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Postural asymmetries, pain, and ability to change position of children with cerebral palsy in sitting and supine: a cross-sectional study

CASEY, Jackie
ROSENBLAD, Andreas
RODBY-BOUSQUET, Elisabet
2020

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Purpose: To examine any associations between postural asymmetries, postural ability, and pain for chil- dren with cerebral palsy in sitting and supine positions.

 

Methods: A cross-sectional study of 2,735 children with cerebral palsy, 0-18years old, reported into the Swedish CPUP registry. Postural asymmetries, postural ability, the gross motor function classification sys- tem levels I–V, sex, age and report of pain were used to determine any relationship between these variables.

 

Results: Over half the children had postural asymmetries in sitting (n1⁄41,646; 60.2%) or supine (n1⁄41,467; 53.6%). These increased with age and as motor function decreased. Children were twice as likely to have pain if they had an asymmetric posture (OR 2.1–2.7), regardless of age, sex and motor func- tion. Children unable to maintain or change position independently were at higher risk for postural asym- metries in both supine (OR 2.6–7.8) and sitting positions (OR 1.5–4.2).

 

Conclusions: An association was found between having an asymmetric posture and ability to change position in sitting and/or lying; and with pain. The results indicate the need to assess posture and provide interventions to address asymmetric posture and pain.

Legal remedies through litigation for the rights of disabled people

DISABILITY RIGHTS DEFENDERS
EUROPEAN NETWORK ON INDEPENDENT LIVING
ARTICLE 19 AS A TOOL
November 2020

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Even though most countries have ratified the CRPD, the rights of disabled people get violated daily all over the world. In almost every country there are national laws and international agreements which should assure the same rights for disabled people. The main problem is that the laws are widely unenforced, that is why remedies are needed. There is a need for deeper discussions on tools for strategic litigation, including effectiveness of legal and injunctive remedies, different forms of compensation for violations of human rights and procedural strategies for impact, as important tools to fight against violations of disability rights. Thereby, every law system and country has different ways and possibilities to redress violations. In this webinar we want to look at the need for better remedies, access to justice and strategic litigation. We learn from the experience of international experts with strategic litigation and remedies and discuss what kind of changes we would like to see in the remedies available or what kind of new remedies are needed. How can we establish an exchange of international experience and cooperation between organizations in the work towards better remedies?

 

The following speakers shared their expertise:

Paul Lappalainen, Swedish/US lawyer, European Equality Law Network: Access to justice / Access to remedies
Mari Siilsalu, lawyer at Article 19 as a tool, Independent Living Institute: Survey on legal remedies
Ann Campbell, Co Executive Director at Validity Foundation: Looking beyond compensation: innovative remedies for women with disabilities
Stellan Gärde, Swedish lawyer and author: A human right - The right to legal aid
Timothy Hodgson, legal advisor at ICJ, lecturer at University of Pretoria: Economic and social rights litigation

 

The webinar was moderated by Ola Linder, Swedish lawyer and project leader of Article 19 as a tool. 

Leaving no one behind in education - A focus on children with disabilities

ADEREMI-IGE, Toyin
KAPUSCINKI DEVELOPMENT LECTURES
November 2020

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This lecture by Dr. Toyin Aderemi-Ige shed light on the educational situation of children with disabilities in low and middle income countries, highlighting how the interaction of multiple discriminatory factors (like gender and disability) results in increased exclusion. The 2030 Agenda sets the commitment to “leave no one behind” and its Sustainable Development Goal 4 calls to ensure inclusive and quality education for all. However, 10 years away from the 2030 deadline, children with disabilities are still significantly excluded from education and, consequently, from life’s opportunities.

 

The event was moderated by Dr. Harlan Koff of the Luxembourg University.

The lecture was followed by a panel discussion with:

  • Catherine Léglu, Vice-rector for Academic Affairs, University of Luxembourg
  • Julia McGeown, Global Education Specialist, Handicap International
  • Graham Lang, Chief of Education at Education Cannot Wait

Ensuring the right to quality inclusive education for persons with disabilities: From commitment to action

UNESCO
November 2020

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The international symposium "Ensuring the right to quality inclusive education for persons with disabilities: From commitment to action", co-organized by UNESCO, the Leonard Cheshire, and the Ministry of Education of Portugal brought together a wide range of stakeholders across the globe to discuss progress, successes achieved and challenges to ensure full participation and access to quality learning opportunities for all learners.

The symposium aims were to:

  • review persisting, as well as new challenges, due to the COVID-19 pandemic that are hindering the fulfilment of the right to inclusive education for learners with disabilities.
  • facilitate the exchange of experiences on factors influencing successful inclusive policies and practices for learners with disabilities and strengthen dialogue and cooperation amongst stakeholders at policy and practice levels.
  • explore how the inclusion of learners with disabilities in inclusive settings can be more effectively addressed by governments with regards to the commitments of Article 24 of the Convention on the Rights of Persons with Disabilities (CRPD), the CRPD General Comment 4 on article 24, and Sustainable Development 4 SDG 4, to ‘ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.

The programme included:

Opening session - Accelerating efforts towards inclusive education for learners with disabilities. (Video recording: English - French - Spanish)

Session 1 - From legislation to inclusive practices: Re-designing policy frameworks, funding and monitoring arrangements across sectors for inclusive education for learners with disabilities. (Video recording: English - French - Spanish)

Session 2 - Revisiting the teaching and learning process to ensure access and participation of learners with disabilities.

Session 3 - Moving towards inclusive and safe learning environments, including by addressing violence and bullying against learners with disabilities.
 

Closing session - Rebuilding a Stronger Global Disability Inclusive Education System post COVID-19. (Video recording: English - French - Spanish)

Teaching for inclusion – a review of research on the cooperation between regular teachers and special educators in the work with students in need of special support

PAULSRUD, David
NILHOLM, Claes
2020

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This article presents a review of qualitative research on interprofessional cooperation between regular teachers and special educators published from 2005 to 2019. The aim of the review was to gain knowledge about how different forms of cooperation take shape and about factors at multiple levels that facilitate or constrain cooperation as a means of achieving inclusion. In total, 25 studies were selected. The results are discussed in relation to Thomas Skrtic’s theory of bureaucracies within the school organisation in order to compare and analyse different forms of interprofessional cooperation and schools’ organisations of special educational work. Cooperative teaching, special educational consultations and mixed forms of cooperation were found to entail different benefits and challenges related to communication and the cooperating actors’ roles. Facilitating factors included personal chemistry, an equal distribution of power and responsibilities and support from the school management through provision of professional development and adequate planning time. In several studies, a flexible cooperation was argued to be hindered by curricular constraints and standardised testing. Education policy is therefore emphasised in this review as important for understanding the conditions under which school staff are responsible for inclusion.

Do both ‘get it right’? Inclusion of newly arrived migrant students in Swedish primary schools

TAJIC, Denis
BUNAR, Nihad
2020

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The aim of this article is to advance knowledge on how Swedish primary schools organise education and what strategies they deploy to ensure inclusion and attainment of newly arrived migrant students. The article is based on semi-structured interviews with 30 teachers and school administrators, and one-year of fieldwork undertaken in two multicultural urban primary schools in the Stockholm region. One of the schools initially places students in separate classes, while the other one places them directly into mainstream classes. Both are evoking inclusion and attainment as a reason for using their respective models. As such, do both ‘get it right’? Using inclusion as the theoretical and conceptual framework this article addresses the broader question: How is the meaning of inclusion constructed in the processes of its practical implementation in these two schools? The results show the ambitious tale of inclusion in both schools was, in the process of the construction of its meaning and implementation, reduced to some of its aspects. Teachers and school administrators are allowed to include or leave out of their model whatever they deem necessary, obsolete, expensive or unrealistic and still fitting under the umbrella of inclusion. Sometimes it works, sometimes it does not, and both schools ‘get it right’ and ‘wrong’ in some aspects.

Teachers’ and parents’ attitudes towards inclusion of pupils with a first language other than the language of instruction

KAST, Julia
SCHWAB, Susanne
2020

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Due to the rising linguistic heterogeneity in schools, the inclusion of pupils with a first language other than the language of instruction is one of the major challenges of education systems all over the world. In this paper, attitudes of in-service teachers, pre-service teachers and parents towards the inclusion of pupils with a first language other than the language of instruction are examined. Additionally, as the paper focused on how the participants perceive the development of this pupils in different school settings (fully included, partly included, fully segregated).


Data from 1501 participants were investigated. Descriptive results showed that pre-service teachers’ attitudes towards the inclusive schooling of pupils with different language skills in composite classes were rather positive, while attitudes of in-service teachers and parents rather tend to be neutral. Regarding the results concerning the participants’ attitudes towards the pupils’ development in different school settings, all three sub-groups belief that pupils with German as first language would develop in a more positive way, compared to pupils without German as first language. Moreover, the migration background of pre-service teachers and parents had a positive influence on the participants’ attitudes.
 

Gap Analysis: the inclusion of people with disability and older people in humanitarian response Part 2. Beyond the evidence: Implications for innovation and practice

PRYOR, Wesley
MARELLA, Manjula
ROBINSON, Alex
November 2020

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The first part of the Gap Analysis was published in July 2020, which presented the findings of an academic literature review and grey literature review.

Part 2 of the Gap Analysis presents the insights from individuals working in humanitarian response, disability inclusion and older age inclusion. This report begins by looking at how an agenda for the inclusion of people with disability and older people in humanitarian response has been established. The report then considers the ways in which standards and guidance inform humanitarian practice and the challenges associated with translating commitments into practice. Finally, the report identifies seven areas where there are key gaps and opportunities presenting the potential for innovation in research and practice

The case for investing in assistive technology

ATscale
November 2020

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In this new report, ATscale describes the enormous gains that access to assistive technology (AT) can have in health, for the community and the economy. The figures are dramatic: investment in the provision of four assistive products - hearing aids, prostheses, eyeglasses, and wheelchairs - will result in a return on investment of 9:1.

Having access to AT can make the difference between failure or success in school, between a job or unemployment, between a life of opportunity or a life of dependency. An example: for a child in a low- or middle-income country, access to AT can make a difference of $100,000 in lifetime income.

Altogether, providing AT to all who need it would yield more than USD 10 trillion in economic benefits over the next 55 years.

Investing in AT both has a transformative impact on people’s wellbeing and makes sound economic sense for funders and governments. 

Cluster Munition Monitor 2020

INTERNATIONAL CAMPAIGN TO BAN LANDMINES – CLUSTER MUNITION COALITION (ICBL-CMC)
November 2020

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this report provides a 10-year review of developments in addressing the global cluster munitions problem, with information included up to September 2020. Profiles published online provide additional country-specific findings on these topics. Thematic maps are also published in the report and available online.

As well as a 10-year review, Cluster Munition Monitor 2020 covers cluster munition ban policy, use, production, transfers, and stockpiling globally, and also contains information on the impact of cluster munition contamination and casualties, as well as developments and challenges in addressing such impact through clearance, risk education and victim assistance.

 

11th Annual edition

Estimating assistive product need in Cameroon and India: results of population‐based surveys and comparison of self‐report and clinical impairment assessment approaches

BOGGS, Dorothy
KUPER, Hannah
MACTAGGART, Islay
MURTHY, GVS
OYE, Joseph
POLACK, Sarah
November 2020

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To estimate population need and coverage for distance glasses, hearing aids and wheelchairs in India and Cameroon, and to explore the relationship between assistive product (AP) need measured through self‐report and clinical impairment assessment.

Population‐based surveys of approximately 4000 people each were conducted in Mahabubnagar district, India and Fundong district, Cameroon. Participants underwent standardised vision, hearing and musculoskeletal impairment assessment to assess need for distance glasses, hearing aids, wheelchairs. Participants with moderate or worse impairment and/or self‐reported difficulties in functioning were also asked about their self‐reported AP need.

 

https://doi.org/10.1111/tmi.13523

Unheard children. Championing deaf children’s rights to family, community, education and independence in developing countries

DEAF CHILDREN WORLDWIDE
November 2020

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This report highlights the specific barriers facing deaf children and young people and demonstrates a number of smallscale approaches and initiatives that have succeeded in breaking down some of these barriers.

Topics are:

  • Language and communication. Early diagnosis and support (example from Bangladesh). Effective and affordable hearing technology. Communication choices. What is sign language? Tanzanian Sign Language – the need for more interpreters
  • Families. Early diagnosis and support. Upskilling parents and primary caregivers. Power to the parents (example from Uganda). Catalyst for change (example from India). 
  • Communities. Deaf role models (example from Bangladesh). Challenging the public and professionals. Educating the police force (example from India). Sharing knowledge across organisations
  • Education. Intensive communication. Extra help in the classroom (example from Kenya). Making secondary education accessible. Developing sign language skills. Inclusive further and higher education
  • Independence. Listening to deaf young people. Involving deaf young people in research. Support to make informed choices. Challenging perceptions in the workplace (example from Kenya)

 

 

Inclusion and exclusion in humanitarian action The state of play.

BARBELET, Veronique
WAKE, Caitlin
November 2020

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This paper provides the foundation for a multi-year study on inclusion and exclusion in humanitarian action being carried out by the Humanitarian Policy Group (HPG) at ODI. It seeks to make sense of the concept of inclusion in humanitarian action, explore how it relates to humanitarian principles and other core concepts and outlines some of the key issues and challenges preventing more inclusive humanitarian action. Drawing on existing practice and evidence from a review of academic and grey literature, the study argues that vulnerability is a critical, but challenging, lens to inform the prioritisation of humanitarian assistance and protection, and that it has failed to lead to more inclusive humanitarian action. 

If not now, when? Keeping promises to older people affected by humanitarian crises

McGIVERN, Verity
November 2020

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This report looks at the extent to which older people’s rights are being upheld in emergencies and their needs met. The picture it paints is a bleak one. Although some efforts are being made to support older people, overall, the humanitarian system is failing by the standards it has set itself.
 
The report draws on the findings of needs assessments carried out by HelpAge International in the 13 months to the end of 2019. We interviewed 8,883 people aged 50 to 80 - plus affected by natural disasters, conflict or socioeconomic crises in 11 countries in Africa, Asia, Latin America and the Middle East.
 
Since the data was collected, COVID-19 has swept across the globe. The pandemic has both increased the need for humanitarian aid and disrupted its delivery. The response to coronavirus has thrown into stark relief the gulf between the risks older people are facing and the level of support available to them. The findings in this report provide important lessons for improving this response
 

Menstrual Hygiene Management: Challenges and Coping Strategies for Adolescents with Disabilities in the Kumasi Metro of Ghana

Enoch, Acheampong
Nadutey, Alberta
Afful, Barbara Fosua
Anokye, Reindolf
2020

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Purpose: Effective menstrual hygiene management is vital to the health, well- being, dignity, empowerment, mobility and productivity of girls and women. This study was conducted to ascertain menstrual hygiene management challenges and coping strategies of adolescents with disabilities in the Kumasi Metro of Ghana.

 

Method: An exploratory study design with qualitative approach was employed to select 18 participants. Data was collected through in-depth interviews and focus group discussions, and then transcribed and categorised into specific themes.

 

Results: Females with visual impairment had difficulty in maintaining good menstrual hygiene because of problems in detecting menstrual blood, inability to fix sanitary pads appropriately and wash underwear properly, and anxiety and stress from not knowing whether their period has started. The problems of those with physical impairment were related to inaccessible washrooms, long hours of being seated on the part of wheelchair-users, and difficulty in fixing sanitary pads for those with upper limb impairment. For those with hearing impairment, the main challenge was the communication barrier between them and their significant others whenever they needed help.

 

Conclusion: There are common challenges faced by all girls across the globe with regard to menstrual hygiene management. Adolescent females with disability however face additional challenges with regard to MHM. Those with physical disability encounter accessibility challenges, while the main challenge for the deaf and those with speech problems is communication. The visually impaired live in anxiety due to fear of staining their clothes.

Life Accomplishment, Social Functioning and Participation of South-Eastern Nigerians with Lower Limb Amputation

Akosile, Olusanjo Christopher
Okonkwo, Arinze Christian
Maruf, Adesina Fatai
Okoye, Chiebuka Emmanuel
2020

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Purpose: For a better understanding of the possible impact of impairments and disabilities on the life of individuals with lower limb amputation,it is important to explore the levels of Life Accomplishment (LA), Social Functioning and Participation (SFP) among them.The present study, set in South-Eastern Nigeria, aimed to study these levels and the influence of selected clinical and demographic variables on these constructs.

 

Method: This cross-sectional survey involved 60 individuals with lower limb amputation (46 unilateral, 14 bilateral) recruited from all the five South-Eastern Nigerian States. The Social Functioning Questionnaire (SFQ), Participation Scale and Life Habit Questionnaire were used for measuring levels of social functioning, social participation and life accomplishment, respectively. Data was analysed using descriptive statistics of frequency count, percentages, mean and standard deviation. Mann-Whitney U and Kruskal-Wallis tests were used to test the hypotheses. Alpha level was set at 0.05.

 

Results: Most of the participants (51.7%-58.3%) had low levels of social functioning across SFQ domains. Most of them (61.7%) had severe participation restrictions, and they all had reduced life accomplishments. Participants with bilateral amputation had poorer levels of social functioning (P<0.0001), participation restriction (P<0.0001), and life habits accomplishment (P<0.0001) than their counterparts with unilateral amputation. Individuals with below-knee amputation had significantly better levels of social functioning (P<0.0001) and participation (P<0.0001) than those with above-knee amputation. Participants with prosthetic mobility aids had significantly better levels of social functioning (P<0.0001) and participation (P<0.0001) than those with no prosthetic mobility aids. There was no significant difference in the levels of social functioning and participation between male and female participants, but female participants had statistically significant (P<0.0001) higher scores in nine out of twelve life habit domains than their male counterparts.

 

Conclusion and Implications: Low social functioning, severe participation restrictions, and reduced life accomplishments were prevalent among individuals with lower limb amputation, particularly amongthose with bilateral and above- knee amputations. There is a need to routinely evaluate the studied constructs among individuals with lower limb amputation. The provision of prosthetic aids may help to improve their levels of life accomplishment, social functioning and participation.

Teachers’ Attitudes towards Inclusion of Blind or Partially-Sighted Students in Secondary Schools in Nigeria

Ajuwon, Paul M
Chitiyo, George
Onuigbo, Liziana N
Ahon, Adaka T
Olayi, James E
2020

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Purpose: This study investigated the attitudes of secondary school teachers towards students with blindness or partial sight in selected states in Nigeria.

 

Method: The authors utilised the modified version of a previous instrument to collect data from 306 secondary school teachers in Nigeria. Six basic questions were established to address: respondents’ attitudes towards inclusion; training acquired related to teaching; knowledge pertaining to policy and legislation; confidence levels to teach students with disabilities.; impact of geographical location; and differences in attitudes by the variables of subject(s) taught, school level taught, and years of teaching experience.

 

Results: Attitudes of participants were mixed but were generally positive. The level of training was low, with teachers showing limited knowledge of policy and legislation. A little over a quarter (27%) of them lacked confidence in teaching. There were differences in attitudes related to the geographical location of respondents. Those who taught at the senior secondary school level tended to have higher attitude scores on average than their counterparts at the junior secondary school level.

 

Conclusion and Limitations: This study used self-report measures, although observations and interviews could be additional ways to evaluate the attitudes of participants throughout the country. Moreover, in-service programmes may need to be implemented to increase teachers’ knowledge base and expand their experiences in line with established policies and legislation.

Physical Activity of the Community- Dwelling Elderly Population in Gujarat, India: A Cross-Sectional Study

Patel, Samira Sirajulhak
Gupta, Nalina
Parmar, Lata
2020

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Purpose: While ageing is an inevitable phenomenon of life, physical activity is important for healthy ageing. Compared to the other age groups, older adults throughout the world have the lowest rate of participation in recommended levels of physical activity. This study aimed to investigate the physical activity status of the community-dwelling elderly population in Gujarat, India.

 

Method: This was a cross-sectional study. A door-to-door survey was conducted among selected communities near Vadodara in Gujarat. Based on the inclusion criteria (age≥60years, MMSE-≥24), 347 elderly persons were included in the study. Data was collected using the Global Physical Activity Questionnaire (GPAQ), and analysed using descriptive statistics.

 

Results: Among the 347 older adults (mean age 67.43±7.46 years) who participated in the study, 159 were male and 188 were female. While 125 participants (36%) were physically active at levels recommended by the World Health Organisation, 222(64%) were physically inactive.

 

Conclusion: Only 36% of the participants were physically active as per WHO recommendations. The men were more physically active than the women in the study sample. This study implies that there is a need to create an awareness regarding the importance of physical activity for healthy aging.

Effects of Biofeedback and Task-Oriented Intervention on Balance Confidence and its Relationship with Social Participation among Stroke Survivors

Pachiappan, Elumalai
2020

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Purpose: The study aimed to compare the effects of balance training on balance confidence and its relationship with social participation among clients with stroke.

 

Method: A pre- and post- experimental group design was used. Stroke survivors who met the inclusion criteria were consecutively assigned to two groups (task- oriented and biofeedback). Participants in the task-oriented group received task- oriented activities for 20 minutes and the biofeedback group received intervention in correckta (equipment used for balance training) for 20 minutes, along with conventional occupational therapy - 5 sessions per week, for 12 weeks. Balance Confidence Scale was used for measuring balance confidence, and Frenchay Activities Index (FAI) was used to measure social participation. Statistical calculations were performed with SPSS version 16.0 package. Statistical tests were carried out with the level of significance set at p≤ 0.05.

 

Results: The findings suggest that both the biofeedback and task-oriented groups showed significant improvement in balance confidence and there was no statistically significant difference between the groups. There was a moderate to good relationship between balance confidence and social participation.

 

Conclusions and Implications: There is evidence that many stroke survivors have low balance confidence. Therapists should assess the balance confidence of their clients and encourage them to participate in these beneficial interventions.

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