Social Work Physical Disabilities
by
Michael Wolf-Branigin
  • LAST REVIEWED: 06 May 2015
  • LAST MODIFIED: 25 June 2013
  • DOI: 10.1093/obo/9780195389678-0190

Introduction

Physical disabilities can be an intriguing and yet a confusing field for conducting research. Confusion can arise from unclear definitions and the frequent presence of coexisting intellectual and developmental, sensory, communication, or cognitive disabilities. To begin, the term physical disability must be defined. For the purposes of this article, physical disability covers a broad sweep of areas. Types may include congenital disabilities (e.g., cerebral palsy), acquired disabilities (e.g., spinal cord injury), and sensory/communication disabilities (e.g., low vision). Although co-occurring intellectual and developmental disability may be present, this article focuses solely on persons with a physical disability. Similar to responses to the other disabilities, these individuals and their advocates increasingly focus on concerns to improve environmental accessibility and inclusion in their communities. Causes of physical disabilities include prenatal, perinatal, and postnatal. Prenatal disabilities are acquired before birth and may occur because of an illness carried by the mother during pregnancy or by a genetic problem between the parents. Perinatal disabilities occur during birth and may be acquired because of a lack of oxygen or the obstruction of the respiratory tract, damage to the brain during birth, or premature birth. Postnatal disabilities are acquired after birth and are caused by accidents, infection, or other illnesses. Several themes arise when considering the roles of social work and civil rights when supporting persons with physical disabilities. The following addresses several vital issues, including conceptualization of new perspectives arising from the field of disability studies in which the traditional medical model is rejected in favor of inclusive and interconnected lives. This shift from a medical model to a social model of disability touches on topics that include relevant employment issues and services that lead to increased community participation (e.g., supported employment); health issues; the projected increase of incidence; housing; community in which increasing use is made of approaches based on person-centeredness, peer support, consumers, the independent living movement, and person-first language; legislation and court decisions to support inclusive and community-based environments; maintenance of independence; types of physical disabilities that range from acquired to congenital; veterans issues; and the built environment in which the person with a physical disability lives.

Conceptualizing Physical Disability

Consistent with social work’s person-in-environment perspective and emerging social policy for more inclusive and accessible environments, the current literature focuses on issues such as employment, housing, transportation, health care, and education. Since the 1970s, several initiatives have provided the underpinning framework to shift to community-based and inclusive services (Rothman 2010). Most prominently, the disability rights movement emerged in which individuals with disabilities advocate for full inclusion (Fleischer and Zames 2001, cited under Violence and Discrimination). Disability advocates applied political pressure to local, state, federal, and international decision makers to fund services, including accessible transport, education, housing, employment, health, and communications. A significant paradigm shift occurred in 1970 in the United States with enactment of Section 504 of the Rehabilitation Act. This act banned discrimination on the basis of disability for entities receiving federal funding. Subsequent legislation followed in the 1970s and 1980s as countries shifted disability policy from a medical, institutional model to a set of services that supported community living and that viewed a person’s ability to function across several life domains. In the United States, these laws culminated in passage of the Americans with Disabilities Act (ADA) in 1990. This section includes entries that seek to frame how people with physical disabilities are perceived and to offer contemporary views of what constitutes disability (Mary 2007, O’Brien 2011), to question what is normal (Clear 1999), to identify perceptions of what constitutes disabling conditions (DePoy and Gibson 2004, Russell 1981), and to explain how these views have shifted since the 1970s (Hilbourne 1973, Saleeby 2007).

  • Clear, M. 1999. The “normal” and the monstrous in disability research. Disability and Society 14.4: 435–448.

    DOI: 10.1080/09687599926055Save Citation »Export Citation »

    This article serves as a preliminary work on the evolving concept of ableism, a form of social discrimination against people with disabilities. Ableism perceives a disability as a barrier that someone must overcome in order to be “normal” and conform to societal expectations.

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    • DePoy, E., and S. F. Gibson. 2004. Rethinking disability: Principles for professional and social change. Belmont, CA: Brookes-Cole.

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      The authors apply their Explanatory Legitimacy Theory to build upon the current disabilities studies literature by providing a conceptual framework. This framework uses the interactive elements of description, explanation, and legitimacy to underpin the many perspectives on disability.

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      • Hilbourne, J. 1973. On disabling the normal: Implications of physical disability for other people. British Journal of Social Work 3.4: 497–504.

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        Physical disabilities were traditionally regarded as attributes of individuals. This article suggests that the physical disability of one individual may become a substantially disabling attribute for others, particularly family members with whom the person is associated. The author explores this issue and some of its consequences are examined.

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        • Mary, N. L. 2007. An approach to learning about social work with people with disabilities. Journal of Social Work in Disability & Rehabilitation 6.1–2: 1–22.

          DOI: 10.1300/J198v06n01_01Save Citation »Export Citation »

          The construct of “disability,” it is argued, is in the eye of the beholder. The author provides an outline for an introductory course in working with people with physical, cognitive, developmental, and psychiatric disabilities. Common themes used in practice as well as the unique role played by social workers in interagency collaboration are discussed.

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          • O’Brien, G. V. 2011. Eugenics, genetics, and the minority group model of disabilities: Implications for social work advocacy. Social Work 56.4: 347–354.

            DOI: 10.1093/sw/56.4.347Save Citation »Export Citation »

            Genetic research and related practice innovations have expanded as indicated by human genome mapping, growth of genetic counseling, and other biogenetic research. Concurrently, the disability rights movement has expanded. The concerns of disability rights activists relative to genetic innovations and the role of the social work community are discussed.

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            • Rothman, J. C. 2010. The challenge of disability and access: Reconceptualizing the role of the medical model. Journal of Social Work in Disability & Rehabilitation 9.2–3: 194–222.

              DOI: 10.1080/1536710X.2010.493488Save Citation »Export Citation »

              Numerous frameworks for understanding disability exist; however, these are polarized between problem-centered “medical” models and “disability as construction” models. Four foundational theoretical models are considered in terms of integrating disability frameworks. The bio-psycho-socio-cultural-spiritual model is suggested as the optimal model to both resolve the disability frameworks’ duality and optimally integrate service provision.

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              • Russell, R. A. 1981. Concepts of adjustment to disability: An overview. Rehabilitation Literature 42.11–12: 330–338.

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                Since the 1980s the person-oriented approach that has gained prominence is disability services. This paper on socio-environmental approaches discusses influences of external situations on individuals, the social construction of reality, and effects of labeling. An integrative approach appears most comprehensive because it views adjustment as occurring through interactions between individuals and their environments.

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                • Saleeby, P. W. 2007. Applications of a capability approach to disability and the International Classification of Functioning, Disability and Health (ICF) in social work practice. Journal of Social Work in Disability & Rehabilitation 6.1–2: 217–232.

                  DOI: 10.1300/J198v06n01_12Save Citation »Export Citation »

                  The capability approach and the International Classification of Functioning, Disability and Health (ICF) provide helpful tools for social worker training. The capability approach emphasizes the need to assess individual abilities in real-life environments (capabilities) rather than capacity or functional status. The ICF provides disability-related terminology to assist in developing interventions that facilitate capability development.

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                  Types of Physical Disabilities

                  Physical disabilities cover a broad range as they may be congenital or acquired through illness, infection, or injury, with the most common being mobility. Physical disability includes upper and/or lower limb disability, manual dexterity, and disability in coordination with different organs of the body. Disability in mobility can be either congenital or acquired through injury, illness, or the aging process (Katz and Florian 1986). Sensory disability, such as disabilities related to vision or hearing, may also be considered physical disability. The following citations address issues relating to differing types of physical disabilities and their effect on the families in which the person lives (Beauregard and Noreau 2010; Bellin, et al. 2008; Florian and Findler 2001), the different types of physical disabilities and disparities across groups (Wu, et al. 2011), and the services and supports provided and worldwide incidence and prevalence (United Nations Enable, Healthy people 2010, World Health Organization: Disabilities).

                  • Beauregard, L., and L. Noreau. 2010. Spouses of persons with spinal cord injury: Impact and coping. British Journal of Social Work 40.6: 1945–1959.

                    DOI: 10.1093/bjsw/bcp140Save Citation »Export Citation »

                    Twenty-four spouses of persons with spinal cord injury revealed that the impact focuses on three areas: leisure, domestic/family responsibilities, and sexuality. Spouses indicated strategies to address these areas, including setting aside time for hobbies without the spouse, hiring staff to reduce the increased task load, reshuffling roles to coincide with the capabilities of the person with the spinal cord injury, and maintaining open, honest communication on the topic of sexuality.

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                    • Bellin, M., P. J. Kovacs, and K. J. Sawin. 2008. Risk and protective influences in the lives of siblings of youths with spina bifida. Health and Social Work 33.3: 199–209.

                      DOI: 10.1093/hsw/33.3.199Save Citation »Export Citation »

                      Traditionally physical disabilities and the handicaps they entail have been regarded as attributes of individuals. More recently some of the sociogenic aspects of physical handicap have been explored. It is suggested that the possession of a physical disability by one individual may also substantially disable others, particularly family members with whom she or he is associated. This argument is explored and some of its consequences are examined.

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                      • Florian, V., and L. Findler. 2001. Mental health and marital adaptation among mothers of children with cerebral palsy. American Journal of Orthopsychiatry 71.3: 358–367.

                        DOI: 10.1037/0002-9432.71.3.358Save Citation »Export Citation »

                        Employing a model emphasizing risk-resistance factors for maternal adaptation, the authors compared mothers of children with cerebral palsy to mothers of children without a physical disability. Among mothers of children with cerebral palsy, self-esteem, self-mastery, and family network size were the main variables that contributed to the psychological and marital adaptation of the mothers.

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                        • Katz, S., and V. Florian. 1986. A comprehensive theoretical model of psychological reaction to loss. International Journal of Psychiatry in Medicine 16.4: 325–345.

                          DOI: 10.2190/YGRX-AA2B-XUY5-F7DLSave Citation »Export Citation »

                          The authors studied three types of loss: interpersonal loss through death or separation, loss of a limb or function, and environmental loss. Three dimensions were identified for the model: stages of reactions to loss, consisting of shock, mourning, and adjustment; common reactions, such as grief and depression, psychosomatic manifestations, guilt, or denial; and influential factors, consisting of individual attributes, family system, and sociocultural environment.

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                          • United Nations Enable.

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                            This site provides general information on the prevalence and incidence of disabilities worldwide.

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                            • Healthy people 2010. Centers for Disease Control and Prevention.

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                              Provides demographics, prevalence, and incidence of disability in the United States. Serves as a source for creating goals and objectives when planning to address important issues for persons with disabilities.

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                              • World Health Organization: Disabilities.

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                                Provides general information of the activities supported by the WHO in addressing issues concerning persons with disabilities throughout the world.

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                                • Wu, Y. W., G. Xing, E. Fuentes-Afflick, et al. 2011. Racial, ethnic, and socioeconomic disparities in the prevalence of cerebral palsy. Pediatrics 127.3: 674–681.

                                  DOI: 10.1542/peds.2010-1656Save Citation »Export Citation »

                                  A retrospective analysis of 6.2 million births determined whether low birth weight accounted for racial and ethnic disparities in the prevalence of cerebral palsy and whether socioeconomic factors impact cerebral palsy across racial/ethnic groups. African American infants were 29 percent more likely to have cerebral palsy than white infants. Women of all ethnicities without prenatal care were twice as likely to have infants with cerebral palsy, as were Latina adolescent mothers.

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                                  Legislation and Court Decisions

                                  In recent decades several nations have encouraged the shift from a medical-model orientation of services to an inclusionary one in which supports and services are provided in the person’s natural environment (see Barnartt 2007, cited under Violence and Discrimination). This movement grew largely from the efforts of Scandinavian countries in the 1950s and 1960s. In the United States, Several legislative acts and court decisions have encouraged individuals with disabilities to become participating citizens (Karger and Rose 2010). These include the Americans with Disabilities Act (ADA) of 1990 for reasonable accommodations; the court decision of Sullivan v. Zebley, 493 U.S. 521 (see Indicators of Welfare Dependence) for eligibility standards; the Individuals with Disabilities Education Act of 2004) for ensuring that students with disabilities have educational plans and appropriate supports provided; the Olmstead Decision, which stipulates the use of least restrictive environments; and Section 504 of the Vocational Rehabilitation Act of 1973 for ensuring accessible services. Successes and problems have been encountered and specific legislation has also been adopted worldwide (International Classification of Functioning, Disability and Health [ICF], United Nations Convention on the Rights of Persons with Disabilities). The average age in many countries is increasing, which gives rise to new concerns regarding the array of services that need to be provided (Putnam 2011).

                                  • Americans with Disabilities Act (ADA) of 1990.

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                                    This landmark legislation focuses on ensuring that persons with disabilities are able to become fully participating citizens in society. The ADA main provision of reasonable accommodations requires that accessibility be provided and serves as a model for international legislation.

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                                    • Individuals with Disabilities Education Act of 2004.

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                                      The Individuals with Disabilities Education Act (IDEA) requires that services to children with disabilities are available throughout the United States. IDEA oversees early intervention and special education efforts as well as related services to eligible infants, toddlers, children, and youth with disabilities.

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                                      • International Classification of Functioning (ICF), Disability and Health. World Health Organization.

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                                        This classification of health and health-related domains is based on individual and societal perspectives. It includes two lists: (1) body functions and structure and (2) domains of activity and participation. Because functioning and disability occur in a context, the ICF also lists environmental factors. This is the World Health Organization’s framework for measuring health and disability, and it was officially endorsed at the Fifty-fourth World Health Assembly on 22 May 2001.

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                                        • Karger, H., and S. R. Rose. 2010. Revisiting the Americans with Disabilities Act after two decades. Journal of Social Work in Disability & Rehabilitation 9.2–3: 73–86.

                                          DOI: 10.1080/1536710X.2010.493468Save Citation »Export Citation »

                                          In this study undertaken twenty years after passage of the Americans with Disabilities Act (ADA), the authors examine who has disabilities and how they are faring, and they trace how the ADA evolved through court cases limiting its scope. In addition, the article looks at misuse of the ADA as well as its economic impact and issues in defining a disability as the ADA continues to evolve.

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                                          • Putnam, M. 2011. Perceptions of difference between aging and disability service systems consumers: Implications for policy initiatives to rebalance long-term care. Journal of Gerontological Social Work 54.3: 325–342.

                                            DOI: 10.1080/01634372.2010.543263Save Citation »Export Citation »

                                            The author explores professionals’ perceptions of how and why older adults and younger persons with disabilities are different consumers and clients within long-term care. Results suggest that professionals working within the fields of aging, developmental disability, and physical disability believe that significant distinctions exist concerning client age, type of disability, and the nature and type of delivery of service.

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                                            • United Nations Convention on the Rights of Persons with Disabilities. 13 Dec. 2006, G.A. Res. 61/106, U.N. GAOR, 61st Sess., UN Doc. A/RES/61/106.

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                                              This international human rights instrument of the United Nations serves to protect the rights and dignity of persons with disabilities. Parties to the Convention must promote, protect, and ensure the full enjoyment of human rights by persons with disabilities and ensure that they enjoy full equality under the law.

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                                              • US Department of Health and Human Services. Indicators of welfare dependence: Annual report to Congress.

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                                                This annual report highlights the guidelines associated with the 1990 Sullivan v. Zebley court decision, 493 U.S. 521 on determining childhood Social Security disability benefits in the United States. The decision found that substantial portions of the Supplemental Security Income program were inconsistent with the Social Security Act.

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                                                • Vocational Rehabilitation Act of 1973.

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                                                  As a precursor to the American with Disabilities Act of 1990, Section 504 of the Rehabilitation Act protects qualified individuals from discrimination based on their disability. The law applies to employers and organizations receiving financial assistance from any US department or agency. Section 504 forbids organizations and employers from excluding or denying individuals with disabilities an equal opportunity to receive program benefits and services.

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                                                  Employment and Income

                                                  Individuals with physical disabilities are increasingly included universally in their communities, and, likewise, new approaches for providing employment training and related supports have evolved with varying levels of support among professionals (Wolf-Branigin, et al. 2000). These innovations are largely supported by legislation and various court decisions, but they have also been facilitated by advocates (Chima 2005) and the increasing use of universal design (Mackelprang and Clute 2009). As new services such as supported employment (Bedggood and Csiernik 2009) replace outdated and segregated approaches (e.g., sheltered workshops), individuals with disabilities have increased opportunities to develop natural supports and allies in their communities (Hartnett, et al. 2010). The following citations provide background references to these recent advances, income transfers, and useful accommodations and related worker/client perceptions (Balser 2007), while they offer simultaneously considerations regarding the frequent negative financial impacts that having a disability (Parish, et al. 2009) or a child with a disability has on family resources (Parish and Cloud 2006).

                                                  • Balser, D. B. 2007. Predictors of workplace accommodations for employees with mobility-related disabilities. Administration and Society 39.5: 656–683.

                                                    DOI: 10.1177/0095399707303639Save Citation »Export Citation »

                                                    Defining a reasonable accommodation in the workplace remains unclear. Individuals with disabilities need specific accommodations, not just any accommodation. The author in this article inquires into four types of accommodations received by employees with mobility-related disabilities. The results demonstrate that factors facilitating or constraining an employer’s capacity to make certain accommodations were stronger predictors of accommodations made than was individual need.

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                                                    • Bedggood, J., and R. Csiernik. 2009. Appointment choice and outcome at a supported employment agency. Journal of Evidence-Based Social Work 6.4: 390–400.

                                                      DOI: 10.1080/15433710902911139Save Citation »Export Citation »

                                                      This Canadian study examined appointment choice in successful job placement. Clients who had legal conflicts were least likely to be appointment compliant. Social assistance recipients mandated to attend were the most likely to postpone initial agency visits and terminate contacts with the employment support service. Younger clients usually had more choices selecting a meeting time than had older clients. Clients with a developmental delay or learning disability also had more choices than did those with no disability or a physical disability.

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                                                      • Chima, F. O. 2005. Persons with disabilities and employment: Implications for social work and rehabilitation roles and advocacy. Journal of Social Work in Disability & Rehabilitation 4.3: 39–60.

                                                        DOI: 10.1300/J198v04n03_05Save Citation »Export Citation »

                                                        The Americans with Disabilities Act (ADA) provides the framework for eliminating discrimination against individuals with disabilities and improving their employment opportunities. Evidence indicates that implementation has lagged in increasing employment opportunities. The role of social work in advocating for social justice is discussed as well as implications for rehabilitation counselors and issues related to employment.

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                                                        • Hartnett, H. P., H. Thurman, and K. Cordingly. 2010. Individuals’ perceptions of employment accommodation decisions and solutions: Lessons for social workers. Journal of Social Work in Disability & Rehabilitation 9.1: 53–68.

                                                          DOI: 10.1080/15367100903526278Save Citation »Export Citation »

                                                          Advocates for disability rights claim that employment opportunities facilitate empowerment and social inclusion. This article examines efforts under Title I of the ADA in incorporating the voices of individuals with disabilities who accessed services. The authors conclude that understanding individuals’ perspectives contributes to better accommodation outcomes for people with disabilities, employers, and advocates.

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                                                          • Mackelprang, R. W., and M. A. Clute. 2009. Access for all: Universal design and the employment of people with disabilities. Journal of Social Work in Disability & Rehabilitation 8.3–4: 205–221.

                                                            DOI: 10.1080/15367100903202771Save Citation »Export Citation »

                                                            Employment among individuals with disabilities remains low largely because of attitudinal and socioeconomic barriers. Universal access, a paradigm and blueprint for building employment success, is discussed in eliminating environmental obstacles preventing employment of persons with disabilities. In a universally accessible environment, few modifications are needed, regardless of employee characteristics. This philosophy is compatible with social work values and perspectives.

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                                                            • Parish, S. L., and J. M. Cloud. 2006. Financial well-being of young children with disabilities and their families. Social Work 51.3: 223–232.

                                                              DOI: 10.1093/sw/51.3.223Save Citation »Export Citation »

                                                              Young children with disabilities have a greater likelihood of living in poverty than their peers without disabilities, and doing so introduces an additional risk of adverse outcomes. Several key circumstances contributing to this increased risk were analyzed, including elevated costs of raising these children, low levels of public-income transfer benefits, balancing parental employment, caregiving responsibilities, unavailable or costly child care, and inadequate leave time at parents’ places of employment.

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                                                              • Parish, S. L., R. A. Rose, and M. E. Andrews. 2009. Income poverty and material hardship among US women with disabilities. Social Service Review 83.1: 33–52.

                                                                DOI: 10.1086/598755Save Citation »Export Citation »

                                                                The authors used the National Survey of America’s Families data to describe hardship among women with and without disabilities, and they found that women with disabilities experience hardships related to food insecurity, housing instability, inadequate health care, and loss of phone service at rates higher than those for nondisabled women. Hardships decline as incomes rise for all women; however, having a disability created hardships well into the middle- and upper-income ranges.

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                                                                • Wolf-Branigin, M., M. Daeschlein, B. Cardinal, and M. Twiss. 2000. Differing priorities of counselors and customers to a consumer choice model in rehabilitation. Journal of Rehabilitation 66.1: 18–22.

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                                                                  Individuals with disabilities and those providing services in partnership with them often have diverse opinions regarding what is most important. This study investigated how these two groups prioritized the importance of employment services. The individuals with disabilities ranked the services that tended to be more time intensive and offered face-to-face contacts as the most useful, whereas the counselors and social workers prioritized those that were less intensive.

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                                                                  Health Issues

                                                                  Individuals with disabilities may encounter unique health problems resulting directly from their disability, and effects increase with age (Murabito, et al. 2008). Often these health concerns are secondary conditions that result directly (e.g., bedsores from wheelchair use) or indirectly (e.g., depression or substance abuse) from their disability and from maintenance and availability of durable medical equipment. Many gaps in knowledge remain (Perrin 2002). Furthermore, genetic counseling is growing in use as a means to inform prospective parents of a congenital disability that a child may acquire. The citations listed deal with many of the most prevalent issues individuals encounter, including abuse and neglect in older adults with physical disabilities, the increasing use of genetics (Ettorre 2009) and possible concerns surrounding that use, interactions resulting from co-occurring conditions, discrimination (Bahm and Forchuk 2009), gender (Parish and Huh 2006), and health behaviors (Wu, et al. 2008).

                                                                  • Bahm, A., and C. Forchuk. 2009. Interlocking oppressions: The effect of a comorbid physical disability on perceived stigma and discrimination among mental health consumers in Canada. Health and Social Care in the Community 17.1: 63–70.

                                                                    DOI: 10.1111/j.1365-2524.2008.00799.xSave Citation »Export Citation »

                                                                    Individuals self-reporting psychiatric disability and a co-occurring physical disability encounter higher levels of perceived discrimination/stigma than those with only a psychiatric disability. Perceived discrimination/stigma correlated positively with psychiatric problem severity and negatively correlated with self-rated general health, physical condition, emotional well-being, and life satisfaction.

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                                                                    • Ettorre, E. 2009. Prenatal genetic technologies and the social control of pregnant women: A review of the key issues. Marriage and Family Review 45.5: 448–468.

                                                                      DOI: 10.1080/01494920903050680Save Citation »Export Citation »

                                                                      Prenatal genetic technologies have transformed the social process of human reproduction, are powerful ways of regulating family normality and health, and have the unintended consequence of dividing women into “good” and “bad” reproducers. It is vital to expose repressive dynamics in the increased use of these technologies to address issues of disabilities, risk, and shame as well as those of embodied affect and molecular medicine.

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                                                                      • Murabito, J. M., M. J. Pencina, L. Zhu, M. Kelly-Hayes, P. Schrader, and R. B. D’Agostino. 2008. Temporal trends in self-reported functional limitations and physical disability among the community-dwelling elderly population: The Framingham heart study. American Journal of Public Health 98.7: 1256–1262.

                                                                        DOI: 10.2105/AJPH.2007.128132Save Citation »Export Citation »

                                                                        This study identified levels of functional limitations and physical disability among the community-dwelling elderly population across three decades using the Nagi scale and physical disability using the Rosow–Breslau and Katz scales. Functional limitations and physical disability declined. Among community-dwelling elders, functional limitations and physical disability declined significantly, possibly because of assistive technology.

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                                                                        • Parish, S. L., and J. Huh. 2006. Health care for women with disabilities: Population-based evidence of disparities. Health and Social Work 31.1: 7–15.

                                                                          DOI: 10.1093/hsw/31.1.7Save Citation »Export Citation »

                                                                          Women with disabilities experience worse health care and worse preventive care than women without disabilities. The health care of a national probability sample of 8,721 women with disabilities and 45,522 without disabilities, adjusted for age and household income, were examined on eight measures of health care. Results indicate potentially serious consequences for women with disabilities, who are at increased risk of developing secondary conditions if their care needs are not met.

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                                                                          • Perrin, J. 2002. Health services research for children with disabilities. Milbank Quarterly 80.2: 303–324.

                                                                            DOI: 10.1111/1468-0009.t01-1-00005Save Citation »Export Citation »

                                                                            Increasingly, children and adolescents have long-term disabilities but are excluded frequently from health services research on people with disabilities because of concerns about the risks and perceived problems when studying this population. Therefore, scant information exists concerning epidemiology, characteristics of children and adolescents with disabilities, financing of services, best and promising practices, methods of assessing and improving care, protecting children from medical errors, and basic issues of long-term clinical management.

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                                                                            • Wu, Y., S. H. McCrone, and H. J. Lai. 2008. Health behaviors and transitions of physical disability among community-dwelling older adults. Research on Aging 30.5: 572–591.

                                                                              DOI: 10.1177/0164027508319473Save Citation »Export Citation »

                                                                              The transitions of disability over five years among older adults and the influences of health behaviors were investigated using the National Long-Term Care Survey. Being obese, underweight, or physically inactive increased risk of disability, while light drinking decreased the risk. Taking vitamin and/or mineral supplements, working on a hobby, maintaining contacts with friends, attending regular social activities, and maintaining higher body mass were found to be beneficial.

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                                                                              Violence and Discrimination

                                                                              Individuals with physical disabilities have a history of experiencing higher rates of violence and levels of discrimination than those of the general population (Fleischer and Zames 2001). Concerns regarding different forms of abuse have been noted (Ansello and O’Neill 2010; Martin, et al. 2006). When addressing the issue of discrimination, new perspectives arising from the field of disability studies reject the traditional medical model in favor of inclusive and interconnected lives (Barnartt 2007, Longmore and Umansky 2001). See also Latimer v. Her Majesty the Queen.

                                                                              • Ansello, E. F., and P. O’Neill. 2010. Abuse, neglect, and exploitation: Considerations in aging with lifelong disabilities. Journal of Elder Abuse and Neglect 22.1–2: 105–130.

                                                                                DOI: 10.1080/08946560903436395Save Citation »Export Citation »

                                                                                Individuals with lifelong disabilities are newcomers to changes experienced in later life in that they are often highly active and engaged members of their communities. Some, however, are victims of abuse, neglect, or exploitation. This review identifies factors in the victimization of older adults, reports on current prevalence and treatments, and suggests initiatives to strengthen community living via prevention and identification strategies.

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                                                                                • Barnartt, S. N. 2007. The implications of disability protests for social work practice. Journal of Social Work in Disability & Rehabilitation 6.1–2: 195–216.

                                                                                  DOI: 10.1300/J198v06n01_11Save Citation »Export Citation »

                                                                                  The demands of more than eight hundred disability protests were analyzed. Many demands were cross-disability while others were disability specific. Key aspects for social work practice are that disabilities continue to be destigmatized, that people have choices, and that they are able to keep control over their lives.

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                                                                                  • Fleischer, D. Z., and F. Zames. 2001. The disability rights movement: From charity to confrontation. Philadelphia: Temple Univ. Press.

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                                                                                    This book reflects on how the disabilities rights movement began and provides examples of how people with disabilities have been present throughout history and how far they have come in their desire for equity. Although differences exist among the advocates of disability rights, the reflective approach taken in this work identifies those who are advocating for the same cause while having diverse beliefs.

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                                                                                    • Latimer v. Her Majesty the Queen 112 C.C.C. (3d) 193. Supreme Court of Canada, 18 January 2001.

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                                                                                      The Supreme Court of Canada ruled on the controversial case of Robert Latimer, who was convicted of murdering his daughter, Tracy, who had cerebral palsy. The case engendered intense debate surrounding the defense’s position on the grounds that the act constituted a mercy killing. The Supreme Court ruled that the crime could not be justified and upheld the original sentence.

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                                                                                      • Longmore, P. K., and L. Umansky, eds. 2001. The new disability history: American perspectives. New York: New York Univ. Press.

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                                                                                        This book of essays and narratives is written from the perspective of individuals with disabilities. Contributions trace the broad history of disability and how the conceptualization of disability has changed in the course of American history.

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                                                                                        • Martin, S. L., N. Ray, D. Sotres-Alvarez, et al. 2006. Physical and sexual assault of women with disabilities. Violence against Women 12.9: 823–837.

                                                                                          DOI: 10.1177/1077801206292672Save Citation »Export Citation »

                                                                                          The study revealed that women who have physical disabilities were not significantly more likely to experience physical assault than women without disabilities. Women with disabilities, however, were four times more likely to experience sexual assault in the past year when compared to women without disabilities.

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                                                                                          Inclusion and Advocacy in Community

                                                                                          Social work’s values support the person-in-environment perspective, inclusiveness, and interconnectedness. Contemporary services to individuals with physical disabilities have become increasingly person- and/or family-centered since the 1980s (Strick-Lynskey and Keller 2007) and several methods have facilitated this approach, including peer support (Kirshbaum 1995), self-determination (Jurkowski, et al. 2002), self-advocacy (Brooks 1991), consumer-driven services, person-centeredness (Hasnain, et al. 2003), and the independent living movement. These services aim to ensure the full participation of individuals with disabilities in planning for their futures and in experiencing what their peers without disabilities experience (Beaulaurier and Taylor, 2001). Such services have increased worldwide to varying degrees (Kayama 2010), and they are the direct consequence of the rise of the disability rights movement. Demands for full opportunities will likely expand with aging populations in many countries (Moone and Lightfoot 2009). A related topic, person-first language, seeks to reduce stigma associated with disabled persons by ensuring that individuals who are disabled are seen as people first and are not defined or perceived as a symptom or label of their disability.

                                                                                          • Beaulaurier, R. L., and S. H. Taylor. 2001. Social work practice with people with disabilities in the era of disability rights. Social Work in Health Care 32.4: 67–91.

                                                                                            DOI: 10.1300/J010v32n04_04Save Citation »Export Citation »

                                                                                            The ADA and related legislation emphasize self-determination. A conceptual framework is provided in this article that promotes practices that maximizes clients’ involvement in exploring more options and choices, prepares clients to be more effective in dealings with professionals and agencies unaware of self-determination, and seeks to empower groups of people with disabilities to organize so as to consider policy and program alternatives that can improve their situation.

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                                                                                            • Brooks, N. A. 1991. Self-empowerment among adults with severe physical disability: A case study. Journal of Sociology and Social Welfare 18.1: 105–120.

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                                                                                              People with disabilities often have been inhibited from exercising political self-determination. The combined effects of physical, communicative, or emotional impairments; social stigma; and isolation constituted substantial obstacles to overcome on the path to self-determination. A residential setting for adults with severe physical disabilities was studied to observe the actions of the residents’ council and expressions of group interests. The capacity for self-advocacy emerged as a dynamic enterprise that was clearly related to the structure and interests of the service agency.

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                                                                                              • Hasnain, R., P. Sotnik, and C. Ghiloni. 2003. Person-centered planning: A gateway to improving vocational rehabilitation services for culturally diverse individuals with disabilities. Journal of Rehabilitation 69.3: 10–17.

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                                                                                                This study focused on the positive impact of the planning process for a group of individuals with disabilities who participated in the state vocational rehabilitation program. Factors that influence employment-based outcomes included cultural differences, social class and gender, cultural diversity initiative, person-centered career planning as components of the systems change project, and information on the benefits of person-centered planning.

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                                                                                                • Jurkowski, E., B. Jovanovic, and L. Rowitz. 2002. Leadership/citizen participation: Perceived impact of advocacy activities by people with physical disabilities on access to health care, attendant care and social services. Journal of Health and Social Policy 14.4: 49–61.

                                                                                                  DOI: 10.1300/J045v14n04_04Save Citation »Export Citation »

                                                                                                  Individuals with disabilities who participated in advocacy activities were more likely to feel that their actions improved access to health care and social service resources. Advocates also perceived the impact of access on their family, local organizations, and at regional and national levels. The value of consumer/citizen participation and the need to collaborate with social workers for system changes, health resources, and policy development were highlighted.

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                                                                                                  • Kayama, M. 2010. Parental experiences of children’s disabilities and special education in the United States and Japan: Implications for school social work. Social Work 55.2: 117–125.

                                                                                                    DOI: 10.1093/sw/55.2.117Save Citation »Export Citation »

                                                                                                    US and Japanese parents report similar difficulties, such as establishing relationships with professionals providing services for their children, while having different expectations regarding these relationships. Japanese parents tend to emphasize emotional connections while US parents believe their children are entitled to appropriate educational resources. The Japanese case suggests strengthening empathy and trust, while the US case provides an inclusion model.

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                                                                                                    • Kirshbaum, M. 1995. Through the looking glass. Marriage and Family Review 21.1–2: 9–28.

                                                                                                      DOI: 10.1300/J002v21n01_02Save Citation »Export Citation »

                                                                                                      This study describes an organization providing peer-oriented clinical and support services, professional training, and research serving infants, young children, and families with a disability or medical issue. Historical context is provided regarding disability issues relevant to the program’s mission and philosophy. The evolution of the agency is outlined.

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                                                                                                      • Moone, R. P., and E. Lightfoot. 2009. Social marketing strategies for reaching older people with disabilities: Findings from a survey of Centers for Independent Living. Journal of Social Work in Disability & Rehabilitation 8.2: 65–81.

                                                                                                        DOI: 10.1080/15367100902937864Save Citation »Export Citation »

                                                                                                        Centers for Independent Living (CILs) support and advocate for people with disabilities so that they may live independently. With an increasing population of older people with disabilities, many CILs are considering how to engage older adults actively. This study identified social marketing techniques that community organizations can use to reach out effectively by using a social marketing mix that includes a critical examination of product, place, price, participants, and partnering.

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                                                                                                        • Strick-Lynskey, D., and D. W. Keller. 2007. Integrating a family-centered approach into social work practice with families of children and adolescents with disabilities. Journal of Social Work in Disability & Rehabilitation 6.1–2: 111–134.

                                                                                                          DOI: 10.1300/J198v06n01_07Save Citation »Export Citation »

                                                                                                          Family-centered practice, a construct for working with children and adolescents with disabilities and their families, as a framework is illustrated with clinical anecdotes.

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                                                                                                          Advocacy Organizations

                                                                                                          Several organizations, including the American Association of People with Disabilities, the National Council on Independent Living, and the Association for the Severely Handicapped (TASH) have emerged worldwide to support persons with disabilities as they become fully participating citizens. These organizations arose from the disability rights movement that sought to obtain and secure equal rights for persons with disabilities. Physical and environmental accessibility were initial concerns, whereas improving a person’s inclusion in his or her community through housing, identifying health and income supports, and employment opportunities followed these advances.

                                                                                                          Quality of Life

                                                                                                          The quality of life construct measures an individual’s success in developing relationships in the community with those who will become naturally supportive. Developing such relationships may improve quality of life through assistive technology (Seymour and Lupton 2004). This construct can be used across types of disability (Burwinkle, et al. 2005; Wang and Brown 2009) and relies on determining to what extent the individual is in control of his or her environment (Alriksson-Schmidt, et al. 2007). When determining quality of life among persons with a physical disability, several instruments are available, including, for children and adolescents, the Pediatric Quality of Life and the Ansell-Casey Life Skills Assessment and, for adults, the Quality of Life Profile for Adults with Physical Disabilities (Renwick, et al. 2003). As beliefs, perspectives, services, and outcomes continue shifting to inclusionary models, this useful research construct measures to determine whether individuals are in control of their lives (Swam, et al. 2003). The following articles introduce useful measures and provide some initial psychometric properties of these instruments (Connelly and Rapoff 2006; Nolan, et al. 2002).

                                                                                                          • Alriksson-Schmidt, A., J. Wallander, and F. Biasini. 2007. Quality of life and resilience in adolescents with a mobility disability. Journal of Pediatric Psychology 32:370–379.

                                                                                                            DOI: 10.1093/jpepsy/jsl002Save Citation »Export Citation »

                                                                                                            This Lithuanian study (n = 101) of individuals with physical disabilities used data from the generic WHO QOL-100 questionnaire to evaluate quality of life. Results indicate that people with physical disabilities described their quality of life as moderate. Those who were employed ranked their quality of life better than those who were unemployed. Being married led to better overall health, quality of life, physical and psychological well-being, independence, social relationships, environment, and increased spirituality than remaining single.

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                                                                                                            • Burwinkle, T., S. Sherman, K. Hanna, et al. 2005. Health-related quality of life of children and adolescents with cerebral palsy: Hearing the voices of the children. Developmental Medical Child Neurology 47:592–597.

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                                                                                                              Issues concerning children with cerebral palsy and the effects on their quality of life as presented in multiple dimensions. Included are the perspectives of family members.

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                                                                                                              • Connelly, M., and M. Rapoff. 2006. Assessing health-related quality of life in children with recurrent headache: Reliability and validity of the PedsQL 4.0 in a pediatric headache sample. Journal of Pediatric Psychology 31:698–702.

                                                                                                                DOI: 10.1093/jpepsy/jsj063Save Citation »Export Citation »

                                                                                                                The psychometric properties of the revised Pediatric Quality of Life instrument (PedsQL 4.0) are presented. This instrument provides a useful construct for measuring child and adolescent quality of life functioning across populations.

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                                                                                                                • Nolan, K., M. Horn, C. Downs, and P. Perora. 2002. Ansell-Casey life skills assessment (ACLSA) and life skills guidebook manual. Seattle, WA: Casey Family Programs.

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                                                                                                                  This manual provides the necessary procedures, norm-referenced data, and psychometric properties when using the Ansell-Casey Life Skills Assessment. This instrument provides a tool for measuring life skills among youth on several domains. It has age-appropriate instruments for children and adolescents with disabilities.

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                                                                                                                  • Renwick, R., N. Nourhaghighi, P. J. Manns, and D. L. Rudman. 2003. Quality of life for people with physical disabilities: A new instrument. International Journal of Rehabilitation Research 26.4: 279–287.

                                                                                                                    DOI: 10.1097/00004356-200312000-00005Save Citation »Export Citation »

                                                                                                                    The development and validation of the Quality of Life Profile for Adults with Physical Disabilities (QOLP-PD), which assumes that quality of life issues are the same for people with and without disabilities, is described. Reliability and validation coefficients are reported, with the psychometric properties of the instrument appearing sound.

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                                                                                                                    • Seymour, W., and D. Lupton. 2004. Holding the line online: Exploring wired relationships for people with disabilities. Disability and Society 19.4: 291–305.

                                                                                                                      DOI: 10.1080/09687590410001689421Save Citation »Export Citation »

                                                                                                                      The Internet offers people with disabilities the possibility of confronting the issues of time, space, communication, and the body. This article investigates several quality of life issues related to Internet use and questions whether it is a failed promise for those with disabilities.

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                                                                                                                      • Swam, J., S. French, C. Cameron, and L. Burton. 2003. Controversial issues in disabling society. Buckingham, UK: Open Univ. Press.

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                                                                                                                        This insightful book on disability studies raises issues concerning quality of life and the dominant values in society while also examining more controversial issues, including the right to die. Using the social model of disability, readers are encouraged to reflect on and discuss relevant issues.

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                                                                                                                        • Wang, M., and R. Brown. 2009. Family quality of life: A framework for policy and social service provisions to support families of children with disabilities. Journal of Family Social Work 12.2: 144–167.

                                                                                                                          DOI: 10.1080/10522150902874842Save Citation »Export Citation »

                                                                                                                          The Family Quality of Life (FQoL) instrument introduces two conceptual frameworks that are influential in the international research literature for families who have a member with a disability. Besides the delineation of conceptualization and measurement development of the FQoL, the article addresses issues applicable to professions such as social work and special education.

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                                                                                                                          Transitioning from Childhood

                                                                                                                          Children with physical disabilities are increasingly likely to live well into adulthood (Palmer and Boisen 2002; Wolf-Branigin, et al. 2007). This benefit results in a growing need to make sure that these adolescents have opportunities and experiences identical to those available to their adolescent peers without a disability (Arnett 1998) and that they are able to develop career skills essential for their adult lives. The following citations address issues relating to the supports that adolescents with physical disabilities use as they transition into adulthood (Antle, et al. 2009; Hartman, et al. 2000). Adopting an ecosystems approach, common to social work practice, facilitates this transition (Cohen and Napolitano 2007) as does involving parents and other caregivers early in childhood (Farber and Mahara 2005, Schwartz and Hadar 2007).

                                                                                                                          • Antle, B. J., G. Montgomery, and C. Stapleford. 2009. The many layers of social support: Capturing the voices of young people with spina bifida and their parents. Health and Social Work 34.2: 97–106.

                                                                                                                            DOI: 10.1093/hsw/34.2.97Save Citation »Export Citation »

                                                                                                                            Knowledge of the social support that young people with physical disabilities use as they transition into adulthood is lacking. This study identified four support domains: tangible, information, companionship/belonging/mutuality, and emotional in which the parents provided substantial support. The authors showed that support from peers and friends follows a unique and varied path with distinctive characteristics related to the realities of living with a disability.

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                                                                                                                            • Arnett, J. 1998. Learning to stand alone: The contemporary American transition to adulthood in cultural and historical context. Human Development 41.5–6: 295–315.

                                                                                                                              DOI: 10.1159/000022591Save Citation »Export Citation »

                                                                                                                              The issue of emerging adulthood plays a large role as adolescents with disabilities transition into adulthood because they often come from protective environments in which they were not encouraged to explore. This article advocates for giving children and adolescents with disabilities growing experiences identical to those without disabilities.

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                                                                                                                              • Cohen, C. B., and D. Napolitano. 2007. Adjustment to disability. Journal of Social Work in Disability & Rehabilitation 6.1–2: 135–155.

                                                                                                                                DOI: 10.1300/J198v06n01_08Save Citation »Export Citation »

                                                                                                                                The experiences of two individuals who acquire disabilities at two different stages in life are documented. The importance of integrating an ecosystems framework that centers on the interrelations among biological, psychological, social, technological, cultural, and political factors are discerned.

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                                                                                                                                • Farber, M. L., and R. Mahara. 2005. Empowering high-risk families of children with disabilities. Research on Social Work Practice 15.6: 501–515.

                                                                                                                                  DOI: 10.1177/1049731505276412Save Citation »Export Citation »

                                                                                                                                  This study evaluated a parent education curriculum applied to meet the parenting needs of high-risk African American families rearing children with developmental delays on measures of caregivers’ empowerment, emotional outlook, parent–child interaction, and community involvement. All outcomes were statistically significant and practically meaningful positive trends were identified subject to design limitations. With the adaptations the program met the needs of the targeted participants.

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                                                                                                                                  • Hartman, A., E. DePoy, C. Francis, and D. Gilmer. 2000. Adolescents with special health care needs in transition: Three life histories. Social Work in Health Care 31.4: 43–58.

                                                                                                                                    DOI: 10.1300/J010v31n04_03Save Citation »Export Citation »

                                                                                                                                    Six themes were identified concerning services and supports for adolescents with physical disabilities while transitioning into adulthood: begetting a service, pathology or not, educational stability, role blurring of parents and practitioners, private life being made public, and loss of independence. Findings indicate that adolescents with physical disabilities do not follow typical developmental sequences.

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                                                                                                                                    • Palmer, M., and L. Boisen. 2002. Cystic fibrosis and the transition to adulthood. Social Work in Health Care 36.1: 45–48.

                                                                                                                                      DOI: 10.1300/J010v36n01_04Save Citation »Export Citation »

                                                                                                                                      Individuals with cystic fibrosis (CF), typically considered a childhood disease, are experiencing longer life expectancy that often reaches well into adulthood. This exploratory study examined the perceptions of young adults with CF concerning how this has affected their lives as they transitioned from adolescence to adulthood. The results indicate concerns about health insurance and finances and about their independence as well as the degree of optimism for the future.

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                                                                                                                                      • Schwartz, C., and L. Hadar. 2007. Parents caring for adult children with physical disabilities: The impact of hope and closeness on caregiving benefits. Families in Society 88.2: 273–281.

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                                                                                                                                        Parents described the benefits of caregiving and reported positive feelings about their involvement in caregiving and personal growth. Parents indicated that caregiving yielded benefits when they perceived it as causing less emotional strain, and they expressed higher levels of hope. The importance of developing closeness and hope among parents of children with physical disabilities is emphasized.

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                                                                                                                                        • Wolf-Branigin, M., V. Schuyler, and P. White. 2007. Improving quality of life and career attitudes of youth with disabilities: Experiences from the Adolescent Employment Readiness Center. Research on Social Work Practice 17.3: 324–333.

                                                                                                                                          DOI: 10.1177/1049731506295623Save Citation »Export Citation »

                                                                                                                                          Study carried out within an ecosystems model to enable adolescents with disabilities to obtain the skills to find and maintain meaningful employment as adults. Physical health, psychosocial functioning, and attitude toward employment among those participating in the program were measured. Physical health, school functioning, and total functioning improved. Career attitudes were above the norms in earlier grades but fell in later grades.

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                                                                                                                                          Veteran Issues

                                                                                                                                          The involvement of social work in veterans’ issues is long-standing. For the past century these issues have focused increasingly on rehabilitation of acquired disabilities, whether physical (Sporner, et al. 2009), behavioral, or cognitive (Otis, et al. 2009). This material is timely as disability claims and payments resulting from acquired physical disabilities will likely increase dramatically because of recent global conflicts (Grubaugh, et al. 2009) and increased financial hardship, especially for those who acquire a disability (Heflin, et al. 2012). Furthermore as the population continues to age in many industrialized countries, an increasing number of veterans will acquire disabilities (Kinosian, et al. 2007).

                                                                                                                                          • Grubaugh, A., J. D. Elhai, K. J. Ruggiero, L. E. Egede, J. A. Naifeh, and B. C. Frueh. 2009. Equity in veterans affairs disability claims adjudication in a national sample of veterans. Military Medicine 174.12: 1241–1246.

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                                                                                                                                            Sociodemographic, access, and illness correlates of both the award and rate of general disability benefits awarded by the US Veterans Administration (VA) were examined. Variables associated with both the award and the rate of benefits awarded, combat exposure, unemployment, and physical impairment accounted for the strongest effects. Veterans’ needs were not overshadowed by factors related to demographic background or access, reducing concerns about disparities in general VA disability disbursements.

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                                                                                                                                            • Heflin, C. M., J. M. Wilmoth, and A. S. London. 2012. Veteran status and material hardship: The moderating influence of work-limiting disability. Social Service Review 86.1: 119–142.

                                                                                                                                              DOI: 10.1086/665643Save Citation »Export Citation »

                                                                                                                                              Having a work-limiting disability is associated with material hardship. Nondisabled-veteran households reported lower or equivalent levels of material hardship than did households with no veteran or disabled member; regardless of whether a veteran is present, households that include a person with a disability have higher levels of hardship than other households; and households with a veteran with a disability experienced more hardship than those without a veteran with a disability.

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                                                                                                                                              • Kinosian, B., E. Stallard, and D. Wieland. 2007. Projected use of long-term-care services by enrolled veterans. Gerontologist 47.3: 356–364.

                                                                                                                                                DOI: 10.1093/geront/47.3.356Save Citation »Export Citation »

                                                                                                                                                A projection model revealed that the number of oldest veterans (age 85+) will double, and VHA-enrolled veterans age eighty-five and older will increase sevenfold in the near future. This will create a 20–25 percent increase in the need for both nursing home and home- and community-based services. As the increased projected use for long-term care will grow predominately for home- and community-based services, the VHA needs to expand long-term care resources.

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                                                                                                                                                • Otis, J. D., T. M. Keane, R. D. Kerns, C. Monson, and E. Scioli. 2009. The development of an integrated treatment for veterans with comorbid chronic pain and posttraumatic stress disorder. Pain Medicine 10.7: 1300–1311.

                                                                                                                                                  DOI: 10.1111/j.1526-4637.2009.00715.xSave Citation »Export Citation »

                                                                                                                                                  Cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) and cognitive-behavioral therapy (CBT) for chronic pain management were used in an integrated treatment. Participants indicated an appreciation of the treatment format, learned that chronic pain and PTSD share some common symptoms, and realized that the two disorders interact with one another. Participants appeared to benefit from receiving the integrated treatment for pain and PTSD.

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                                                                                                                                                  • Sporner, M. L., S. G. Fitzgerald, B. E. Dicianno, et al. 2009. Psychosocial impact of participation in the National Veterans Wheelchair Games and Winter Sports Clinic. Disability Rehabilitation 31.5: 410–418.

                                                                                                                                                    DOI: 10.1080/09638280802030923Save Citation »Export Citation »

                                                                                                                                                    Participant characteristics in the National Veterans Wheelchair Games (NVWG) and the Winter Sports Clinic (WSC) were identified. Participants tended to be more mobile, but have increased physical and cognitive limitations as measured by the CHART when compared to the non-attendees. Recommending veterans participate in events such as the NVWG and WSC can provide psychosocial benefits to veterans with disabilities.

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                                                                                                                                                    Built Environment, Accessibility, and Universal Design

                                                                                                                                                    Many factors relating to the physical or built environment contribute to the ability of individuals to participate in, and serve as full citizens of, their community (Morgan, et al. 2006). Governments worldwide have passed legislation and funding to improve the accessibility of build environments by means such as installing curb cuts, ramps, and accessible transportation (Lilja, et al. 2003). In conjunction with the growth of the community inclusion and independent living movements, the study of appropriate and inclusive housing (Wahl, et al. 2009), transportation (Wolf-Branigin, et al. 2012), and design for this population has increased. Issues primary to successful participation include accessible transportation, the presence of universal design (Rose and Meyer 2000), and assistive technology that may include specific computer software (Freedman, et al. 2006; Judge, et al. 2008) or durable medical equipment. Articles detailed in this section cover the lifespan as children (Seymour and Lupton 2004, cited under Quality of Life) and well as older adults may use assistive technology. See also Parker 2010.

                                                                                                                                                    • Freedman, V. A., E. M. Agree, L. G. Martin, and J. C. Cornman. 2006. Trends in the use of assistive technology and personal care for late-life disability, 1992–2001. Gerontologist 46.1: 124–127.

                                                                                                                                                      DOI: 10.1093/geront/46.1.124Save Citation »Export Citation »

                                                                                                                                                      For older Americans living in the community and experiencing difficulty with self-care activities, assistive-technology use increases while use of personal care typically decreases. The authors demonstrate that this change in assistance toward technology accounts for a reduction in the number of people dependent on personal care.

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                                                                                                                                                      • Judge, S., K. Floyd, and T. Jeffs. 2008. Using an assistive technology toolkit to promote inclusion. Early Childhood Education Journal 36.2: 121–126.

                                                                                                                                                        DOI: 10.1007/s10643-008-0257-0Save Citation »Export Citation »

                                                                                                                                                        The use of assistive technology for young children is increasing; however, lack of awareness and training limit its consistent use. The authors present an assistive technology toolkit for children with disabilities that can be easily assembled and implemented. They describe assistive technology tools that support young children’s participation in their daily activities.

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                                                                                                                                                        • Lilja, M., I. Mansson, L. Jahhlenius, and M. Sacco-Peterson. 2003. Disability policy in Sweden: Policies concerning assistive technology and home modification services. Journal of Disability Policy Studies 14.3: 130–135.

                                                                                                                                                          DOI: 10.1177/10442073030140030101Save Citation »Export Citation »

                                                                                                                                                          Swedish policy effects on decentralization, responsibility, equity, and costs relative to assistive technologies and environmental modifications for persons with physical disabilities are discussed. The authors note that the national policy is clearly stated and supported by legislation and with political consensus existing to implement and sustain the policy.

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                                                                                                                                                          • Morgan, L. A., J. K. Eckert, T. Piggee, and A. C. Frankowski. 2006. Two lives in transition: Agency and context for assisted living residents. Journal of Aging Studies 20.2: 123–132.

                                                                                                                                                            DOI: 10.1016/j.jaging.2005.07.004Save Citation »Export Citation »

                                                                                                                                                            This ethnographic study explored later-life transitions, including those leading to moves into housing and care settings. Transition histories highlighted the loss of autonomy with advancing frailty, illness, and relocation into supportive housing. A second theme identified was understanding contemporary events and nesting them within the temporal context of earlier life events.

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                                                                                                                                                            • Parker, D. 2010. Housing as an intervention on hospital use: Access among chronically homeless persons with disabilities. Journal of Urban Health 87.6: 912–919.

                                                                                                                                                              DOI: 10.1007/s11524-010-9504-ySave Citation »Export Citation »

                                                                                                                                                              The demographics and hospital utilization for twenty persons who were chronically homeless and had disabilities were studied at pre-housing enrollment and at six months post-housing. During the study, emergency department visits and inpatient hospitalization use decreased. Although these differences were not statistically significant, they translate into significant savings.

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                                                                                                                                                              • Rose, D., and A. Meyer. 2000. Universal design for individual differences. Educational Leadership 58.3: 39–43.

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                                                                                                                                                                Universal design represents an approach to the built environment in which products can be used without adaptation for the widest audience possible. The author advocates for equitable, flexible, simple, intuitive, and minimal physical effort to use especially in educational environments.

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                                                                                                                                                                • Wahl, H. W., A. Fänge, F. Oswald, L. N. Gitlin, and S. Iwarsson. 2009. The home environment and disability-related outcomes in aging individuals: What is the empirical evidence? Gerontologist 49.3: 355–367.

                                                                                                                                                                  DOI: 10.1093/geront/gnp056Save Citation »Export Citation »

                                                                                                                                                                  Two critical questions concerning home environments were asked. What evidence supports a relationship between home environments and disability-related outcomes? What evidence exists on the effects of home modifications on disability-related outcomes? Evidence supports the concept of the role of home environments in the disablement process; however, inconsistencies existed across studies.

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                                                                                                                                                                  • Wolf-Branigin, K., M. Wolf-Branigin, J. D. Culver, and K. Welch. 2012. Can travel training services save public transportation agencies money?. TR News 278 (January–February): 36–38.

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                                                                                                                                                                    The implementation of the ADA-facilitated segregated transportation services; para-transit used by persons with disabilities and fixed-route services used by the general public. To resolve this divide, travel training services were created to train and support individuals on the use of less costly fixed-route services.

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