Journal of Disability Policy Studies current issue

Not Immune: Access to Substance Abuse Treatment Among Medicaid-Covered Youth With Mental Retardation

Maclean Slayter, E. — Thu, 04 Feb 2010 16:40:04 PST

Youth with mental retardation* (MR) have experienced increasing levels of participation in community life over the last 30 years. This freedom has facilitated access to community life beyond school settings; it has also created the potential for alcohol and drug use and for the development of substance abuse (SA). Little is known about access to SA treatment for youth with MR—an especially vulnerable population. Through the application of a set of standardized performance measures, this study examines SA treatment access among youth aged 12 to 21 with and without MR (N = 150,009). Guided by Andersen’s sociobehavioral model of health care utilization, multivariate logistic regression analyses modeled SA treatment initiation and engagement. Youth with MR and SA were less likely to initiate or engage in treatment. Engagement among youth with MR and SA was associated with being male and/or non-White. Implications relate to a need for improved treatment access for youth with MR and SA through cross-system collaboration.

Analyzing the Impact of Disability Legislation in Canada and the United States

Kovacs Burns, K., Gordon, G. L. — Thu, 04 Feb 2010 16:40:04 PST

Experiences with disability legislation are different between Canada and the United States, but both countries have experiences to share regarding trends and best practices, as well as challenges addressing the accessibility of public facilities, housing, and transportation for persons with disabilities. Based on this distinction, a literature review was conducted focusing on the similarities and differences between Canadian and American disability legislation, primarily for trends and best practices that have resulted in positive outcomes for people with disabilities. Three times as much literature exists on U.S. experiences based on disabilities legislation over the past two decades. One major reason is that the United States has federal legislation specific to disabilities (dating back to 1990) and Canada has none. The impact of federal legislation is seen across each American state. Without federal legislation in Canada, the provinces are left to implement their own, often different, practices. This country comparison includes gaps in practices and considerations for improvements.

Inclusive Education in Botswana: The Perceptions of School Teachers

Chhabra, S., Srivastava, R., Srivastava, I. — Thu, 04 Feb 2010 16:40:04 PST

The purpose of this study was to identify the attitudes and concerns of teachers toward the inclusion of students with disabilities in the general classroom. The findings indicate that teachers in Botswana have somewhat negative attitudes with some concern about inclusive education. Significant correlation was observed between attitudes and concerns (r = .323). The results also reveal that many regular teachers feel unprepared and fearful to work with learners with disabilities in regular classes and so display frustration, anger, and negative attitudes toward inclusive education because they believe that it could lead to lower academic standards.

A Response to Jason et al. (2009), "Evaluating the Centers for Disease Control's Empirical Chronic Fatigue Syndrome Case Definition"

Reeves, W. C., Gurbaxani, B. M., Lin, J.-M. S., Unger, E. R. — Thu, 04 Feb 2010 16:40:04 PST

The recent article by Jason, Najar, Porter, and Reh, "Evaluating the Centers for Disease Control’s Empirical Chronic Fatigue Syndrome Case Definition" (2009; Journal of Disability Policy Studies, 20:2, 93—100) attempted to critically explore several pertinent issues concerning diagnosing chronic fatigue syndrome (CFS). Most of these issues have been brewing since international adoption of the 1994 CFS case definition by Fukuda et al., and it is high time to address them in a peer-reviewed and public forum.

Moving from Independence to Interdependence: A Conceptual Model for Better Understanding Community Participation of Centers for Independent Living Consumers

White, G. W., Lloyd Simpson, J., Gonda, C., Ravesloot, C., Coble, Z. — Thu, 04 Feb 2010 16:40:04 PST

This article provides a brief historical review of disability and personal and environmental limitations to community participation. Attention is given to policies that have limited consumer choice and to the pushback from disability rights advocates. These advocates eventually started the independent living movement as a reaction to the medical model that identifies disability as a personal defect rather than an environmental limitation. The authors discuss the basic philosophy and core services of independent living, and they present a conceptual model for helping centers for independent living (CIL) consumers more fully participate in the community. This model describes a continuum from independence to interdependence approaches to providing CIL services. Finally, the authors describe current research to determine the effectiveness of these two approaches to increasing consumer community participation.

Aging Families and the Demographics of Family Financial Support of Adults With Disabilities

Fujiura, G. T. — Thu, 04 Feb 2010 16:40:04 PST

Using data from the 2007 American Community Survey (ACS), the study estimated the degree of family financial support for adult members with disabilities living at home. Using the Internal Revenue Service definition of a "qualifying dependent," need for financial support was defined in terms ability to financially contribute to one’s own support. Estimates indicated that 32.3% of the family-based population of adults with disabilities needed financial support. Among those meeting the support test, approximately 4 in 10 lived in households where the primary income earner was 60 years or older. Results are discussed in terms of greater attention to the impact of emerging family demographics for policy and assumption of a family perspective in policy making.

A Constructive Debate With the CDC on the Empirical Case Definition of Chronic Fatigue Syndrome

Jason, L. A., Porter, N., Brown, M., Brown, A., Evans, M. — Thu, 04 Feb 2010 16:40:04 PST

The Centers for Disease Control and Prevention (CDC) estimates of the prevalence of chronic fatigue syndrome (CFS) have dramatically increased over the past 20 years, from 0.002% to 2.54%. Once considered a rare disorder, CFS is now characterized as a more common chronic health condition, with prevalence numbers suggesting that more than 4 million people in the United States have it. The authors’ research group proposes that selection criteria for CFS cases have broadened and provides data indicating 38% of those with a Major Depressive Disorder were misclassified as having CFS under the new CDC empirical case definition. The authors respond to concerns cited in Reeves, Gurbaxani, Lin, and Unger (2009). Given the importance of standardizing procedures for identifying CFS, more research is needed using different criteria on samples of patients with CFS and other illnesses. The erroneous inclusion of people with primary psychiatric conditions in CFS samples has detrimental consequences for interpreting epidemiologic and etiological findings.