Disabilities

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