Sally Lindsay

Discrimination and other barriers to employment for teens and young adults with disabilities

Purpose. Having a disability is a barrier to securing and maintaining employment. Most research has focussed on employment barriers among adults, while very little is known about young peoples experience finding paid work. Method. Young people aged 15–24 were selected from the 2006 Participation and Activity Limitation Survey to explore the barriers and discrimination they experienced in seeking employment ((n  ==  1898)). Results. Our findings show that teens and young adults with disabilities encountered several barriers and discrimination in seeking paid employment. The types of barriers that these young people encountered varied by age and type of disability. There were fewer yet different types of barriers to working that were encountered between the two age groups ((teens and young adults)). Several socio-demographic factors also influenced barriers to working. Severity of disability, type and duration of disability, level of education, gender, low income, geographic location and the number of people living in the household all influenced the kind of barriers and work discrimination for these young people. Conclusions. Rehabilitation and life skills counsellors need to pay particular attention to age, type of disability and socio-demographic factors of teens and young adults who may need extra help in gaining employment.

Experiences of social exclusion and bullying at school among children and youth with cerebral palsy

Purpose: Although bullying amongst typically developing school-aged children has been well explored, it is under-researched for children with disabilities. The purpose of this study was to understand the experiences of exclusion and bullying among children with disabilities. Method: We draw on qualitative in-depth interviews and a focus group with children and youth with disabilities (n = 15) to explore their experiences of exclusion and bullying. Results: Our results showed that restrictions in the socio-contextual environment influenced the social exclusion that children experienced. Youth encountered social exclusion from both teachers and peers. Children reported that teachers’ attitudes toward children with disabilities often influenced the social exclusion experienced by peers. Bullies engaged in both implicit and explicit forms of social exclusion toward children with disabilities which often lead to verbal and physical bullying. Conclusions: Children with cerebral palsy are victims of bullying and social exclusion within the school context. More opportunities for social inclusion are needed. Implications for Rehabilitation Children and youth with cerebral palsy experience verbal and physical bullying at school. Rehabilitation health care providers and educators should be cognizant of the symptoms of childhood bullying and be prepared to provide children and their parents with resources on how to cope. Health care providers and educators should teach children how to explain their disability and their specific needs to their teachers and peers to create more awareness and understanding about their condition.

A systematic review of disability awareness interventions for children and youth

Purpose: Children’s lack of knowledge about disability can adversely impact their attitudes toward people with disabilities. The purpose of this study is to review the common elements of effective disability awareness interventions. Methods: A systematic review of disability awareness interventions for children and youth was conducted to assess the effective components of these interventions. Electronic searches were conducted using OVID, CENTRAL, PsychInfo, ERIC, Social Science Citation Index, GreyNET Scopus and Google Scholar. The inclusion criteria included (i) an intervention raising awareness about disability, (ii) school-age children with the average age between 5–19 years old, (iii) at least one measurable outcome focusing on knowledge about disability or attitudes towards and/or acceptance of people with a disability and (iv) published article or grey literature. Results: Of the 1031 articles that were identified in the search, 42 met the criteria to be included in the review. We classified the disability awareness interventions into 5 broad types including (i) social contact, (ii) simulation, (iii) curriculum, (iv) multi-media curriculum and (v) multiple components. Thirty-four studies showed an improvement in attitudes towards and/or acceptance of peers with disabilities. Eight of these studies also demonstrated an improvement in knowledge of people with disabilities. Five of the interventions found no support for improving knowledge about, or acceptance of people with disabilities. Conclusion: Disability awareness interventions can successfully improve children’s knowledge about and attitudes towards peers with a disability; they should include several different components over multiple sessions. Relevance: These findings are being used to further develop disability awareness interventions to help improve the social inclusion and participation of children with disabilities within mainstream classrooms. Implications for Rehabilitation Well-designed disability awareness interventions for children and youth can help improve knowledge about disability, attitudes towards people with a disability and acceptance of peers with a disability. Rehabilitation health care providers and educators should be trained to recognize when children with disabilities are being socially excluded and be prepared to provide or recommend appropriate resources and interventions on how to address this issue. Clinicians, educators and children with disabilities should all be involved in the development of disability awareness programs. Educators should carefully choose an appropriate intervention to meet the needs of the children in their class while considering age appropriateness and diversity of the students. It is also important for educators to be cognizant of the broader societal influences that impact attitudes towards disability.

Educators’ Challenges of Including Children with Autism Spectrum Disorder in Mainstream Classrooms

Although children with autism spectrum disorder (ASD) are increasingly being placed within mainstream classes, little is known about the challenges that teachers encounter with including them as full participants in the class. This qualitative study draws on a purposive sample of 13 educators who have experience teaching children with ASD within two cities in Ontario, Canada. Through in-depth interviews we asked about teachers’ challenges regarding creating an inclusive environment within their classroom. Teachers reported several challenges, including: understanding and managing behaviour; socio-structural barriers (i.e., school policy, lack of training and resources); and creating an inclusive environment (i.e., lack of understanding from other teachers, students and parents). Teachers recommend that more resources, training and support are needed to enhance the education and inclusion of children with ASD.

Working with immigrant families raising a child with a disability: challenges and recommendations for healthcare and community service providers

Purpose: Although providing culturally sensitive care is an important element of family-centered rehabilitation very is little known about providers’ experiences working with immigrant families in pediatric settings. The purpose of this study is to develop a better understanding of the experiences of service providers working with immigrant families raising a child with a physical disability. Method: We draw on a qualitative approach involving in-depth interviews and focus groups with healthcare and community service providers (n = 13) in two multi-cultural Canadian cities. Results: The findings indicate that healthcare and community service providers encounter several challenges in providing care to immigrant families raising a child with a disability. Such challenges include the following: (1) lack of training in providing culturally sensitive care; (2) language and communication issues; (3) discrepancies in conceptualizations of disability between healthcare providers and immigrant parents; (4) building rapport; and (5) helping parents to advocate for themselves and their children. Service providers also have several recommendations for improving services to better meet the needs of immigrant families. Conclusion: Clinicians should be cognizant of how culture influences the care they provide to clients. More training opportunities are needed for enhancing culturally sensitive care. Implications for Rehabilitation Pediatric rehabilitation providers working with immigrant families raising a child with a disability should engage in training and education around culturally sensitive care to better meet the needs of these clients. More time is needed when working with immigrant families to build trust and rapport. Clinicians need to be sensitive around gender issues and try to involve both parents in the decision making around the care for their child. Healthcare providers should help clients to become more aware of the resources available to them in the hospital and in the community.

Parents’ Experiences of Caring for a Child With Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a developmental disorder involving abnormal communication, repetitive and restrictive interests, and impaired social functioning. ASD can have a profound impact on family life, including the roles and responsibilities that parents assume. In this metasynthesis, we explore the experiences of parents who care for a child with ASD. We undertook a thematic synthesis to integrate qualitative evidence, searching 10 electronic databases and reviewing 4,148 abstracts. We selected 31 articles for inclusion (involving 160 fathers and 425 mothers) and examined the articles using a constant comparative approach. We identified six themes: prediagnosis, diagnosis, family life adjustment, navigating the system, parental empowerment, and moving forward. Our findings can inform the development of programs and services for families, provide insight for health care workers who advocate on behalf of parents, and provide valuable information to parents, particularly those of children newly diagnosed with ASD.

Becoming men: Gender, disability, and transitioning to adulthood

Children and youth with progressive conditions are living longer, and there is increased interest in designing programs that will assist them with “transitioning” to adulthood. Almost none of the transitions research to date, however, has attended to the experiences of disabled boys in “becoming men,” nor has there been critical conceptual work problematizing notions of “normal” adulthood or theorizing the complex, diverse, and gendered experiences of transitioning. In this Canadian study, we investigated the intersectionality of gender, disability, and emerging adulthood with 15 young men with Duchenne muscular dystrophy. Participants created audio diaries and photographs that were explored in in-depth interviews. Using a Bourdieusian lens and Arthur Frank’s notion of the narrative habitus, we examined how participants re/negotiated identities in everyday practices. Our analysis suggested that disability, masculinities, and generational (life stage) identities intersected through “narratives of nondifference,” wherein participants worked to establish identities as typical “guys.” Within limited fields of school and work, participants distanced themselves from the label of “disabled” and discussed their successes and challenges in terms of normative developmental trajectories. We suggest that the pursuit of “normal” is reproduced and reinforced in health and social programs and closes off other narratives and possibilities.

A sociological focus on ‘expert patients’

Abstract The increase of chronic illness as a leading cause of death has given rise to self-care and expert patient initiatives. Caring for chronically ill people places a tremendous economic burden on the health care system, informal carers, the labour market and benefit system (Department of Health 2001, 2004, 2005). Thus, in many countries health policy encourages patients to become ‘experts’ in the self-management of their conditions in the belief that it will help save money and improve health and well-being (Wanless 2002). For example, the notion of ‘expert patients’ has emerged in UK policy and is pivotal to government plans to modernise the National Health Service (NHS) by linking patient expertise to ideas of empowerment, a better quality of life, self-esteem and a user-driven NHS (Department of Health 2001; Fox et al 2005). Self-management and expert patient initiatives aim to encourage chronically ill patients to become more actively involved in decisions concerning their care and well-being (Lorig and Holman 2003; Lorig et al 1985, 1999, 2001).

An ecological approach to understanding barriers to employment for youth with disabilities compared to their typically developing peers: views of youth, employers, and job counselors

Abstract Purpose: The purpose of this study is to explore the extent to which youth with physical disabilities encounter different barriers to finding employment compared to their typically developing peers. Methods: This study draws on 50 qualitative in-depth interviews with a purposive sample of 31 youth (16 typically developing and 15 with a disability), and youth employers and job counselors knowledgeable about employment readiness among adolescents (n = 19). We utilize Bronfrebrenner’s ecological framework to reveal the complex web of factors shaping youth’s labor market outcomes. Results: Only half of youth with a disability were working or looking for work compared to their peers. The findings show this was a result of different expectations of, and attitudes toward, youth with disabilities. For many youth with a disability, their peers, family and social networks often acted as a barrier to getting a job. Many youth also lacked independence and life skills that are needed to get a job (i.e. self-care and navigating public transportation) compared to their peers. Job counselors focused on linking youth to employers and mediating parental concerns. Employers appeared to have weaker links to youth with disabilities. System level barriers included lack of funding and policies to enhance disability awareness among employers. Conclusions: Youth with physical disabilities encounter some similar barriers to finding employment compared to their typically developing peers but in a stronger way. Barriers to employment exist at several levels including individual, sociostructural and environmental. The results highlight that although there are several barriers to employment for young people at the microsystem level, they are linked with larger social and environmental barriers. Implications for Rehabilitation Clinicians working with youth should promote the development of skills that can lead to improved self-confidence and communication skills for youth. Encourage the development of extracurricular activities and social networking to build these skills and to make contacts for finding employment. Clinicians should support youth with disabilities and their parents in practicing independence skills (such as self-care, self-advocacy and navigating public transportation) they need prior to seeking employment. Vocational rehabilitation professionals should educate youth on how to disclose their condition to a potential employer, how to ask for ask for accommodations and how to market their abilities. Clinicians should help to link youth with disabilities to volunteer opportunities and to employers. Advocate for disability awareness training for employers regarding how to accommodate people with disabilities and the potential they offer in the workplace.

Skill development in an employment-training program for adolescents with disabilities

Purpose: Relatively little is known about the first employment experiences and skill development of youth with disabilities. The purpose of this study is to explore the skills gained by adolescents with disabilities who have completed an employment-training program. Methods: In-depth, qualitative semi-structured interviews were conducted with 18 adolescents with a physical and/or mobility-related disability. The youth and their parents also completed a brief questionnaire about their experience in the program and we reviewed their self- and staff-assessments that were completed throughout the program. Results: The findings highlight how adolescents with disabilities developed several practical, social and communication skills, and self-confidence over the course of an employment-training program. Despite personal gains, youth reported challenges in their post-program search for employment. Conclusions: Youth valued involvement in the workforce and perceived that through their participation they developed important life skills. Implications for Rehabilitation Educators and health care providers should be awar that teens with disabilities as young as 15 years old are thinking about their future and looking for employment experience. Educators and clinicians can assist youth and their families by talking about the benefits of involvement in volunteering and providing practical suggestions for how to get involved, including discussing the strengths and areas for skill development. At a community level, advocacy can raise awareness of the importance of early work experience and the potential contributions of youth with disabilities. Advocacy should target community employers, but also increased government funding for employmenttraining programs and employment transition supports for this age group.