Nondisabled Peers Research Articles

Impact of disability on survival from severe acute malnutrition in a developing country setting - a longitudinal cohort study

<h3>Aims</h3> Severe acute malnutrition (SAM) causes over 1 million under-5 child deaths in developing countries each year. Among those at risk are children with disabilities. Because their growth often differs from that of non-disabled peers, they are often excluded from SAM-related studies. Little data is therefore available on their outcomes from SAM. We aimed to address this gap by describing: ▶Prevalence of disability among a cohort of children with SAM ▶Short and long term outcomes among disabled children with SAM. <h3>Methods</h3> Secondary data analysis. All children admitted to an urban nutrition rehabilitation unit in Malawi between July 2006 and March 2007 were monitored and followed-up at 1 year post discharge. <h3>Results</h3> Of 1024 children, 60 (5.9%) had an obvious disability: most commonly developmental delay or cerebral palsy (46/60, 77%). Multivariable logistic regression incorporating age, sex, admission anthropometry, oedema and HIV status showed that disabled children were significantly less likely to be HIV positive (p&lt;0.001) and more likely to have a weight-for-height Z score of &lt;−3 (p=0.047). Disabled children were significantly more likely to die in the first 90 days of treatment (hazard ratio 2.29, 95% CI 1.36-3.85, p=0.002 and also more likely to die in the longer term (HR 2.29, 95% CI 1.51-3.45, p&lt;0.001). <h3>Conclusions</h3> Our data suggest that children with disability are a particularly vulnerable SAM subgroup, with high risk of mortality both short and long term. It is important to recognise that there may be many modifiable factors underlying this observation: it is unlikely explained by greater physiological vulnerability alone. Social factors might include suboptimal care practices at home and in communities which increase the risk of a disabled child developing SAM; delayed presentation to care when problems do arise; suboptimal post-SAM care. Treatment services also need to be more proactive about their approach to disability. Protocols should recognise and offer guidance to help identify and care for children with disability. This might include closer referral linkages with disability support services. Finally, more research focusing on this group is needed to determine how treatments might be improved and better tailored to those with underlying disability.

Disability and the Education System

Education is important for all children, but even more so for children with disabilities, whose social and economic opportunities may be limited. In this article, Laudan Aron and Pamela Loprest assess how well the nation's education system is serving students with disabilities. Aron and Loprest trace the evolution of the special education system in the United States from its origins in the civil rights movement of the mid-twentieth century. They note the dual character of federal legislation, which both guarantees eligible children with disabilities the right to a "free, appropriate public education in the least restrictive setting" and establishes a federal funding program to help meet this goal. They then review the types of services and accommodations these children receive from infancy through young adulthood. The special education system has given children with disabilities much greater access to public education, established an infrastructure for educating them, helped with the earlier identification of disabilities, and promoted greater inclusion of these children alongside their nondisabled peers. Despite these advances, many problems remain, including the over- and underidentification of certain subgroups of students, delays in identifying and serving students, and bureaucratic, regulatory, and financial barriers that complicate the program for everyone involved. More important, the authors show that special education students still lag behind their nondisabled peers in educational achievements, are often held to lower expectations, are less likely to take the full academic curriculum in high school, and are more likely to drop out of school. Only limited evidence is available on the effectiveness of specific special education services or on how to improve student achievement for this important subgroup of students. Improving the system will require better ways of understanding and measuring both ends of the special education continuum, namely, what services special education children need and receive, and what academic outcomes these students achieve. Without stronger evidence linking these two aspects of the system, Aron and Loprest argue, researchers will be unable to gauge the efficacy of the services now being delivered or to formulate effective reforms to the system as a whole.

Including children with special educational needs in physical education: has entitlement and accessibility been realised?

The return of the Labour government to power in 1997 brought an increased focus upon inclusive education for children with special educational needs (SEN). Alongside this there has been a desire to enhance the opportunities young people have to access physical education (PE) and school sport. Previous research has shown that children with SEN often have fewer opportunities to access physical activity due to physical, social and emotional barriers to participation. With the advent of a new Con–Lib-Dem government in 2010 and a planned review of inclusion policies and practices, this paper examines the extent to which children with SEN have arrived at utopia in relation to their entitlement and access to PE. The paper identifies four themes central to successful inclusive PE, whilst suggesting there is still some way to go for children with SEN to have the same opportunities in physical activity as their non-disabled peers.

Enabling Integration in Sports for Adolescents with Intellectual Disabilities

Promoting the health and social participation of adolescents with intellectual disability is important as they are particularly vulnerable to encountering difficulties in those areas. Integration of these individuals in integrated sports is one strategy to address this issue. The main objective of this study was to gain a better understanding of the factors associated with the integration of adolescents with intellectual disability in sports alongside their non-disabled peers. Individual interviews were completed with 40 adolescents with intellectual disability and their parents, while 39 rehabilitation staff participated via either a discussion group or self-administered questionnaires. The Disability Creation Process (DCP) theoretical model was used to frame the analysis and the presentation of the findings (The Quebec Classification: Disability Creation Process. International Network on the Disability Creation Process/CSICIDH, Québec, QC, 1998). Various personal and environmental factors that have an impact on integration in sports were identified by participants. For example, attitudes, practical support, individuals' experiences in sports and in integrated settings as well as behaviour control emerged as important elements to consider. Integration in integrated sports can engender a lot of benefits for individuals with intellectual disability, their parents and non-disabled athletes. However, many barriers need to be removed before such benefits can be more widely realized.

A Review of the Potential for Cardiometabolic Dysfunction in Youth with Spina Bifida and the Role for Physical Activity and Structured Exercise

Children and adolescents who have decreased mobility due to spina bifida may be at increased risk for the components of metabolic syndrome, including abdominal obesity, insulin resistance, and dyslipidemia due to low physical activity. Like their nondisabled peers, adolescents with spina bifida that develop metabolic risk factors early in life have set the stage for adult disease. Exercise interventions can improve metabolic dysfunction in nondisabled youth, but the types of exercise programs that are most effective and the mechanisms involved are not known. This is especially true in adolescents with spina bifida, who have impaired mobility and physical function and with whom there have been few well-controlled studies. This paper highlights the current lack of knowledge about the role of physical activity and the need to develop exercise strategies targeting the reduction of cardiometabolic risk and improving quality of life in youth with spina bifida.

Workforce Development Policy: Unrealized Potential for Americans with Disabilities

Individuals with disabilities have lower rates of workforce participation and lower earnings than their nondisabled peers. This article traces the history of the U.S. workforce development policy framework, including the Workforce Investment Act of 1998; the Rehabilitation Act of 1973, as amended; and the impact of the Ticket to Work and Work Incentives Improvement Act of 1999 on both of these policies. Reviewing literature and administrative data, we discuss how these policies have impacted current rehabilitation practice and identify remaining service delivery gaps. We conclude with a set of recommendations for enhancing the current workforce development policy and practice environment.

Enhancing human rights: computer and information technologies with access for all

Inclusion of people with disabilities in the new knowledge-based society can be facilitated by universal design of information and communication technologies (ICTs). This will be a first step in providing the tools to reduce poverty and enhance human rights. Here, we present highlights of the Adaptech Research Network's ten-year corpus of empirical work on education and ICTs for postsecondary learners with disabilities. Consistent with various versions of the social model of disability, recurring findings from our research link the need for availability, affordability and accessibility of both the technological and learning environments and show a clear link to the notions advocated by various versions of the social model of disability. When these three pertinent elements are provided, individuals with disabilities achieve academic success - and obtain jobs - at the same rate as their non-disabled peers.

Valued life activities and readiness to quit smoking among mobility-impaired smokers.

People with physical disabilities smoke at a higher rate than their nondisabled peers, with rates as high as 28-40% among nonelderly adults. One possible explanation for these findings is that restriction of valued life activities (social, professional, pleasurable or otherwise meaningful) due to mobility impairment interferes with smoking cessation. Forty-seven smokers (48.9% female; Mage = 48.91) with chronic mobility impairments (i.e., regularly use equipment to ambulate) were interviewed over the telephone. We assessed demographics, self-efficacy to quit smoking, stage of change, current engagement in valued activities, current restriction of valued activities due to physical limitations, and efforts to replace restricted valued activities in a cross sectional design. Bivariate results indicate that 74% of those in the preparation stage had satisfactory replacements for their most valued restricted activity, whereas only 27% in the contemplation stage and 17% in the precontemplation stage had such satisfactory replacements. Multinomial ordinal regression analyses revealed that (a) having satisfactory replacements for activities restricted due to physical disability was significantly associated with higher stage of change and (b) more current valued activities and, to a lesser extent, fewer restricted activities were significantly associated with higher levels of self-efficacy to quit smoking. These results support the need for the development of treatments for smoking cessation that aim to increase engagement in valued activities, such as behavioral activation.

The effects of inclusion class programmes on physical fitness for children with mental challenges

Objective: The purpose of this study was to compare the effects of inclusion education programmes with special education programmes on physical fitness levels of children with mental challenges.Methods: Participants were 69 elementary school students with mental challenges. Thirty-four children with a mean age of 12.3 ± 2.4 were included in an inclusion physical education programme with non-disabled peers. In addition, 35 children with a mean age of 12.1 ± 1.8 participated in a special class for children with mental challenges. Balance tests, grip strength and Brockport Physical Fitness Test (BPFT) were used to evaluate the physical fitness levels of children.Results: Results indicated that physical fitness parameters; 20 metre shuttle run, push-up, trunk lift, vertical jump and balance test scores were significantly lower in children in the special class (p < 0.05). There were no significant differences in BMI, calf skinfold thickness, grip strength in dominant hand, sit and reach test and modified Apley test (p > 0.05).Conclusion: The physical fitness level was better in children with mental challenges who were participating in an inclusion programme with non-disabled peers. Therefore, it is recommended for children with mental challenges to be part of an inclusion programme with their non-disabled peers.

Instructional Strategies for Learners with Dual Sensory Impairments in Integrated Settings

This article presents information on instructional strategies and the effective use of personnel needed for educating students with dual sensory impairments in integrated learning environments. To counter the practice of educating students in separate environments according to their most apparent weaknesses and limitations, the authors contend that learners with dual sensory impairments can benefit from shared learning environments (cross-categorical) and from daily interactions with nondisabled peers. Specific examples and practical intervention strategies to accommodate for the sensory losses are provided.

SIG 16 Perspectives Vol. 12, No. 4, December 2011

SIG 16 Perspectives Vol. 12, No. 4, December 2011

Interpersonal Sources of Conflict in Young People with and without Mild to Moderate Intellectual Disabilities at Transition from Adolescence to Adulthood

Interpersonal conflict is a source of stress and contributes to poor mental health in people with mild to moderate intellectual disabilities. Understanding the contexts in which conflict typically occurs can better equip services to help people with such difficulties. However, existing studies into the contexts of conflict have included participants with wide-ranging ages and may not reflect the experiences of young adults in particular. Twenty-six young adults (16-20 years) with intellectual disabilities and 20 non-disabled young adults completed a semi-structured interview about a recent experience of interpersonal conflict. Participants were asked to describe their beliefs and feelings about the event and their subsequent response. Participants with intellectual disabilities were more likely to encounter conflict with strangers or peers outside their friendship group and to describe incidents of aggression than non-disabled participants. They were also more likely to characterize the other person globally as 'bad' and to perceive the other's actions as being personally directed at them. Young women with intellectual disabilities were less likely to describe responding aggressively to incidents. Findings suggest that young adults with intellectual disabilities are often the target of overt aggression from those outside their inner social sphere, while their non-disabled peers are more likely to experience conflict with people close to them. Young adults with intellectual disabilities may also be more likely to feel victimized by interpersonal conflict. Implications of these findings and limitations of the study are discussed.

Science Instruction for Students with Learning Disabilities: A Meta-Analysis

Although science has received much attention as a political and educational initiative, students with learning disabilities (LD) perform significantly lower than their nondisabled peers. This meta-analysis evaluates the effectiveness of instructional strategies in science for students with LD. Twelve studies were examined, summarized, and grouped according to the type of strategy implemented. Effect sizes (ES) were calculated for each study. Across all studies, a mean ES of .78 was obtained, indicating a moderate positive effect on students with LD science achievement. Findings also align with past reviews of inquiry-based instruction for students with special needs, indicating that students with LD need structure within an inquiry science approach in order to be successful. Additionally, results suggest that mnemonic instruction is highly effective at increasing learning disabled students' acquisition and retention of science facts.

Cultural Competence: How Qualified Are You?

Cultural Competence: How Qualified Are You?

Kindergarten Children’s Growth Trajectories in Reading and Mathematics

The authors used a large sample of children (N ≈ 7,400) participating in the Early Childhood Longitudinal Study–Kindergarten Cohort (ECLS-K) to estimate kindergarten children’s academic achievement growth trajectories in reading and mathematics. The authors were particularly interested in whether the growth trajectories of children with learning disabilities (LD) or speech language impairments (SLI)—as well as those of other groups of children—were consistent with a cumulative or compensatory developmental cycle. Both LD and SLI children displayed significantly lower levels of kindergarten reading achievement than nondisabled children. However, and over the subsequent 5 years of elementary school, only children with SLI lagged increasingly behind nondisabled peers in their reading skills growth. The authors observed a different pattern for mathematics achievement. Children with LD, but not SLI, lagged increasingly behind nondisabled children in their mathematics skills growth. The authors also observed some consistency in “poor-get-poorer” effects across reading and mathematic achievement for additional population subgroups. Those kindergarten children who were from lower socioeconomic status families, who were African American, and who more frequently displayed learning-related behavior problems initially had lower levels of reading and mathematics achievement and also lagged increasingly behind in their acquisition of these skills over time. Some groups of children, including those with SLI, experience a cumulative rather than a compensatory cycle of achievement growth.

Still ‘more of the same for the more able?’ Including young disabled people and pupils with special educational needs in extra-curricular physical education

Writing over a decade ago, Penney and Harris examined extra-curricular physical education (ECPE) provision in state schools in England and Wales and focused, in particular, on issues of inclusion, equality and equity. They concluded, among other things, that ECPE provision was highly gendered, characterised by a disproportionate emphasis on traditional team games and competitive sport and provided a limited number of opportunities to only a minority of pupils. Although Penney and Harris were less concerned with reflecting upon how the content, organisation and delivery of ECPE may come to impact the involvement and experiences of young disabled people and those with special educational needs (SEN), their analysis nevertheless has important implications for understanding this largely under-explored and neglected aspect of research. In this paper, therefore, we draw upon some key aspects of Penney and Harris's analysis to examine the extent and ways in which physical education (PE) teachers have endeavoured to incorporate disabled pupils and those with SEN in ECPE. In particular, by drawing upon the findings of a study conducted with 12 PE teachers working in five secondary schools in north-west England, the central objectives of this paper are to: (i) examine the ways and extent to which teachers have endeavoured to incorporate young disabled people and pupils with SEN in ECPE; and (ii) explore the extent to which the content, organisation and delivery of ECPE impacts on pupils’ involvement and experiences. The findings suggest that the trend towards including disabled pupils and those with SEN in mainstream schools has not radically altered the content, organisation and delivery of ECPE which, according to PE teachers, continues to be heavily dominated by competitive team sports that retain a strong emphasis on performance, excellence and skills. This provision, it is claimed, appears to have done more to reduce, rather than enhance, the opportunities for pupils to participate in the same activities and to the same extent in ECPE than they might have done in the special school sector. Indeed, when compared to their non-disabled peers, some disabled pupils and those with SEN typically tended to be provided with a limited and somewhat narrow range of sports and physical activities in which to participate. Teachers also suggested that some pupils rarely participated, if at all, in ECPE and, in some cases, they were often taught separately from other pupils in clubs and teams that were developed specifically for them in an effort to cater more adequately for their needs and abilities. It is concluded that until PE teachers and schools are willing and/or able to bring about desired change in the content, organisation and delivery of ECPE, rather than developing more inclusive and non-segregated forms of provision, teachers in many schools will be constrained and/or inclined to continue providing programmes that, in effect, continue to provide what Penney and Harris call ‘more of the same for the more able’ pupils in ECPE.

Preparing for the world of work: an exploratory study of disabled students’ experiences of work placement

For people with disabilities, one of the best ways to achieve independence is through work. Experience gained by undertaking a work placement whilst a student provides valuable knowledge and understanding of the demands of work, and enhances employability on graduation for both students with disabilities and for their non-disabled peers. The aims of this study were to explore the experiences of disabled students who had undertaken work placements as part of their degree courses, and to determine if their experiences adequately prepare them for the world of work once they graduate. A survey, using the Delphi method, was carried out to reveal the five most important positive and negative experiences of students with disabilities following completion of a work placement. Fifty-one students entered the study and 42 completed all requirements. The most important positive experience reported was ‘gaining experience/knowledge’ and the primary negative experience was ‘demanding expectations’. The responses showed highly significant agreement (Kendall’s Co-efficient of Concordance; p < 0.001) for both positive and negative experiences. Findings revealed that students with disabilities have similar work placement experiences to students in general. However, these experiences may have a greater impact on the abilities of students with disabilities to cope and to achieve.

The relative benefits found for students with and without learning disabilities taking a first-year university preparation course

Positive outcomes have been reported for university preparation courses for students without disabilities. Little is known about whether these courses can offer the same benefit to students with learning disabilities and whether the inclusion of psychosocial factors, in addition to academic skills, would benefit both groups. First-level students with and without learning disabilities were tested on variables known to influence academic performance at the beginning and end of a university preparation course. Results revealed that students entering university with and without learning disabilities have similar challenges. Both groups showed increases in attentiveness, and academic and general resourcefulness after the course. Students with learning disabilities experienced greater gains in academic self-efficacy in comparison to their non-disabled peers. The study showed benefits in including psychosocial measures in a university preparation course, and that integrating students with learning disabilities into the course could help to alleviate the limited resources of disabilities programs.

Complicating and Explicating: Taking up Reason in Learning Disabilities Research

In these days of achievement gap, evidence-based practices, and accountability issues, Julie Allan's Complicating, not explicating: Taking up philosophy in learning disability challenges us to think seriously about how well we as a field are meeting our mission of providing for academic and social needs of students with learning disabilities, including preparing them for life after school. In Allan's view, research and practice in field of learning disabilities as currently construed are not working; students with learning disabilities are not empowered, but constrained and controlled by discourses and practices in special education (p. 154). According to Allan, inequalities of a normative power of ideology that attributes success to children's characteristics results in students with learning disabilities viewing themselves in terms of what they lack (p. 159). Allan further asserts that knowledge base of field of learning disabilities is seriously flawed; its linear, hierarchical nature, grounded as it is in scientific method, makes it out of touch with subjective reality experienced by students with learning disabilities. For Allan, solution requires a political liberation of sorts, a deconstruction of status quo, not more conventional science. Allan goes on to propose that we align our research and practices not with scientific method, but with philosophers of difference in order to think differently about construction of learning disability and to envision new forms of learning. To do so, she suggests following theoretical concepts of transgression and rhizome, as well as theoretical practices of deconstruction and rhizomic analysis. All of this leads to what Allan sees as a theory and ethics of research that shifts our attention within learning disabilities away from fault, blame, and lack and towards ... more positive understandings of human differences that lead to more productive teaching practices and arrangements, more inclusion, and, in end, a more lucid sense of what we are about as educators and researchers (pp. 159-160). There is merit to what Allan is saying, but I find it disconcerting that she dismisses, largely through omission, current body of knowledge and practice in learning disabilities. While this stance is consistent with her philosophy of deconstruction, I had thought that purpose of her paper was to foster healthy dialogue, consider both the value and limitations of scientific thinking, and widen circle of discourse, not create a new, exclusive one. That said, points Allan makes are worthy of consideration. Certainly, we need to be sure that we don't become so obsessed with measurable outcomes that we fail to take into account feelings and preferences of our students; indeed, if, in process of serving students, we unwittingly cause them to feel at fault for their problems and/or disassociated from their classmates, we need to know about it and adjust what we do accordingly. We need to keep student failure in perspective and be ever mindful that a failure in one area we deem important does not mean that a student is failing in everything. Student perceptions must be a critical part of our research and teaching agendas so that we can monitor any unintended ill effects. Too, we need to continually and aggressively question our research assumptions, hypotheses, and findings. Now is not time to be complacent, particularly in view of less-than-robust life outcomes attained by students with learning disabilities compared to nondisabled peers, in form of lower graduation rates (U.S. Department of Education, 2001), higher rates of underemployment (Wehman, 2001), lower earnings (Shapiro & Rich, 1999), and a greater dependency on others (Blackorby & Wagner, 1996). As Allan states, being too linear can leave us unprepared to adjust to derailments . …

Editorial: Waist Deep in the Big Muddy: The Individuals with Disabilities Education Act (IDEA) and No Child Left Behind (NCLB)

Individuals With Disabilities Education Act (IDEA) The first iteration of IDEA, the Education of All Handicapped Children Act, passed more than 35 years ago, had several positive elements. Key among these was the concept of a Free Appropriate Public Education (FAPE) for all children, regardless of the extent of the The establishment of an Individualized Education Plan (???) has had an even more far-reaching impact. Under the guidelines of IDEA, along with parents, professionals with appropriate knowledge and expertise, develop IEPs to meet the unique educational needs of children diagnosed as disabled in one of the thirteen federal categories. In recent years approximately six and a half million American children, or 12% of the total public school enrollment, receive educational services developed through IEPs. The mandate for education in the Least Restrictive Environment (LRE) is the major provision that has caused the most confusion and controversy, especially, but not entirely, in the field of education of the deaf. Although there have been attempts, the term has never been defined over the past 35 years to everyone's satisfaction. In general, it has been interpreted to mean that educational placement of a disabled student contiguous to nondisabled peers is preferable to the greatest extent possible. Readers of the Annals are aware of the opposing view that educational placement of deaf children with other deaf children in many instances can increase communication and access to information more efficiently than immersion in a completely hearing environment. From this perspective placement of deaf students with other deaf students constitutes the least restrictive environment. However, because the classification Deaf and Hard of Hearing is one of the 13 federal disability categories, the impact of the mainstreaming/inclusion model interpretation of LRE has been significant. For a number of reasons, educational placement of deaf students had been moving away from residential and center schools since shortly after World War II, but it is undeniable that the LRE provision of IDEA has speeded up the process. In short, the subsumption of education of deaf students under the IDEA umbrella led to a loss of independence in our field, making it more difficult to address the unique needs of deaf students. In some ways the outcome to date has been positive. For example, our educational programs to a large extent were too narrow, concentrating on speech, English, and grammar to the detriment of math, science, social studies, and literature. There has been an important change in emphasis to adapt regular education curricula, especially with the knowledge that many, perhaps a majority, of our children will find themselves in different educational environments. Quite simply, our expectations were too low. On the other hand, we are in danger of losing our identity and being swallowed up within the far larger population of children classified as disabled. The federal government has identified approximately 70,000 deaf and hard of hearing children served under IDEA, slightly more than one child in a hundred with an 1ER If we assume one-half of these students would have severe or profound hearing loss, perhaps one child in 200 children with an IEP is deaf. Two categories - Learning Disabilities and Speech and Language Disorders - constitute the majority of disabled children under IDEA. They receive the type of attention due to them for their numbers; the parameters for them for LRE, for example, are different than they are for deaf students. If regulations for inclusion and for other elements of an IEP are based on majorities, the implications for deaf students may be of concern. Although I know that IEPs, by definition, are individualized, I also know they can be generated by computer. In sum, I think that IDEA has been a mixed blessing for deaf students. Our expectations and curricula are better, but our children may be overlooked and they may not be getting the specialized services they need. …