Volume 12, Issue 3

By collecting and analyzing existing systems of symbols linked to disabilities and thereby identifying possible problems that these symbol systems pose, this study proposes improvements that account for primary disability groups worldwide. A content analysis was applied to textual and digitalized formats to review the predominant systems of symbols. Then disability experts analyzed the proposed symbol system in a panel setting. The proposed system of disability symbols offers standardized format and content. This system outlines compliance parameters as well as the scope of group referents. Those attempting to standardize the disability field should take advantage of common synergies that reflect universal usage choices.

This study was designed to investigate the difference between perceived parenting style of adolescents with visual and hearing impairment, as well as their emotional competence as an effect of perception of parenting style. We also found a relationship between the variable of perceived parenting and the emotional competence. The sample consisted of 140 participants, 70 visually and 70 hearing impaired adolescents, who were equally divided according to gender in each group. Results indicated that adolescents of both groups differed significantly on perceived parenting and the emotional competence variable. Visually impaired adolescents showed more positive perception and were more emotionally competent than the adolescents with hearing impairment. A positive significant relationship was shown by the visually impaired group between most of the modes of perceived parenting and aspects of emotional competence variable. On the whole, the perception of parenting of adolescents with hearing impairment was found to be significantly lower than the visually impaired adolescents. Similarly, emotional competence among the hearing impaired group as regards the relationship between the two variables was also found to be significantly lower as compared with the visually impaired group. Regarding gender, boys with visual impairment perceived more positive parenting and showed more emotional competence than the girls compared with hearing impaired group.

A wheelchair, as a basic equipment for disabled, older, and weak persons, gives them a chance for independent living. Knowledge of the most frequent circumstances of wheelchair-related falls is a key part of medical science and clinical practice. It allows the wheelchair user to anticipate the threat of falls and take appropriate precautions, thereby improving the results of therapy and care. This article aims to discuss the influence of wheelchair-related falls to the results of therapy and care by synthesizing published literature. The article also aims to investigate the extent to which available research opportunities are being exploited, including the direction of further research. Three major databases were searched to identify relevant articles using specific keywords as well as inclusion and exclusion criteria. Representative literature was synthesized to present the thematic scope and weight of current evidence. Up to this point, synthesized literature appears to confirm the hypothesis that wheelchair-related falls have a significantly negative influence on the results of therapy and care. There is a need for a common effective prevention policy in the area of wheelchair-related falls.

Background: The purpose of this study is to examine the differences in health-risk behavior patterns and lifestyles between students residing in the city of Ariel and those residing in communal settlements within the Ariel region. Our research rational is that significant differences can be found between these two groups regarding environmental, cultural and behavioral conditions, which promote healthy or risky lifestyles. Methods: This cross-sectional study is based on an anonymous structured self-reported questionnaire that deals with topics of health, welfare and health-risk behaviors, completed by over 1500 undergraduate students. Results: The findings indicate meaningful and significant differences between the groups, both in their socio-demographic levels and in their health and risk behaviors. Students residing in Ariel maintained a better lifestyle, which included a sensible diet and physical activity routine, compared with students from communal settlements and those who reside in other areas of the country. Conclusions: The findings indicate that cultural differences play a decisive role in predicting health and risk behaviors, more so than the residential area itself.

Background: The relationship between attention-deficit/hyperactivity disorder (ADHD), oppositional defiant and conduct disorders (ODD/CD) requires further studies. Methods: The aim was to examine the relationship among ADHD severity [assessed by ADHD Rating Scale-Parent Version (PV)], ADHD subtypes, and the comorbidity with ODD/CD in 217 Italian ADHD children. Results: A total of 35.02% of the participants displayed ADHD with ODD, 14.29% ADHD with CD, and 50.69% no ODD/CD comorbid diagnosis. The Hyperactivity Score of the ADHD Rating Scale-PV was a significant predictor of ODD; age and the Hyperactivity Score were significant predictors of CD. The combined subtype was significantly higher in CD children. Conclusions: Data, which confirm the only recent article on the topic, help to clarify the relationship between ADHD and externalizing disorders.

Aim: The aim of this study was to determine the role of the Test of Variables of Attention (TOVA), a computer-based continuous performance test (CPT), in assessing suspected attention-deficit/hyperactivity disorder (ADHD), a pervasive cause of disability in children and adolescents. Methods: One hundred and fifty children and adolescents referred to a community-hospital-based neurology clinic for suspected ADHD underwent a comprehensive clinical evaluation by a pediatric neurologist in addition to the TOVA test. Retrospective chart data were analyzed separately for children aged 6–12 years (n=101) and adolescents (13–18 years) (n=49). Parents and teachers completed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR, 2000) questionnaires for children 6–12 years old. Results: The correlation between the neurologist’s impression of the presence of attention deficit and the TOVA scores was good in the younger group (r=0.28, p≤0.001) and weaker in the older group (r=0.29, p≤0.05). On nonparametric analysis, the neurological evaluation did not distinguish between low and high TOVA scorers in the older group. The neurologist’s impression correlated more closely with the DSM-IV parents ratings (r=0.29, p≤0.01) than the teachers’ (r=0.08, p≤0.05). Conclusions: The TOVA correlated well with clinical assessment of ADHD and has added value in the evaluation of ADHD in adolescents, for whom standardized rating scales are lacking. In younger children, an experienced clinician can usually reach an accurate diagnosis based on accepted clinical criteria, including parent and teacher reports.

Background: Aboriginal and Torres Strait Islander individuals continue to experience greater levels of chronic disease than the general Australian population. Evidence suggests that increased sedentary behaviors compared with the traditional healthy and active lifestyles of this population have contributed to this situation. This investigation aimed to examine the health benefits of a community-based singing activity intervention on chronic disease among Aboriginal and Torres Strait Islander Australians. Methods: From 2010 to 2011, 291 Aboriginal and Torres Strait Islander people, from Queensland, Australia, were recruited through five communities to participate in a 1-year community singing program. Participants completed a survey, in the pre- and post-intervention phases of the study, that measured social connectedness, health behavior (e.g., smoking, alcohol consumption), frequency of exercise and art activities, and medication use. Results: Improvements in health behavior were observed for both male and female participants with chronic disease of all age groups in the community singing program. Improvements in the male and female participants included decreased social loneliness and reduced smoking behavior, increased social support, and increased participation in exercise and art activities. Conclusions: The participative community singing program was successful in improving the health status and increasing physical activity among Aboriginal and Torres Strait Islander adults.

There is increasing international interest in the idea that well-being and health are related to resilience. Participative community singing is beneficial for well-being not only in people who are free from health problems, but especially for those whose physical and mental health is compromised. This study examined the development of five Aboriginal and Torres Strait Islander singing groups and the benefits relating to promoting resilience and ultimately preventing chronic disease in this population. Mixed methods, including both quantitative and qualitative approaches, were used. Questionnaires were administered to collect data on chronic life stresses, resilience, social support and social connectedness. Focus group interviews were conducted to obtain data on the participants’ and stakeholders’ perceptions of the impact of the singing groups. Multivariate analysis of variance was used to test the effectiveness of the intervention program on improving resilience at both the individual and the community levels. Structural equation modelling was used to analyse the pathways from the benefits gained from the singing program to the prevention of chronic disease. The results suggested that the singing groups served multiple functions, which are underpinned by social ecological resilience mechanisms to promote self-esteem, learning and education and confidence at the individual level, as well as community connectedness, reduction of loneliness and promoting social support from family, community and the social context such as support from community-controlled health services, and ultimately preventing chronic disease.

Objective: The objective of this study was to assess the effectiveness of a 12-month community singing program on quality of life (QoL) using survey methods. Methods: We prospectively collected data on Aboriginal and Torres Strait Islander people with chronic diseases involved in a participatory community singing program. Aboriginal and Torres Strait Islander people with a chronic disease and an average age of 51 years (range, 18–85 years) self-selected to participate in the singing group (n=45), which included a weekly singing rehearsal and a monthly performance. There were 27 people in the control group. We compared the intervention and control groups by evaluating the QoL, social and emotional well-being, health behaviors, social isolation, and loneliness at a baseline and at 12 months. Results: At 12 months, those who participated in the singing program showed a significant increase in QoL, reduced stress, and a significant reduction in social isolation and loneliness compared with patients in the control group. Conclusions: The community singing program may enhance social and emotional well-being and QoL in Aboriginal and Torres Strait Islander people with chronic diseases, and the singing program is a viable health promotion intervention program for this population.

This article uses data from the 2008 International Social Survey Programme to examine the disability gap in happiness in 14 countries. This study builds on previous research linking disability to depression by exploring whether there are significant differences in the gap between disabled and non-disabled people’s happiness internationally and if differences in happiness systematically vary across welfare state regimes. Disabled respondents were found to be significantly less happy than non-disabled respondents from the same nation in all 14 countries and that the levels of happiness between disabled people and unemployed people were similar by welfare regime except in the conservative welfare regime. The disability gap in happiness varied across welfare state regimes, and social democratic countries generally had significantly smaller disability gaps than countries with conservative welfare regimes. These findings highlight the international scope of the disability gap and underscore the important role that welfare regimes have in shaping these differences.

Background : Barriers make an environment unsafe and cause a high level of difficulty to the user. But more importantly, barriers cause space to be out of reach, denying disabled people the opportunity of participation in various spheres of life. This ranges from education, economic, social, cultural, and other activities. Many studies have focused on the disabilities study but less research has been devoted to the specific area such as railway transport facilities. Thus, this study was done with the objective to ascertain the extent to which a railway transport facility in Ludhiana city of Punjab is barrier free for the disabled. Methods : A pretested questionnaire (Access Survey and Audit Checklist) was used, designed by the Rehabilitation Council of India and Samarthya National Center for Promotion of Barrier Free Environment for Disabled Persons was modified according to our study environment. Various aspects of study domains were scored according to their importance of usage as described by disabled people interviewed before the commencement of the study. Results : It was found in the study that disable friendliness of the railway transport facility remains a largely unrealized goal in Ludhiana city to date. The score obtained by the railway station of Ludhiana city was 41 and its disable friendliness was graded as average. The railway transport facility was far from being satisfactory than to be called barrier free. This loss of opportunity is not only a loss for the person concerned but also a loss for society, which misses out on their contribution. Conclusions : Simply put, a barrier causes exclusion and its removal is necessary for ensuring inclusion and participation of all in society.

Background: Classically, the assessment of reading disabilities is based on the accuracy for word and nonword reading, as well as on the accuracy or sensibility measures (such as d′) for phonological awareness tasks. Recent studies indicate that in terms of phonological awareness results, the response time is a more accurate indicator than sensibility measures (such as d′), thus providing an important measure explaining some of the differences between good and poor readers. This article explores the discriminative capability of phonological awareness task time (PATT) in reading disability assessment. Methods: One hundred and eighty-six children were tested using conventional tasks, specifically word reading, nonword reading, and phonological awareness tasks. The word and nonword accuracy and PATT were used to train self-organizing maps (SOM) to classify children into three distinct groups. Results: Phonological awareness response time provides a powerful discriminative measure. Conclusions: Our results indicate that the PATT constitutes a useful selective measure, particularly in the third and fourth grades when classical variables such as word and nonword reading accuracy lose their discriminative capabilities. Also, the use of SOM to classify children’s reading abilities can successfully categorize children and capture meaningful measures such as the lexicality effect.

Background: Although there are several assessments that directly measure adaptive behavior, other comprehensive measures include adaptive behavior scales, including the Behavioral Assessment System for Children-Second Edition Parent Rating Scale (BASC-2-PRS). Methods: BASC-2-PRS data from 19 individuals diagnosed with autism spectrum disorders were analyzed to determine score discrepancies between diagnoses [autistic disorder, Asperger’s syndrome (AS), and pervasive developmental disorder-not otherwise specified (PDD-NOS)] on the adaptive behavior profiles on this measure. Differences were hypothesized to correlate with diagnostic intensity (autistic disorder, including the most intense characteristics, followed by AS, and then PDD-NOS). Communication sub-scores of the adaptive behavior scale were expected to be significantly lower for the group with autism than the two other groups. Results: Results indicated significant differences between diagnoses on the adaptability subscale. Differences in cluster score patterns in relation to diagnosis were also observed in the areas of Social Skills and Communication. Interestingly, ratings of the ability to engage in activities of daily living were more often the highest subscale for those with autistic disorder than those with AS or PDD-NOS. Conclusions: The utility of the BASC-2 adaptive behavior scale is discussed in this context.

Background: Tension type headache is the most widespread and most common primary headache disorder accounting for nearly 90% of all headaches. Efficacy of electromyography biofeedback in patients with tension type headache has been proven but efficacy of galvanic skin resistance biofeedback has not been studied adequately. The aim of the present study was to compare the efficacy of electromyography biofeedback and galvanic skin resistance biofeedback in patients with tension type headache. Methods: We performed a randomized single blinded controlled study. Out of 116 recruited subjects, 91 (59 females and 32 males) were randomly assigned to three groups receiving electromyography biofeedback (n=30), galvanic skin resistance biofeedback (n=30), and a control group (n=31). Each subject (except the control group) received 15 biofeedback sessions for 30 min each in an isolated room. The control group received only medication prescribed by their physician. Each patient was blinded to the type of biofeedback being given. Pain variables, SF-36 quality of life scores, and analgesic usage were recorded at baseline, 1 month, 6 months, and 1 year after therapy. Results: There was a significant difference in frequency and duration of headache in electromyography and galvanic skin resistance groups (p<0.01), whereas the control group showed significant differences in intensity (p=0.05) and duration (p<0.001). Significant improvement was seen only in total SF-36 scores after 1 year in the electromyography and control groups (p=0.03 and p=0.00, respectively). A significant drop in analgesic usage was seen in all groups at 1 year (p<0.001). Conclusions: Electromyography and galvanic skin resistance biofeedback are effective in the treatment of tension type headache, with electromyography biofeedback being more effective than galvanic skin resistance biofeedback.

Background: Poststroke patients need effective rehabilitation because of limitations in activities of daily living (ADLs). The aim of the study was to assess the results of ADL rehabilitation of patients after ischemic stroke who underwent NDT-Bobath therapy for adults method using selected items of the Barthel Index. Methods: The investigated group consisted of 60 patients after ischemic stroke who participated in the program of rehabilitation: 10 sessions of the NDT-Bobath therapy for 2 weeks (10 days of the therapy). The measurement of the ADLs using selected items of the Barthel Index were performed in every patient on admission (before the therapy) and after the last session of the therapy to assess rehabilitation effects. Results: Results among patients involved in the research were as follows: recovery, 30 cases (50%); no measurable changes, two cases (3.33%); relapse, not stated. Conclusions: Observed statistically significant and favorable changes in the health status of patients, described by Barthel Index outcomes, confirm the effectiveness of the NDT-Bobath method.

Background: In many countries, resources are not sufficient to meet the need for the rehabilitation and supportive services of the disabled population. More attention must be focused on them to reduce health inequality in our societies. Methods: A review of case files of patients with disability (n=155) and controls (n=526) at Oluyole Cheshire home, Ibadan, Nigeria from April, 2009 to December, 2010 was conducted using a total sampling method. Results: The three most common groups of illnesses observed among the disabled were plasmodiasis (41.3%), upper respiratory tract infections (14.8%) and trauma following domestic accident and physical abuse (11.6%). Cervical spondylosis and arthralgia were the most common musculoskeletal disorders (OR 4.95, 95% CI 1.95–12.53). The disabled were significantly more likely than the controls to be physically assaulted (OR 6.15; 95% CI 2.84–13.33). Conclusions: The findings from this study demand prompt diagnosis and prevention of malaria, respiratory tract infection, cervical spondylosis, and physical abuse in all disabled patients in our environment.

The time course of recovery from neurologic disorders varies significantly depending on the severity of impairment, therapeutic measures during recovery, and patient characteristics, and no particular method can be perceived as more predominant over others. Traditional neurorehabilitation based on specific intervention techniques can be complemented by an eclectic approach that is based on the stable principles of the methods, is open to development, and can be used in conjunction with the elements of various methods. An eclectic approach in neurorehabilitation has the potential for a greater impact on the impairment because it can be tailored to the individual’s needs, can better predict the outcomes in individual patients with neurologic disorders, is better supported by experienced physiotherapists, and is expected to lead to progress in interdisciplinary therapy and care. The easy deployment of rehabilitation strategies and their applicability across a wide range of motor impairment make the eclectic approach an attractive and efficient solution. Its limitations are measurement reliability (especially inter-rater reliability) and validity, timing of rehabilitation, and the capacity to deliver high-intensity training protocols. The eclectic approach can be an important and useful strategy in neurorehabilitation, and this article discusses the advantages and limitations of current traditional and eclectic neurorehabilitation paradigms and suggest possible research directions.

Angelman syndrome (AS) is a genetic condition characterized by severe mental retardation, ataxic gait, severe speech delay, dysmorphic features, abnormal behavior, and movement disorder. It is caused by a variety of genetic mechanisms that all interfere with the expression of the UBE3A gene on chromosome 15q11-13. The management of AS patients is complex and involves a multidisciplinary approach. Here, we present our experience in the diagnosis and treatment of children with AS.

Background: The aim of this study was to report a patient with complex visual perceptual disturbances and a 30-year history of schizophrenia and alcohol dependence, and to formulate a comprehensive clinical approach to this unique neuropsychiatric phenomenon. Methods: The authors report subjective and objective information from the patient’s past medial history and current admission. The authors also did a comprehensive review of the literature on complex visual hallucinations. Results: Complex visual hallucination is a frightening experience, with a pathogenesis ranging from chronic psychiatric disorders, such as schizophrenia, to acute neurological events, such as cerebrovascular accident. The hallucination content is typically described by patients as vivid with dynamic images, in striking colors and clear contours. The authors report a patient earlier diagnosed with schizophrenia and alcohol dependence disorder who became agitated following a sudden onset of visions of vivid, interactive images of people and animals. Conclusions: Due to the scope of the differential diagnosis, identifying the exact underlying etiology of complex visual hallucinations is often challenging, yet critical, in preventing the high risk of morbidity and mortality associated with some of the root causes of this neuropsychiatric phenomenon.