General Education Participation Improves the Social Contacts and Friendship Networks of Students with Severe Disabilities

One desired outcome of inclusive education is the enhanced social development of students with disabilities. Some have suggested that planned and systematic support of students with severe disabilities in general education environments may lead to greater social interaction between these students and their peers without disabilities. In an effort to analyze this proposition, we studied two students with severe disabilities as they began participating in general education classrooms. Using within-student multiple baseline designs across class periods, the effects of participating in general education were studied across a range of social participation indicator variables. Our results suggest that planned and systematic efforts to include students with severe disabilities into general education courses can have positive effects on their social contacts and friendship networks. Our findings are discussed in relation to policy efforts to establish inclusive education in public schools, strategies for structuring general education participation, and the potential effects such efforts can have on the social inclusion of students with disabilities.     

Promoting step responses of children with multiple disabilities through a walker device and microswitches with contingent stimuli

Children with severe or profound intellectual and motor disabilities often present problems of balance and locomotion and spend much of their time sitting or lying, with negative consequences for their development and social image. This study provides a replication of recent (pilot) studies using a walker (support) device and microswitches with preferred stimuli to promote locomotion in two children with multiple disabilities. One child used an ABAB design; the other only an AB sequence. Both succeeded in increasing their frequencies of step responses during the B (intervention) phase(s). These findings support the positive evidence already available on the effectiveness of this intervention in motivating and promoting children's locomotion.     

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.     

Case study: Examining the relationship between self-initiations of an individual with disabilities and directive behavior of staff persons in a residential setting

This case study examines the relationship between self-initiations of an adult woman with severe disabilities and the directive behavior of staff persons in a community residential setting. Hypotheses generated from functional assessment procedures indicated that (a) Susan's low self-initiations were very likely related to high directive behavior of staff persons, and (b) infrequent problem behaviors during the morning routine were maintained by escape from repeated staff demands. An intervention was implemented to enable Susan to increase self-initiation in choice and sequence of activities and simultaneously decrease staff directives. Results and discussion focus on the need for a contextual approach for addressing problematic situations and an affirmation of the effectiveness of the positive behavioral support technology for increasing adaptive behaviors in individuals with severe disabilities.     

Focusing on Educational Outcomes

National education goals, content standards, and national tests are the hot topics of the day in educational reform. Special services personnel eventually will be faced with these issues, and can either be part of the discussion from the beginning, or wait and have to deal with someone else's decisions. In this article, we highlight some recent national and state educational reform activities and their probable implications for students with disabilities. We explain in brief the impetus behind the thrust toward an outcomesbased approach to education, and summarize the response of the National Center on Educational Outcomes for Students with Disabilities to this push. Possible ways in which special service providers can act to influence the focus on outcomes are described.     

Interventions for inappropriate sexual behavior in individuals with intellectual and developmental disabilities: A brief review

Although prevalence rates vary, 6% to 28% of individuals with intellectual or developmental disabilities (IDDs) engage in inappropriate sexual behavior (ISB), ranging from public masturbation to sexually aggressive behavior. Along with increased risk for contacting the criminal justice system, people with IDDs who display ISB may encounter negative social consequences, restricted community access and barriers to independence, and a variety of counter-therapeutic outcomes. The purpose of the present review is to highlight recent, efficacious behavior-analytic treatments for ISB in individuals with IDDs. Ethical considerations and areas for future research will be discussed.     

Siblings of Children with disabilities: Psychological and behavioural characteristics

The purpose of the current study was to assess the behavioural and psychological characteristics of siblings of children with disabilities and the perceptions of parents and children regarding sibling relationships. Participants included 32 children between 6 and 13 years of age, one-half with a younger sibling with a disability and one-half with a younger sibling without a disability. Analyses revealed a difference in children's perceptions of maternal partiality, with siblings of children with disabilities perceiving their mothers to be more partial to their siblings than did siblings of children without disabilities. Further, parents of children with disabilities indicated a greater difference in status/power between their child and his/her younger sibling than did parents of children without disabilities. No significant differences were found between groups on measures of behaviour problems, social competence, or self-esteem, supporting other research that has failed to find negative outcomes for siblings of children with disabilities. The implications of these results for parents and professionals are discussed.     

Adult Influence on the Participation of Peers Without Disabilities in Peer Support Programs

Three peers without disabilities who volunteered to serve as peer supports and were identified by general education teachers as having academic difficulties were studied across three conditions. In baseline, a peer without disabilities worked alone, while the student with severe disabilities was supervised by an adult. In the Peer Support condition, peers without disabilities worked with the student with severe disabilities, and both individuals were supervised by an adult. In the Adult Involvement condition, peers without disabilities were supervised by an adult as in the Peer Support condition, but peers worked separately from the student with severe disabilities. Dependent measures included the active engagement of peers without disabilities and students with severe disabilities, and social interactions between students and peers. Our data indicate that the Peer Support and Adult Involvement conditions resulted in higher, but similar, levels of active engagement for two of three peers without disabilities when compared to baseline. For the third peer, high levels of active engagement occurred across all conditions. Active engagement varied across students with severe disabilities, but was typically highest in conditions where peers without disabilities were involved. For all students with severe disabilities, social interactions were more frequent and longer in the Peer Support condition.     

Freedom and Disability Rights: Dependence,Independence, and Interdependence

The increasing focus on disability rights—as found, for instance, in the U.N. Convention on the Rights of Persons with Disabilities (CRPD)—challenges philosophical imaginaries. This article broadens the philosophical imaginary of freedom by exploring the relation of dependence, independence, and interdependence in the lives of people with disabilities. It argues (1) that traditional concepts of freedom are rather insensitive to difference within humanity, and (2) that the lives of people with severe disabilities challenge philosophers to argue and conceptualize freedom not only as independence and interdependence but also as dependence. After tracing this need through a Hegelian understanding, via Julia Kristeva's work on disability, and finally the CRPD, it concludes that a unified solution might not be possible. Hence, it argues that disability issues necessitate philosophical modesty.     

Social relationships in the workplace

As more workers with disabilities are competitively employed, there are numerous opportunities to form social relationships with their co-workers. Close social relationships are associated with a number of positive outcomes (e.g., happiness, less stress) and should be actively pursued for those individuals desiring them. In this paper, we describe the types of social interactions displayed in work settings employing workers with and without disabilities. We also discuss some of the social problems experienced by some workers with disabilities. Finally, we describe two general categories of intervention strategies that have been used to impact social relationships: (a) strategies that involve changing the social behaviors of workers with disabilities, and (b) natural support strategies. The results from these strategies are discussed, and future areas of research are described. MRDD Research Reviews 7:128-133, 2001.     

What We Know About Women's Technology Use,Avoidance, and Abandonment

With the increasing availability of assistive technologies, persons with disabilities have unprecedented opportunities for full societal participation. But women, especially women with disabilities, have typically not had much exposure to and experience with technologies and can find them intimidating and frustrating. While many women use technologies regularly and with satisfaction, others use theminfrequently and with reluctance, avoid them entirely, or try them only to abandon their use. This article discusses factors associated with technology use, avoidance, or abandonment as being outcomes of the interactionof: (a) The particular technology (design, service delivery), (b) the person's abilities and personality (judgment, expectations), (c) characteristics of the disability (type, severity), and (d) the person's psychosocial environment (social support, training and education). Assessment instruments exist comprehensively profile individuals in the four areas so the most appropriate technologies can be recommended and needed modifications to technologies made.     

‘I don't want to be the mother of a paedophile’: the perspectives of mothers whose adolescent sons with learning disabilities sexually offend

The subject of sexual abuse is a major focus of professional and public concern. Sexual abuse of (and by) people with learning disabilities evokes even greater disquieting emotions, and makes severe demands on the social services, and the criminal justice system. The aims of the project were: 1) to determine whether group psychotherapy produced effective outcomes for adolescent boys with learning disabilities who exhibit sexually abusive behaviour, 2) to explore the perspectives of parents and other care-givers, and 3) to document the nature and extent of service support to families. This paper focuses solely on the mothers' perspectives. This was a three-year project with six boys (under 16) receiving group psychotherapy, using both quantitative and qualitative methods. Clinical measures were used to track changes throughout the course of psychotherapy. Semi-structured interviews (taped and transcribed) were held (separately) with the boys, their parents, paid care-givers and the therapists. The mothers tried hard to make sense of, and come to terms with, what was happening to their sons and to themselves, they struggled to reconcile their own confused and often conflicting emotions, and to maintain their own sense of identity. They felt almost totally unsupported by the services, both in the past and present, and could see little hope for the future. There is an urgent need for development of effective and sympathetic services for the parents of boys with learning disabilities who have been abused, and who are now showing abusive behaviour.     

Expanding Community Participation by People with Disabilities: Implications for Counselors

Many people with disabilities are realizing the goal of full participation in community life. Basic beliefs and values have guided the movement from special institutions and other more restrictive settings to life and work in the community. The movement has been sustained by social, political, and technological developments. The future will involve continuing advances in the opening of communities to mainstream activities on the part of people with severe disabilities, given commitment to basic beliefs and effective services from counselors and other professionals.     

Disability Awareness and Etiquette: Transforming Perceptions Through a Series of Experiential Exercises

Individuals with disabilities represent one of the largest and most diverse subgroups within the population. Because of this diversity and the potential for many disabilities to be hidden, however, biases exist regarding what these individuals may look like or how they may act. The majority of these perceptions focus on inabilities as opposed to abilities despite the risk for all individuals to possess or develop a disability. Therefore, there is an increased need to address these issues. As such, this article involves a discussion regarding the integration of several experiential activities to target disability awareness, including information regarding the rationale, assumptions, objectives, and outcomes of these techniques as well as potential adaptations across various groups.     

A PEER-MEDIATED SOCIAL NETWORK INTERVENTION TO ENHANCE THE SOCIAL INTEGRATION OF PERSONS WITH MODERATE AND SEVERE DISABILITIES

Increasingly, parents, teachers, and students with disabilities are advocating for interventions that go beyond skill training to provide support for participation in integrated environments and support for friendships. The present research demonstrated a social network intervention for youths with moderate and severe disabilities. Two groups of nondisabled peers were recruited to participate in weekly discussions with an adult integration facilitator to increase opportunities for social interaction for 2 students (1 with autism and 1 who was moderately mentally retarded). The groups met to discuss social interactions that had occurred with the students with disabilities and to talk about strategies to promote greater inclusion of the students into ongoing social interaction. The nondisabled students participated in the design and implementation of social skills interventions during transition times and lunch. The nondisabled students used self-monitoring data sheets to record the quantity and quality of interactions. The frequency of interaction, number of opportunities for interaction, and appropriateness of social interactions were analyzed with a multiple baseline design. Results indicated that the social network intervention was successful in increasing the quantity and quality of interactions and that the network strategy promoted the development of friendships. The results are discussed in terms of the need for additional research showing the relationships between increases in social competence, peer-mediated intervention, and the development and support of friendship.     

Noncontingent reinforcement for the treatment of severe problem behavior: An analysis of 27 consecutive applications

Noncontingent reinforcement (NCR) is a commonly used treatment for severe problem behavior displayed by individuals with intellectual and developmental disabilities. The current study sought to extend the literature by reporting outcomes achieved with 27 consecutive applications of NCR as the primary treatment for severe problem behavior. All applications of NCR were included regardless of treatment outcome to minimize selection bias favoring successful cases. Participants ranged in age from 5 to 33 years. We analyzed the results across behavioral function and with regard to the use of functional versus alternative reinforcers. NCR effectively treated problem behavior maintained by social reinforcement in 14 of 15 applications, using either the functional reinforcer or alternative reinforcers. When we implemented NCR to treat problem behavior maintained by automatic reinforcement, we often had to add other treatment components to produce clinically significant effects (five of nine applications). Results provide information on the effectiveness and limitations of NCR as treatment for severe problem behavior.     

An outcome management program for extending advances in choice research into choice opportunities for supported workers with severe multiple disabilities

We evaluated an outcome management program for increasing choice opportunities provided by 2 job coaches for 5 supported workers with severe multiple disabilities in a community job. The program involved specifying and monitoring behavioral outcomes among workers and staff, training staff, and supportive and corrective feedback. Increased choice provision occurred for both job coaches across a 1-year period. Results indicate how outcome management can help translate advances in choice research into routine practice.     

Measuring functional outcomes after prematurity: developmental impact of very low birth weight and extremely low birth weight status on childhood disability

Our purpose was to describe functional outcomes in essential activities in preschool, school-age, and adolescent children who were born very (<32 weeks gestation) and extremely (<28 weeks gestation) prematurely. Very low birth weight (VLBW; 1000-1499 g), or extremely low birth weight (ELBW;<1000 g) populations are the focus of our analysis. We describe models of disablement and enablement for specifying the complexity of childhood outcomes using a framework of pathophysiology, impairment, functional limitation and functional strengths, disability in social roles and social participation, societal limitations and environmental facilitators. Representative early childhood, preschool, school-age, and adolescent studies were examined in terms of describing children's functional strengths and challenges after VLBW and ELBW survival. In early childhood, disability was assessed by diagnosing neurosensory impairments and delays on developmental testing. Instruments for measuring functional status in essential activities of self-care, mobility, communication and learning are described. Rates of neurosensory disability in the first three years among recent ELBW survivors ranged from 9-26% for cerebral palsy, 1-15% for blindness, 0-9% for deafness, and 6-42% for evolving cognitive disability (MDI <70). Rates of preschool functional limitation were 5-27% motor, 5-30% self-care, and 5-22% communicative. Rates of school-age functional educational disabilities exceeded 50%. Rates of adolescent activity limitation were 13-32% and vocational limitations were 27-71%. By examining the functional strengths and challenges of children with major neurodevelopmental impairments after very or extremely preterm birth, we can examine causal pathways that lessen the risk of severe functional disability. Among children with mild to moderate disability, we can enhance functional outcomes, optimize community participation, and provide quality family supports. In order to assess the changing outcomes of this vulnerable population of survivors, combinations of clinical and survey based methodologies are required.     

Corporate culture and the employment of persons with disabilities

This article addresses key questions arising from the economic and social disparities that individuals with disabilities experience in the United States. For instance, “What role does corporate culture play in the employment of people with disabilities?” “How does it facilitate or hinder their employment and promotional opportunities, and how can corporations develop supportive cultures that benefit people with disabilities, non‐disabled employees, and the organization as a whole?” Corporate culture can create attitudinal, behavioral, and physical barriers for workers and job applicants with disabilities. This research concludes that if the employment prospects of people with disabilities are to be improved significantly, attention must be paid to the ways in which corporate culture creates or reinforces obstacles to employees with disabilities, and how these obstacles can be removed or overcome. Ultimately, we will make the case that corporate culture and societal attitudes must change if people with disabilities are to be accepted and incorporated fully into the workplace. Copyright © 2005 John Wiley & Sons, Ltd.     

The Future of Psychology in Medicaid's Health Delivery System for People with Disabilities

State Medicaid programs are rapidly converting fee-for-service health delivery systems to managed care for people with disabilities. In theory, managed care models of health delivery will substantially improve the quality of care for people with disabilities, but in reality, few successful models exist. This period of transition holds both opportunities and challenges for psychologists in medical settings. Because Medicaid reforms for people with disabilities may herald similar reforms for both the public and the private sectors, psychology's response will determine its role in the future of health care delivery for this population. Changes in training and increased attention to outcomes research, innovations in practice, and advocacy will be the keys to success.