Search results

This article explores the nature of the classifications of learning disabilities as promulgated in the diagnostic manuals. By leaving aside all doubts and controversies that surround the concept and measurement of intellectual functioning, weaknesses are exposed from within those manuals' own frames of reference. The difficulties arising from using the international sub‐classifications of learning disabilities when the national classifications should apply are discussed.

The debate as to whether intellectual disability (ID) should be conceptualized as a health condition or as a disability has intensified as the revision of World Health Organization’s (WHO’s) International Classification of Diseases (ICD) is being finalized. Defining ID as a health condition is central to retaining it in ICD, with significant implications for health policy and access to health services. The purpose of this paper is to include some reflections on the consensus document produced by the first WHO Working Group on the Classification of MR (WHO WG-MR) and on the process that was followed to realize it. The consensus report was the basis for the development of official recommendations sent to the WHO Advisory Group for ICD-11.

A mixed qualitative approach was followed in a series of meetings leading to the final consensus report submitted to the WHO Advisory group. These recommendations combined prior expert knowledge with available evidence; a nominal approach was followed throughout with face-to-face conferences.

The WG recommended a synonym set (“synset”) ontological approach to the conceptualisation of this health condition underlying a clinical rationale for its diagnosis. It proposed replacing MR with Intellectual Developmental Disorders (IDD) in ICD-11, defined as “a group of developmental conditions characterized by a significant impairment of cognitive functions, which are associated with limitations of learning, adaptive behaviour and skills”. The WG further advised that IDD be included under the parent category of neurodevelopmental disorders, that current distinctions (mild, moderate, severe and profound) be continued as severity qualifiers, and that problem behaviours removed from its core classification structure and instead described as associated features.

Within the ID/IDD synset two different names combine distinct aspects under a single construct that describes its clinical as well as social, educational and policy utilities. The single construct incorporates IDD as a clinical meta-syndrome, and ID as its functioning and disability counterpart. IDD and ID are not synonymous or mirror concepts as they have different scientific, social and policy applications. New diagnostic criteria for IDD should be based on a developmental approach, which accounts for the complex causal factors known to impact the acquisition of specific cognitive abilities and adaptive behaviours. The paper focuses on a new clinical framework for the diagnosis of IDD that also includes and complements the existing social, educational and policy components inherent in ID.

The International Classification of Functioning, Disability and Health (ICF) was published in 2001 after over a decade of international discussion and field testing (see, for instance, Bickenbach, Chatterji, Badley, & Ustun, 1999). Its ratification by the World Health Assembly was keenly awaited in Australia, by people interested in working with a model of disability attuned to a human rights and equal opportunities approach, and by people wanting to use the new model in disability and health policy and information systems. This paper outlines developments being implemented and ideas being discussed in Australia, particularly with the Australian Collaborating Centre (ACC).¹

Several international and supranational organizations have undertaken efforts to improve and standardize the measurement of disability in population-based surveys. Among these are the Organization for Economic Cooperation and Development, the Statistical Office of the European Commission, the United Nations Statistical Division, the World Health Organization Regional Office for Europe, the World Health Organization, and Réseau sur l’Espérance de Vie en Santé Européennes. In this report their activities and recommendations are reviewed and examined from the viewpoint of the International Classification of Functioning, Disability, and Health.

Historically, the condition we now refer to as intellectual disability has been conceptualized using models that were extension of the medical model. Recent advances, however, have emphasized person-environment fit models of disability that view disability, intellectual, and other cognitive disabilities, as the lack of fit between a person’s capacities and the demands of the context. This chapter examines these shifts in conceptualization and the ways in which this changes how interventions are designed to provide support to enable people with intellectual disability to live, learn, work, and play in their communities. Such interventions and supports include issues pertaining to Universal Design for Learning, multi-tiered systems of supports, and the primacy of promoting the self-determination of people with disabilities. The importance of efforts to promote social inclusion is also discussed, as well as strategies to promote transition to adulthood. Authors from several countries provide examples of how these new intervention paradigms are being implemented across the world.

This chapter explores some of the complexities involved when undertaking research at an international level in the area of “inclusive” education and “special needs” education. The complexities encountered by researchers working in these fields, mirror many of the challenges that comparativists in education studies find themselves addressing. Drawing from earlier investigations and from reports by international organizations, this chapter highlights some of the dilemmas and challenges that researchers face when considering inclusion and special needs education in different countries. Differing interpretations of “inclusion” are discussed and then contrasted with thinking around “special needs” practices. The chapter moves forward to analyze how the adoption of differing theoretical frameworks can influence the way that “disability” is conceptualized and therefore how inclusive and special needs education are interpreted and then put into practice. The chapter argues that cross-cultural work opens up opportunities for further development and learning in this field. We further argue that such cross-cultural work can become a mechanism to instigate fundamental change in education.

The purpose of this paper is to determine if issues relevant to multidisciplinary rehabilitation care from the perspective of the patient and caregiver can be addressed utilising the International Classification of Functioning, Disability and Health (ICF) framework; also to identify gaps in evidence and service provision to optimise clinical care.

Participants with motor neurone disease (MND) (n=44) and their caregivers (n=37) were recruited from a tertiary MND clinic. Cross‐sectional predominantly qualitative methodology was used to explore the perspectives of MND patients and their caregivers on disability and service gaps. Their disability experience and relevant environmental factors were then mapped onto the ICF framework. Personal factors were described. The impact of MND on caregivers was also described.

There were significant gaps in MND care. In particular, the need for coordinated care by neurology, rehabilitation and palliative care services (“neuropalliative rehabilitation” model) was highlighted. The ICF framework adequately incorporated patient‐and caregiver‐ reported disability in MND.

This is the first review that the authors can identify, that lays the foundation for development of an ICF “Core set” (expert‐selected ICF categories that should be addressed in multidisciplinary care settings) for MND, which could improve consensus of care and communication amongst treating clinicians.

The objective of this study is to show the utility of the newly-approved World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) as a framework for organizing data from the National Health Interview Survey describing limitations in life activities among the U.S. population. Data were obtained from the 1994 to 1995 National Health Interview Survey (NHIS) Disability Supplement, Phase I (n=202,569). Forty-two items were selected from the survey to operationalize selected life domains of the ICF. Results indicated a prevalence rate of 19% for at least one life-domain limitation, with rates of limitations increasing with age, lower income and less education. Movement limitations were most frequently reported across the sample, but variations occurred within demographic characteristics. Life activities by sex and race produced noteworthy differences, by race/ethnicity generally, and by sex and race/ethnicity specifically. An example of mental health issues highlighted the use of the framework for health outcomes.

The ICF provides a foundational conceptual and classification system for improving disability science. These data suggest that the ICF has utility by providing data consistent with other disability measures, while providing an expanded and integrated model for science and policy. Fresh information is gleaned from organizing the data by ICF’s personal activity limitations. Differences by demographics across life domains, for example, can be more clearly presented and future analyses can assess associated impairments and environmental factors, including health service planning, health promotion, and access to care. The system can frame coherent integrated public health science and associated interventions to address the health and well being of people with disabilities.

Classification schemes make things happen. The Australian Disability Discrimination Act (DDA), which derives its classification system from the World Health Organization's International Classification of Functioning, Disability and Health (ICF), legislates for adjustments to support the inclusion of people with disability. This study explores how students with disability enrolled in a university experience the systems intended to facilitate their studying “on the same basis” as students without disability.

Through an online questionnaire and interviews comprising open and closed questions made available to students registered with the disability services unit of a university and follow-up interviews with a small number of students, students’ views of their own disability and effects on their participation in learning were gathered, alongside reports of their experiences of seeking support in their learning. Interview data and responses to open-ended questions were analysed using a priori and emergent coding.

The findings demonstrate that students are aware of the workings of the classification scheme and that most accept them. However, some students put themselves outside of the scheme, often as a way to exercise autonomy or to assert their “ability”, while others are excluded from it by the decisions of academic staff. Thus, the principles of fairness and equity enshrined in legislation and policy are weakened.

Through the voices of students with disability, it is apparent that, even though a student's classification according to the DDA and associated university policy remains constant, the outcomes of the workings of the scheme may reveal inconsistencies, emerging from the complexity of bureaucracy, processes and the exercises of power.

The purpose of this paper is to explore the multi-level mechanisms of institutional formation and change and, in particular, how this occurs through the interplay of multi-level mechanisms? This is answered with a processual analysis of the International Paralympic Committee which is the international governing body of sports for people with an impairment.

This study uses a case-study approach based upon archival records, collected in relevant national and international sport organizations. More than 2,700 pages of archives were gathered, some of them being accessible to researchers for the first time. Embargo was also successfully lifted on recent and sensitive documents.

This study highlights multi-level mechanisms involved in institutional change processes triggered by a shifting institutional logic at the organizational field level. This paper also shows how field logic shifted at the moment of alignment between the societal, field and organizational levels. Moreover, it underlines how societal discourses influenced processes of institutional change by shaping the range of organizational actions available at the organizational and field levels.

This paper proposes a rare account of institutional change processes in which interplay between the societal, field, and organizational levels is analyzed. Furthermore, this paper provides a longitudinal investigation of an under-researched empirical setting, the Paralympic movement. Finally, this study integrates insights from the disability studies’ research field, which significantly deepens this analysis.