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This chapter discusses the comparisons made in cases where there is a conflict of equality rights by reference to four cases in the Supreme Court, Bull v Hall and Preddy, the Jewish Free School case, the Gay Cake Case and the Paulley the wheel cahris on buses case. It considers what is the best way to resolve those conflcits and where and how the comparison of the rights should be made.
Paying particular attention to the story of one of the most key social and political figures in modern disability history – Zhang Haidi (b.1955), model hero, writer and current chair of the China Disabled Persons Federation – Chapter 2 reveals how disabled people began to emerge from the shadows following the end of the Cultural Revolution. It demonstrates how political, social and economic changes prompted the rise of new model para-citizens; it also shows how these changes have continued to keep disability at the forefront of the public imagination in subsequent times. From greater international engagement in the 1980s, to the emergence of neoliberalism, disability has become a prominent trope in state discourses of citizenship. While drawing on earlier narratives of individual productivity and social engagement, the new ‘responsibilised’ para-citizen has been further transformed in response to pressures to ‘fend for oneself’ and pay back one’s ‘debt’ to society. For many, this is an affective discourse, continuing, as it does, to decouple (semantically and metaphorically) the terms ‘disabled’ and ‘useless’ and offer ways to be recognised as a valuable member of the community.
The Introduction sets out the academic rationale for studying disability and citizenship in China, before mapping out current theoretical understandings of disability and citizenship, as well as the historical context of disability in China in particular, all of which set the foundations for the study that follows. It engages with a wide range of viewpoints on disability, from the medical and social models to notions of ableism and ‘normalcy’ and more recent rights-based models. It also provides a brief history of disability in China, from early philosophical conceptualisations to late imperial developments when bodies, literally and metaphorically, became the crucibles for the birth of a new republic in 1912. It then proceeds to look at the way in which citizenship is seen to intersect with disability by asking whether there can ever be such a thing as a ‘good’ disabled citizen, given that most societies have developed the template of an ideal citizen characterised by able-bodiedness, able-mindedness and normalcy. The chapter concludes with an overview of the book’s route towards the concept of ‘para-citizenship’ as a new framework for understanding disability and belonging.
The book concludes that, while there might be many areas of common experience, the ways in which disabled identities and citizenship are constituted and imagined in China might equally be a world away from those envisaged and experienced elsewhere. Theories of disability provide extremely useful tools for decoding the evidence we find, yet they can only take us so far as the various comparative lenses inherent in them inevitably leave China wanting. Proposing a broader conceptualisation of citizenship – para-citizenship – that acknowledges both the structural rules and resources that shape social systems and the individuals (and groups) within them, as well as the agency that enables individuals (and groups) to identify and respond to, or draw on, these particular power relationships, offers an approach that can encapsulate the diversity of disabling structures and disabled experiences, as well as reflect their fluidity and dynamism. And, with a much firmer understanding of disability in China’s recent past, we can begin to see how new forms of para-citizenship might be re-imagined in future, particularly as China transforms from within and opens up further to outside influences.
Research in the field of mathematical learning disability (MLD) is growing. Though a proportion of children in every school appear to struggle with mathematical achievement, MLD characterizes a subgroup of students with poor achievement and skill deficits that differentiate them from their low-achieving peers. This chapter explores some of the characteristics of children with MLD, including underachievement in mathematics, poor number sense, limited working memory, and additional processing deficits. Emerging evidence for universal screening, prevention, and early intervention are also presented. The chapter ends with guidelines for school psychologists to apply the extant literature to their own practice, along with a list of resources to gain further expertise on the typical and atypical development of numerical cognition.
Increasingly, students with intellectual disabilities (ID) in the United States are overcoming historical barriers to accessing traditionally exclusionary higher education. These gains undoubtedly represent a hard-fought victory for the broader disability rights movement. However, this advance has not come through enforcing the civil rights and non-discrimination statutes that generated disability rights victories in other areas or the disability-specific education laws that promoted access to primary and secondary schooling. Instead, many students with ID are accessing higher education opportunities through specialised programmes, often styled as ‘inclusive’ despite their segregated nature. Such programmes present new arenas for familiar forms of disability-based discrimination to once more manifest — such as suspect admissions criteria, second-class status and biased disciplinary procedures. Thus, despite the proliferation of inclusive post-secondary programmes, there remains an urgent social need to address barriers to full and effective participation in higher education that students with ID continue to face when navigating university and college campuses.
Numerous challenges face people living with disabilities in attempting to navigate the higher education (HE) space in South Africa. These include stigma and discrimination, lack of accommodations, lack of appropriate access to services and curriculum and policy oversights, often compounded by racial, gender and class inequalities that are also determinants of access. Even where disability is accommodated for, these accommodations often do not extend to the realm of ‘invisible’ disabilities, namely psychosocial and intellectual disabilities. This chapter considers how structural and systemic factors might militate to exclude people living with psychosocial disabilities from the HE space, particularly in terms of diversity and inclusion policies, and what can be done to address forms of marginalisation. In particular, it examines the accommodations made for people living with psychosocial disabilities in South Africa’s institutions of HE, while also examining the ways in which such accommodations can be supportive factors in retention and completion. Similarly, it considers what role the lack of accommodations might play in marginalising people living with psychosocial disabilities, hindering their participation and potentially adversely affecting outcomes. It also considers best practice in addressing the specific needs of people living with psychosocial disabilities in other HE contexts.
Research on sickness absence has typically focussed on single diagnoses, despite increasing recognition that long-term health conditions are highly multimorbid and clusters comprising coexisting mental and physical conditions are associated with poorer clinical and functional outcomes. The digitisation of sickness certification in the UK offers an opportunity to address sickness absence in a large primary care population.
Lambeth Datanet is a primary care database which collects individual-level data on general practitioner consultations, prescriptions, Quality and Outcomes Framework diagnostic data, sickness certification (fit note receipt) and demographic information (including age, gender, self-identified ethnicity, and truncated postcode). We analysed 326 415 people's records covering a 40-month period from January 2014 to April 2017.
We found significant variation in multimorbidity by demographic variables, most notably by self-defined ethnicity. Multimorbid health conditions were associated with increased fit note receipt. Comorbid depression had the largest impact on first fit note receipt, more than any other comorbid diagnoses. Highest rates of first fit note receipt after adjustment for demographics were for comorbid epilepsy and rheumatoid arthritis (HR 4.69; 95% CI 1.73–12.68), followed by epilepsy and depression (HR 4.19; 95% CI 3.60–4.87), chronic pain and depression (HR 4.14; 95% CI 3.69–4.65), cardiac condition and depression (HR 4.08; 95% CI 3.36–4.95).
Our results show striking variation in multimorbid conditions by gender, deprivation and ethnicity, and highlight the importance of multimorbidity, in particular comorbid depression, as a leading cause of disability among working-age adults.
Fieldwork forms the basis of geoscience studies. However, field activities present limitations for people with mental or physical impairments. This aspect can preclude participation in field trips by certain groups of students or limit their experience. In recent years, new types of supporting material and the development of accessible field trips have been a step forward towards the reduction of barriers to inclusion and equal opportunity. In the present work, normal practices of field teaching and potential solutions (and their limitations) to foster inclusion and accessibility to fieldwork are presented.
It is recognised that the attitudes of parents and teachers are important in supporting inclusive education in developing countries. This study involved the application of quantitative research through the administration of a survey to determine the attitudes of parents and teachers in the Republic of Nauru. The results have provided preliminary data regarding attitudes related to the emergence of inclusive education in Nauru. Parents were more positive concerning issues that relate directly to the educational benefits of their children over more general benefits of inclusion in education. At this stage, teachers report higher levels of positive attitude than parents. A more fine-grained level of analysis revealed that there is a wide range of attitudes to aspects of education for students with disabilities, and areas of expertise needed to support inclusive education. This research has provided an understanding of current parental and teacher attitudes and levels of existing teacher expertise towards inclusion that is able to inform future policy development in Nauru.
Chapter 6 discusses children’s relationships with their parents when a mother had migrated while a father stayed at home. This configuration was rare because it so contravened local gender norms it usually signalled inherent family vulnerabilities, typically economic hardship and a father’s physical impairment or else marital discord. In these ‘weak’ families, academically gifted children held out some hope to their parents that with support from the mother’s remittances, the family could strengthen over time. But in families where parents’ relationships were discordant, migrant mothers could be side-lined, while the parents’ divorce or a father’s death could trigger a migrant mother’s complete exit from the striving team. Men whose wives had migrated alone were at gravest risk of negative gender assessment if they earned little. They therefore tried to shore up their masculine worth by entrusting the ‘women’s work’ of childcare to the children’s grandmothers while stressing their commitments outside the home. But intimacy could still develop between the left-behind fathers and children. The family circumstances and the academic aptitude of the children of lone-migrant mothers differed but these children all had to contend with striving pressures and with managing relationships in families perceived by others to be social oddities.
A cross-sectional analysis was conducted using data from a prospective cohort study to investigate whether frailty is associated with pain intensity, disability caused by low back pain (LBP), and quality of life in an older population with acute non-specific LBP. Six hundred and two individuals with a mean age of 67.6 (standard deviation [SD] 7.0) years were included in the analysis. In relation to frailty status, 21.3 per cent of the sample were classified as robust, 59.2 per cent were classified as pre-frail, and 19.5 per cent were classified as frail. In the unadjusted analysis, pre-frail and frail groups showed significantly higher pain and disability scores than the robust group. Moreover, the same two groups exhibited lower scores in both physical and mental domains of quality of life than the robust group. After adjusting for socio-demographic and clinical variables, disability scores and the physical component of quality of life were significantly associated with frailty. In older adults with acute LBP, frailty is associated with more disability and worse scores in the physical component of quality of life.
Limited research has been conducted about ageing in place among older parents who co-habit with their ageing offspring with intellectual disability (ID). This study aims to explore which older parents would choose ageing in place together with their ageing offspring with ID instead of moving and what factors are associated with this choice. A face-to-face interview was conducted using the ‘housing pathways’ framework with older parents (⩾60 years) co-habiting with their ageing offspring with ID (⩾40 years) from two local authorities in Taiwan. In total, 237 families completed our census survey between June and September 2015. The results showed that 61.6 per cent of the participants would choose ageing in place with their ageing offspring with ID, while 38.4 per cent of the participants would stay in their previous place without their disabled children, move in with their other children or move to a nursing home. Logistic regression analyses revealed that parents who preferred ageing in place together with their offspring with ID were more likely to own a house (‘personal control’), have higher levels of life satisfaction (‘self-esteem’) and satisfaction with their current community (‘self-identity’), and have a lower level of social support than parents who chose another option. To meet the needs of older parents and their ageing offspring with ID, care and housing transitions should be considered as part of long-term care policy.
Aggressive behaviour is a highly prevalent and devastating condition in autism spectrum disorder resulting in impoverished quality of life. Gold-standard therapies are ineffective in about 30% of patients leading to greater suffering. We investigated cortical thickness in individuals with autism spectrum disorder with pharmacological-treatment-refractory aggressive behaviour compared with those with non-refractory aggressive behaviour and observed a brain-wide pattern of local increased thickness in key areas related to emotional control and overall decreased cortical thickness in those with refractory aggressive behaviour, suggesting refractoriness could be related to specific morphological patterns. Elucidating the neurobiology of refractory aggressive behaviour is crucial to provide insights and potential avenues for new interventions.
In 1870, the New York State Suffrage Association published a pamphlet titled “Woman as Inventor.” White suffragists distributed this history of female invention to prove women's inventiveness, countering arguments that biological disabilities justified women's legal disabilities. In the United States, inventiveness was linked to the capacity for original thought considered crucial for voters, making female inventiveness relevant to the franchise. As women could and did receive patents, activists used them as government certification of female ability. By publicizing female inventors, counting patents granted to women, and displaying women's inventions, they sought to overturn the common wisdom that women could not invent and prove that they had the ability to vote. Although partially successful, these efforts left undisturbed the equally common assertion that African Americans could not invent. White suffragists kept the contemporary Black woman inventor invisible, relegating the technological creations of women of color to a primitive past. White suffragists created a feminist history of invention, in words and objects, that reinforced white supremacy—another erasure of Black women, whose activism white suffragists were eager to harness, yet whose public presence they sought to minimize in order to keep the woman voter, like the woman inventor, presumptively white.
Drawing on a 2010 analysis of the reform and costs of adult social care commissioned by Downing Street and the UK Department of Health, this paper sets out projected future costs under different reform scenarios, reviews what happened in practice from 2010-19, explores the impact of the growing gap between need and funding, and explores the relationship between future spending and economic growth. In the process, it identifies a ‘lost decade’ in which policy makers failed to act on the warnings which they received in 2010, draws attention to the disproportionate impact of cuts on older people (compared to services for people of working age) and calls for urgent action before the current system becomes unsustainable.
Very little is known about the risk of developing psychological morbidities among adults living with cerebral palsy (CP) or spina bifida (SB). The objective of this study was to compare the incidence of and adjusted hazards for psychological morbidities among adults with and without CP or SB.
Privately insured beneficiaries were included if they had an International Classification of Diseases, Ninth revision, Clinical Modification diagnostic code for CP or SB (n = 15 302). Adults without CP or SB were also included (n = 1 935 480). Incidence estimates of common psychological morbidities were compared at 4-years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident psychological morbidities.
Adults living with CP or SB had a higher 4-year incidence of any psychological morbidity (38.8% v. 24.2%) as compared to adults without CP or SB, and differences were to a clinically meaningful extent. Fully adjusted survival models demonstrated that adults with CP or SB had a greater hazard for any psychological morbidity [hazard ratio (HR): 1.60; 95% CI 1.55–1.65], and all but one psychological disorder (alcohol-related disorders), and ranged from HR: 1.32 (1.23, 1.42) for substance disorders, to HR: 4.12 (3.24, 5.25) for impulse control disorders.
Adults with CP or SB have a significantly higher incidence of and risk for common psychological morbidities, as compared to adults without CP or SB. Efforts are needed to facilitate the development of improved clinical screening algorithms and early interventions to reduce the risk of disease onset/progression in these higher-risk populations.
Ancient Greece is well known for its many temples and sanctuaries, including several dedicated to healing and associated cults. Informed by disability studies, this article analyses the architecture of public spaces and facilities, alongside epigraphic, iconographic and literary evidence, to argue that the ancient Greeks sought to ensure the accessibility of healing sanctuaries. Even without a framework of civil rights as we understand them today, the builders of these sites made architectural choices that enabled individuals with impaired mobility to access these spaces. It is hoped that this research may stimulate further investigations into accessibility at other sites in the Classical world and beyond.
This article examines the effects of UK welfare reform since 2008 on people with mental health conditions and disabilities. The results have been profound, particularly during a time of economic austerity, damaging the social safety net and pushing many vulnerable people into poverty and hardship. It has perpetuated inequalities and increased the social exclusion of disabled groups. The holes in the safety net require repair, alongside extensive social policy reform to both protect and empower people with disabilities and long-term conditions.