Disabilities

Developmental central hypotonia describes children with decreased muscle tone due to non-progressive central damage, and includes many genetic conditions (e.g., Down, Prader–Willi or Joubert syndromes etc.), cerebral palsy with hypotonia as the main motor type, developmental delays and congenital hypotonia with favorable outcome. This umbrella review aims to systematically describe the best available evidence for interventions that may be used by early intervention therapists in home and community settings. We conducted electronic searches in PubMed, Medline, CINAHL, EMBASE, EBM Reviews and PEDro during August 2024. Methodological quality and risk-of-bias were rated by all authors, and included reviews were compared and contrasted. Eight systematic reviews (SRs) and two overviews of interventions for children with developmental central hypotonia under 6 years of age were identified through databases and other search methods. Four SRs and one overview evaluated treadmill training, one SR evaluated use of orthotics, another evaluated therapeutic exercise, and two SRs and one overview evaluated a range of occupational and physical therapy interventions. Methodological quality and risk-of-bias of included reviews were variable. Most evidence is related to children with Down syndrome, with few studies addressing children with central hypotonia from other causes. Low-quality (GRADE) evidence supports treadmill training to promote walking onset in children with Down syndrome. Motor, sensorimotor, orthotics, positioning, mobility and infant massage interventions are supported by positive but low- or very-low-quality evidence, and recommendations in favor are all conditional. Primary research on effectiveness of all occupational and physical therapy early interventions for children with developmental central hypotonia from all causes is warranted. Full article

This systematic review examines the evolution of higher education and disability-focused professional literature from 2013 to 2022, conducted across 77 countries. The review highlights the geographical distribution of the literature, methodologies utilized, and disability types represented in the publications. Results indicate the majority of the literature is concentrated in North America and Europe, with a principal focus on non-intervention research. Additionally, the review examines the thematic focus of the research, with results highlighting an emphasis on student-level studies. The current state of global higher education and disability literature emphasizes the impact of international legislative documents, declarations, and mandates on postsecondary education trends for individuals with disabilities. Lastly, insight is provided regarding areas that merit exploration to further advance higher education for individuals with disabilities worldwide. Full article

The purpose of this study was to describe the perspectives of young adults with cerebral palsy on participating in the transition process when transitioning from children’s health care to adults’ health care and rehabilitation. A phenomenographic approach with data collected with semi-structured interviews was used. Fourteen young adults aged 19–26 with cerebral palsy participated. The analysis resulted in four categories: (1) need for comprehensive and participatory rehabilitation; (2) barriers in the rehabilitation system; (3) self-awareness, courage and activity are rewarded; and (4) a dream of an active role in society. To conclude, the young adults had both positive and negative experiences of the transition process as well as of the rehabilitation planning at the adult health care service. It is important to start the transition planning early, and to involve the young adult as an active participant in the planning process. Both in the transition phase and in the adult health care service an anticipatory and collaborative approach where the young adult’s holistic needs would be considered should be standard practice. A focus is needed on how to grow towards a good adulthood and how to live a meaningful life as a valued member of society. Full article

Maternal primary caregivers in rural low-income contexts who care for children with cerebral palsy (CP) experience significant barriers related to their caregiving responsibilities that have a profound impact on all aspects of their lives. This paper reports on a study that aimed to explore barriers related to caring for a child living with CP in the rural province of Limpopo, South Africa. An exploratory qualitative research design was employed. Purposive, convenience, and snowball sampling was used to recruit 10 primary maternal caregivers of children living with CP between the ages of 3 and 18 years. A semi-structured interview was used to collect data. The data were analyzed using a thematic analysis. This study found six barriers related to caring for a child living with CP in rural areas, which included physical, financial, social, emotional, spiritual, and health barriers. The primary maternal caregivers of children living with CP in rural areas experience a significant burden of care. Consequently, they need support and respite care to ease these challenges. Full article

Despite advancements in legal protections for people with disabilities in Vietnam, significant barriers to employment persist. This qualitative phenomenological study explored the employment experiences of people with physical disabilities in Vietnam. Semi-structured interviews with 15 participants employed across different sectors were thematically analysed, with the ecological systems theory applied as a guiding framework to interpret the findings and implications. Three primary themes were revealed: accessibility, vulnerability, and discrimination and ableism. The results also emphasised the importance of positive attitudes and interactions from co-workers and supervisors in fostering inclusive workplaces. Recommendations include policy reforms for attitudinal shifts, focus on equity to improve workplace culture, and the involvement of people with disabilities in organisational decision making. These actions are essential for creating more diverse and inclusive workplaces in Vietnam, where employees with physical disabilities feel included, valued, and empowered. Full article

Leisure education has the potential to improve the quality of life and prepare students for social participation after graduation. This study elucidates the perspectives of special education teachers on leisure instruction. The study surveyed 129 teachers from 10 special needs schools for students with intellectual disabilities in Prefecture A, a rural area of Japan. An online survey was conducted from 21 October to 17 November 2023. The survey items were based on 13 aspects of leisure instruction identified from a literature review related to leisure instruction in Japan and a qualitative analysis of interviews with high school teachers in special needs schools for students with intellectual disabilities. The results showed that “The ability to pass time during brief periods of free time”, “Various activity experiences that lead to leisure”, and “Knowing one’s strengths and weaknesses in activities” were significantly more important during school. Conversely, “understanding the psychological importance of leisure”, “connecting with organizations that support leisure activities”, and “finding places to engage in leisure activities” were significantly more important after graduation. The results of this study can be used to identify the gaps in perception between special education teachers and vocational rehabilitation practitioners responsible for post-social participation support. Full article

This mixed-methods study examined school-based physical activity (PA) and the quality of physical education (PE) experiences for children with physical or sensory disabilities. The participants included 10 children (4 girls, 6 boys) with a mean age of 10 years, 5 of whom had sensory disabilities, and 5 of whom had physical disabilities. PA was measured using accelerometry over a 7-day period. Semi-structured interviews explored the children’s experiences in PE classes. Interview data were deductively coded using the Quality Participation Framework to identify examples of autonomy, belongingness, challenge, engagement, mastery, and meaning. On average, children engaged in 17 min per day (standard deviation (SD) = 16) of moderate-to-vigorous-intensity physical activity (MVPA) during school, and 5 min of MVPA (SD = 6) during PE classes. Most children did not meet the provincial policy of 30 min per day of school-based MVPA. Children reported both positive and negative examples of autonomy, belongingness, challenge, engagement, and mastery, and positive experiences of meaning. Overall, children with physical or sensory disabilities accumulate minimal MVPA during school and have mixed-quality participation experiences in PE. These insights can guide efforts to enhance both the quantity of school-based MVPA and the quality of participation in PE for children with disabilities. Full article

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder with challenges in social communication and interaction as well as stereotyped and repetitive behaviors, interests, and activities. Students with ASD often prefer to engage with technology because of its predictability and limited social demands. In recent years, the application of Artificial Intelligence (AI) in education has gained considerable attention. The present study aims to reveal the research trends regarding the design and development of AI teaching interventions in special education, especially for students with ASD, who often face significant challenges in academic, cognitive, and social domains. A search of the research literature from 2018 to 2024 in three electronic databases identified 1762 records. After applying eligibility criteria, 13 empirical studies were finally included, which were coded and analyzed in detail. The results demonstrated the potential of AI technology in supporting students with ASD in their learning, while also identifying gaps that warrant further investigation. This article concludes with future considerations for how AI could support students with ASD, emphasizing there are still gaps in the research, particularly in terms of long-term effectiveness and the standardization of methodologies for AI-based educational practices. Full article

The Mobility Intensive Training (Mob-IT) protocol is an innovative intervention focused on motor learning to improve the mobility of children with cerebral palsy (CP). The objective was to describe the feasibility and intervention fidelity of Mob-IT. A single-subject experimental study was conducted with four children with CP, a median age of 11 (7–13) years, and a Gross Motor Function Classification System I–III. The Mob-IT included 24 h of practice of mobility goals, delivered three times a week in 2 h sessions over four weeks. Feasibility was assessed using the Qualitative Feedback Questionnaire (QFQ), evaluating adherence, acceptability, adverse effects, the clarity of procedures, and intervention time. The Canadian Occupational Performance Measure (COPM) was used to assess participant and caregiver satisfaction. Fidelity was measured by the type of feedback provided (intrinsic vs. extrinsic), task challenge level, and intervention volume. Participants reported good acceptance, few adverse effects, and satisfaction with the outcomes. The intervention adhered to the proposed principles, with a focus on extrinsic feedback and tasks showing progression over time. Time was well spent, being 78% focused on activities and using mostly extrinsic-focused feedback. The Mob-IT protocol was considered feasible and faithful to its principles. As this is a feasibility study, the results indicate the need to expand the intervention to a larger, randomized study. Full article

Dementia is recognised as a disability under the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). People with disabilities like dementia have the right to access specialised health and social care services, including interventions that support independence and community participation. Cognitive Stimulation Therapy (CST) is an evidence-based psychosocial intervention that improves cognition, communication, confidence, and quality of life for people living with dementia, but an implementation gap means that CST is often not available. This study examines whether trained CST practitioners implemented CST, their perceptions of the acceptability and efficacy of CST, whether the perceived acceptability and efficacy of CST predicted implementation, and practitioners’ opinions on the barriers and facilitators to CST implementation. A mixed-methods approach was used, with 62 participants (91.9% female). Although 95% of participants were trained to deliver CST, 45.2% did not facilitate CST groups. Statistical analysis showed that perceived efficacy significantly predicted both the likelihood of running CST groups (p = 0.006) and the number of groups delivered (p = 0.01). Thematic analysis of qualitative data identified the three key themes of ‘resources’, ‘awareness and education’, and ‘acceptability of CST’. Overall, the results show that while CST is acceptable and deemed highly effective, resources and staffing often impede implementation. The results are discussed in the context of prioritising the rights of people with disabilities and recommendations are made on improving access to evidence-based support. Full article

This study examines the link between language abilities and Theory of Mind (ToM) development in individuals with Williams Syndrome (WS) and Down Syndrome (DS). We compared the results of 16 participants with WS, aged 6.3 to 27.2 years (Mean = 15.9 years, SD = 6.8 years), to those of 16 participants with DS, aged 10.7 to 23.9 years (Mean = 16.8 years, SD = 3.6 years). Using the French version of the ToM test-Revised (ToM test-R), we assessed three levels of ToM development: prerequisites, first-order beliefs, and second-order beliefs. Language abilities were evaluated using the Isadyle French language assessment battery, focusing on word comprehension, word production, syntax comprehension and production, and emotional lexicon. The results showed that the WS group performed significantly better in overall ToM skills in the ToM test-R compared to the DS group. Moreover, language skills were significantly associated with ToM development in the WS group, but not in the DS group. These findings underscore the importance of language development, particularly syntax and emotional understanding, in ToM acquisition. Through the application of a cross-syndrome approach, this study provides insights into how each syndrome impacts ToM development and the role of language in this process. Full article

Esports involves competition conducted through online computer games, a format that allows individuals to compete together regardless of age, sex, or physique. However, due to preconceived notions about individuals with visual impairments, their abilities are occasionally underestimated or overestimated. Furthermore, while esports heavily depend on visual elements, there has been little clarification on which abilities can be performed equally by both sighted and visually impaired individuals and which abilities differ. This study examined whether rapid tapping speed, a skill potentially utilized in esports, is affected by visual impairment, testing the hypothesis that there is no significant difference in tapping speed between visually impaired and sighted individuals. By identifying skills that show no differences and those that do, this research lays the groundwork for designing environments where all participants can equally enjoy activities, including the appropriate use of handicaps. The study employed a 30 s rapid tapping speed evaluation model in which participants were asked to tap a key on a computer keyboard as quickly as possible. The total number of taps, initial speed, and speed maintenance were measured over three trials, and temporal changes, such as deceleration, were assessed. No significant differences were observed between groups in the total number of taps, initial speed, or speed maintenance, indicating that tapping speed is not dependent on visual impairment. Thus, a rapid tapping ability can be equally demonstrated by both visually impaired and sighted individuals, highlighting the potential for increasing inclusivity in esports. These findings highlight the potential for creating inclusive esports environments that accommodate visually impaired players, thereby promoting broader participation. Full article

In this qualitative study, we examined the experiences of Rafael, a professional baseball player diagnosed with attention deficit hyperactivity disorder (ADHD), a prevalent neurodevelopmental condition. Through an extensive interview with the participant, our research aimed to determine how baseball can effectively support individuals with this diagnosis in overcoming their obstacles. Qualitative analysis of the verbal data revealed four interconnected themes—Formative Years and Key Experiences, Dealing with ADHD, Learning through Baseball, and Navigating Life Today—highlighting how the sport has served as a vital developmental and supportive activity for this athlete. Baseball ameliorated Rafael’s personal growth and self-regulation, transforming his challenges into opportunities for resilience and self-mastery. The study emphasizes the importance of physical team activities, particularly baseball, as a beneficial strategy for individuals with neurodevelopmental challenges and recommends further research into the long-term effects and mechanisms through which sports can alleviate symptoms associated with ADHD and related diagnoses. Full article

Sharing disability-related information with an employer to gain workplace adjustments is a complex process for young people with intellectual and/or psychosocial disabilities. We examined the disclosure experiences of young Australians with intellectual and psychosocial disabilities, their subsequent access to workplace adjustments, and their employment outcomes. Using narrative inquiry, we analysed qualitative data collected from 24 interviews with participants with an intellectual (n = 10) and psychosocial disability (n = 14) between 18 and 25 years old recruited as part of an Australian Government-funded Youth Employment Study. Four main narratives emerged among the participants responses. Positions ranged from their having no control over disclosure experiences to a high level of control resulting in access to workplace adjustments. These positions were impingent on their knowledge of rights and adjustments, previous experiences, workplace context, and self-advocacy capacity. Our study provides unique insights into the employment experiences of young people with intellectual and psychosocial disabilities. The findings may inform initiatives aimed at building their capabilities for disclosure to gain workplace adjustments that can improve their employment outcomes in turn. Full article

People with disabilities have difficulties in digital inclusion, although it is considered essential for participation in the knowledge-based society. This form of inclusion seeks to ensure equal opportunities in the use of digital technologies and their active participation as citizens in the virtual world. The educational environment is key to this digital inclusion, but teacher attitudes and training influence its effectiveness. The aim of this study was to explore, through a descriptive cross-sectional study, Chilean teachers’ perspectives on the safety, benefits, and risks of the Internet for students with intellectual disabilities or autism spectrum disorder. A questionnaire was administered to 211 pre-service and in-service teachers. The results highlight the perception of the Internet as an unsafe environment for these students, where risks prevail over potential benefits. These findings underline the need to improve both initial and ongoing teacher training in digital skills and risk mediation for these students in order to ensure the digital participation of all students. Full article

Advancements in Assistive Technologies (ATs) have significantly improved the quality of life and autonomy for people with intellectual disabilities and autistic individuals, enhancing education, social interaction, employment, and mental health. Nevertheless, several barriers still emerge in the daily implementation of such technologies, highlighting the need to explore them in depth. Using a two-round Delphi method, we conducted a research study with an expert panel of 284 participants from 31 European countries, collecting quantitative and qualitative data. We tested ten future-oriented projections and gathered insights on participants’ backgrounds and attitudes towards ATs for this demographic. To enhance representation, experts from academia, service providers, industry, and disability organizations, as well as individuals with disabilities and their families, were included. Although the findings show strong consensus among experts on the positive impact and desirability of ATs for promoting the social inclusion of people with intellectual disabilities and autistic individuals, they also reveal differing perceptions across expert groups and identify two distinct future scenarios linked to different cultural, social, and economic hindrances. In this sense, our study provides diverse global perspectives, with the potential to help governing bodies understand the expectations, concerns, and needs related to ATs for often underrepresented groups–people with intellectual disabilities and autistic individuals in this case. Full article

Employer disability confidence is a concept being used increasingly in employment interventions and policies targeting the demand side of the labour market to support the employment of people with disability. However, the concept is not well-defined and lacks a theoretical basis, inhibiting its application to best effect. This study aims to develop a conceptual model of employer disability confidence to fill in the definitional and theoretical gap in the current practice and literature. The paper presents a synthesis of the Theory of Planned Behaviour (TPB) and explores the literature that reports on use of TPB in disability employment contexts. We have applied the TPB to explain the concept of employer disability confidence. In the proposed framework, disability confidence is theorised to be the sum of the attitudes towards hiring people with disability, the perceived social expectations, and the perception of the employer and workplace of control over factors enabling and hindering employment of people with disability. Development of a theory-based and action-oriented framework for employer disability confidence could contribute to designing initiatives and interventions aimed at employers and workplaces to remove barriers to employment for people with disability, as well as understanding and assessing the effectiveness of implementation of such interventions. Full article

Workers’ attitudes towards people with disabilities can influence labor inclusion. Despite the relevance of learning about these attitudes, in Chile, there are no reliable and validated instruments to measure them in workers. An instrumental study was carried out to adapt and psychometrically analyze the Spanish version of the Scale of Attitudes towards People with Disabilities (EAPCD) in the Chilean population. By means of a non-probabilistic convenience sampling, 310 people between 19 and 76 years of age (M = 39.4; SD = 11.2) from different regions of Chile participated in the study. The linguistic adaptation included the change in Spanish idioms and expressions to the Chilean context, whose relevance was validated with cognitive interviews. Descriptive analysis, internal consistency analysis, and CFA (confirmatory factor analysis) were performed. The CFA indicated an adequate fit to the three-factor model proposed in the original scale (χ²(431) = 808.070, p < 0.01; RMSEA = 0.053; CFI = 0.93; TLI = 0.93). The Social Relations and Normalization dimensions were reliable; however, it is recommended that the items of the Intervention Programs dimension be revised or eliminated, since they could be confusing in the local context. It is concluded that the scale is reliable and valid to evaluate attitudes towards the inclusion of people with disabilities in Chile in the work context. Full article

People with disabilities disproportionately face barriers to homeownership, many of which are associated with costs. One related, but unexplored barrier to homeownership in the United States (U.S.) is the role of Supplemental Security Income (SSI) policy. SSI is a means-tested federal program in the U.S. that provides monthly income to those who are blind or disabled. Recipients may not own assets totaling more than USD 2000 (or 3000 per married couple). While homes are excluded from this assessment, the strict cap on savings generally means that SSI recipients who do not already own a home when they begin to receive benefits cannot accrue sufficient savings to qualify for a mortgage. Using data from the 2019 American Community Survey, this analysis explores the relative importance of SSI receipt in predicting rate of homeownership by using logistic regression to examine the effect of having a disability and receiving SSI on the odds of homeownership. Marginal effects identify the average predicted probabilities of homeownership to demonstrate the extent to which SSI receipt is related to each category of disability and race differently, suggesting that this policy may be related to a lower rate of homeownership for people with disabilities. Full article