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Abstract: Developmental disabilities are a heterogeneous group of chronic conditions that may result in substantial activity limitations. The type and number of limitations may vary by impairment characteristics. Economic and social constraints may impact activity limitations beyond those attributable to their impairment. Using the International Classification of Functioning (ICF), Disability, and Health conceptual framework, this study tests the hypothesis that activity limitations in young adulthood are not inevitable consequences of childhood impairment. The Metropolitan Atlanta Developmental Disabilities Follow-up Study of Young Adults, a cohort of young adults ages 21–25, is used to examine the relationship between childhood impairment and activity limitations in young adulthood. For young adults with isolated impairment, activity limitations are not probable outcomes. This situation is not the case for those with severe intellectual disability and/or multiple impairments. The type and extent of activity limitations vary by impairment characteristics. With the goal of improving and preventing activity limitations in young adults with various types and severities of childhood impairment, additional research is needed to further identify areas for secondary and tertiary prevention of the consequences of childhood impairment. The conceptual framework of the ICF provides a useful tool for testing hypotheses to pinpoint areas of intervention. [Copyright &y& Elsevier]

Objectives. We sought to identify the income-disability prevalence relationship among older Brazilians. Methods. Data were from 63985 individuals 60 years and older from the 1998 and 2003 Brazilian National Household Surveys. Generalized additive logistic models with cubic regression splines were used to estimate the disability-income relationships. Results. There was a strong linear relationship between increased income and reduced disability prevalence for most of the income distribution. Benefits were still present above the 90th percentile of income but were more modest. Because incomes among the wealthiest few are disproportionately large, odds ratios of disability nevertheless showed marked improvements, even across the very highest income groups. Conclusions. Among older Brazilians, reduced disability is associated with higher income, and these associations are present even above the 90th percentile of income. In addition to understanding mechanisms of disability reduction among impoverished individuals, work is needed to understand these mechanisms in middle-and high-income groups. (Am J Public Health. 2009;99:81-86. doi:10.2105/AJPH.2007.130708) [ABSTRACT FROM AUTHOR]

The aim of this research was to examine levels of happiness among persons with and without physical disability, and to study prediction of happiness from satisfaction with various life aspects. A group of persons with physical disability ( N = 397) and the control group of persons from the general population ( N = 913) filled in the Fordyce instrument ( Social Indicators Research, 20:355–381, ) to evaluate levels of happiness and the “International Well-being Index” to measure satisfaction with particular life aspects. Both groups expressed positive happiness level and satisfaction with the majority of life aspects. However, happiness level of persons with disability was significantly lower. Forty-eight percent of the variance in happiness among persons with disability and 30% of the variance in happiness among the control group can be assigned to various life satisfaction aspects. Satisfaction with health, relationships, and achievements contribute to happiness in both groups, while satisfaction with physical safety and acceptance by the community are significant happiness predictors only for persons with disability. Economic status is the only significant predictor for the control group. [ABSTRACT FROM AUTHOR]

This paper focuses on the application of the participatory research approach in non-Western contexts. The aim is to provide critical insights into the participatory research discourse through an examination of its theory and practice based on our own experiences of using this approach in our doctoral research in five Central Asian countries and Zambia. Firstly, we summarise the published literature on the approach in both disability and development studies which are our academic disciplines. Secondly, we critically analyse some of the challenges we came across in applying participatory research in our doctoral studies in practice. By this we wish to contribute to making this approach more viable and to increase research participation by disabled persons in non-Western contexts. Finally, based on our own experiences we give some suggestions for the use of the participatory research approach in non-Western contexts. [ABSTRACT FROM AUTHOR]

A small sample of 20 hearing students and 20 students who are deaf and hard-of-hearing participated in this study, which compared their performances on two measures of metacognition. The first measure required participants to visually analyse real-life pictures and then to choose a response from four options (voiced or signed) indicating which was the best explanation of what was depicted. The second measure required participants to look at five pictures and then to point to the picture that was different. Results identified no significant differences between the performances of the two groups of students on either measure. Males in both groups performed at comparable levels on the two measures, whereas females who were hearing and those who were deaf or hard-of-hearing performed significantly better on the visual-voiced measure than on the visual-visual measure. Limitations of this study and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

Disabilities impact individuals across all demographic groups, resulting in multiculturalism within the culture of disability. Several years ago researchers within the area of disabilities studies noted a tendency to overlook the cultural heterogeneity within their samples of individuals with disabilities and called for greater awareness. It is unclear to what degree research psychologists as well as other disciplines have heeded the call to adopt a cultural lens when studying populations with disabilities. A methodological and content review of sexuality and disability studies was conducted to evaluate how researchers are conceptualizing and presenting cultural data. Recent articles in four leading disability journals from 2002 to 2006 were reviewed, yielding 54 studies and over 11,000 participants. The content analysis found tremendous inconsistency in the collection style and reporting of cultural information (e.g. gender, race, ethnicity, socio-economic status, sexual orientation). Results indicate ethnic minorities may continue to be under-recruited and understudied in the disability and sexuality literature. [ABSTRACT FROM AUTHOR]

This article explores the changing expectations, practices and policies supporting Social Capital for people with disabilities living in the community. It introduces relevant developments in how communityworks, inc. operates in two arenas to support community membership. First, in the arena of people who buy services from the agency, philosophical principles that support community membership are delineated, including a personal story that illuminates these principles. Second, in the arena of people paid to work through the agency, a discussion of standards developed by staff that give them ownership in the process and create consistency in developing Social Capital across the agency. In conclusion, the article addresses ongoing challenges we face as an agency that is always pushing the edge to further enhance Social Capital. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of the study was to explore the background biopsychosocial status of teachers with a relative voice handicap. The study also intended to investigate this biopsychosocial status in relation to behavior of not always reporting voice complaints. Methods: This research was a cross-sectional survey, performed using questionnaires: a general voice questionnaire, the Voice Handicap Index (VHI), and the Symptom Checklist-90 (SCL-90). The focus of the study is on those teachers who score the highest and the lowest on the SCL-90 as they report a higher or lower level of overall physical and psychosocial dysfunction. Fifty-five teachers score in the lowest quartile and 51 teachers score in the highest quartile of the total score of the SCL-90 (N=106 teachers). The upper quartiles of SCL-90 scores are mentioned as “high scores” and the lower quartile scores are mentioned as “low scores”. VHI scores above the 75th percentile are referred to as “high voice handicap” and VHI scores below the 25th percentile are referred to as “low voice handicap”. Results: Subjects who had a high voice handicap have a greater relative risk for a high score on all the subscales (ORs between 2.1 and 20.2) and total score (OR=12.5) of the SCL-90. Teachers who had a high voice handicap and who did not report voice complaints have a greater relative risk for a high score for all the subscales (ORs between 1.8 and 24.5) and total score (OR=22.4) of the SCL-90. Conclusion: The voice handicap and the behaviour of nonreporting of voice complaints when having a voice handicap appear to be in relation to the biopsychosocial status of the teachers. [Copyright &y& Elsevier]

Background: Substantial differences between disability and impairment are commonplace and puzzling. Subjective (psychosocial) factors may be paramount given that pain is a more important determinant of perceived overall arm-specific disability than is objective elbow impairment. To further evaluate the relationship between impairment and disability, we tested the hypothesis that objective loss of elbow motion predicts perceived elbow-related task-specific disability better than does pain after elbow trauma. Methods: One hundred and fifty-eight patients were evaluated at a median of twenty-six months after a traumatic elbow injury and completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Predictors of the total DASH score and of the scores for individual DASH items that were expected to be related to elbow function were evaluated with univariate and multivariate analyses. Results: Motion accounted for 35% of the variability in the total DASH score, for 11% to 12% of the variability in the responses to questions specific to hand-based activities, and for 24% to 33% of the variability in the scores for tasks depending on elbow motion. Pain accounted for 41% of the variability in the total DASH score and was a better predictor than motion of disability associated with three tasks: opening a tightjar (with pain and motion accounting for 24% and 11% of the variability, respectively), pushing open a door (25% and 12%, respectively), and placing an object overhead (28% and 25%, respectively). None of the multivariate models explained more than 53% of the variability in the DASH scores. Conclusions: Objective physical elbow impairment correlated with self-reported disability with respect to specific tasks, but a large proportion of disability remains unexplained. Further research is needed to better understand the differences between objective impairment and perceived disability. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the experiences that teenagers with physical disabilities have of their participation at school. Fourteen students from several locations in Norway aged between 13 and 18 years took part. Data were collected through focus-group interviews and individual interviews. The analysis revealed three main themes: Just like the others—but not quite; Participation in terms of being where things actually happen and; Participation as student-teacher cooperation. A major finding was the importance the students put on being where things actually happen, this being regarded as being even more important than doing the same activities as the other students. Opportunities to increase cooperation by holding short meetings with teachers on how to solve both practical and learning problems promoted participation. The need to include the individual's experience in the concept of participation is discussed. [ABSTRACT FROM AUTHOR]

Accessible mobile phones for people with physical disabilities is an area that is still developing with new products and services emerging to assist these people to access the telecommunications equipment that is currently available. This research evaluated the effectiveness a prototype interface system for a mobile phone and accompanying speech generating device that enabled the user to independently initiate, answer, conduct and terminate voice calls and send text messages through the use of their communication device. Separate trials were conducted with two teenage participants with a physical disability who cannot speak and require a communication device to communicate. After their respective trials, both participants recorded very high overall performance and satisfaction outcomes. This paper highlights that involving the end-user in customization of the interface system during the trial had resulted in a very successful outcome. The trials demonstrated that people with severe mobility and speech impairments are able to effectively use a mobile phone in its many modes of operation. The trials affirmed that the system has given the participants a sense of independence, safety and security, and also contributed to improving their communication skills, leading to the self confidence to engage in conversation and social activities. [ABSTRACT FROM AUTHOR]

Outcomes from a developmental instructional training course for youths with congenital physical disability have been investigated for the purpose of clarifying whether or not the participants' personal competencies in terms of living an independent life were developed and whether or not these competencies were maintained after termination of the project. In the course of the intervention, there was focus on user involvement and each participant defined his own occupational performance problems, articulated specific goals for the intervention and evaluated the results by means of the Canadian Occupational Performance Measure (COPM). Eight young adults participated in the course from 16-26 months with a follow-up evaluation 10-20 months later. Changes in COPM scores on performance and satisfaction indicate that the participants developed personal competencies and that it was possible to maintain some of these competencies after completion of the course. [ABSTRACT FROM AUTHOR]

This commentary reviews selected biomedical and clinical research examining the relationship between physical exercise and cognitive function especially in youth with disability. Youth with physical disability may not benefit from the effects of exercise on cardiovascular fitness and brain health since they are less active than their non-disabled peers. In animal models, physical activity enhances memory and learning, promotes neurogenesis and protects the nervous system from injury and neurodegenerative disease. Neurotrophins, endogenous proteins that support brain plasticity likely mediate the beneficial effects of exercise on the brain. In clinical studies, exercise increases brain volume in areas implicated in executive processing, improves cognition in children with cerebral palsy and enhances phonemic skill in school children with reading difficulty. Studies examining the intensity of exercise required to optimize neurotrophins suggest that moderation is important. Sustained increases in neurotrophin levels occur with prolonged low intensity exercise, while higher intensity exercise, in a rat model of brain injury, elevates the stress hormone, corticosterone. Clearly, moderate physical activity is important for youth whose brains are highly plastic and perhaps even more critical for young people with physical disability. [ABSTRACT FROM AUTHOR]

When clients deliberately injure themselves their relationships with staff can be put uncier strain. Rebecca Fish and Helen Duperouzel describe research that involved gathering clients' views of such relationships, and of attitudes and interventions perceived as helpful and unhelpful. [ABSTRACT FROM AUTHOR]

This article presents a research review on the psychological and social aspects related with the sexuality of persons with spinal cord injury. The relevance that the impact of injury has on people and its environment, in general, and on sexuality sphere in particular, becomes an area of great scientific and social interest. This is explained by the constant growth in the prevalence and in the radical bio-psycho-social changes that the spinal cord injury involves. So, people must cope in their sexual life with changes as much in the physical as in the emotional areas as well as in social relationships. With this purpose, the available bibliography is revised trying to focus in i) the size of publications where the topic appears in, ii) the thematic areas object of study, iii) the publications methodology, to reach finally iv) the conclusions of our review. [ABSTRACT FROM AUTHOR]

The degree of acceptance of dog guides at public facilities, which is required by law in Japan, was investigated, and evidence of rejection was found. Japanese people with visual impairments who used dog guides reported higher daily stress levels than did those who did not use dog guides. [ABSTRACT FROM AUTHOR]

Background The idea that raising a child with disabilities has a negative impact on the parents’ relationship is still widely accepted despite contradictory research findings. This article addresses the impact of raising a child with disabilities on family structure in the present Norwegian context. Method Family demographics were collected at two stages during the childhood of children with physical, intellectual or multiple disabilities born 1993–1995 (1999, n = 603 and 2003, n = 489). These figures were compared with the corresponding data for all children (Statistics Norway, Children Statistics). Results The family structures of children with disabilities were fairly similar to those of the typical family. Slightly fewer children with disabilities had siblings and a higher proportion of the parents of children with disabilities were married or cohabiting. The type or degree of impairment was not found to have any impact on family structure. Conclusions The results suggest that family structure in families raising a child with a disability is similar to other families. Whether this should only be seen as positive is discussed, as is whether the disability may produce a stronger feeling of obligation to stay together. [ABSTRACT FROM AUTHOR]

The study was planned to investigate the effect of a sensory integration therapy program on sensory problems of children with autism. This study was conducted at the Trakya University Training and Research Center for Mentally and Physically Handicapped Children in Turkey. The children were separated into two groups, each comprising 15 children between 7 and 11 years of age with autism, according to DSM-IV criteria. The children in each group were assessed initially on a checklist, Sensory Evaluation Form for Children with Autism, developed to evaluate sensory characteristics of children with autism, and at the end of the study, participants were assessed again on the checklist. Statistically significant differences between groups indicated that the sensory integration therapy program positively affected treated children. [ABSTRACT FROM AUTHOR]

Background: Surgery for spinal stenosis is widely performed, but its effectiveness as compared with nonsurgical treatment has not been shown in controlled trials. Methods: Surgical candidates with a history of at least 12 weeks of symptoms and spinal stenosis without spondylolisthesis (as confirmed on imaging) were enrolled in either a randomized cohort or an observational cohort at 13 U.S. spine clinics. Treatment was decompressive surgery or usual nonsurgical care. The primary outcomes were measures of bodily pain and physical function on the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 6 weeks, 3 months, 6 months, and 1 and 2 years. Results: A total of 289 patients were enrolled in the randomized cohort, and 365 patients were enrolled in the observational cohort. At 2 years, 67% of patients who were randomly assigned to surgery had undergone surgery, whereas 43% of those who were randomly assigned to receive nonsurgical care had also undergone surgery. Despite the high level of nonadherence, the intention-to-treat analysis of the randomized cohort showed a significant treatment effect favoring surgery on the SF-36 scale for bodily pain, with a mean difference in change from baseline of 7.8 (95% confidence interval, 1.5 to 14.1); however, there was no significant difference in scores on physical function or on the Oswestry Disability Index. The as-treated analysis, which combined both cohorts and was adjusted for potential confounders, showed a significant advantage for surgery by 3 months for all primary outcomes; these changes remained significant at 2 years. Conclusions: In the combined as-treated analysis, patients who underwent surgery showed significantly more improvement in all primary outcomes than did patients who were treated nonsurgically. [ABSTRACT FROM AUTHOR]

We reviewed intervention studies on teaching augmentative and alternative communication (AAC) to deaf–blind individuals. Studies meeting pre-determined inclusion-exclusion criteria were identified through electronic databases and hand searching and were summarized in terms of: (a) participants, (b) AAC mode, (c) target skills, (d) intervention procedures, and (e) main findings. Certainty of evidence was assessed through critical appraisal of each study’s design and methodological rigor. Seventeen studies, comprising 103 participants, were identified. Most participants had combinations of developmental, physical, and sensory impairments. A range of AAC modes were taught, including textures, tangible objects, and line-drawn symbols. Basic requesting skills were the most common intervention targets and these were most often taught using well-established behavioral procedures (e.g., prompting, differential reinforcement). Positive outcomes were reported for 90% of participants, but the evidence for 11 of the 17 studies was inconclusive because of methodological weaknesses. Implications for clinical practice and future research are discussed. [ABSTRACT FROM AUTHOR]

Abstract People with intellectual disabilities have few opportunities to actively participate in research affecting programs and policies. Employment of participatory action research has been recommended. Although use of this approach with people who have intellectual disabilities is growing, articles on specific participatory research methods are rare. Photovoice is a participatory method often used with underrepresented groups and is effective for engaging people with intellectual disabilities in research or program development. A literature review is presented for use with this population as is a description of Photovoice as a participatory research tool for engaging people with intellectual disabilities. An example of a participatory study among people with intellectual disabilities is provided. Benefits and challenges of employing Photovoice with this population are discussed. [ABSTRACT FROM AUTHOR]

This study identified challenges and available supports for conducting research and engaging in outreach and dissemination activities with people with disabilities from diverse ethnic backgrounds. Seventy nine researchers funded by the National Institute of Disability and Rehabilitation Research (NIDRR) participated in the study. The results indicated that most of the respondents (72%) conduct research with people with disabilities from diverse backgrounds and that the most significant challenges for conducting research were finding research protocols, surveys and questionnaires developed or adapted for minorities with disabilities and recruiting research team members who are ethnic minorities or ethnic minorities with disabilities. The findings have implications for practices related to the hiring and training of research team members and for building national networks, where researchers can share their experiences and strategies for outreach and dissemination efforts with populations from diverse ethnic backgrounds. [ABSTRACT FROM AUTHOR]

We experimentally examined fairness perceptions of accommodating people with disabilities by manipulating the granting of an accommodation, reward structure, and the best performer on a word search task. Data from 134 undergraduate students indicated that granting an accommodation was seen as less fair than not granting it, that having a person with a disability excel in performance was seen as less fair than when the person did not excel, and that fairness perceptions were lowest when the person with a disability received an accommodation and excelled in performance. Although the intent of the Americans with Disabilities Act (ADA) is to level the playing field for people with disabilities, our results show that when an accommodation helps the requester, others think it is unfair. [ABSTRACT FROM AUTHOR]

Diagnosed as having celiac disease during my final year of undergraduate studies at McGill University, in the spring of 2005, my identity and lifestyle have undergone a transformative process. In this article I examine my experience of having celiac disease post-diagnosis, using the social model of disability framework. I examine the barriers that persons having celiac disease experience, both generally and personally. At the general level I explore the parallels between the experience of having celiac disease and the experience of being disabled: culturally, environmentally and financially. At the personal level I recount the emotional experience of being disabled. [ABSTRACT FROM AUTHOR]

Disability research is conducted within a highly politicised 'hotbed' of competing paradigms and principles. New researchers, who want to work within the social model, are soon faced with complex and challenging methodological and philosophical dilemmas. The social model advocates research agendas that are focused on the emancipation and empowerment of disabled people but, in reality, these are rarely achieved. To be successful researchers need to engage with innovative and creative methodologies and to share their experiences of these within environments that welcome challenge and debate. This paper focuses on Lifeworld and assesses its value as a tool for emancipatory research. Using examples from a study with parents, whose children were in the process of being labelled as having autism, the paper illustrates how the principles that 'underpin' the methodology offered a supportive framework for a novice researcher. [ABSTRACT FROM AUTHOR]

Background Little is known about the mortality of individuals with Down syndrome who have lived at home with their families throughout their lives. The current study evaluates the predictors, causes and patterns of mortality among co-residing individuals in midlife with Down syndrome as compared with co-residing individuals with ID owing to other causes. Method This paper examines mortality in 169 individuals with and 292 individuals without Down syndrome from 1988 to 2007. Dates and causes of death were obtained from maternal report, the Social Security Death Index and the National Death Index. Risk factors predicting mortality, including demographic variables, transition variables, and initial and change measures of health, functional abilities and behaviour problems, were obtained from maternal report. Results Having Down syndrome is a risk factor of mortality, net of other risk factors including older age, poorer functional abilities, worsening behaviour problems, residential relocation and parental death. The causes of death among individuals with and without Down syndrome who are in midlife and co-residing with their families are similar, and are most commonly due to cardiovascular or respiratory problems. Conclusions The findings indicate that midlife adults with Down syndrome who co-reside with their families generally exhibit similar causes of mortality as do midlife adults with intellectual disability owing to other causes, but show an elevated risk of mortality in midlife net of other variables, such as age and changes in functional abilities and behaviour problems. [ABSTRACT FROM AUTHOR]

In the last few years, experimental data have been reported on differences in implicit memory processes of genetically distinct groups of individuals with Intellectual Disability (ID). These evidences are relevant for the more general debate on supposed asynchrony of cognitive maturation in children with abnormal brain development. This study, comparing implicit memory processes in individuals with Williams syndrome (WS) and Down syndrome (DS), was planned to verify the ‘etiological specificity' hypotheses pertaining to the skill learning abilities of individuals with ID. A modified version of Nissen and Bullemer's (1987) Serial Reaction Time (SRT) task was used. The performances of three group were evaluated. The first group consisted of thirty-two people with WS (18 males and 14 females). The second group was comprised of twenty-six individuals with DS (14 males and 12 females). The two groups of individuals with ID were selected so that the groups were comparable as for mental age and chronological age. The third group consisted of forty-nine typically developed children with a mental age similar to that of the groups with WS and DS. The two groups of individuals with ID demonstrated different patterns of procedural learning. WS individuals revealed poor implicit learning of the temporal sequence of events characterizing the ordered blocks in the SRT task. Indeed, differently from normal controls, WS participants showed no reaction time (RT) speeding through ordered blocks. Most importantly, the rebound effect, which so dramatically affected normal children's RTs passing from the last ordered to the last block, had only a marginal influence on WS children's RTs. Differently from the WS group, the rate of procedural learning of the participants with DS was comparable to that of their controls. Indeed, DS and typically developed individuals showed parallel RT variations in the series of ordered blocks and, more importantly, passing from the last ordered to [ABSTRACT FROM AUTHOR]

Background This preliminary study served as a pilot for an ongoing analysis of spectral power in adults with Down syndrome (DS) using a 151 channel whole head magnetoencephalography (MEG). The present study is the first step for examining and comparing cortical responses during spontaneous and task related activity in DS. Method Cortical responses were recorded with a 151 channel whole head MEG system in three adults with DS and three age-matched adults without DS. MEG data were obtained at rest with eyes open and during observation of point-light displays of human motion and object motion. Data from both groups were evaluated by spectral analysis. Results The preliminary results showed greater alpha (8–14 Hz) power particularly in the occipital and parietal areas during the eyes open condition in the adults with DS in relation to a normal comparison group. The visual task had little effect on alpha power in the comparison group. Engaging in the visual task reduced power in alpha across all regions in the DS group to the level observed in comparisons. In the gamma band (30–50 Hz), power values were similar across both groups for the eyes open condition. In the comparison group, large reductions in gamma were observed in the occipital and bilateral temporal areas during the visual task. This change was not observed in the DS group. Conclusions The results from this pilot study suggest that MEG may be useful in characterizing task-specific changes in cortical activity in individuals with DS. Future studies with a larger group of individuals will further contribute to our understanding of the neurophysiology of Down syndrome. [ABSTRACT FROM AUTHOR]

Persons with Down syndrome are frequently described as ‘clumsy’. The recent progress in the development of quantitative approaches to motor synergies has allowed researchers to move towards an understanding of ‘clumsiness’ at the level of underlying control mechanisms. This progress has also offered an opportunity to quantify changes in motor synergies that accompany improvement in the performance of motor tasks. Previous studies of our group have shown, in particular, that persons both with and without Down syndrome are able to show improvements in indices of their multi-finger synergies in tasks that require accurate production of finger forces. In particular, 3 days of practice has been shown to lead to significant improvements in indices of multi-finger synergies that stabilize the time patterns of the total force produced by the fingers of a hand. Persons with Down syndrome showed a qualitative change in their synergies that failed to stabilize the total force altogether prior to practice and became able to do so after practice. In addition, the studies have also shown that variable practice is more beneficial for the improvement of motor synergies than blocked practice. I would like to draw an optimistic conclusion that persons with Down syndrome are not inherently ‘clumsy’, but have a vast potential for an improvement of their motor performance. The current state of the area of motor control allows researchers and practitioners to tap into these reserves, and to use quantitative indices of changes in motor synergies with practice to optimize motor performance of these individuals. [ABSTRACT FROM AUTHOR]

Background and Purpose Although a criterion reference of 10,000 steps per day is recommended for health benefits, a literature search yielded no normative standard for daily steps. Therefore, a meta-analysis was used in estimate the number of pedometer-documented steps that adults take daily. Methods Studies were retrieved using electronic databases and cross-referencing from retrieved studies. A random-effects model and 95% confidence intervals (CIs) were used tor all analyses of daily step data. Results Seventy-one outcomes, representing 6,199 subjects from 42 studies, met the inclusion criteria. Excluding Amish subjects, the daily step count averaged 9,448 (95% CI=8,899-9,996) and was greater in subjects younger than 65 years of age (mean=9,797, 95% CI=9,216-10,377) compared with subjects 65 years of age or older (mean=6,565, 95% CI=4,897-8,233). Discussion and Conclusion This study provides an estimate of the number of daily steps taken by adults. The number is less than the recommended 10,000 steps per day and is especially low in adults 65 years of age or older. [ABSTRACT FROM AUTHOR]

Medical advances and the growth of the elderly population have focused interest on trends in the health of the elderly. Three theories have been advanced to describe these trends: compression of morbidity, expansion of morbidity, and dynamic equilibrium. We applied multistate life table methods to the Medicare Current Beneficiary Survey to estimate active and disabled life expectancy from 1992 to 2003, defining disability as having difficulty with instrumental activities of daily living or activities of daily living. We found increases in active life expectancy past age 65 and decreases in life expectancy with severe disability. These trends are consistent with elements of both the theory of compression of morbidity and the theory of dynamic equilibrium. [ABSTRACT FROM AUTHOR]

The article focuses on two surveys which were conducted in Latvia to obtain the perceptions of disabled students and their families to including students with disabilities in general education classes, and to determine the perceptions of general physical educators' perceptions of including students with physical disabilities in general physical education classes. The surveys revealed that there was frustration and dissatisfaction with both students and teachers with the manner in which students with disabilities were included in general physical education classes, and that more research needed to be done before inclusion could be properly managed.

This article describes the use of drawings in a research project aimed at understanding the personal experience of spinal cord injury. The article briefly reviews the use of visual methods in disability research, and then describes the specific procedures used to elicit and analyze two sets of drawings: ‘draw your self’ and ‘draw how you see spinal cord injury in your mind’. The drawings were a small but essential part of a larger study focused on the community integration and participation of adults (n = 160) with spinal cord injury. Despite the challenges posed by this method for research participants with paralysis, the drawings provided unique insight into the personal meanings of spinal cord injury and how this injury is understood and represented to others. Using examples of participants' own drawings, we show how elicited drawings are a useful adjunct to traditional interview methods in studies of disability. [ABSTRACT FROM AUTHOR]

Objective:The objective of this paper is to outline the proposed development process for the ICF Core Sets for Spinal Cord Injury (SCI) and to invite clinical and consumer experts to actively participate in this process. ICF Core Sets are selections of categories of the International Classification of Functioning, Disability and Health (ICF) that are relevant to persons with a specific condition or in a specific setting.Method:The project is a cooperation between the ICF Research Branch of the World Health Organization (WHO) Collaboration Centre of the Family of International Classifications (DIMDI, Germany), the Classification, Assessment and Terminology (CAT) team and the Disability and Rehabilitation (DAR) team at WHO, the International Spinal Cord Society (ISCoS) and International Society for Physical and Rehabilitation Medicine (ISPRM) and partner institutions across the world. The project will consist of four worldwide studies to be conducted from 2006 to 2007 with a proposed ICF Core Set Consensus Conference to be held in 2007. ICF categories relevant for SCI are to be identified by means of (I) an empirical study, (II) a systematic review of outcomes and measures used in SCI research (III) an expert survey and (IV) focus groups and semistructured interviews with persons with SCI. Consensus about items that have to be part of a Comprehensive and of a Brief ICF Core Set for SCI will be reached in a final ICF Core Set Consensus Conference. Subsequent field testing will be necessary to validate this first version of ICF Core Sets for SCI.Invitation for participation:The development of ICF Core Sets is an inclusive and open process. Anyone who wishes to actively participate in this process is invited to contact the project coordinator (Monika.Scheuringer@med.uni-muenchen.de or http://www.icf-research-branch.org/research/spinalcord-injuries.htm). Individuals, institutions and associations can be formally associated as partners of the project.Spinal Cord (2006) 44, 541–546. doi:10.1038/sj.sc.3101918 [ABSTRACT FROM AUTHOR]

Objective. To characterize physical activity levels of adults with mental retardation and identify limitations in published research. Data Sources. Key word searches for “mental retardation,” “intellectual disability,” “learning disability,” or “developmental disability” combined with “physical activity” or “habitual exercise” identified articles from MEDLINE, Academic Search Elite, Psych Articles, Health Source, and SPORT Discus. This produced a total of 801 citations. Study Inclusion and Exclusion Criteria. Published English-language literature that quantitatively measured physical activity levels of adults with mental retardation was included in this review. Fourteen articles met this criterion. Data Extraction. Characteristics of participants, study design, outcome measures, methods of analyses, and findings in terms of percentages, step counts, and accelerometer output were extracted. Data Synthesis. Data were synthesized to identify the percentage of adults with mental retardation who met published health-related physical activity criteria and compare them with adults without mental retardation and to examine study limitations. Results. The studies with the greatest rigor indicate that one-third of adults or fewer with mental retardation were sufficiently active to achieve health benefits. However, data are insufficient to determine whether adults with mental retardation are less active than the general community. Conclusions. Future research would be enhanced by including appropriately powered representative samples, by including comparison groups, by validating physical activity questionnaires, and by determining the accuracy of proxy respondents. (Am J Health Promot 2006;21[1]:2–12.) [ABSTRACT FROM AUTHOR]

This article presents research findings from a larger research project entitled "Finding our Way Home" which explored the narrative accounts of end-of-life transitions of 24 people with disabilities living in inner-city Winnipeg, Manitoba, Canada as well as of 8 service providers with a special emphasis on their housing needs during these transitions. We suggest that end-of-life transitions for people with disabilities who live in Winnipeg's inner-city, especially those related to housing, are complicated by poverty, feelings of safety and security, the provision of appropriate supports and other life circumstances. End-of-life housing issues for these people have become issues related to home—creating, maintaining and going home. [ABSTRACT FROM AUTHOR]

"What makes your life meaningful?" is a question previous research- ers explored with people of various ages, but not of individuals who have significant physical impairments. In this study, 26 individuals with physical disabilities were asked to describe what makes their lives meaningful. Analysis showed human relationships were the most frequently reported source of meaning in life, the sources being family members, friends, and people in the community. The second most frequently cited meaning was service, specifically, helping and educating others, such as other people with physical disabilities. [ABSTRACT FROM AUTHOR]

Research on the positive and negative events experienced by parents with acquired physical disabilities is limited, and research on their children's experiences is even rarer. Thus, with this project the author merged stress-and-coping research with the social model of disability to develop two specifically tailored profiles of life events specific to the experiences of these family members. Fifty knowledgeable informants (parents with acquired disabilities, their spouses, their adolescent children, and professionals) were interviewed about the positive and negative aspects of being or living with a parent with a physical disability. From these discussions, the author identified samples of meaningful positive and negative events so that future researchers can examine the associations among the experiences of these events and adolescents' and parents' coping and adjustment as well as evaluate social policy to reduce barriers and create supports for parents with physical disabilities and their families. [ABSTRACT FROM AUTHOR]

We outline a theoretical view of narrative inquiry as both phenomenon and method, and we explore the growth and development of narrative inquiry in the field of education. Drawing on research with participants labeled as developmentally disabled, we show how narrative inquiry can illuminate how disability is understood and lived out in social, cultural, and institutional narratives that shaped the lived and told stories of individuals. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Retrospective follow-up study with two cohorts: one treated with reduction and the other with fusion in situ.OBJECTIVE.: To assess the long-term effects of reduction versus fusion in situ on lumbar spine in children and adolescents with severe L5 isthmic spondylolisthesis.SUMMARY OF BACKGROUND DATA.: Severe isthmic spondylolisthesis is commonly treated with fusion in situ, but modern surgical techniques and instrumentation permit the reduction of a severely slipped fifth lumbar vertebra. Advocates of one or another of these procedures present different claims to defend their choice. However, to our knowledge, no long-term results of the reduction maneuver exist.METHODS.: Between 1983 and 1991, 22 adolescents with severe (more than 60%) slip were treated surgically. In 11 of them, reduction was performed with a Magerl/Dick transpedicular device, followed by fusion posteriorly from L4 or L5 to S1 and anteriorly from L5 to S1. In the others, fusion was performed in situ posteriorly from L4 (n = 7) or L5 (n = 4) to S1 and anteriorly from L5 to S1. The average age of patients at surgery was 14.7 years (range 10.7–18.5). Radiographs obtained before surgery, after surgery, and at the final follow-up evaluation were assessed for quality of fusion. In addition, magnetic resonance imaging was obtained at the last follow-up visit. Average follow-up time was 14.8 years (range 11.6–18.7). Physical examination, spinal mobility, and nondynamometric trunk strength measurements were used to assess, and Oswestry Disability Index and Scoliosis Research Society scores were used to calculate outcome at the last follow-up visit.RESULTS.: In the reduction group, mean Oswestry Disability Index was 7.2 (range 0–20) and in the fusion in situ group, was 1.6 (range 0–4) (P = 0.0096). The Scoliosis Research Society total score averaged 90.0 (range 39–107) in the reduction group and 103.9 (range 93–120) in the fusion in situ group (P = 0.046). At the last follow-up evaluation, mean vertebral slip had decreased from the preoperative value of 90% to 57% in the reduction group but remained the same (80% vs. 78%) in the fusion in situ group (P = 0.04 and 0.013, respectively, for preoperative and postoperative comparison). On magnetic resonance imaging, disc degeneration above the fusion was more common in the reduction group (P = 0.004). None of the patients had spinal stenosis above the fusion. Nerve root canal impingement at the L5–S1 level was more common in the fusion in situ group (P = 0.03), but all patients were free of L5 nerve root symptoms. There was no difference in spinal mobility or trunk strength measurements between the groups.CONCLUSIONS.: The fusion in situ group seems to perform better in almost all clinical parameters measured. These findings suggest that fusion in situ should be considered as a method of choice in severe L5 isthmic spondylolisthesis. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: A retrospective, comparative follow-up study.OBJECTIVE.: To compare clinical and radiographic outcomes after posterolateral, anterior, or circumferential fusion in situ for high-grade spondylolisthesis in children and adolescents.SUMMARY OF BACKGROUND DATA.: Controversial opinions still exist about the surgical treatment of severe isthmic spondylolisthesis. There are no long-term comparative studies of different fusion in situ techniques in these patients.METHODS.: A total of 21 patients treated using posterolateral, 23 using anterior, and 26 using the circumferential fusion technique without instrumentation for high-grade isthmic spondylolisthesis (≥50% slip) participated. Their mean age at surgery was 14.4 years (range 8.0–19.6). The follow-up rate was 84% after a mean of 17.2 years (range 10.7–26.0). Radiographs were obtained before surgery, at 2-year follow-up, and at final follow-up. The Scoliosis Research Society (SRS) and Oswestry Disability Index questionnaires were completed, and a physical examination was performed at the final follow-up visit.RESULTS.: Progression of lumbosacral kyphosis (≥10°) was found in 9 (43%), 3 (13%), and 3 (12%) patients of the posterolateral, anterior, and circumferential fusion groups, respectively (P = 0.017). The SRS total score averaged 89.7 (range 56–105) in the posterolateral, 93.2 (range 66–114) in the anterior, and 100.0 (range 71–117) in the circumferential fusion groups (P = 0.021). Patients in the circumferential fusion group had better values for pain (P = 0.023) and function from back condition domains (P = 0.079) than patients in the posterolateral or anterior groups. The Oswestry Disability Index averaged 9.7 (range 0–62) in the posterolateral, 8.9 (range 0–32) in the anterior, and 3.0 (range 0–16) in the circumferential fusion groups (P = 0.035).CONCLUSIONS.: Circumferential fusion provided significantly better long-term clinical, radiographic, and SRS total score than posterolateral or anterior fusion for high-grade isthmic spondylolisthesis. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the concordance in physical activity among parents and youth with physical disabilities. Parent and youth pairs were divided into two groups based on the child's age (children: N = 123, age 9.15± 1.39 years; adolescents: N = 133, age 14.40± 1.83 years) and completed a modified version of the Canada Fitness Survey. There were no associations between parent and youth physical activities (children: r s = .17, p = .06; adolescents: r s = .09, p = .31), regardless of disabling condition. Additional research is needed to better understand familial influences of physical activity behavior in this population. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to examine the association between selected childhood adverse experiences and disability due to mental health problems in a community sample of women. Variables of interest included childhood physical and sexual abuse, parental psychiatric and substance abuse history, and sociodemographic factors. Method: Girls and women (aged 15 to 64 years) from a province-wide community sample (n = 4239) were asked about disability and most childhood adverse experiences through interview; a self-administered questionnaire inquired about child abuse. Logistic regression (crude and adjusted odds ratios) was used to test the associations between childhood adversity and disability due to mental health problems. Results: Approximately 3% of the women had a disability due to mental health problems. Among women with a disability, about 50% had been abused while growing up. After controlling for income and age, we found that disability showed the strongest association with childhood sexual abuse, physical abuse, and parental psychiatric disorder. Conclusion: Disability due to mental health problems was experienced by women with and without exposure to abuse in childhood. However, childhood sexual abuse and physical abuse were important correlates of disability. Disability creates suffering and loss for the individual and society; this issue merits more research in relation to child abuse. [ABSTRACT FROM AUTHOR]

This article presents information on the life course studies of siblings with developmental disabilities. The sibling relationship constitutes the longest lasting family tie, beginning with the birth of the younger sibling and ending with the death of one member of the sibling pair. Siblings share a common family heritage, both genetically and experientially, and perhaps for this reason, the sibling relationship is normatively characterized as egalitarian, reciprocal, and mutual. In addition, there may be less genetic and experiential similarity between members of the sib-pair and less egalitarianism and reciprocal exchange due to unequal abilities and patterns of life course outcomes. However, there may also be greater continuity in contact across the life course when the sibling has a developmental disability. A growing body of research on adult sibling relationships when one individual has a developmental disability suggests that, in general, these siblings tend to maintain high levels of involvement across the life course, although there is variability in the degree of contact and closeness.

Presents information on the sense of happiness, well-being and character strengths in people with disabilities. Fact that breaking tradition with the usual focus on what is wrong with these people, the growing field of positive psychology instead asks what contributes to people doing well and being happy; Fact that positive psychology aims to more fully understand such positive states as hope, gratitude, satisfaction, flow, engagement, virtues, purpose, and meaning; Information on the researchers examining the families of children with mental retardation who have long assumed a psychopathological orientation.

Nearly 20% of US citizens are disabled. Epidemiologic studies have shown that people with physical disabilities have a 1.2- to 3.9-fold increase in obesity prevalence. Obesity is becoming a serious problem in disabled individuals. The mechanisms by which obesity occurs in people with physical disabilities is not clear, but pathophysiological changes of body composition and energy metabolism, physical inactivity, and muscle atrophy all favor the development of obesity. Health professionals should identify disabled patients at risk and provide early prevention guidance. Research is needed to help generate detailed clinical guidelines to promote weight control among people with physical disabilities. [ABSTRACT FROM AUTHOR]

This study investigated the nature of kindergarten children's understanding about and attitudes toward disabilities. Interviews with 77 Canadian children enrolled in inclusive classrooms showed that kindergarten children (a) conceptualize disabilities chiefly according to physical appearances and (b) possess a fairly accurate understanding of some aspects of disabilities. Kindergarten children also hold generally positive attitudes toward persons with disabilities. These attitudes, however, do not reflect their reported friendships with persons with disabilities. Only half of the nondisabled children reported having friends who have disabilities. Possibilities for future research and the need to further enhance the social inclusion of children with disabilities are suggested. [ABSTRACT FROM AUTHOR]

This paper outlines a recent study which, in an attempt to illuminate the processes surrounding the formation of what is increasingly being referred to as 'the disabled identity', set out to explore the effects of the onset and ongoing experience of impairment in relation to disabled people's self-perceptions. A grounded theory approach was adopted and the data derived from the stories of 92 people from four countries, through telephone dialogues and autobiographical material which sought to answer, or, in the case of unsolicited material, could be said to have answered, the question: How has [the illness or disabling condition] affected the ways in which you see yourself and how others treat you? The major areas of identity which were found to be affected by disability were those which related to independence, work and appearance/sexuality, all of which were heavily influenced by the negative attitudes of others and each of which were related to qualities which could be argued to represent the pivotal characteristics separating the 'affiliated and the marginalised' in contemporary Western society. [ABSTRACT FROM AUTHOR]

The topic of this article is the analysis of statistical data of the disability situation in Uzbekistan. The number of new registered people has been decreasing since 2000. On one hand the Government accepts various state programmes on population health care improving and the integration of disabled people into the society. On the other hand, authorities begin restrictive policy concerning disabled people. In the conditions of low living standards state pension has a vital importance for disabled people. Therefore, a number of those who can have it are falling. [ABSTRACT FROM AUTHOR]