PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Disability”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 865 records · Page 48Linked to original sources

A reconceptualization of learning disabilities via a self-organizing systems paradigm.

A dilemma exists regarding the interpretation of learning disabilities. A self-organizing systems (SOS) paradigm suggests widespread, diffuse outcomes, whereas a specific learning disability concept suggests more localized dysfunction. There may be very good reason to doubt the veridicality of the concept of a specific learning disability, not because the construct of learning disabilities itself is a frivolous concept, as some have held, but because the biological or neurological events that underlie a learning disability do not remain focal and constrained only to specific dysfunction. It is important to know whether an identified learning disability remains contained or whether processing disorders might be found in other areas. The assessment profiles of school-age children identified with nonverbal learning disabilities (NLD), assumed to have primarily right-hemispheric brain dysfunctions, and children with language-based learning disabilities (LLD), assumed to have primarily left-hemispheric brain dysfunctions, were examined to explore learning disabilities using an SOS paradigm. The pilot study reported here is used as an exemplar of how a self-organizing systems paradigm is conceptualized. Although a more comprehensive study is needed to confirm the data, this exemplar suggests that overflow into areas not typically associated with each disability subtype may occur. Concerns regarding ways of determining discrepancy for diagnostic purposes are noted, and remediation strategies designed for specific disabilities are questioned.

Adolescent↗

A study of the attitudes of a rural Indian community toward people with physical disabilities.

OBJECTIVE: To examine the attitudes of a rural community in southern India toward its disabled members. DESIGN: Prospective cross-sectional study. METHOD: One hundred and twenty randomly selected villagers around the town of Vellore in southern India were invited to take part in the study. The attitudes towards individuals with physical disabilities were examined using a modified version of the Scale of Attitudes Toward Disabled Persons (SADP). The questionnaire was administered in its original English format with simultaneous translation into Tamil. RESULTS: Data were complete in 111 cases, 82% of whom showed a positive attitude toward people with disability. Gender and employment status did not appear to have an influence on whether the respondent regarded disabled people in a positive or negative way but most older individuals expressed prejudice and/or challenged the rights of disabled people to equal opportunities in education, employment and social integration. Further data analysis demonstrated that more subjects with than without a disabled family member supported the rights of disabled individuals to education, employment and social integration. By contrast, the items of SADP which described the personal attributes of disabled people did not discriminate between the two groups. CONCLUSION: The attitudes of the rural community studied toward people with disabilities were unrelated to the sex or educational status of the respondents but was influenced by their age. This suggests that older subjects in rural communities in developing countries should be the main target for educational programmes which promote positive images of disability.

Adolescent↗

Hierarchy levels, sum score, and worsening of disability are related to depressive symptoms in elderly men from three European countries.

OBJECTIVES: The objectives were to investigate the predictive value of hierarchy levels and sum score of disability and change in disability on depressive symptoms. METHOD: Longitudinal data of 723 men age 70 and older from the Finland, Italy, and the Netherlands Elderly Study were collected in 1990 and 1995. Self-reported disability was based on three disability domains (instrumental activities, mobility, and basic activities) and depressive symptoms on the Zung questionnaire. RESULTS: Severity levels of disability were positively associated with depressive symptoms. Men with no disability scored 5 to 17 points lower (p < .01) on depressive symptoms than did those with disability in all domains. Among men with mild disability, those who had worsening of disability status in the preceding 5 years scored 5 points higher (p = .004) on depressive symptoms than did men who improved. DISCUSSION: Hierarchic severity levels, sum score of disability, and preceding changes in disability status are risk factors for depressive symptoms.

Activities of Daily Living↗

The interrelations between disability and quality of life in patients with multiple sclerosis in the area of Bajo Aragon, Spain: a geographically based survey.

Multiple sclerosis (MS) is one of the most disabling diseases in young people, but the interrelation between disability and quality of life is poorly understood. As individual correlations between disability and the perspective of the patient may be weak in individual subjects, the purpose of our work was to analyze and correlate quality of life with neurologic impairment and disability in all patients with MS from the geographic area of the Bajo Aragón in the northeastern region of Spain. A total of 36 patients with a diagnosis of probable or clinically definite MS had an average age was 38.1 years (range,17-66 years). The majority of them were women (66.6%) and had relapsing-remitting forms (83.3%). The Minimal Record of Disability measured neurologic impairments, functional limitations, and handicaps. Quality of life was measured by the Functional Assessment of Multiple Sclerosis (FAMS) scale. Statistical analysis was performed with the Kruskal-Wallis nonparametric test and Pearson's coefficient of correlation. The mean EDSS of our cohort was 2.76 (range, 0-9). The mean FAMS score was 78.6 (SD, 52.5). We found that patients moderately or severely disabled (EDSS >3) showed a significantly decreased satisfaction in comparison with the nondisabled or mildly disabled ones. Disability and handicaps were significantly related to some items of FAMS: mobility, symptoms, and emotional well-being, but not with the remaining items: general contentment, thinking and fatigue, family and social well-being, and additional concerns. In comparison with patients from other population-based surveys, our patients were less disabled and enjoyed a better quality of life. Although we globally observed poorer quality of life in more disabled patients, the perspectives of the patients did not necessarily agree with disability scales in some domains of health. Quality of life should be included in the approach to MS patients if we want to provide cost-effective health care.

Adolescent↗

Magnetic resonance spectroscopy of normal appearing white matter in early relapsing-remitting multiple sclerosis: correlations between disability and spectroscopy.

BACKGROUND: What currently appears to be irreversible axonal loss in normal appearing white matter, measured by proton magnetic resonance spectroscopy is of great interest in the study of Multiple Sclerosis. Our aim is to determine the axonal damage in normal appearing white matter measured by magnetic resonance spectroscopy and to correlate this with the functional disability measured by Multiple Sclerosis Functional Composite scale, Neurological Rating Scale, Ambulation Index scale, and Expanded Disability Scale Score. METHODS: Thirty one patients (9 male and 22 female) with relapsing remitting Multiple Sclerosis and a Kurtzke Expanded Disability Scale Score of 0-5.5 were recruited from four hospitals in Andalusia, Spain and included in the study. Magnetic resonance spectroscopy scans and neurological disability assessments were performed the same day. RESULTS: A statistically significant correlation was found (r = -0.38 p < 0.05) between disability (measured by Expanded Disability Scale Score) and N-Acetyl Aspartate (NAA/Cr ratio) levels in normal appearing white matter in these patients. No correlation was found between the NAA/Cr ratio and disability measured by any of the other disability assessment scales. CONCLUSIONS: There is correlation between disability (measured by Expanded Disability Scale Score) and the NAA/Cr ratio in normal appearing white matter. The lack of correlation between the NAA/Cr ratio and the Multiple Sclerosis Functional Composite score indicates that the Multiple Sclerosis Functional Composite is not able to measure irreversible disability and would be more useful as a marker in stages where axonal damage is not a predominant factor.

Adolescent↗

Psychosocial environment for the integrated education opportunities of the disabled in Lithuania.

BACKGROUND: The policy of the diminution of the social isolation of the disabled is the main objective of the strategy of the EU new policy concerning the disabled. Lithuanian society faces this objective as well. For this reason, this study aiming at providing the theoretical basis for and predicting the possible psycho-social environment in an integrated education system, as well as at the evaluation of the reasons for the formation of a positive approach to the disabled, is especially relevant, since it creates the prerequisites for the optimisation of the process of the integration of disabled schoolchildren into the general system of education. METHOD: The sample of the study consisted of 2471 children from the same schools: not integrated (1958), integrated (126) and special schools (382). Empirical methods: questionnaire poll, comparative analysis. The statistical analysis was carried out using SAS. RESULTS: Our study showed that the majority of schoolchildren without disabilities and disabled schoolchildren have positive intentions for interpersonal interactions (>82%) and positive emotions (>69%) independently of the discrepant character of interpersonal contacts, different conditions of education and family life, and despite of low level of knowledge. CONCLUSION: The results of the study confirmed positive intentions for interpersonal interaction between disabled schoolchildren and schoolchildren without disabilities, as well as a positive character of emotions, and disprove the unsound myth of the opponents of the social integration of the disabled stating that disabled children in comprehensive schools would undoubtedly experience offence from their peers without disabilities.

Adolescent↗

Prediction of chronic disability in work-related musculoskeletal disorders: a prospective, population-based study.

BACKGROUND: Disability associated with work-related musculoskeletal disorders is an increasingly serious societal problem. Although most injured workers return quickly to work, a substantial number do not. The costs of chronic disability to the injured worker, his or her family, employers, and society are enormous. A means of accurate early identification of injured workers at risk for chronic disability could enable these individuals to be targeted for early intervention to promote return to work and normal functioning. The purpose of this study is to develop statistical models that accurately predict chronic work disability from data obtained from administrative databases and worker interviews soon after a work injury. Based on these models, we will develop a brief instrument that could be administered in medical or workers' compensation settings to screen injured workers for chronic disability risk. METHODS: This is a population-based, prospective study. The study population consists of workers who file claims for work-related back injuries or carpal tunnel syndrome (CTS) in Washington State. The Washington State Department of Labor and Industries claims database is reviewed weekly to identify workers with new claims for work-related back injuries and CTS, and these workers are telephoned and invited to participate. Workers who enroll complete a computer-assisted telephone interview at baseline and one year later. The baseline interview assesses sociodemographic, employment-related, biomedical/health care, legal, and psychosocial risk factors. The follow-up interview assesses pain, disability, and work status. The primary outcome is duration of work disability over the year after claim submission, as assessed by administrative data. Secondary outcomes include work disability status at one year, as assessed by both self-report and work disability compensation status (administrative records). A sample size of 1,800 workers with back injuries and 1,200 with CTS will provide adequate statistical power (0.96 for low back and 0.85 for CTS) to predict disability with an alpha of.05 (two-sided) and a hazard ratio of 1.2. Proportional hazards regression models will be constructed to determine the best combination of predictors of work disability duration at one year. Regression models will also be developed for the secondary outcomes.

Activities of Daily Living↗

Changes in life goals of people with neurological disabilities.

OBJECTIVE: To investigate the relationship between changes in life goals and progression of disabilities among subjects with neurological disorders over a period of four years. DESIGN: Retrospective study. SETTING: A centre for continuing disability management in the UK. SUBJECTS: Patients with static or progressive neurological disabilities. INTERVENTIONS: Review of rehabilitation team notes. MAIN OUTCOME MEASURES: Barthel ADL Index and Rivermead Life Goals Questionnaire from four consecutive annual assessments from 1997 to 2000. RESULTS: Thirty-two subjects had progressive disabilities and 24 had static disabilities. In subjects with static disabilities there was no significant change in grades of any of the life goals over a period of four years. Among subjects with progressive disabilities, significant reductions were noted in importance given to partner (p = 0.034), work (p = 0.008) and leisure (p = 0.028) over four years. While there was no significant change in number of life goals considered as extremely important in subjects with static disabilities, there was a significant reduction in number of goals considered as extremely important in subjects with progressive disabilities (p = 0.022) CONCLUSION: People with progressive disabilities tend to downgrade the significance attached to goals related to partner, work and leisure. They also reduce number of goals graded as extremely important. This change is not seen in people with static disability.

Activities of Daily Living↗

Implications for estimates of disability in children: a comparison of definitional components.

OBJECTIVE: To test how prevalence estimates and characteristics of children vary by the way that disability is defined. Specifically, to determine 1) the proportions of children identified as disabled by one particular operationalization of disability based on parental reports of three types of consequences (i.e., functional limitations [FL]), dependence on compensatory mechanisms (CD), and service use or need beyond routine [SU/N]), and 2) whether children identified as disabled by these three types of consequences differ by type of disorder or condition, age, socioeconomic status, or race. METHOD: We analyzed a national dataset representing a random sample of 712 households with 1388 children. The Questionnaire for Identifying Children with Chronic Conditions (QuICCC) was used to identify children with disabling conditions. We divided the QuICCC items into three discrete sets, reflecting three definitional components of disability, and compared the proportions and characteristics of children fitting these components separately and in combination. RESULTS: Using the QuICCC definition of disability, SU/N identified the largest proportion of children (72%), followed by CD (55%) and FLs (49%). Forty-four percent of children were identified by only one component, 36% by two components in any combination, and 20% by all three components. The type of disorder or condition generally did not vary by the three definitional components, although the FL component may be more effective at identifying children with sensory impairments. Children identified by two or more components were more likely to have multiple conditions and had more pervasive disorders than those identified by only one component. The youngest children (0 to 3 years old) may be less likely to be identified as disabled than children of other ages, especially by FLs. FLs also were more likely to identify children from the poorest and least educated families. CONCLUSIONS: Although the specific findings reported here pertain to a single definitional approach (the QuICCC), the data highlight that who will be classified as disabled (and who will not) may be dependent on how disability is defined. The implications of using different definitions and definitional components on both the prevalence and the characteristics of children with disabilities need to be considered before data can be applied responsibly and appropriately.

Adolescent↗

[Life expectancy with functional disability in elderly persons in São Paulo, Brazil].

OBJECTIVE: For persons 60 years of age or older living in the city of São Paulo, Brazil, in the year 2000 to estimate four characteristics: (1) life expectancy free of functional disability, (2) life expectancy with functional disability, (3) life expectancy with functional disability but without dependence, and (4) life expectancy with functional disability and dependence. METHODS: The estimates of the four characteristics were calculated by means of a life table constructed based on the method proposed by Sullivan. The basic data used for the calculations were the elderly population estimated for the city of São Paulo as of mid-2000, obtained from the demographic censuses of 1991 and 2000, and deaths in the elderly population, obtained from the State Data Analysis System Foundation (Fundação Sistema Estadual de Análise de Dados, or SEADE) of the state of São Paulo. The prevalences of functional disability and of functional dependence were calculated based on data concerning activities of daily living collected in the city of São Paulo as part of a project called Health, Well-being, and Aging in Latin America and the Caribbean (the "SABE project"). The activities of daily living considered were: dressing, eating, bathing, using the bathroom, lying down on the bed and getting up from it, and walking across a room. Functional disability was defined as difficulty in performing one or more of the activities of daily living. Dependence was defined as the need for help in performing at least one of the activities of daily living. RESULTS: In 2000, 60-year-old men from the city of São Paulo could expect to live, on average, 17.6 years, of which 14.6 years (83%) would be free of functional disability. Women of the same age could expect to live 22.2 years, of which 16.4 years (74%) would be free of functional disability. Men would have a functional disability and be dependent on others for 1.6 years (9%), while the comparable period for women would be 2.5 years (11%). CONCLUSIONS: Despite their longer life expectancy, the women faced more years with functional disability. The number of years with functional disability and dependence was also higher for the women. Public policies should take into account the differing needs of elderly women and of elderly men as well as other specific characteristics of this older population.

Activities of Daily Living↗

Work disability among individuals with diabetes.

OBJECTIVE: Diabetes is rapidly increasing in prevalence among working-age adults, but little is known about the clinical characteristics that predict work disability in this population. This study assessed clinical predictors of work disability among working-age individuals with diabetes. RESEARCH DESIGN AND METHODS: In a cohort of diabetic individuals (n = 1,642) enrolled in a large health maintenance organization, excluding homemakers and retirees, we assessed the relation of diabetes severity, chronic disease comorbidity, depressive illness, and behavioral risk factors with work disability. Three indicators of work disability were assessed: being unable to work or otherwise being unemployed; missing > or =5 days from work in the prior month; and having severe difficulty with work tasks. RESULTS: In the study population, 19% had significant work disability: 12% were unemployed, 7% of employed subjects had missed > or =5 days from work in the prior month, and 4% of employed subjects reported having had severe difficulty with work tasks. Depressive illness, chronic disease comorbidity, and diabetes symptoms were associated with all three types of work disability. Diabetes complications predicted unemployment and overall work disability status, whereas obesity and sedentary lifestyle did not predict work disability. Among subjects experiencing both major depression and three or more diabetes complications, >50% were unemployed; of those with significant work disability, half met the criteria for major or minor depression. CONCLUSIONS: Depressive illness was strongly associated with unemployment and problems with work performance. Disease severity indicators, including complications and chronic disease comorbidity, were associated with unemployment and overall work disability status. Effective management of work disability among diabetic patients may need to address both physical and psychological impairments.

Comorbidity↗

The relationship between visual-perceptual motor abilities and clumsiness in children with and without learning disabilities.

One visual-perceptual test, four visual-motor tests, and a test of motor impairment were administered to 22 children with learning disabilities and 22 children without learning disabilities, aged 5 to 8 years. The children with learning disabilities were divided into two groups--"clumsy" and "nonclumsy"--based on their scores on the motor impairment test. It was hypothesized that the clumsy children with learning disabilities would score significantly lower on visual-perceptual and visual-motor tests than the nonclumsy children with learning disabilities who, in turn, would score significantly lower than the children without learning disabilities. It was further hypothesized that there would be a significant correlation between the degree of clumsiness and the degree of visual-perceptual and visual-motor deficit. Analysis of the data indicated that, as expected, the clumsy children with learning disabilities scored significantly lower than the children without learning disabilities (the control group). There was no significant difference between the clumsy and nonclumsy children with learning disabilities or between the nonclumsy children with learning disabilities and the control group. Degree of clumsiness significantly correlated with scores on four of five tests. Results are discussed in terms of subtypes of learning disabilities and sample size.

Analysis of Variance↗

Can the social model explain all of disability experience? Perspectives of persons with chronic fatigue syndrome.

OBJECTIVE: The social model of disability has had a major influence on the academic field of disability studies and on contemporary understandings of the causes and experience of disability. The purpose of this study was to examine the adequacy of the social model for explaining the disability experience of persons with chronic fatigue syndrome (CFS). METHODS: This qualitative study examined the experiences of 47 adults with CFS participating in a research project that aimed to evaluate a participant-designed rehabilitation program. Data were aggregated from focus group interviews, open-ended questionnaires, progress notes, and from a program evaluation questionnaire. Data analysis was based on a grounded theory approach and used triangulation of multiple data sources and member checks to assure dependability of findings. RESULTS: Four themes emerged from the analysis: (1) minimization and mistrust of the disability; (2) negative experiences of impairment; (3) lack of identification with the disability community; and (4) the focus on advocacy as a quest for legitimacy. These themes varied in the extent to which they conformed to the principles set forth by the social model. CONCLUSIONS: Although the social model has important contributions to lend to occupational therapy practice, it is important to recognize that it may not capture the full reality of disability. In particular, the social model has serious limitations in describing the disability experience of individuals with disabilities who do not have visibly obvious disabilities and whose impairments do not conform to the traditional viewpoint of disability.

Adult↗

The disabled elderly living in the community: care received from family and formal services.

OBJECTIVES: Based on a community sample, to assess the reasons disabled elderly people need care, the type of formal services they receive, the characteristics of their carers and the degree of psychological morbidity in these carers. DESIGN AND SETTING: A community survey of people aged 70 or more years living in Canberra or Queanbeyan. Survey participants were asked to nominate informants, who were interviewed about the subjects' state of health. The informants provided information on need for care, services received and the role of carers. Informants also reported on their own health, including symptoms of anxiety and depression. RESULTS: Elderly people needed care because of physical disability more often than behavioural disability. Those with physical disability received more formal services and more help from health professionals than those with behavioural disability. Contact with general practitioners was high for both disabled and non-disabled subjects. Carers of the physically disabled had raised levels of anxiety and symptoms of depression, and poorer self-rated health, but carers of the behaviourally disabled did not. Wives, daughters and husbands made up the biggest categories of carers and around two-thirds of carers were women. CONCLUSION: Family carers play an important role in maintaining disabled elderly people in the community and this role is often stressful. Formal services have to be aimed as much at the needs of the carers as at the disabled people themselves.

Activities of Daily Living↗

Collecting information on disability in the 2000 Census: an example of interagency cooperation.

The United States Constitution requires that an enumeration (or census) of the population be conducted every 10 years to apportion seats in the House of Representatives. Census information is also used to allocate funds and to plan and manage programs. Census 2000 occurs on April 1, 2000, when one-sixth of all American households will be mailed the "long form," containing disability, demographic, economic, and housing questions. Although no short set of commonly accepted questions on disability existed, one was developed for Census 2000 by a collaborative, federal interagency work group on disability, convened by the Office of Management and Budget. The work group consisted of staff from the Social Security Administration (SSA), the Department of Health and Human Services, the U.S. Census Bureau, and other agencies. They reviewed questions initially proposed by the Census Bureau, developed an alternative proposal, tested both versions in the Census Bureau's cognitive questionnaire lab, and on the basis of testing, derived a consensus version for Census 2000. In many ways, the six questions now contained on Census 2000 are an improvement over previous efforts. Disability is ascertained for children as well as for adults, and information will be collected separately for several domains of disability (for example, sensory, mental, physical). The need for a brief set of disability measures goes beyond Census 2000. If such data were collected regularly on national surveys, critical policy and program concerns across agencies could be addressed because better information could be gathered on changes in disability prevalence and on the characteristics of persons with disabilities. Other similar efforts include the former Disability Evaluation Study, now known as the National Study of Health and Activity--a national sample survey on working-age disability to be conducted by SSA--and the President's Task Force on the Employment of Adults with Disabilities (Executive Order 13078).

Activities of Daily Living↗

[A multicenter cross-sectional study on the Health Related Quality of Life of patients with rheumatoid arthritis using a revised Japanese version of the Arthritis Impact Measurement Scales Version 2 (AIMS 2), focusing on physical disability and its associative factors].

OBJECTIVE: A multicenter cross-sectional survey was conducted to study the current status of Health Related Quality of Life (HRQL) of Japanese patients with rheumatoid arthritis using a revised Japanese version of the AIMS 2, to investigate the association among the self-report physical disability scores and demographic, socioeconomic, and clinical variables in these patients. METHODS: A Japanese version of the AIMS 2 was administered to the randomly chosen 1614 patients with classical and definite rheumatoid arthritis attending arthritis clinics at eleven hospitals across the country. Self-report functional disability scores (FDSs) were calculated, by which patients were classified into five groups with graded levels of disability. Univariate correlations were examined between FDSs and the scores of the other four components of AIMS-HRQL, disease duration, age, medical costs, and physical and laboratory measures. Analysis of variance was performed to test for among level differences of these variables in each group of patients. Mean values and standard deviations of FDSs were calculated and analysis of variance was used to test for among level differences of the following factors: demographic, socio-economic, clinical measures, and treatment status. RESULTS: Among four scales composing the AIMS 2-HRQL, work disability scores were most strongly correlated with FDSs, followed by the scores of pain, affection and social interaction. The more severely disabled group proved to have weaker grip strength, higher joint count, longer disease duration, higher ESR and blood level of CRP, and lower level of Hb. Patients with more disabilities proved to be older, pay more medical costs, have longer duration of morning stiffness, and higher level of RF. Patients with more advanced Steinbrocker's functional class, doctor's global assessment, Steinbrocker's anatomical stage, higher daily dose of prednisolone intake, lower level of annual income and formal education, and patients taking more kinds of NSAIDs proved to be more severely disabled. Separate, single (never married, widowed), and divorced patients proved to be more severely disabled compared with married ones. Overall, females were more disabled than males. CONCLUSION: Physical disability is associated with the other important aspects of QOL, clinical signs and symptoms, and socio-economic conditions in RA patients. Prevention and management of physical disability should be seriously planned in consideration of the changes in these conditions in RA patients.

Arthritis, Rheumatoid↗

Impairment and disability rating in low back pain.

LBP is one of the two most common forms of disability in Western society (mental illness is the other), and remains a thorny problem in the arena of disability evaluation. Disability evaluation after LBP differs whether the pain is work-related or not. If work-related, guidelines for disability evaluation differ by jurisdiction and type of employment (e.g., private vs. federal employee). When outside of the workplace, thresholds for disability differ between entitlement programs (Social Security Disability) and private insurance programs (long-term disability insurance). In the patient without obvious findings, the disability evaluating physician needs to be caring and compassionate and yet maintain an objective stance with the understanding that there may be significant psychosocial overlay in patients with nonobjective pain complaints. Although some would argue that objective independent medical evaluation is an oxymoron, psychiatrists have excellent training and perspective with which to do so. The patient suffering from catastrophic brain injury or spinal cord injury offers a useful contrast--on the most severe end of the disability spectrum--to the patient with persisting low back complaints but normal physical examination. As a society, we have to wisely manage the funds that comprise our social "safety net" in order to provide for persons with severe disability who cannot provide for themselves. It would then follow that patients with minor impairments/disabilities should receive minor (i.e., noninflated) ratings. Psychiatrists need to enable rather than disable their patients.

Adult↗

Disability, poverty and development.

Disability is both a cause and consequence of poverty. Eliminating world poverty is unlikely to be achieved unless the rights and needs of people with disabilities are taken into account. According to the United Nations, one person in 20 has a disability. More than three out of four of these live in a developing country. More often than not they are among the poorest of the poor. Recent World Bank estimates suggest they may account for as many as one in five of the world's poorest. Disability limits access to education and employment, and leads to economic and social exclusion. Poor people with disabilities are caught in a vicious cycle of poverty and disability, each being both a cause and a consequence of the other. A large proportion of disability is preventable. Achieving the international development targets for economic, social and human development will undoubtedly reduce the levels of disability in many poor countries. However, general improvements in living conditions will not be enough. Specific steps are still required, not only for prevention, but also to ensure that people with disabilities are able to participate fully in the development process, obtain a fair share of the benefits, and claim their rights as full and equal members of society. An integrated approach is required, linking prevention and rehabilitation with empowerment strategies and changes in attitudes. This paper assesses the significance of disability as a key development issue, and its importance in relation to poverty, human rights, and the achievement of internationally agreed development targets. It also sets out ways in which development co-operation, including DFID's own work, can help incorporate the rights and needs of people with disabilities into the mainstream of poverty reduction work and the achievement of human rights.

Altruism↗