Intersections between disability, type of impairment, gender and socio-economic disadvantage in a nationally representative sample of 33,101 working aged Australians

Background:People with disabilities are socio-economically disadvantaged and have poorer health than people without disabilities; however, little is known about the way in which disadvantage is patterned by gender and type of impairment.Objectives:1. To describe whether socio-economic circumstances vary according to type of impairment (sensory and speech, intellectual, physical, psychological and acquired brain injury) 2. To compare levels of socio-economic disadvantage for women and men with the same impairment typeMethods:We used a large population-based disability-focused survey of Australians, analysing data from 33,101 participants aged 25 to 64. Indicators of socio-economic disadvantage included education, income, employment, housing vulnerability, and multiple disadvantage. Stratified by impairment type, we estimated: the population weighted prevalence of socio-economic disadvantage; the relative odds of disadvantage compared to people without disabilities; and the relative odds of disadvantage between women and men.Results:With few exceptions, people with disabilities fared worse for every indicator compared to people without disability; those with intellectual and psychological impairments and acquired brain injuries were most disadvantaged. While overall women with disabilities were more disadvantaged than men, the magnitude of the relative differences was lower than the same comparisons between women and men without disabilities, and there were few differences between women and men with the same impairment types.Conclusions:Crude comparisons between people with and without disabilities obscure how disadvantage is patterned according to impairment type and gender. The results emphasise the need to unpack how gender and disability intersect to shape socio-economic disadvantage.

Achieving socially inclusive practice: analysing power dynamics in a participatory approach to service development

The paper is concerned with what works and why in relation to socially inclusive practice in diverse community services settings. Drawing on the findings from a research study involving a participatory evaluation and service development project in a large community services organisation in Melbourne, Australia, the paper asserts that organisations can become more inclusive by paying attention to the ways in which they perpetuate existing oppression and by intentionally challenging associated limiting power/knowledge formations. The study was situated in rights-based approaches to health and social development and drew on Foucauldian conceptualisations of power that see the point of operation of power as the point of resistance, and therefore containing the possibility for change. The researchers worked in three diverse service contexts: children and families experiencing homelessness, people with disabilities, and older people with a history of homelessness and exclusion. The ongoing analysis of the power relations between and within the different stakeholder groups was important in ensuring that the development of the process did not reinscribe oppression and marginalisation. Within the growing body of work that theorises participatory and inclusive practices, the application of a Foucauldian framework offers new insights for anti-oppressive practice in the context of service development.

Facilitated communication and authorship: a systematic review

Facilitated Communication (FC) is a technique whereby individuals with disabilities and communication impairments allegedly select letters by typing on a keyboard while receiving physical support, emotional encouragement, and other communication supports from facilitators. The validity of FC stands or falls on the question of who is authoring the typed messages--the individual with a disability or the facilitator. The International Society for Augmentative and Alternative Communication (ISAAC) formed an Ad Hoc Committee on FC and charged this committee to synthesize the evidence base related to this question in order to develop a position statement. The purpose of this paper is to report this synthesis of the extant peer-reviewed literature on the question of authorship in FC. A multi-faceted search was conducted including electronic database searches, ancestry searches, and contacting selected authors. The authors considered synopses of systematic reviews, and systematic reviews, which were supplemented with individual studies not included in any prior reviews. Additionally, documents submitted by the membership were screened for inclusion. The evidence was classified into articles that provided (a) quantitative experimental data related to the authorship of messages, (b) quantitative descriptive data on the output generated through FC without testing of authorship, (c) qualitative descriptive data on the output generated via FC without testing of authorship, and (d) anecdotal reports in which writers shared their perspectives on FC. Only documents with quantitative experimental data were analyzed for authorship. Results indicated unequivocal evidence for facilitator control: messages generated through FC are authored by the facilitators rather than the individuals with disabilities. Hence, FC is a technique that has no validity.

Teachers’ aides working in secondary school settings: preparedness and professional learning

In Victoria, Australia teachers’ aides (TAs) are employed to provide support to students with disabilities in accessing their education. The role of the TAs varies within and across school settings. Drawing from the findings of a quantitative study, the purpose of this paper is to develop an understanding of teachers’ aides’ perceptions of their preparedness to perform 18 student-related tasks within the state secondary school setting in Victoria, Australia. In all, 163 participants completed the on-line questionnaire. The results of the study showed that that in general TAs perceive there are tasks relevant to their roles in supporting students with disabilities; and there are tasks that are not applicable to that role. The TAs in this study considered that they had training that enabled them to effectively perform the listed student related tasks to support students with disabilities in the secondary school environment.

An analysis of the role of teachers’ aides in a state secondary school: perceptions of teaching staff and teachers’ aides

In Victoria, Australia, one of the major roles of the teachers’ aide (TA) is to assist students with disabilities to access their education. Researchers have identified the inconsistencies in defining the roles of the TA, in a variety of settings, by TAs, teachers, parents, and other research participants. Four main themes that have been frequently reported in educational research related to the role of TAs formed the basis for this study: (a) inclusion in the school community, (b) curriculum, (c) classroom management, and (d) student support. Drawing on the results of a questionnaire administered to teachers and TAs at a government nonselective secondary school in Victoria, Australia, data were collected to explore the differing perspectives on the role of the TAs by the teaching staff and the TAs. In all, 65 individuals participated in this study. The participants formed 3 groups: TAs (n = 10), teachers (n = 49), and T/TAs (n = 6; participants in this group had worked as both a teacher and TA). The results of the study showed a diversity of views across the 4 themes. In 3 of the 4 themes that included inclusion, classroom management, and student support, the 3 groups agreed on the role of the TA. In the remaining theme, curriculum, opinions varied significantly. The results of the study reveal that a concerted effort to clarify the role of TAs would be beneficial to all stakeholders.

Does disability status modify the association between psychosocial job quality and mental health? A longitudinal fixed-effects analysis

BACKGROUND: People with disabilities have difficulties in obtaining work. However, evidence suggests that those with disabilities derive substantial mental health benefits from employment. This paper assesses how the relationship between work and mental health is influenced by psychosocial job quality for people working with a disability. METHODS: The study design was a longitudinal cohort with 13 annual waves of data collection, yielding a sample of 122,883 observations from 21,848 people. Fixed-effects within-person regression was used to control for time invariant confounding. The Mental Component Summary (MCS) of the Short Form 36 (SF-36) measure was used as the primary outcome measure. The main exposure was a six-category measure of psychosocial job quality and employment status (including 'not in the labour force' [NILF] and unemployment). Disability status ('no waves of disability reported' and 'all contributed waves with reported disability') was assessed as an effect modifier. We also conducted a secondary analysis on respondents contributing both disability and non-disability waves. RESULTS: For those with no disability, the greatest difference in mental health (compared to optimal employment) occurs when people have the poorest quality jobs (-2.12, 95% CI -2.48, -1.75, p < 0.001). The relative difference in mental health was less in relation to NILF and unemployment (-0.39 and -0.66 respectively). For those with consistent disability, the difference in mental health when employed in an optimal job was similar between the poorest quality jobs (-2.25, 95% CI -3.84, -0.65, p = 0.006), NILF (-2.84, 95% CI -4.49, -1.20, p = 0.001) or unemployment (-2.56, 95% CI -4.32, -0.80, p = 0.004). These results were confirmed by the secondary analysis. CONCLUSIONS: Efforts to improve psychosocial job quality may have significant mental health benefits for people with disabilities. This will contribute to the economic viability of disability employment insurance schemes in Australia and other high-income countries.

Anxiety, depression, impulsivity and substance misuse in violent and non-violent adolescent boys in detention in China

The present investigation aims to identify the factors which differentiate violent from non-violent juvenile offenders, with a particular emphasis on the association between internalizing psychiatric morbidity (i.e. anxiety and depression), impulsivity, substance misuse, and violence. A total of 323 incarcerated male juvenile offenders from one of three Youth Detention Centers (YDCs) in China were recruited between August 2007 and November 2008. Interviews were conducted by trained psychiatrists using the Barratt Impulsivity Scale (BIS-11), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Birleson Depression Self-Rating Scale (DSRS) to assess impulsivity, anxiety and depression, respectively. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) was also used to assess psychiatric diagnoses. Violent offenders had significantly higher BIS-11 total scores, and attention and nonplanning subscale scores (p<0.05). In the multiple logistic regression model, substance use disorders (SUD) and BIS-11 total scores independently predicted violence. Prison-based treatment services designed to reduce impulsivity and substance misuse in juvenile detention facilities should be prioritized.

Teachers' aides training and professional learning in mainstream secondary schools

 Dianne Gibson investigated the training and professional learning needs of teachers’ aides supporting students with disabilities in mainstream secondary schools in Victoria, Australia. Using survey and focus group methods, analysis showed that teachers’ aides perceived they had participated in training and professional learning to effectively perform work-related items and student-related tasks.

The right to supported decision-making for people rarely heard

 This thesis explored supported decision-making for people with severe or profound intellectual disability. The findings provide guidance to supporters and policy makers to assist people with severe or profound intellectual disability to lead maximally autonomous lives, a clear obligation of Australia under the Convention on the Rights of Persons with Disabilities.