Peer reviewed resources
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Emergent Disability voices on Social Media during COVID -19 times
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Persons with disabilities are invisible and almost silent in the Indian media. This paper examines the emergence of articulate expressions of persons with disabilities (pwd) in the social media over the months March to June 2020 during COVID Lockdown. While technology has been seen as a great leveller for persons with disabilities, the digital divide, however, remains very real for masses of disabled persons, whereby it is largely the educated middle class who have access to internet facilities and presence on social media. This paper draws from observation and analysis of posts on Facebook by different categories of persons with disabilities. There appear to be a number of discourses emerging and imageries running almost parallel. Accessibility and support appear to be very important issues especially in terms of access to domestic workers, regular medical checkups, and procuring daily provisions as well as access to online teaching. On the other hand, little concern is being paid to the huge humanitarian crisis of returnee workers from cities to villages. Interestingly, disabled persons appeared more connected, participating in discussions and Webinars and voicing out their experiences with greater clarity and also analysing the COVID situation through Disability Studies (DS) perspectives.
Opening the GATE: systems thinking from the global assistive technology alliance
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Purpose:
This paper describes international actions to collaborate in the assistive technology (AT) arena and provides an update of programmes supporting AT globally.
Methods:
The World Health Organisation (WHO) identifies the severe global uneven distribution of resources, expertise and extensive unmet need for AT, as well the optimistic substantial capability for innovations and developments in appropriate and sustainable AT design, development and delivery. Systems thinking and market shaping are identified as means to address these challenges and leverage the ingenuity and expertise of AT stakeholders.
Results:
This paper is a ‘call to action’, showcasing emerging AT networks as exemplars of a distributed, but integrated mechanism for addressing AT needs globally, and describing the Global Alliance of Assistive Technology Organisations (GAATO) as a vehicle to facilitate this global networking.
Conclusion:
Partners in this Global Alliance aim to advance the field of assistive technology by promoting shared research, policy advocacy, educating people and organisations within and outside the field, teaching, training and knowledge transfer by pulling together broad-based membership organisations.
Required to be creative. Everyday ways for dealing with inaccessibility
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Today’s society promises that people with disabilities can access anything, but in practice there are numerous obstacles, and the ways in which people deal with them can be easily missed or taken for granted by policy makers. This article draws on a project in which researchers ‘go along’ people with disabilities in Sweden who demonstrate and recount accessibility troubles in urban and digital settings. They display a set of mundane methods for managing inaccessibility: (a) using others, (b) making deals and establishing routines, (c) mimicking or piggybacking conventions, (d) debunking others’ accounts and performing local politics. The employment of these shared but tailored methods shows the difficulties to be accepted that people with disabilities still face, as well as the wide-ranging tension that exists between the grand rhetoric of inclusion and modest results. The tension implies that people with disabilities are required to be creative.
- Declarations and policies often say that people with disabilities should have access to anything, but in practice this is not the case.
- This study investigates what people with disabilities actually do when they have trouble accessing various places or resources. The results show their common and practical ways, and these ways are often taken for granted, overlapping, and combined.
- People with disabilities ask others to support them when they face troubles to access places or resources, they make deals with important actors and they develop routines. They also observe, imitate and follow others’ actions, to pick out precisely those ways that suit their needs.
- When people with disabilities find their ways in today’s society they also act with words. They argue against other people’s excuses or justifications for not providing access.
- The study has found a lot of frustration among people with disabilities who get blocked, excluded or delayed. This gives them motives to engage in politics.
Disability, mobility and transport in Low- and Middle-Income Countries: A thematic review
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This paper discusses issues affecting the transport and mobility needs of people with disabilities in middle- and low-income countries and how disability intersects with a range of other factors to impact on transport needs, use and engagement. The paper is intended to stimulate discussion and identify areas for further research, and identifies a number of key issues that are salient to discussions around equitable and inclusive transport provision, including patterns of transport use, behaviour and experiences, solutions and policy directions, measuring access and inclusion, policies and intersectionality. The paper also identifies gaps in knowledge and provision, barriers to addressing these gaps, and some possible solutions to overcoming these barriers. These include shifting the focus from access to inclusion, reconceptualising how ‘special’ transport might be provided, and most importantly listening to the voices and experiences of adults and children with disabilities. Despite lack of transport often being cited as a reason for lack of inclusion of people with disabilities, there is surprisingly little evidence which either quantifies this or translates what this lack of access means to people with disabilities in their daily lives in low- and middle-income countries.
Sustainability 2020, 12(2), 589
https://doi.org/10.3390/su12020589
Effects of assistive technology for students with reading and writing disabilities
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Background:
Assistive technology has been used to mitigate reading disabilities for almost three decades, and tablets with text-to-speech and speech-to-text apps have been introduced in recent years to scaffold reading and writing. Few scientifically rigorous studies, however, have investigated the benefits of this technology.
Purpose:
The aim was to explore the effects of assistive technology for students with severe reading disabilities.
Method:
This study included 149 participants. The intervention group received 24 sessions of assistive technology training, and the control group received treatment as usual.
Results:
Both the intervention and control groups improved as much in 1 year as the normed population did. However, gains did not differ between the groups directly after the intervention or at 1 year of follow-up.
Conclusions:
The use of assistive technology seems to have transfer effects on reading ability and to be supportive, especially for students with the most severe difficulties. In addition, it increases motivation for overall schoolwork. Our experience also highlights the obstacles involved in measuring the ability to assimilate and communicate text.
Access into professional degrees by students with disabilities in South African higher learning: A decolonial perspective
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Background: Former historically disadvantaged social groups such as women, black people and those with disabilities are expected to participate in the skilled labour force that South Africa has pledged to produce for the 21st century. However, in the South African context, research widely neglects access of those into professional degrees in higher learning. There is a need for such an exploration because people with disabilities have been found to be excluded from professional employment.
Objectives: Using decolonial theory, this empirical study sought to explore obstacles confronted by students with disabilities at entry in a specific institution of higher learning in South Africa. The aim was to unveil the invisible obstacles and their causes for an effective intervention.
Method: A qualitative research design was adopted and in-depth interviews were conducted to collect data from the participants. This particular dimension of research method was chosen to enable dialogue and development of partnership, which is important for collecting rich data.
Results: While policies of inclusion still enabled access of all students into professional degrees, there were however inequitable practices, alienation and inequality that excluded students with disabilities at entry. Obstacles seen at surface level were not the real ones; the real ones were the deep-seated issues of coloniality.
Conclusion: If the underlying causes of obstacles at entry are not visible to students with disabilities themselves and the responsible stakeholders, students might continue to be oppressed on entry into the professional degrees and in higher learning generally. Obstacles can only be dismantled when there is an awareness about their deep-seated causes.
African Journal of Disability, Vol 8, 2019
Access to Social Organisations, Utilisation of Civil Facilities and Participation in Empowerment Groups by People with Disabilities in Maharashtra, India
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Purpose: This survey aimed to assess the baseline level of access to social institutions, utilisation of civil facilities and participation in empowerment schemes by people with disabilities in Amravati district of Maharashtra State, India.
Method: Sixty villages from two blocks in Amravati district were randomly selected for the survey. From these villages, 522 households were sampled and 3056 individuals were surveyed. Interviews were conducted with 590 individuals with disability from among the surveyed population. The structured interview schedule consisted of demographic data, access to social organisations, utilisation of civil services, and participation in empowerment schemes.
Results: Locomotor disability was the most prevalent (44.6%) type of disability in the study area. Disabilities were more often present among male adolescents and young adults than among the older population and females. Over 50% of the study participants had no occupation (including children and students) and had not been to school. Only 48% had achieved secondary education and more. The proportion of disability among people belonging to Scheduled Castes and Scheduled Tribes was considerably higher than among the general population. Access to social institutions was less than 50% for most of the items, and was even lower among females. Except for the ration card and Aadhar card, civil services were generally under-utilised by people with disability. Only 3.2% of the participants were members of self-help groups, and not a single person was a member of the Disabled People’s Organisation.
Conclusions: In the study area access to social institutions, utilisation of civil services and participation in empowerment schemes was very low.
Limitations: Data, including general socio-demographic, access and utility data, was not collected for the general population but was limited to people with disabilities. This restricted the scope for comparison between people with and without disabilities.
Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)
Utilisation and Satisfaction with Health Services among Persons with Disabilities in Accra, Ghana
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Purpose: Healthcare, one of mankind’s basic needs, is generally accessible to persons without disability, but people with disabilities are marginalized and stigmatized in developing countries and as such are unable to utilise the health services they require. The health-related Sustainable Development Goals (SDGs) talk about good health and well-being, and about reducing inequality in societies. In South Africa and Ghana, constitutional provisions and policies have been made for inclusion and for reducing inequality among persons with disabilities, but implementation is still in its infancy. The aim of this study is to determine the level of utilisation and satisfaction with health services among persons with disabilities, and to recommend strategies to improve the current situation in the country.
Method: A non-interventional, descriptive cross-sectional study was employed, with a quantitative data collection method. A structured questionnaire comprising of both open- and closed-ended questions was used for the data collection. A total of 363 respondents were involved in the study – 360 were persons with disabilities, and 3 were key informants.
Results: While A total of 66.9% of persons with disabilities reported being warmly received by health professionals, 23.1% reported encountering a cold attitude, and 5.6% reported being scorned at health facilities. Only 20.5% of persons with disabilities reported frequent visits to health facilities, 42.8% did not visit health facilities frequently, and 36.4% rarely visited a health facility. Moreover 76.4% reported that they made hospital visits for all their ailments.
Conclusion: Although health facilities were utilised by few persons with disabilities, the majority of respondents reported that they were well-received there and as such would visit health facilities for all their medical needs.
Implications: Persons with disabilities should be included in all areas of society by spreading awareness about their abilities. Partnerships between persons with disabilities and the government and other non-governmental organization’s should be established, to mainstream health services to meet their general and specific needs. It is increasingly important that persons with disabilities play an active role in managing their healthcare needs.
Assistive technology products: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit
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This paper is based on work from the Global Research, Innovation, and Education on Assistive Technology (GREAT) Summit that was coordinated by WHO’s Global Cooperation on Assistive Technology (GATE). The purpose of this paper is to describe the needs and opportunities embedded in the assistive product lifecycle as well as issues relating to the various stages of assistive product mobilization worldwide.
The paper discusses assistive technology product terminology and the dangers of focusing on products outside the context and rolling out products without a plan. Additionally, the paper reviews concepts and issues around technology transfer, particularly in relation to meeting global needs and among countries with limited resources. Several opportunities are highlighted including technology advancement and the world nearing a state of readiness through a developing capacity of nations across the world to successfully adopt and support the assistive technology products and applications.
The paper is optimistic about the future of assistive technology products reaching the people that can use it the most and the excitement across large and small nations in increasing their own capacities for implementing assistive technology. This is expressed as hope in future students as they innovate and in modern engineering that will enable assistive technology to pervade all corners of current and potential marketplaces. Importantly, the paper poses numerous topics where discussions are just superficially opened. The hope is that a set of sequels will follow to continue this critical dialog.
An Evaluative Study of Services Provided in Community-Based Rehabilitation Centres in Jordan
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Purpose: This research study aimed to investigate the effectiveness of the services provided by CBR programmes in Jordan.
Method: This was a mixed-methods investigation. A survey was carried out with 47 participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised 18 questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The quantitative data was analysed using SPSS Version 22.0. Qualitative data was analysed through thematic content analysis and open coding to identify emergent themes.
Results: 40.4% of the participants evaluated the effectiveness of CBR services as low. This mainly stemmed from the lack of efforts to increase the local community’s knowledge about CBR, disability and the role of CBR programmes towards people with disabilities.
Conclusions: A proposal was offered concerning the priorities of CBR programmes in Jordan. Efforts need to be directed at promoting livelihood and empowerment components in order to actualise the principles of CBR, mainly by promoting multispectral collaboration as a way of operation.
Implications: This study was inclusive of all types of disability. Barriers to the effectiveness of services may stem from accessibility issues to the families of persons with disabilities (hard to reach) or from CBR services themselves (hard to access). The culturally specific evaluative tool in this study was of “good” specificity and sensitivity, this evaluative instrument can be transferrable to measure the impact of CBR programmes in other settings.
Barriers to Healthcare Services for People with Disabilities in Developing Countries: A Literature Review
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Purpose: This literature review aimed to identify the main barriers in access to mainstream healthcare services for people with disabilities.
Method: Online databases were searched for relevant articles published after 2006. Preference was given to articles pertaining to developing countries. On the basis of pre-determined inclusion and exclusion criteria, 16 articles were selected for the review. Barriers noted in the articles were grouped thematically.
Results: There appeared to be 7 main barriers - 4 related to the demand side i.e., pertaining to the individual seeking healthcare services, and 3 barriers on the supply side i.e., pertaining to healthcare provision. These are: 1) Lack of information; 2) Additional costs of healthcare; 3) Limited mobility; and, on the demand side, 4) Stigmatisation; while on the supply side, 5) Staff attitude; 6) Communication barriers; and, 7) Inaccessible facilities.
Conclusion: To ensure that people with disabilities can successfully access the necessary health services, the barriers on the demand side (the individuals requiring healthcare) as well as the barriers that are part of the healthcare system, should be attended to.
“I Guess that the Greatest Freedom … ”: A Phenomenology of Spaces and Severe Multiple Disabilities
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This paper expresses wonder about how bodies in motion can lead towards an understanding of lived meaning in silent lifeworlds. In such lifeworlds, expressions are without words, pre-symbolic, and thus embodied. To address the wonder, phenomenological philosophy and phenomenological methodology were employed to frame an approach that acknowledges lives with disabilities as qualitatively different from, and yet not inferior to, nor less imbued with meaning than, lives without.
The paper focuses on spatiality as decisive in determining possibilities for persons to express their perspectives through a wide range of movements. Movements take place in the continuum between the spatiality of positions as objective bodily sensations and the spatiality of situations as embodied interactions with others and the world. Thus, in order to access the perspectives of students with severe and multiple disabilities, transitions between and movements within different spaces are examined.
Approaching an educational everyday life where students are restricted in the possibilities available to them for moving in and out of spaces, the study reported points to the importance of recognizing the relationship between subjective movements and the spaces enveloping them as what creates a spatiality that is meaningful to the subject. It is accordingly suggested that choosing which spaces to include in educational contexts are formative choices that express a view of humanity. The paper also emphasizes the importance of recognizing temporality as a pedagogical resource when detecting and acting upon students’ changing expressions.
Cross-sectional Survey to Assess Prevalence of Disability and Access to Services in Albay Province, The Philippines
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Aim: A cluster randomized cross-sectional survey to assess the prevalence of disability and access to support services was conducted in Albay Province, the Philippines in April 2016.
Method: The population-based survey methodologies developed by the Washington Group of the United Nations Statistical Commission and UNICEF were utilized. A sample of 70 barangays (the 3rd level administrative division in the Philippines) was selected as clusters, with probability proportional to size, and 30 households were selected randomly in each barangay to be surveyed.
Results: The estimated prevalence of disability using the standard criteria of the Washington Group and UNICEF among children (2-17 years old) was 2.0% and for adults (≥18 years old) it was 6.5%. The estimated prevalence of disability was higher in rural than in urban areas. Deficiencies in the performance of existing services were identified; access by children with disabilities to support services was lowest in rural highland and rural plain barangays.
Conclusions: There was a large unmet demand for support services addressing the needs of persons with disabilities in Albay Province, especially in rural highland areas. Persons with disabilities were disadvantaged in access to education and employment; many had not been educated in their basic rights.
Implications: To identify, educate and fully support persons with disabilities, community-based rehabilitation (CBR), health and other rehabilitation services must communicate effectively with each other, their current work should be mapped and analysed, their comparative strengths identified, and their future work coordinated. It is a priority to educate persons with disabilities and their families about their rights, and facilitate their access to support services; this requires increased investment in communication targeting persons with disabilities and the communities, especially rural. Providers caring for persons with disabilities need to work in partnership to identify unreached persons with disabilities. Prevalence surveys, with stronger focus on the profiles and performance of CBR and related services, would add to the evidence-base to improve the quality and coverage of services for persons with disabilities.
Access to Services and Barriers faced by People with Disabilities: A Quantitative Survey
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Purpose: In low- and middle-income countries, reliable and disaggregated disability data on prevalence, participation and barriers is often not available. This study aimed to estimate disability prevalence, determine associated socio-demographic factors and compare access in the community between people with and without disability in Dehradun district of Uttarakhand, India, using the Rapid Assessment of Disability Survey.
Methods: A cross-sectional population-based survey was conducted on a sample of 2431 adults, selected using a two-stage cluster randomised sampling technique. The survey comprised an interviewer-administered household survey and an individual survey measuring disability, wellbeing and participation. For each person with disability, an age and sex-matched control (without disability) was selected. In addition to prevalence, the difference in participation and barriers faced by people with and without disability were analysed.
Results and Conclusions: The prevalence of disability was 6.8% (95% CI 5.8-7.8) with significant associations with age, sex, economic status, education and employment. Psychosocial distress (4.8%) and mobility impairment (2.7%) were the most common disabilities identified. The study showed that people with disabilities had significantly less access to services than those without disability, and the barriers reported most often were lack of information, transport and physical inaccessibility.
Public health, research and rights: the perspectives of deliberation panels with politically and socially active disabled people
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Public health research purports to provide the evidence base for policies, programmes and interventions to improve the health of a population. However, there is increasing awareness that the experiences of disabled people have played little part in informing this evidence base. This paper discusses one aspect of a study commissioned by England’s National Institute for Health Research (NIHR) to review the implications for public health of theories and models of disability. This part of the study focused on the development of a tool or decision aid to promote ethical inclusion of disabled people in public health randomised controlled trials (RCTs) and evaluative research. The tool was introduced at four regional ‘deliberating panels’ involving politically and socially active disabled people. In addition, we held a panel with public health professionals. The deliberation panels debated how the focus of public health was narrowing, why disability was excluded and positive and negative issues with using rights to guide research and evaluative practice. Politically active disabled people argued for a social model of human rights to guide any rights based tools or decision aids in public health and disability research.
New Perspectives on Equality: Towards Transformative Justice through the Disability Convention?
Improving a web-based employability intervention for work-disabled employees: results of a pilot economic evaluation
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Purpose
The purpose of this study is to improve web-based employability interventions for employees with work-related health problems for both intervention content and study design by means of a pilot economic evaluation.
Methods
Uptake rate analysis for the intervention elements, cost effectiveness, cost utility and subgroup analyses were conducted to identify potential content-related intervention improvements. Differences in work ability and quality-adjusted life years and overall contribution of resource items to the total costs were assessed. These were used to guide study design improvements.
Results
Sixty-three participants were a-select allocated to either the intervention (n = 29) or the control (n = 34) group. Uptake regarding the intervention elements ranged between 3% and 70%. Cost-effectiveness and cost-utility analyses resulted in negative effects although higher total costs. Incremental effects were marginal (work ability −0.51; QALY −0.01).
Conclusions
The web-based tool to enhance employability among work disabled employees requires improvements regarding targeting and intensity; outcome measures selected and collection of cost data. With respect to the studies of disability and rehabilitation, the findings and methods presented in this pilot economic evaluation could guide the assessment of future assistive “e-health” technologies.
Political liberalism and the justice claims of the disabled: a reconciliation
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Unlike his theory of justice as fairness, John Rawls’s political liberalism has generally been spared from critiques regarding what is due to the disabled. This paper demonstrates that, due to the account of the basic ideas of society and persons provided by Rawls, political liberalism requires that the interests of numerous individuals with disabilities should be put aside when the most fundamental issues of justice are settled. The aim is to accommodate within public reason the due concern for the disabled while upholding political liberalism. To achieve this aim, a revision of the basic ideas of persons and society is proposed. The idea of persons should be regarded as more fundamental than that of social cooperation, and persons should be defined in terms of minimal moral powers.
The economic and social benefits and the barriers of providing people with disabilities accessible clean water and sanitation
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Resolution A/HRC/RES/16/2 adopted by the UN Human Rights Council on 8 April 2011 declared access to safe drinking water and sanitation a human right. However many people around the globe including people with disabilities do not have access to safe drinking water, hygiene or sanitation facilities. Inaccessibility of clean water sources, hygiene and sanitation facilities negatively impacts among others health, education, the ability to work, and the ability to partake in social activities. This paper looks at the benefits of, and access barriers to, clean water and sanitation for people with disabilities.
Sustainability, Vol 4, No 11