Disabilities doi: 10.3390/disabilities6030054

Authors: Urban Schwegler Mahesh Sarki George Austin-Cliff Albert Marti Martin W. G. Brinkhof

Vocational integration (VI) services aim to support sustainable employment for persons with disabilities. However, in individuals with spinal cord injury, evidence on effective intervention targets and the evaluation of sustainable integration remains limited. The Work–Life Study aims to build an evidence base for supporting sustainable employment in Switzerland by (1) identifying typical work–life trajectories; (2) examining key work–life transitions and their predictors; (3) establishing a multi-state model for intervention targets; (4) exploring individual work–life narratives; and (5) developing guidelines for personalized VI practice. The study combines a mixed methods design with a collaborative Integrated Knowledge Translation approach, actively involving VI professionals and individuals with spinal cord injury. Participants are recruited from the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Work–life history data are collected through a Biographical Survey and Biographical Interviews and analyzed alongside SwiSCI data. Guideline development includes a stakeholder meeting with representatives from the Swiss Paraplegic Group, spinal cord injury clinics, individuals with spinal cord injury, employers, and disability insurers. Of 2041 eligible SwiSCI participants, 478 (23.4%) completed the Biographical Survey (median age 57.5 years; median time since injury 19.1 years), with responders and non-responders showing comparable characteristics. Work–life data closely matched existing SwiSCI data (rho > 0.8), indicating good recall. The resulting guidelines will help VI providers coordinate rehabilitation services to optimally promote sustainable employment for individuals with spinal cord injury.

Disabilities doi: 10.3390/disabilities6030053

Authors: Brenda Sánchez-Sánchez Pablo A. Cantero-Garlito

Introduction: Increased life expectancy and the growing prevalence of disability have led grandmothers and grandfathers to assume a significant role in the care of grandchildren with disabilities. However, their experiences have been scarcely explored from a qualitative and occupational perspective. Objective: To examine the experiences of grandmothers and grandfathers in relation to their participation in caregiving tasks for grandchildren with disabilities. Methods: A qualitative exploratory study framed within a constructivist–interpretive paradigm was conducted. Eleven grandparents of children with disabilities participated and were selected through criterion-based purposive sampling complemented by snowball recruitment. Data were collected through flexible semi-structured interviews and a field diary and were analyzed using inductive thematic analysis. Results: Three main themes emerged: (1) caregiver time, characterized by constant availability and occupational reorganization; (2) emotional impact, with predominant feelings of satisfaction, fulfillment, and strengthening of the emotional bond; and (3) adaptation to change, described as a progressive process of learning, acceptance, information seeking, and negotiation of family roles. Conclusions: The caregiving experience profoundly transforms the daily lives of grandmothers and grandfathers, constituting a highly demanding yet meaningful occupation. The findings highlight the need to recognize their role within the family system and to incorporate an occupational perspective into the support provided to this population.

Disabilities doi: 10.3390/disabilities6030052

Authors: Monica Pinilla-Roncancio Marco Stampini Natalie Vanessa Schwarz

Approximately 16 per cent of the global population lives with a disability. Although there are no definitive figures, it is certain that a higher proportion of people with disabilities are poor compared with people who are living without disabilities. In the case of monetary poverty, evidence for their levels of poverty is not conclusive; however, it is well known that people with disabilities face direct and indirect costs associated with their condition, and therefore their levels of income and consumption are lower in comparison with those of persons without disabilities; but in some cases, monetary poverty lines do not capture those differences. This study aims to analyse the levels of poverty of people with disabilities after computing an equivalence scale to capture the needs of people with disabilities and their families. To achieve this objective, we used the Income and Expenditures Survey 2022 (ENAHO-2022) from Peru. We first tested whether the current poverty line in Peru captures the needs of people with disabilities. Then we analysed the consumption patterns of households with and without members with disabilities. Finally, we proposed to adapt the national poverty line for Peru using an equivalence scale that captures the extra costs of living with a disability in Peru. Using this equivalence scale, we recalculated the poverty rate for households with disabilities. The results revealed that the presence of a member with a disability in the household reduces household income and consumption. The estimation of the equivalence scale showed that a household of one member was equivalent to a household with two members without disabilities. When recalculating the incidence of poverty, the percentage of households with disabilities living in poverty increased from 35% to 50% or 760,000 people with disabilities and their families became poor.

Disabilities doi: 10.3390/disabilities6030051

Authors: Angela Gordon Laura Fox Kathryn Asbury

Autism is a neurodevelopmental condition that is often characterised by differences in social communication, sensory processes, and cognition. Due to the underdiagnosis of autism in women and girls, their voices are often missing from research, limiting our understanding of their experiences at school. This study addressed the gap around the factors which impacted women’s late and/or pre-diagnosed experiences of school by using semi-structured interviews with ten autistic women; among them, eight were diagnosed after school. The interviews were analysed through reflexive thematic analysis. Three themes and areas of insight were constructed from the data: (1) The impact of social norms on peer relationships. (2) We found ways of coping, but at what cost? (3) How schools could help someone like me. The findings show that all women in the study had negative school experiences, with diagnosis during school also being linked to identity and mental health difficulties. Schools should enhance pastoral support, foster positive relationships, improve communication, and use strengths-based approaches to improve outcomes for autistic girls. Proactively adopting neuroaffirming modifications may improve support during autistic girls’ formative years, leading to a lasting impact on their lives. This is particularly important for autistic girls, who face marginalisation on two levels: neurotypical expectations for females and stereotyped expectations of autism. The implications of these findings are discussed with suggestions for future research and practical implementations within mainstream school settings.

Disabilities doi: 10.3390/disabilities6030050

Authors: Antti Teittinen

Inclusion has become a central concept in disability policy, education, and welfare state reform, yet its practical implementation remains ambivalent. While inclusion is promoted as a rights-based ideal grounded in equality, it can also function as an administrative label that obscures persistent exclusion. Drawing on critical disability studies, this article analyses inclusion as a contested, power-laden concept and develops a three-stage framework—access, participation, and agency—to distinguish formal inclusion from substantive belonging and influence. The framework is applied to key domains of disabled people’s lives—education, housing, service systems, working life, crises, and digitalised everyday life—showing how ableist norms, managerial governance, and institutional logics can reproduce exclusion within ‘inclusive’ reforms, including forms of transformed institutionalisation. The article argues that meaningful inclusion requires dismantling ableist norms, addressing structural power relations, resourcing supports, and strengthening disabled people’s agency in decision-making.

Disabilities doi: 10.3390/disabilities6030049

Authors: Marios Adamou Niki Kyriakidou Sarah Lobley

Objective: To analyse the rhetorical strategies employed in formal complaints regarding adult Attention Deficit Hyperactivity Disorder and Autism assessments, specifically where no service failure was identified. Methods: A rhetorical analysis was conducted on 48 complaints determined to be not upheld overall, submitted to a UK NHS Trust between 2024 and 2025. Results: Complainants demonstrated high rhetorical sophistication, frequently deploying a “Triple Core” strategy: Causal Attribution (blaming the service for life failures), Emotional Impact Description (framing dissatisfaction as medical trauma), and Procedural Challenge (alleging administrative breach). A minority (18.8%) employed economic arguments, whilst 81.2% included specific outcome demands, such as a prescription or a specific diagnosis. Conclusions: Complaints in this area of clinical practice demonstrate sophisticated rhetorical construction, functioning as instruments of organisational pressure. The “Triple Core” strategy creates an epistemic conflict where clinical judgement is contested by the patient’s lived experience narrative. These findings suggest that high complaint volumes may reflect a systemic gap between public expectation and clinical criteria rather than safety failures.

Disabilities doi: 10.3390/disabilities6030048

Authors: Matthijs A. Heijstek Vanessa C. Olivier-Pijpers Eline E. Roelofsen Lex Wijnroks Marian J. Jongmans

Stress is increasingly recognised as a key factor underlying health and behavioural problems in people with intellectual disabilities. However, little is known about chronic stressors embedded in residential care environments. This study aimed to identify chronic stressors in residential care for people with intellectual disabilities from the perspective of stakeholders. A group concept mapping design was used, combining qualitative data generation with quantitative clustering analyses. Direct support workers, family members, and experts by experience generated statements describing situations perceived as stressful in residential care settings. After data cleaning, 125 unique statements were retained. Participants subsequently clustered and rated these statements on frequency, impact, and controllability. Thirty-eight statements were identified as daily stressors with high frequency and impact. Ward’s hierarchical cluster analysis grouped the statements into eight clusters representing broader conditions within residential care environments. Several clusters contained multiple high-frequency, high-impact stressors and were therefore interpreted as potential chronic stressors. These clusters reflected structural characteristics of residential care, including dependence on support staff, limited autonomy, and shared living environments. Identifying chronic stressors provides a framework for studying chronic stress in people with intellectual disabilities and may inform organisational and environmental interventions aimed at reducing exposure to such stressors.

Disabilities doi: 10.3390/disabilities6030047

Authors: Jacob Adams Byron Lai James Rimmer Danielle Powell Aviya Khan Robert A. Oster Gordon Fisher

Purpose: Recent studies have shown that high-intensity interval training (HIIT) can improve cardiometabolic health in individuals with spinal cord injury (SCI); however, many barriers remain for individuals with spinal cord injury to participate in exercise such as lack of time, accessible equipment and facilities, and transportation. The use of telehealth interventions may be a form of exercise delivery that can ease the burden on the participant and lead to greater exercise participation. Thus, the purpose of this study was to determine the feasibility and efficacy of a home-based telehealth HIIT arm crank exercise training program for individuals with spinal cord injury. Methods: Participants were randomly assigned to 16 weeks of telehealth HIIT arm crank exercise training or a no-exercise control group. Body composition, resting energy expenditure (REE), blood lipids, insulin sensitivity, blood pressure, aerobic capacity (VO2 max), and a qualitative interview were assessed at baseline and at 16 weeks post intervention. Results: Six individuals (four male and two female, mean age 52.7 ± 10.2 years) with spinal cord injury were recruited for this study. Four out of five HIIT participants showed improvements in aerobic capacity, insulin sensitivity, and resting energy expenditure. Three qualitative themes emerged: (1) convenience and perceived benefits were critical elements of engagement; (2) high-intensity exercise elicited time-sensitive responses; and (3) trainers played a key role in promoting strong program adherence. Conclusions: Overall, we found that this program could be easily implemented and per-formed at home in individuals with spinal cord injury. We also found that participants enjoyed the 1:1 training sessions with a telecoach and that the intervention was easy to adhere to, as demonstrated by participant attendance. There is a need for future randomized controlled trials to determine the efficacy of telehealth exercise training for improving cardiometabolic health in spinal cord injury.

Disabilities doi: 10.3390/disabilities6030046

Authors: Martina Gnazzo Giuditta Bargiacchi Maria Esposito Rosa Passerini Emanuela Varriale Francesco Cerroni Eva Germanò Agata Maltese Lucia Parisi Michele Roccella Giulia Spoto Gabriella Di Rosa Rita Barone Lidia Scifo Beatrice Gallai Annamaria Maddalena Terracciano Marco Carotenuto

Background: Autism Spectrum Disorder (ASD) is characterized by social communication deficits, restricted/repetitive behaviors, sensory processing atypicalities, and impaired adaptive functioning. Neuropsychomotor Therapy of Early Development (TNPEE) integrates motor, cognitive, and socio-emotional domains, promoting functional skills, while Therapy in Aquatic Motor Activities (TAMA) targets motor and sensory engagement. This multicenter, 18-month study compared TNPEE, TAMA, and their combination, hypothesizing that TNPEE would drive core symptom and adaptive improvements, with TAMA providing complementary benefits. Methods: Seventy-seven children with Autism Spectrum Disorder (31.6% females) were recruited from four Italian centers (Palermo, Perugia, Sarno, Messina) and allocated to three groups: TAMA only, TNPEE combined with TAMA, and TNPEE only. Assessments included the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), the Childhood Autism Rating Scale, Second Edition (CARS-2), Vineland Adaptive Behavior Scales, Sensory Processing Measure and HAARS at baseline, 6, 12, and 18 months. Results: By 18 months, children receiving TNPEE, alone or combined with TAMA, exhibited significant reductions in autism severity, significant improvements in adaptive functioning, and enhanced sensory processing. In contrast, the TAMA-only group demonstrated improvements in aquatic competence (HAARS) but no statistically significant changes in ASD severity or adaptive functioning. Conclusions: TNPEE was the intervention most consistently associated with improvements in ASD severity, adaptive functioning, and sensory processing, whereas TAMA alone showed a more limited impact on broader developmental outcomes.

Disabilities doi: 10.3390/disabilities6030045

Authors: Tone Ristad Sissel Horghagen Jørn Østvik Lisbeth Kvam Aud Elisabeth Witsø

Despite the known benefits of workforce participation, many individuals with disabilities remain excluded. This exploratory study utilises selected analytical tools from constructivist grounded theory to investigate how 46 diverse stakeholders perceive disability during the transition from higher education to employment. Additionally, it examines how these perceptions influence efforts toward inclusion and the advice given regarding disability disclosure. Six workshops were conducted to facilitate dialogue on pathways to work for students with disabilities. The constructivist approach to analysis leads to the development of several concepts that capture stakeholders’ perspectives on disability, their strategies for promoting inclusion, and their recommendations regarding disclosure. Disabilities are conceptualised as an asset, a liability, or as insignificant. The views of disability as an asset or a liability influence advocacy strategies and disclosure recommendations, ranging from celebrating to concealing. These attitudes also shape how individuals who disclose disabilities are perceived. Society often expects people with disabilities to disclose their conditions to promote inclusion, even though performing such can involve risks like stigma and exclusion. At the same time, employers share responsibility for creating inclusive environments through universal design and supportive practices. The findings show that both disclosure and concealment can lead to inclusion or exclusion, emphasising the importance of universally designed institutions.

Disabilities doi: 10.3390/disabilities6030044

Authors: Andrew Joyce Perri Campbell Jenny Crosbie Erin Wilson

The Disability Royal Commission in Australia has reinforced concerns that segregated employment settings can increase risks of exploitation, violence and abuse, including within Australian Disability Enterprises (ADEs), strengthening the case for community-based employment options for people with intellectual disability. This qualitative study examined how features of supported employment might inform the design of an inclusive job guarantee (JG) model. Drawing on 77 interviews with supported employees and staff, we identified enabling conditions that support wellbeing and participation (including customised roles, structured routines, peer connection, and holistic support), alongside structural constraints that can limit inclusion and progression. While participants and staff described clear well-being benefits from supported employment, they also highlighted frustrations associated with disconnection from the wider community, low pay, and limited pathways to advancement or transition. Given that transition rates between supported and mainstream employment remain very low, the findings emphasise that any JG model seeking to include people with intellectual disability will need investment in supports and credible transition pathways. This paper concludes by outlining how these design implications intersect with the broader economic logic of unemployment and what an inclusive JG could contribute as part of a wider disability employment reform agenda.

Disabilities doi: 10.3390/disabilities6030043

Authors: Claudia Valderrama-Ulloa Francisco Sanhueza-Durán Nicolás Gálvez Roslyn Bahamondes Leonardo Andrade

Population aging requires residential environments that go beyond basic accessibility. This study theorizes and validates the Accessibility Gap (the divergence between regulatory compliance and the functional lived experience of older adults) using a Multi-Criteria Decision Analysis (MCDA) tool. The research uses a weighted linear aggregation model based on user-centered design and the International Classification of Functioning, Disability, and Health (ICF). Thirty dwellings—apartments, single-story, and two-story houses—were evaluated in Chile’s Metropolitan Region. The model applies 40 indicators, normalized on a 0–100% scale across six dimensions, and weighted by older adults and caregivers. Results reveal fragmented accessibility gap: basic features often meet standards; yet important deficits remain in highly prioritized areas—autonomy, safety, and communication. The Global Performance Index (GPI) identifies “accessibility gaps” that traditional assessments miss. By combining objective metrics with subjective experiences, this study delivers a replicable, evidence-based framework. It shows that specific design choices, rather than architectural configuration, better support functional independence. The MCDA approach provides a robust tool for guiding housing rehabilitation and public policies that support aging in place and ensure homes meet the needs of an aging population.

Disabilities doi: 10.3390/disabilities6020042

Authors: Daryl Patrick Gamboa Yao Delphine Labbé Heather Ansley Peter Athanasopoulos William C. Miller

People with disabilities continue to face significant barriers when flying, despite decades of policies enacted to protect their rights and ensure equitable and dignified access. These challenges are often linked not to a lack of policy but to inconsistencies, fragmentation, and unclear responsibilities across operators and jurisdictions. This review examines international, U.S., and Canadian air travel policies to assess their comprehensiveness, coherence, and alignment across jurisdictions, to promote accessible air travel for travelers with disabilities. We conducted a structured policy review following Arksey and O’Malley’s framework. We systematically identified, selected, charted, and analyzed 28 U.S. policies, Canadian policies, and international guidelines. Policy content was compared using the themes of a scoping review on air travel experiences of people with disabilities and the Disability Policy Lens to examine definitions, aims, and coverage. Findings highlighted substantial variation across jurisdictions in the allocation of responsibilities among actors and the specificity of policy provisions. These variations contribute to uneven interpretation and implementation of accessibility measures, shaping inconsistent travel experiences for people with disabilities. International guidelines have the potential to serve as an important reference point, but currently lack comprehensiveness. There is a need for greater cross-jurisdictional coherence in air travel policies.

Disabilities doi: 10.3390/disabilities6020041

Authors: Derek M. Zike Robin S. Vealey Monna Arvinen-Barrow

This study aimed to explore athletes’ experiences of transitioning out of sport following spinal cord injury (SCI). Using a multiple-case study design, three former nondisabled competitive athletes participated in one-on-one semi-structured interviews. The participants’ interview responses were informed by quantitative measure data collected prior to the interviews using the Athletic Identity Measurement Scale, the Social Support Questionnaire-6, and the Satisfaction with Life Scale. The thematic analysis of the interviews revealed that participants experienced a range of cognitive, emotional, social, and behavioral influences during the transition process. These influences contributed to outcome-related appraisals of post-SCI transition. Balanced self-identity, adaptive sport participation, and peer-mentor relationships were common factors influencing athletes’ transition with spinal cord injury. The results partially support the conceptual model of adaptation to career transition and extend it to account for athletes’ experiences following SCI. The results also benefit rehabilitation professionals and athletes with spinal cord injury by providing insight into psychosocial factors and resources that may influence the transition experience.

Disabilities doi: 10.3390/disabilities6020040

Authors: James Rimmer Victoria Christian Raven Young Stephanie Ward Pooja Arora Phuong Quach Byron Lai

Background: Adults with disabilities living in low-resource communities experience persistent inequities in access to healthcare, mental health services, and community participation. However, qualitative data capturing lived experiences in the Deep South remain limited. This study aimed to identify priority needs among adults with mobility disabilities residing in economically distressed communities near Birmingham, Alabama, to inform future telehealth programming. Methods: Fifteen adults (mean age = 60 ± 10 years), predominantly African American and female, completed semi-structured phone interviews exploring basic needs, neighborhood accessibility, health priorities, and perceived supports. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s six-phase thematic analysis. Results: Five themes emerged: (1) seeking stability amid severe mental health strain and inadequate supports; (2) constrained food environments shaped by cost, location, and safety; (3) feeling forgotten: systemic neglect and restricted participation in community life; (4) physical health deprioritized by competing needs and structural barriers; and (5) remote support as a viable but unrealized option. Participants described how safety concerns, transportation barriers, and rising food costs constrained daily functioning, while unmet mental health needs compounded isolation. Despite widespread cardiometabolic disease, immediate needs related to mental health, food, and housing consistently superseded physical health. Mental health support was identified as the most feasible area for remote delivery, though poor awareness of available resources limited engagement with any service model. Conclusions: Findings demonstrate that disability-related disparities in low-resource communities are driven largely by structural and environmental factors rather than individual choice. Telehealth and mobile-based services may provide a feasible access strategy for mental health and supportive care in under-resourced settings, particularly when integrated with broader community supports. Addressing foundational needs is essential for advancing health equity among people with disabilities in the Southeast.

Disabilities doi: 10.3390/disabilities6020039

Authors: Judith Baart Willem Elbers

International agreements require reducing and eliminating the exclusion faced by persons with disabilities. Achieving this goal depends on having reliable data on persons with disabilities, yet a wide variety of instruments are used to identify who is counted as disabled. This literature review aims to investigate different approaches to disability identification in terms of the prevalence rates they produce, the population they capture, and their defining characteristics. We searched five databases and identified fifteen studies conducted in an international development context. The results show that prevalence estimates and populations vary considerably across instruments. We inductively identify four main approaches to disability identification and discuss key characteristics of each. The results reiterate that there is no ‘gold standard’ for identifying disability; there are multiple conceptualizations of what disability is, each reflected in different instruments and assumptions. Promoting greater reflexivity amongst practitioners can foster transparency and accountability in data collection and use.

Disabilities doi: 10.3390/disabilities6020038

Authors: Edy Quizhpe Carolina Puente Gabriela Valverde Andrés Guerra Liseth Luzuriaga Fredinah Namatovu Miguel San Sebastián

In 2007, Ecuador ratified the United Nations Convention on the Rights of People with Disabilities and introduced a national social programme to improve access and quality of life for people with disabilities. This study assessed disability prevalence and socioeconomic inequalities in three social protection outcomes: household visits, benefits received during visits, and official disability accreditation. A cross-sectional study analysed data from the 2014 national population-based survey, which showed a 3.84% disability prevalence. Overall, 37% of respondents reported at least one household visit among them, 77% received a benefit and 60% had official accreditation. Marked socioeconomic disparities expressed in absolute differences were observed. Visits were less frequent among individuals without formal education (AD: −30.41; 95% CI: −37.15, −14.09) and those in the poorest households (AD: −17.74; 95% CI: −23.01, −12.48). Participants with primary education were less likely to receive benefits (AD: −19.51; 95% CI: −32.83, −6.19), while Afro-Ecuadorian (AD: 20.07; 95% CI: 4.20, 35.95) and Indigenous individuals (AD: 19.61; 95% CI: 6.99, 32.24) were more likely to receive them. Conversely, those with basic education (AD: 21.38; 95% CI: 13.53, 29.23) were more often accredited than those with higher education. Although the programme has reached many individuals, access remains unequal.

Disabilities doi: 10.3390/disabilities6020037

Authors: Ahsan Romadlon Junaidi I Nyoman Suputra Buyung Adi Dharma Andi Basuki Nor Laili Afis Baghiz Syafruddin

Career assessment instruments for children with special needs are not fully inclusive and precise. This study uses both quantitative and qualitative methods to identify the key problems students face, refine the career matching stages, and assess the desirability, feasibility, and viability of the services developed. This study found that co-design in the preparation and validation of the career matching platform has integrated several aspects, namely people with disabilities’ behavior, interests, and career paths, and has been adjusted to national competency standards, according to the group. The development of this platform uses the Double Diamond approach, including focus group discussions with several extraordinary school teachers across two activities. The existing analysis shows that the fifteen-stage career development model has prepared students for career paths, making it a potential reference for career services for people with disabilities. In addition, implementing a career development model integrated with the platform can make it easier for students to find a job profile that best suits the world of work. The results of this research can be the basis for disability career development policies, programs that bridge students to the world of work, and the formation of an industrial ecosystem that cares more about children with special needs.

Disabilities doi: 10.3390/disabilities6020036

Authors: Maria-Leticia Meseguer Felix-Manuel Vargas Francisco-Ramon Sanchez-Alberola

One of the main focuses of social innovation is the fight for social inclusion for all. The prevalence of violence against women with disabilities shows how the lack of recognition of diversity hinders real equality for these individuals. This violence is a structural problem that is caused by a combination of gender and disability dynamics, the perpetuating inequalities and social exclusion. Researchers have analyzed specific vulnerabilities in the areas of work, education and health, and point out that only by addressing diversity can we overcome the consequences of such discrimination. Using a qualitative methodological approach, this study utilized critical documentary analysis and a thematic review of recent scientific, academic, and institutional literature, alongside empirical data, to identify the most prevalent forms of violence faced by women with disabilities: sexual (affecting up to 80% of women with disabilities), economic (with wage gaps exceeding 24%), and institutional (a lack of accessibility to basic services). The barriers hindering these women’s access to resources and services are also highlighted. The results point to the urgent need to develop innovative public policies and social strategies that value social diversity as a driver of change. This study concludes with specific recommendations for implementing inclusive approaches that promote equality, universal accessibility, and comprehensive protection in order to move toward more just, cohesive, and innovative societies.

Disabilities doi: 10.3390/disabilities6020035

Authors: Leonie Lena Maria Johanna Snijders Carla Francina Johanna Nooijen Nathan Bray

Background: The Mobility and Quality of Life-7 Dimension (MobQoL-7D) is a new patient-reported outcome measure for mobility-related quality of life. Our aim was to translate and test a Dutch-language version. Methods: A cross-sectional psychometric evaluation study was undertaken. The sampling frame was community-dwelling adults living in the Netherlands who had a long-term (>6 months) mobility impairment. Participants were recruited through a Dutch research agency, and data were collected via online survey. Statistical and psychometric analyses were undertaken to assess the interpretability, validity and reliability of the MobQoL-7D Dutch, including assessment of missing data, floor/ceiling effects, test–retest reliability, structural validity, known-group validity and convergent validity. Results: n = 308 respondents completed the survey; sub-group sample sizes ranged from n = 29 to n = 87. No issues with missing data were found. Despite ceiling effects per item (ranging from 23.1% to 56.5%), there were no floor/ceiling effects for overall index values (12.3% and 0%, respectively). The findings show excellent test–retest reliability of the index value over a two-week period (n = 37; ICC = 0.95), and potential discriminative ability to detect differences between known groups. Factor analyses confirmed unidimensionality. Conclusions: The results provide promising evidence of the validity and reliability of the MobQoL-7D Dutch; further research is needed to confirm these findings.

Disabilities doi: 10.3390/disabilities6020034

Authors: Shooroq Maberah Mohammed Abu Al-Rub

Digital transformation has profoundly reshaped caregiving practices, yet its influence on family cohesion within disability contexts remains underexplored, particularly in Arab societies. This qualitative phenomenological study examines how digital technologies shape family cohesion among Jordanian caregivers of children with disabilities. In-depth, semi-structured interviews were conducted with 22 primary caregivers, and data were analyzed using reflexive thematic analysis. The findings reveal a central tension of being “between connectivity and care,” articulated through four interrelated themes: (1) a digital double-bind in which online support networks function as a vital “virtual village” while simultaneously contributing to intra-familial fragmentation; (2) the reconfiguration of care labor, whereby digital management emerges as an invisible and gendered form of caregiving work, often positioning mothers as primary digital coordinators; (3) the translation of traditional social capital (wasta) into digital spaces to navigate systemic resource constraints, producing new moral and emotional burdens; and (4) the strategic use of digital platforms to preserve cultural, religious, and familial identity in the face of stigma, thereby reinforcing internal cohesion. These findings suggest that digital technologies do not merely facilitate connection but actively reconfigure family dynamics through ongoing negotiation between support and strain. The study underscores the need for family-centered digital inclusion policies and support interventions that mitigate digital burdens while harnessing technology’s potential to strengthen culturally grounded resilience among families of children with disabilities.

Disabilities doi: 10.3390/disabilities6020033

Authors: Sabastain Gunda Allan Ndadzungira Sipho Sibanda Mahesh Chougule

Caring for children with physical disabilities can be a daunting responsibility, often placing significant financial, psychological, social and health-related strains on the primary caregivers. This qualitative study explored the experiences of caregivers caring for children with physical disabilities in the Hardap region of Namibia. Using purposive sampling, twenty caregivers were selected as participants in the study. Data was collected using semi-structured interview schedules. Following the interviews, the data were manually analysed and categorised into distinctive themes and sub-themes and summarised in the final report as verbatim quotations. Study findings reveal that caregivers are motivated and determined to provide optimum care for children with physical disabilities under their care by acquiring assistive devices for them and assisting the children with activities of daily living. However, poverty and the general shortage of assistive devices, mostly wheelchairs, provide adverse conditions that are inimical to the development of children’s functional independence in daily living tasks. The burden of carrying the children was noted to be potentially deleterious to the caregivers’ physical health. The study concluded that providing assistive equipment for the children will ease the caregivers’ burden of care while equalising socioeconomic opportunities for both children with physical disabilities and their caregivers. The study only covered a small sample size in a small geographical area of Namibia. Therefore, interpretation and generalisation of the findings need to account for the specific context in the Hardap region of Namibia. Therefore, there remains scope for conducting further research with a larger sample size and one that is more geographically representative of Namibia.

Disabilities doi: 10.3390/disabilities6020032

Authors: Jovana Uzelac Sandra Glamočak Vesela Milankov Mirjana Đorđević Špela Golubović

Parents’ priorities significantly influence decisions regarding their children’s support, reflecting parental attitudes, knowledge, and experiences. This research aimed to identify parents’ priorities when choosing professional support for their children, examine the link between these priorities and children’s current abilities, and examine which developmental domains children receive professional support and whether these domains align with parental priorities. The sample consisted of 82 parents of children aged three to six years, divided into two groups: 41 parents of children with developmental disabilities and 41 parents of children without. All participants completed a Treatment Priorities Questionnaire (TP). The results showed that parents of children with developmental disabilities prioritize Communication skills, Social relationships, and Pre-Academic skills. In contrast, parents of children without developmental disabilities focus on Self-Care and Pre-Academic skills. These priorities often relate to the child’s areas in need of improvement. While children with developmental disabilities receive appropriate support, those without often do not receive support in the areas their parents prioritize. This highlights the need for parents to also recognize and build on their child’s strengths, creating a more balanced approach to their development.

Disabilities doi: 10.3390/disabilities6020031

Authors: Mariasole Antonietta Guerriero Giovanni Messina Emilia Florina Grosu Rita Polito Marcellino Monda Antonietta Messina Antonella De Maria Gianluca Russo Valentin Alexandru Enache Maria Ruberto Nicola Mancini Fiorenzo Moscatelli

Background: Children and adolescents with hearing loss frequently experience reduced participation in physical activity and impairments in balance and postural control, often associated with vestibular dysfunction and altered sensory integration. In this context, school-based motor interventions may represent an accessible strategy to support functional balance. The present study investigated the effects of a 12-week dance- and rhythm-based motor programme implemented within the school curriculum on static and dynamic balance in students with hearing loss. Methods: Twenty-five participants were randomly allocated to an experimental group (n = 15), which received the intervention in addition to standard curricular activities, or to a control group (n = 10), which continued with regular school-based physical activity only. Balance was assessed at baseline and post-intervention using stabilometric measures under eyes-open and eyes-closed conditions and the Pediatric Reach Test. Results: Stabilometric outcomes showed mixed patterns: improvements over time were observed in both groups under eyes-closed conditions, whereas under eyes-open conditions greater reductions in sway were detected in the control group. A significant Group × Time interaction emerged exclusively for backward reach performance and for the composite balance score, indicating a relative preservation of posterior dynamic balance and a more favourable multidimensional adaptation in the experimental group. Conclusions: These findings suggest that dance- and rhythm-oriented motor activities integrated into school settings may support specific, functionally relevant components of balance in students with hearing loss, although the results should be interpreted with caution due to the small sample size and the heterogeneity of the participants.

Disabilities doi: 10.3390/disabilities6020030

Authors: Bérangère Naudé Nolwenn Lapierre Krista Best Diana Lim Marie Malouin Nathalie Rhéaume Jacques Laberge François Routhier

People with special needs often face barriers to participating in adapted outdoor leisure physical activities. A participatory action research project involving a nonprofit organization, a citizen with motor disabilities, and researchers aimed to co-develop a digital platform connecting people with special needs interested in outdoor leisure physical activities with trained volunteers. The adopted co-design methodology followed four stages: (1) Exploration (identifying users’ needs and preferences), (2) Co-design (defining key information and platform features), (3) Validation (prioritizing features), and (4) Development (implementing and testing the platform). This article focuses on stages 2, 3, and 4. During stage 2, key information and features were identified to support matching people with special needs and volunteers and informing users about adapted outdoor leisure physical activities. In stage 3, these elements were prioritized using eight key considerations, including technological (e.g., ease of use), environmental (e.g., avoiding redundancy with existing initiatives), organizational (e.g., availability of human resources), and financial factors (e.g., grant planning). Stage 4 resulted in the launch of Tandem Actif, followed by user testing to document user experience and guide improvements. This article details the application of co-design within a participatory action research project aimed at promoting safe, ethical, and accessible participation in outdoor leisure physical activities for people with special needs.

Disabilities doi: 10.3390/disabilities6020029

Authors: Babra Duri

Public transport is vital for social and economic life, but many people with disabilities still face exclusion due to both physical and psychosocial barriers. This study examined how psychosocial barriers influence public transport travel behavior among people with mobility, vision, and hearing disabilities in the City of Tshwane, South Africa. A quantitative survey was conducted using a structured questionnaire among 214 respondents. The results showed that fear of crime, lack of personal safety, anxiety when travelling alone or to unfamiliar places, and negative treatment by drivers and co-passengers are major deterrents to public transport use. Psychosocial barriers were significantly associated with travel behavior and a strong preference for private cars as well as ride-hailing services. Group comparisons revealed that individuals with vision disabilities experience significantly higher levels of transport-related fear compared to other groups. People with mobility and vision disabilities are more affected by negative attitudes from co-passengers compared to people with hearing disabilities. Psychosocial barriers are associated with low trip frequencies for non-essential activities, indicating suppressed travel. The study concludes that achieving inclusive urban mobility requires addressing psychosocial barriers alongside physical accessibility to ensure safe, dignified, and independent travel for people with disabilities.

Disabilities doi: 10.3390/disabilities6020028

Authors: Ginny S. Paleg Álvaro Hidalgo-Robles Pragashnie Govender Hércules Ribeiro Leite Riclef Schomerus Putri (Dani) Abdullah Roslyn W. Livingstone

A recent umbrella review evaluated evidence-based interventions for children with developmental central hypotonia, including those with Down syndrome. Motor, sensorimotor, orthotics, positioning, mobility, and infant massage interventions are supported by positive but low- or very-low-quality evidence. Using a retrospective case report format, these interventions are described, and their proposed mechanism of action is examined through the F-words lens tool and from the perspective of the parent. Tummy time, compression garments, early supported sitting for grasp and reach, ON-Time use of a supported stepping device, and orthotics are all used in the context of coaching in natural environments and family-centered care.

Disabilities doi: 10.3390/disabilities6020027

Authors: Melissa N. Savage Andrew M. Colombo-Dougovito Farwa Kelly

While many benefits exist from regular engagement in physical activity (PA), adults with intellectual and developmental disabilities often do not engage in the recommended levels of PA needed to access those benefits. Barriers, such as a lack of accessible environments or knowledgeable support staff, have been shown to limit participation in PA. This study used an explanatory sequential mixed methods approach to, first, examine the quantitative fitness outcomes of 31 adults with intellectual and developmental disabilities enrolled in an adapted fitness program, followed, second, by inspecting qualitative field observations of fitness classes and interviews with their fitness instructor for possible explanations of the earlier findings. Quantitatively, there was a significant reduction in body mass index after 12 months of participation, while additional fitness outcomes (such as situps and balance) were maintained. Qualitative findings from conducted field observations and interviews provided a possible rationale for these quantitative outcomes. Five themes were generated: (1) personalized goal setting; (2) progressive challenge; (3) safe and flexible environments; (4) connection and belonging; and (5) celebration of progress. These findings, in total, highlight the importance of building capability, providing opportunities, and incorporating motivational strategies to ensure that adults with intellectual and developmental disabilities can achieve positive outcomes from PA engagement.

Disabilities doi: 10.3390/disabilities6020026

Authors: Yukiko Kumazawa Kyoko Terada Ayako Satonaka Michio Wachi Noriyuki Kida

Wheelchair provision remains an essential component of rehabilitation and participation support for children with disabilities, yet there is limited evidence on how wheelchairs are incorporated into daily activities and schooling decisions in rural low-resource contexts where environmental, social, and service constraints are substantial. This study employed a strictly exploratory multiple case study design involving two children with disabilities. Two home visits were conducted for each case, and a qualitative, descriptive cross-case analysis was conducted by integrating semi-structured interview data with WeeFIM scores and ICF Environmental Factors ratings. Wheelchair provision supported short-distance mobility and engagement in household and community activities and reduced some caregiving demands. Positive experiences during outdoor mobility and community interactions contributed to enjoyment and confidence. However, inaccessible housing, limited transportation, and family concerns about safety and readiness continued to inhibit broader independence and school enrollment. Both children remained outside formal schooling, while activities offered by Special Education Centers provided meaningful but limited opportunities for social interaction and development. The findings highlight not only practical implications but also the conceptual importance of environmental constraints and the ambivalent role of family support in shaping participation in rural settings.

Disabilities doi: 10.3390/disabilities6020025

Authors: Patricia Solís García Alejandra Barreiro-Collazo Irlanda Armijos Sara Real Castelao

Educational inclusion remains a global challenge, with teachers’ attitudes toward disability being crucial for the implementation of inclusive classroom practices. This study compares the attitudes toward disability of 252 teachers from Spain and Ecuador, two countries whose educational systems promote inclusion but differ in the maturity of their legislative and institutional frameworks. The aim was to examine cross-national differences in attitudes and analyze how personal and professional variables relate to these attitudes. A descriptive, observational, cross-sectional design was used. Data were collected through an online administration of the Attitudes Toward Persons with Disabilities Scale, Form G via non-probabilistic. The instrument assesses five attitudinal dimensions: capacity assessment, rights recognition, personal involvement, generic rating, and role assumption. Results showed that Spanish teachers reported significantly more positive attitudes than Ecuadorian teachers in all dimensions except role assumption. Among sociodemographic and professional variables, only Early Childhood Education training and prior experience working with individuals with disabilities consistently correlated with more favorable attitudes, while age and teaching experience demonstrated weak and inconsistent associations across countries. These findings underscore the influence of cultural, educational, and institutional contexts on teachers’ attitudes toward disability and highlight the need to reinforce both initial and ongoing preparation in inclusive education. Strengthening structured practicum experiences, socio-emotional competencies, and inclusion-focused coursework may contribute to more positive attitudes, while adapting training policies and inclusive practices to each country’s cultural characteristics is essential for effective and sustainable implementation.

Disabilities doi: 10.3390/disabilities6020024

Authors: Lazar Stefanović Delia Ferri

In the European Union (EU), cultural participation is recognised both as a human right and as a key factor in fostering a shared European identity. To promote access to culture, the EU has launched several initiatives, including the European Heritage Label (EHL), which aims to highlight heritage sites of symbolic significance for Europe. This article discusses how accessibility for persons with disabilities features in the EHL. It does so further by outlining the international obligations undertaken by the EU to promote participation in culture and ensure accessibility, particularly under the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Drawing on a document analysis of key legal and operational EHL texts, the article demonstrates that accessibility is only partially integrated into the initiative and is weakly prioritised in both the site selection and monitoring processes. While self-reporting by the EHL sites on accessibility has improved in recent years, the measures adopted tend to be limited in scope and depth. Overall, the article calls for a stronger and more systematic integration of accessibility requirements within the EHL framework, as well as for the meaningful involvement of organisations of persons with disabilities in assessing and monitoring the accessibility of EHL sites.

Disabilities doi: 10.3390/disabilities6020023

Authors: Wejdan T. Albladi Mona F. Sulaimani Nizar H. Bagadood

Sex education for students with autism spectrum disorder in Saudi Arabia remains limited and underdeveloped, raising concerns related to safety, body awareness, and healthy personal development during the school years. This qualitative study employed semi-structured interviews with four teachers and three family members and was analyzed using thematic analysis. Participants discussed school-aged autistic children educated in mainstream inclusive settings alongside peers with diverse learning profiles. All students referenced were verbally communicative, and some were reported to have co-occurring developmental or behavioral conditions. The findings revealed key challenges, including heightened vulnerability to harassment, limited understanding of bodily boundaries, and difficulties related to personal hygiene and privacy. Participants also identified substantial gaps in existing curricula, inconsistent teacher preparation, and limited access to guidance for families, resulting in fragmented approaches to sex education. The findings highlight the urgent need for culturally responsive, developmentally appropriate sex education curricula, targeted professional development for teachers and families, and strengthened collaboration between home and school. Such efforts are essential to promote safety, well-being, and protection for autistic students within the Saudi educational context.

Disabilities doi: 10.3390/disabilities6020022

Authors: Manuela Arias Campos Markus Gebhardt Andreas Gegenfurtner

Teacher training should promote a social understanding of disability to support effective inclusive practices and reduce barriers. This study surveyed 150 pre-service primary and secondary teachers at one German university using a mixed-methods design to examine their attitudes toward inclusive education and their agreement with the social model of disability. It was found that participants held neutral to slightly positive attitudes toward inclusion and partially agreed with the social model of disability. Structural equation modeling revealed that social contact, even if limited, influenced the agreement with the social model of disability, but not the attitudes toward the inclusion of pupils with special educational needs in mainstream schools (CMIN/df = 1.50, CFI = 0.96, IFI = 0.96, TLI = 0.94, RMSEA = 0.06). Interview data showed that participants have concerns about working with these pupils, citing a lack of training in special education and inclusive practices.

Disabilities doi: 10.3390/disabilities6010021

Authors: María Luján Rubio Ana María Rojo López Marina Ramos Caro Konrad Rudnicki

Recent studies in Cognitive Translation and Interpreting Studies have spurred a surge in experimental research, particularly in Audio Description (AD) reception studies. However, experimental research has largely focused on the linguistic composition of scripts, leaving the impact of vocal delivery comparatively underexplored. Addressing this gap, the current study investigates the cognitive and emotional effects of narrator voice gender within the complex framework of poetic AD for contemporary dance. Using a within-subjects design, 33 participants with blindness or visual impairments listened to dance performances with ADs voiced by synthetic male and female narrators. A multi-method approach was employed, combining subjective measures (mental effort, valence, arousal, enjoyment, transportation, and recall) with physiological indicators (electrodermal activity and heart rate variability). Results showed that female voices were associated with significantly lower perceived cognitive effort and higher emotional valence and arousal. Physiologically, female voices elicited lower levels of phasic skin conductance, suggesting a calming rather than arousing effect. However, no significant effects were found on enjoyment, transportation, or recall performance. These findings suggest that narrator’s voice modulates the cognitive and emotional experience of poetic AD, particularly at a subjective level. The study contributes to the growing field of inclusive media by highlighting the importance of voice characteristics in shaping accessibility and engagement.

Disabilities doi: 10.3390/disabilities6010020

Authors: Abbas H. Quamar Diane M. Collins Harshal P. Mahajan

Background: Utilizing internet-connected assistive devices is essential for completing instrumental activities of daily living (IADL) for people with disabilities. Globally, the COVID-19 lockdown restrictions resulted in drastic lifestyle changes. Methods: A global online survey was conducted to determine whether self-reported satisfaction with completing IADL using internet-connected assistive devices changed from pre-to-during the COVID-19 pandemic. Results: A cross-sectional analysis of the electronic instrumental activities of daily living satisfaction assessment survey of 700 participants from 32 countries revealed that during lockdown, people with disabilities had lower satisfaction for IADL domains of transportation, banking, shopping, health, nutrition, and leisure. Satisfaction with IADL domains, transportation, banking, and household and security needs was lower for people with disabilities compared to people without disabilities, both pre- and during lockdown. Additionally, for both people with and without disabilities, satisfaction with all IADL domains decreased during lockdown, except for the domains of household and security needs and memory needs. Pre-COVID-19, the employed individuals with disabilities were more satisfied with their performance of IADLs than those not employed, and no significant differences were found in the satisfaction levels during COVID-19. Conclusions: The pandemic had a measurable impact on IADL satisfaction, especially in people with disabilities.

Disabilities doi: 10.3390/disabilities6010019

Authors: Thesandree Padayachee Harsha Kathard

Continuity of Care (CoC) refers to how individuals experience care over time and is a vital component of delivering high-quality, person-centred primary healthcare (PHC). It is especially valuable for Persons with Disabilities who experience barriers in accessing healthcare and are at risk for poor health outcomes. In South Africa (SA), as the healthcare system evolves and aims to achieve universal healthcare, it is crucial to evaluate how primary healthcare policies address the CoC needs of Persons with Disabilities within primary healthcare (PHC). This study examined four policies: (1) the Policy on Quality in Health Care for South Africa (2007), (2) the Policy Framework and Strategy for Ward-Based Primary Healthcare Teams (2018/19–2023/24), (3) the Referral Policy for South African Health Services and Referral Implementation Guidelines, and (4) the Framework and Strategy for Disability and Rehabilitation Services in South Africa (FSDR) (2015–2020). Using an exploratory modified EquiFrame analysis, the findings reveal interesting insights into how CoC is conceptualized and articulated across these policies. While the Framework and Strategy for Disability and Rehabilitation Services displayed moderate alignment with CoC’s Core Concepts, it lacked detailed implementation strategies. Although PHC policies in SA recognize the significance of CoC, they exhibit gaps in conceptual clarity and practical application, posing challenges for the implementation of integrated and inclusive health systems.

Disabilities doi: 10.3390/disabilities6010018

Authors: Carla Sousa Pedro P. Neves Pedro M. Fernandes João Freire Pedro Gouveia Mariana Rodrigues Tiago dos Santos Cátia Casimiro Filipe Luz

Accessible digital games represent an emerging frontier for inclusion, offering both challenges and opportunities to advance the cultural participation of neurodivergent people. This study presents a systematic literature review of empirical research on game accessibility for neurodivergent players, including autistic individuals and persons with intellectual disabilities. Forty-eight studies published between 2014 and 2025 were analysed to examine how accessibility is defined, implemented, and evaluated in game design. The results reveal that accessibility is often framed as a functional or therapeutic adjustment rather than as a social or cultural right. Although growing attention has been paid to sensory and cognitive barriers, few studies adopt neurodiversity-affirming or participatory frameworks. Most remain confined to educational or rehabilitation contexts, with limited involvement of neurodivergent co-designers. The findings call for a redefinition of accessibility as a creative, ethical, and political principle central to inclusive digital culture and the neurodiversity movement.

Disabilities doi: 10.3390/disabilities6010017

Authors: Berta Benito-Colio María Zapata-Vila Carmen Ocete

In the current paradigm of adapted sport in Spain, national sports federations play a crucial role. This study aims to map and characterize the public visibility of the current situation of Spanish sports federations in relation to the integration and development of Sports for People with Disabilities on their official websites, and to interpret these publicly reported indicators in relation to federation-level integration practices discussed in the international literature and legislative changes promoted by Sports Law 39/2022. To this end, through an exploratory and descriptive cross-sectional study, a systematic survey of the published digital resources of the 61 national single-sport federations recognized by the Higher Sports Council has been carried out. The results show that federations present initiatives related to the integration of people with disabilities in sport: 21 have a Paralympic category, 42 present themselves as inclusive entities, 13 of the federative regulations specifically address the issue, and in 38 cases, specialized personnel can be found or linked to sport for people with disabilities. In conclusion, this research shows the degree of integration and development of Spanish sports federations in relation to sport for people with disabilities.

Disabilities doi: 10.3390/disabilities6010016

Authors: Anetta Müller Attila Lengyel Ferenc Mező Anikó Varga Nagy Éva Bácsné Bába Zita Popovicsné Szilágyi Nóra Laoues-Czimbalmos Katalin Mező

Background: Early childhood motor development plays a critical role in shaping participation and quality of life for children diagnosed with autism spectrum disorder. Parental perspectives provide unique insights into barriers, facilitators, and the real-world impact of interventions. Objectives: This study applied qualitatively led an exploratory mixed-method design grounded in a biopsychosocial paradigm. The qualitative component captured parental narratives, while quantitative summaries were generated to identify consensus areas of motor challenges and environmental influences. This dual approach aimed to reveal both the diversity of lived experience and recurring patterns that may inform screening and intervention planning. Methods: Semi-structured interviews were conducted with 58 parents of preschool-aged children diagnosed with autism spectrum disorder in Hungary. Transcripts were analysed thematically, and through descriptive frequency summaries and exploratory chi-squared analyses of coded data. Results: Parents consistently reported fine and gross motor differences, with consequences extending to participation in family, school, and community contexts. Early diagnosis was seen as beneficial primarily when it facilitated access to supportive services. Environmental adaptations, such as inclusive playgrounds and adaptive tools, were perceived by parents as enhancing children’s opportunities to participate, while the lack of accommodations amplified difficulties. Interventions embedded in real-life contexts and actively involving families were viewed as most effective. Exploratory quantitative summaries indicated consensus on five key challenges, including pencil grip, small object manipulation, and playground participation. Conclusions: The findings demonstrate that motor development in autism spectrum disorder is best understood within a biopsychosocial framework linking individual abilities, environmental modifications, and social acceptance. By integrating qualitative and quantitative perspectives, this study illustrates how family experiences can inform the design of family-centred interventions and context-sensitive policies that foster meaningful participation.

Disabilities doi: 10.3390/disabilities6010015

Authors: Iván Vázquez-Villar Rosa Espada-Chavarria Ricardo Moreno-Rodriguez

This study explores the educational trajectories of elderly deaf people in Spain who were educated between 1960 and 1980. The research was based on biographical-narrative methodology as a qualitative research technique. The data analysis was structural, using code identification and a system of categories and dimensions. Based on the stories and testimonies of 18 deaf people over the age of 65 living in Galicia, the stereotypes, prejudices and academic barriers in their school experience are analysed. The testimonies reveal an exclusionary education system, marked by a lack of accessibility, an absence of sign language interpreters, and the imposition of oralism as the only means of teaching. These conditions negatively affected the participants’ personal development, self-esteem, and employment opportunities. Discriminatory attitudes on the part of teachers and the school community were also identified. However, some highlighted key support and the informal use of sign language as positive elements. The study emphasises that, although there have been improvements in the education of deaf people, further progress is needed in the development of inclusive education policies that recognise sign language and promote accessibility and equity in the education of deaf people.

Disabilities doi: 10.3390/disabilities6010014

Authors: Mar Flores-Cortés Ferran Cuenca-Martínez Tasha R. Stanton

Knee osteoarthritis (KOA) is a leading cause of disability in older adults, characterized by persistent pain and reduced physical function. Beyond localized joint pathology, many individuals with knee osteoarthritis experience multisite pain and live with multiple comorbidities, reflecting a heterogeneous and multifactorial pain condition. Prognostic models based primarily on biomedical variables have shown limited ability to explain long-term outcomes, partly due to insufficient integration of pain chronicity, comorbidity count and psychosocial determinants such as treatment expectations and pain self-efficacy. While exercise and education are commonly recommended as primary non-surgical treatments, people often respond to them very differently. This study protocol describes a secondary longitudinal observational analysis of data from the EPIPHA-KNEE two-arm, multicentre randomized controlled trial. The primary outcomes will be knee OA pain intensity and physical function, assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire at baseline, 3, 6 and 12 months. Baseline prognostic factors will include pain duration, pain distribution, comorbidity count and patient expectations, including treatment expectations and pain self-efficacy. Linear mixed-effects models will be used to examine longitudinal associations between these predictors and pain and function trajectories, with particular emphasis on predictor-by-time interactions to characterize differential patterns of change over time. The planned analyses aim to improve understanding of how clinical characteristics and expectancy-related factors jointly shape 12-month pain and physical function trajectories in older adults with knee osteoarthritis receiving education and exercise-based care, thereby informing prognostic stratification within non-surgical management.

Disabilities doi: 10.3390/disabilities6010013

Authors: Alejandro De la Hoz Ester Ceballos Javier Cubero

In recent decades, technological advances have fostered new therapeutic approaches for children with neurodevelopmental disorders, particularly Autism Spectrum Disorder. Educational robotics has emerged as a promising resource for acquiring social skills, recognizing emotions, and developing theory of mind. However, there is still a need to understand which dimensions are most susceptible to this specific intervention and how its impact differs based on individual profiles. This study analyzes the effect of a therapeutic intervention based on Educational Robotics on Social Skills, Emotional Recognition, and Theory of Mind in two students diagnosed with Autism Spectrum Disorder. The intervention was structured in seven sessions using the ANDY® kit. Tests from the NEPSY-II battery and an observational rubric of Social Skills recorded session by session were applied. Both participants showed significant improvements in Social Skills, especially in rules of courtesy, nonverbal communication, and conversational interaction. Regarding Emotional Recognition, one participant improved in identifying highly affective emotions, while the other showed more modest progress. Theory of Mind showed progress in only one of the participants. Adherence was high, although a slight decrease in motivation was identified in the last sessions. These results suggest that Educational Robotics, when applied within a structured therapeutic framework, can effectively foster socioemotional development in children with Neurodevelopmental Disorders. However, variability across domains highlights the importance of tailoring interventions to individual profiles and complementing them with strategies that support the transfer of learning to natural contexts.

Disabilities doi: 10.3390/disabilities6010012

Authors: Addisu Taye Abate Lenora Duhn Rosemary Wilson Pilar Camargo-Plazas

Access to health care is a fundamental human right established in various legal frameworks worldwide. However, increasing evidence indicates that individuals with physical disabilities in rural Ethiopia continue to face barriers and disparities in accessing health care, leading to unmet needs and worsening health. Guided by Critical Disability Theory and Intersectionality Theory, this instrumental case study explored the barriers to accessing primary health care (PHC) for adults with physical disabilities in rural Ethiopia and examined how disability intersects with poverty, gender, and rurality to shape exclusion. Following purposeful sampling, we conducted 14 interviews and one focus group discussion (n = 7) with adults with physical disabilities, supplemented by PHC facility infrastructure observation. Using reflexive thematic analysis, we identified intersecting barriers across four domains: physical and environmental barriers, socioeconomic marginalization, socio-cultural stigma and attitudinal barriers, and systemic weaknesses in health service delivery. This revealed that disability-related barriers are rooted in structural ableism and intersecting inequities, underscoring the urgent need for inclusive policies and disability-inclusive practices. Such practices include enforcing accessibility standards, expanding community-based health insurance to cover disability-specific needs, supporting transportation, and providing disability-specific training for health professionals. Implementing these practices is essential to advancing disability rights and ensuring equitable health access in Ethiopia.

Disabilities doi: 10.3390/disabilities6010011

Authors: Lovorka Brajković Ana Sopta Dora Korać

Deafblindness is a combined vision and hearing impairment, which results in difficulties with communication, information acquisition, orientation, and mobility. Access to information in accessible formats and communication support is crucial for individuals who are deafblind, particularly within the healthcare system, where communication barriers can result in inadequate medical treatments or misdiagnoses. Accordingly, this study aimed to investigate the experiences and challenges of deafblind individuals within healthcare settings, as well as their satisfaction with the quality of care received. A focus group with six deafblind individuals was conducted, with an interpreter facilitating communication. Analysis of participants’ experiences identified eight themes, with the greatest challenges being inadequate organization of the healthcare system and communication difficulties with medical professionals. Although interpreters are essential for effective communication, participants reported situations where they were not allowed to be present during examinations. Despite the dedication of certain healthcare professionals, they mostly emphasized negative experiences and expressed overall low satisfaction with the quality of care received. Deafblind individuals face numerous challenges in the healthcare system that diminish satisfaction with care, underscoring the importance of raising awareness about deafblindness and ensuring that the accessibility requirements of this population (such as communication support) are addressed in healthcare practice.

Disabilities doi: 10.3390/disabilities6010010

Authors: Petra Potmesilova Milon Potmesil Ling Guo Veronika Ruzickova Gabriela Spinarova Jana Kvintova

Background: Emotions—including joy, sadness, fear, and anger—are fundamental expressions of human experience. For children and adults who are deaf or hard-of-hearing, emotional experiences and communication can differ due to linguistic and communication-related factors. Methods: This scoping review identifies instruments that are suitable for assessing emotional intelligence in the context of the lived and cultural experiences of individuals who are deaf or hard-of-hearing. A comprehensive search was conducted in April 2024 following the JBI methodology. Results: Out of 3091 articles, 21 studies were included. Two adapted methods were identified: the Meadow/Kendall Social–Emotional Assessment Inventory and ISEAR-D. Assessments supported by sign language revealed no significant differences in age or gender. Conclusions: The authors recommend further development of screening instruments that reflect the specific experiences of the population who are deaf or hard-of-hearing.

Disabilities doi: 10.3390/disabilities6010009

Authors: Babra Duri

Rural transport remains a critical factor of social inclusion in South Africa, particularly for people with disabilities who rely on public transport. This study explores the experiences of minibus taxi drivers in transporting passengers with disabilities in Mt Elias, a rural community in the KwaZulu-Natal province. A qualitative research design was adopted, involving semi-structured interviews with 15 drivers operating between Dalton and Mt Elias route. Thematic analysis was conducted using ATLAS.ti to identify key patterns and relationships across the dataset. The four key themes that emerged from the dataset are: infrastructure and environmental challenges, accessibility and support for passengers, operational and economic constraints, and human interactions and attitudes. Findings reveal that drivers face multiple barriers, including poor road conditions, limited vehicle space, and a lack of formal training, yet many demonstrate empathy and commitment to assisting passengers with disabilities. The study highlights the need for targeted policy interventions to improve road infrastructure, provide disability awareness training for drivers, and redesign vehicles for accessibility. Promoting inclusive rural transport requires coordinated action among government spheres, taxi associations, and disability advocacy groups. This research contributes new insights into the lived realities of rural drivers and promotes the importance of inclusive mobility as a component of social justice.

Disabilities doi: 10.3390/disabilities6010008

Authors: Allison D. Francis Samantha Glasgow

Trinidad and Tobago (T&T) has regional influence in the Caribbean, with a diversified economy focused on energy, manufacturing, and finance compared to the tourism-related economies of most of the other Caribbean islands. Notwithstanding, this has not translated into equitable opportunities for all, specifically for people with disabilities. A lack of disaggregated employment data thwarts effective policy planning for people with disabilities. This research sought to examine the barriers to their employment in T&T. Underpinned by the social model of disability, a concurrent mixed-methods approach was employed. Emanating from interviews with people with disabilities and key informants, challenges to employment access, employer perceptions, and apathy emerged as key themes, together with the underlying issues of a lack of legislation and inequitable access to mainstream education. The survey findings indicated that 64% of employers had never employed people with disabilities, 57% expressed neutrality regarding future employment of such individuals, and 69% had not introduced workplace accommodations. A key recommendation of the study is the establishment of an employer resource centre that assists employers in creating and maintaining inclusive workplace accommodations for people with disabilities. This study is the first in Trinidad and Tobago to examine these research objectives from multiple perspectives.

Disabilities doi: 10.3390/disabilities6010007

Authors: Monica Pinilla-Roncancio María Antonella Pereira

People with disabilities worldwide encounter barriers to accessing care and support systems. Existing care frameworks often focus on supporting caregivers, operating under the assumption that people with disabilities are largely dependant. However, under a human rights framework it is fundamental to recognise the role that people play, both providing and receiving care, and if care needs are adequately met. This study collects and analyses data from 1001 individuals with disabilities in Bogotá, Colombia, to assess the extent of unsatisfied care needs among this group. We identified individual and household characteristics that are associated with unsatisfied care needs using a multinomial probit and a probit model. The result revealed that 58.7% of participants received an insufficient amount of care, and 7.6% did not receive care at all despite needing it. In total, 66.3% of respondents had unsatisfied care needs. Adults with disabilities experiencing unsatisfied care needs were more likely to be older, male, experiencing functional limitations in daily activities, unemployed, or having lower educational attainment. Notably, 35.7% of respondents also provided care to household members—including children, older adults, individuals with disabilities, and those who were ill or injured. Findings highlight the need for Bogotá’s care system to recognise people with disabilities as both care recipients and caregivers, and to tailor support mechanisms to meet their diverse needs.

Disabilities doi: 10.3390/disabilities6010006

Authors: Juan Manuel Núñez Marián Pérez-Marín Ana Soto-Rubio

Background: Children with disabilities and special educational needs show heterogeneous developmental profiles that may be associated with executive functioning and family factors. This study examined functional developmental profiles in primary education and their associations with executive functions, behavioural indicators, and parental mental health. Methods: Participants were 106 children aged 6–12 years attending mainstream schools, including a subgroup with special educational needs. Parents completed the Developmental Profile-3 (DP-3) and a family mental-health record, while teachers completed the Screening of Emotional and Behavioural Problems in Children (SPECI) and Behaviour Rating Inventory of Executive Function-2 (BRIEF-2) based on structured ratings derived from daily interaction with the child. Correlational and regression analyses were conducted. Results: Executive functions—particularly working memory and planning/organisation—were consistently associated with global, adaptive, and social development. Parental overload showed negative associations with several developmental domains. Associations with behavioural indicators were modest. Conclusions: Developmental functioning in children with and without special educational needs is associated with executive functions and family factors as perceived by parents and teachers. Findings should be interpreted as relational and inform future assessment and inclusive educational planning.

Disabilities doi: 10.3390/disabilities6010005

Authors: Issa Alkinj

Individuals with developmental disabilities often experience physical and mental chronic conditions from early childhood, which can negatively affect their education, employment, and social participation without appropriate interventions. These impairments frequently limit the acquisition of essential daily living skills, including personal hygiene skills. This study examined a multicomponent intervention package—comprising video prompting, step-by-step instruction based on task analysis, systematic error correction, and reinforcement—to support the acquisition of handwashing skills for two adolescents with developmental disabilities (Autism Spectrum Disorder and Intellectual Disability) and toothbrushing skills for one adolescent. A nonconcurrent multiple-baseline design across participants and skills was employed, including baseline, intervention, maintenance, and generalization phases. The intervention was conducted over eight weeks. The results indicated low and stable baseline performance for both participants, followed by a systematic increase in performance after the introduction of the intervention, reaching accuracy levels between 80% and 91%. Participants demonstrated meaningful improvements in hygiene skill performance following intervention. These gains were maintained over time and generalized to new settings, although a few task steps continued to require prompting. Furthermore, teachers and parents rated the intervention as highly feasible, practical, and useful for supporting hygiene skills, while students reported enjoyment, perceived improvement, and willingness to participate again. Overall, the findings suggest that structured, evidence-based instructional approaches may support increased functional participation in essential daily living skills, particularly when complete independence may not be attainable for all individuals.

Disabilities doi: 10.3390/disabilities6010004

Authors: Shaminder Dhillon Tal Jarus Christopher Farley Sarah Wojkowski

The number of students living with disabilities entering post-secondary education, including health professional programs (HPPs), is increasing. However, disabled students continue to experience challenges in both the on-campus and fieldwork components of these programs. The purpose of this study is to understand the experiences and perspectives of fieldwork educators to determine how they can be supported by HPPs when supervising students living with disabilities. An online survey was developed and circulated to fieldwork educators who supervise students in nine HPPs at McMaster University in Canada. Descriptive statistics and content analysis were used to analyze survey responses. The survey was completed by 42 respondents, 10 of whom reported living with a disability and demonstrated a nuanced understanding of accommodation issues. More than half of the total respondents reported they had supervised disabled students in fieldwork; however, only 12 received accommodation plans and evaluation occurred informally, if at all. Respondents requested training on how to accommodate specific student needs. Efficient processes are needed for educator training, and the involvement of educators is needed in accommodation development. Accommodations must be evaluated to ensure students have equitable opportunities for learning and assessment. Educators living with disabilities provide valuable insights on dismantling systemic barriers to inclusion.

Disabilities doi: 10.3390/disabilities6010003

Authors: Ayman Noor Hanan Almukhalfi El-Sayed Atlam Talal H. Noor

Adaptive technologies have become more sophisticated with Artificial Intelligence (AI) and the Internet of Things (IoT), providing world-changing solutions to help people living with disabilities live better lives. In this article, we discuss the potential of AI and IoT to address issues related to Down Syndrome (DS), Autism Spectrum Disorder (ASD), Mobility Impairment (MI), Hearing Impairment (HI), Attention-Deficit/Hyperactivity Disorder (ADHD), and Visual Impairment (VI). In addition, we propose an analytical framework for evaluating AI and IoT disability assistance prototypes. The framework consists of three different layers: Disability Monitoring, Disability Analysis, and Disability Assistance layers. In each layer, a set of dimensions are identified (e.g., technology, data, security, customization, and response time) and used as criteria to evaluate the research prototypes. Moreover, we evaluate 30 representative AI and IoT disability assistance research prototypes published from 2020 to 2024. The evaluation offers valuable insights into the new strategies, technologies, and approaches that will define AI and IoT disability support in the future. While these technologies have promise in enabling access, autonomy, and interfacing, there remain major open research issues such as data privacy, security, cost, scalability, and real-time response. Furthermore, we discuss future research directions to tackle these issues and allow the people with disabilities community to enhance their quality of life and be more independent.

Disabilities doi: 10.3390/disabilities6010002

Authors: Ana Geppert Emma M. Smith Malcolm MacLachlan

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is the first international treaty to provide a basis for standards for the rights of persons with disabilities. It also represents the first human rights convention formally ratified by the European Union. In 2008, the UNCRPD was ratified by the majority of EU and EEA member states. Article 30 of the Convention specifically addresses the right to participate in cultural life, recreation, leisure, and sport is referenced and addressed in the UNCRPD States Parties reports submitted by all EU and EEA countries, as well as the United Kingdom. Research Question: How is sport represented in the State Party reports submitted under the UNCRPD? Methods: Data were collected from the UN Treaty Body Database. When multiple States Parties reports were available for a country, both reports were included for analysis. Results: Thematic analysis of 31 UNCRPD States Parties reports from EU, EEA, and UK countries revealed six key themes: General Factors, Sport in Article 30, Types of Support, Entities, Assistive Technologies, and Assistive Technologies in Sport. Sport was mentioned in all reports, with 90.3% referencing recreational sport and 83.9% elite-level sport. Funding and programmes were the most frequently cited supports for inclusive sport. Nearly half of the countries reported dedicated entities overseeing disability sport. Assistive technology was widely referenced across multiple UNCRPD articles, but only 16.1% of countries discussed its use specifically in sport. Countries differ significantly in their implementation of the UNCRPD in the context of sports. While some nations are advancing toward full inclusion, where disability does not affect an individual’s ability to participate in sports, others remain in the early stages of addressing participation in sport. These countries often rely on targeted programs specifically designed to facilitate the participation of persons with disabilities. Discussion: The analysis reveals significant disparities in how countries report and implement sport-related provisions under the UNCRPD. Ambiguities in categorizing elite versus recreational sport, underreporting of existing programs and entities, and limited references to strategic frameworks like the Kazan Action Plan highlight inconsistencies in reporting. Assistive technology (AT), while widely acknowledged across UNCRPD articles, is rarely linked to sport, despite its critical role in facilitating access and participation. These gaps suggest a need for clearer guidelines and more comprehensive reporting to ensure inclusive and equitable sport opportunities for persons with disabilities. Conclusions: There are notable disparities among countries’ reports in terms of mentioning participation for people with disability in sport, with some mentioning greater emphasis in integration and accessibility than others. To advance the UNCRPD rights through sport, clearer guidelines, standardized terminology, and more comprehensive reporting practices are essential.

Disabilities doi: 10.3390/disabilities6010001

Authors: Jurgi Olasagasti-Ibargoien Naroa Uria-Olaizola Olatz Zabala-Domínguez

Inclusive education is currently a central priority within the Basque educational system, where the right to education is understood as a fundamental right that must be guaranteed in inclusive environments fostering social interaction among all members of the school community. Attitudes towards inclusion are a key factor for ensuring the participation of students with disabilities, and empathy has been identified as one of the main capacities supporting inclusive practices. The aim of this study was to translate to Basque, culturally adapt, and validate the Attitudes towards Inclusion of Students with Disabilities in Physical Education Questionnaire (AISDPE) and the Basic Empathy Scale (BES). A validation and reliability study was conducted with 151 students enrolled in compulsory secondary education at a public school in Gipuzkoa. Confirmatory factor analysis was applied to assess construct validity. Reliability was examined using Cronbach’s alpha and omega coefficients for each dimension of both questionnaires. Results demonstrated satisfactory reliability for both instruments (α and ω > 0.75), supporting their applicability in Basque. These findings contribute to the availability of validated tools to assess attitudes towards inclusion and empathy, thereby facilitating future research on inclusive education in the Basque context.

Disabilities doi: 10.3390/disabilities5040119

Authors: Claudel R. Mwaka Krista L. Best Toufo A. A. Tcheutchoua Nicole Brais Dannia Henriquez François Routhier

The Réseau de transport de la Capitale (RTC), Quebec City’s public transportation provider, has launched a training program to enhance skills and self-efficacy for using the bus, including training for people with disabilities: “Service d’accompagnement en mobilité intégrée (SAMI)”. This pre-post study with a convergent mixed approach aimed to evaluate the influence of the SAMI program (P-SAMI) on transportation self-efficacy, mobility and satisfaction with the bus use among people with disabilities. The study also explored people with disabilities’ experiences and perceptions with the P-SAMI and bus use. The P-SAMI was delivered, and questionnaires and semi-structured interviews were completed before and after P-SAMI. Paired t-tests, Wilcoxon tests, and deductive thematic analyses were performed. Thirty-three participants (53.7 ± 14.9 years-of-age) showed statistically significant gains in transportation self-efficacy (p < 0.01) and satisfaction with bus use (p < 0.01), with no statistically significant differences in mobility (p > 0.05). Qualitative findings confirmed enhanced transportation self-efficacy and satisfaction with bus use, with participants reporting using buses to carry out some daily activities. The P-SAMI shows promise for improving transportation self-efficacy and satisfaction with using the bus, with the potential to enhance participation in daily activities. Controlled trials should be conducted in the future to test the effectiveness of transportation training for people with disabilities.

Disabilities doi: 10.3390/disabilities5040118

Authors: Noemí Cárdenas-Rodríguez Norma Angélica Labra-Ruíz Eduardo Espinosa-Garamendi

The most prevalent chromosomal condition, Down syndrome (DS), is often linked to deficiencies in working memory, executive function, and visuospatial skills. Innovative approaches to promote cortical plasticity and improve cognitive development have been suggested, including play- and technology-based therapies like LEGO®-based neurohabilitation. In this pre-experimental study, a 16-year-old adolescent with DS undertook 30 sessions of increasingly sophisticated LEGO®-based therapy, covering everything from robotic assembly and programming to block creation. Before and after the session, a neuropsychological evaluation was carried out using the Rey complex figure, motor control, and five-digit tests. The reliable change index (RCI) was used to analyze changes in performance. Constructive praxis, processing speed, and overall efficiency all showed notable clinical improvements, especially in the copy score, total complexity, and total processing. These findings imply that LEGO®-based neurohabilitation can provide significant gains in executive efficiency, visual–spatial abilities, and cognitive processing while offering a stimulating, developmentally appropriate therapy setting.

Disabilities doi: 10.3390/disabilities5040117

Authors: Elisabeth De Schauwer Jentel Van Havermaet Inge G. E. Blockmans Hanne Hellin Bronwyn Davies

We, five co-authors of this paper, came together for a three-day collective biography workshop to reflect on moments of recognition that have impacted our lives. We told our stories from lives lived with disability; we listened to each other’s stories and wrote and read them to each other with careful attention. In the discussions that followed, both during the workshop and during the following months of finalizing this paper, we explored the ways in which disability is made to matter and how. In that process, we each moved beyond our own singularity, our own particular memories of recognition and belonging, to a new, emergent understanding of our shared materiality and response-ability.

Disabilities doi: 10.3390/disabilities5040116

Authors: Raaya Alon

Research on families with a child with Down syndrome (DS) focused primarily on the impact on parents, with less attention to siblings, yet typically developing siblings are particularly important for individuals with DS as they play a unique role in the family and often become their sibling with DS’s primary caregivers. One of the central aspects in sibling dynamics is acceptance, an area that has largely been ignored in research to date. The current study examined variables that predict typically developing siblings’ acceptance of their brother/sister with DS, focusing on the internal resources of optimism and sense of coherence (SOC), and the potential mediating role of social support and emotions towards the sibling. Functionality of the brother/sister with DS was explored as a moderating variable. Participants included 306 Israeli typically developing siblings (201 sisters, 105 brothers) ranging in age from 18 to 27 (M = 21.54, SD = 2.50). Participants reported their sibling’s independent functioning as higher or lower independence. The results showed that both social support and negative emotions towards the brother/sister mediated the relations between optimism and acceptance and SOC and acceptance. Functionality of the brother/sister with DS moderated these relations, such that acceptance was more strongly predicted by negative emotions when the sibling was low-functioning. The study’s findings emphasize the importance of social support and emotions as mediators between the personal resources of optimism and SOC, with functionality as a significant moderator. As individuals with DS have varying levels of functionality, it is necessary to take this variable into consideration and appropriately adapt support for typically developing siblings. Further, examining acceptance and how it may be predicted by personal resources lends itself to practical insights regarding supporting siblings and promoting sibling relationships.

Disabilities doi: 10.3390/disabilities5040115

Authors: Dongheon Kang Seon-Deok Eun Jiyoung Park

Manual wheelchair users with spinal cord injury (SCI) often experience upper-limb strain and pain due to repetitive propulsion. A detachable dual-propulsion add-on device has been developed to mitigate this issue by offering an alternative propulsion mechanism, but its user acceptability and practical benefits must be rigorously evaluated. This study will implement a structured mixed-methods usability assessment of the new device with 30 adult wheelchair users with SCI. The evaluation will combine quantitative surveys, objective task-based performance metrics, and qualitative interviews to capture a comprehensive picture of usability. We will conduct a single-arm mixed-methods protocol using a device-specific 45-item usability questionnaire and semi-structured interviews, followed by convergent triangulation to integrate quantitative scores and qualitative themes. Participants will use the dual-propulsion device in realistic scenarios and then complete a 45-item questionnaire covering effectiveness, efficiency, safety, comfort, and psychosocial satisfaction. In addition, semi-structured interviews will explore users’ experiences, perceived benefits, challenges, and suggestions. During a standardized mobility task course (doorway navigation, ramp ascent, threshold crossing, and 50 m level propulsion), objective performance indicators—including task completion time, task success/error rate, number of lever strokes, and self-selected speed—will be recorded as secondary usability outcomes. The use of both a standardized questionnaire and in-depth interviews will ensure both broad and nuanced assessment of the device’s usability. Data from the survey will be analyzed for usability scores across multiple domains, while interview transcripts will undergo thematic analysis to enrich and validate the quantitative findings. This protocol is expected to provide robust evidence of the device’s usability, inform iterative improvements in its design, and highlight the importance of structured usability evaluations for assistive technologies.

Disabilities doi: 10.3390/disabilities5040114

Authors: Vladimir Vukovic Kate Sykes Oliwia Kowalczyk Margaret Denny Francoise Hickey Suzanne Denieffe Martin McMahon

Background: People with intellectual disabilities, in comparison to the general population, face multiple health inequalities and poor health outcomes. Service organisations for people with intellectual disabilities are one of the key players in ensuring that people with intellectual disabilities have access to adequate healthcare. Methods: A cross-sectional web-based survey was implemented from 8 to 22 April 2025, focusing on organisations providing services to people with intellectual disabilities, with a peak response rate of 9%. The survey comprised 29 questions, split into three sections: general information, experience, and opinions on cancer prevention policy. Results: A total of 29 organisations from 14 upper-middle- and high-income European countries participated. Approximately 20% (n = 6) of organisations reported the existence of a cancer prevention policy in their country designed to address the needs of people with intellectual disabilities, with most considering them inadequate. Overall, 86.2% of organisations identified tailoring cancer prevention policy for people with intellectual disabilities to be of major importance. Respondents identified national government/ministries (n = 26, 90%), organisations for people with intellectual disabilities (n = 24, 82.8%), and research entities (n = 23, 79.3%) as the responsible stakeholders for implementing policy changes. Conclusions: Respondents expressed strong support for tailored policies, alongside support for a pan-European approach. From a policy perspective, findings support the critical need for policymakers to prioritise cancer prevention strategies, improve coordination, and ensure training and co-production with organisations supporting people with intellectual disabilities.

Disabilities doi: 10.3390/disabilities5040113

Authors: Kamila Rodrigues Paixão Junior Vagner Pereira da Silva

The study aimed to analyze the public sports policy of the State of Mato Grosso do Sul in the educational context and the inclusion of people with disabilities. This is a retrospective, qualitative, exploratory, and documentary longitudinal study, with analysis of documents that regulate sports policy for educational contexts in Mato Grosso do Sul between 2020 and 2024, using the documentary analysis technique. The existence of a macro program that anchors seven other programs/projects was evidenced, with a predominance of the sport-performance dimension (47.5%). No program or project explicitly aims to include people with disabilities in its objectives. One project was specifically designed with inclusion goals; however, it fails to effectively include individuals with disabilities. Another project targets individuals with disabilities, although it was not originally intended to do so. We concluded that the inclusion of people with disabilities is not contemplated, as they are only integrated into a single project.

Disabilities doi: 10.3390/disabilities5040112

Authors: Ariane Cristina Zöll Ana Cristina Ferreira Garcia Amorim Illora Aswinkumar Darbar Shimozato Fabia Lopes Borelli de Moraes Maria Fernanda Setúbal Destro Rodrigues Raquel Agnelli Mesquita-Ferrari Rebeca Boltes Cecatto

Background/Objectives: Cerebral palsy (CP) is a non-progressive, permanent syndrome of childhood, with approximately 80% of patients exhibiting spasticity. Untreated spasticity can cause pain, structural changes in bones, muscles, and nerves negatively impacting quality of life and functionality. Photobiomodulation (PBM) has demonstrated biological effects such as tissue regeneration, muscle relaxation, inflammation reduction, and pain relief. The objective of this pilot study is to evaluate the action of PBM on the spasticity of the medial and lateral right gastrocnemius muscles of children and adolescents with spastic cerebral palsy. Methods: This single-blinded, randomized, controlled trial evaluated PBM’s effect on gastrocnemius spasticity in children and adolescents with CP. The study presents pilot preliminary results from twelve children and adolescents (7–16 years) with spastic CP who were randomized into two groups: active PBM (850 nm, 100 mW, 1.5 J/point, 2 points, weekly for 8 weeks) or placebo (same protocol, device off). Both groups received standard rehabilitation exercises. Outcomes were assessed using the Modified Ashworth Scale (MAS), Pediatric Evaluation of Disability Inventory (PEDI), Gross Motor Function Classification System (GMFCS), and ankle range of motion before and after the intervention (8 weeks). Results: MAS and all outcomes improved significantly over time in both groups. No significant differences were found between groups for all outcomes. The PBM effect size on MAS improvement (ANOVA, Analysis of Vari, η2 = 0.171) suggests modest but positive benefits. PBM did not worsen spasticity, and no adverse effects were reported. Conclusion: This study represents a pioneering effort in evaluating a safe PBM protocol for the spastics gastrocnemius in children and adolescents with CP. This protocol, used as an adjunct to physiotherapy, demonstrated no short-term adverse effects and no participant dropouts. Future studies should explore this PBM protocol in patients with less severe GMFCS levels, those with minimally preserved functionality, or those with contraindications to physiotherapeutic exercises.

Disabilities doi: 10.3390/disabilities5040111

Authors: Rachel Spencer Robin Gibson Leigh Creighton Catherine Watson Roy McConkey

People with Down Syndrome often experience more barriers to achieving a good quality of life compared to people without disabilities. A lot of the existing research has focused on the views of parents and professionals, rather than directly including the voices and perspectives of people with Down Syndrome themselves. We wanted to find out how this might be done. At the 2024 World Down Syndrome Conference, over 140 adults with Down Syndrome came together at a one-day Forum to talk about their lives—aspects that are going well and what could be better. The goal was to hear directly from them. This article explains how the Forum was run so that others with Down Syndrome can use a similar process. We describe how Artificial Intelligence (AI) was used to assist the authors in organising and sharing the information from participants, such as grouping what people said into different themes and helping to create plain language reports. This process worked. Eight key themes were found that could help people to have a good life, such as having good relationships with family and friends; having a job; making personal choices; and being respected and included. The list was longer than previously reported in other studies. The Forum gave valuable insights and helped us think of new ideas for supporting people with Down Syndrome to speak up for themselves. Used thoughtfully, AI (Artificial Intelligence) could be a helpful tool in the future to help these people share their experiences and needs. More research is needed to understand how people with Down Syndrome can be more involved in making changes through advocacy projects where they take an active role.

Disabilities doi: 10.3390/disabilities5040110

Authors: Abby Mulcahy Elizabeth K. Schmidt Darcy Jones McMaughan Kelsey Shinnick Goddard Katie Batza Anna Marie Wallisch Carl G. Streed Noelle K. Kurth Jean P. Hall

Disabled people face discrimination in healthcare settings, yet the compounding effects of intersectional identities remain underexplored. This project examines how different types of discrimination affect healthcare access and outcomes. We conducted a cross-sectional study of disability-based, race-based, gender-based, and sexuality-based discrimination using the 2022 National Survey on Health and Disability (NSHD; n = 2725) administered October 2021–January 2022. Measures used in this study include: (1) demographics; (2) types of discrimination; (3) unmet healthcare needs. Our sample was not nationally representative, as it consisted primarily of white, college-educated participants. Data were analyzed using summary statistics (STATA crosstab) among respondents with health insurance (n = 2566). Chi-squared tests were used to determine statistical significance. We fit logistic regression models for categorical responses (STATA logit), adjusting for participant characteristics. Some participants (41%; n = 2566) reported experiencing at least one form of discrimination, with 4.9% reporting race-, 15.08% gender-, 5.9% sexuality-, and 38.3% disability-based discrimination. Most participants (94%; n= 2412) reported at least one unmet healthcare need, from unmet prostheses (2.6%) to unmet dental care (34.8%). Compared with other care types, participants had the lowest odds ratio (OR = 0.38, p < 0.001) of having their preventive care or specialist care needs met. These findings highlight that discrimination contributes to disparities in particular areas of healthcare access and emphasizes a need for tailored interventions and additional research.

Disabilities doi: 10.3390/disabilities5040109

Authors: Sally Lindsay Peiwen Cao Nicole Thomson Jennifer Stinson Sharon Smile

Youth with disabilities face persistent disability-related discrimination (ableism) but research frequently overlooks the experiences of racially minoritized youth. The purpose of our study was to explore the experiences and perceived impact of discrimination among racially minoritized youth and young adults with disabilities. This qualitative study involved a sample of 15 youth and young adults with disabilities (mean age 22 years) identifying as racially minoritized. A descriptive inductive thematic analysis was applied to the interview data. Our findings highlighted the following themes: (1) types of discrimination (i.e., cultural and family-related ableism, racist ableism, and gendered/sexist ableism); (2) perceived impact of discrimination (i.e., social isolation, avoidance of unwelcoming and unsafe situations, impact on physical and mental health, decisions about identity disclosure, and a lack of access to resources and opportunities); and (3) positive coping strategies (i.e., inclusive and safe spaces, self-advocacy, and social and family supports).

Disabilities doi: 10.3390/disabilities5040108

Authors: Joanne Mampaso-Desbrow Margarita Alonso-Criado María Dolores López-Salmerón Ángel Vicario-Merino

As digital technologies become increasingly integrated into daily life, individuals with intellectual disabilities face both opportunities and risks in virtual environments. Despite widespread internet access and frequent use of digital devices among the general population, many individuals with disabilities continue to experience significant barriers to digital participation. These include difficulties in using technological tools, limited access to devices at home, and challenges in navigating online environments safely and independently. This study investigates the cybersecurity knowledge, risk perception, and privacy practices of 28 university students with mild intellectual disabilities in Spain. Utilizing a validated, accessible self-assessment questionnaire, the research analyzes participants’ understanding of digital threats, self-protective behaviors, and gender-based differences in knowledge and decision-making. Results reveal a generally high awareness of online risks and appropriate use of privacy settings, though inconsistencies in password security and high social media usage persist. Female participants demonstrated slightly higher levels of theoretical knowledge. The findings underscore the urgent need for inclusive, accessible cybersecurity education tailored to cognitive diversity. Promoting digital autonomy and safety through targeted interventions can reduce the digital divide and foster full social participation. This research contributes to the broader discourse on digital inclusion and protection for individuals with disabilities in an increasingly connected world.

Disabilities doi: 10.3390/disabilities5040107

Authors: Bárbara Valenzuela-Zambrano Paola Domínguez-Ramírez Carolina Fernández-Chávez Susana Araya-Navarro

Student mobility in Higher Education Institutions (HIEs) significantly contributes to students’ personal and academic development. However, participation of people with disabilities remains limited due to various barriers. This study explores the perceptions of students with disabilities regarding mobility within universities in southern Chile. A descriptive qualitative approach was used, and semi-structured interviews and a focus group with 15 undergraduate students with diverse types of disabilities were conducted. Data analysis was conducted using reflexive thematic analysis. The results revealed that students with disabilities prefer one-semester mobility experiences, typically near the end of their studies. Identified barriers include a lack of physical and digital accessibility, insufficient implementation of reasonable adjustments in the teaching-learning process, and poor coordination in mobility management between institutions. Additionally, specific requirements emerged depending on the type of disability, such as the need for sign language interpreters for deaf individuals and additional medical insurance, subsidies for personal assistants, or accessible transportation for those with reduced mobility. This study highlights the importance of adopting inclusive and proactive policies to facilitate student mobility for individuals with disabilities and promote an accessibility ecosystem that involves all institutional stakeholders.

Disabilities doi: 10.3390/disabilities5040106

Authors: Louis-Pierre Auger Isabelle Quintal Katia Goulet Mirabelle Miron Simon La Charité-Harbec Annie Rochette Johanne Higgins

This study aimed to adapt and translate the Knowledge, Comfort, Approach and Attitude towards Sexuality Scale (KCAASS) for stroke rehabilitation clinicians who are Canadian French speakers and to determine its measurement properties. The KCAASS was adapted for stroke rehabilitation by three occupational therapists and translated into Canadian French using a back-translation process. After being pretested, the resulting KCAASS-Stroke-FrCan was disseminated to seven rehabilitation centers in Quebec, Canada. Exploratory factor analysis, Cronbach alphas, intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change (MDC) were computed. 199 clinicians participated. Factor analysis revealed a four-factor solution. Internal consistency for the total score (α = 0.942) and subscales “Knowledge” (α = 0.834), “Comfort” (α = 0.966), and “Approach” (α = 0.836) were very good, and critical for “Attitude” (α = 0.628). Test–retest reliability was very good (0.81; p < 0.001) for the total score, good for “Knowledge” (0.69; p < 0.001) and “Comfort” (0.74; p < 0.001), very good for “Approach” (0.82; p < 0.001), and poor for “Attitude” (0.37; p = 0.003). SEM and MDC were presented. The KCAASS-Stroke-FrCan showed good measurement properties to assess stroke rehabilitation clinicians’ training needs and educational interventions.

Disabilities doi: 10.3390/disabilities5040105

Authors: Rina Xue Li Choo Jia Ling Oh Haibin Yu Boon Chong Kwok

Background: Spinal cord injury is a life-changing condition for individuals who have previously been independent in activities of daily living. Motor recovery prognosis for individuals with complete spinal cord lesion above thoracic level ten is poor after nine months of injury. Although the corticospinal tract is responsible for voluntary mobility functions such as walking, it is possible, through neuroplasticity, that involuntary lower limb movements can be trained. Methods: This case study discusses the use of multi-modal rehabilitation strategies, from weightbearing exercises using traditional manual-controlled exoskeleton to ambulation using advanced automotive exoskeleton. Results: The patient’s perspective showed themes that align with the World Health Organization’s International Classification of Functioning and Disability. In spinal cord injury, majority of concerns are in environmental and personal factors. This could be due to the perceived permanent disability in complete spinal cord lesion. The moderate-intensity two-hour intervention using traditional and advanced exoskeletons during physical rehabilitation showed that it was possible to stimulate deep sensations, and muscle pull and cramp for a patient diagnosed with complete spinal cord lesion. Conclusions: The use of traditional and advanced exoskeletons in weightbearing exercises may benefit patients with complete spinal cord lesions in regaining deep sensations in the lower limbs.

Disabilities doi: 10.3390/disabilities5040104

Authors: Abdul-Aziz Seidu Ndidiamaka Nwodo Farrukh Ishaque Saah Theophilus I. Emeto

Women with disabilities often face unique barriers to accessing healthcare, potentially increasing their vulnerability and reducing engagement with vital health services, including human immunodeficiency virus (HIV) testing. This study assessed the prevalence and associated factors of HIV-testing among women with disabilities in Ghana. Cross-sectional data from the 2017–2018 Ghana Multiple Indicator Cluster Survey, encompassing 819 women with disabilities, were analysed both descriptively and inferentially. The overall prevalence of HIV testing was 48.0% (95%CI = 44.6–51.4). Educational attainment, marital status, and geographical region were key determinants of HIV testing uptake. Women possessing a Senior High School or Tertiary level education demonstrated higher odds of HIV testing compared to those with no formal education. Women residing in Greater Accra, Volta, Brong Ahafo, and Upper West regions were more likely to have undergone HIV testing than those in the Western Region. Never-married women exhibited lower odds of HIV testing uptake than their married counterparts. No statistically significant association was found between various disability types and HIV testing uptake. Less than half of women with disabilities in Ghana had ever tested for HIV, highlighting a substantial unmet need and underscoring the urgent need for targeted interventions, including enhanced, region-specific educational and health promotion initiatives, and tailored support for never-married women with disabilities.

Disabilities doi: 10.3390/disabilities5040103

Authors: Sorcha Walsh Vlad Glaveanu

Attention Deficit Hyperactivity Disorder (ADHD) is a neuro-behavioural condition associated with limitations and deficits. Previous literature has largely focused on the lived experiences of males with ADHD. Despite a recent increase in studies on females with ADHD, there is a lack of empirical research on school experiences. This study aimed to address this gap in the literature by examining the perceived effect of ADHD on the school experiences of women. 13 women aged between 18–35 with a medical diagnosis of ADHD answered a series of questions in qualitative semi-structured interviews. Three were diagnosed during school and ten were diagnosed after school. The data was analysed using structured inductive thematic analysis. Four themes emerged, with sub-themes as follows: (1) Personal impact; the impact ADHD had on self-identity in school pre- and post-diagnosis. (2) Attitudes and opinions of others; how parents, teachers and societal attitudes on gender affected diagnoses and school experiences. (3) Friendships and relationships; how ADHD affected personality and socialising in school, and (4) ADHD and academia; the academic struggles participants faced whether diagnosed in school or not. The results suggest that ADHD contributed to negative school experiences for all participants. While the perception was that gender and attitudes towards ADHD in females often delayed diagnoses and that early diagnosis would have improved self-identity and school experience, results suggest even with early diagnosis, it is important that teachers are educated about the symptoms and deficits affecting females with ADHD and that schools provide resources to support female students with ADHD to ensure the best school experience.

Disabilities doi: 10.3390/disabilities5040101

Authors: Mariasole Antonietta Guerriero Fiorenzo Moscatelli Giovanni Messina Emilia Florina Grosu Emese Ágnes Maniu Valentin Alexandru Enache Vlad Teodor Grosu Rita Polito Marcellino Monda Antonietta Messina Claudia Casella Paride Vasco Nicola Mancini

This study examined the efficacy of a 12-week school-based program combining proprioceptive and plyometric training to enhance static and dynamic balance in children and adolescents with visual impairment. A total of 33 students were randomly assigned to either an experimental group (EG; n = 18), receiving a one-weekly session of integrative training alongside regular physical education, or a control group (CG; n = 15), following only the standard curriculum. Balance outcomes were assessed at baseline (T0) and post intervention (T1) using stabilometric measures under visual deprivation (eyes closed) and BOT-2 (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition) balance subtests. The EG demonstrated statistically significant reductions in ellipse surface area (p = 0.002, d = −1.29), center of pressure displacement (p < 0.001, d = −1.67), and sway velocity (p = 0.015, d = −1.06), indicating improved postural stability when vision was unavailable. BOT-2 Test 4 showed significant intra-group improvement (p = 0.006, d = 1.37), while BOT-2 Test 3 and between-group comparisons revealed medium-to-large effect sizes, though not always statistically significant. These findings suggest that augmenting somatosensory input through proprioceptive and plyometric training may partially compensate for visual deficits and improve postural control in individuals with visual impairments. This improvement likely reflects the activation of compensatory mechanisms that enhance proprioceptive and vestibular contributions to balance maintenance. Importantly, meaningful improvements occurred with just one weekly session, making this an accessible and scalable intervention for inclusive school settings.

Disabilities doi: 10.3390/disabilities5040102

Authors: Mario Ruggiero Pietro Montesano Leopoldo Ferrante Cristina Mennitti Olga Scudiero Filomena Mazzeo

This pilot study evaluates the effectiveness of basketball, implemented according to Universal Design for Learning (UDL) principles and educational best practices, as an inclusive tool for students with Special Educational Needs in lower secondary school. The research involved 24 adolescents aged 11–14 with Special Educational Needs, who participated in a structured 30-session basketball program designed to enhance motor, relational, and individual skills. The program incorporated evidence-based methodologies such as differentiated instruction, peer modeling, and cooperative activities. Motor tests and psychometric questionnaires were administered pre- and post-intervention to assess three key developmental dimensions. Results demonstrated significant improvements across all three dimensions: relational competencies and individual factors showed equal progress (+20.8% each), while motor skills showed slightly more modest but still substantial gains (+16.6%). These findings confirm that a structured pedagogical approach can transform sport into a powerful vehicle for inclusion. The article highlights how the integration of physical activity, inclusive teaching methodologies, and unified sports represents an effective strategy to address the complexity of Special Educational Needs.

Disabilities doi: 10.3390/disabilities5040100

Authors: Shaked Ofer Racheli Asgali Liat Lifshitz Ben Israel Shaul Ayelet Gur

Recognizing a dearth of understanding on the experiences of foster parents of children with disabilities, this study aimed to compare well-being, psychological flexibility, and social support among foster parents and biological parents of children with disabilities, as well as parents of children without disabilities, while exploring the impact of service use and social support on psychological flexibility and well-being. A convenience sample comprised 135 parents: 36 biological parents of children with disabilities, 32 foster parents of children with disabilities, and 67 biological parents of children without disabilities. Statistical analyses included one-way ANOVA, Pearson correlation, simple linear regression, and multiple linear regression. Results showed that foster parents of children with disabilities exhibited significantly higher psychological flexibility, well-being, and social support compared to biological parents of children with disabilities. Among biological parents of children with disabilities, psychological flexibility and well-being showed significant correlations with service satisfaction and social support, with social support explaining 62% of variance in psychological flexibility and 51% in well-being. Among foster parents of children with disabilities, neither service use nor social support significantly predicted psychological flexibility or well-being, suggesting different adaptive mechanisms. Among parents of children without disabilities, social support significantly predicted both psychological flexibility and well-being. The findings, which should be interpreted cautiously given the small sample size, highlight the need for targeted support interventions for biological parents of children with disabilities and further research into foster care families’ unique experiences.

Disabilities doi: 10.3390/disabilities5040099

Authors: Galia Taller Azulay Tali Heiman Dorit Olenik Shemesh

The current study examined the attitudes of elementary and middle school principals and school counselors toward including students with special needs in regular classrooms. 243 participants completed questionnaires on their self-efficacy, job satisfaction, stress, and attitudes toward inclusion. Additionally, 22 semi-structured interviews were conducted to gain a deeper understanding of how principals and counselors deal with the inclusion of students with special needs in their school. The study’s findings reveal a difference between middle school counselors and principals and those in elementary schools in terms of the desire for inclusion. It was also found that the less the counselors believe in themselves, the less they are in favor of inclusion, while the more satisfied they are with their work, the more they support inclusion. Qualitative analysis brought up various difficulties in the inclusion process.

Disabilities doi: 10.3390/disabilities5040098

Authors: Nur Fajrie Imaniar Purbasari Slamet Khoeron Ika Yuni Purnama Hendri Pratama

This study explores the artistic experiences of individuals with low vision in creating clay-based artworks at the Pandawa Social Home for Blind Sensory Disabilities in Kudus Regency, Indonesia. The research used a qualitative, descriptive-exploratory design, and fifteen participants with varying levels of visual impairment were involved. Data were obtained through in-depth interviews, observations, and analysis of their clay creations. The findings reveal that clay, with its tactile qualities, serves as an effective medium for creative expression, enabling participants to explore form through touch and pressure. This process supported the development of fine motor skills, creativity, and self-confidence while fostering emotional well-being and social interaction. Participants relied on memory, imagination, and sensory perception to produce artworks that held personal and aesthetic meaning, despite differing from conventional visual standards. The study underscores the therapeutic benefits of clay art and highlights the crucial role of supportive environments—families, educators, and art communities—in nurturing creativity and enhancing the quality of life for individuals with visual impairments. The limitations of this study include its small sample size, its single-institution approach, and its focus on clay. Future research should expand the participant pool, explore other accessible art media, and examine the long-term impact on psychosocial development.

Disabilities doi: 10.3390/disabilities5040097

Authors: Nathali Fernanda Feliciano Isabella dos Santos Alves Renata Máximo Guidetti-Turchetti Maria Luiza Tanure Alves

This study focuses on the experiences of female Paralympic athletes in Brazil through the lens of feminist disability studies. It is a qualitative study, grounded in the voices of disabled women, positioning them as the foundation of knowledge within a post-structuralist epistemological framework. The research involved in-depth interviews with four Brazilian Female Paralympians, conducted using a predefined interview guide, and the data were analyzed using thematic content analysis. The athletes were between 25 and 34 years of age and had experience competing in international competitions. From their narratives, two distinct yet interconnected categories emerge: (1) Being a disabled woman and (2) Like sportswomen. Disabled women have shown that they navigate an ableist and sexist society as disabled women within the context of sport; at the same time, they embody an empowered and inspirational identity as sportswomen. By exploring these perspectives, this study highlights the need to challenge and redefine societal perceptions and expectations surrounding disability. It provides insights into the experiences and agency of female Paralympic athletes.

Disabilities doi: 10.3390/disabilities5040096

Authors: Gloria Alberti Giulio E. Lancioni Nirbhay N. Singh Mark F. O’Reilly Jeff Sigafoos

People with intellectual disability and visual impairment often have difficulties in accessing leisure events, engaging in cognitive activities, and performing physical exercise. The present study assessed a program aimed at helping six adults with moderate or moderate-to-mild intellectual disability and blindness in each of the aforementioned areas. The program relied on the use of a technology system involving a smartphone, which was supplied with Internet connection and fitted with the Live Transcribe and MacroDroid applications. These applications were set up to (a) enable the participants to use verbal utterances to successfully access preferred songs and comic sketches (leisure events) and answer series of verbal questions (cognitive activity) automatically presented to them, and (b) enable the smartphone to verbally guide the participants’ performance of series of body movements (physical exercise). The program was introduced according to a nonconcurrent multiple baseline design across participants. The intervention was divided into two phases, which included 17–33 and 39–48 sessions, respectively. The results showed that the participants’ baseline performance (without the support of the system) was generally poor. During the intervention with the system, all participants succeeded in accessing the music or comic events available, satisfactorily answering series of questions, and performing series of body movements. The Percentage of Nonoverlapping Data and the Tau (novlap) methods used to compare baseline and intervention performance produced indices of 1 for all participants (confirming the strong impact of the intervention). These results, which need replication to establish their generality, suggest that the technology system might represent a useful tool for helping people like the participants of this study.

Disabilities doi: 10.3390/disabilities5040095

Authors: Chelsea Hannah Marsh Alicia Yon Elizabeth Kendall Kelsey Chapman

Significant others—family members, friends, and informal carers—play a vital yet underrecognised role in supporting people with disability in Australia. This study aimed to explore their lived experiences and identify systemic barriers impacting their well-being and caregiving capacity. A total of 188 significant others participated in a statewide survey, co-designed using inclusive research principles. Quantitative and qualitative data were collected and analysed collaboratively, using an a priori coding framework adapted to new themes. Four key findings were described: the joy and meaning found in caregiving; the overwhelming burden of navigating fragmented systems; the erosion of carer well-being due to financial, physical and emotional strain; and the urgent need for systemic support including respite and equitable access to services. Participants emphasised that caregiving itself was not inherently burdensome, rather, the lack of formal support and recognition creates unsustainable conditions. These findings highlight the critical role significant others play in sustaining Australia’s care economy and underscore the need for disability-inclusive policy reform. Strengthening support systems and embedding lived experience into reform and policy design are essential to ensuring the long-term sustainability of informal care and the rights and well-being of both carers and people with disability.

Disabilities doi: 10.3390/disabilities5040094

Authors: Marina Carvalho Arruda Barreto Ricardo Goes de Aguiar Ricardo Cartes-Velásquez Shamyr Sulyvan de Castro

Multimorbidity has emerged as a pressing public health concern on a global scale, primarily driven by population aging and the epidemiological transition, which has resulted in an increased prevalence of chronic non-communicable diseases. Objective: The objective of the study was to investigate the functioning profile of individuals with multimorbidity in Chile, focusing on capacity and performance, and to explore the association between multimorbidity and compromised functioning. Methods: Data from the II ENDISC, a cross-sectional population study conducted in Chile in 2015, were analyzed. The sample comprised 12,265 randomly selected individuals aged 17 and above, who were interviewed using the Model Disability Survey. Generalized linear models (GLMs) were employed to assess the impact of multimorbidity on capacity and performance. Results: The results revealed that individuals with multimorbidity presented worse capacity scores (38.31 vs. 19.72) and performance scores (44.51 vs. 27.28) compared to those without multimorbidity. Furthermore, adjusted risk through GLM shows that individuals with multimorbidity had a higher risk of experiencing worse capacity (1.39) and performance (1.29) scores. Gender, self-rated health, age, employment status, and education level were identified as factors associated with varying degrees of impact on functioning. Conclusions: These findings underscore the importance of addressing multimorbidity and its associated factors in healthcare planning and intervention strategies, particularly for socioeconomically vulnerable populations, to enhance well-being and functioning among individuals with multimorbidity.

Disabilities doi: 10.3390/disabilities5040093

Authors: Daria Andreoli Alex Reed Shelly Coe Helen Dawes Johnny Collett

Handwriting impairment is a cardinal symptom of Parkinson’s. However, treatment options are limited. Here we evaluate the utility and estimate effects of a novel low-resource handwriting intervention (Clinicaltrials. gov NCT03369587). Forty-eight people with Parkinsons with self-reported handwriting problems were recruited to an exploratory, assessor-blind two-arm parallel randomized trial to either diverging (n = 24, n = 19 analysed) or parallel (n = 24, n = 20 analysed) groups. Both received a six-week, five times a week, handwriting program: writing a daily diary on lined paper (diverging: 10 mm increasing to 13 mm apart, parallel: 10 mm apart). Outcomes were measures of impairment (cursive ‘el’, single and dual-task), handwriting function (sentence and free writing) and self-reported difficulties. Median diary entries (31, IRQ: 17.5–39) were greater than requested (30) with no differences between groups, p = 0.302. No adverse events were reported. Regardless of group, improvements were found in writing ‘el’ speed (single task: d = −0.90, 95% CI: −1.41: −0.38, p = 0.001; dual task: d = −0.72, 95% CI: −1.24: −0.21, p = 0.09) and amplitude (single task: d = 1.07, 95% CI: 0.49: 1.66, p < 0.001; dual task: d = 0.86, 95% CI: 0.35: 1.37, p = 0.002). Sentence amplitude (d = 0.80, 95% CI: 0.30: 1.29, p = 0.003) and perceived difficulties also improved (OR = −3.6, 95% CI: −12.6: −1.0, p = 0.047). Between-group effects were small (d = 0.11 to 0.48). Large improvements to handwriting, which required less attention, were found after self-directed well-adhered-to practice. Potential additional benefits of exaggerated cueing were small.

Disabilities doi: 10.3390/disabilities5040092

Authors: Yuke Wu Jinyu Fan Huan Li

The promotion of public awareness regarding accessible environments is crucial for their effective construction and utilization. While there has been extensive research focusing on the physical construction of accessible facilities, the issue of public awareness remains underexplored, especially in underdeveloped regions. This potential lack of awareness could hinder effective use and societal support of accessible environments. The present study explored the current state of public awareness regarding accessible environments and its influencing factors in Urumqi, a provincial capital in an underdeveloped region of China. Through stratified sampling, approximately 80 residents from each of seven districts in this western city were surveyed, resulting in 501 valid questionnaires. The findings indicated that public awareness of accessible environments was moderate, characterized by insufficient understanding of basic concepts and relevant legal policies. The presence of family members with mobility difficulties, personal experience with mobility challenges, and occupational roles were all relevant factors that contributed to differences in public awareness of accessible environments. The study identified two key influencing factors, including public attitudes towards accessible environments and the presence of family members with mobility difficulties. These insights could inform strategies to enhance public awareness of accessible environments. Future research should further explore the underlying mechanisms linking public awareness and its influencing factors.

Disabilities doi: 10.3390/disabilities5040091

Authors: Rafat Ghanamah Julnar Khaldi-Mreh

This study examined the relationships between anxiety and executive functioning in Arab Israeli female adolescents diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), compared to their typically developing peers. The aim was to explore differences in emotional and metacognitive executive functions, as well as how anxiety correlates with these cognitive domains within a culturally specific and gender-sensitive population. Eighty adolescent girls aged 15–18 (40 with ADHD and 40 controls) completed self-report measures assessing anxiety and executive functions using the BRIEF-SR and State-Trait Anxiety Inventory. No significant group differences were found in behavioral aspects of executive functions (inhibition, shifting, emotional control, and monitoring) or in overall anxiety levels. However, the ADHD group demonstrated significantly greater difficulties in all metacognitive executive function domains—including working memory, planning, organization, and task completion—as well as higher scores on the Metacognitive Index and Global Executive Composite. Correlational analyses revealed that anxiety was significantly associated with both behavioral and metacognitive executive dysfunction in the control group. In the ADHD group, however, anxiety was only significantly related to behavioral regulation, not metacognitive functioning. These findings underscore the importance of metacognitive support in interventions for adolescent girls with ADHD. Culturally tailored educational strategies that target working memory, planning, and organizational skills may help improve academic performance and overall adaptive functioning in this underserved population.

Disabilities doi: 10.3390/disabilities5040090

Authors: Liviu Florian Tatomirescu Cristiana Susana Glavce Gabriel-Ioan Prada Suzana Turcu Adriana Borosanu

Background: The rising prevalence of neurodegenerative conditions such as dementia underscores the impact of population aging. Consequently, long-term care needs have increased and are often met by family members through informal caregiving, thereby supporting formal care systems by reducing associated costs. These caregivers face physical and mental health challenges, raising concerns about their psychological well-being and prompting interest in both clinical and psychosocial research. Ryff’s eudaimonic model offers a robust framework for the assessment of psychological well-being; yet, in Romania, data on this population segment remain limited. Objective: This study aimed to compare the psychological well-being of Romanian dementia family caregivers with a reference population from the Romanian adaptation of the 54-item Ryff Psychological Well-Being Scale, and to explore how sociodemographic characteristics relate to relevant differences across well-being dimensions. Methods: A cross-sectional study was conducted among 70 Romanian family caregivers recruited from a single clinical hospital in Bucharest, Romania. Caregivers completed the 54-item Ryff Scale (Romanian adaptation), and scores were compared to reference values using one-sample t-tests with bootstrap confidence intervals. The most relevant dimension (purpose in life) was dichotomized and further examined in relation to sociodemographic and caregiving variables using Chi-squared and Fisher’s exact tests. Results: Caregivers reported significantly lower scores compared to the reference population in purpose in life (p < 0.001, d = −1.01), personal growth (p < 0.001, d = −0.91), and positive relations (p = 0.01, d = −0.30). The most pronounced deficit was observed in purpose in life, with 85.7% of caregivers scoring below the reference mean. This dimension was further examined in relation to caregiver characteristics. Retirement status showed a statistically significant association with Purpose in Life, with retired caregivers more likely to report lower scores (χ2 (1) = 4.04, p = 0.04), supported by the likelihood ratio test (p = 0.01) and a linear trend (p = 0.05). Additional marginal associations were found for household income (p = 0.14) and whether the patient slept in a separate room (p = 0.15), suggesting possible links between caregiver well-being and economic or environmental conditions. Conclusions: The study findings highlight notable psychological vulnerabilities among Romanian dementia caregivers, particularly in purpose in life and personal growth. Associations with structural and contextual factors such as retirement status, income, and caregiving environment suggest that caregiver well-being is shaped by broader socioeconomic conditions. While the magnitude of these deficits may be underestimated due to elevated stress levels in the reference group, the findings underscore the need for targeted clinical, social, and policy-level interventions aimed at strengthening existential meaning and personal development in culturally specific settings.

Disabilities doi: 10.3390/disabilities5040089

Authors: Eileen T. Crehan Anna Phillips Anh Ngo Abigail Donaghue Natalie Bartlett Daniella Rothstein Simone R. Dufresne

College websites are a primary source of information for prospective students. As increasing numbers of autistic students head to college, we wanted to capture whether and how college websites were presenting themselves as autism-friendly or autism-aware environments. This is a descriptive study of how college websites from liberal arts institutions in the U.S. talk about autism. The top 50 liberal arts schools, as ranked by the US World and News Report from 2023, were searched for the following terms: “autism”, “autistic”, “ASD”, “neurodiversity”, “neurodivergent”, and “neurodivergence.” Five website areas where these terms may appear, or where prospective students may look for them, were identified: admissions, accessibility, counseling/mental health, faculty resources, and student life. Overall, the occurrence of any searched terms was extremely low across all areas. This lack of terminology representation likely reflects the reality of autism-related services on these campuses. On some websites, mentions of autism did not reflect a deeper cultural understanding of the term. The lack of representation of and information about autism and neurodiversity on college websites should be a call to these types of institutions that there are a number of students whose identities are not being recognized by these academic spaces.

Disabilities doi: 10.3390/disabilities5040088

Authors: Fatemeh Azadinia Mahshid Mosharaf Atefeh Lesani Nicola Ryall Ebrahim Sadeghi-Demneh

Background: Mobility assessment is a crucial aspect of rehabilitation for individuals with lower limb amputation, as it directly influences their independence and quality of life. The objective of this study was to translate and cross-culturally adapt the Special Interest Group in Amputee Medicine (SIGAM) mobility grades questionnaire in the Persian language and to investigate its psychometric properties. Methods: The SIGAM mobility scale was translated into Persian according to international guidelines for cross-cultural adaptation of self-reported measures and was administered to forty Persian-speaking people with lower limb amputations. Measurement properties were evaluated following COSMIN (COnsensus-based Standards for the Selection of Health Measurement INstruments) recommendations and included internal consistency, test–retest reliability, and hypotheses testing for construct validity by comparing SIGAM mobility grades to the Locomotor Capabilities Index-5 (LCI-5), Houghton scale, Activities-specific Balance Confidence (ABC) scale, the 2-Minute Walk Test (2-MWT), and the Timed Up and Go (TUG). Results: SIGAM mobility scale demonstrated acceptable internal consistency (Kuder-Richardson 20 coefficient = 0.72) and excellent test–retest reliability (Cohen Kappa coefficient = 0.85). Hypothesis testing for construct validity confirmed the good to very good correlations of the Persian SIGAM mobility scale with the LCI-5 (r = 0.63, 0.55, and 0.63 for the general, basic, and advanced activities components, respectively), Houghton scale (r = 0.63), ABC scale (r = 0.73), 2-MWT (r = 0.50), and TUG test (r = −0.51). Conclusion: The Persian version of the SIGAM mobility scale demonstrated preliminary evidence of acceptable psychometric properties, supporting its clinical applicability.

Disabilities doi: 10.3390/disabilities5040087

Authors: Ana Guadalupe Gallego Camino Ferreira Ana Rosa Arias-Gago

Film and television play a key role in shaping cultural perceptions of disability, but they often rely on recurring stereotypes that may reinforce stigma and exclusion. Although scholarly interest in this issue has increased, the academic literature remains fragmented and lacks a comprehensive synthesis. This critical review examines how disability is represented through stereotypical portrayals in narrative audiovisual media, specifically scripted films and television series. It synthesizes peer-reviewed studies that explicitly analyze these representations and their narrative or sociocultural functions. The review identifies dominant tropes, theoretical frameworks, and disciplinary approaches while providing a qualitative synthesis of key trends and findings. Although persistent stereotypes are still common, the review also highlights a growing presence of more inclusive and complex portrayals that challenge traditional norms. By providing a structured overview of existing research, this study enhances academic understanding of how disability is depicted on screen and supports efforts to promote more inclusive and accurate representations in popular media.

Disabilities doi: 10.3390/disabilities5040086

Authors: Marta García-Plata Irene Garcia-Molina

The intersection of autism and motherhood/parenthood remains largely underexplored, particularly within the Spanish context. Autistic mothers and birthing parents are often silenced, with limited representation and scarce accessible information, contributing to a broader social and institutional unawareness. This study explores the postpartum experiences of autistic and non-autistic mothers during the first two years following childbirth. Twelve semi-structured interviews were conducted with six autistic and six non-autistic mothers and analyzed using Reflexive Thematic Analysis. Three key themes were constructed, as follows: (1) Ups and Downs: Navigating Emotional and Sensory Experiences, highlighting the intense sensory and emotional load of early motherhood; (2) Lack of Information and Support: The Root of Increased Vulnerability, addressing gaps in institutional support and knowledge; and (3) The Social Dimensions of Early Postpartum: Tensions and Expectations, focusing on family and societal pressures as well as identity struggles. While experiences overlapped in several areas, two tentative distinctions were observed, as follows: autistic mothers appeared to favor self-guided strategies (e.g., books, personal guidelines), whereas non-autistic mothers relied more on professional guidance; additionally, autistic mothers expressed a stronger preference for autonomy, while non-autistic mothers often valued companionship. These findings underscore the urgent need for healthcare professionals to receive training on autistic motherhood/parenthood and for the development of tailored postpartum care guidelines to ensure inclusive, responsive support.

Disabilities doi: 10.3390/disabilities5040085

Authors: Stefanie Köb Frauke Janz Paula-Marie Mühlstädt

Inclusive education aims to ensure not only academic development but also social participation among students with intellectual disabilities. However, research consistently shows that students with intellectual disabilities are prone to social exclusion in secondary school settings. While theoretical frameworks increasingly highlight the importance of contextual and systemic factors—particularly classroom social dynamics—empirical studies on teachers’ practices for fostering participation remain scarce. This qualitative study investigates how secondary school teachers in inclusive classrooms perceive and enact their role in promoting social participation. Semi-structured interviews were conducted with 30 teachers from various German secondary schools. The data were analyzed using qualitative content analysis based on the social dynamics management (SDM) framework, which distinguishes between universal, selected, and indicated intervention levels. The results reveal that teachers use a wide range of strategies across all three levels. In addition to the categories proposed by the SDM framework, two further areas were identified inductively: (1) teachers’ pedagogical beliefs and (2) internal and external cooperation. These findings suggest a need to expand the SDM model and provide guidance for the professional development of teachers aiming to promote inclusive classroom environments.

Disabilities doi: 10.3390/disabilities5040084

Authors: Nikki H. T. Verdellen-Krauwel Noud Frielink Anna-Eva J. C. Prick Arno P. A. M. Willems Petri J. C. M. Embregts

Individuals with severe intellectual disabilities and challenging behaviour often face limited access to effective therapeutic interventions, as conventional approaches like cognitive behavioural therapy may not be suitable. Creative arts therapies (CATs), psychomotor therapy, and play therapy have emerged as promising non-verbal alternatives, yet their use in this population remains underexplored. This scoping review aimed to map and synthesize the existing evidence on the application and outcomes of these interventions for individuals with severe intellectual disabilities and challenging behaviour. A comprehensive search was conducted across eight databases in May 2023 (with an update of the search in June 2025). Thirteen studies met the inclusion criteria, namely eight quantitative and five qualitative designs. Interventions included music therapy (n = 7), art therapy (n = 4), a combination of both (n = 1), and play therapy (n = 1); no studies on psychomotor therapy were identified. Reported outcomes were grouped into five domains: cognitive, psychological and emotional, social and interactional, communicative, and creative domain. Improvements were observed in areas such as attention, emotional regulation, social responsiveness, and communicative expression, particularly in structured and attuned therapeutic environments. However, most studies had methodological limitations, including small sample sizes and limited standardisation. These findings suggest potential benefits of CATs and play therapy, while highlighting the need for further research into underrepresented modalities and the use of rigorous single-case experimental designs.

Disabilities doi: 10.3390/disabilities5030083

Authors: Irene Belperio Ruth Walker

Dementia is a global health issue. For adults with intellectual disabilities living with dementia, diagnosis and support pose unique challenges. For those who reside in shared disability supported accommodation (group homes), there are additional considerations regarding support and ageing in place. Semi-structured interviews with twelve staff from three disability service providers in Australia were conducted to explore the experiences of disability service providers supporting adults with intellectual disabilities and dementia. The study found that delays in diagnosis hampered timely and effective interventions and, consequently, the care and support received by those adults with intellectual disabilities living with dementia. This impacted organisations’ ability to adequately staff accommodation and remunerate disability support workers. This had implications for those in group homes, where the needs of other residents were affected. Lastly, while ageing in place was considered desirable, none of the provider organisations had guidelines for remaining in the home. This study highlights the need for further investigation into this growing population, including those living in the community.

Disabilities doi: 10.3390/disabilities5030081

Authors: Jacob D. Sartor Amy E. Latimer-Cheung Shane N. Sweet Brooke H. Thompson Jennifer R. Tomasone

The Quality Participation Framework proposes that repeated quality experiences foster continued quality participation (i.e., participation quantity over time). This study explored the relationship between the quality and quantity of participation in an exercise setting. Individuals (n = 17) with a physical disability engaged in Revved Up @ Home, a 10-week online community-based exercise program designed to foster quality participation. Using a mixed-methods sequential explanatory design situated in critical realism, participants completed quality experience global questionnaires at baseline and 10 weeks, and acute questionnaires following each exercise session. Participant attendance was retrieved from program records. In semi-structured interviews at 10 weeks, participants were shown graphs of results derived from the acute questionnaires and asked about their quality and quantity of participation during the program. Correlations quantified the relationship between quality and quantity of participation, and thematic analysis facilitated an exploration of the contextual relationship. Qualitative and quantitative findings were integrated, highlighting important relationships between belongingness and quantity, meaning and quantity, as well as between challenge and mastery. Findings provide preliminary evidence that repeated quality experiences foster quality participation, and detail relationships between the aspects of quality participation and between quantity and quality participation. Findings can be used to enhance quality participation and attendance among individuals with physical disabilities who attend community-based exercise programs.

Disabilities doi: 10.3390/disabilities5030082

Authors: Luis Enrique Espinoza Amanda M. Hinson-Enslin Heather F. de Vries McClintock Paris G. Rangel Alina M. Jordan

This study examined the association between formal sex education (FSE), sensory disability status, and contraceptive use among U.S. women. Women with disabilities face barriers to contraceptive decision-making, such as limited accessible FSE content and topics. Data were weighted and analyzed from the 2011–2019 National Survey of Family Growth among women 15–25 years of age. Multivariable logistic regression and moderation analysis examined the association between sensory disability status, contraceptive use during last sexual encounter, and FSE topics. Women with hearing loss or both hearing loss and vision loss were less likely to use contraceptives during last sexual encounter than women without sensory disability (hearing loss: adjusted odds ratio (aOR): 0.36; 95% confidence interval (CI): 0.14, 0.96; both: aOR: 0.28; CI: 0.08, 0.91). Exploratory moderation analysis showed women with vision loss who received FSE on birth control methods (aOR: 6.14; 95% CI: 1.70, 22.23) and on sexually transmitted infections (aOR: 28.24; 95% CI: 1.71, 46.63). The estimates were based on small numbers of individuals within each subgroup and wide confidence intervals, and thus should be interpreted with caution. The findings point to differences in contraceptive use according to sensory disability status, indicating future studies need larger sample sizes to better understand the role of FSE for women with sensory disability.

Disabilities doi: 10.3390/disabilities5030080

Authors: Jennifer Brilmyer Robert J. Palisano Margaret E. O’Neil Kathleen Shroyer

This study compared physical activity (PA) intensity during leisure and recreation between youth with chronic pain with and without (overweight, obesity) healthy weight. Thirty youth with chronic pain, 11–19 years old, completed the Children’s Assessment of Participation and Enjoyment (CAPE), Functional Disability Inventory (FDI), and a Demographic and Participation Questionnaire. Metabolic equivalent of task (MET) values for CAPE activities were estimated. Youth in both groups reported moderate perceived disability in physical functioning due to pain and mostly participated in leisure and recreation at a low PA intensity. Mann–Whitney U and t-tests indicated that the number of activities performed at high, moderate, and low MET intensity levels did not differ between the two groups (p > 0.05). Perceived disability in physical functioning due to pain was not related to PA intensity (p > 0.05). Youth reported that pain, anxiety/stress, and not having time limited their PA intensity. The findings suggest that multiple factors are potential barriers to PA participation and intensity during leisure and recreation activities. Engagement with youth is encouraged to identify preferred PA at moderate to high intensity and integrate them into interventions and daily routines to promote a physically active lifestyle and reduce disability in physical functioning due to pain.

Disabilities doi: 10.3390/disabilities5030079

Authors: Laura M. Zagacki Lisa A. Chiarello Robert J. Palisano Rebecca G. Lieberman-Betz

This case report describes the implementation of participation-based occupational therapy for children with physical disabilities and their siblings in two families. Case 1 was a girl with myelomeningocele spina bifida and her brother, and case 2 was a boy with cerebral palsy and his sister. Goals targeted joint participation in play. The Sibling Participation in Occupational Therapy (SPOT) approach adapted the Collaborative Process for Action Plans to Achieve Children’s Participation Goals in order to assess goal-related factors and develop actionable steps to achieve the goal. Corresponding interventions addressing performance skills differed across cases and related to all children’s ages, interests, and functional abilities. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) measured sibling dyad’s achievement of their family’s goal, and participants completed an experiential questionnaire. Parent COPM ratings demonstrated a meaningful increase in performance and satisfaction, and the therapist and parent ratings of the GAS met or exceeded expected achievement. Parents and sibling dyads reported positive experiences in SPOT. The outcomes support the use of a participation-based approach inclusive of siblings that is consistent with family-centered practice to facilitate participation in meaningful joint sibling activities with families who have a child with a physical disability.

Disabilities doi: 10.3390/disabilities5030078

Authors: Kayla Korolek Kirsten Ward Heather Lamb Christopher B. McBride Katherine Bailey Chelsea Pelletier

The aim of this study was to explore the perceived relationship between inclusion and participation in social and physical activities for people with physical disabilities. In partnership with a local disability-focused non-profit organization, we completed semi-structured interviews with 12 individuals with physical disabilities. Interview transcripts were analysed using an inductive thematic approach considering the social–ecological model and quality participation framework for people with disabilities. We developed three themes to describe the relationship between inclusion and participation in social and physical activities: physical accessibility of spaces and places, advocates are needed to share knowledge, and social inclusion and social/physical activities influence each other. Participants discussed the facilitating role of social inclusion on physical and social activities and the bi-directional relationship between inclusion and community participation. Fostering social inclusion through increased accessibility, education, and awareness at the community or program level can facilitate full community participation for people with physical disabilities.

Disabilities doi: 10.3390/disabilities5030077

Authors: Noémie Fortin-Bédard Félix Nindorera Jean Leblond Caroline Rahn Krista L. Best Jaimie Borisoff Shane N. Sweet Kelly P. Arbour-Nicitopoulos François Routhier

Introduction: The change in environmental and social context during the COVID-19 pandemic affected daily activities of people with spinal cord injury (SCI), their interactions within the community, and, consequently, their social participation during the first wave of the pandemic. However, there is little information about the changes in social participation as the pandemic evolved in Canada. Objective: Our aim was to explore the change in the social participation of adults with SCI after the first two years of the COVID-19 pandemic in Canada. Methods: A follow-up from a previous study exploring the social participation of adults with SCI living during the first wave was conducted eight months later (second wave). Social participation was measured using the Assessment of Life Habits (LIFE-H 4.0) and Measure of Quality of the Environment (MQE) among 18 adults with SCI. Results: Participants reported increases between both waves of COVID-19 in some life habit categories, including mobility, personal care and health, nutrition, and recreation. New environmental factors were identified as facilitators, including the increased availability of businesses in the community. Conclusion: These findings indicate that people with SCI experienced greater realization and satisfaction with certain life habits. Although most barriers and facilitators showed little or no change between the two waves, the reduction in environmental barriers and the increase in facilitators may have contributed to improved social participation as the pandemic progressed.

Disabilities doi: 10.3390/disabilities5030076

Authors: Zarah Ford Martin E. Block

One of the greatest benefits of inclusion in general physical education (PE) is the opportunity for social interactions between students with and without disabilities. Unfortunately, interviews with students with disabilities who have participated in PE often find that social interactions with students without disabilities were limited. A model that promotes interaction between students with and without disabilities in PE is Special Olympics Unified Physical Education (UPE). In UPE, students with and without disabilities participate in activities together rather than the one-way focus on traditional peer tutoring. There have been anecdotal reports on the positive benefits of UPE for both students with and without disabilities. To date, there has been no published research on UPE. Additionally, some question how UPE has been implemented in schools, specifically questioning if UPE provided quality PE and whether students with disabilities were forced into UPE and denied opportunities to participate in general PE. The purpose of this qualitative study was to better understand how UPE was developed and implemented in select U.S. schools and the impact on social interactions between students with and without disabilities. Interviews with twelve teachers who were directly involved in their UPE programs revealed the following four major themes: (1) our students were not being served appropriately, (2) a mix of PE standards and Special Olympics programming, (3) UPE is a choice, and (4) our students improved in many ways. The discussion examined the results in relation to the criticisms of UPE and how UPE proved to be a positive alternative to limited social interactions in general PE.

Disabilities doi: 10.3390/disabilities5030075

Authors: Claire Flemmer Alison McIntosh

Accessing the built environment poses many challenges for people with disabilities, severely affecting their independence and quality of life. A panel of experts with a lived experience of disabilities co-designed a survey capturing the challenges in New Zealand’s public places. There were 319 survey respondents with impairments related to mobility (66.5%), vision (18.8%), hearing (5.0%), sensory processing and cognition (8.8%). They perceived sports stadiums as the least accessible venue, followed by bars, boutique shops and public toilets. The most accessible venues were supermarkets, libraries and shopping malls. The type of disability affected the main accessibility challenges. Significant outdoor barriers included uneven and cluttered paths, inadequate provision of curb cuts, seating and accessible parking spaces, and obscure wayfinding. Entrance barriers included heavy doors, complex access control, remote ramps and narrow, obscure entrances. Interior problems included cluttered paths and poor signage. The top priorities for improvement were simplifying layouts, keeping paths clear, and providing clear, inclusive signage, communication and assistance for people with varying impairments. Providing lower counters, better colour contrast, hearing loop facilities and better control of lighting and acoustics also improve accessibility. This research contributes novel experiential data from people with disabilities that is critical to achieving an inclusive built environment.

Disabilities doi: 10.3390/disabilities5030074

Authors: Thendo Gertie Makhado Rachel Tsakani Lebese

Education about epilepsy plays a vital role in reducing stigma, improving seizure response, and preventing school dropout among affected learners. Despite this importance, there is a lack of a structured conceptual framework guiding epilepsy education in primary schools, where children’s foundational learning and social development take place. This study aims to develop a conceptual framework that integrates epilepsy education into the life skills curriculum to reduce epilepsy-related stigma from an early age. A qualitative multi-methods approach was employed during the empirical phase, which was conducted in two stages using an exploratory–descriptive design. Data were collected from teachers, life skills education advisors (LEAs), and learners to explore their views on incorporating epilepsy education into the life skills curriculum of primary schools. The findings informed the development of a conceptual framework guided by the Three-Legged Stool Model and Dickoff’s Practice-Oriented Theory. This educational framework is tailored for primary school settings and highlights the roles of learners and teachers in promoting self-esteem through knowledge acquisition, value formation, and skill development, all underpinned by the Ubuntu philosophy.