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.     

How the Powerful Decide: Access to Research Participation by those at the Margins

How do those in power decide to include and exclude those at the margins from community life? We used simulated review of research vignettes to examine how researchers and members of Institutional Review Boards make decisions concerning the research participation of adults with and without intellectual disabilities. Results indicate that decision‐makers are influenced by the disability status of the sample, characteristics of the research in which they are engaged, and their attitudes toward the research participation of adults with intellectual disabilities as well as their own relationship to the research process. For example, decision‐makers may create situations that limit the self‐determination of adults with intellectual disabilities and adults without disabilities within the research context, particularly when the research poses some risk of harm to participants. Implications for theory, action and research are explored.     

Family Policy Initiatives in Latin America: The Case of Colombia and Ecuador

Family policy initiatives in Colombia and Ecuador have targeted primarily families living in poverty. This paper discusses some of the major policy initiatives oriented to improve the living conditions of economically disadvantaged families in both countries. We argue that, even though governments recognize the importance of family policies, existing policies and programs for families living in poverty do not directly focus on family issues. They represent more implicit than explicit family policies. We analyze some of the issues that may hinder the development, implementation, and evaluation of family policies in Colombia and Ecuador. Such issues stem from political and economic instability, legislation, changing family demographics, as well as coordination among agencies that develop, implement, and evaluate policies. We discuss challenges related to family policies in both countries and recommendations to improve existing policy initiatives.     

‘On-the ground’ strategy matrix for fostering quality participation experiences among persons with disabilities in community-based exercise programs

ObjectiveThe purposes of this paper are to (1) document the generation and refinement of a quality participation strategy list to ensure resonance and applicability within community-based exercise programs (CBEPs) for persons with physical and intellectual disabilities, and (2) identify theoretical links between strategies and the quality participation constructs.MethodsTo address purpose one, a list of strategies to foster quality participation among members was extracted from qualitative interviews with providers from nine CBEPs serving persons with physical disabilities. Next, providers from CBEPs serving persons with physical (n = 9) and intellectual disabilities (n = 6) were asked to identify the strategies used, and examples of their implementation, within their programs. Additional strategies noted by providers and in recent published syntheses were added to the preliminary list. A re-categorization and revision process was conducted. To address purpose two, 22 researchers with expertise in physical and/or intellectual disability, physical activity, participation and/or health behaviour change theory completed a closed-sort task to theoretically link each strategy to the constructs of quality participation.ResultsThe final list of 85 strategies is presented in a matrix. Each strategy has explicit examples and proposed theoretical links to the constructs of quality participation.ConclusionsThe strategy matrix offers a theoretically-meaningful representation of how quality participation-enhancing strategies can be practically implemented “on-the-ground” in CBEPs for persons with disabilities.     

Behavior analysts in the war on poverty: A review of the use of financial incentives to promote education and employment

Poverty is a pervasive risk factor underlying poor health. Many interventions that have sought to reduce health disparities associated with poverty have focused on improving health‐related behaviors of low‐income adults. Poverty itself could be targeted to improve health, but this approach would require programs that can consistently move poor individuals out of poverty. Governments and other organizations in the United States have tested a diverse range of antipoverty programs, generally on a large scale and in conjunction with welfare reform initiatives. This paper reviews antipoverty programs that used financial incentives to promote education and employment among welfare recipients and other low‐income adults. The incentive‐based, antipoverty programs had small or no effects on the target behaviors; they were implemented on large scales from the outset, without systematic development and evaluation of their components; and they did not apply principles of operant conditioning that have been shown to determine the effectiveness of incentive or reinforcement interventions. By applying basic principles of operant conditioning, behavior analysts could help address poverty and improve health through development of effective antipoverty programs. This paper describes a potential framework for a behavior‐analytic antipoverty program, with the goal of illustrating that behavior analysts could be uniquely suited to make substantial contributions to the war on poverty.     

Influential Factors of Poverty Dynamics among Korean Households that Include the Aged with Disability

The purpose of this longitudinal study was to examine closely the economic status of households that include the aged with disabilities in South Korea, as well as the factors contributing to their poverty dynamics. This study analyzed the poverty dynamics of households that include the aged with disabilities by using data from the Panel Survey of Employment for the Disabled for the years 2008 to 2012. This Survey is conducted by the Korea Employment Agency for the Disabled. Poverty dynamics were classified by the changes in poverty status in 2008 and 2012, including sustained poverty, sustained non-poverty, poverty exit, and poverty entry. We carried out a multinomial logistic regression for poverty dynamics based on demographics and analyzed the differences of income composition and consumption patterns according to poverty dynamics. Gender, education, degree of disability, economic activity, and change in the number of employed family members were identified as significant factors that determine poverty dynamics.     

Personal and Environmental Factors Predict Participation of Children With and Without Mild Developmental Disabilities

Enhancing participation in age-related activities is a key goal in the education and rehabilitation of children with diverse disabilities. The aim of this study was to explore a multidimensional and ecological model of participation for young children. Seventy eight children with mild developmental disabilities (MDD, such as motor and visual-motor difficulties), and 110 children without disabilities, between the ages 4 and 6 years old, participated in the study together with their parents. Data were collected using standardized assessments for child capacities and newly developed questionnaires for child participation and for human and physical environmental factors. Associations were found between personal and environmental factors and the participation dimensions amongst young children, thus supporting the validity of the proposed model of participation. Moreover, the study results outline different pathways for the participation of children with and without MDD. Child factors (e.g. process skills) were found to be crucial predictors of participation particularly for children with MDD, whereas human environmental factor (e.g. maternal self-efficacy beliefs) was associated with higher participation scores especially for children without disabilities. These findings may facilitate the development of effective intervention programs which focus on environmental factors as well as on child factors.     

Enhancing Poverty-Abatement Programs: a Subjective Well-Being Contribution

This paper questions the assumption used in designing social policies that raising people’s income automatically translates into greater well-being. Based on a subjective well-being approach and a representative survey from Costa Rica the paper shows that there is substantial dissonance in the classification of persons as poor and as being in well-being deprivation. The existence of dissonances leads to the conceptualization of different trajectories out-of-poverty and into well-being. Public policies oriented towards the abatement of income poverty can have a greater impact on people’s well-being if they recognize the complexity of human beings and acknowledge that their programs affect satisfaction in all domains of life. The paper states that public policy should not only be concerned with getting people out of income poverty, but also with placing them in a life-satisfying situation. The paper also discusses strategies that could improve poverty-abatement programs.     

Can I Make a Difference? Efficacy,Employment, and Disability

Political efficacy is a widely studied phenomenon and an important predictor of political participation, but little is known about the political efficacy of the millions of people with disabilities in the United States. This paper reports the results of a nationally representative telephone survey of 1,240 people—stratified to include 700 people with disabilities—following the November 1998 elections. Several measures of efficacy that help predict political activity were found to be significantly lower among people with disabilities than among otherwise similar people without disabilities. Although lower levels of internal efficacy and civic skills could largely be explained by educational and employment gaps, lower levels of other variables (external efficacy, perceived influence of people with disabilities, and perceived treatment of people with disabilities) remained after applying a wide range of controls, indicating that people with disabilities are less likely to see the political system as responsive to them. This perception is concentrated among non–employed people with disabilities. The lower efficacy levels linked to "disability gaps" in employment, income, education, and group attendance appear to account for as much as half of the disability political participation gap; hence, policies intended to increase employment and educational opportunities for people with disabilities have potentially important political effects.     

Students with Disabilities Use of Various Options to Access Alternative Schools and Area Learning Centers

Alternative schools that were developed to encourage students experiencing difficulties in conventional schools to graduate from high school have been in existence since the 1970s. Alternative schools represent a form of school choice available to parents and students. This investigation focused on the extent to which students with disabilities are accessing Alternative Schools and Area Learning Centers (ALC) in Minnesota. More specifically, attention centered on (a) the option used by both students with and without disabilities to enroll in the school, (b) the extent to which students crossed district boundaries to attend the school, and (c) differential participation by category of disability. Results indicate that students with disabilities are accessing Alternative SchooVALC programs in ways similar to non-disabled students. Moreover, students with emotionalhehavioral disorders are heavily represented in these schools. It also was discovered that when students enter these programs, special education labels are often dropped and services discontinued. Implications for students with emotional and behavioral disorders are discussed.     

Acquired physical disability: Personal meanings in a rural South African setting

This study explored personal meanings attached to acquired physical disabilities in a rural South African community. Informants were seven adults with disability (females?=?4; age range?=?18 to 55 years). They responded to semi-structured face-to-face interviews on the meanings they attached to their physical disabilities acquired during adulthood. Four themes emerged from the thematic analysis: new life style, activity limitations, participation restrictions, and cultural marginalisation. The meanings and accompanying lifestyle changes have implications for personal functioning and social well-being.     

Aging family caregivers: policies and practices

This review examines later life family support for adults with developmental disabilities from a life course perspective that takes into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: (1) trends affecting family caregiving, (2) health and social outcomes of life-long caregiving, (3) support needs of families, (4) family support policies and practices, and (5) recommendations for a research and policy agenda. Research examining outcomes of life-long caregiving has shown that most families adapt well to having a family member with disabilities. However, some families are at risk for poorer physical and mental health outcomes. These include cultural minorities and families of adults with behavioral challenges. Caregiving does seem to have a negative impact on maternal employment and family income as mothers often give up or cut back on employment to care for a child with developmental disabilities, who is more likely to continue living in the family home throughout adulthood than other adult children. Federal and state initiatives are addressing issues of family support through both the developmental disabilities and aging service systems.     

Improving instruction for adults with developmental disabilities: Evaluation of a staff training package

Improvements in adaptive behavior among adults with developmental disabilities often depends on the quality of instruction delivered by direct-care staff. The present study evaluated the effectiveness of a multifaceted package for improving the quality of instructional interactions among three staff/adult dyads. Instructional interactions were first analyzed to identify areas for improvement. A multifaceted intervention package consisting of inservice training, participative management, and on-going feedback was then implemented in a multiple-baseline design across dyads. The package trained staff to increase their use of time delay and reinforcement strategies and these changes were associated with greater independence in a sandwich making task among two of the three participating adults. The results suggest direct observation of existing instructional interactions may provide valuable information when training staff to implement effective habilitative programs for adults with developmental disabilities.     

How infant-directed actions enhance infants’ attention,learning, and exploration: Evidence from EEG and computational modeling

When teaching infants new actions, parents tend to modify their movements. Infants prefer these infant-directed actions (IDAs) over adult-directed actions and learn well from them. Yet, it remains unclear how parents’ action modulations capture infants’ attention. Typically, making movements larger than usual is thought to draw attention. Recent findings, however, suggest that parents might exploit movement variability to highlight actions. We hypothesized that variability in movement amplitude rather than higher amplitude is capturing infants’ attention during IDAs. Using EEG, we measured 15-month-olds’ brain activity while they were observing action demonstrations with normal, high, or variable amplitude movements. Infants’ theta power (4–5 Hz) in fronto-central channels was compared between conditions. Frontal theta was significantly higher, indicating stronger attentional engagement, in the variable compared to the other conditions. Computational modelling showed that infants’ frontal theta power was predicted best by how surprising each movement was. Thus, surprise induced by variability in movements rather than large movements alone engages infants’ attention during IDAs. Infants with higher theta power for variable movements were more likely to perform actions successfully and to explore objects novel in the context of the given goal. This highlights the brain mechanisms by which IDAs enhance infants’ attention, learning, and exploration.     

The Role for Public Funding of Faith-Based Organizations Delivering Behavioral Health Services: Guideposts for Monitoring and Evaluation

The paper reviews policies promoting faith-based organizations' (FBO) participation in publicly-funded programs since the Charitable Choice statute was enacted during the Clinton administration and then additional faith-based initiatives were implemented by the Bush administration. The paper focuses on research findings on FBO participation in publicly-funded human service programs under these policies. It then proposes a framework for evaluation to assess the appropriateness of public funding for behavioral health services delivered by FBOs, in order to address: (1) the programmatic and systemic effects resulting from the infusion of new players from the faith community, and the consequences to the profile of services and who gets served; and (2) the content and effectiveness of faith-infused services as a basis for identifying interventions appropriate for public funding. The analysis considers classification issues, theoretical bases of measured effects of faith-infused services, and the transferability of faith-based interventions across religious and secular applications in order to satisfy constitutional issues and client choice.     

Participation in school environment of children and youth with disabilities: a person-oriented approach

This study investigated patterns of interrelated positive subject and environmental factors related to participation in school activities of pupils with different kinds of disabilities. Questionnaires concerning participation were collected from 472 pupils with disabilities and their teachers, parents and special education consultants. A person-oriented approach with the aim to identify patterns of variables related to a high degree of participation of pupils with disabilities was used. Cluster-groups were formed based on scores for individual subjects on factors identified as important for participation. Groups with a high degree of participation were characterized by high scores in autonomy and perceived interaction with peers and teachers and an internal locus of control. Type and degree of disability did not predict cluster group membership. A conclusion is that the outcome participation is better predicted by patterns of interrelated positive subject and environmental factors than by type of disability or any other single factor.     

Dead end jobs or a path to economic well being? The consequences of non-standard work among people with disabilities

How do non-standard jobs affect the economic well-being of workers with disabilities, and what happens when non-standard workers use disability lawsuits to challenge discrimination and improve their economic opportunities? This study uses data from the Current Population Survey, the Survey of Income and Program Participation, and a Lexis search of legal cases to help answer these questions. Temporary employment, independent contracting, and part-time employment are almost twice as likely among workers with disabilities as among those without disabilities. Non-standard workers with disabilities receive lower pay and fewer benefits due both to the types of job they hold, and disability gaps within job types, which contribute to their high poverty rates. They would continue to have high poverty rates even if these pay gaps were eliminated, however, because they work fewer hours than non-standard workers without disabilities and are concentrated in lower-paying occupations. In attempting to improve their opportunities through disability lawsuits, non-standard workers prevail in only a small minority of cases. Several policy implications of the lawsuits and survey data are discussed. Copyright © 2002 John Wiley & Sons, Ltd.     

How students invest their time outside of school: Effects on school-related outcomes

The purpose of this study is to examine the degree towhich various kinds of out-of-school activitiesadolescents participate in influence their schoolengagement, achievement, and perceptions of their lifechances. The conceptual framework outlined by theauthors suggests personal investments students makeoutside of school in meaningful, structured activitiesand with the help and guidance of adults serving asrole models have significant effects on variouseducational outcomes. To that end, the authors foundsome evidence suggesting that student participation instructured activities and religious activities andtime spent interacting with adults during tenth gradeappear to have positive and significant effects onvarious educational outcomes by Grade 12. Conversely,time spent hanging out with peers was consistentlynegatively associated with educational outcomes in thestudy, with few exceptions. The effects of time spentworking for pay and time spent alone were somewhatinconsistent throughout the analysis but this may bedue to methodological problems within the measures. The result of the analysis has implications forafter-school and summer school policies and programs. The authors discuss these implications and suggestfurther study of the effects of school context, familyinfluence, and the availability of community resourceson students' personal investments.     

Cognitive-behavioural Anger Management Training for Adults with Mild Intellectual Disability

Although people with intellectual disabilities often display anger control problems, little research has been conducted on the development and evaluation of cost-effective anger management training programs for this special population. This study evaluated the efficacy of cognitive-behavioural anger management for 11 adults with mild intellectual disabilities in a group therapy format. Improvements were evident on self-report measures of anger and self-esteem. Additionally, caregiver reports indicated general improvements in emotional and behavioural adjustment. Limitations of the study are acknowledged, including the absence of a control condition.