Disabilities

Augmentative and Alternative Communication (AAC) research highlights the critical role of collaborative efforts among communication partners in supporting children with diverse educational needs in the school setting. This study aims to describe AAC strategies and systems employed in African schools to facilitate participation for learners with diverse educational needs. A qualitative literature review was employed to describe 18 studies involving 659 participants across special schools and inclusive classrooms. The participants included 488 learners with diverse educational needs and 171 teachers. The research designs predominantly featured quantitative approaches, with some mixed-methods studies. This study found that reviewing classroom instruction strategies, learning processes, participant proficiency, and AAC strategies is cardinal for communication participation within the classroom. However, outcomes varied widely due to factors including learner characteristics and contextual familiarity. Key outcomes included improved use of the AAC system labeling and the identification of different symbols. Recommendations for further research include increased professional training and the development of collaborative AAC services. The findings underscore the need for a collaborative approach to AAC implementation, further research, and enhanced training to address the diverse needs of learners and promote the sustainability of AAC use. Full article

While studies consistently show that the popular media often provide medicalized images of disabled people as “other” or inferior, dynamic societal changes, such as the diffusion of human rights laws, increasing public awareness, and the mediatization of disability activism, also influence media representations. The present research aims to identify relevant discursive practices in Hungarian online news media, a non-Western European country with about 50 years of a state party system under communism, and offer insight into how progressive policy changes and mediatized activism shape media features on disability. To establish the dataset, the most visited and independent online news media portal in Hungary (24.hu) was searched for articles discussing disability between 2019 and 2022. The 481 relevant articles extracted were analyzed using Critical Discourse Analysis (CDA) with the help of MAXQDA 2020. The findings reveal a multiplicity of disability representations: medicalized and victimized images on the one hand, and reports of resilience and “heroism” on the other. Three distinct discursive practices are identified: (1) traditional/ableist representations, (2) alternative representations with ableist framing, and (3) agency and the co-creation of disability representations. Results suggest that even 30 years after the political changes, disabled people’s collective agency is marginal in Hungary, and that socio-legal changes and mediatized disability activism are yet to influence news media features. Full article

Flourishing in children is an indicator of positive development in the areas of emotional, social, and cognitive development. Using a recent dataset from the US National Survey of Children’s Health, this study investigates the association between access to a quality healthcare system and flourishing indicators in school-aged children with autism. The outcome variable describes the proportion of children aged 6–17 with autism meeting the flourishing criteria, which include measures related to learning, resilience, and self-regulation. The main independent variable includes six core indicators for school-aged children and adolescents, which assess whether the family feels like a partner in their child’s care, the child has a medical home, receives regular medical and dental preventive care, has adequate insurance, has no unmet needs or barriers to accessing services, and has prepared for transition to adult healthcare. Multivariable logistic regression models were used to examine the relationships between various independent variables and the outcome of interest. The results show that children with autism who receive comprehensive and coordinated care are more likely to flourish compared to those without such care for five of these six indicators, while controlling for sex, race, parental education, household income, self-reported autism severity, general health status, and the number of adverse childhood experiences. Children with autism are more likely to flourish when their families and healthcare providers work together effectively. Addressing gaps in the quality care system is essential for developing holistic approaches that empower children with autism to thrive and reach their full potential. Supportive health policies and effective coordination between families and healthcare providers are crucial for fostering the flourishing of children with autism, ensuring comprehensive, individualized, and continuous care. Full article

Purpose: This study explored the potential long-term effects of academic-related variables, including academic satisfaction, college degree attainment, unmet academic accommodation needs, and demographic characteristics on the job and career satisfaction of adults with disabilities using modern machine learning techniques. Method: Participants (n = 409) completed an online survey assessing these constructs. All had a disability or chronic health condition, had attended school in the U.S. throughout their K-12 education, and were between 19 and 86 years of age. Results: The random forest models had 68.6% accuracy in correctly identifying job satisfaction and 72.5% accuracy in correctly identifying career satisfaction. When using mean decrease in impurity (MDI) and permutation importance to identify statistical predictors, academic satisfaction was the most important predictor of job satisfaction in both MDI and permutation importance, while unmet academic accommodations was the fourth highest predictor for MDI behind academic satisfaction, disability level, and age, but ahead of other demographic variables and college degree status, and the second highest predictor of job satisfaction in permutation importance. For career satisfaction, academic satisfaction accounted for the highest MDI, while unmet academic accommodations ranked fourth. For permutation importance, academic satisfaction ranked first, and unmet academic accommodations ranked fifth behind academic satisfaction, age, college degree status, and disability level. Discussion: Meeting the academic accommodation needs of disabled students is linked with lasting vocational success. This study underscores the associations between unmet academic accommodation needs and future job and career satisfaction, illuminated using novel machine learning techniques. To our knowledge, this is the first investigation of the potential long-term associations between unfulfilled accommodation needs and future job and career satisfaction. Full article

Children with intellectual disabilities experience unique developmental, social, and environmental challenges that intersect with adverse childhood experiences (ACEs) and positive childhood experiences (PCEs), shaping their psychosocial outcomes. While prior research has mainly examined single adversities or protective elements, the frameworks of ACEs and PCEs provide a broader understanding of their cumulative and interactive effects. However, these constructs remain underexplored in children with intellectual disabilities. This scoping review maps the range, conceptualization, and impact of ACEs, PCEs, and related concepts on psychosocial outcomes. Following the Joanna Briggs Institute (JBI) methodology, a search of PsycInfo, MEDLINE, CINAHL, Web of Science, and Google Scholar identified studies until October 2024. Two reviewers screened and extracted data using standardized criteria. Findings reveal variability in how ACEs and PCEs are defined and measured. ACE exposure, particularly the cumulative impact of multiple ACEs (polyvictimization), links to adverse psychosocial outcomes, including emotional (e.g., anxiety, depression, Post-Traumatic Stress Disorder), behavioral (e.g., aggression, conduct problems), and developmental (e.g., social and adaptive skill deficits) difficulties. PCEs—such as positive parent–child relationships, teacher–student support, and peer acceptance—mitigate risks, though impact varies by context. Intellectual disabilities severity and socioeconomic adversity shape associations. Further research is needed to inform the adaptation of ACE–PCE frameworks for children with intellectual disabilities. Full article

Background: Assessment of physical competencies is one way to enhance uptake and maintain participation in a leisure-time physical activity (LTPA) for manual wheelchair (MWC) users. Weineck’s model explains physical competencies through eight physical qualities. The use of this model may influence MWC users’ motivation for participation in LTPA. The aim of this study was to identify and categorize existing assessment tools designed for MWC users of physical qualities (strength, speed, power, muscular endurance, cardiovascular endurance, balance, and flexibility). Methods: A mapping review was conducted following the “Preferred reporting items for systematic reviews and meta-analyses (PRISMA)” guidelines. Two reviewers selected articles that documented assessment tools for the physical qualities of MWC users. Tools were extracted from each article to categorize them in a list. Results: A total of 149 articles that contained assessments of physical qualities were included in the review. A total of 97 assessment tools were extracted and categorized according to the eight physical qualities. Conclusions: These assessments are categorized into physical qualities that would facilitate the creation of test batteries aimed at assessing physical qualities in MWC users. This study is the first step in the construction of a test battery to assess the physical qualities of MWC users. Full article

The aim of this pilot study is to explore the applications and relevance of heart rate (HR) monitoring in unified basketball during training and competition circumstances, focusing on athletes with intellectual disabilities. Six UB national team athletes were monitored using Polar Verity Sense heart rate monitors throughout training sessions and competitions. The data revealed considerable individual variability in HR responses among the athletes. These variations highlight the importance of personalized HR monitoring to accurately assess training loads and optimize performance. However, when applying HR monitoring, it is essential to account for factors that may affect data accuracy, including consistency in device placement and environmental stressors such as competition anxiety. Additionally, athletes with cardiovascular comorbidities may display atypical HR patterns, requiring cautious interpretation of HR thresholds. Although the small sample size limits the broader applicability of the findings, this study explores the application and relevance of HR monitoring, highlighting the need for future research to further validate its effectiveness. Full article

Globally, many countries have promulgated extensive, contextually relevant disability legislative policies for children with hearing impairment/d/Deafness (HI/d/D). The alignment of policies with their implementation, with robust monitoring, is essential for effective early intervention (EI) and early education (EE) outcomes. The study’s purpose was to review current South African EI and EE regulations, acts, and policies in relation to children with HI/d/D from birth to age six. An adapted Arksey and O’Malley framework with inductive thematic analysis was applied to synthesise and evaluate relevant information. Documentation was sourced between 1993 and 2023 from the official South African government portal and Google online searches using keywords. While 7976 documents were initially identified with the broad search and 1249 with a refined category search, only 17 met the specific inclusion criteria for policies referencing hearing impairment in early intervention and education. Seventeen documents were selected for study inclusion, with sixteen mentioning HI/d/D and multi-disciplinary, multi-sectoral, family-centred, culturally sensitive considerations superficially. One document from the Department of Health (DoH) specifically addressed early hearing detection and intervention (EHDI). Three main themes emerged, including Partnerships, Participation and Integration, Screening, Identification and/or Intervention, and Education/Special Education. Greater engagement with South African EI and education policies is essential to strengthen implementation, especially across sectors and at the community level. Mandating EHDI guidelines is critical to improving service delivery and ensuring smoother transitions between health, education, and social services for children with hearing impairment. Full article

This study aimed to clarify the menstrual experiences and perceptions of women with visual impairments in Japan. An anonymous web-based questionnaire consisting of both multiple-choice (quantitative) and open-ended (qualitative) questions was administered to female Riryouka Kyouin (visually impaired teachers who provide instruction in traditional Japanese therapeutic practices—such as acupuncture, moxibustion, and massage—to students with visual impairments) employed at prefectural schools for the blind. The multiple-choice responses suggested several difficulties in menstrual management, including challenges in detecting menstrual blood, limited access to information, and concerns related to embarrassment. The open-ended responses revealed that participants, as individuals with visual impairments who also serve as educators and healthcare professionals, expressed efforts to manage menstruation appropriately in social contexts. These findings highlight the practical experiences of visually impaired women who are actively engaged in society and suggest the importance of support approaches that respect individual autonomy in managing menstruation—a bodily practice imbued with social meaning. Full article

In Sweden, persons with intellectual disability have a legal right to support in everyday life, including housing with support and participation in daily activities, but government reports show that many do not receive the support they need or would prefer. The aim of this study was to explore how persons with intellectual disability experience and reflect upon support in everyday life. Thirteen adults with mild intellectual disability participated in one to three interviews each. Content analysis yielded an overarching theme “Persons with intellectual disability request two different forms of support” and three themes: “Support requested to achieve independence”, “Challenges in requesting support”, and “Mutual support in a safe environment”. The study shows that persons with intellectual disability can be hindered in requesting and obtaining support due to both internal factors and support persons’ inability to provide support in a way that is acceptable to the person with intellectual disability. Persons with intellectual disability adapt to the support person to receive support without burdening them. Persons with intellectual disability also strive to become more independent in everyday life. Being situated in a context where mutual support is a natural part of the social life is found to be optimal. Full article

Supporting the social participation of individuals aging with long-term neurological disabilities is key to healthy aging. However, knowledge about the factors influencing their social participation remains limited and fragmented. Following the Joanna Briggs Institute methodology, this scoping review synthesized and integrated knowledge regarding the barriers and facilitators to the social participation of individuals aging with long-term neuro-disabilities. A search in four databases (MEDLINE, CINAHL, PsycInfo, and EMBASE) resulted in 18 studies involving 2587 participants with nine neurological conditions: stroke, multiple sclerosis, spinal cord injury, traumatic brain injury, aphasia, post-polio syndrome, spina bifida, cerebral palsy, and muscular dystrophy. A total of 38 barriers, 25 facilitators, and 4 factors with mixed influence to social participation were identified. Key reported barriers included the organic system (e.g., fatigue or pain) and macro environments (e.g., inaccessible built environment). The most common facilitators involved physical dimensions in personal factors (e.g., good physical functions) and micro-environments (e.g., supportive social environment). This review highlights the need for accessible infrastructure and community support to promote inclusivity and equity. Future research should focus on community-level factors and mixed study designs to provide robust evidence to improve social participation and healthy aging in this vulnerable population. Full article

Accessible housing plays a vital role in promoting independent living and quality of life for people with disabilities. However, the existing design standards often fail to address the specific needs of diverse disability groups. This study aims to establish architectural and habitability criteria for housing adapted to various disabilities, including wheelchair users, individuals with achondroplasia (little people), Autism Spectrum Disorder (ASD) and Down syndrome, individuals with visual and hearing impairments, and older adults, by integrating international frameworks and prior research. The Analytic Hierarchy Process (AHP) was used to prioritize key factors in the housing design. The factors analyzed included autonomy, independence, safety, comfort, communication, and mobility. Findings reveal that autonomy consistently emerged as the most relevant criterion across groups, particularly for older adults (61.8%), wheelchair users (83%) and little people (64%). Secondary priorities varied: mobility was emphasized by wheelchair users (77%), communication by visually impaired individuals (64%), and comfort by deaf and hard of hearing participants (43%). The results underscore the need for housing solutions that reflect the priorities of each disability group. This study contributes by validating user-centered design criteria and offering a framework to guide inclusive housing policies and practices. By highlighting needs, it bridges the gap between generic accessibility standards and design. These findings support policy development and enrich the literature by incorporating unique resident-centered perspectives and overlooked indicators of housing accessibility and inclusive residential design. Full article

There is a growing body of evidence regarding the barriers to participation in sport for people with sight loss and for people from ethnically diverse communities. However, far less is known about the experience of people with sight loss who are also from ethnically diverse communities. Semi-structured interviews with people with lived experience and focus groups with civil society organisations that work with people with sight loss in the UK were undertaken. The aim was to explore how issues concerning ethnicity, culture, and heritage overlap with sight loss to affect sport participation. This research found that the intersecting occurrences of sight loss and ethnicity/cultural factors, as well as other socio-demographic factors like gender, compound and exacerbate the barriers to sport participation for people with sight loss from ethnically diverse communities. Further research is needed in different settings to unpack the heterogeneity related to sight loss, ethnicity, and sport. Full article

Background: People with disabilities, particularly those from developing countries, often fare worse during disasters, pandemics, and other emergencies. China is located in the most disaster-prone region in the world. However, no study has examined emergency evacuation planning among people with disabilities in China. The latest literature on emergency preparedness tends to focus on individual-level factors such as demographic characteristics, self-efficacy, and disability status. A focus on individual-level factors overlooks the importance of environmental influences on disaster preparation. Objective: This paper explores how individual and environmental factors are associated with emergency preparedness among people with disabilities in China. Methods: Two hundred and forty-eight people with various disabilities filled out an online cross-sectional survey on the level of emergency preparedness among people with disabilities in China. We conducted a hierarchical logistic regression to examine which environmental-level factors are associated with emergency preparedness after controlling for individual-level factors. Results: The results show that when entering only individual-level factors, self-efficacy in evacuation and previous emergency experiences are significant factors associated with being prepared. After including the environmental-level factors, self-efficacy remains significant. People with a physical disability and those from Hubei province, when compared with respondents from the rest of China, are less likely to be prepared. Another protective factor other than self-efficacy is being part of an online disability peer-support group. Conclusions: When designing risk management interventions, public health officials should consider both individual- and environmental-level factors. Using an online peer-support community may be considered an innovative component when designing these interventions. Full article

This study examines strategies to enhance transport inclusivity and passenger satisfaction for persons with disabilities in public bus systems in the Philippines. Drawing on data collected through an online questionnaire from 396 persons with disabilities who responded across various regions in the country, this study investigates eight key factors affecting satisfaction: vehicle design, diverse seating options, sensory considerations, assistance services, safety measures, subsidies/discounts, accessibility, and communication and information quality. Structural equation modeling (SEM) was used to analyze the hypothesized relationships between these variables, passenger satisfaction, and intention to reuse public transport. The SEM results revealed that accessibility (β = 0.359, p = 0.005), vehicle design (β = 0.248, p < 0.001), diverse seating options (β = 0.485, p < 0.001), safety measures (β = 0.3867, p = 0.001), and subsidies/discounts (β = 0.447, p < 0.001) significantly influenced passenger satisfaction. In turn, satisfaction had a strong positive effect on the future intention to use public transport (β = 0.760, p < 0.001). However, sensory considerations (β = 0.163, p = 0.225), assistance (β = 0.133, p = 0.519), and communication and information quality (β = 0.171, p = 0.345) were not statistically significant. The model demonstrated a good fit (chi-square/df = 4.03; SRMR = 0.078; NFI = 0.956), supporting the robustness of the proposed framework. These findings suggest that design-centered improvements and subsidies/discounts are critical to inclusive transport experiences, while overreliance on assistance may not guarantee satisfaction. This study recommends promoting autonomy through universal design, enhancing digital and physical accessibility, and increasing public awareness. These insights are intended to guide policymakers and transit authorities in creating a more inclusive, equitable, and user-driven transportation system. Full article

This study aimed to examine caregivers’ perceptions, practices, and challenges regarding rehabilitation services for people with disabilities, with a focus on identifying factors influencing their decisions to bring care recipients for formal rehabilitation. A cross-sectional study was conducted in rural Thai Nguyen Province, Vietnam. Data were collected from 214 primary caregivers using a structured questionnaire covering demographics, caregiving roles, and rehabilitation-related perceptions. A pilot study was conducted to refine the tool, and data were collected via face-to-face interviews by a trained team. Statistical analyses included descriptive statistics, chi-square tests, and stepwise logistic regression to identify key predictors of care-seeking behaviors. Results showed that 92% of caregivers perceived rehabilitation as necessary or very necessary. Female caregivers were more likely to provide care at home (95.3%), while male caregivers were more likely to utilize hospital-based services (73.5%) and to bring care recipients for rehabilitation overall (79.4% vs. 67.1%). Logistic regression revealed that female caregivers were significantly less likely than males to bring people with disabilities in for care (OR = 0.34, p = 0.02). Longer caregiving duration was associated with a reduced likelihood of seeking care (OR = 0.96 per year, p < 0.001), whereas caregivers of individuals with mobility needs (OR = 3.15, p < 0.001) and social integration needs (OR = 2.12, p = 0.05) were significantly more likely to seek care. These findings highlight gender-based differences and caregiving dynamics that influence access to rehabilitation. To enhance rehabilitation outcomes and support caregiver engagement, targeted policies are needed to address gender roles, caregiving fatigue, and the specific needs of care recipients. Full article

With the enforcement of the Act for Eliminating Discrimination against Persons with Disabilities, the provision of reasonable accommodations in pharmacies has become mandatory in Japan. This study aimed to develop and validate the effectiveness of a training program to improve pharmacists’ ability to assist people with intellectual disabilities. The educational staff of one chain pharmacy company announced the program, and pharmacists at this company were invited to participate in the program. A 90 min online training was conducted with 15 pharmacists. The session included a lecture on reasonable accommodations and small group discussions (SGD). Before and after the training, participants answered an online survey about 1. Their basic attributes (number of years of experience and awareness of reasonable accommodations and constructive dialogue); 2. Their confidence in providing medication guidance to people with intellectual disabilities (10-point scale); and 3. Possible accommodations that could be provided by pharmacies. Training resulted in an increase in the average score for question 2 from 3.93 to 5.87. In addition, an increase in the number of keywords within the free-text descriptions and in the number of co-occurrences within the responses of mentions of possible accommodations in pharmacies was observed. Despite the shortness of the training, it changed the participants’ awareness about accommodations for people with intellectual disabilities. Further study is needed to enhance the content and evaluate changes in practice. Full article

As Canada’s population ages and disability prevalence increases, understanding the built environment’s impact on mobility and social participation is essential. This study evaluates the measurement properties of the Stakeholders’ Walkability/Wheelability Audit in Neighbourhoods (SWAN) tool, a user-led instrument designed to assess environmental factors affecting older adults and individuals with disabilities. Using community-based participatory research, we recruited 54 participants from five cities to assess the SWAN tool’s inter-rater reliability, construct validity, and internal consistency. The results indicated a high overall inter-rater reliability of 85.22%, with substantial Cohen’s Kappa coefficients across domains, particularly in the Safety domain (0.73). The construct validity was confirmed through moderate to strong correlations with established measures, notably a correlation of 0.79 between the Street Crossing subdomain and the Sidewalk Index. The internal consistency analysis showed excellent reliability in the Functionality domain (α = 0.95) and a lower consistency value in the Social Environment domain (α = 0.63), suggesting the need for further refinement. These findings provide preliminary evidence of the SWAN tool’s potential for evaluating neighbourhood accessibility. By identifying barriers and facilitators to mobility, the SWAN tool can guide urban planning efforts aimed at creating inclusive environments for aging populations and individuals with disabilities. Future research should focus on larger samples to explore structural validity. Ultimately, the SWAN tool can contribute to improving the quality of life of vulnerable populations and promote more equitable urban policy development. Full article