Development Of Disability Policies Research Articles

Disability Policy Meets Cultural Values: Chinese Families of Children and Young People with Developmental Disabilities in Taipei and Sydney

ABSTRACT Supporting families of people with developmental disabilities from culturally diverse backgrounds is receiving increased attention in the era of globalisation. However, there is little information about how disability policy and cultural values work together to support families. This article examined how disability policy and Chinese cultural values influence family care of children and young people with developmental disabilities. By comparing qualitative interview data from Chinese families in Taipei (15) and Sydney (10), we analysed how their expression of cultural values in family care differs by policy context, relative to ethics of care claims for recognition, rights and redistribution. We found that positive expressions of Chinese culture in family care fade if policies do not complement them. Policies can alleviate potential tension with cultural values in three ways: reinforcing family capacity to care; ensuring the rights of both family caregivers and people with disabilities; and extending care choices for families. These approaches resonate with ethics of care principles. We argue that culturally responsive disability policy for families means working with cultural values to achieve ethics of care. This implies that incorporating principles of ethics of care could inform cultural responsiveness in disability policy development.

When the war is over: Accounting for people with disabilities

We assess the extent to which accounting discourse was used during the aftermath of the Second World War as a way of reconceptualising the notion of a person with disabilities from welfare recipient to income earner. Drawing on Foucault's notion of pastoral power, we interpret archival documents from this important period in the development of disability policy in Australia, which is so far unexplored in the accounting literature. We reveal the role of accounting in rationalising and operationalising government initiatives and programs assembled to address the ‘problem of disability’. We show that accounting terminology and techniques were mobilised as a way of justifying the transference of people with disabilities into sheltered workshops, a process that aimed to transform them into income earners who could contribute to the national economy.

Building Inclusive Development for People with Disability in Post-Pandemic Era to Pursue ASEAN Community 2025: Learning from Asia-Pacific Development Center (APDC)

This qualitative research conducted with the study case method tries to point out the impact of COVID-19 on the employment condition of disabled-person and what ASEAN might consider adopting from the Asia-Pacific Development Center (APCD) when it faces disability policy development. ASEAN itself has many legal commitment papers to establish an inclusive community, particularly for people with disabilities. COVID-19 has hit multi-sector of development in ASEAN and facing bigger challenges to establish an inclusive environment to achieve ASEAN Community 2025 due to the economic slump and mass unemployment. The study found that the pandemic's negative effect doubled when it hit people with disabilities and required rapid response. ASEAN established the Comprehensive Recovery Framework (ACRF), a set of principle guidelines, to respond to the challenge. However, it lacks procedures on how to implement the principles and guidelines at regional level. ASEAN may learn from Asia-Pacific Development Center for Disability (APCD) program, 60+Plus Project, as policy implementation guidelines for ASEAN Member States.

Understanding Disability Policy Development: Integrating Social Policy Research with the Disability Studies Perspective

Studies on the development of social policies have provided us with a rich body of knowledge. However, being based mostly on class, gender or racial analysis, this body of work has seldom used disability as an analytical framework. This article proposes a systematic research agenda for addressing this lacuna. Drawing on the political and institutional approaches, this article illustrates how mainstream theories on social policy development cannot be assumed applicable to disability policies ‘as is’. To apply them effectively, we argue, students of social policy need to rework them in light of the insights of disability studies. Such conceptual work would involve closer attention to the uniqueness of disability as a socio-political category. Integrating these social policy theories with disability studies will allow us to better identify the unique political and institutional factors behind the trajectories of disability related policy. We conclude this discussion with suggestions for future research.

Domestic NGOs Resisting Global Neoliberalism: The Impact of the All-Russian Societies of the Disabled, the Deaf, and the Blind on Russian Government Policy

This essay analyses the impact of Russian domestic actors (specifically, traditionalist NGOs) on the government’s adoption and regulation of international norms and practices regarding disability. The Russian state supports traditionalist NGOs established in Soviet times—such as the All-Russian Societies of the Disabled, the Blind, and the Deaf—rather than promoting the growth of an independent third sector based on grassroots welfare-oriented initiatives. To defend their interests and secure resources, the All-Russian Societies actively participate in the development of disability policy in Russia and advocate for adoption of practices based on international norms on disability. The essay raises the question of how traditionalist NGOs, exemplified by the All-Russian Societies, position themselves regarding the government’s adoption of international norms and practices on disability and how they generally react to the state’s regulation of disability. To answer this question, four phases of interactions between traditionalist NGOs and the Russian government were identified on the basis of the activities of the All-Russian societies in the field of disability regulation. The essay draws on content analysis of Russian legislative acts on social protections for people with disabilities; documents, websites, and social media of the All-Russian Societies and mass media sources from 1995 until 2021; and 13 semistructured interviews of All-Russian Societies’ representatives and experts on the Russian third sector. Text in English

An Overview of Intellectual Disability: Definition, Diagnosis, Classification, and Systems of Supports (12th ed.).

The American Association on Intellectual and Developmental Disabilities (AAIDD) has published terminology and classification manuals since 1921. Their goals over the last 100 years have been consistent: To fulfill the Association's continued responsibility to be the primary repository of intellectual disability-related research and best practices; to publish a scientific definition of intellectual disability (ID) and its assumptions based on research and one that provides a long, stable definitional history; to provide a singular focus on ID and the lives of people with ID and their families; and to communicate professional standards, ethics, and best practices regarding diagnosis, classification, and planning supports. Consistent with these historical goals, the goals of the 12th edition of the AAIDD manual (Schalock et al. 2021) are to: (a) integrate material published in the 11th edition (Schalock et al., 2010) of the AAIDD manual with post-2010 developments and historical markers; (b) develop a user-friendly manual that combines the theoretical and conceptual thoroughness of a manual with the practical aspects of a user's guide; (c) describe a systematic approach to the diagnosis, optional subgroup classification, and planning of supports for people with intellectual disability based on conceptual models, a clear rationale and purpose, and evidence-based practices; (d) combine current empirical knowledge and best practices into an integrative approach to intellectual disability; and (e) provide practice guidelines that frame best practices, increase understanding, and facilitate precise, valid, and effective decisions, recommendations, and actions.The content of the 12th edition reflects the transformation that is occurring in the field of ID. This transformation, which is occurring to various degrees internationally, is characterized by using precise terminology, incorporating a functional and holistic approach to ID, embracing the supports model and evidence-based practices, implementing outcome evaluation, empowering individuals and families, understanding better the multidimensional properties of context, and incorporating an explicit notion of professional responsibility (Schalock et al., in press). As a result of this transformation, the manual contains both modifications of previous concepts and terminology, and the addition of new terms and concepts. These modifications and additions are reflected in the definition of intellectual disability, the evidence-based approach to diagnosis and optional postdiagnosis subgroup classification, the operationalization of systems of supports, and the incorporation of an integrative approach to ID. Throughout the manual, human functioning is viewed from a systems perspective towards understanding human functioning, which includes human functioning dimensions, interactive systems of supports, and human functioning outcomes.Intellectual disability is characterized by significant limitations both in intellectual functioning and adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates during the developmental period, which is defined operationally as before the individual attains age 22. As with previous editions of the AAIDD manual, there are five assumptions that are essential to the application of the definition.In reference to the age of onset criterion for a diagnosis of ID, there has been historic consistency that ID originates during the developmental period. Recent scientific research has demonstrated, however, that the developmental period extends longer than previously understood. The age of onset criterion (“before the individual attains age 22”) found in the 12th edition is based on recent research that has shown that important brain development continues into our 20s. Research using advanced imaging techniques has documented that a number of critical areas of the human brain continue their growth and development into early adulthood, including cortical gray matter volume, corpus callosum, and white matter (Giedd et al., 1999; Jiang & Nardelli, 2016; Mills et al., 2014). As discussed further in the manual, this criterion of “before the individual attains age 22” is also consistent with age 22 in the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (DD Act, 2000) and the standards used for a diagnosis of ID by the Social Security Administration (2021).A diagnosis of ID requires the presence of significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills, and a verification that the disability originated during the developmental period. Although the three criteria of a diagnosis of ID (significant limitations in both intellectual functioning and adaptive behavior, and age of onset) have remained consistent over time, the 9th to 11th editions of the AAIDD manual established greater precision in the diagnostic process. This greater precision required the use of individually administered standardized assessment instruments (first introduced in the 9th edition; Luckasson et al., 1992), the operational definition of significant limitations as an intelligence quotient (IQ) score or adaptive behavior score that is approximately two standard deviations below the population mean (introduced in the 10th edition; Luckasson et al., 2002), and the use of the standard error of measurement to establish a statistical confidence interval within which a person's true score falls (9th and 10th edition for intellectual functioning; 11th edition for both intellectual functioning and adaptive behavior).Classification in the field of ID is an optional postdiagnosis organizing scheme. As described in the manual, classification involves using an explicit framework and a systematic process to subdivide the group of individuals with ID into smaller groups based on the established important purpose for the subgrouping. The three major purposes of subgroup classification are to describe (a) the intensity of support needs; (b) the extent of limitations in conceptual, social, and practical adaptive skills; or (c) the extent of limitations in intellectual functioning.A multidimensional approach to subgroup classification (as reflected in a-c in the previous paragraph) was first introduced in the 9th edition of the AAIDD manual. As the field shifted at that time to a more social-ecological model of disability, and with the introduction of the supports paradigm, four levels of classification based on the intensity of needed supports were proposed in the 9th edition (i.e., intermittent, limited, extensive, and pervasive). These levels did not appear in subsequent editions of the manual (although a discussion of “classification by levels of needed supports” did) due to the lack of standardized data on which to establish psychometrically sound classification bands. As described in Chapter 4 of the 12th edition, current standardized scales of supports intensity yield standard scores that permit a data-based approach to classifying support intensity levels, as was initially proposed in the 9th edition.The 9th edition of the AAIDD manual introduced the supports paradigm to the field. Subsequent editions of the manual introduced a supports delivery model and a supports evaluation model (10th edition), as well as a process for assessing, planning, monitoring, and evaluating individual supports; a community health supports model; and a listing of the support needs of persons with ID who have higher IQ scores (11th edition). The 12th edition of the AAIDD manual updates these areas and relates them to the standardized assessment of support needs, the multiple uses of assessed support need information, systems of supports, and the parameters of support evaluation.Systems of supports are resources and strategies that promote the development and interests of the person and enhance an individual's functioning and personal well-being. Systems of supports are (a) person-centered, comprehensive, coordinated, and outcome oriented; (b) built on values, facilitating conditions, and support relationships; (c) incorporate choice and personal autonomy, inclusive environments, generic supports, and specialized supports; and (d) integrate and align personal goals, support needs, and valued outcomes.With the systematic approach presented in the 11th edition of the AAIDD manual in place and referenced in the professional literature and legal decisions, the 12th edition synthesizes the 11th edition with post-2010 developments in the field and presents an integrative approach to ID. The integrative approach to ID described in the manual combines current knowledge and best practices into a holistic, unified, and systematic approach to defining, diagnosing, classifying, and planning supports for people with ID. The components and associated benefits of an integrative approach to ID include a comprehensive framework, precise terminology, evidence-based practices, clinical judgment standards, an increased understanding of human functioning, and a shared vision of valued outcomes.The role of clinical judgment in the diagnosis of ID, optional postdiagnosis subgroup classification of people with ID, planning supports for people with ID, and implementing an integrative approach to ID are discussed throughout the manual. Clinical judgment is an essential component of one's professional responsibility, which also includes being knowledgeable in the current evidence-based practices of one's profession, maintaining professional standards, and abiding by a professional code of ethics. Throughout the manual, the term clinical judgment is used to refer to the processes, strategies, and standards that clinicians use to enhance the quality, precision, and validity of their decisions and recommendations. Clinical judgment is defined as a special type of judgment that is built on respect for the person, and emerges from the clinician's training and experience, specific knowledge of the person and their environments, analysis of extensive data, and the use of critical thinking skills.The practice guidelines found at the end of each chapter were critiqued, edited, and validated by a peer-review panel of 32 international experts who served as the 12th Edition Advisory Committee. The basis of these practice guidelines is current research, expert opinion, legal decisions, and peer-reviewed publications. The purposes of the Guidelines are to (a) facilitate best practices regarding the definition, diagnosis, classification, and planning supports for people with ID; (b) provide an integrated approach to disability policy development, implementation, and evaluation; (c) suggest a holistic framework for ID-related research; (d) connect foundational concepts to valued policy; and (e) enhance the functioning and well-being of people with ID.The Glossary, which is found at the end of the manual, provides current literature-based definitions of the major terms and concepts found in the manual and the field. The Glossary provides a common language and understanding of important terms for clinicians, researchers, teachers, policy makers, service/support providers, and people with ID and their families.The 12th edition incorporates the significant advancements that have occurred in the field over the last 2 decades. These advancements relate to the increased understanding of ID that comes from the multiple perspectives of ID; the standardized measurement of intellectual functioning and adaptive behavior; the emphasis on the human and legal rights of persons with disabilities, including self-advocacy and consumer empowerment; the application of the capacities approach to disability and the supports paradigm; the establishment of community-based alternatives and inclusive environments; and the emphasis on evidence-based practices and outcomes evaluation.This 12th edition has been developed recognizing the diverse interests and needs of those who will read and use the manual. Thus, every effort was made to develop a user-friendly manual that combines theoretical and conceptual material with practical application guidelines for the individuals and groups who will use the manual. In addition, the authors recognize that knowledge is cumulative and emerges from evidence-based information and an active dialog among stakeholders. Both the members of the 12th Edition Advisory Committee and members of the Disability Experience Expert Panel of The Ohio State University contributed significantly to this dialog and consequently to the manual.The field of ID will continue to evolve based on continuing advancements in the understanding of ID and its amelioration. This 12th edition of the AAIDD manual provides a strong foundation for the field's continuing evolution and for further opportunities for people with ID to create their desired futures. During the field's continued evolution, it is important that AAIDD continue to carry out its definitional responsibilities, as AAIDD is the only professional organization specifically focused on ID with the historical engagement, expertise, and resources to accomplish the work.

Exploring equity and inclusion in Malawi\u2019s National Disability Mainstreaming Strategy and Implementation Plan

BackgroundEquity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.MethodsWe applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.ResultsThe development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.ConclusionsThe development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.

Disability Focal Point Persons and Policy Implementation Across Sectors: A Qualitative Examination of Stakeholder Perspectives in Zambia.

Background: Zambia has created new disability policies and updated existing policies to be consistent with the United Nations Convention on the Rights of Persons with Disabilities. These initiatives require the widespread engagement of ministries and departments to achieve effective policy development and implementation. To pursue widespread engagement, the Government of Zambia developed a structure of disability focal point persons (FPPs). The Zambian disability FPP structure has not yet been explored systematically.Objective: To explore disability policy stakeholder perspectives about FPPs as a feature of disability policy development and implementation.Methods: We conducted semi-structured interviews with 24 disability policy stakeholders (10 policymakers, 2 researchers, and 12 disability advocates) as part of a larger study about the development and implementation of disability-related policies in Zambia. Interviews were audio recorded and transcribed. Data were analyzed using content analysis.Results: Participants presented FPPs as a promising way to mainstream disability within the government. According to participants, the initial launch of the FPP structure was ineffective, with a lack of clarity about the structure and an initial cohort of FPPs that wielded minimal influence. The FPP structure has since been revised. Participants express promise that the improved second launch will achieve mainstreaming.Discussion: Zambian disability policy stakeholders describe a disability FPP structure that is different from the models suggested for treaty implementation. Pre-established commitments to mainstreaming among stakeholders might have stimulated interest in following the cyclical development of the disability FPP structure, encouraging a whole-of-government approach to disability policy implementation.

Disability Policy and Active Citizenship: The Case of Australia’s National Disability Insurance Scheme

In this article, we illustrate how Australia’s new National Disability Insurance Scheme (NDIS) extends the active citizenship of people with disabilities. This is done by examining how the NDIS changes their relation between persons with disabilities and to the welfare state, and through an analysis of its eligibility criteria and needs assessment planning. The support provided and the way in which it is provided reproduce a particular understanding of disability that has a direct influence on the roles assigned to people with disabilities in society as well as on their opportunities to exercise their rights as active citizens. This is important because the implementation of NDIS in Australia is likely to influence the development of disability policy on a global level. Understanding how its mechanisms restricts or facilitates citizenship is therefore crucial.

Leveraging the Power of Context in Disability Policy Development, Implementation, and Evaluation: Multiple Applications to Enhance Personal Outcomes

The article provides an overview and integration of work examining the multiple applications of context to enhancing personal outcomes, with a focus on how a clearer understanding of context can be leveraged in disability policy development, implementation, and evaluation. Specifically, a clear operational definition of context and an empirically based conceptual model of context are presented, followed by an approach to the analysis or measurement of context, and guidelines for applying an understanding of context to enhance personal outcomes through policy development, implementation, and evaluation. The article concludes with a discussion of five specific actions that can be taken to leverage the power of context.

Equal participation of persons with disabilities in the development of disability policy on accessibility in China

The UN Convention on the Rights of Persons with Disabilities (CRPD) of 2006 has been in effect in China for a decade since 31 August 2008. This treaty impacts the rights of persons with disabilities in China in different ways, especially with regard to the public understanding of disability and accessibility for social inclusion. This article scrutinizes two major and interrelated areas: accessible testing to promote the rights of persons with disabilities to inclusive higher education and the contribution of persons with disabilities and their representative organizations in pertinent policy development. It introduces the evolvement of polices on testing accommodations for the national college entrance examination (Gaokao). It also indicates the gap between policy and service provision for accessible testing in Gaokao and the individual needs of persons with disabilities in taking the test. It further emphasizes the strategic and collaborative advocacy of organizations of persons with disabilities (DPOs) to address the challenges for the improvement of disability policy and practice.

An Integrated Approach to Disability Policy Development, Implementation, and Evaluation.

This article provides a framework for an integrated approach to disability policy development, implementation, and evaluation. The article discusses how a framework that combines systems thinking and valued outcomes can be used by coalition partners across ecological systems to implement disability policy, promote the effective use of resources, incorporate specific support strategies that advance identified disability policy goals and lead to systemic changes and enhanced personal outcomes, and focus on activities that advance a unified vision for disability policy and the attainment of personal outcomes. The article concludes with a discussion of the significant challenges and opportunities regarding an integrated approach to disability policy in a time of change.

The Meaning of Social Inclusion for People with Disabilities in South Korea

This study sets out to examine and understand the meaning of social inclusion for people with disabilities, as constructed by people with disabilities themselves. Focus group interviews with 34 people who have physical impairments, cerebral palsy, or hearing or visual impairments were conducted for the study. Using the data obtained from these interviews, the interviewees’ various definitions and perceptions of social inclusion were analysed and four meaning categories for social inclusion were identified: excluded/segregated, present, participating, and actively participating. The findings of this research can be used as foundational material in the development of disability policies and the improvement of social services to better enable full social participation and social inclusion for people with disabilities.

Commuting and communication: An investigation of taxi drivers’ experiences, attitudes and beliefs about passengers with communication disorders

BackgroundOne of the most popular means of public transport within South Africa is mini-bus taxis.ObjectivesAs South Africa is made up of diverse cultures, religions and beliefs, the aim of this study was to explore Johannesburg based taxi drivers’ experiences of beliefs about, and attitudes towards passengers who have a communication disability.MethodSemi-structured interviews were conducted with 10 mini-bus taxi drivers.ResultsInterviews revealed that almost all the taxi drivers had encountered passengers with a communication disability, and had an awareness of passengers with a hearing disability as opposed to a speech disability. Furthermore mini-bus taxi drivers generally held a positive view of their passengers with a communication disability.ConclusionStudy findings contribute to existing literature within the fields of speech pathology and audiology, advocacy groups and policy makers, particularly research studies on participation experiences of persons with communication disabilities related to transportation access. The results of the study should also provide a foundation for disability policy development initiatives with the aim of increasing levels of public awareness.

Negotiating disability in everyday life: ethnographical accounts of women with rheumatoid arthritis

Purpose: Drawing on data from a larger study, the aim of this paper is to illuminate how the everyday doings of women with disabilities are coordinated to and shaped by organizational processes and social context, particularly as these relate to the potential of being labelled disabled. Methods: An institutional ethnography was conducted with seven Austrian women diagnosed with rheumatoid arthritis (RA). Interviews and participant observations were conducted, and texts about the historical development of disability policies were identified. Data analysis included grouping similar doings of participants together to subsequently explore links between what the women did and how their doings are shaped by disability policies and the social context. Results: The women, who participated in this study, spent time and effort to keep the disease invisible, resist disability and negotiate a disability pass. By drawing upon the historical development of Austrian disability policies, the interpretation reveals how this development infiltrates into participants’ lives and shapes their everyday doing. Conclusion: This study furthers understanding of how broader policies and practices, shaped over historical time, infiltrate into the daily lives of women with disabilities. It illustrates how full participation may not necessarily be a lived reality for people with disabilities at this point in Austria.Implications for RehabilitationMaximising full participation for people with rheumatoid arthritis is important.This requires focusing not only on the bodily health of people with rheumatoid arthritis but also on their interaction with the social, cultural and political context in their daily lives.This requires also understanding how knowledge about disability is passed on from previous generations.

Disability meta-organizations and policy-making under new forms of governance

Disability meta-organizations are playing a significant role in influencing the development of disability policy. An example of this is the Disabled Peoples Organizations – Denmark (DPOD), which has managed to unify the disability movement and place itself in a unique position of power. The strategy of DPOD is based on organizational adaptation fitting into the institutional settings of government and building its influence on dialogue, and the establishment of a relationship of trust with political actors in network-based political settings. The change in governance towards cooperation through formal disability councils at municipal level requires the ability to recruit an increasing number of politically active representatives of disabled people. Tensions based on identity conflicts and different political priorities are revealed between different kinds of member organizations when representatives of DPOD are placed in political settings delegated to speak on behalf of disabled people in general.

The accomplishments of disabled women’s advocacy organizations and their future in Korea

Since the late 1990s disabled women’s advocacy organizations have fought against oppression and have made great strides in Korea. This paper aims to describe the accomplishments, challenges and future directions of disabled women’s advocacy organizations in Korea. A qualitative design was employed to explore disabled women’s perspectives. Participants were leaders in disabled women’s advocacy organizations and were recruited from each of the organizations existing in Korea in 2007. Among seven potential participants, five were interviewed. Accomplishments to date include significant gains in the recognition and visibility of disabled women, advances in the use of gender‐sensitive approaches to the development of disability policies and the growth of networks among disabled women’s organizations. Disabled women’s advocacy will continue to become stronger in the future through increased organizational membership, the development of a distinct organizational identity, the articulation of more focused policy concerns and continued network development.

In search of European disability policy: Between national and global

This paper examines the development of disability policy at the European level, from the mid 1970s to the present day, based on documentary research. The development of European policy discourses in this period reflects dramatic changes of thinking about disability that are also evident in global policy debates driven by activism from the international disabled people's movement. Early policy, based on discourses care and rehabilitation, aimed to compensate for the presumed limitations of individual disabled people but policy today is more concerned with human rights, citizenship, full participation and the removal of structural barriers to inclusion. The analysis draws on theories of disability, Europeanization, policy transfer and globalisation to explain European Union (EU) policy development and its uneasy relationship with national and global policy regimes. This analysis suggests a characteristically “European” policy project, involving a socially-oriented but legalistic rights-based discourse. Europeanization is challenged on two fronts: by high levels of national subsidiarity in relevant policy domains and by the emergence of new global regimes of governance (including the United Nations Convention in 2007). The most significant policy catalysts are now at the global level while the most significant implementation constraints are at the national level. Yet, European actors remain important, providing strong support for implementation in member states and as policy entrepreneurs on the global stage.

Mainstreaming community based rehabilitation in primary health care in Bosnia‐Herzegovina

There are over 600 million disabled people and over 20% of the world population is impacted by disability. However, the strategies for including disabled people in the process of reform of developing countries have been rarely considered. The paucity of research is striking. Mainstreaming Community Based Rehabilitation (CBR) in Bosnia‐Herzegovina is one example where the needs of disabled people were a development priority and research was conducted to evaluate this experience. The research demonstrated that unlike the pre‐war environment, disabled people are increasingly active members of the community. The significance is that the needs of disabled people were ‘targeted’ and CBR was ‘mainstreamed’ in the primary health care system creating opportunities for sustained development. CBR is contributing to the citizenship of disabled people. This partnership project set the stage for the continued development of disability policies. These are important lessons.

Demystifying disability: a review of the International Classification of Functioning, Disability and Health.

The paper describes and evaluates the theoretical underpinnings of the International Classification of Functioning, Disability and Health (ICF), and develops the proposition that its conceptual framework provides a coherent, if uneven, guide through the competing conceptions of disability. To date, however, there has been little evaluation of the theoretical efficacy of the ICF. In seeking to redress this, the paper develops the argument that the ICF fails to specify, in any detail, the content of some of its main claims about the nature of impairment and disability. This has the potential to limit its capacity to educate and influence users about the relational nature of disability. The paper develops the contention that three parts of the ICF require further conceptual clarification and development: (a) (re)defining the nature of impairment; (b) specifying the content of biopsychosocial theory; and (c) clarifying the meaning and implications of universalisation as a principle for guiding the development of disability policies.