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PubMedDate not supplied

At second glance: employers and employees with learning disabilities in the Americans with Disabilities Act era.

The impact of the Americans with Disabilities Act (ADA) of 1990 on the American workplace is examined. The findings of a previous study (Gerber, 1992) on employer knowledge about learning disabilities are compared to current findings. Important themes and employer beliefs and practices that were consistent in employer responses are described. Although employers are continuing to make efforts to comply with the regulations of the ADA, they still have relatively little knowledge or experience with it in terms of learning disabilities.

Attitude↗

PubMedDate not supplied

The Technology-Related Assistance to Individuals with Disabilities Act: relevance to individuals with learning disabilities and their advocates.

Assistive technology (AT) was recognized by Congress as a viable need for people with disabilities when it passed the Tech Act in 1988. The legislation, which was reauthorized in 1994, has resulted in numerous programs and services that have helped people with disabilities access and use AT devices. The Tech Act's implications for people with learning disabilities is discussed in this article.

Health Services Accessibility↗

PubMed2001

Disability and prognosis in multiple sclerosis: demographic and clinical variables important for the ability to walk and awarding of disability pension.

OBJECTIVE: To evaluate disability and prognosis in an untreated population-based incidence cohort of multiple sclerosis (MS) patients. METHODS: The Expanded Disability Status Scale (EDSS) score was recorded in 220 MS patients. Disease progression was assessed by life table analysis with different endpoints and multivariate Cox regression analysis was performed for evaluation of prognostic factors. RESULTS: The probability of being alive after 15 years was 94.8 +/- 1.8% (s.e.), of managing without a wheelchair (EDSS < 7.0) 75.8 +/- 3.2%, of walking without walking assistance (EDSS<6.0) 60.3 +/- 3.6%, and of not being awarded a disability pension 46.0 +/- 3.7%. The probability of still having a relapsing-remitting (RR) course after 15 years was 62.0 +/- 4.1%. A RR course and long interval between the initial (onset) and second episode (> 3 years) predicted favorable outcome. There was also a trend towards favorable outcome in patients with optic neuritis, sensory symptoms and low age at onset but these factors were associated with the RR course. Motor symptoms and high age at onset indicated unfavorable outcome, but these factors were associated with the primary progressive course. CONCLUSIONS: A RR course and long inter-episode intervals in the early phase of the disease were associated with a better outcome. Other onset characteristics indicating a favorable outcome were associated with the RR course while characteristics indicating an unfavorable outcome were associated with the PP course.

Adult↗

PubMedDate not supplied

A position paper from the Academy of Dentistry for Persons with Disabilities. Preservation of quality oral health care services for people with developmental disabilities.

As administrators, health care planners, and community-based non-dental professionals plan for care and placement of disabled clients into community settings, the Academy of Dentistry for Persons with Disabilities encourages the inclusion of dentistry as part of the process and urges that experienced institutional dental personnel be utilized, recognizing their vast experience and special skills related to providing for the oral health care of persons with disabilities.

Deinstitutionalization↗

PubMedDate not supplied

[Spanish version of the new World Health Organization Disability Assessment Schedule II (WHO-DAS-II): initial phase of development and pilot study. Cantabria disability work group].

The aim of the present paper is to present the initial phases of the development of the Spanish version of the "World Health Organization Disablement Assessment Schedule II" WHO-DAS-II and also to describe the quantitative and qualitative methodological strategies used in the elaboration process of an instrument: i) compatible with the new International Classification of Functioning and Disability -ICIDH-2- of the World Health Organisation; ii) with criteria of cross-cultural applicability and; iii) to allow us to assess the disability in all its dimensions.

Cross-Cultural Comparison↗

PubMed1998

Asymptomatic HIV as a disability under the Americans with Disability Act.

The Americans with Disability Act (ADA) does not state whether it prohibits discrimination against individuals who are infected with HIV but asymptomatic. Some courts have held that the language of the ADA is unambiguous and does not cover asymptomatic HIV as a disability because the virus is not an "impairment" that substantially limits a "major life activity." Other courts have looked behind the statutory language and found that Congress intended to protect asymptomatic individuals with HIV because the virus impairs one's ability to procreate and/or engage in sexual relations. This Comment argues that asymptomatic individuals with HIV are indeed protected under the ADA, but that the analytic framework thus far employed by the courts is flawed. Asymptomatic HIV is a protected disability not because it is independently debilitating, but because the prejudices and fears of other may prevent HIV-infected persons from fully participating in society. The ADA was enacted to prevent exactly this type of discrimination.

Persons with Disabilities↗

PubMed2001

An evaluation of community learning disability services for children with a learning disability.

This study outlines the results of a survey carried out with parents of children with a learning disability, general practitioners and community learning disability teams as to the health service needs for this client group. Overall, 40% of parents were very dissatisfied or dissatisfied with the services they received. A number of gaps in service provision were identified. In particular, psychological and behavioural difficulties of children were of major concern to all those involved, but needs in relation to these areas were often unmet or inadequately dealt with. Of greater concern was that some families in the area studied were paying privately for child learning disability clinical psychology services because they had such difficulty in accessing NHS services. Implications for service provision are discussed.

Adolescent↗

PubMed1992

Dental fellowships in developmental disabilities help broaden care of disabled.

Continuation of the national trend toward deinstitutionalization and community placement for persons with developmental disabilities, physical handicaps and other medical problems will mean increased demand for dentists trained to care for this segment of the population. The New York State Office of Mental Retardation and Developmental Disabilities now offers dental fellowships in developmental disabilities to help fill the learning gap.

Academic Medical Centers↗

PubMed1993

Disability and the years of potential productivity lost: modifying the years of potential life lost and the investment-production-consumer model by disability level.

The full impact and the loss to society from disability are seldom evaluated. We suggest a modification of the years of potential life lost (YPLL) by the overall percentage of permanent disability to obtain estimates of years of potential productivity lost (YPPL). We compare YPPL with the maximal years of potential productivity of an individual by difference and ratio measures. We employ similar methodology to modify valued years of potential life lost (VYPLL) according to the investment-producer-consumer model. We demonstrate the methodology by an example using data on disabled veterans.

Adolescent↗

PubMed1980

Differential performance of learning disabled and non-learning disabled children on the McCarthy scales, WISC-R, and WRAT.

Individually administered the McCarthy Scales of Children's Abilities, WISC-R, and WRAT to 30 learning disabled and 30 non-learning disabled second-grade students. The McCarthy General Cognitive Index and the WISC-R Full Scale IQ scores were compared for both groups. In addition, correlations between the General Cognitive Index, WISC-R IQ, and mean WRAT achievement were reported. There was marginal support for previous studies that suggested that the McCarthy Scales are more consistent with the academic functioning of learning disable students. Implications and directions for future research were discussed.

Child↗

PubMed1994

The Disability Rating Index: an instrument for the assessment of disability in clinical settings.

The purpose of this study was to evaluate an instrument for assessment of physical disability, mainly intended for clinical settings, the Disability Rating Index (DRI). Healthy persons (n = 1092), both white and blue collar workers, and patients (n = 366) with different levels of physical capacity, were assessed. Most of the patients (n = 303) underwent rehabilitation programmes for neck/shoulder/low-back pain but some (n = 47) were arthritis patients waiting for hip or knee replacement surgery, or wheelchair patients with multiple sclerosis (n = 16). The reliability was investigated by test-retest studies, intra- and inter-rater and internal consistency studies. Five construct validity tests were carried out: a discrimination study; a converging validity test; a test for sensitivity to small alterations in health status; and two correlational validity tests. Correlation of the self-reported DRI to the actual performance in similar activities was carried out. Responsiveness was tested by correlation of the DRI before/after replacement surgery for arthritis. The test-retest correlations were 0.83-0.95 in the studies, including correlation of different versions. The intra- and inter-rater reproducibility was 0.98 and 0.99 respectively. The Kruskal-Wallis test in the discrimination study yielded p < 0.0001. More than 90% of the respondents completed the questionnaire correctly. Correlation of the DRI to the Functional Status Questionnaire was 0.46. The responsiveness was excellent, p = 0.0001. The DRI proved to be a robust, practical clinical and research instrument with good responsiveness and acceptability for assessment of disability caused by impairment of common motor functions.

Adult↗

PubMed2005

Rules for the classification of younger children with nonverbal learning disabilities and basic phonological processing disabilities.

Rules for the classification of Nonverbal Learning Disabilities (NLD) and Basic Phonological Processing Disabilities (BPPD) that had been generated and tested on older children (ages 9-15) were applied to younger children (ages 7-8). The goal was to evaluate the applicability of these classification rules for a younger population with NLD and BPPD, and to make revisions if necessary. These rules were used to differentiate these two subtypes of learning disabilities using levels and patterns of performance on motor/psychomotor, tactile/perceptual, visual-spatial, auditory-perceptual, problem solving, and language measures. An experienced child-clinical neuropsychologist classified each child. Only those children who received a classification of NLD or BPPD by the neuropsychologist and those who met criteria for definite or probable NLD and BPPD as defined by the rules were used in this study. Revisions were made to these rules for younger children. Revised rules allow for their use as a source of information to assist a clinician in deciding whether a comprehensive neuropsychological evaluation would be valuable. They may also be useful for research purposes.

Articulation Disorders↗

PubMed2005

Guidelines to the United Kingdom Disability Discrimination Act (DDA) 1995 and the Special Educational Needs and Disability Act (SENDA) 2001 with regard to nurse education and dyslexia.

This paper concerns the impact of disability legislation on nurse education, nurse educators and student nurses, in relation to academic work and clinical placement, with regard to dyslexia. The two United Kingdom acts considered are the Disability Discrimination Act (DDA), 1995 and the Special Educational Needs and Disability Act (SENDA), 2001, which is an amendment to the DDA. The paper examines and defines the main points of the acts, such as discrimination; less favourable treatment and its justification; reasonable adjustments; making adjustments in advance; disclosure and confidentiality requests; substantial disadvantage; current systems and regulations and concludes by raising issues which require clarification.

Certification↗

PubMed1999

Models of disablement, universalism and the international classification of impairments, disabilities and handicaps.

A review and critique of models of disability is presented, tracing the development of frameworks and classificatory instruments (International Classification of Impairments, Disabilities and Handicaps) over the past 20 years. While the 'social' model is now universally accepted, it is argued that universalism as a model for theory development, research and advocacy serves disabled persons more effectively than a civil rights or 'minority group' approach. The development of the revised International Classification (ICIDH-2) is discussed in this light.

Activities of Daily Living↗

PubMed2003

Assessment of migraine disability using the migraine disability assessment (MIDAS) questionnaire: a comparison of chronic migraine with episodic migraine.

BACKGROUND: Chronic migraine is the most common type of chronic daily headache seen in headache tertiary care centers. Most patients with chronic migraine report their ability to function and feeling of well-being as severely impaired. OBJECTIVE: To measure the headache-related disability of patients with chronic migraine using the Migraine Disability Assessment (MIDAS) Questionnaire, comparing it with that obtained in a control group of patients with episodic migraine. METHODS: The clinical records of 703 patients with chronic daily headache treated in a headache specialty clinic were reviewed to identify 182 with chronic migraine who were evaluated using the MIDAS at their initial visit. Our control group consisted of 86 patients with episodic migraine. RESULTS: Of the 182 patients with chronic migraine, 127 (69.8%) were overusing acute-care medication. Patients were predominantly women (72.5%), with a mean age of 38.3 years. The group with episodic migraine consisted of 59 women (68.6%), with a mean age of 36.1 years. No statistically significant demographic differences were observed between the two groups. The group with chronic migraine had more total headache days over 3 months (66.7 versus 15.5, P<.001), missed more days of work or school (5.3 versus 2.3, P =.0007), had more reduced effectiveness days at work or school (11.9 versus 4.6, P =.0001), missed more days of housework (16.5 versus 3.3, P<.0001), and missed more days of family, social, or leisure activities (7.0 versus 5.5, P =.03). The group with chronic migraine was more likely to be in MIDAS grade IV (64.3% versus 43.2%, P =.001), reflecting the great likelihood of severe disability in this group. The average total MIDAS score was 34.9 in the group with chronic migraine versus 19.3 in the group with episodic migraine (P<.001). CONCLUSION: In subspecialty centers, patients with chronic migraine demonstrate remarkable impairment of their daily activities and are severely burdened by their headache syndrome, reflected by their high MIDAS scores. The chronicity and pervasiveness of migraine thus is associated with increased functional impairment as well as increase in headache frequency.

Adult↗

PubMed2001

Classification rules for basic phonological processing disabilities and nonverbal learning disabilities: formulation and external validity.

Rules for the classification of two subtypes of learning disabilities (LD), namely, Basic Phonological Processing Disabilities (BPPD) and Nonverbal Learning Disabilities (NLD), are reported. These rules (refined as a result of application to two separate samples of children with LD) were used to select children from an entirely new sample who could be classified as having "definite" or "probable" BPPD or NLD. As a first step in the external validation of these rules, the patterns of psychosocial functioning exhibited by these two subtypes of LD were determined. As predicted, the vast majority of the BPPD subtype exhibited a pattern most consistent with normal or relatively normal psychosocial adjustment, and no appreciable increase in the incidence of significant psychosocial disturbance with advancing years. Also, as predicted, an increasing incidence of internalized psychosocial dysfunction (a form of significant psychosocial disturbance) was evident in the NLD subtype with advancing years. It is clear that children classified as having BPPD or NLD using these rules exhibit quite different, and predicted, relative patterns of psychosocial functioning. Thus, in this sense, the rules have concurrent validity. Finally, sets of rules/criteria for classification are presented that reflect their actual incidence in the two subtypes of LD generated for use in the validation phase of this investigation. These rules would appear to be useful for clinical purposes. It is also clear that they should be subjected to further validation studies in a broader age range for clinical and research purposes.

Adolescent↗

PubMed2004

The utility of math difficulties, internalized psychopathology, and visual-spatial deficits to identify children with the nonverbal learning disability syndrome: evidence for a visualspatial disability.

This study examined the criteria currently employed to identify children with the nonverbal learning disability syndrome (NVLD). The most widely accepted definition of NVLD relies on deficits in visual-spatial-organizational, tactile-perceptual, psychomotor, and nonverbal problem-solving skills. These deficits are believed to coexist with strengths in rote verbal learning, phoneme-grapheme matching, verbal output, and verbal classification. The combination of these assets and deficits has been hypothesized to lead to psychosocial and academic problems, including difficulties with mathematics and increased rates of psychopathology. This study compared performance of three groups of children: those with NVLD, those with verbal learning disabilities (VLD), and controls. The results show that the criteria currently employed to identify children with NVLD may not adequately differentiate them. In contrast to previous findings, the study reveals that children with NVLD can demonstrate good math abilities when performing certain types of math tasks, especially those that draw on their robust verbal skills. Also in contrast to most previous findings, in this study children with NVLD (and normal controls) demonstrated lower rates of psychopathology than children with VLD. Finally, for children with NVLD it appears that their visual-perceptual deficits may include a primary deficit in locating objects in space. Based in part on the findings of this study, it may be helpful for diagnostic and treatment purposes to reserve the term Nonverbal Learning Disability for children whose visual-spatial deficits are primary and severe enough to affect academic performance in subjects such as written mathematics. Given the integral nature of social relations in children's lives, a separate category (e.g., social processing disorder) could be created for children whose social skills deficits are primary and impair their social interactions. A broader nonverbal learning model or syndrome, as conceptualized by Rourke (1995), could be retained for describing a broader constellation of assets and deficits across disease types.

Child↗

PubMed2001

Nutritional parameters, body composition, and progression of disability in older disabled residents living in nursing homes.

BACKGROUND: The evaluation of nutritional status is one of the primary components of multidimensional geriatric assessment. We investigated the relationship between some markers of malnutrition and the modifications in functional status in a sample of older disabled residents living in nursing homes. METHODS: Ninety-eight subjects who were independent in at least two activities of daily living (ADLs) were enrolled in a 2-year longitudinal study. Anthropometric, nutritional, and metabolic parameters, as well as body composition, were measured at baseline and after 2 years. RESULTS: Deteriorating functional status (> or =2 additional lost ADLs) was associated with baseline albumin levels (Tertile 3 vs Tertile 1; odds ratio [OR] 0.16, 95% confidence interval [CI] 0.04-0.67) and subscapular skinfold thickness (Tertile 3 vs. Tertile 1; OR 0.06, 95% CI 0.006-0.50). After multivariate adjustment, the OR for increasing disability was >4 in subjects with decreasing body cell mass (BCM), compared with subjects with a stable BCM. The degree of BCM reduction was strongly related to the number of additional ADLs lost at follow-up (test for trend, p = .003). CONCLUSIONS: In a sample of older disabled nursing home residents, signs of malnutrition seem to predict further worsening in functional status. Furthermore, BCM declines proportionally to the loss in ADLs, suggesting the existence of a strong relationship between BCM loss and the progressive deterioration of functional status.

Activities of Daily Living↗