Engineering Ableism: The Exclusion and Devaluation of Engineering Students and Professionals with Physical Disabilities and Chronic and Mental Illness

Background

The experiences of students and professionals with disabilities are routinely excluded from scholarly and policy debates about equity in engineering. Emergent research suggests that engineering is particularly ableist, yet systematic accounts of the possible exclusion and devaluation faced by engineers with disabilities are largely missing.

Purpose/Hypothesis

This paper asks, do engineers with disabilities have more negative interpersonal experiences in engineering classrooms and workplaces than those without disabilities? Utilizing a social relational model of disability, I hypothesize that engineers with physical disabilities and chronic and mental illness are more likely to experience exclusion and professional devaluation than their peers and, partly as a result, have lower persistence intentions.

Data/Methods

The paper uses survey data from 1,729 students enrolled in eight US engineering programs (ASEE Diversity and Inclusion Survey) and 8,321 US-employed engineers (STEM Inclusion Study Survey). Analyses use regression, mediation, and intersectional approaches.

Results

Consistent with expectations, engineering students and professionals with disabilities are less likely than their peers to experience social inclusion and professional respect at school and work. Students with disabilities are more likely to intend to leave their engineering programs and professionals with disabilities are more likely to have thought about leaving their engineering jobs compared to peers, and their greater risks of encountering interpersonal bias help account for these differences. Analyses also reveal intersectional variation by gender and race/ethnicity.

Conclusion

These results suggest that engineering harbors widespread ableism across education and work. The findings demand more scholarly attention to the social, cultural, and physical barriers that block people with disabilities from full and equal participation in engineering.

Enter into society: Digitalized livelihoods and prosumer labor for people with disabilities in China

Background

The current debates on “digital labor” focus on a gorgeous and comprehensive experiential description and theoretical exposition but do not provide a thorough examination of the unique context and social structure. In China, the development of internet is closely tied to politics, the Chinese Government uses internet as a tool of social governance. More importantly, aside from desire-based communications produced by corporate ideology, the Chinese people’s passion for the Internet also comes from individual survival, especially the middle and lower class of information represented by the disabled people. This means that analysis of the digital labor among people with disabilities in China must be done from a variety of angles, including politics, society and culture.

Methods

This study combines life-history interviews and field research methods to explore the value and significance of digitalized livelihoods and free prosumer labor for people with disabilities in China through self-narration. Since 2020, researchers have been volunteering at two social organizations serving people with physical disabilities in Wuhan city, Hubei Province. We participated in 26 assistance activities for disabled groups which included three 14-day training camps, and interviewed 40 people with physical disabilities.

Results

This study found that although the digitalized livelihoods practice of people with disabilities is still “precarious labor” in nature, whose self-expression in the cyberspace is easy to fall into the shackles of capital flow logic. However, digital labor practice provides them with the opportunity to “sit at home, enter the community and society,” also enables them to “live independently.” More importantly, this opportunity and possibility enable people with disabilities to experience a sense of value and self-esteem as “competent people.” Therefore, in the realistic environment of structural obstacles in the social life of the people with disabilities in China, the possibility of “inclusiveness” brought by digital labor is the core value brought by digital society.

A Multifunctional Adaptive and Interactive AI system to support people living with stroke, acquired brain or spinal cord injuries: A study protocol

Background

Acquired brain injury and spinal cord injury are leading causes of severe motor disabilities impacting a person’s autonomy and social life. Enhancing neurological recovery driven by neurogenesis and neuronal plasticity could represent future solutions; however, at present, recovery of activities employing assistive technologies integrating artificial intelligence is worthy of examining. MAIA (Multifunctional, adaptive, and interactive AI system for Acting in multiple contexts) is a human-centered AI aiming to allow end-users to control assistive devices naturally and efficiently by using continuous bidirectional exchanges among multiple sensorimotor information.

Methods

Aimed at exploring the acceptability of MAIA, semi-structured interviews (both individual interviews and focus groups) are used to prompt possible end-users (both patients and caregivers) to express their opinions about expected functionalities, outfits, and the services that MAIA should embed, once developed, to fit end-users needs.

Discussion

End-user indications are expected to interest MAIA technical, health-related, and setting components. Moreover, psycho-social issues are expected to align with the technology acceptance model. In particular, they are likely to involve intrinsic motivational and extrinsic social aspects, aspects concerning the usefulness of the MAIA system, and the related ease to use. At last, we expect individual factors to impact MAIA: gender, fragility levels, psychological aspects involved in the mental representation of body image, personal endurance, and tolerance toward AT-related burden might be the aspects end-users rise in evaluating the MAIA project.

Beyond question wording: How survey design and administration shape estimates of disability

BACKGROUND

Between 2008 and 2014, annual estimates of disability prevalence among U.S. adults varied somewhat across federal surveys that use a standardized measure of disability, but trends over-time were relatively stable and consistent. In 2014, however, estimates of disability from the Survey of Income and Program Participation (SIPP) increased markedly relative to previous years and were much higher than disability estimates from other federal surveys.

OBJECTIVE

To examine why disability prevalence among adults aged 40 and older substantially increased in the first wave of the 2014 SIPP Panel.

METHODS

We consider three factors that may have contributed to the rise in disability: data processing, context effects linked to question order, and sampling. To do so, we compare estimates with and without survey weights and imputed data, analyze supplemental disability-related data collected among SIPP participants, and employ decomposition analysis to assess what proportion of the increase in disability can be attributed to changes in sample composition.

RESULTS

We find evidence that differences in sample composition contributed to the observed rise in disability prevalence in SIPP between 2011 and 2014. There is less evidence that weighting and imputation or context effects played a role.

CONCLUSIONS

Previous studies emphasize differences in operationalization and conceptualization of disability as the major factor driving discrepancies in disability estimates. This study suggests that other factors related to survey design and administration may influence disability measurement. Such aspects of surveys, like question order and sampling, may be difficult to standardize, leading to meaningful cross-survey differences in disability estimates.

Pandemic "Disability Cons"

Disability rights law has made issues of access and accommodations much more visible in American life. Yet a byproduct of the increased awareness of disability rights has been "fear of the disability con," that is, the common apprehension that people are abusing the law to gain an unfair advantage. Many times, this moral panic creates an invisible, oft-overlooked barrier for people with disabilities who desire to utilize their rights. They either are refused the right altogether or give up asking for it in the first place because they are afraid of being accused of being fakers. This Article shows how fear of the disability con surfaced along the progression of the COVID-19 pandemic. It describes the schism between the ways in which people with disabilities generally fared under the pandemic and some popular perceptions regarding the "privileges" they allegedly received because of their protected legal status. Those so-called privileges include mask exemptions, vaccination priority, and permission to continue remote work. The Article concludes with lessons the COVID-19 pandemic experience can teach us about the nature and scope of the fear of the disability con.

An evaluation of the American Community Survey indicators of disability

BACKGROUND

Collection of data in the Census for implementing disability legislation has been continuous since 1970 although the questions used have changed several times. Concerns have been raised about the ability of the newest question set developed for the American Community Survey (ACS) to adequately represent the population with disabilities because it does not capture all those eligible for certain benefit programs.

OBJECTIVE

Using national data, we examine how the addition of questions on the receipt of SSI/SSDI changes the composition of the population identified by the ACS measures. In ancillary materials we also examine the addition of a work limitation question to the population identified by ACS measures.

METHODS

Using descriptive secondary analysis of 2011 NHIS data we compare the characteristics of those identified by the ACS questions to those identified by the ACS questions and receipt of SSI/SSDI and those only receiving SSI/SSDI. The comparison is based on conditions, specific functional limitations and severity of limitation.

RESULTS

The results provide evidence ACS questions identify a population representing persons at risk for participation difficulties including those who receive SSI/SSDI. The ACS population has higher proportions with mental health and development disabilities than comparison population. The ancillary data demonstrates the work limitation question does not make a significant difference in identifying recipients of SSI/SSDI.

CONCLUSION

The analysis demonstrates that the disability measures developed for the ACS produce an unbiased picture of the population with disabilities by including persons with all conditions, more severe disability or selected types of functional limitations.

World Health Organization disability assessment schedule 2.0: An international systematic review

PURPOSE

This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument.

METHOD

Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases.

RESULTS

We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry).

CONCLUSIONS

The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.

Estimating the Size of the Adult Population Needing Personal Assistance Services

Legislative initiatives to expand federal funding of personal assistance services (PAS) have relied primarily or exclusively on need for assistance with activities of daily living (ADLs). Analyses of the U.S. Census Bureau's 1990 and 1991 Survey of Income and Program Participation (SIPP) indicate that roughly 1.4 million Americans report needing assistance with three or more ADLs, and that 35% of these are under age 65. Only a small subset of the population needing assistance with three or more ADLs (22%) also report family incomes at or below the federal poverty level, suggesting that means-testing could significantly reduce the size of the population eligible for a federal benefit. Different ADL, age, and income criteria substantially affect the size and composition of the eligible population. The policy implications and limitations of these findings are discussed.

The Social Construction of Personnel Policy

The goal of this investigation was to develop an understandrng of the social context of state merit systems of personnel. Ten key informants were interviewed following an “interpretivist” paradigm to illuminate the political and social construction of public policy. The key informants reveal a basic self-belief in the rationality of merit systems of personnel under which only the “best-qualified” candidates are given employment. Under this doctrine, merit may mean equality without equity for people with disabilities. Merit systems of personnel are dominated by people who have historically had more access to experience and training than people with disabilities, who are underrepresented in state jobs. However, the informants argue that underrepresentation is the result of unintended consequences. Personnel administrators' willingness to ascribe underrepresentation to an unintended consequence may undercut policies requiring reasonable accommodations for applicants with disabilities.

Defining and applying a functionality approach to intellectual disability

BACKGROUND

The current functional models of disability do not adequately incorporate significant changes of the last three decades in our understanding of human functioning, and how the human functioning construct can be applied to clinical functions, professional practices and outcomes evaluation.

METHODS

The authors synthesise current literature on human functioning dimensions, systems of supports and approaches to outcomes evaluation for persons with intellectual disability (ID), and propose a functionality approach that encompasses a systems perspective towards understanding human functioning in ID. The approach includes human functioning dimensions, interactive systems of supports and human functioning outcomes.

RESULTS

Based on this functionality approach the authors: (1) describe how such an approach can be applied to clinical functions related to defining ID, assessment, classification, supports planning and outcomes evaluation; and (2) discuss the impact of a functionality approach on professional practices in the field of ID.

CONCLUSIONS

A functionality approach can increase focus on the integrative nature of human functioning, provide unified language, align clinical functions and encourage evidence-based practices. The approach incorporates a holistic view of human beings and their lives, and can positively affect supports provision and evaluation.

Connecting Contemporary Paradigms to the Social Security Administration’s Disability Evaluation Process

From 1998 to 2008, the Social Security Administration’s (SSA) disability insurance program (DI) applications rose from 1.2 million to 2.3 million and exceeded 3 million in 2009. Given these large and growing numbers, even small changes in processing disability applications may reduce processing time, lower program costs, and improve performance of SSA’s disability programs. A literature review examining current conceptual models of disability and SSA’s disability evaluation process for adults was conducted. A gap exists between contemporary models of disability and how SSA defines and operationalizes disability. This is complicated by substantial variation in the timing, quantity, and quality of applicant functional information and workplace demands. A focus on impairment marginalizes more comprehensive assessment of function necessary to assess capacity for work. Novel assessment methodologies, such as computer adaptive testing to measure human functioning may hold promise for SSA’s data collection methods and disability assessment.

Breast Cancer Survivorship and Work Disability

Breast cancer survivors can anticipate a number of years of paid labor market participation. Therefore, the link between breast cancer survivorship and productivity deserves serious consideration. The hypothesis guiding this study is that arm disability, particularly pain and range of motion limitations, are important explanatory variables in survivors’ loss of productivity. The study investigates the association between productivity and arm disability over time. The longitudinal data are drawn from survivors in four geographical locations in Canada. Regression results indicate that survivors with arm pain, 2.5 to 3 years postsurgery, are almost 8 times more likely to experience a loss in productivity compared to those survivors without pain, and those with some range of motion limitations are 4 times more likely to experience productivity loss 2.5 to 3 years postsurgery compared to their counterparts without limitations. More than 40% of survivors begin to or continue to experience productivity loss as long as 30 to 36 months after surgery and that the loss in productivity is primarily due to two forms of arm disability: pain and range-of-motion limitations. These findings highlight the importance of rehabilitation programming for breast cancer survivors.

Disability, Dependence, and Old Age: Problematic Constructions

This paper argues that fear of aging can more precisely be recognized as a fear of disability and that fear of disability can be centrally understood as a fear of dependence. Accordingly, we are not likely to see old people being treated as important members of society until we see a change in attitudes towards disability. The argument is developed with reference to a consideration of attitudes toward and treatment of elders and people with disabilities, a consideration of the social construction of dependency, and an examination of statistics on the Canadian population of people with disabilities. The ubiquity of disability across all age groups means that there needs to be a re-conceptualization of disability as part of the human experience.

Convergence and divergence: differences in disability prevalence estimates in the United States and Canada based on four health survey instruments

An analysis of data from the Joint Canada/United States Survey of Health (JCUSH), allows us to compare prevalence estimates that result from four different question sets designed to assess disability from a group of respondents residing in either Canada or the United States. Depending upon the question set used and the coding applied to the responses, age-standardized prevalence estimates varied widely in both countries. In the U.S. noninstitutionalized adult population, disability prevalence estimates ranged from as low as 15.3% to as high as 36.4%, while in Canada the estimates ranged from 13.4% to 37.3%. Concordance and discordance in identification as disabled among these question sets were also examined. In both countries, less than 20% of those identified as disabled by any question set were identified as disabled on all four question sets when using conservative response coding to define disability. Concordance in answers to these questions was also found to be associated with older age, single marital status, low education and low income in both countries. Discordance between question set pairs was similar across both countries whether among measures based on the same domains of disability or different domains of disability. The theory, methods and future of disability measurement in health surveys are discussed in light of these findings. We conclude that understanding and interpreting national prevalence estimates requires more thoughtful attention to the purposes for which data are being collected, the specific definition and operationalizations of disability for those purposes, the methodology used in the data collection and analysis process and the areas of both commonality and difference in the populations identified by each question set. In terms of cross-cultural comparisons, the use of a common set of questions and answer categories and similar survey methodologies provides much more robust results.

Person-centredness: conceptual and historical perspectives

PURPOSE

The definition and aims of rehabilitation are both topics of frequent debate. Recently several authors have suggested defining rehabilitation and its goals in terms of 'person-centredness'. However such attempts to define rehabilitation in this way have not occurred without running into their own difficulties and criticisms. Consequently, one may question whether person-centredness is a good candidate to characterize and define rehabilitation. The purpose of this article is to reflect upon the historical background and conceptual underpinnings of this term and their relevance for understanding contemporary person-centred rehabilitation.

METHOD

We conducted a conceptual and historical analysis of the notion of person-centredness in relation to rehabilitation. We ask first whether person-centredness has a consistent and fixed definition and meaning? Secondly, where does person-centredness come from, what is its conceptual history and does an historical approach enable us to identify a unique source for person-centredness?

RESULTS

In the context of rehabilitation, we have identified four main understandings or interpretations of the term person-centredness, each of which denotes several ideas that can be, in turn, interpreted in quite different ways. Thus the concept of person-centredness in rehabilitation has multiple meanings. The conceptual history indicates that person-centredness has diverse meanings and that it has been used in a variety of contexts somewhat unrelated to disability and rehabilitation. Moreover, there does not seem to be any strict relationship between person-centredness as it is used in the context of rehabilitation and these prior uses and meanings.

CONCLUSION

Person-centredness has an ancient pedigree, but its application in the field of rehabilitation raises both practical and theoretical difficulties. It may be that rehabilitation might get a better sense of what it should be and should do by focusing less on the rhetoric of person-centredness and by putting more emphasis on the investigation and operationalization of its key conceptual components.

“Nobody's just normal, you know”: The social creation of developmental disability

This paper examines the process through which early childhood developmental disability is socially created within a US public program called Early Intervention (EI). In doing so, the paper analyses and links the social creation of early childhood disability as a category at both the macro-level level and at the micro-level. The analysis is based on qualitative interview data from 31 parents and 19 professions involved in EI programs in Massachusetts. At the macro-level, the paper addresses how federal legislation and state regulations establish the boundary between normalcy and disability. At the micro-level, it analyses adults' social creation of developmental disability, measured as impairment. The paper also investigates the impairment categories that are produced by these processes, exposing the kinds of early childhood developmental delays that have been legislated as worthy of public intervention and discusses some implications of the disability determination process.

Inclusion of people with disabilities in telephone health surveillance surveys

OBJECTIVES

Telephone survey data are widely used to describe population health, but some fear that people with disabilities cannot participate. We tested the hypothesis that a telephone survey would underrepresent adults with disabilities, and that the adults with disabilities who responded would report lower prevalences of sensory, mental, self-care, and multiple limitations than those observed in people with disabilities in the general population.

METHODS

We compared characteristics of adults with disabilities identified by the 2001 Washington State Behavioral Risk Factor Surveillance Survey (BRFSS) to Washington adults with disabilities in the Census 2000 Supplementary Survey (C2SS), to 2 BRFSS Disability Supplements, and to the Washington State Population Survey. All except the C2SS are telephone surveys.

RESULTS

Contrary to expectations, post hoc analyses of all telephone surveys found significantly higher prevalence of disability in the Washington adult population than did the C2SS. The hypothesis of more sensory, mental, and self-care limitation in telephone disability samples was supported in only 2 of 11 instances in which a disability sample was asked about 1 of these limitations. Findings were not explained by differences in disability definition or type of informant.

CONCLUSIONS

These results suggest that population telephone surveys do not underrepresent adults with disabilities. The counterintuitive finding of their higher survey participation raises further questions.

Impact of Service Supply, Need, and Municipal Factors on the Use of Residential Services for People With Intellectual Disabilities

We examined the use of residential services for people with intellectual disabilities in Finland from a regional perspective. Our aims were to investigate how service supply and need, as well as municipal factors, impact the use of residential services and to analyze whether the available information in registers and databases can be effectively utilized in studies of this kind. According to the model based on the register data, after age adjustment the most important factors determining service use were service supply, the prevalence of intellectual disabilities, the municipality's level of urbanization, the number of persons granted long-term care as a percentage of all care recipients, and the percentage of middle-class and managerial households in a given municipality.

Continuum of Intellectual Disability: Demographic Evidence for the “Forgotten Generation”

Demographic features of Americans with mild intellectual disabilities were estimated in an analysis of the National Health Interview Survey. The cohort was compared to the population of the United States, persons with specific learning disabilities, and persons with mental retardation. Comparison on basic indices of adaptive functioning and SES suggest a large cohort of Americans who share many support needs and social and economic vulnerabilities with those labeled "mentally retarded." The combined prevalence of intellectual disability/mental retardation was estimated to be 1.27%. Implications are discussed in terms of the "forgotten generation" report of the 1999 President's Committee on Mental Retardation and evolving conceptions of mental retardation.

Secondary health conditions among middle-aged individuals with chronic physical disabilities: implications for unmet needs for services

Data from the Aging with Disability (AwD) Study are used to examine variations in the types and frequency of secondary conditions experienced by 301 middle-aged individuals living with the effects of three disabling conditions: polio (n = 124), rheumatoid arthritis (RA) (n = 103), and stroke (n = 75). All respondents were randomly selected from a county rehabilitation hospital or a community-based subject pool. Secondary conditions are operationalized as (1) the number of new health problems diagnosed or treated since the onset of the primary disability and (2) the amount of change/decline in basic and instrumental daily activities since a previous reference period in the disability trajectory. Also analyzed are changes in use of assistive devices and unmet needs for services. Differences in secondary conditions are examined within the AwD sample by impairment group and between samples by comparing AwD rates to national estimates for the same cohort. Results reveal significant differences in the types of new health problems reported by persons living with polio, RA, and stroke and document marked disparities, or accelerated aging, between disabled and nondisabled adults. Findings are discussed in terms of the changing health care needs of persons aging with disability and the importance of improving access to preventive services, ongoing rehabilitation, and assistive technology.

Models of disablement, universalism and the international classification of impairments, disabilities and handicaps

A review and critique of models of disability is presented, tracing the development of frameworks and classificatory instruments (International Classification of Impairments, Disabilities and Handicaps) over the past 20 years. While the 'social' model is now universally accepted, it is argued that universalism as a model for theory development, research and advocacy serves disabled persons more effectively than a civil rights or 'minority group' approach. The development of the revised International Classification (ICIDH-2) is discussed in this light.

Disability theory and public policy: implications for critical gerontology

Current gerontological theories and aging policy often fail to acknowledge the social and economic consequences of disability in later life, while disability theories and policies tend to focus only on the employment impacts of disability in younger populations. This article attempts to apply a critical gerontology framework to aging and disability issues. The authors review theoretical models of the disablement process, and note the primacy of environmental factors. The production and distribution of disability are assessed, using both social epidemiology and political economy insights. The authors examine the linkage of disability and work impedance and the consequences in disability programming, giving special consideration to inherent age, gender, and racial biases. Some of the historical antecedents of disability stigma in aging populations are also identified. The article concludes by suggesting that analysts and policymakers who wish to address the tremendous social and economic inequities that accompany aging and disability should look to the principles put forth by the independent living movement and to recent work on the moral economy of interdependency over the life course.

An analysis of the effects of ramp slope on people with mobility impairments

A study was conducted to evaluate the usability of the range of ramp slopes allowed under the current ADA accessibility guidelines. One hundred seventy-one subjects of all ages and using different types of mobility aids traversed a 30-foot ramp varying in slope from 1:8 to 1:20. Data were recorded for pulse rate, energy expenditure, rate of travel, distance traveled, and the location of rest stops. Findings show that among all subjects only a few manual wheelchair users had difficulty traversing all 30 feet in ascent, even on slopes as steep as 1:8. Based on these results, changes to the technical requirements for ramp slope and length cannot be recommended at this time.

People with mobility impairments in the United States today and in 2010

This article presents a study undertaken to develop a population profile of people with mobility impairments in the U.S.A. today and to estimate the profile of people with mobility impairments in the year 2010. The profile was developed under contract to the U.S. Architectural and Transportation Barriers Compliance Board (Access Board) as part of a project to examine technical requirements for ramp slope and length. The profile was used to establish a representative (both today and in the future) sampling frame for human subjects in the current project, as well as to guide the Access Board in developing accessibility guidelines in the future. The present article highlights findings concerning mobility impairments in the population today and trends likely to influence the future prevalence of such impairments. The findings have implications for accessibility requirements and disability policy in general.