A scoping review of the experiences,benefits, and challenges involved in volunteer work among youth and young adults with a disability

Purpose: To develop a better understanding of the experiences of volunteer work among youth with disabilities. Method: A scoping review was undertaken to assess the benefits and challenges of volunteering among youth with disabilities. Comprehensive searches using six international databases were conducted. Eligible articles included: (a) youth aged 30 or younger, with a disability; (b) empirical research on the benefits or challenges of volunteering; (c) published in a peer-reviewed journal between 1980 and 2014. Results: Of the 1558 articles identified, 20 articles – involving 1409 participants, aged 12–30, across five countries – met the inclusion criteria. Studies linked volunteering to the development of human capital (i.e. practical experience, improved self-determination, self-confidence, coping), enhanced social capital (i.e. social and communication skills, social inclusion) and improved cultural capital (i.e. helping others, contributing to community). Many youth with disabilities also encountered challenges – including lack of accessible volunteer opportunities, difficulties arranging transportation, and negative attitudes from potential supervisors. Conclusions: Young people with disabilities are willing and able to volunteer, and they report benefits of volunteering; however, they face many challenges in finding suitable volunteer positions. More rigorous research is needed to understand the health and social benefits of volunteering and how it can help youth develop career pathways.

• Implications for Rehabilitation

• Clinicians, educators and parents should discuss the benefits of volunteering with youth with disabilities and assist them in finding placements that match their interests and abilities.

• Managers and clinicians should consider incorporating volunteering into vocational rehabilitation programming (i.e. addressing how to find placements and connecting youth to organisations).

• Clinicians should encourage youth to take part in social and extracurricular activities to help build their social skills and networks where they can learn about volunteer opportunities.

• Clinicians and educators should advocate on behalf of youth with disabilities among community organisations to help break down barriers and reduce misconceptions and negative attitudes by showcasing the abilities that youth with disabilities have to offer.

     

Current perspective regarding adults with intellectual and developmental disabilities accessing computer technology

Purpose: This article was written to summarize current efforts in the research community in regards to assisting adults with severe developmental and intellectual disabilities to access a computer. Method: A literature search was conducted to determine contemporary research that has been conducted to enable computer use in persons with significant developmental disabilities utilizing databases such as ERIC or PubMed. Results: Although various assistive technology devices and interventions have been developed for persons with all types of disabilities, a lack of research into methods to help persons with severe developmental disabilities access a computer is evident. This perpetuates the underutilization of computers in this population such as those attending day programs or residing in residential facilities. Conclusions: Persons with developmental disabilities, particularly adults, are often overlooked and are not thought to be capable of using a personal computer. Though communities have endeavored to further enhance participation by persons with disabilities in many aspects of mainstream society, there is a scarcity of research pertaining to how adults with intellectual disabilities can access a computer, especially those with severe impairments. Once formal schooling is over, there appears to be scant interest in supporting adults using computers.

Implications for Rehabilitation

• Helping a person to access a computer use should be considered to be within the purview of rehabilitation professionals, even when an individual has an intellectual disability.

• Research into methods to enable access to computer technology should incorporate persons with severe intellectual disabilities, including adults.

• Assistive technology devices, including those associated with computer technology should be developed with persons with severe developmental disabilities in mind to facilitate access.

• Rehabilitation professionals such as speech therapists, occupational therapists and physical therapists should work in concert to develop guidelines and protocols founded on research to aid persons with severe and multiple disabilities who want to access a computer.

     

Skill development in an employment-training program for adolescents with disabilities

Purpose: Relatively little is known about the first employment experiences and skill development of youth with disabilities. The purpose of this study is to explore the skills gained by adolescents with disabilities who have completed an employment-training program. Methods: In-depth, qualitative semi-structured interviews were conducted with 18 adolescents with a physical and/or mobility-related disability. The youth and their parents also completed a brief questionnaire about their experience in the program and we reviewed their self- and staff-assessments that were completed throughout the program. Results: The findings highlight how adolescents with disabilities developed several practical, social and communication skills, and self-confidence over the course of an employment-training program. Despite personal gains, youth reported challenges in their post-program search for employment. Conclusions: Youth valued involvement in the workforce and perceived that through their participation they developed important life skills.

Implications for Rehabilitation

• Educators and health care providers should be awar that teens with disabilities as young as 15 years old are thinking about their future and looking for employment experience.

• Educators and clinicians can assist youth and their families by talking about the benefits of involvement in volunteering and providing practical suggestions for how to get involved, including discussing the strengths and areas for skill development.

• At a community level, advocacy can raise awareness of the importance of early work experience and the potential contributions of youth with disabilities. Advocacy should target community employers, but also increased government funding for employmenttraining programs and employment transition supports for this age group.

     

Work-ability assessment in young adults with disabilities applying for disability benefits

Purpose: To investigate the impact of diagnosis, co-morbidity, secondary conditions (e.g. learning problems, subclinical mental and somatic complaints, addictions, and socio-emotional and behavioral problems) and problems in social context on work ability as assessed by Insurance Physicians (IPs) in young adults applying for a disability benefit.

Method: IPs of the Social Security Institute assessed young adults with disabilities (aged 15–27) applying for a disability benefit (n = 1755). Data were analyzed with multilevel ordinal regression techniques.

Results: Primary diagnosis, co-morbidity and subclinical mental complaints were associated with IP-assessed work ability. Persons with mental health conditions as primary diagnosis were less likely to reach a higher work ability than persons with somatic diseases. Young adults with two or more co-morbid conditions and those with psychiatric or developmental co-morbidity were less likely to reach a higher work ability level than persons without co-morbidity. Young adults with subclinical mental complaints were half as likely to reach a higher IP-assessed work ability than young adults without this condition.

Conclusion: Primary diagnosis, type and number of co-morbid conditions and subclinical mental complaints are associated with IP-assessed work ability. Work-ability assessments among adolescents with disabilities applying for disability benefits still focus mainly on medical factors.

Implications for Rehabilitation

• Work participation of young adults with disabilities is limited.

• Young adults with disabilities often need support to be able to function in social and economic life.

• Adequate work ability assessment of young adults with disabilities and subsequent support may help to improve their participation rates.

     

Do community-based rehabilitation programmes promote the participation of persons with disabilities? A case control study from Mandya District,in India

Abstract

Purpose: In this paper, we measure the effectiveness of Community-Based Rehabilitation (CBR) programmes in promoting the well-being of people with disabilities and removing the barriers to their participation in family and community decision-making processes. Method: To evaluate the impact of the CBR programme, we use data from a large-scale control study in Karnataka, India. Propensity score matching is used to evaluate the impacts on disabled persons after 2, 4 and 7 years of entering the CBR. The theoretical framework for the analysis is based on the CBR guidelines, which are combined with the International Classification of Functionings (ICF), the United Nations Convention on the Rights of People with Disabilities (UN CRPD) and Amartya Sen’s capability approach. Results: CBR has a positive impact on the well-being of persons with disabilities participating in the programme and particularly on their participation within the family and the society at large. Conclusions: CBR programmes have a multidimensional and positive impact on individual and collective capabilities; on individual, agency and social empowerment.

• Implications for Rehabilitation

• Community-Based Rehabilitation (CBR) can make a lasting difference in the life of persons with disabilities.

• CBR improves participation and inclusion of persons with disabilities in the family and in the community.

     

The impact of humorous media on attitudes toward persons with disabilities

Purpose: To examine the relationship between disability-related humor and attitudes toward persons with disabilities in business students (i.e. “future employers”). Method: Students watched one of two films designed to reduce negative attitudes toward persons with disabilities (one humorous in tone and the other serious in tone) or no film at all, and completed a measure of attitudes toward persons with disabilities. Results: Results indicated that, after controlling for previous contact with persons with disabilities, age, and gender, students who watched the humorous film reported significantly more positive attitudes toward persons with disabilities. Conclusions: Disability humor may be an effective means of positively influencing attitudes toward persons with disabilities in future employers.

Implications for Rehabilitation

• The acceptance and integration of persons with disabilities into society continues to be limited by negative attitudes.

• Previous research has shown that employers with positive attitudes toward persons with disabilities may be more likely to hire a person with a disability than employers with negative attitudes.

• In this study, students who watched a humorous film reported significantly more positive attitudes toward persons with disabilities than students who watched a serious film or no film at all.

• Consequently, it may be beneficial to embed disability humor into job-placement strategies in order to improve attitudes and positively influence hiring decisions.

     

Realizing the potential of accessible ICTs in developing countries

Purpose: To raise the awareness of policy makers, economic development practitioners, and service providers about the importance of making information and communication technology (ICT) based international economic development in low- and middle-income countries inclusive of people with disabilities and to discuss the role and importance of addressing the complete ICT and assistive technology (AT) ecosystem to ensure sustainable, scalable, and affordable access to ICTs and ICT-based programs. Method: This commentary piece draws upon recent literature and practice cases to examine the role of accessible ICTs in international development. Results: Accessible ICTs can enhance economic participation and prevent exclusion from participation in international development programs. Access to and use of accessible technologies are largely determined by the ecosystem in which they exist and can be enhanced or hindered by government policy and legislation and the quality of the service delivery systems and financing mechanisms. Conclusions: People with disabilities in developing countries face daunting barriers to socioeconomic participation. Accessible ICTs can eliminate or mitigate some of these barriers. However, technology advancements do not solely promote penetration, affordability, or scalability of ICT-based development for persons with disabilities. A comprehensive ecosystem approach can help in developing sustainable mechanisms for access, affordability, and availability.

Implications for Rehabilitation

• Accessible ICTs are unavailable to the majority of people with disabilities living in low- and middle-income countries thus posing barriers to socioeconomic participation and ICT enabled social and economic development programs (ICT4D).

• Availability of and access to ICT is determined by the nature and components (individual, social, financial, and government actors and systems) of its ecosystem.

• The promise of ICTs for people with disabilities cannot be realized in low- and middle-income countries without supportive legislation, policy, infrastructure and financing.

• The ICT ecosystem will promote successful outcomes when its stakeholders, policy structures, and resources align to strengthen and support one another.

     

Validity of the Utrecht Scale for Evaluation of Rehabilitation-Participation

Purpose: There is still a need for a generic participation instrument that measures both objective and subjective participation in adults living in the community and that is feasible for use in rehabilitation practice. The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was developed to satisfy this need, comprising 31 items in three scales: Frequency, Restrictions and Satisfaction. The aim of this study was to examine the validity of this measure. Methods: Cross-sectional study involving former rehabilitation outpatients from five rehabilitation facilities in the Netherlands (n?=?395). The Frenchay Activities Index (FAI), the participation subtotal score of the ICF Measure of Participation and Activities Screener (IMPACT-SP) and the Participation Scale were included as reference measures. Results: Internal consistency of the USER-Participation scales was satisfactory (α 0.70–0.91). Spearman correlations between these scales were between 0.36 and 0.52. Concurrent validity was shown by strong correlations between the Frequency scale and the FAI (0.59), the Restrictions scale and the IMPACT-SP (0.75) and the Satisfaction scale and the Participation Scale (?0.73). Discriminant validity was shown by significant differences in USER-Participation scores between participants with different levels of independence and between participants with different health conditions. Conclusion: The USER-Participation appears to be a valid measure to rate objective and subjective participation in persons with physical disabilities.

Implications for Rehabilitation

• The Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) is a new brief generic instrument to rate objective and subjective participation.

• The USER-Participation comprises 31 items in three scales: Frequency, Restrictions and Satisfaction.

• The USER-Participation appears to be a valid measure to rate objective and subjective participation in persons with physical disabilities.

     

Participation-based therapy for children with physical disabilities

Purpose: Optimizing home and community participation of children with physical disabilities is an important outcome of rehabilitation. Method: A review of literature identified research and theory on participation of children with physical disabilities. The authors’ incorporated current knowledge to conceptualize the experience of optimal participation, formulate principles of participation-based physical and occupational therapy, and develop a five-step process for intervention. A case report was completed to illustrate application to practice. Results: Optimal participation involves the dynamic interaction of determinants (attributes of the child, family, and environment) and dimensions (physical, social, and self engagement) of participation. Real-life experiences enable children to learn new activities and develop skills that optimize their participation and self-determination. Interventions are: goal-oriented, family-centered, collaborative, strengths-based, ecological, and self-determined. A distinguishing feature of intervention is that the therapist’s primary role is to support the child and family to identify challenges to participation and solutions to challenges. The therapist is a consultant, collaborating with the child, family, and community providers to share information, educate, and instruct in ways that build child, family, and community capacity. Conclusion: The model may have utility for collaboration with families and community providers, determining goals for participation, and providing evidence-informed interventions.

Implications for Rehabiliation

• Home and community participation of children with physical disabilities is an important outcome of rehabilitation.

• Optimal participation is conceptualized as the dynamic interaction of determinants (attributes of the child, family, and environment) and dimensions (physical, social, and self engagement) of participation.

• Participation-based physical and occupational therapy is based on the assumption that real-life experiences enable children to learn new activities and develop skills and that the empowerment of families enables them to advocate for the full inclusion and integration of their children in society.

• In participation-based therapy, the therapist is a consultant, collaborating with the child, family, and community providers to share information, educate, and instruct in ways that build child, family, and community capacity.

     

“They don’t understand that we also exist”: South African participants in competitive disability sport and the politics of identity

Purpose: To describe how athletes with disabilities talk about their experiences of participating in competitive disability sport in South Africa.

Method: In-depth semi-structured interviews were conducted with 20 athletes with disabilities. Data were analysed via thematic content analysis using an inductive data driven process.

Results: Participants described their involvement in competitive sport as a positive experience; they described it as a catalyst for the recasting of identities and reframing an understanding of physical impairment, a context for empowerment and resistance of disablist attitudes, and an arena in which a sense of inclusion and belonging is experienced. However, their narratives also lay bare something of the struggle on the part of persons with disabilities to be seen as fully human and reveal how participants reproduce some unhelpful disablist discourses.

Conclusions: There are complex contradictions and cross-currents in the way athletes with disabilities describe their participation in competitive disability sport. These narratives highlight political and ideological tensions about inclusion and representation and remind us of the need to document the experiences of persons with disabilities and the potential dangers inherent in idealizing disability sport.

• Implications for Rehabilitation

• Competitive sport is a useful context for rehabilitation and the empowerment of persons with disabilities.

• Athletes with disabilities say that they are able to resist dominant stereotypes about disability and recast their identities through participation in competitive sport.

• Disability sport seems to provide a setting in which persons with disabilities can reproduce unhelpful disablist discourses.

• There are dangers inherent in idealizing competitive disability sport.

• Even where athletes with disabilities are competing at the highest level and are successful, rehabilitation professionals must be aware of these issues, must be able to listen for experiences of exclusion and low self-esteem, and to engage with athletes on these issues.

     

Determinants of participation in further training among workers with disabilities

Abstract

Purpose: To analyse the determinants of the participation in further training for workers without and with disabilities in Germany. In particular, we are interested in testing the hypothesis that people with disabilities are less likely to receive further training. Method: Using longitudinal data from the German Socio-Economic Panel which covers the period 1989 to 2008, we estimate panel data regression models that allow us to identify the factors affecting the likelihood to participate in further training for people without and with disabilities. Results: The results confirm that workers with disabilities are less likely to participate in further training as compared to workers without disabilities (especially among males). In addition, variables such as age, years of education, occupation and firm size have a significant effect on the likelihood to get involved in further training for the disabled sample. We also found that people with disabilities have experienced more intensely the changes and variations in the participation rates over the period analysed compared to people without disabilities. Conclusions: From a public policy perspective, these findings show the importance of designing and implementing specific training programs for people with disabilities, which can contribute to maintaining and increasing their integration in the German labour market.

• Implications for Rehabilitation

• Training and vocational rehabilitation can in many cases be critical to achieve or secure employment.

• A person becoming disabled may, even after completion of the medical rehabilitation process, not be able to continue to work in the previous occupation.

• Rehabilitation specialists must be more involved within the design, provision and implementation of further training. They can also help to identify adaptive equipment and specific training tools that contribute to increasing the participation in further training among the disabled population.

• However, the odds of participating in further training among workers with disabilities is around 17% lower than that registered for their non-disabled counterparts.

     

An emancipatory research on CBR and the barriers faced by persons with disabilities

Abstract

Purpose: The aim of this research was to understand the barriers faced by persons with disabilities in their daily lives and the role of CBR projects in overcoming them. Method: A group of persons with disabilities involved in CBR activities was identified and trained in participatory research methodologies. Research was carried out, with support from a scientific advisory group, through sharing of life stories in residential meetings focusing on specific themes. These meetings were attended by 368 persons with disabilities. Results: The barriers identified ranged from isolation, neglect, abuse and violence to lack of access to social, health, education and livelihood opportunities. People faced their first barriers in their own families. Families also played an important role in overcoming some barriers at the individual level. CBR projects assisted people in overcoming barriers mainly by providing information, by facilitating access to existing support and by helping persons in communities to take collective action against the barriers. The research also stimulated DPOs and CBR projects to identify some gaps in tackling the barriers and to start action to overcome them. Conclusions: CBR projects can play a role in overcoming some barriers faced by persons with disabilities. Emancipatory research yields rich data, facilitates ownership and possibly future sustainability.

• Implications for Rehabilitation

• Community-based rehabilitation (CBR) programmes can promote mainstreaming and helping in overcoming some barriers faced by persons with disabilities in the communities.

• CBR programmes can facilitate collective action by persons with disabilities in overcoming barriers to inclusion and participation.

• Participatory research approaches such as emancipatory research can play a role in understanding disability issues and at the same time, help CBR programmes to identify gaps and strengthen activities.

     

Development of the participation and environment measure for children and youth: conceptual basis

Purpose: The purpose of this paper is to describe the conceptual foundation of a new parent-report measure of the participation and environment of children and youth: the Participation and Environment Measure ? Children and Youth version (PEM-CY). Methods: The ICF-CY provided an initial conceptual framework. Results from a qualitative study to obtain parent perspectives and in-depth review of the literature were used to identify relevant dimensions, items and rating scales for measurement. Results: Life situations, defined as sets of activity categories, were identified for three settings: home, school and community. Participation was operationalized as a multidimensional construct with three measurement dimensions: frequency, extent of involvement and desire for change. Parallel sets of items examining environmental factors that are perceived to help or facilitate participation were defined in relation to the typical activities of each setting. Conclusions: The PEM-CY provides a new measure of participation and environment that reflects the perspectives of parents of children and youth. The instrument will facilitate research and professional practice to understand and support the participation of children and youth with and without disabilities.

Implications for Rehabilitation

• As defined by the International Classification of Functioning, Disability, and Health (ICF), participation and environment are multidimensional constructs that have been challenging to measure.

• A new parent-report survey measure has been developed that is feasible for use in large-scale studies of children and youth with and without disabilities.

• The instrument examines participation and environment of children and youth aged 5 to 17 years across three major settings: home, school and community.

     

Disability in post-earthquake Haiti: prevalence and inequality in access to services

Abstract

Purpose: To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. Methods: A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5?+?years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. Results: The prevalence of disability was 4.1% (3.4–4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Conclusion: Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled.

• Implications for Rehabilitation

• Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability.

• Fewer than half of people who reported needing medical rehabilitation had received this service.

• The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with transport (40%).

• People with disabilities did not participate equally in education or employment and had poorer access to health care.

     

Lucy Montoro Rehabilitation Network mobile unit: an alternative public healthcare policy

Purpose: The aim is to analyze rehabilitation services provided by a mobile rehabilitation clinic (MU) in nine regions of the State of São Paulo, demonstrating the distribution of orthoses, prostheses and other mobility aids for persons with physical disabilities according to age groups and impairments, as well as the number of persons with physical disabilities as estimated by Brazilian official data sources. Method: The number of persons with disabilities in each region was obtained through estimations from the 2010 Brazilian IBGE Census. The number of assistive technologies suppliers and technicians were provided by the Brazilian Technical Orthopedics Association (ABOTEC). Patients were referred to the MU by Regional Health Departments. After examination of a multidisciplinary team, assistive devices are prescribed and delivered according to patients' needs. Data on patients were also assessed according to questionnaires on their age, diagnosis, gender, marital status and education level. Results: From 2009 to 2011, the MU went through 15?000 km providing rehabilitation services through the Public Health System to 1801 patients. Additionally, 3328 devices were delivered in this period. Different age, diagnosis, gender, marital status and schooling profiles are highlighted in each of the analyzed regions. Conclusion: Data on patients' profiles were made available through services provided by the MU – including the average index of 1.85 devices delivered to each patient and demand projections – which can be used in the planning of public policies. The MU made rehabilitation services more accessible, trained professionals, raised awareness on the correct delivery and use of assistive devices, and identified and organized people's demand in each region.

• Implications for Rehabilitation

• Delivering prostheses, orthoses and other mobility aids fulfills the rights of persons with disabilities to personal mobility with the greatest possible independence, as foreseen by the Convention on the Rights of Persons with Disabilities, increasing their participation in society on an equal basis with others.

• The direct impact of actively reaching out into the community to provide quality rehabilitation services and assistive devices increases the level of access of persons with disabilities to health services and equalizes opportunities.

• Outreach initiatives to deliver rehabilitation services in the community must include a capacity-building component. Building the capacities of local practitioners and health personnel will further empower both these professionals and persons with disabilities, diminishing attitudinal barriers.

• Reaching out into the community allows gathering data on the prevalence of health conditions, local need and demand for assistive devices and rehabilitation services, and informs decision-making.

     

Cross-cultural validation and psychometric evaluation of the Participation and Environment Measure for Children and Youth in Korea

Purpose: To develop the Korean version of the Participation and Environment Measure for Children and Youth (KPEM-CY) and examine its psychometric properties.

Method: The PEM-CY was cross-culturally translated into Korean using a specific guideline: pre-review of participation items, forward/backward translation, expert committee review, pre-test of the KPEM-CY and final review. To establish internal consistency, test–retest reliability and construct validity of the KPEM-CY, 80 parents of children with disabilities aged 5–13 years were recruited in South Korea.

Results: Across the home, school and community settings, 76% of participation items and 29% of environment items were revised to improve their fit with Korean culture. Internal consistency was moderate to excellent (0.67–0.92) for different summary scores. Test–retest reliability was excellent (>0.75) in the summary scores of participation frequency and extent of involvement across the three settings and moderate to excellent (0.53–0.95) in all summary scores at home. Child’s age, type of school and annual income were the factors that significantly influenced specific dimensions of participation and environment across all settings.

Conclusions: Results indicated that the KPEM-CY is equivalent to the original PEM-CY and has initial evidence of reliability and validity for use with Korean children with disabilities.

• Implications for rehabilitation

• Because ‘participation’ is a key outcome of the rehabilitation, measuring comprehensive participation of children with disabilities is necessary.

• The PEM-CY is a parent-report survey measure to assess comprehensive participation of children and youth and environment, which affect their participation, at home, school and in the community.

• A cross-cultural adaptation process is mandatory to adapt the measurement tool to a new culture or country.

• The Korean PEM-CY has both reliability and validity and can therefore generate useful clinical data for Korean children with disabilities.

     

Differences in participation based on self-esteem in power and manual wheelchair users on a university campus: a pilot study

Objectives: To examine the relationship of self-esteem and wheelchair type with participation of young adult manual and power wheelchair users with diverse physical disabilities. Design: Cross-sectional survey study. Setting: Large University Campus. Participants: A convenience sample of college students (N?=?39) with self-reported physical disabilities who are full time wheelchair users (>40 per week) and are two or more years post illness or injury. Interventions: Not applicable. Main outcome measures: The Rosenberg Self-Esteem Scale was used to measure self-esteem, and the Craig Handicap Assessment and Reporting Technique was used to measure participation. Results: Self-esteem correlated highly with cognitive independence (CI) (r?=?0.58), mobility (r?=?0.67) and social integration (SI) (r?=?0.52). Use of manual wheelchair was significantly related to higher levels of CI and mobility while longer use of any wheelchair (power or manual) was significantly associated with higher levels of mobility and SI. In addition higher self-esteem independently predicted a significant proportion of the variance in CI, mobility and SI, while type of wheelchair predicted a significant proportion of the variance in CI (p?Conclusions: High self-esteem was found to be the strongest predictor of participation in a population of young adults with mobility limitations. Better understanding of the factors influencing participation may help to facilitate new interventions to minimize the disparities between persons with disabilities and their able bodied peers.

• Implication for Rehabilitation

• A total of 46.8% of wheelchair users report the desire for increased community participant but face significant barriers.

• The type of wheelchair has been identified as having a large impact on participation.

• This study found self-esteem to be the strongest predictor of participation, which is notable because self-esteem is a characteristic that is potentially modifiable with treatment.

     

Rehabilitation strategies enhancing participation in shopping malls for persons living with a disability

Purpose: After rehabilitation, it is not clear the extent to which persons living with a disability return to their former activities in the community, such as going to shopping malls. Rehabilitation professionals are faced with the challenge to adequately prepare their clients to resume community participation. The purpose of this study was to identify rehabilitation strategies aimed at preparing clients to engage in activities in shopping malls.

Method: Twenty-two participants including 16 rehabilitation clinicians and 6 persons living with a disability participated in four nominal group sessions. Participants were questioned on current or potential rehabilitation strategies carried out to enhance participation in shopping malls for persons living with a disability. Discussions were audio-recorded and qualitative content analysis was conducted.

Results: Participants mentioned strategies that were either carried out by the clinician, or in collaboration with other parties. The latter type of strategies was either carried out with the collaboration of the client, the interdisciplinary team, the relatives, or community organizations.

Conclusions: Rehabilitation clinicians have a role to play in preparing persons living with a disability to resume activities in a shopping mall. Additionally, therapeutic interventions in community settings may enhance the participation of rehabilitation clients in their everyday activities.

• Implications for rehabilitation

• Many strategies are currently used in rehabilitation to prepare persons living with a disability to resume shopping activities.

• Clinicians could implement shopping-oriented rehabilitation strategies with the client and/or with other rehabilitation partners.

• Involving clients in activities related to shopping might enhance their participation in shopping malls after rehabilitation.

• Rehabilitation clinicians can be facilitators for people living with a disability to reach optimal participation.

     

Using the ICF to develop the capability-oriented database of persons with disabilities: a case study in Nakornpanom province,Thailand

Purpose: This study aims to determine functioning information, rehabilitation needs, and environmental barriers of persons with disabilities (PWDs) using a developed ICF-based questionnaire with community survey approach in Thailand. Method: A systematic review of the use of ICF and disability surveys from January 2000– June 2010 was undertaken. A questionnaire was then developed and tested in two pilot studies before using in a face-to-face interview conducted with legally registered PWDs in Nakornpanom province. Forty-six ICF codes were used in the questionnaire; two second-level codes in body functions, 18 second-level and six third-level codes in activities & participation and 14 second-level and six third-level codes in environmental factors. Each code had 2–6 qualifiers. Results: One thousand and seven PWDs (56.6% male, mean age = 48.4 ± 0.64 years) were interviewed by 16 trained-interviewers. Interview duration was approximately 17?min. The functioning profile could be revealed for both individual and population. These reflected the need for rehabilitation. Several cut-off points to identify “disabled persons” were offered. Regarding participation, PWDs were concerned more about environmental barriers. One-fourth of PWDs needed home environment adaptation, almost 13% were uneducated and 23% had limited chance to participate in social activities. Conclusions: ICF framework and codes can be used to develop a questionnaire to measure population functioning profile and rehabilitation needs of PWDs by community survey. Results can be used to develop a capability-oriented disability database to identify prevalence of disabilities and rehabilitation needs. Policy makers may use this database to plan, monitor and evaluate rehabilitation service programs and removal of environmental barriers.

Implications for Rehabilitation

• Capacity-oriented database of person with disabilities (PWDs) can be developed using ICF concept and codes

• It is shown in the database that, to some extent, PWDs in community are uneducated, have limited chance to participate in social activities, need home adaptation and have some concerns about environmental barriers

• The findings can be used to guide policy makers to plan, monitor, evaluate and allocate resources to rehabilitation services