Disabilities, Volume 2, Issue 4 (December 2022) – 15 articles

Background: The impact of the COVID-19 pandemic among people with physical disabilities might differ between countries due to differences in implemented measures and infection rates. This study aimed to understand the impact of the pandemic on physical activity (PA) and social isolation among adults with physical disabilities in Canada and the Netherlands, and examine associations between PA and social isolation. Methods: Secondary data from two studies were used: the Canadian COVID-19 Disability Survey (n = 353) and the Dutch Rehabilitation, Sports and Active lifestyle (ReSpAct) 2.0 study (n = 445). Self-reported PA was measured using IPAQ-SF and Adapted-SQUASH. Social isolation was measured using the PROMIS Social Isolation. Descriptive and regression analyses were performed. Results: Canadian participants spent on average 163 min (Median = 0; IQR = 120) on moderate-to-vigorous PA per week and Dutch participants 934 min (Median = 600; IQR = 1125). In Canada, 64% reported to have become less physically active since the pandemic compared to 37% of Dutch participants. In both samples, no clinically relevant associations were found between PA and social isolation. Conclusions: The findings emphasize the negative impact of the pandemic on PA and social isolation in adults with physical disabilities in Canada and the Netherlands. Future research is needed to better understand if and how PA can be used to reduce social isolation in people with disabilities. This study illustrates how cross-country collaborations and exchange provide opportunities to inspire and learn from initiatives and programs in other countries and may help to improve PA support among people with disabilities during and after the pandemic. Full article

Youth with developmental disabilities (DD) face challenges that may impact their participation in physical activity. One of the biggest challenges is the availability of opportunities to engage in activities that are adapted for youth with DD. In addition, due to challenges with current physical activity assessment methods for youth with DD, the activity levels during modified activities remain unclear. The purpose of this investigation was to determine the activity levels of youth with DD during structured and unstructured activities offered during a therapeutic camp. This camp was a five-day, overnight experience in an outdoor camp center in the southeastern region of the U.S. Youth (n = 29; 14.6 ± 3.9 years) with more than one DD and with varying abilities wore accelerometers while they engaged in 13 activities of varying categories (functional/gross motor, game, sociodramatic, fine motor, free play) and contexts (ropes, horses, outdoor adventure, music and movement, yoga, come on down, sports and games, theatre, cabin challenge, arts, cooking, mad science, free play). Activity level varied by activity category and context and the intensity level of the majority of the camp activities was classified as either sedentary or light. There was a time course effect on activity; most activities resulted in a gradual decline over the session, except for cooking, sports and games, and free play. This therapeutic camp provided an opportunity for youth to engage in physical activity that would be classified as light intensity. The activities available at this camp were designed to address specific goals and objectives and provided enrichment opportunities (e.g., life skills, social skills) for youth to obtain multiple skills while using movement as a framework to deliver the content. Full article

The COVID-19 pandemic presents unique challenges for people living with acquired neurological conditions. Due to pandemic-related societal restrictions, changes in accessibility to medical care, equipment, and activities of daily living may affect the mental health of individuals with a SCI or ABI. This study aimed to understand the impact of the pandemic on psychological wellbeing, physical health, quality of life, and delivery of care in persons living with SCI and ABI. A secondary objective included exploring the use of virtual services designed to meet these challenges. In a companion study, participants were surveyed using validated scales of psychosocial health, physical health and healthcare access. In this study, 11 individuals gathered from the survey participated in virtual individual semi-structured interviews to provide accounts of lived experiences regarding critical health challenges and eHealth. Two researchers independently coded interviews for themes using a hermeneutic phenomenological approach. Through analysis of interviews, 5 themes were identified regarding COVID-19 and recovery, access to care, virtual healthcare, systemic barriers, and coping. Overall, limited opportunities due to the pandemic led to a need for adaptation and multifaceted outcomes on one’s wellbeing, which provides guidance for future clinical practice. Full article

Individuals with disabilities underwent substantial changes in life due to the COVID-19 pandemic. However, little is known about the experiences of this population during the first year of the pandemic. Hence, drawing on data from a longitudinal mixed-methods study, this study aimed to identify different COVID-19 life profiles among people with disabilities. Sixty-one participants were interviewed at four timepoints, which paralleled restriction changes in British Columbia, Canada. These data were analyzed to identify different life profiles over the course of the first year of the pandemic. The analysis identified three interlinked profiles: (1) ‘being in a straitjacket’ examines the increasing restriction-related frustrations experienced by participants; (2) ‘seizing the reins’ explores the positive routines that participants established by filling the gaps with meaningful activities; and (3) ‘staying content during COVID’ describes a ‘keep calm, carry on’ attitude, where minimal impact of the pandemic was observed by participants. The three COVID-19 life profiles provide insight to the challenges encountered, resources used, and the varying experiences of individuals with disabilities as they adjusted to a different way of living. These findings can facilitate future research that could develop interventions and services for individuals with disabilities in subsequent pandemics or disasters. Full article

Despite legislation affirming the rights of people with intellectual disabilities to take equal part in society, marginalization persists. Accessibility needs can impact this group’s ability to engage in the digital society and in aspects of daily living, such as employment and socializing. The Digi-ID PLUS study was established with a team of seven people with an intellectual disability. Team members were hired as a diverse group to give insight into their lived experiences in reviewing and validating research findings. Their insights were key to every aspect of Digi-ID PLUS. It has been recognized that user-centered design enhances technology development and accessibility; therefore, the aim of establishing a Citizen Advisory Panel (CAP) in our program design and delivery is to include the critical role of users by experience to review, validate and test our solution to enhance the accessibility of all aspects of the program. Working with Digi-ID PLUS, the CAP spoke of the impact being paid team members had on their lives. Analysis of insights shared indicated that being a part of the team had a positive impact on their self-image confidence and digital skills acquisition CAP members discussed the importance of supporting each other and the value of being paid for their insights. Full article

Personal assistance (PA) has long been a key support for Irish people with physical and sensory disabilities, but evidence shows that Ireland lacks national standards for allocation, provision and data collection. Addressing a particular gap in understanding the experiences of disabled people, this paper draws on a large-scale mixed-method study with PA service users which was conducted in summer 2021. Overall, the evidence shows satisfaction among many service users, but suggests that systemic shortfalls have a clearly detrimental effect on the functionings and capabilities valued by the participants in relation to their ability to participate in social and economic activities that many people take for granted. The findings of this study provide valuable insights into what good personal assistance means for disabled people’s everyday lives and what Irish PA service users want to see change in the system. The findings are grounded in the Irish context, but they are useful to an international audience in clearly showing the value of PA and the importance of meaningfully including disabled people in its design and regulation. Full article

Background: This study examined self-reported physical activity (PA) participation, well-being, and perceived needs of Canadians with disabilities during the COVID-19 pandemic. In addition, we assessed physical and mental health and the extent to which pre-identified needs were being met or unmet. Methods: Two iterations of the COVID-19 Disability Survey were conducted during two pandemic timeframes: June–December 2020 (iteration 1, n = 599) and December 2020–September 2021 (iteration 2, n = 528). PA participation was assessed with the International Physical Activity Questionnaire. Physical and mental health were assessed with the PROMIS Global-10 questionnaire. A needs assessment was conducted on 11 needs pre-identified in partnership with community organizations. Results: Approximately 50% of respondents to both iterations reported that they did not do any moderate-vigorous intensity PA. While physical health was not different between timeframes, mental health was worse during iteration 2 than iteration 1 (p = 0.028). During both timeframes, access to recreation and leisure facilities was the greatest unmet need. Conclusion: These data highlight the low levels of PA and the perceived changes in PA, mental health, and recreational needs of Canadians with disabilities during the pandemic. The findings of the Survey were used to support policy change to remove barriers to PA participation for people with disabilities in Ontario. Full article

Introduction: Increased life expectancy among people with intellectual disabilities (ID) raises the risk of their diagnosis being superimposed by behavioral and psychological symptoms of dementia (BPSD). The difficulties facing direct support professionals dealing with this is an emerging, under-investigated issue. The study investigates direct support professionals’ perceptions and experiences of their daily support for aging people with ID presenting with superimposed BPSD. Method: Twenty-four direct support professionals from long-term care facilities responded to clinical vignettes and attended focus groups conducted to investigate perceptions and lived experiences of the barriers and struggles they faced. Results: Direct support professionals’ reactions to vignettes revealed their difficulties recognizing BPSD superimposed on the known challenging behaviors of people with ID. Focus groups highlighted daily struggles with BPSD, the lack of knowledge about detecting and dealing with them, and associated somatic and psychopathological diseases of aging. Conclusion: Improved knowledge transfer about good practices for person-centered support to aging people with ID presenting with BPSD is strongly recommended. Full article

One foundational aspect within the essential skill of literacy is reading comprehension. While students can learn comprehension strategies in a variety of settings, students with disabilities have shown increased success in inclusive classrooms with instruction supported by both general education and special education staff. To address the needs to increase the reading comprehension outcomes for students with intellectual disability as well as increase the fidelity of use of evidence-based practices by school staff (general education teachers, special education teachers and paraprofessionals) within instruction, an interactive action research study was implemented in five schools in one school district in the United States. The study was designed to use action research to create a model of professional development with extensive coaching support surrounding evidence-based practices as well as the development of resources to support co-planning and adaptations within instruction in inclusive classrooms. Results indicated that both purposes were met within the study with several implications for practice as well as the development of a second iteration of the model using student outcomes and frequent educator feedback. Full article

Content validity and clinical utility of the Collaborative Process for Action Plans to Achieve Children’s Participation Goals were evaluated. The collaborative process is designed to assess child, family, and environment strengths and areas for improvement specific to a child’s participation goal and identify intervention strategies and the person(s) responsible for each strategy. Twelve pediatric therapists participated in one of two Nominal Group Consensus Process. Following discussion, therapists rated the importance of child, family, and environment attributes, clarity of wording, and the usefulness of the collaborative process. Ratings for 91% (first group consensus) and 100% (second group consensus) of the statements met the criterion for consensus, supporting content validity. Ten parent/child/therapist teams evaluated clinical utility. Written responses to open-ended questions were coded using inductive content analysis. Parents and therapists indicated that the collaborative process promotes engagement, the goal is considered from many viewpoints, and there is a joint commitment to the action plan. Limitations included time to complete, the need for preparation and more guidance, and unfamiliar expressions. Familiarity with collaborative, solution focused processes and participation interventions are considerations for use in practice. Research is recommended in which the action plan is implemented, progressed, and achievement of participation goals are evaluated. Full article

Emotions influence processes of learning and thinking in all people. However, there is a lack of studies in the field of emotion research including people with intellectual disabilities (ID) addressing the existing diversity. The present study investigates the emotional competence of people with ID (N = 32). The first aim was to assess the emotional development using the Scale of Emotional Development (SEED). Based on these insights, the second objective was to replicate existing findings, validating the emotional reaction of people with ID to pictures of the International Affective Picture System (IAPS) based on self-reports. In an additional pilot-like analysis, the third aim was to investigate if these self-reported emotional reactions match the emotions expressed in their faces using the automated and video-based facial expression analysis software ‘Affectiva (Affdex SDK)’. In the present study, the self-reported emotional reactions of participants with ID were in line with previous research. In addition, the present study shows the general potential of this innovative approach of using and applying commercially available automated emotion recognition software for the field of special needs and social science. Full article

Individuals with learning disabilities (LDs) are more likely to have a mental illness, yet few studies explore this association in emerging adulthood, a developmental period with an increased risk for mental illness. The purpose of the current study was to investigate psychological distress in emerging adults (15–29 years) with and without LDs. The 2012 Canadian Community Health Survey—Mental Health was used (n = 5630), and multiple and logistic regression models with survey weights were computed. Adjusting for demographic, psychosocial, and health covariates, there was no evidence for significant differences in psychological distress among emerging adults with vs. without LDs. However, age and sex were significant effect modifiers. Among emerging adults with LDs, both males (OR = 2.39 [1.01, 5.67]) and those aged 25–29 years (OR = 3.87 [1.05, 14.30]) had an increased odds of clinically relevant psychological distress in comparison to those without LDs. These findings suggest a need for improved awareness and support for prevention of psychological distress among emerging adults with LDs, especially for males and those in later emerging adulthood. Full article

This study investigated strategies for people with intellectual disabilities to self-advocate for inclusion of their priorities in social policy processes in South Africa. Method: Self advocacy strategies were identified through a scoping literature review, a review of self advocacy toolkits and semi structured interviews with people with intellectual disabilities and other stakeholders working at non-governmental and disabled people’s organisations. These data sources were triangulated to identify strategies to upskill and support young adults with intellectual disabilities to share their opinions and perspectives to deepen the diversity of voices engaged in social policy advocacy. Results: Data triangulation identified three core strategies for self advocacy, in person, written strategies and engagement through social media. Discussion: Inclusion of people with intellectual disabilities in civic and political life is crucial, and will only be achieved if self advocates are accepted into the policy-making arena. The cycle of perpetuating exclusion needs to be disrupted, to give people with an intellectual disabilities a say in policy decisions that have an impact on their lives. Conclusion: Adopting strategies which enable the inclusion of the voices of people with intellectual disabilities in civic activities holds potential for diversifying perspectives brought to public participation in policy development and implementation, which is currently primarily the domain of non-disabled citizens. Full article

The restrictions in 2019 due to Coronavirus impacted Canadians’ daily living, especially those at higher risk of compromised health conditions. This study aimed to describe the physical, psychological, and social well-being of adults with disabilities, and older adults from May to June 2020. Participants from the group of community-dwelling adults (≥19 years of age), who communicated in English, lived in British Columbia, and had Internet access via a computer, tablet, or smartphone with special focus on populations who had stroke, spinal cord injury and other disabilities were included. For measurement outcomes, an online survey was used to administer standardized measures of level of participation, mobility, anxiety and depression, boredom, resilience, technology readiness, social support, and social networks. Seventy-two participants were recruited, with a mean age (SD) of 61.2 (13.8). This study was comprised of two groups: the adult group consisted of individuals with disabilities under the age of 65 (48.6%) and the older adult group consisted of individuals over the age of 65 with and without self-identified disability (51.4%). There was no significant difference in the proportion of participation restriction between adult (83%) and older adult’ (81%) groups (p = 0.69). In the study population, 27.8% and 16.7% of participants exceeded the anxiety and depression cut-off scores, respectively. Boredom was experienced by 76.4% of participants. Participants’ mean (SD) resilience and life space scores were 72.4 (14.0) and 51.9 (24.0), respectively. The older adults (≥65 years) showed significantly lower depression (p = 0.012) and better resilience (p = 0.038), social support (p = 0.043), and social network (p = 0.021) than the younger adults. Issues with anxiety, boredom, participation, and life space activity were identified in both study groups. This information may provide supporting evidence when creating policies to mitigate existent health and social inequities. Full article

Background: People with an intellectual and/or developmental disability are at increased risk of adverse oral health outcomes and often require support from caregivers to assist in maintaining or seeking treatment for their oral health needs. However, caregivers and support workers are often family members with limited formal oral health training. Hence, the aim of this pilot study was to review the outcomes of the ‘Smiles for Life’ oral health education workshop with reference to their knowledge, attitudes, and practices of caregivers of people with an intellectual or developmental disability. Methods: A single group pre-test post-test intervention design was used to explore the preliminary effectiveness and appropriateness of the Smiles for Life oral health education workshop. Results: A total of 244 participants completed both the pre and post knowledge test. Oral health literacy scores decreased following the post test. Those with higher levels of education achieved higher post-training knowledge scores. Overall, caregivers reported satisfaction on the material presented however, it could be improved with more practical demonstrations. Conclusion: Providing an oral health education tool that caters to the diverse caregiver audience presents a unique set of challenges, despite oral health education in this professional group being vital. Future studies may benefit from reviewing the efficacy of a more tailored educational intervention. Full article