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PubMed2003

Aging, disability, and disabled older people in India.

India is witnessing a demographic revolution, leading to a considerable increase in the proportion of older people in the population. Similarly, life expectancy of both the mentally and physically disabled has improved considerably. About 5% of Indian older people have problems with physical mobility. Aging has become a gender issue in India not only because more women are surviving into old age; they are also vulnerable and disadvantaged in many ways. In most cases they are the only caregivers available for the old and disabled. Older Indians are considered a high-risk group for multiple morbidity. It is estimated that nearly four million Indians suffer from mental problems. India has around 12 million people designated as "handicapped." However, little information is available about disabled people who grow older. The National Policy on Older Persons, which has been recently formulated, aims at providing an improved quality of life for millions of older Indians. However, the concerns of older disabled and of the disabled who grow old are still treated separately in both policy and practice.

Aged↗
PubMed1996

Evidence of nonverbal learning disability among learning disabled boys with sensory integrative dysfunction.

The presumed sensorimotor basis of the nonverbal learning disability syndrome was investigated among 90 learning disabled boys (M age = 6 yr., 8 mo., SD = 12.2 mo.) with sensory integrative dysfunction. The majority of the boys were Caucasian, lower to middle socioeconomic status, and from urban, English-speaking families. 14% (n = 13) of the boys satisfied core discrepancy criteria for nonverbal learning disability, including both a significantly higher Wechsler Verbal than Performance IQ and a higher standard score in Reading than Arithmetic on the Wide Range Achievement Test. Compared with a control group of 19 boys from the same sample who had no significant discrepancies, boys with nonverbal learning disability had significantly greater weaknesses in space visualization and visuomotor coordination. As predicted, rote verbal memory and syntactical strengths were also exhibited by boys with nonverbal learning disability, but the two groups did not differ significantly.

Child↗
PubMedDate not supplied

A new measure for assessing the physical activity behaviors of persons with disabilities and chronic health conditions: the Physical Activity and Disability Survey.

PURPOSE: Assess the psychometric properties of the Physical Activity and Disability Survey (PADS), a new physical activity measure for persons with disabilities and chronic health conditions. DESIGN: Cross-sectional and pre-post designs were employed. SETTING: A Midwestern university fitness center. SUBJECTS: Participants were 103 individuals with disabilities and/or chronic health conditions. MEASURES: The Physical Activity and Disability Survey (PADS), peak oxygen uptake (peak VO2), maximum workload (MW), and time to exhaustion (TE) during exercise. RESULTS: Factor analysis revealed a four-factor model that generally corresponded to PADS subscales. Cronbach alpha coefficients ranged from .67 (Exercise) to .77 (Time Indoors). Test-retest reliability (1-week interval) ranged from .78 (Time Indoors) to .95 (Leisure Time Physical Activity). Interrater reliability ranged from .92 (Household Activities) to .99 (Exercise, Leisure Time Physical Activity, Total Activity). Significant (p < .05) correlations were found between PADS subscales and absolute peak VO2 (Leisure Time Physical Activity, Household Activity, Total Activity), relative peak VO2 (Exercise, Time Indoors), MW (Time Indoors, Household Activity), and TE (Household Activity, Total Activity). Analyses of variance revealed that, unlike controls, health promotion program participants evidenced significant pre-post gains as measured by the Exercise subscale and Total Activity score. CONCLUSIONS: The findings lend support for the reliability and validity of the PADS as a measure of physical activity of groups who are sedentary and disabled.

Adult↗
PubMed1991

Enabling or disabling? Students' attitudes toward persons with disabilities.

Persons with disabilities are devalued by society. Occupational therapists may be contributing to this devaluation through their attitudes. This study focused on the attitudes of undergraduate students. From a sample of 223 occupational therapy students and 326 business students at an Australian university, it was found, with the use of the Attitudes Toward Disabled Persons Scale-Form A (Yuker, Block, & Young, 1966), that the attitudes of freshman occupational therapy students did not differ significantly from those of their business-major peers. Furthermore, the occupational therapy students' attitudes did not vary with the years of undergraduate education completed. However, those students who had had contact with persons with disabilities beyond the context of a caregiver-care receiver relationship (i.e., those students who had assumed roles that emphasized valued attributes of the person with a disability) had significantly more positive attitudes than did those students without such contact. Educational curricula must address the issue of students' attitudes and, in particular, the facilitation of valued social role contact with persons with disabilities.

Attitude of Health Personnel↗
PubMed1992

Benefits of the Americans With Disabilities Act of 1990 for children and adolescents with disabilities.

The Americans With Disabilities Act of 1990 (ADA) (Public Law 101-336) is a civil rights law intended to bring men, women, and children with disabilities into the mainstream of American life. This paper discusses the relation of the law to pediatric occupational therapy practice. The spirit of the ADA is highly compatible with occupational therapy's philosophical perspective. Occupational therapy personnel value functional independence, which requires an interactive relation between the environment and the child. Current pediatric practice models focus on deficit reduction and give limited attention to the environment, even though physical, social, and temporal environments contribute to disability, as do performance component deficits. An environment-centered model is suggested as a pediatric service provision approach compatible with the philosophical background of the ADA. This model emphasizes education and consultation to businesses and individuals for the purpose of altering environments to be accessible and accommodating to children and adolescents with disabilities. Three examples of environment-centered services are presented: (a) an evaluation of environments and reasonable accommodation recommendations for a teenager with a physical disability, (b) the mother of a child with cerebral palsy, and (c) the parents and program director of a community recreation program.

Activities of Daily Living↗
PubMed1992

Guidelines for meeting the communication needs of persons with severe disabilities. National Joint Committee for the Communicative Needs of Persons with Severe Disabilities.

In summary, the current best practices in the facilitation and enhancement of communication among persons with severe disabilities reflect six major tenets: (a) communication is social behavior; (b) effective communicative acts can be produced in a variety of modes; (c) appropriate communicative functions are those that are useful in enabling individuals with disabilities to participate productively in interactions with other people; (d) effective intervention must also include efforts to modify the physical and social elements of environments in ways that ensure that these environments will invite, accept, and respond to the communicative acts of persons with severe disabilities; (e) effective intervention must fully utilize the naturally occurring interactive contexts (e.g., educational, living, leisure, and work) that are experienced by persons with severe disabilities; and (f) service delivery must involve family members or guardians and professional and paraprofessional personnel. These six tenets have resulted in assessment, intervention, and service delivery models that offer maximum responsiveness to the need to establish communicative repertoires that will allow persons with severe disabilities to function effectively in least restrictive environments--in productive interactions with others.

American Speech-Language-Hearing Association↗
PubMed1992

The diagnosis of disability. Treating and rating disability in a pain clinic.

Medical diagnosis sanctions illness and directs physicians toward effective treatment. In chronic illness, these two functions of diagnosis can come into conflict. Nowhere is this conflict more striking than in the case of disability ratings for those with chronic pain. An institutional case study examining the relation between a pain clinic and a worker's compensation program is presented and analyzed in terms of two questions: (1) Is it ethical for one physician to both treat pain and rate disability in patients with chronic pain? (2) Is physician rating of disability due to pain scientifically valid? Ethical and conceptual analyses support a negative response to each of these questions. The roots of the ethical and scientific problems concerning disability ratings are identified in society's demand to differentiate medical and nonmedical distress. We propose a system of time-limited compensation for pain as a therapeutically superior alternative to disability ratings.

Attitude of Health Personnel↗
PubMed1992

Posttraumatic disablement: a prospective study of impairment, disability, and handicap.

This study was designed to evaluate both the frequency and the course of impairments, disabilities, and handicaps resulting from trauma. It was conducted in Aquitaine, France, on a sample of 1005 trauma patients (mean ISS, 10.5 +/- 0.3) in which severe trauma (ISS > 25) was rather overrepresented (169 of 1005). A prospective follow-up of disablement according to the WHO classification was based on medical examinations performed 6 and 12 months after the trauma. Of 664 survivors reviewed at 6 months, the findings were cross tabulated with Injury Severity Score (ISS) and age. There was a good relationship between ISS and the mean length of stay in the hospital (r = 0.46; p < 0.001), the duration of rehabilitation, and the time away from work or school. Out of this sample of 1005 patients with rather major injuries, 73% of the survivors suffered from at least one impairment, with a consistently lower frequency in children whatever the severity. At least one disability was encountered in 52.3% of these patients depending on both ISS and age. Handicap was noted in at least 26% of the cases. Between the sixth month and the end of the first year, the minimal handicap regression was 35.8%, whereas the minimal regression of the disability rate was 19.5%. The best improvement was observed essentially in the low ISS categories. Whereas for minor trauma the course of disablement seems to be fixed 1 year after the injury, such is not the case for severe trauma.

Absenteeism↗
PubMed2006

Return to work still possible after several years as a disability pensioner due to musculoskeletal disorders: a population-based study after new legislation in Sweden permitting "resting disability pension".

Different strategies have been used to stimulate a return to work (RTW) among individuals suffering from long-term ailments. In Sweden a new law on "resting disability pension" permits disability pensioners to go back to work without jeopardising their benefits. In this study different variables related to RTW during 2000 by means of this legislation were identified among disability pensioners with musculoskeletal disorders. Individuals in the study group, when compared to a control group, had more often been disability pensioners for several years, had additional education, estimated their previous job to have been physically strenuous to a lesser degree, were more satisfied with the treatment at the social insurance office and had a more positive self-image. This study shows that it may be meaningful to continue/resume rehabilitation efforts and to try to motivate an individual suffering from musculoskeletal disorders to return to work even after several years as a disability pensioner.

Adult↗
PubMed1995

Integrated disability management: taking a coordinated approach to managing employee disabilities.

1. Disability management provides opportunities to control costs and improve employee benefits through three levels of prevention: primary prevention of disabilities (work and non-work related); secondary minimization of disability costs; and tertiary facilitation of rehabilitation and early return to work. 2. A totally integrated disability management program has many components, all of which must be effectively coordinated. Management of these components will result in lower disability related costs, increased employee productivity and job satisfaction, and less employee turnover. 3. All employees receive individualized services designed to assist them in returning to work and emphasizing their contributions to the company's overall dedication to global leadership, continuous growth, and success.

Persons with Disabilities↗
PubMed1994

Disability process redesign: the proposal from the SSA Disability Process Reengineering Team.

About a year ago, the Social Security Administration (SSA) began the Disability Process Reengineering Program. This agency-wide project is one way SSA is seeking to improve its overall service to its customers while enriching and improving the worklives of its employees. The Disability Process Reengineering Team's objective is to fundamentally rethink and redesign SSA's disability programs under OASDI and SSI to achieve dramatic improvements in critical measures of performance. The Team asked, "If SSA had the opportunity today to design the processes, what would they look like?" The Disability Reengineering Team's proposal to SSA for reengineering the disability process was announced in the Federal Register (April 15, 1994, pp. 18188-18264). This is not the final proposal; comments from the public were solicited in the announcement. This note gives a brief description of the new process proposed by the Team as well as a summary of the current process.

Persons with Disabilities↗
PubMed2003

Classification of communication disabilities in children: contribution of the International Classification on Functioning, Disability and Health.

Problems in communication serve as frequent markers of developmental delay and disability in childhood. Documentation of delayed or atypical receptive or expressive communication is one of the key diagnostic factors in the identification of children for intervention and support. This paper (1) reviews issues in classification and measurement of communication disabilities, (2) presents an overview of the development and publication of the WHO International Classification of Functioning, Disability and Health (ICF), and (3) identifies the implications of the ICF for children and youths with communication disabilities. As a conceptual framework, the ICF may be used productively to define the focus for different efforts to address children's language and communication difficulties. Impairments of a physical or mental nature can be covered in the Body Function and Body Structure components, complementing the information provided by the ICD-10 with descriptive documentation. The component of Activities, encompassing performance aspects of communication, lends itself to functional assessment and intervention in habilitation and education programs. The component of Participation provides an operational basis for policy initiatives focusing on social integration and community life Finally, the Environmental Factors component serves as a framework for identifying the nature and extent of access and opportunity for individuals and populations.

Activities of Daily Living↗
PubMed2003

Return to work and claim duration for workers with long-term mental disabilities: impacts of mental health coverage, fringe benefits, and disability management.

This paper examines the relationship of mental health benefits provided by 116 employers, to return to work and duration of disability claims for 407 of their employees who were on long-term disability (LTD) leave for mental disorders. Mental health benefits data were coded from summary plan description booklets provided by employers. Information on other fringe benefits and employers' disability management practices were obtained from a survey of the employers. Relationships between mental health benefit features, other fringe benefit and disability management factors, and our outcomes were estimated via logistic regression and survival analysis. Results indicated that three mental health benefit plan features were negatively related to the return-to-work probability:(1) a high deductible (> $600), (2) longer preexisting condition exclusion periods, and (3) having a carve-out. This suggests that cost saved by access restrictions may be partially offset by higher turnover costs for employees with disabilities due to mental disorders. Carve-outs were also predictive of shorter claims duration.

Female↗
PubMed2001

Disability awareness training for disability professionals.

PURPOSE: This article describes work at the Virginia School of the Deaf and Blind in Hampton, Virginia, USA. Disability sensitivity training in businesses and government organizations has become a more important activity in the United States since the Americans with Disability Act (ADA) of 1992 was published. That act of the US Congress required organizations to hire and make reasonable accommodations for the disabled. ISSUE: Lack of sensitivity or awareness of the plight of the disabled in business and government continues to be a distinct problem requiring attitude changes and training, but this problem can become acute even for professionals in organizations dedicated to the care and education of the disabled. CONCLUSION: Professionals tend to become inured to the hardships of others and lose sight of the need for both verbal and non-verbal sensitivity in the workplace.

Adolescent↗
PubMed2002

Face recognition in age related macular degeneration: perceived disability, measured disability, and performance with a bioptic device.

AIMS: (1) To explore the relation between performance on tasks of familiar face recognition (FFR) and face expression difference discrimination (FED) with both perceived disability in face recognition and clinical measures of visual function in subjects with age related macular degeneration (AMD). (2) To quantify the gain in performance for face recognition tasks when subjects use a bioptic telescopic low vision device. METHODS: 30 subjects with AMD (age range 66-90 years; visual acuity 0.4-1.4 logMAR) were recruited for the study. Perceived (self rated) disability in face recognition was assessed by an eight item questionnaire covering a range of issues relating to face recognition. Visual functions measured were distance visual acuity (ETDRS logMAR charts), continuous text reading acuity (MNRead charts), contrast sensitivity (Pelli-Robson chart), and colour vision (large panel D-15). In the FFR task, images of famous people had to be identified. FED was assessed by a forced choice test where subjects had to decide which one of four images showed a different facial expression. These tasks were repeated with subjects using a bioptic device. RESULTS: Overall perceived disability in face recognition did not correlate with performance on either task, although a specific item on difficulty recognising familiar faces did correlate with FFR (r = 0.49, p<0.05). FFR performance was most closely related to distance acuity (r = -0.69, p<0.001), while FED performance was most closely related to continuous text reading acuity (r = -0.79, p<0.001). In multiple regression, neither contrast sensitivity nor colour vision significantly increased the explained variance. When using a bioptic telescope, FFR performance improved in 86% of subjects (median gain = 49%; p<0.001), while FED performance increased in 79% of subjects (median gain = 50%; p<0.01). CONCLUSION: Distance and reading visual acuity are closely associated with measured task performance in FFR and FED. A bioptic low vision device can offer a significant improvement in performance for face recognition tasks, and may be useful in reducing the handicap associated with this disability. There is, however, little evidence for a correlation between self rated difficulty in face recognition and measured performance for either task. Further work is needed to explore the complex relation between the perception of disability and measured performance.

Aged↗
PubMed1981

The Framingham Disability Study: I. Social disability among the aging.

The Framingham Disability Study (FDS), a recent component of the Heart Disease Epidemiological Study in Framingham, Massachusetts, was designed to investigate the nature and magnitude of disability among mon-institutionalized aging adults. From September 1976, through November 1978, 2,654 individuals aged 55 to 84 years from the original cohort were interviewed in person or by telephone (94 per cent of the potential participant pool). This paper reports results on the prevalence social disability in five areas: housekeeping, transportation, social interaction, food preparation, and grocery shopping. Only 6 per cent of the sample have existing unmet needs in one or more of these five areas. The magnitude of social disability increases with advancing age. Women, in general, report a higher degree of unmet social needs than men. These findings are compared with other epidemiological investigations of social disability among the elderly.

Activities of Daily Living↗
PubMedDate not supplied

The relationships between self-reported hearing disability and measures of auditory disability.

Although required for many practical purposes, adequate measures of hearing disability are not yet available. In an attempt to identify a set of performance tests for predicting hearing disability in daily life the relationship between self-reported disability scores and measures of auditory disability was examined. The Amsterdam Inventory was completed by 51 respondents aged 30 to 70 years who also performed on various tests. Earlier factor analysis of the inventory scores resulted in the distinction of five aspects of auditory disability. Stepwise multiple regression analysis in the present study shows that the tests describe and differentiate quite well between these five aspects. Multiple correlation coefficients range from R = 0.60 to R = 0.74.

Adult↗