COGNITIVE DISABILITY IN A SOCIETY OF EQUALS

Abstract: This essay considers the range of possible policy options that are available if we wish to attempt to treat people with cognitive disabilities as equal members of society. It suggests that the goal of policy should be to allow each disabled person to establish a worthwhile place in the world and sets out four policy options: cash compensation, personal enhancement, status enhancement, and targeted resource enhancement. The essay argues for the social policy of targeted resource enhancement for individuals with cognitive disabilities, in the form of providing cash, with some limits on its use. Taking the example from the United Kingdom of "self-directed support," it argues that such policies can be cost-effective and advance the autonomy of people with cognitive disabilities, especially when compared with current policies of centrally provided services.     

RESPECTING HUMAN DIGNITY: CONTRACT VERSUS CAPABILITIES

Abstract: There appears to be a tension between two commitments in liberalism. The first is that citizens, as rational agents possessing dignity, are owed a justification for principles of justice. The second is that members of society who do not meet the requirements of rational agency are owed justice. These notions conflict because the first commitment is often expressed through the device of the social contract, which seems to confine the scope of justice to rational agents. So, contractarianism seems to ignore the justice claims of the severely cognitively impaired. To solve this problem, Martha Nussbaum proposes the capabilities approach. The justifiability condition, on this approach, is met by the idea of overlapping consensus. This essay argues that overlapping consensus cannot meet liberalism's justifiability condition, nor is it more inclusive of the cognitively impaired. Therefore, we have reason to retain the contract device and look for another way to ensure that liberalism respects the justice claims of all.     

The development and validation of the pictorial motivation scale in physical activity

The purpose of the present research was to report the validation of the pictorial motivation scale in English. This scale is designed for adolescents and adults with an intellectual disability who are unable to independently read a questionnaire. The scale has a picture and phrase depicting 16 items related to participation in sport and physical activity; four for each of the following subscales, intrinsic motivation, self-determined extrinsic motivation, non self-determined extrinsic motivation, and amotivation. Phase 1 of the research describes the formal translation of the scale from French to English. Results from three studies conducted with Special Olympians (Phase 2) and adolescents in a special school (Phases 3 and 4) provided support for the internal consistency, test–retest reliability, and factorial and construct validity of the scale. Overall, the scale would appear to be sufficiently reliable and valid to warrant its continued use and further development.

Excess disability and malignant social psychology: A case study of Alzheimer's disease

An in-depth case study was undertaken to assess the effects of what Kitwood has termed ‘malignant social psychology’ on the observed behaviour of an Alzheimer's disease sufferer. Interviews were conducted with the spouse and observations were made in an adult day-care centre, where staff members were also interviewed. Abilities that the spouse reported to be absent at home were readily observed at the day-care centre, lending support to Brody's idea of excess disability, i.e. disability not due to disease alone. Furthermore, forms of malignant social psychology existed in the home environment but did not exist in the day-care centre. Excess disability and its absence coincided with the presence and absence of aspects of malignant social psychology. The sufferer's behaviour was found to be affected not only by the extant neuropathology, but also by social relationships.     

精神分裂症病人对成人面部表情的辨别

本文对比研究了精神分裂症病人和正常人对成人面部表情辨别的水平,发现精神分裂症病人存在着表情辨别障碍。病程长、以阴性症状为主的病人易出现这种障碍。表情辨别障碍是一种情绪障碍,属阴性症状。     

Broad-Perspective Perceptual Disorder of the Right Hemisphere

Traditional accounts of right-posterior brain injury describe a syndrome of low-level perceptual sequelae producing marked acute dependency and transient safety concerns. The syndrome is also held to spare cognition and to carry a generally favorable long-term prognosis. The present paper reviews publications and anecdotal data that challenge this picture. Recent theoretical expositions and empirical studies stipulate three major cognitive functions of the right posterior association cortex: processing novel input, guiding reactions to emergencies, and anticipating consequences. Appearing benign after acute recovery, the impairment of these processes produces vocational, social and marital dysfunctions that increase as a function of chronicity, ultimately becoming more broadly disabling than focal injuries in other cortical loci. The unique symptom picture and serious implications suggest that the long-term syndrome should be labeled (Broad-Perspective Perceptual Disorder) and incorporated in future clinical taxonomies, underscoring the need for extraordinary long-term assistance and specialized therapeutics. Procedures for assessment and differential diagnosis are outlined.     

Psychosocial Issues That Face Patients With Charcot-Marie-Tooth Disease: The Role of Genetic Counseling

Charcot-Marie-Tooth (CMT) disease is a hereditary debilitating progressive muscular atrophy and sensory neuropathy of the distal extremities. CMT is usually nonlife threatening. Signs of the disease usually present in childhood or in young adulthood and the level of disability can be variable within and between families. Research addressing specific psychosocial and emotional issues faced by individuals with CMT is limited. Fourteen adults with a clinical and/or molecular diagnosis of CMT (ages 32–74 years) consented to an audio taped interview. The format of the interview was based around an informal questionnaire to prompt and guide the interviewee to describe their experiences of living with a disabling genetic disorder. The interviews focused on their experiences of first symptoms and diagnosis, their life experience with CMT, their limitations due to disability and the role of genetic counseling. This study identifies and explores life issues that individuals with CMT may face, specifically grief over the loss of independence, emotional pain and stress such as embarrassment and guilt of passing on a gene mutation, impact on quality of life, the impact of wearing orthopedic devices, and fear of progressive disability. Our findings suggest that that there are emotional and psychosocial issues specific to affected individuals at different life stages and genetic counselors need to be aware of these issues in order to provide age appropriate support and advice to individuals affected by CMT.     

More Alike than Different? Comparison of Formerly Incarcerated Youth with and Without Disabilities

We describe and compare the demographic characteristics of incarcerated youth with and without disabilities. These data were gathered as part of a 5-year longitudinal study that examined the experiences of 531 incarcerated youth from Oregons juvenile justice system as they left the correctional system on parole and returned to the community. Data on the demographic characteristics of the sample were gathered from files and through interviews conducted while the sample was still in state custody. We compared the two groups on 22 selected variables. Statistical comparisons indicated that the two groups were similar on most variables. The final statistical model indicated that participants with disabilities were more likely to have flunked a grade while in school, been committed to the juvenile correctional system for a person-related crime, and to have been last adjudicated for a felony in an urban setting. The implications of these findings for research and practice are discussed.     

Chronic illness and COVID-19-related risk and protective behaviors

People with chronic illnesses are at increased risk of contracting COVID-19. Still, little is known about whether such an increased risk relates to COVID-19-related protective behaviors among those with chronic illness. This study compares the self-reported COVID-19 risky and protective behaviors—specifically physically distancing, handwashing, and having houseguests—of people (N = 936) (1) living with chronic illnesses or (2) cohabiting with someone with chronic illness to those who fall in neither category at the beginning of the COVID-19 pandemic (April 2020). Study results were mixed: people with a chronic illness were more likely to have had houseguests in the past 5 days and less likely to have increased their handwashing in response to the pandemic, but were also more likely to physical distance when outside the home. Those cohabiting with someone with a chronic illness were more likely to have had houseguests, but did not differ in other outcomes.     

The Case for Early Intervention in Diagnosing Specific Reading Disability

In the present article, we argue against the use of psychometric assessment as the primary or sole vehicle for diagnosing specific reading disability. We suggest instead that the diagnostic enterprise should be initiated with early and labor intensive remedial intervention, and that the child’s ability to profit from such intervention should be the most important piece of information in making the diagnosis, notwithstanding the confirmatory value of psychometric assessment in given cases. We support our arguments with selected findings from an intervention study we have recently completed demonstrating that most children who perform poorly in reading can be readily brought to at least an average level of performance if their reading difficulties are addressed at the beginning stage of reading development.