Perception Of Disability Research Articles

Disability as Diversity: Educational Opportunities for Family Medicine.

Disability is an aspect of diversity that often receives less attention in healthcare and medical education than other aspects of diversity, such as gender or race. Approximately one in four Americans has some type of disability, and individuals with disabilities have less access to healthcare, greater dissatisfaction with their healthcare, and report being in poorer health than individuals without a disability. Although many factors likely contribute to these disparities, physician perception and understanding of disability have been examined as potential pathways that influence health inequity. It is important to incorporate disability as a form of diversity in family medicine education to train physicians that provide excellent care to patients with disabilities and work toward equitable healthcare for them. In this article, we review definitions and data related to disability. We examine disparities and forms of stigmatization toward individuals with disabilities. We then present scenarios in the context of family medicine residency education that involve stigmatization of a person with a disability. Following each scenario, we identify the stigmatizing problem and its potential impact on the individual with a disability. In addition, we outline a potential intervention as an individual witnessing this scenario, and an alternative, non-stigmatizing approach to the scenario. Finally, we present proposed core competencies on disability for health care education and potential strategies to incorporate these competencies into family medicine curricula.

Rasch analysis of the Oxford shoulder score in a non-surgical occupational population.

The Oxford shoulder score (OSS) questionnaire for measuring patient perception of shoulder disability, has not tested specifically in a non-surgical population and no study has assessed the OSS with modern psychometrics based on Rasch model (RM). To assess the psychometric properties of the OSS using RM among health-care workers with shoulder disorders and to verify its interest in a non-surgical population. In an occupational health department of a French hospital center, a retrospective review was performed of the medical records from June 2019 to October 2020. Responses to 110 questionnaires were examined from 55 subjects (97% of women). A polytomous Rasch model based on the Partial Credit Model was used. Overall fit was satisfactory, the reliability coefficient was high and an ascending order was observed with the 5 categories of the scale. Analysis of the residuals supports unidimensionality and the local independence assumption. Item performance remained stable across the subgroup examined (DIF measures). Scale to-sample targeting indicated a substantial floor effect, and the mildest impairments were not well discriminated. OSS presents good psychometric qualities. However, it does not clearly discriminate subjects presenting the lowest levels of impairment. Its use in a non-surgical population is questionable.

Inclusivity of children with disabilities and downsides of welfare-oriented service delivery system in Sri Lanka with special reference to rural areas in Galle district

Disability is a result of the attitudinal and environmental barriers that hinder persons with impairments from their full and effective participation in society on an equal basis with others. Advocacy movements of persons with disabilities have contributed to changing the perception of disability. Disability-inclusive development has emerged as a method to secure equal rights for persons with disabilities. Social constructionists view the problem of disability as situated within the minds of able-bodied persons: individually as prejudice, and collectively as hostile social attitudes and practices. These negative assumptions of impairments lead to institutional discrimination against persons with disabilities. This article is based on an ethnographic study exploring the lived experience of children with disabilities and their vulnerable families in remote areas of Sri Lanka. It examines the awareness levels of service providers and the recipients on the rights-based approach to disability. The data for this article was gathered by way of qualitative interviews with parents, self-help groups, and service providers. The article describes the shortcomings of the welfare-orientated service delivery system in Sri Lanka and illustrates how the discriminatory practices in education, health, and transport services reinforce the marginalization of children with disabilities. The findings of this article contribute to the limited body of empirical evidence on children with disabilities. Drawing from these findings, the article suggests transforming systems through disability inclusive development.

The Bioarchaeology of Disability: A population-scale approach to investigating disability, physical impairment, and care in archaeological communities

ObjectiveThis research introduces ‘The Bioarchaeology of Disability’ (BoD), a population-scale approach which allows for a comprehensive understanding of physical impairment and disability in past communities through a combination of palaeopathological, funerary, and documentary analyses. MethodsThe BoD consists of three phases: 1) Contextualisation includes period-specific literature review; 2) Data collection consists of palaeopathological re-analysis of all individuals with physical impairment and collation of mortuary treatment data; and 3) Analysis integrates the gathered data, literature review, and theoretical frameworks to explore contemporary perceptions of disability. MaterialsThe BoD is demonstrated through an investigation of physical impairment and disability in later Anglo-Saxon England (c.8th-11th centuries AD) which includes four burial populations (Ntotal=1543; Nimpaired=28). ResultsIndividuals with physical impairment could be buried with normative or non-normative treatment (e.g., stone/clay inclusions, non-normative body positioning), and in marginal, non-marginal, and central locations. ConclusionsThe overall funerary variation for individuals with physical impairment was relatively slight, which may suggest that religious factors were influencing normative funerary treatment of impaired and potentially disabled individuals. The funerary variability that was observed for individuals with physical impairment was probably influenced by individual and community-specific beliefs. SignificanceThis research describes a population-scale approach to archaeological disability studies that can be replicated in other archaeological contexts. LimitationsIndividuals with non-skeletal physical impairment (e.g., soft tissue, mental) are not considered by the BoD. Suggestions for further researchThe BoD should be applied to different archaeological communities around the world to better understand disability and physical impairment in the past.

Knowledge, Attitude and Perception of Disability among Healthcare Workers in a Nigerian Tertiary Health Institution

In Nigeria, people living with disabilities often face unintentional poor treatment and neglect. This cross-sectional study was aimed at exploring the level of knowledge, attitude, and perception of healthcare professionals towards PLWD in Nnamdi Azikiwe Teaching Hospital, Nnewi Anambra State.

Effectiveness of a smoking cessation program among low-income pregnant women

ABSTRACT Objective To determine the effectiveness of a smoking cessation program. Method A one-group pretest–posttest quasi-experimental study was performed with 42 pregnant women, who lived in İzmir city center, earned less than $4.3/day, and were 12–20 week pregnant. The smoking cessation program included 6 face-to-face interviews at the family practice centers. The effectiveness of the intervention program was evaluated by measuring the exhaled CO level, cotinine level in the urine, and the results of the health belief model in pregnant women. Results The results of the study showed that the post-intervention smoking cessation rate of the pregnant women was 42.9%, and a statistically significant difference was found between the cotinine ratios in the urine and expiratory CO levels before and after the intervention. A statistically significant difference was observed between the mean scores of sensitivity, severity, motivation, benefit, disability, and self-efficacy perception regarding smoking during pregnancy before the intervention in pregnant women who smoked after the intervention. Conclusion Questioning the habit of cigarette smoking during pregnancy and providing professional consultation for overcoming the obstacles in quitting smoking were successful methods for cessation of smoking among pregnant women, and those were considered as the first step by nurses for overcoming this smoking addiction.

Self-Report and Administrative Data on Disability and IEP Status: Examining Differences and Impacts on Intervention Outcomes

Differences in perceptions of disability between students and administrators can play a role in youth’s educational experience. This study used data from a cluster randomized controlled trial (C-RCT) of the Self-Determined Learning Model of Instruction (SDLMI) to first compare student self-report of disability status to matched administrative data and second to examine the impact of the data source utilized on trial outcomes. The findings demonstrate substantive gaps between self-reports and administrative reports of disability. While some differences might be expected, the size of the differences is notable, especially given that many students identified as having an Individualized Education Program in administrative data did not self-identify as receiving services or having a disability. The findings advance understanding of discrepancies in self-reported disability and administrative data in secondary intervention research. We also found the interpretation of group differences (students with vs. without disabilities) on trial outcomes was sensitive to the source of the data (self vs. administrative) used to establish disability status. This finding can inform future research and policy, as the data source selected to define disability populations across research studies likely has substantive impacts on conclusions drawn about the impact of interventions on students with disabilities. We cannot identify all the factors driving these differences. Nonetheless, the findings underscore the importance of providing clarity about decisions made in defining disability populations in intervention research.

Impact of Situated Learning Approach on Teacher Learning: Physical Education Teacher Trainees' Perception of Disability and Inclusion

Globally, educational inclusion for Students with Disabilities (SWDs) has been a rising movement since the 1990s. However, discourses on professional development processes that prepare teachers to become inclusive practitioners for SWDs are still limited. This qualitative case study examined the learning experiences of Physical Education Teacher Trainees (PETTs) in an introductory adapted physical education course designed with a situated learning framework to explore its influences on their understanding of disability and inclusion in physical education. The course was re-designed incorporating three interrelated dimensions-context, learner, and activity-of the situated learning. A qualitative intrinsic case study design driven by an interpretive perspective was undertaken to describe and understand the PETTs' experiences. Four PETTs' (3 females, 1 male) perceptions were gathered through a semi structured interview, reflections on learning activities, photos, a pre-course survey, and field notes. Three themes emerged from the thematic analysis are: (1) The power of authenticity in learning, (2) Beyond empathy: accepting individual differences, and (3) Inclusion as an integral part of education. Findings reveal that PETTs have shown perceptual transformation in disability and inclusion. This study discusses the PETTs' conceptualization of disability and inclusion with the notion that direct engagement with practices can deepen their learning within social and cultural contexts, such as adapted/inclusive physical education and social relationships with the Community of Practices (CoPs).

Access to the Disability Allowance in the Maldives: National coverage and factors affecting uptake

Disability-targeted cash transfers are increasingly used by governments in low- and middle-income countries as a tool to address poverty and exclusion among people with disabilities. However, in many settings, accurate estimates of coverage and an understanding of factors affecting uptake are needed for effective delivery. This study explores coverage of the Disability Allowance in the Maldives, an unconditional, non-means tested cash transfer (2000 MVR or US$130 per month) and factors affecting uptake. It uses mixed methods, combining data from a nationally representative population-based survey with qualitative research among people with disabilities who are and are not receiving the Disability Allowance. This research found that 25.6% of people with disabilities across the Maldives are receiving the Disability Allowance. Coverage was lowest for women, older adults, people living in the capital (Malé), wealthier households and people with sensory impairments. Factors affecting uptake included lack of information about the programme, perceptions of disability and eligibility criteria, geographical and financial factors, and stigma.

A Study of Voice Handicap and Acoustic Measures in Arab Kuwaiti Prospective Professional Singers

Introduction: Despite its clinical significance, few studies have explored the applicability of the validated Arabic version of the Voice Handicap Index (VHI-Arab) in professional voice users, especially singers. The correlation between VHI-Arab scores and acoustic measures in this targeted group remains unclear. The aim of this study was to explore Arab Kuwaiti prospective professional singers’ perception of voice handicap using the validated VHI-Arab. Additionally, we examined the association between VHI-Arab scores and acoustic measures such as fundamental frequency (F0), shimmer, jitter, and signal-to-noise ratio. Methods: VHI-Arab scores and acoustic measures of 100 adult prospective professional singers (50 females and 50 males) were compared with those of 100 adult controls (50 females and 50 males). Results: Female prospective professional singers differed significantly from female controls in terms of functional and physical subscale scores, total VHI-Arab scores, and shimmer and jitter values. Male prospective professional singers showed significant differences neither in VHI-Arab scores nor in acoustic measures; however, their shimmer values showed significant a difference. There was no correlation between VHI-Arab scores and acoustic measures. Conclusion: Kuwaiti prospective professional singers did not perceive their voice as handicapped. Female prospective professional singers had a better perception of their voice compared with female controls. The results of the current study suggest that the perception of voice handicap and acoustic measures are different attributes that do not correlate.

Towards Web Equality: Efforts on Web Accessibility for Persons with Cognitive Disability

With the fast-paced development of digital innovations, web technologies are on the rise. With this in mind, making the web accessible for all became an interesting line of research and development. Web accessibility means that websites, tools, and technologies are designed and developed so that people with disabilities can use them with minimal to no supervision. More specifically, people can perceive, understand, navigate, and interact with the web. Over the past years, there have been attempts to achieve web accessibility for web users with physical, visual, and sensory disabilities. However, people with cognitive disabilities were not seen as a user group, thus, leaving them far behind the target general population for improving web accessibility. This paper presents an overview of the current state of web accessibility for people with cognitive disabilities. This paper attempts to come up with a unified definition of web accessibility and identify its components. The study identified the common reasons for the non-conformity of web accessibility. Moreover, the different cognitive disabilities and their linked issues are presented. Furthermore, this study reviews the various interventions made by governments and private organizations worldwide. The study uncovered that web accessibility for people with cognitive disabilities hadn’t been a priority for research which resulted in non-conformities with the accessibility guidelines such as poor interface design, confusing guides and instructions, robustness, and lack of features to cater to the needs of people with cognitive disabilities. Results show that in each kind of cognitive disability, namely Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Intellectual Disability, Memory Impairments, Perceptual Disability, and Seizure Disorder, people experience various difficulties in accessing the web, specifically on processing too much content or information, confusing instructions, typographies, and grammar. Laws have been imposed on different Asian and Western countries to address these difficulties. In contrast, other countries and organizations have adopted the Web Accessibility Guidelines of the World Wide Web Consortium (W3C). In conclusion, as organizations gear toward web equality, governments have the initiative to move towards the goal by implementing different laws and policies driving the WCAG 2.0 as a basis of these to orchestrate the design of websites effectively. Furthermore, this study calls for action for extensive research on web accessibility for cognitive disabilities as it is not only valuable to the vulnerable sector of society but also for the rest of the population.

Towards Web Equality: Efforts on Web Accessibility for Persons with Cognitive Disability

With the fast-paced development of digital innovations, web technologies are on the rise. With this in mind, making the web accessible for all became an interesting line of research and development. Web accessibility means that websites, tools, and technologies are designed and developed so that people with disabilities can use them with minimal to no supervision. More specifically, people can perceive, understand, navigate, and interact with the web. Over the past years, there have been attempts to achieve web accessibility for web users with physical, visual, and sensory disabilities. However, people with cognitive disabilities were not seen as a user group, thus, leaving them far behind the target general population for improving web accessibility. This paper presents an overview of the current state of web accessibility for people with cognitive disabilities. This paper attempts to come up with a unified definition of web accessibility and identify its components. The study identified the common reasons for the non-conformity of web accessibility. Moreover, the different cognitive disabilities and their linked issues are presented. Furthermore, this study reviews the various interventions made by governments and private organizations worldwide. The study uncovered that web accessibility for people with cognitive disabilities hadn’t been a priority for research which resulted in non-conformities with the accessibility guidelines such as poor interface design, confusing guides and instructions, robustness, and lack of features to cater to the needs of people with cognitive disabilities. Results show that in each kind of cognitive disability, namely Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Intellectual Disability, Memory Impairments, Perceptual Disability, and Seizure Disorder, people experience various difficulties in accessing the web, specifically on processing too much content or information, confusing instructions, typographies, and grammar. Laws have been imposed on different Asian and Western countries to address these difficulties. In contrast, other countries and organizations have adopted the Web Accessibility Guidelines of the World Wide Web Consortium (W3C). In conclusion, as organizations gear toward web equality, governments have the initiative to move towards the goal by implementing different laws and policies driving the WCAG 2.0 as a basis of these to orchestrate the design of websites effectively. Furthermore, this study calls for action for extensive research on web accessibility for cognitive disabilities as it is not only valuable to the vulnerable sector of society but also for the rest of the population.

Towards Web Equality: Efforts on Web Accessibility for Persons with Cognitive Disability

With the fast-paced development of digital innovations, web technologies are on the rise. With this in mind, making the web accessible for all became an interesting line of research and development. Web accessibility means that websites, tools, and technologies are designed and developed so that people with disabilities can use them with minimal to no supervision. More specifically, people can perceive, understand, navigate, and interact with the web. Over the past years, there have been attempts to achieve web accessibility for web users with physical, visual, and sensory disabilities. However, people with cognitive disabilities were not seen as a user group, thus, leaving them far behind the target general population for improving web accessibility. This paper presents an overview of the current state of web accessibility for people with cognitive disabilities. This paper attempts to come up with a unified definition of web accessibility and identify its components. The study identified the common reasons for the non-conformity of web accessibility. Moreover, the different cognitive disabilities and their linked issues are presented. Furthermore, this study reviews the various interventions made by governments and private organizations worldwide. The study uncovered that web accessibility for people with cognitive disabilities hadn’t been a priority for research which resulted in non-conformities with the accessibility guidelines such as poor interface design, confusing guides and instructions, robustness, and lack of features to cater to the needs of people with cognitive disabilities. Results show that in each kind of cognitive disability, namely Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Intellectual Disability, Memory Impairments, Perceptual Disability, and Seizure Disorder, people experience various difficulties in accessing the web, specifically on processing too much content or information, confusing instructions, typographies, and grammar. Laws have been imposed on different Asian and Western countries to address these difficulties. In contrast, other countries and organizations have adopted the Web Accessibility Guidelines of the World Wide Web Consortium (W3C). In conclusion, as organizations gear toward web equality, governments have the initiative to move towards the goal by implementing different laws and policies driving the WCAG 2.0 as a basis of these to orchestrate the design of websites effectively. Furthermore, this study calls for action for extensive research on web accessibility for cognitive disabilities as it is not only valuable to the vulnerable sector of society but also for the rest of the population.

Ambivalence about disability: Why people with mild learning difficulties who are looking for employment may not identify as disabled

UK government policies over several decades have sought to actively encourage disabled people to take up paid employment, most recently by focusing on the ‘gap’ between employment rates of disabled and non-disabled people. These policies implicitly assume a clear distinction between people who are and are not disabled, linked to medically-oriented, hierarchical notions of deservingness. They also assume that people who need support will self-identify. This article explores factors that undermine those assumptions or expose their contradictory effects. It presents findings from qualitative research with people with mild learning difficulties, discussing their perceptions of disability and how they negotiated an ever-shifting balance of consequences of identifying as disabled or disclosing needs, linked to risks and experiences of prejudice, discrimination and exclusion. Points of interest Government policy to support disabled people into paid work suggests that it is obvious who is and who is not disabled. This research looks at what disability means for people with mild learning difficulties who are looking for paid work. People with mild learning difficulties sometimes view themselves as disabled but sometimes refuse that label, even when they accept that they need support. The research participants gave a wide range of reasons for accepting or rejecting the label of disability. They showed how they balanced hopes for support against fears of rejection or abuse, based on their personal experiences.

Effects of Complex Rehabilitation Program on Reducing Pain and Disability in Patients with Lumbar Disc Protrusion—Is Early Intervention the Best Recommendation?

(1) Background: Due to its frequency and possible complications, low back pain (LBP) has a high social impact, it is a common problem of the active population and the second reason for visiting a physician. In patients with lumbar disc protrusion (LDP), one of the most common causes of LBP, the nucleus pulposus bulges against the disc and then protrudes into the spinal cord, but the annulus fibrosus remains intact; (2) Objectives: The primary objective of this study was to determine the efficacy of a rehabilitation treatment (RT) comprising electrotherapy (ET), hydrotherapy (HT) and individualized physical therapy (PT) versus ET alone in patients with LDP. The second objective was to investigate whether there is a correlation between early RT and the symptomatology of patients with LDP; (3) Methods: The research was conducted between July 2021 and January 2022 at the Ceres Hotel Treatment Centre from Baile 1 Mai, Romania, and all the study subjects signed an informed consent form. For this study, the block randomization method was used to randomize subjects into groups that resulted in equal sample size, in order to maintain a reasonably good balance among groups. Therefore, the two groups had the same number of subjects (30 subjects) and the randomization was made taking into account the patient’s motivation or the subject’s willingness to receive not only electrotherapy treatment, but also the physical exercises and hydrotherapy. The eligibility criteria were: low back pain for more than three months, an MRI confirmed diagnosis of LDP (without dural compression), and ability to perform a PT program. The control group received only a classical ET program. In addition, the patients in the experimental group received a complex individualized PT program associated with HT and ET. To achieve these objectives, the study subjects were monitored for spinal mobility (lateral lumbar flexion—LLF, index fingers-ground—IFG, lumbar Schober tests for flexion—LS, Inverted Schober test for extension—ILS), trunk flexor and extensor muscle strength (LF strength, LE strength), level of pain (Short Form McGill Pain Questionnaire—SF-MPQ, Visual Analogue Scale—VAS), and the degree of limitation in activities of daily living (Oswestry Disability Index—ODI); (4) Results: Comparing the evolution of the subjects, using the One-Way ANOVA between groups, we observed a significant improvement in all variables [SF-MPQ (95% CI, 7.996/11.671), VAS (95% CI, 1.965/3.169), mobility FTF (95% CI, −7.687/−3.940), LS (95% CI, 2.272/2.963), LE strength (95% CI, −5.676/−3.324), LF strength (95% CI, −5.970/−3.630), disability (95% CI, 8.026/10.441) after six months of treatment for the experimental group subjects. A clear correlation was found, using the Bravis–Pearson test, between the earliest possible initiation of RT and improvement of patients’ symptoms; (5) Conclusion: The current study proves the importance of combining ET with HT and PT. The earlier the RT is implemented, the lower the pain perception and level of disability associated with the lumbar disease.

Exploring the intersection of critical disability studies, humanities and global health through a case study of scarf injuries in Bangladesh

This article puts critical disability studies and global health into conversation around the phenomenon of scarf injury in Bangladesh. Scarf injury occurs when a woman wearing a long, traditional scarf...

The incapacity to work as moving target. Exploring the possibilities of praxiography for analysing realities of disability in history

While acknowledging the discursive meaning of bodies, both gender and disability scholars try to overcome a strict nature–culture or medical model–social model divide. This article explores the possibilities of praxiography for disability history to overcome this divide. Praxiography, as introduced by Annemarie Mol, approaches the body and gender as something that is made up in encounters between people, objects, and practices. Mol has shown that, although a singular term may suggest there is coherence, this coherence is managed in practice. This article provides a practice-focused analysis of appeal cases in which incapacity to work was contested in the context of the first disability benefit act in the Netherlands (1901–1921) and shows how incapacity to work was made up as incapacity to earn a living and shifted to meticulous descriptions of the functioning of individual body parts. Although the topic of power remains to be explored, by looking at incapacity to work as a site of interaction, we can challenge perceptions of disability and gender as a biological or a cultural truth and incorporate matter into the historical analysis of the making of social categories.

Il ricorso al video nella formazione del docente della scuola dell’infanzia per la costruzione di competenze inclusive incarnate

Cognitive sciences and neuroscientific landings allow to support the existence of a circular dialogue between perception, action, emotion and cognition and their ability to influence and strengthen each other in the process of knowledge. These considerations are unavoidable, so they can and must have many impacts on teacher training. In particular, the training of support teachers requires cognitive reflections that are closely linked to experiential content, information, and body representations, that are capable of narrating effective and inclusive interpersonal relationships. After a description of the Embodied based constructs, that formed the basis of the training model, this contribution discusses about the treatment of the literature in support of the use of video both as an embodied training tool, designed to promote the centrality of the body in the processes of observation and simulation of inclusive strategies; and as a means of “narration” of effective and real inclusive processes, capable of having a positive impact on the perception of disability and its functioning. The undertaking of experiential and emotional body dimensions in training is an essential element, in order to promote, the construction of crossmodal skills of the teacher (corporeal-emotional-empathic) for the structuring of real inclusive processes and contexts in the classroom.

Perceived health versus perceived disability among individuals with lower limb amputation and its associating factors: evidence from an exploratory study in Mumbai and Kolkata, India

Background: Self-rated health (SRH) has been used to predict the perception of health in objective measures. Understanding the perception of disability goes beyond simple perception of health. Lower limb amputation and locomotors disability has been studied in various aspects, however, measurement of the extent of disability in a single term has hardly been done. This study aims to find the difference between perceived health (SRH) and perceived disability self-rated disability (SRD) and its association with demographic and socio-economic factors.Methods: A primary study has been conducted on 270 adult lower limb amputees in Mumbai and Kolkata following mixed methodology approach. Descriptive statistics, correlations and narration were used to measure the SRH and SRD among individuals with lower limb amputation.Results: The 63% of respondents have achieved good SRH, while only 43% have achieved good SRD. Prosthetics satisfaction, perceived support, perceived body shape, and level of education influence the SRH and SRD. Health components explain SRH, whereas, functional components explain SRD more.Conclusions: SRD can be better in analyzing the coping with the disability status, and promoting the role of health care and rehabilitation programs. It can be used not only for the population having disability, but in a larger population with functional restrictions that can be used to address the health care need.

Aging, Crip Time, and Dependency Care in Joyce Farmer’s <i>Special Exits</i>

This essay explores how Joyce Farmer’s Special Exits resists the prevailing decline-burden discourse concerning aging-into-disability and dependency care by imagining alternative perceptions of aging-into-disability temporal and caregiving constructs that are not centered on productivity, independence, and progress. Drawing on Alison Kafer’s “crip time” and Eva Kittay’s “dependency care” concepts, the essay examines a fundamental reorientation that resists ableist-dominated descriptions of normative timelines, and shows how Farmer uses narrative pacing in Special Exits to match the ways that its older adult characters respond to physical and mental challenges that require flexibility and adjustment. The author also shows how aging-into-disability can be reimagined through a crip time lens that emphasizes new forms of living with and in relationship to time instead of only considering deficits and losses. The second part discusses how crip time and care time intersect, and how caregiving takes on a transformative meaning for the story’s characters when dependency is viewed as facilitating interdependence and connection, thus transforming care-giving into care-gifting. Farmer uses this intersection along with an aging-disability nexus lens to address the ongoing need for counternarratives to challenge normative perceptions of aging and disability, and to promote a future in which individuals with age-associated disabilities can flourish by accepting and acting in accordance with their own time requirements.