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In spite of the challenges that disability measurement creates in interpretation of results, this volume contains an exciting variety of different types of papers that add not only to our information about persons with disabilities, but also serve as a useful guide to using this extensive data set to address the numerous questions about this population. Following an overview discussion about the development and production of the NHIS-D, this volume has four separate sections. In the first section three papers describing methodological issues in using the NHIS-D are presented. This section includes a paper on factors associated with response patterns (Hendershot et al.) and another on a strategy to overcome the problems of missing data (Witt et al.). The third paper examines disability prevalence by interpreting the NHIS-D data into domains of the ICF classification (Fedeyko & Lollar). The next section contains three papers which focus on work and health care for adults with disabilities (disability measured in different ways), particularly the barriers they experience in those areas. Included in this group are papers on barriers to work (Loprest & Maag), barriers to preventive care (Jones & Beatty), and the effect of insurance as a facilitator and barrier to health care for mobility limited adults (Iezzoni et al.). The third section of four papers focuses on developmental disabilities. Larson et al. discuss the variety of definitions of developmental disability and how those definitions can be operationalized with the measures used in the NHIS-D. Two of the papers examine the outcomes or consequences of childhood disability. Honeycutt et al. focus on the economic costs of developmental disability across the life-span and Maag examines the unmet need for supportive services for this population. Hogan et al. also looks at consequences for siblings of children with disabilities. This section can also be viewed as a methodological one providing a variety of ways to measure developmental disabilities within the same data source. The next section looks at the needs and characteristics of two specific populations; Native Americans (Altman & Rasch), and adult women with MR/DD (Anderson et al.). It also contains a unique approach to understanding the effects of two different aspects of disability, the age of onset of the disability and the proportion of life lived with a disability (Verbrugge & Yang). The book concludes with a discussion of the policy implications of NHIS-D work (Drabeck).

Inclusion is a concept that has been around for years and is implemented in our schools. Some schools do it well and others are still working on it. Inclusion is meant to include students with disabilities in the general education classroom and curriculum. This chapter will briefly discuss special education as well as inclusion. Inclusion will be defined, and benefits and also myths of inclusion will be discussed. In addition, research that supports inclusion will be described. This chapter lays the foundation for the other chapters in this volume that will discuss inclusion and students with specific types of disabilities.

It is generally difficult for the government to come up with any meaningful programs for persons with disabilities (PWDs) unless statistics to that effect have been made available. Disability Statistics in Uganda is one of those areas of social statistics which has been growing at a slow pace in the past compared to other socioeconomic indicators, but now is an area of growing concern and picking up steadily. Censuses have remained the major data providers for disability statistics and the first of which was the 1991 census. The 2002 census similarly collected information on PWDs, and this information is to be widely disseminated at national and lower levels. Both censuses were conducted by the Uganda Bureau of Statistics (UBOS). UBOS has collected similar but a little more detailed information on disability using two household surveys.

However for effective program design, implementation and resource allocation for PWDs, a lot needs to be done in terms of harmonizing the concepts on disability with the International Classification of Functional Disability and Health (ICF). The power of the census results is that it provides data to the lowest administrative level. Conducting a fully fledged national survey for PWDs will provide adequate baseline data for meaningful purposes and priority issues for government and other users.

This report provides information on the various sources of disability data and how concepts are defined by each institution. It highlights the Uganda Bureau of Statistics, Ministry of Education and Sports (Annual School Census and the Department for Special Needs), Ministry of Gender, Labour and Social Development (Community-Based Rehabilitation Program) and the Ministry of Health as data collecting institutions. It is noted that each institution use different concepts and methodology for data collection. Engaging both users and producers in the disability data production process, encouraging regular dialogue and establishing collaborative arrangements with local and international research institutions are avenues for utilizing the scarce resources for the development of disability statistics. The focus and direction of the development of disability statistics in Uganda calls for a sustained system of monitoring intervention that government and other development partners have to put in place.

The issues raised in this report will facilitate the process of harmonisation of concepts and definitions used while collecting disability data. It is noted that except for the Community-Based Rehabilitation Information pilot system under the Ministry of Gender, Labour and Social Development, there is little or no use at all of the ICF. The pilot system is ongoing and is expected to expand to other districts. It is hoped that this will enrich the process of harmonizing concepts with the Integrated Community-Based Rehabilitation Information System to provide meaningful results. The process of coordination is hereby called for.

The following is a reaction to the new developments in measurement language and the approaches to definitions of disability developed through the revisions of the ICIDH and the resulting ICF. It provides the view of an individual who has lived with limitations as well as an individual who has served as the president of an international disability organization.

A new measure of disability used in the 2000 Census allows an expanded data set on the population with disabilities within all regions of Brazil. Using two different conceptualizations of disability including limitations in activities and impairments in body function and structure, the questions provide a richer source of information for policy issues. Initial use of the data has provided increased knowledge about the age, sex and racial makeup of the populations with disabilities and the geographic distribution of this population within Brazil.

There are more than 40 million Americans with disabilities. If U.S. hospitality and leisure professionals are keen to attract customers with disabilities, then the particular services in line with the needs of those individuals have to be addressed, given the lack of clear actions toward the service delivery to individuals with disabilities. This study attempts to discover the issues pertaining to the perceptions of the services and facilities offered to visitors with disabilities. A total of three thousand questionnaires are distributed to visitors with disabilities. Cross-tabulations, chi-square, and ANOVA are deployed to determine the differences among visitors with different disabilities. Promotion strategies, suggestions regarding accessibility issues, and the benefits associated with a visit to various destinations are also presented.

Every successful program needs someone to champion its cause. This also applies to programs for students with disabilities. It is upon this person's shoulders that responsibility falls for initiating the steps to bring disability programs to fruition at an institution. Support services are typically coordinated by this full-time staff member who is responsible for providing students with disabilities a variety of “academic adjustments” that are mandated under Section 504 of the Vocational Rehabilitation Act. Again, this law requires that post-secondary institutions make modifications to their academic requirements and ensure that they do not discriminate against a qualified student with a disability (Frank & Wade, 1993; Simon, 2001). These modifications may include appropriate academic adjustments such as the provision of course substitutions, adaptation of instruction methods, alternate exam formats, and modifications in the length of time for the completion of requirements; or the provision of auxiliary aids, such as taped texts, sign language interpreters, guide dogs, use of tape recorders, readers or writers, and access to adaptive technology (see Pavone & Rotatori, 1994). The individual who provides these core supports is often instrumental in linking students with disabilities with other support services on campus (e.g., writing laboratory, math tutorial, and academic development center) (Smith, 2004).

The ADA provides its own definition of disability. The term is defined as: a physical or mental impairment that substantially limits one or more of the major life activities of such individual; a record of such an impairment; or being regarded as having such an impairment. The phrase physical or mental impairment means: (i) Any physiological disorder or condition, cosmetic disfiguration, or anatomical loss affecting one or more of the following body systems: neurological; musculoskeletal; special sense organs; respiratory, including speech organs; cardiovascular; reproductive; digestive; genitourinary; hemic and lymphatic; skin; and endocrine; and (ii) Any mental or psychological disorder such as mental retardation, organic brain syndrome, emotional or metal illness, and specific learning disabilities.…The phrase major life activities means functions such as caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working (EEOC & U.S. Department of Justice, 1991, pp. 16–18 as cited in Hishinuma & Fremstad, 1997).Apparently, persons identified with specific learning disabilities are covered under the ADA (Hishinuma & Fremstad, 1997). Grant and Grant (2002) affirmed that learning disabilities have been viewed as a perplexing category of exceptionality. Learning disabilities are marked in persons by a discrepancy between intellectual ability and actual school achievement. There are many definitions for the term learning disability. In fact, lack of commonality for defining the term has been cited as the reason for a vast difference in agreement of prevalence (Kirk et al., 2003). As Stanovich (1989) stated, “the decision to base the definitions of a reading disability on a discrepancy with measured IQ is…nothing short of astounding. Certainly, one would be hard pressed to find a concept more controversial than intelligence in all psychology” (p. 487). Even though there is a lack of common definition for learning disability, it is agreed upon that students with learning disabilities comprise the largest proportion of students receiving special education services (Kirk et al., 2003). The Federal Register (1999) has established criteria and non-criteria for identification of students with a specific learning disability. The criteria include: (a) presence of academic difficulties; (b) perceptual disabilities; (c) brain injury; (d) minimal brain dysfunction; (e) dyslexia; and (f) developmental aphasia. The non-criteria include: (a) academic problems due to visual, hearing, or motor disability; (b) mental retardation; (c) emotional disturbance; and (d) environmental, cultural, or economic disadvantage (Murdick et al., 2002).

Many employers lack disability confidence about how to include people with disabilities in the workforce, which can lead to stigma and discrimination. This paper explores the concept of disability confidence from two perspectives - employers who hire people with a disability and employees with a disability.

Thematic analysis was carried out of 35 semi-structured interviews (18 with employers who hire people with disabilities and 17 with employees with a disability).

Four main themes emerged. First, disability discomfort arose from a lack of experience working with the disabled, resulting in stigma and discrimination. Second, disability confidence involved “reaching beyond comfort zones” to find new ways of thinking. Third, broader perspectives came from challenging stigma and stereotypes. Finally, disability confidence among employers was critical in developing an inclusive working culture.

The issue is important because negative attitudes to disabled people are common and they lead to stigma and exclusion. But there has been very little research exploring both employers’ and employees’ perspectives