Disability Statistics in the Developing World: A Reflection on the Meanings in our Numbers

The use of the Washington Group on Disability Statistics questionnaires to identify hearing disability: a systematic review

PURPOSE

To investigate the use of instruments from the Washington Group on Disability Statistics (WG) to obtain data on hearing disability (HD).

RESEARCH STRATEGIES

We conducted searches in the PubMed, Scopus, Science Direct, Web of Science, Lilacs databases and the grey literature. The software "The State of the Art through Systematic Review" and "Mendeley" were used to assist in the bibliographic reference organization, selection, and storage.

SELECTION CRITERIA

we followed the guidelines proposed by the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" and we selected studies that met the following inclusion criteria: written in English or Portuguese, within the period of 2001 to 2017 and have used the WG hearing disability question.

DATA ANALYSIS

The variables analyzed into the studies were: WG module, country and year of data collection, sample size and composition, objective of the study, publication journal, HD estimate of prevalence and accuracy measures.

RESULTS

Sixty-five studies are included in the review, conducted with data from 30 countries. The WG Short Set of question was the most often used. Hearing disability prevalence ranged from 0.2 to 2.3% and only three studies estimated the accuracy of the instrument to identify HD.

CONCLUSION

The hearing disability question of WG has been used worldwide and mainly in developing countries. The short variation in the estimated prevalence measurements within studies seems favorable to the WG's goal of generate estimates that allow international comparison. However, the shortage of validity studies indicates the need for further investigations with this purpose.

Decolonial theory and disability studies: On the modernity/coloniality of ability

This paper applies a decolonial approach to hegemonic psychological science by engaging marginalized knowledge perspectives of Disability Studies (DS) to reveal and disrupt oppressive knowledge formations associated with standard understandings of ability. In the first section of the paper, we draw upon mainstream DS scholarship to challenge individualistic orientations to disability (evident in the medical model and positive psychology perspectives) that pervade psychological science. The purpose of this approach is to normalize disability by thinking through disabled ways of being as viable and valuable. In the second section of the paper, we draw upon critical race and global disability perspectives to denaturalize hegemonic accounts of ability. Rather than essential properties of human bodies and minds, the capabilities of the modern subject reflect technological and ideological investments that enable a privileged few, while disabling the marginalized global majority. We conclude by discussing implications of decolonial theory for DS and ways in which considerations of disability subjectivity can inform the decolonial project.

Maximizing the use of Special Olympics International's Healthy Athletes database: A call to action

There is a critical need for high-quality population-level data related to the health of individuals with intellectual disabilities. For more than 15 years Special Olympics International has been conducting free Healthy Athletes screenings at local, national and international events. The Healthy Athletes database is the largest known international database specifically on the health of people with intellectual disabilities; however, it is relatively under-utilized by the research community. A consensus meeting with two dozen North American researchers, stakeholders, clinicians and policymakers took place in Toronto, Canada. The purpose of the meeting was to: 1) establish the perceived utility of the database, and 2) to identify and prioritize 3-5 specific priorities related to using the Healthy Athletes database to promote the health of individuals with intellectual disabilities. There was unanimous agreement from the meeting participants that this database represents an immense opportunity both from the data already collected, and data that will be collected in the future. The 3 top priorities for the database were deemed to be: 1) establish the representativeness of data collected on Special Olympics athletes compared to the general population with intellectual disabilities, 2) create a scientific advisory group for Special Olympics International, and 3) use the data to improve Special Olympics programs around the world. The Special Olympics Healthy Athletes database includes data not found in any other source and should be used, in partnership with Special Olympics International, by researchers to significantly increase our knowledge and understanding of the health of individuals with intellectual disabilities.

Trajectories of limitations in activities of daily living among older adults in Mexico, 2001-2012

BACKGROUND

Trajectories of disability are an essential component to understand the burden of disability at the societal level. Longitudinal studies, compared to cross-national studies, enable a better analysis of the progression of physical limitations among the elderly. However, information on disability dynamics in developing countries is limited.

OBJECTIVES

This paper examines the changes in activities of daily living (ADLs) in an 11-yr. period in the Mexican elderly population aged 60 or older and identifies how sociodemographic variables alter these trajectories.

METHODS

The data come from the Mexican Health and Aging Study (MHAS), a national sample of adults born in 1951 or earlier, including a baseline survey in 2001 and follow-ups in 2003 and 2012.

RESULTS

The ADL score increased on average by 0.03 for every year respondents aged after 60. In contrast, the ADL score was reduced by 0.06 for every additional year of education.

CONCLUSIONS

Age, gender, and years of education were confirmed to influence the trajectories of ADL limitations. Understanding the patterns of deterioration of functional limitations will help public health policies to better serve the population.

Transition Experiences of Stroke Survivors Following Discharge Home

BACKGROUND

Little is known about the transition experiences of stroke survivors after discharge home.

PURPOSE

The purpose of this article is to describe three domains of psychosocial experiences of stroke survivors during the first month following discharge for acute stroke.

METHOD

Data were collected from 125 stroke survivors interviewed at 1 month following discharge home.

RESULTS

Findings indicate that changes in sense of self, connectedness with others, and community integration presented the major challenges.

Numbers and policy in care for people with intellectual disability in the United Kingdom

BACKGROUND

Statements or commitments making use of numbers have an important place in government policy. They appear at all stages of the policy process: campaigning, formulation, monitoring and evaluation. Many types of source are involved including research studies, national survey information, routine operational data collections and special systems devised to monitor particular initiatives.

METHOD

The paper presents examples of policy uses of numerical evidence, and some sources of data that have been used to support them in the field of care for people with intellectual developmental disability in England.

CONCLUSIONS

Different levels of precision or coverage are required at different stages of the process. Different types of numerical data are appropriate at the various stages of the policy process.

Attitudes of Pakistani community members and staff toward people with intellectual disability

The acceptance and inclusion of persons with intellectual disability can vary across cultures, and understanding attitudes can provide insight into such variation. To our knowledge, no previous study has explored attitudes toward people with intellectual disability among Pakistani community members and disability service providers. We administered the Community Living Attitudes Scale (Henry et al., 1996), a measure of attitudes toward people with intellectual disability developed in the United States, to 262 community members and 190 disability service providers in Pakistan. Confirmatory factor analysis found a 4-factor solution (empowerment, similarity, exclusion, and sheltering) fit the Pakistani sample. More positive attitudes were observed in staff serving people with intellectual disability, females, Christians, Hindus, Sunnis, and people with greater education. We discuss implications for research, theory, and practice.

Carers' perspectives of a weight loss intervention for adults with intellectual disabilities and obesity: a qualitative study

BACKGROUND

To date, no studies have explored the role of carers in supporting adults with intellectual disabilities (ID) and obesity during a weight loss intervention. The present study explored perceptions of carers supporting adults with ID, as they participated in a 6-month multi-component weight loss intervention (TAKE 5).

METHODS

Semi-structured interviews were used to explore the experiences of 24 carers. The transcripts were analysed qualitatively using thematic analysis.

RESULTS

Three themes emerged from the analysis: carers' perceptions of participants' health; barriers and facilitators to weight loss; and carers' perceptions of the weight loss intervention. Data analysis showed similarities between the experiences reported by the carers who supported participants who lost weight and participants who did not. Lack of sufficient support from people from the internal and external environment of individuals with ID and poor communication among carers, were identified as being barriers to change. The need for accessible resources tailored to aid weight loss among adults with ID was also highlighted.

CONCLUSION

This study identified specific facilitators and barriers experienced by carers during the process of supporting obese adults with ID to lose weight. Future research could utilise these findings to inform appropriate and effective weight management interventions for individuals with ID.

International BMI comparison of children and youth with intellectual disabilities participating in Special Olympics

The purpose of this study was to describe the BMI status of children and youth with intellectual disabilities by world region, gender and age. A total of 9678 children and youth records were available from the Special Olympics International Health Promotion database after data cleaning (6084 boys and 3594 girls). Children were defined as 8-11 year olds (n=2035), and youth were defined as 12-18 year olds (n=7643). BMI prevalence rates were computed using the International Obesity Task Force (IOTF) cut-points, and logistic regression was used to determine if either age or gender was associated with being overweight or obese. Approximately 30% of the sample was overweight or obese; however, the prevalence rates in North America were much higher, particularly among girls. Fifty-four percent of girls (95% confidence interval [CI], 51.4-57.2%) were overweight or obese. Logistic regression revealed that both age and gender were significant predictors in North America; however this pattern was not consistent throughout the world regions. BMI status is a significant indicator of health, and these findings suggest that overweight and obesity are significant health concerns for children and youth with intellectual disabilities around the world. Obesity rates in this population are particularly high in North America, and the odds of becoming overweight or obese increased with age in North America. It is critical that health professionals increase Health Promotion efforts, including physical activity and healthy eating behaviors for children and youth with intellectual disabilities.

Caring for a child with severe intellectual disability in China: the example of Rett syndrome

PURPOSE

Rett syndrome is one of several genetic disorders known to cause severe intellectual and physical disability, mostly in girls. Girls affected by Rett syndrome appear to develop normally in the first 6 months of life, after which the usual clinical presentation comprises regression of communication and hand skills, the appearance of hand stereotypies and impaired gait. Intellectual disability affects more than 1.5% of the population of children in developing countries yet we know little about the daily lives and support services available for them and their caregivers.

METHOD

This qualitative study explored the daily experiences of 14 mothers and one grandmother caring for a child with Rett syndrome in China via telephone interviews.

RESULTS

Participants reported a lack of education, rehabilitation and support services available to them. Limited access to information reduced families' capacity to adequately meet the needs of their child. These gaps were further exacerbated by discrimination and perceived stigma from some members of the community.

CONCLUSIONS

Additional support services and educational programs at the governmental level can improve the quality of life of persons with an intellectual disability and their families and programs involving community participation in the care of people with disabilities may help to address discrimination.

Poverty and people with intellectual disabilities

Epidemiological studies have consistently reported a significant association between poverty and the prevalence of intellectual disabilities. The available evidence suggests that this association reflects two distinct processes. First, poverty causes intellectual disabilities, an effect mediated through the association between poverty and exposure to a range of environmental and psychosocial hazards. Second, families supporting a child with intellectual disabilities and adults with intellectual disabilities are at increased risk of experiencing poverty due to the financial and social impact of caring and the exclusion of people with intellectual disabilities from the workforce. It is likely that the association between poverty and intellectual disabilities accounts in part for the health and social inequalities experienced by people with intellectual disabilities and their families. Implications for policy and practice are discussed in relation to the funding of services for people with intellectual disabilities and preventative approaches to addressing the health and social inequalities experienced by people with intellectual disabilities and their families.