusions: The use of traditional and advanced exoskeletons in weightbearing exercises may benefit patients with complete spinal cord lesions in regaining deep sensations in the lower limbs. Full article

Women with disabilities often face unique barriers to accessing healthcare, potentially increasing their vulnerability and reducing engagement with vital health services, including human immunodeficiency virus (HIV) testing. This study assessed the prevalence and associated factors of HIV-testing among women with disabilities in Ghana. Cross-sectional data from the 2017–2018 Ghana Multiple Indicator Cluster Survey, encompassing 819 women with disabilities, were analysed both descriptively and inferentially. The overall prevalence of HIV testing was 48.0% (95%CI = 44.6–51.4). Educational attainment, marital status, and geographical region were key determinants of HIV testing uptake. Women possessing a Senior High School or Tertiary level education demonstrated higher odds of HIV testing compared to those with no formal education. Women residing in Greater Accra, Volta, Brong Ahafo, and Upper West regions were more likely to have undergone HIV testing than those in the Western Region. Never-married women exhibited lower odds of HIV testing uptake than their married counterparts. No statistically significant association was found between various disability types and HIV testing uptake. Less than half of women with disabilities in Ghana had ever tested for HIV, highlighting a substantial unmet need and underscoring the urgent need for targeted interventions, including enhanced, region-specific educational and health promotion initiatives, and tailored support for never-married women with disabilities. Full article

Attention Deficit Hyperactivity Disorder (ADHD) is a neuro-behavioural condition associated with limitations and deficits. Previous literature has largely focused on the lived experiences of males with ADHD. Despite a recent increase in studies on females with ADHD, there is a lack of empirical research on school experiences. This study aimed to address this gap in the literature by examining the perceived effect of ADHD on the school experiences of women. 13 women aged between 18–35 with a medical diagnosis of ADHD answered a series of questions in qualitative semi-structured interviews. Three were diagnosed during school and ten were diagnosed after school. The data was analysed using structured inductive thematic analysis. Four themes emerged, with sub-themes as follows: (1) Personal impact; the impact ADHD had on self-identity in school pre- and post-diagnosis. (2) Attitudes and opinions of others; how parents, teachers and societal attitudes on gender affected diagnoses and school experiences. (3) Friendships and relationships; how ADHD affected personality and socialising in school, and (4) ADHD and academia; the academic struggles participants faced whether diagnosed in school or not. The results suggest that ADHD contributed to negative school experiences for all participants. While the perception was that gender and attitudes towards ADHD in females often delayed diagnoses and that early diagnosis would have improved self-identity and school experience, results suggest even with early diagnosis, it is important that teachers are educated about the symptoms and deficits affecting females with ADHD and that schools provide resources to support female students with ADHD to ensure the best school experience. Full article

This pilot study evaluates the effectiveness of basketball, implemented according to Universal Design for Learning (UDL) principles and educational best practices, as an inclusive tool for students with Special Educational Needs in lower secondary school. The research involved 24 adolescents aged 11–14 with Special Educational Needs, who participated in a structured 30-session basketball program designed to enhance motor, relational, and individual skills. The program incorporated evidence-based methodologies such as differentiated instruction, peer modeling, and cooperative activities. Motor tests and psychometric questionnaires were administered pre- and post-intervention to assess three key developmental dimensions. Results demonstrated significant improvements across all three dimensions: relational competencies and individual factors showed equal progress (+20.8% each), while motor skills showed slightly more modest but still substantial gains (+16.6%). These findings confirm that a structured pedagogical approach can transform sport into a powerful vehicle for inclusion. The article highlights how the integration of physical activity, inclusive teaching methodologies, and unified sports represents an effective strategy to address the complexity of Special Educational Needs. Full article

This study examined the efficacy of a 12-week school-based program combining proprioceptive and plyometric training to enhance static and dynamic balance in children and adolescents with visual impairment. A total of 33 students were randomly assigned to either an experimental group (EG; n = 18), receiving a one-weekly session of integrative training alongside regular physical education, or a control group (CG; n = 15), following only the standard curriculum. Balance outcomes were assessed at baseline (T0) and post intervention (T1) using stabilometric measures under visual deprivation (eyes closed) and BOT-2 (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition) balance subtests. The EG demonstrated statistically significant reductions in ellipse surface area (p = 0.002, d = −1.29), center of pressure displacement (p < 0.001, d = −1.67), and sway velocity (p = 0.015, d = −1.06), indicating improved postural stability when vision was unavailable. BOT-2 Test 4 showed significant intra-group improvement (p = 0.006, d = 1.37), while BOT-2 Test 3 and between-group comparisons revealed medium-to-large effect sizes, though not always statistically significant. These findings suggest that augmenting somatosensory input through proprioceptive and plyometric training may partially compensate for visual deficits and improve postural control in individuals with visual impairments. This improvement likely reflects the activation of compensatory mechanisms that enhance proprioceptive and vestibular contributions to balance maintenance. Importantly, meaningful improvements occurred with just one weekly session, making this an accessible and scalable intervention for inclusive school settings. Full article

Recognizing a dearth of understanding on the experiences of foster parents of children with disabilities, this study aimed to compare well-being, psychological flexibility, and social support among foster parents and biological parents of children with disabilities, as well as parents of children without disabilities, while exploring the impact of service use and social support on psychological flexibility and well-being. A convenience sample comprised 135 parents: 36 biological parents of children with disabilities, 32 foster parents of children with disabilities, and 67 biological parents of children without disabilities. Statistical analyses included one-way ANOVA, Pearson correlation, simple linear regression, and multiple linear regression. Results showed that foster parents of children with disabilities exhibited significantly higher psychological flexibility, well-being, and social support compared to biological parents of children with disabilities. Among biological parents of children with disabilities, psychological flexibility and well-being showed significant correlations with service satisfaction and social support, with social support explaining 62% of variance in psychological flexibility and 51% in well-being. Among foster parents of children with disabilities, neither service use nor social support significantly predicted psychological flexibility or well-being, suggesting different adaptive mechanisms. Among parents of children without disabilities, social support significantly predicted both psychological flexibility and well-being. The findings, which should be interpreted cautiously given the small sample size, highlight the need for targeted support interventions for biological parents of children with disabilities and further research into foster care families’ unique experiences. Full article

The current study examined the attitudes of elementary and middle school principals and school counselors toward including students with special needs in regular classrooms. 243 participants completed questionnaires on their self-efficacy, job satisfaction, stress, and attitudes toward inclusion. Additionally, 22 semi-structured interviews were conducted to gain a deeper understanding of how principals and counselors deal with the inclusion of students with special needs in their school. The study’s findings reveal a difference between middle school counselors and principals and those in elementary schools in terms of the desire for inclusion. It was also found that the less the counselors believe in themselves, the less they are in favor of inclusion, while the more satisfied they are with their work, the more they support inclusion. Qualitative analysis brought up various difficulties in the inclusion process. Full article

This study explores the artistic experiences of individuals with low vision in creating clay-based artworks at the Pandawa Social Home for Blind Sensory Disabilities in Kudus Regency, Indonesia. The research used a qualitative, descriptive-exploratory design, and fifteen participants with varying levels of visual impairment were involved. Data were obtained through in-depth interviews, observations, and analysis of their clay creations. The findings reveal that clay, with its tactile qualities, serves as an effective medium for creative expression, enabling participants to explore form through touch and pressure. This process supported the development of fine motor skills, creativity, and self-confidence while fostering emotional well-being and social interaction. Participants relied on memory, imagination, and sensory perception to produce artworks that held personal and aesthetic meaning, despite differing from conventional visual standards. The study underscores the therapeutic benefits of clay art and highlights the crucial role of supportive environments—families, educators, and art communities—in nurturing creativity and enhancing the quality of life for individuals with visual impairments. The limitations of this study include its small sample size, its single-institution approach, and its focus on clay. Future research should expand the participant pool, explore other accessible art media, and examine the long-term impact on psychosocial development. Full article

This study focuses on the experiences of female Paralympic athletes in Brazil through the lens of feminist disability studies. It is a qualitative study, grounded in the voices of disabled women, positioning them as the foundation of knowledge within a post-structuralist epistemological framework. The research involved in-depth interviews with four Brazilian Female Paralympians, conducted using a predefined interview guide, and the data were analyzed using thematic content analysis. The athletes were between 25 and 34 years of age and had experience competing in international competitions. From their narratives, two distinct yet interconnected categories emerge: (1) Being a disabled woman and (2) Like sportswomen. Disabled women have shown that they navigate an ableist and sexist society as disabled women within the context of sport; at the same time, they embody an empowered and inspirational identity as sportswomen. By exploring these perspectives, this study highlights the need to challenge and redefine societal perceptions and expectations surrounding disability. It provides insights into the experiences and agency of female Paralympic athletes. Full article

People with intellectual disability and visual impairment often have difficulties in accessing leisure events, engaging in cognitive activities, and performing physical exercise. The present study assessed a program aimed at helping six adults with moderate or moderate-to-mild intellectual disability and blindness in each of the aforementioned areas. The program relied on the use of a technology system involving a smartphone, which was supplied with Internet connection and fitted with the Live Transcribe and MacroDroid applications. These applications were set up to (a) enable the participants to use verbal utterances to successfully access preferred songs and comic sketches (leisure events) and answer series of verbal questions (cognitive activity) automatically presented to them, and (b) enable the smartphone to verbally guide the participants’ performance of series of body movements (physical exercise). The program was introduced according to a nonconcurrent multiple baseline design across participants. The intervention was divided into two phases, which included 17–33 and 39–48 sessions, respectively. The results showed that the participants’ baseline performance (without the support of the system) was generally poor. During the intervention with the system, all participants succeeded in accessing the music or comic events available, satisfactorily answering series of questions, and performing series of body movements. The Percentage of Nonoverlapping Data and the Tau (novlap) methods used to compare baseline and intervention performance produced indices of 1 for all participants (confirming the strong impact of the intervention). These results, which need replication to establish their generality, suggest that the technology system might represent a useful tool for helping people like the participants of this study. Full article

Significant others—family members, friends, and informal carers—play a vital yet underrecognised role in supporting people with disability in Australia. This study aimed to explore their lived experiences and identify systemic barriers impacting their well-being and caregiving capacity. A total of 188 significant others participated in a statewide survey, co-designed using inclusive research principles. Quantitative and qualitative data were collected and analysed collaboratively, using an a priori coding framework adapted to new themes. Four key findings were described: the joy and meaning found in caregiving; the overwhelming burden of navigating fragmented systems; the erosion of carer well-being due to financial, physical and emotional strain; and the urgent need for systemic support including respite and equitable access to services. Participants emphasised that caregiving itself was not inherently burdensome, rather, the lack of formal support and recognition creates unsustainable conditions. These findings highlight the critical role significant others play in sustaining Australia’s care economy and underscore the need for disability-inclusive policy reform. Strengthening support systems and embedding lived experience into reform and policy design are essential to ensuring the long-term sustainability of informal care and the rights and well-being of both carers and people with disability. Full article

Multimorbidity has emerged as a pressing public health concern on a global scale, primarily driven by population aging and the epidemiological transition, which has resulted in an increased prevalence of chronic non-communicable diseases. Objective: The objective of the study was to investigate the functioning profile of individuals with multimorbidity in Chile, focusing on capacity and performance, and to explore the association between multimorbidity and compromised functioning. Methods: Data from the II ENDISC, a cross-sectional population study conducted in Chile in 2015, were analyzed. The sample comprised 12,265 randomly selected individuals aged 17 and above, who were interviewed using the Model Disability Survey. Generalized linear models (GLMs) were employed to assess the impact of multimorbidity on capacity and performance. Results: The results revealed that individuals with multimorbidity presented worse capacity scores (38.31 vs. 19.72) and performance scores (44.51 vs. 27.28) compared to those without multimorbidity. Furthermore, adjusted risk through GLM shows that individuals with multimorbidity had a higher risk of experiencing worse capacity (1.39) and performance (1.29) scores. Gender, self-rated health, age, employment status, and education level were identified as factors associated with varying degrees of impact on functioning. Conclusions: These findings underscore the importance of addressing multimorbidity and its associated factors in healthcare planning and intervention strategies, particularly for socioeconomically vulnerable populations, to enhance well-being and functioning among individuals with multimorbidity. Full article

Handwriting impairment is a cardinal symptom of Parkinson’s. However, treatment options are limited. Here we evaluate the utility and estimate effects of a novel low-resource handwriting intervention (Clinicaltrials. gov NCT03369587). Forty-eight people with Parkinsons with self-reported handwriting problems were recruited to an exploratory, assessor-blind two-arm parallel randomized trial to either diverging (n = 24, n = 19 analysed) or parallel (n = 24, n = 20 analysed) groups. Both received a six-week, five times a week, handwriting program: writing a daily diary on lined paper (diverging: 10 mm increasing to 13 mm apart, parallel: 10 mm apart). Outcomes were measures of impairment (cursive ‘el’, single and dual-task), handwriting function (sentence and free writing) and self-reported difficulties. Median diary entries (31, IRQ: 17.5–39) were greater than requested (30) with no differences between groups, p = 0.302. No adverse events were reported. Regardless of group, improvements were found in writing ‘el’ speed (single task: d = −0.90, 95% CI: −1.41: −0.38, p = 0.001; dual task: d = −0.72, 95% CI: −1.24: −0.21, p = 0.09) and amplitude (single task: d = 1.07, 95% CI: 0.49: 1.66, p < 0.001; dual task: d = 0.86, 95% CI: 0.35: 1.37, p = 0.002). Sentence amplitude (d = 0.80, 95% CI: 0.30: 1.29, p = 0.003) and perceived difficulties also improved (OR = −3.6, 95% CI: −12.6: −1.0, p = 0.047). Between-group effects were small (d = 0.11 to 0.48). Large improvements to handwriting, which required less attention, were found after self-directed well-adhered-to practice. Potential additional benefits of exaggerated cueing were small. Full article

The promotion of public awareness regarding accessible environments is crucial for their effective construction and utilization. While there has been extensive research focusing on the physical construction of accessible facilities, the issue of public awareness remains underexplored, especially in underdeveloped regions. This potential lack of awareness could hinder effective use and societal support of accessible environments. The present study explored the current state of public awareness regarding accessible environments and its influencing factors in Urumqi, a provincial capital in an underdeveloped region of China. Through stratified sampling, approximately 80 residents from each of seven districts in this western city were surveyed, resulting in 501 valid questionnaires. The findings indicated that public awareness of accessible environments was moderate, characterized by insufficient understanding of basic concepts and relevant legal policies. The presence of family members with mobility difficulties, personal experience with mobility challenges, and occupational roles were all relevant factors that contributed to differences in public awareness of accessible environments. The study identified two key influencing factors, including public attitudes towards accessible environments and the presence of family members with mobility difficulties. These insights could inform strategies to enhance public awareness of accessible environments. Future research should further explore the underlying mechanisms linking public awareness and its influencing factors. Full article

This study examined the relationships between anxiety and executive functioning in Arab Israeli female adolescents diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), compared to their typically developing peers. The aim was to explore differences in emotional and metacognitive executive functions, as well as how anxiety correlates with these cognitive domains within a culturally specific and gender-sensitive population. Eighty adolescent girls aged 15–18 (40 with ADHD and 40 controls) completed self-report measures assessing anxiety and executive functions using the BRIEF-SR and State-Trait Anxiety Inventory. No significant group differences were found in behavioral aspects of executive functions (inhibition, shifting, emotional control, and monitoring) or in overall anxiety levels. However, the ADHD group demonstrated significantly greater difficulties in all metacognitive executive function domains—including working memory, planning, organization, and task completion—as well as higher scores on the Metacognitive Index and Global Executive Composite. Correlational analyses revealed that anxiety was significantly associated with both behavioral and metacognitive executive dysfunction in the control group. In the ADHD group, however, anxiety was only significantly related to behavioral regulation, not metacognitive functioning. These findings underscore the importance of metacognitive support in interventions for adolescent girls with ADHD. Culturally tailored educational strategies that target working memory, planning, and organizational skills may help improve academic performance and overall adaptive functioning in this underserved population. Full article

Background: The rising prevalence of neurodegenerative conditions such as dementia underscores the impact of population aging. Consequently, long-term care needs have increased and are often met by family members through informal caregiving, thereby supporting formal care systems by reducing associated costs. These caregivers face physical and mental health challenges, raising concerns about their psychological well-being and prompting interest in both clinical and psychosocial research. Ryff’s eudaimonic model offers a robust framework for the assessment of psychological well-being; yet, in Romania, data on this population segment remain limited. Objective: This study aimed to compare the psychological well-being of Romanian dementia family caregivers with a reference population from the Romanian adaptation of the 54-item Ryff Psychological Well-Being Scale, and to explore how sociodemographic characteristics relate to relevant differences across well-being dimensions. Methods: A cross-sectional study was conducted among 70 Romanian family caregivers recruited from a single clinical hospital in Bucharest, Romania. Caregivers completed the 54-item Ryff Scale (Romanian adaptation), and scores were compared to reference values using one-sample t-tests with bootstrap confidence intervals. The most relevant dimension (purpose in life) was dichotomized and further examined in relation to sociodemographic and caregiving variables using Chi-squared and Fisher’s exact tests. Results: Caregivers reported significantly lower scores compared to the reference population in purpose in life (p < 0.001, d = −1.01), personal growth (p < 0.001, d = −0.91), and positive relations (p = 0.01, d = −0.30). The most pronounced deficit was observed in purpose in life, with 85.7% of caregivers scoring below the reference mean. This dimension was further examined in relation to caregiver characteristics. Retirement status showed a statistically significant association with Purpose in Life, with retired caregivers more likely to report lower scores (χ² (1) = 4.04, p = 0.04), supported by the likelihood ratio test (p = 0.01) and a linear trend (p = 0.05). Additional marginal associations were found for household income (p = 0.14) and whether the patient slept in a separate room (p = 0.15), suggesting possible links between caregiver well-being and economic or environmental conditions. Conclusions: The study findings highlight notable psychological vulnerabilities among Romanian dementia caregivers, particularly in purpose in life and personal growth. Associations with structural and contextual factors such as retirement status, income, and caregiving environment suggest that caregiver well-being is shaped by broader socioeconomic conditions. While the magnitude of these deficits may be underestimated due to elevated stress levels in the reference group, the findings underscore the need for targeted clinical, social, and policy-level interventions aimed at strengthening existential meaning and personal development in culturally specific settings. Full article