Disabilities

The ongoing transformation of mobility, including new services such as on-demand mobility, raises the question of how services need to be designed so that everyone can use them. The number of persons with mobility impairments is increasing as a result of demographic change, and with the current amendment of the law, it will be mandatory in Germany to take these person’s needs into due consideration. After all, a transport provider’s success relies on sufficient demand in society (including persons with and without disabilities). Due to changing mobility routines, increased comfort, and other individual personal requirements, vehicles smaller than conventional buses are necessary for passenger transportation. The following investigation is a research study, which is based on an intensive literature review and expert interview study. The goal of this work is to evaluate the current status quo of the German public transport system with respect to inclusive on-demand services and their satisfaction with user requirements. Therefore, guideline-oriented interviews with experts from the mobility sector were consulted and analyzed. For this purpose, the procedure of the qualitative analysis was used. Furthermore, user analysis and methodological processes were conducted in order to strategically establish necessary measures. On the one hand, the current initial situation is addressed and initial experience with these new services is reported. The current focus is on the automation and electrification of these vehicles. In order to make them accessible to all potential customers, ergonomic requirements should be considered from the beginning. The previous experiences with other vehicle classes as well as the legal framework conditions are to serve as a benchmark. On the other hand, existing challenges will be discussed, and necessary steps will be worked out. A result of this situational analysis shows that the currently available vehicle concepts do not fulfill all requirements. It is important to consider the vehicle and the barrier-free mobility chain (booking and paying for the journey or vehicle, as well as boarding, traveling, and alighting). Overall, the design of barrier-free mobility systems requires a process of both political and social rethinking in order to succeed. Full article

There has been growing recognition of the impact of COVID-19 and the restrictions implemented to contain the virus on mental health. This study provides a preliminary assessment of the longitudinal impact on state anxiety in individuals with disabilities and a subsample of individuals with visual impairment (VI). Two surveys were conducted in April–May 2020 (T1) and March 2021 (T2) to explore state anxiety (State-Trait Anxiety Inventory). Participants who consented to being re-contacted were invited to take part in T2. A total of 160 participants completed T1 and T2. There were no significant group differences in median anxiety at T1; however, at T2 anxiety was significantly higher in those with disabilities and there was a trend towards being higher in participants with VI compared to those with no disabilities. While not statistically significant within any of the three subgroups, state anxiety decreased slightly in those with no disabilities. The absence of a disability affecting mobility, experiencing loneliness, and poorer sleep quality predicted state anxiety at both timepoints. While anxiety appeared to decrease in individuals with no disabilities, it remained comparatively stable, and higher in those with disabilities. Loneliness and poor sleep may need to be addressed to alleviate feelings of anxiety. Full article

Parents provide important insights into the psychology, behaviors, and activities of themselves and their children with intellectual and developmental disabilities (IDD). However, it is unknown how prevalent parental participation in IDD research is in general, nor the diversity of geographical locations and research methods of these studies with parental participation. The current review screened 7845 published works in 7 IDD-focused journals between 2010 and 2019. A total of 1519 articles, accounting for 19.37% of all screened works, included at least one parental measure. For each parental article, we coded the country/continent of authors/participants, measurement tools used to obtain data from parents (e.g., questionnaire, interview), and the focus of the measurement (i.e., about parents, child, or both). We found an increasing number and proportion of studies involving parents between 2010 and 2019. Most studies (76%) came from North America and Europe, whereas other continents such as Africa and South America represented less than 1% of all studies reviewed. The predominant (88.0%) measurement tools were questionnaires and interviews. More studies were about both the children and the parents (42.6%) than either only the children (31.3%) or only the parents (26.1%). Together, our review showed a somewhat limited diversity in parental participation in IDD research and these findings have important implications for future research. Full article

Anecdotal reports suggest that adequate housing and transportation could be fundamental elements required to ensure quality of life (QOL) for people with mobility limitations. Certain home- and community-based services (HCBS) are also necessary to ensure that housing and transportation needs are met. Understanding QOL as it relates to housing and transportation is critical for people with mobility limitations but requires appropriate assessment of these constructs. The aims of this research were to explore the relationships between housing and transportation on QOL for people with mobility limitations, to describe the current conceptual measurement issues and to propose dimensions of access that could facilitate assessment of QOL as it relates to housing, transportation and HCBS. A critical review of the literature was conducted by experts in disability, QOL and access theory. While evidence indicated a potential influence of housing and transportation on QOL for people with mobility limitations, the relationships between these concepts were weak and inconclusive. Moreover, the measurement tools used lacked appropriateness to specifically measure these constructs. Approaching these measurement issues within an access theory may better position future research to address the housing, transportation and HSBS needs of people with mobility limitations. Future research may consider elements of availability, accessibility, accommodation, affordability, acceptability and awareness to ensure access for people with mobility limitations. A better understanding of QOL as it relates to housing, transportation and HCBS will improve the quality of research, which may in turn improve access of adequate services for people with mobility limitations. Full article

Faculty and staff with disabilities are significantly underrepresented within academia and experience alarming rates of discrimination, social exclusion and marginalization. This review aimed to understand the experiences and impact of disability discrimination (ableism) among faculty and staff. We conducted a systematic review while searching six international databases that identified 33 studies meeting our inclusion criteria. Of the 33 studies that were included in our review, they involved 1996 participants across six countries, over a 25-year period. The studies highlighted faculty and staff experiences of ableism in academia, which focused on disclosure (i.e., choosing to disclose or not), accommodations (i.e., lack of workplace accommodations and the difficult process for obtaining them) and negative attitudes (i.e., stigma, ableism and exclusion). Twenty-one studies explained the impact of ableism in academia, including a negative effect on physical and mental health, and career development. Coping mechanisms and strategies to address ableism in academia were also described. There is a critical need for more research and attention to the lived experiences of ableism among faculty and staff in academia and the impact that ableism has on their health and well-being. Full article

Individuals with autism spectrum disorder (ASD) experience significant barriers to employment. This study aimed to look at the support received by individuals with ASD in gaining and maintaining open employment from their perspective. A phenomenological approach was adopted with participants (n = 9) participating in semi-structured interviews. Thematic analysis identified four key themes; being supported, feeling successful, career progression and expectations. The findings suggest that individuals with ASD receive support from many different sources in their employment including supervisors, co-workers and parents. The support they received from disability employment consultants was more focused on obtaining a job rather than job maintenance or career progression. Career progression was rarely discussed by participants with their disability employment consultant, despite some evidence of poor job matches and unused qualifications and skills (reflecting a poor investment for individuals and society). Despite this, participants reported feeling successful due to having a job, having pride in their work, and feeling valued by co-workers. The study highlights the need for more research on understanding the longer-term support needs of people with ASD in open employment. Changes in policy to better resource and incentivize disability employment providers could produce more positive outcomes for people with ASD throughout their working lives. Full article

Research has shown that persons with disabilities continually face discrimination. More research attention has focused on individuals’ experiences of visible disability, despite evidence that there are higher numbers worldwide of people with invisible disabilities. As such, persons with invisible disabilities can feel under-represented in disability literature. A qualitative study was conducted to address this. Twenty-five persons with an invisible disability were recruited to take part in focus groups and interviews aimed at understanding the lived experience of invisible disability on social life and within the workplace. Data were analyzed using Braun and Clarke’s reflexive thematic analysis, identifying themes of (1) Incongruity between looking and feeling, (2) The impact of others, (3), Adaptation, (4) Talking about disability, (5) (Un)supported and (un)accepted, and (6) Discrimination/legislation. The findings indicate that the language, attitudes and behaviour of others are important to support inclusion in the social and working lives of those with invisible disabilities. Persons without a disability should be willing to talk about disability, see the strengths of those with an invisible disability and be mindful of language used around visibility. Suggestions relating to what we can do to be better support those with an invisible disability in society are discussed. Full article

Background: One in four New Zealanders identify as disabled. Disabled people, including Māori (the indigenous people of New Zealand (NZ)), experience health disparities. Systemic and individual health professional (HP) biases are factors that may affect health outcomes. Disability education is a means for improving attitudes and behaviors towards disabled people. The objective of this study was to explore NZ HP students’ understanding of disability and health-related concepts. Methods: HP students from one tertiary institution in NZ were interviewed through Zoom video call about their understanding of disability and health. A relativism paradigm and contextualism epistemology (underpinned by the socio-ecological model) shaped the reflexive thematic analysis. Transcripts were analyzed at a deductive and latent level. Results: Nine HP participants, from different professional courses and cultural backgrounds, were interviewed. Three main themes influenced participants’ understanding of disability: life experiences, professional education, and societal exposure. Participants who had more experience with disabled people had a deeper and more nuanced appreciation of the challenges disabled people face in accessing health services and obtaining equitable health outcomes. Cultural background also influenced the participants’ understanding of disability. Participants preferred more experiential learning methods to improve their knowledge of disability concepts. Lastly, expectations of inclusion are determined by observing social norms. Conclusion: Participants reported learning just a few models of disability. The HP students predominantly came from a perspective of ensuring equality rather than equity. There was limited recognition of the systemic biases that exist within multiple social determinants and how these perpetuate health inequities for disabled people. A socio-ecological consideration of disability throughout the curricula, self-reflection, acknowledging systemic bias, and proactively including disabled people as HP students and teachers are potential means for addressing health inequities. Full article

This study examines the initial impact of the COVID-19 pandemic on adults with physical disabilities from marginalized communities in southeastern Michigan, one of the early pandemic epicenters in the United States. A purposeful sample of fifteen adults with moderate to severe physical disabilities were recruited, taking part in individual remote semi-structured qualitative interviews, which were recorded, transcribed, and coded for emergent themes using a thematic approach to coding and analysis. Three interrelated, overarching themes emerged: fear, feelings of isolation, and a sense of being invisible. These were identified in the contexts of health and healthcare, home care assistance, and access to resources. The findings help illuminate the experiences of those from socioeconomically and racially marginalized communities, populations that are often “always already” vulnerable. Participant narratives made visible the negative impact of the pandemic on physical and mental health as well as the lack of accommodations available. They showed that participants were faced with a dilemma between engaging in risky behavior to have their needs met or avoiding risk and not have those needs met. This knowledge can expand awareness and appreciation of how social, economic, and political systems impact adults with physical disabilities in lower-income and racially diverse communities and provide guidance in designing future clinical and emergency response policies. Full article

Background: Many children with spina bifida and/or hydrocephalus use manual wheelchairs. However, training to ensure appropriate wheelchair use is limited and informal, and this negatively impacts daily activity and participation. Evidence suggests formal training can increase children’s confidence and independence, with early intervention being critical for healthy development. In Ireland, like in many other regions internationally, such interventions are not readily available to families. Aim and objectives: The overall aim of the study was to pilot wheelchair skills training for children aged 3–8 years with spina bifida and/or hydrocephalus and their parents, to develop a sustainable program. The objectives were: (1) to develop and evaluate a wheelchair skills information pack; (2) to investigate the impact of training on children’s performance of wheelchair skills; (3) to explore parents’ perspectives on how training influenced their children’s daily participation; (4) to identify beneficial aspects of program delivery for children and parents. Methods: We applied a mixed-methods study design that included three stages: (1) evaluation of the use of a bespoke wheelchair skills information pack; (2) within-subject pre-post analysis of the wheelchair skills test (WST) and individual training goals; (3) qualitative thematic analysis of Photovoice documentary narratives from focus groups with parents. Results: Four children and their parents participated in the study. Parents reported the wheelchair skills information pack to be useful, recommending more child-friendly images, and the provision of the pack when children first receive their wheelchairs. Analysis of the pre/post-WST showed an increase in the performance of skills. Parents’ perspectives and experiences are captured in two Photovoice themes: (1) children developing their skills, (2) supporting parents to support their children. Conclusion: The pilot program was a success for these families, highlighting potential gaps in Irish wheelchair provision services and the need for wheelchair skills education and training to support parents and children. Full article

Children with disabilities are at greater risk of social exclusion. In part, this results from the negative perceptions of disability held by their peers. An innovative, school-based project used creative music-making sessions facilitated by young disabled musicians to nurture more positive attitudes among children aged 9 years in four schools, with two classes from each. In all, around 200 pupils were involved in weekly sessions totalling 16 h. Their attitudes to disability were assessed before and after participating in the project, along with the reactions of parents and teachers. Pupils were significantly more disposed to interacting with children with disabilities and to persons with disabilities more generally as well as to having a teacher with a disability. Parents and teachers confirmed the pupils’ enthusiasm for the project and the impact it had on them. A core driver for change appeared to be sharing enjoyable musical activities with competent musicians who had disabilities. Further research should explore the potential of mentoring by disabled persons in other arts activities and sports to provide further validation of this approach. Full article

Children with cerebral palsy who are non-ambulant cannot stand or walk independently. In Sweden, daily static standing is part of standard care for these children even though it is time-consuming and costly, and while it may benefit the well-being of many children, it is inconvenient for others. A novel stander enables dynamic standing through walking movements. The aim of this study was to compare dynamic and static standing regarding quality of life and cost-effectiveness. Twenty children with cerebral palsy who were non-ambulant were included in this randomized controlled study with a cross-over design. Mean age of the participants was 11.6 ± 3.6 years, nine were female. They participated in four months of static and four months of dynamic standing. Quality of life was assessed with the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD), which has been shown to be valid and reliable, and is tailored to children with severe cerebral palsy. Information about other aspects of quality of life and about cost-effectiveness was collected by study-specific questionnaires. Dynamic standing was the preferred alternative from the family perspective, as it cost less (€64, p < 0.01) and had greater benefits than standard (static standing) care. From societal and healthcare provider perspectives, dynamic standing had benefits but higher costs than static standing (€290 and €354 respectively, p < 0.01). These findings may contribute to the development of individualized standing recommendations. Full article

The aim of the study was to understand the causal attributions of teachers to challenging behaviours in primary classrooms in West Bengal, India. Data from 21 teachers from government and private primary schools were collected using semistructured interviews. The study investigated the types of challenging behaviours as perceived by teachers, their causal attributions, and the strategies suggested by the teachers for managing them. The participants described challenging behaviour broadly, and it was divided into four categories: aggression, disruption, talking, and noncompliance. They reported the causes of challenging behaviours in five broad categories: home- and parent-related causes (family violence, busy parents); social causes (socioeconomic conditions); student-related causes (disabilities); school- and teacher-related causes (large class sizes); and government- and policy-related causes (banning corporal punishment). The teachers predominantly recommended employing proactive strategies, such as improving teaching strategies, collaborating with parents, and building relationships with students. A small group of teachers recommended using reactive (e.g., discipline and threats) strategies to manage challenging behaviours in their classrooms. Full article

During the COVID-19 pandemic, government and health officials introduced measures such as social distancing and facility closures that amplified barriers to physical activity. Certain groups, including people with multiple sclerosis (MS), have been underserved during the pandemic. In this qualitative study we aimed to: (1) explore the physical activity experiences of people with MS during the COVID-19 pandemic; (2) identify the facilitators and barriers to physical activity during COVID-19 for people with MS; and (3) make recommendations for inclusive physical activity policy and programming. We conducted semi-structured interviews with 11 adults (9 women) with MS during January and February 2021. Following an inductive thematic analysis, three themes were developed: (1) changing opportunities and adapting to new opportunities; (2) social isolation and physical activity; and (3) adapting physical activity to stay safe from COVID-19. Common facilitators identified included having knowledge and resources to adapt activities, social connections, and access to outdoor recreation opportunities. Identified barriers included fear and anxiety related to the spread of the virus, a loss of in-person activity options, and the closure of physical activity spaces. Online and at-home opportunities for physical activity were a valued and accessible way to address barriers to physical activity for people with MS, and should be maintained post-pandemic while considering flexibility to accommodate variable support needs. Full article

Father involvement could play a significant role in the lives of children with disabilities. Research is scarce on father involvement in the education of children with disabilities in Africa. We seek to provide a context for father involvement in the formal education of children with disabilities in Kenya, with the aim of contributing to the development of a conceptual understanding for father involvement in such a circumstance. We examine general research on father involvement in Kenya, explore the policy frameworks that guide fatherhood in the country, and look at the specific area of involvement in education. We then present a case study that examines father involvement in the formal education of children with disabilities in Kenya. Our analysis flags up a key opportunity in the pursuit of education for children with disabilities when fathers are involved; they can support their children with disabilities’ access, participation and success in education. We highlight the need for research that builds upon the voices of fathers to illuminate their role in education and we also make some suggestions toward a conceptual lens that will highlight the contextual realities involved, particularly in regard to the education of children with disabilities. Full article

There are multiple studies demonstrating that 3D printed maps are important to people with blindness. When designed properly, they help users by improving safety and mobility and allow people with blindness to efficiently learn spatial information from the map and plan their travel prior to navigation. However, tactile maps are still not widely among people with blindness, as they are not readily available to them. Creating maps for each person needing a map of a certain location currently requires help from an individual with advanced technical training. They need to use specialized software for 3D models that personnel from disability services and family members of people with blindness usually have no experience with. The goal of this research is to design and implement software that can be used for the automatic generation of maps and be accessible to the general public. Our hypothesis is that by automating all the challenging steps (generation of the 3D model and drawing of optimally designed symbols), this will lead to increased usability and acceptance. Here, we demonstrated an early prototype and evaluated our hypothesis in a user study. To assess the success of this approach, participants answered questions about the process, usability, and social impacts of the software. Overall, participants liked the application because it was easy to use and allowed them to create custom maps with appropriate tactile-encoding features that provide meaningful information to the end user. Full article

Easy-to-Read content results from applying text simplification principles to make information accessible for persons with reading and learning difficulties. While both the creation process and simplification principles have gained the interest of scholars and the general public in the past years, the role of validators is still less visible compared with that of writers or translators. This paper sought to put a spotlight on validators by answering the questions of who these professionals are, what tasks they take on, and how they have acquired the necessary knowledge and skills for the job. In doing so, it investigated a subset of the data about validators’ demographical and educational backgrounds and current activity collected in an online survey launched within the innovative framework of the Erasmus+ project Train2Validate. Full article

Disability sports have been globally promoted to achieve an inclusive society. However, the current opportunities for people with disabilities are few in terms of participating in supporting positions, such as athletic trainers. In Japan, many people with visual impairment (VI) work as physical therapists; thus, they can become active as medical staff in the sports field. An example of a medical assessment is the muscle tightness test (MTT); however, conducting it is expected to be difficult for people with VI. To improve this difficulty, the current study developed an assistive instrument (AsI) and examined its effectiveness. We recruited 22 physical therapists with VI. The measurement for MTT targeted the hamstrings, iliopsoas, gastrocnemius, and quadriceps. The participants performed the MTT using a universal goniometer (UG) and the AsI and filled up a questionnaire. AsI was compared against UG based on three aspects, namely, ease, accuracy, and measurement time. In terms of ease, significant differences were observed in 9 out of 12 questionnaire items. The mean (SD) score for “Comprehensive ease of the MTT” improved from 2.8 (1.0) to 3.9 (0.8). For accuracy, the AsI yielded a decrease in the total error of the measurement. Lastly, the measurement time for AsI was longer than that for the UG. Therefore, the AsI was effective in terms of ease and accuracy, whereas measurement time remained as an issue. Full article