Relegated to the Sidelines: A Qualitative Inquiry of Gatekeepers' Perspectives and Values of Physical Education for Disabled Children.

Several institutional aspects within the U.S. public school system impede the delivery of adapted physical education (APE) services to disabled children, including a lack of understanding and prioritization of these services by the special education team and a lack of qualified APE professionals to deliver these services. Thus, we conducted a qualitative inquiry grounded in a critical-ableism perspective to explore special education gatekeepers' experiences and perspectives of APE. Gatekeepers included parents, physical educators, and school administrators. Using a reflexive thematic analysis, we developed four interrelated themes: (a) disregard, negative, and charity mindsets toward disability; (b) systemic challenges in valuing and prioritizing APE; (c) presence as inclusion: (un)intentional marginalization in physical education; and (d) physical education for my child was a nightmare. These findings illustrate the complexities around the provision of physical education and APE to disabled children.

Referral networks for pediatric patients with genetic conditions: The perspective of occupational therapists.

Families of children with developmental delays but no diagnosed genetic condition may benefit from connection to genetic systems of care. This work examines the role of occupational therapy as a space for families of pediatric patients to gain access to genetic services. Between September 2021 and February 2022, we interviewed 20 occupational therapists in New England who work primarily with pediatric patients. We transcribed the interviews and used a grounded theory approach to identify and code recurring themes. The data reveal several barriers to linking pediatric patients to genetic systems of care, including lack of insurance coverage, wait times for appointments and test results, hesitant primary care providers, and familial and cultural stigma of disability. We discuss the unique role of occupational therapists as professionals who spend substantial time with patients, often in their everyday environments, to bridge these barriers. We also address challenges associated with occupational therapists facilitating connections to genetics services, including their lack of specialized knowledge of genetics and barriers fully integrating with others on the medical team.

Environmental awareness and public support for protecting and restoring Puget sound.

In an effort to garner consensus around environmental programs, practitioners have attempted to increase awareness about environmental threats and demonstrate the need for action. Nonetheless, how beliefs about the scope and severity of different types of environmental concerns shape support for management interventions are less clear. Using data from a telephone survey of residents of the Puget Sound region of Washington, we investigate how perceptions of the severity of different coastal environmental problems, along with other social factors, affect attitudes about policy options. We find that self-assessed environmental understanding and views about the seriousness of pollution, habitat loss, and salmon declines are only weakly related. Among survey respondents, women, young people, and those who believe pollution threatens Puget Sound are more likely to support policy measures such as increased enforcement and spending on restoration. Conversely, self-identified Republicans and individuals who view current regulations as ineffective tend to oppose governmental actions aimed at protecting and restoring Puget Sound. Support for one policy measure-tax credits for environmentally-friendly business practices-is not significantly affected by political party affiliation. These findings demonstrate that environmental awareness can influence public support for environmental policy tools. However, the nature of particular management interventions and other social forces can have important mitigating effects and need to be considered by practitioners attempting to develop environment-related social indicators and generate consensus around the need for action to address environmental problems.

Mental health experiences in 2021 for adults with disabilities who are lesbian, gay, bisexual, or transgender.

PURPOSE/OBJECTIVE: Examine the prevalence of mental health issues, receipt of mental health treatment, and self-reported unmet need for mental health treatment among U.S. adults with and without disabilities by lesbian, gay, bisexual, or transgender (LGBT) status during the pandemic. RESEARCH METHOD/DESIGN: Logistic regression and predicted probabilities using nationally representative, cross-sectional, household survey data from the U.S. Census Bureau's weekly Household Pulse Survey conducted during the COVID-19 pandemic (July 21, 2021-October 11, 2021). RESULTS: Controlling for age, educational attainment, employment, health insurance coverage, and race/ethnicity, adults with disabilities, regardless of LGBT status, had statistically significantly increased odds of having mental health issues, receiving mental health treatment, and reporting the unmet need for mental health treatment compared to adults without disabilities who were not LGBT. Adjusted rates of receipt of mental treatment ranged from a low of 9% for persons without disabilities who were not LGBT to 27% for persons with disabilities who were LGBT, a gap of 18 percentage points. An even larger percentage point gap (22 percentage points) was noted in the unmet need for treatment between persons without disabilities who were not LGBT (9%) and persons with disabilities who were LGBT (31%). CONCLUSIONS/IMPLICATIONS: These results highlight the need for expansions of the mental health service delivery system in the United States as well as a prioritization of accessibility and inclusiveness practices. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Linking job duties, functioning, and employment status using the Work-Disability Functional Assessment Battery (WD-FAB): An expert coding and quantitative analysis.

BACKGROUND: An understanding of the link between specific occupational demands and individual worker functioning is limited, although such information could permit an assessment of the fit between the two in a manner that would inform national and state disability programs such as vocational rehabilitation and Social Security disability programs. OBJECTIVE: Our goal was to examine the utility of assessing physical and mental functioning relative to self-reported job duties to identify the domains of worker functioning most likely to create barriers to fulfilling an occupation's specific requirements. METHODS: Through primary survey data collection, 1770 participants completed the Work-Disability Functional Assessment Battery (WD-FAB) instrument after reporting details on their occupations (or most recent occupation if not working). Expert coders evaluated the level of function expected to successfully carry out each self-reported job duty with respect to six scales of physical and mental function. Quantitative analysis is used to examine the relationship between functioning and job duties. RESULTS: Those not working due to disability were more likely to fall short of the threshold of the physical and mental functioning requirements of their last job's three main job duties compared to those currently employed. Mental function scales were most likely to be the area experiencing a shortfall. CONCLUSIONS: Functional difficulties impede the ability to continue working in particular jobs that require that ability. This points to a need for specific accommodations to be implemented to bridge the gap between job requirements and functional capacity so that workers may remain engaged in their current work.

The association of disability status with job tenure for U.S. workers.

BACKGROUND: Job tenure is a useful economic indicator. To employees, longer job tenure creates higher rewards in pay, promotion opportunities, and job security. For employers, there are fewer costs in recruitment and retraining when job turnover is low. Marginalized populations, such as persons with disabilities, may find work in various economies, but retention is more difficult. They are often the first to be laid off in struggling economies. OBJECTIVE: The purpose of this study is to highlight differences in individual and employment-related factors associated with job tenure for American workers with and without disabilities. METHODS: Using newly available survey data (N = 1,538), OLS regression is used to estimate job tenure for workers with and without disabilities, controlling for worker sociodemographic characteristics, a job quality index, and job characteristics. All disability types are examined. RESULTS: Multivariate results show that workers with disabilities have shorter job tenure than others when controlling for job quality, individual characteristics and job characteristics. CONCLUSION: Employees with disabilities have shorter job tenure than those without. Given the benefits of lengthened job tenure, further efforts should be made to explore this issue and to develop effective strategies that help those with disabilities retain jobs long term.

Exposure to Family and Friend Homicide in a Nationally Representative Sample of Youth.

This study examines the lifetime prevalence and distribution of family/friend homicide exposure among children and adolescents age 2 to 17 in the United States, and assesses the impact of family/friend homicide on emotional and behavioral outcomes, while controlling for potential co-occurring factors. Data were collected by telephone about the experiences of youth in 2008, 2011, or 2014, as part of the National Surveys of Children's Exposure to Violence (NatSCEV). Analyses are based on a pooled sample (n =11,771) from these three surveys. Approximately 8% of all children and youth ages 2 to 17 were exposed to a family/friend homicide. Older adolescents, Black youth, those living in single parent and nonparent family households, those from lower socioeconomic status households, and youth living in large cities were overrepresented among youth experiencing family or friend homicide. Exposed youth were also substantially more likely to be poly-victims, experience other major adversities, and live in neighborhoods with more community disorder. Exposure to family/friend homicide was significantly related to trauma symptoms. However, when other co-occurring factors were taken into account, only family/friend homicide that occurred within the last 2 years remained significant. With respect to delinquency, only nonfamily homicide exposure remained significant with these other factors controlled. Findings suggest that family/friend homicide represents a powerful marker for a broad level of victimization risk and adversity, demonstrating that family/friend murder is often just one relatively small part of a more complicated life of adversity. Although recent exposure is certainly distressing to youth, it is the wider, co-occurring context of poly-victimization and other types of adversity that appears most impactful in the longer term.

Strengthening the predictive power of screening for adverse childhood experiences (ACEs) in younger and older children.

BACKGROUND: There is increasing interest in routine screening for Adverse Childhood Experiences (ACEs) to help identify high-risk children who would benefit from interventions. However, there has not yet been sufficient research concerning which particular set of ACEs would be most predictive as a potential screening tool. OBJECTIVE: This study compared 40 Adverse Childhood Experiences (ACEs), covering 11 different conceptual domains, in their ability to predict trauma symptoms in childhood. PARTICIPANTS AND SETTING: The current study uses pooled data from three National Surveys of Children's Exposure to Violence (NatSCEV) conducted in 2008, 2011, and 2014. Each survey collected information on children aged one month to 17 years. METHODS: Samples were obtained from a mix of random digit dialing and address based sampling methods. Telephone interviews were conducted with children 10 years and older and with caregivers, if the randomly selected child was under age 10. RESULTS AND CONCLUSION: A different set of 15 items best predicted trauma symptoms for younger (2-9-year-old) compared to older (10-17-year-old) youth. Some conventional ACEs, like physical and emotional abuse, proved important for both age groups. However, family-related factors were more predictive for younger children, while community and peer violence exposures were more predictive for older children. Our new proposed measures explained substantially more variance in subsequent trauma symptoms than did the original ACE measure (R2 = .31 vs .18 for 2-9 year olds; R2 = .43 vs .26 for 10-17 year olds; p < .001 for all) and identified a larger percentage of children with high levels of trauma.

Comparing estimates of disability prevalence using federal and international disability measures in national surveillance.

BACKGROUND: The National Health Interview Survey (NHIS) is changing the annual inclusion of standardized disability identifiers, reinvigorating the priority to examine existing disability question sets. These sets include questions developed by the United States (U.S.) National Center for Health Statistics in conjunction with the U.S. Census Bureau (the American Community Survey questions, ACS) and United Nations (the Washington Group Short Set questions, WGSS), that are policy relevant, comparable across populations, and short enough to be included in censuses and surveys across countries. OBJECTIVE: To compare disability prevalence estimates from federal and international standardized disability questions across demographic factors. METHODS: Bivariate analysis of disability question sets asking adults about vision, hearing, ambulation, cognition, and self-care difficulties and demographic factors using secondary data from supplements in the 2010 and 2013-2015 NHIS. RESULTS: Our study found substantial and statistically significant differences in the percentage of disabilities (overall and by type) based on comparable ACS and WGSS questions across demographic categories. Dependent on response coding, WGSS-based disability prevalence was consistently and significantly larger or smaller than ACS-based disability prevalence. Overall disability prevalence using ACS and two different WGSS response combinations were 16.3% and 9.2% or 39.4%, respectively. CONCLUSION: ACS and WGSS measures identify predictably different sized populations of adults with disabilities. Further, with some exceptions, ACS and WGSS questions identify populations with disabilities with relatively consistent demographic factors. Additional research is recommended to understand the comparability of disability prevalence and health disparities and inequities people with disabilities experience when using these measures.

Prescription opioid behaviors among adults with and without disabilities - United States, 2015-2016.

BACKGROUND: Prescription opioid use among people with disabilities has not been well characterized. OBJECTIVE: To examine prescription opioid use, misuse, and use disorder, reason and source for last prescription opioid misuse, and receipt of prescription opioid treatment among people with and without disabilities. METHOD: Stratified analysis of prescription opioid use, misuse, and use disorders; primary reason and primary source for last prescription opioid misuse; receipt of prescription opioid treatment; and disability status among civilian, noninstitutionalized adults (ages 18+) using data from the 2015-2016 National Survey on Drug Use and Health. RESULTS: Adults with disabilities were significantly more likely than adults without disabilities to experience past year prescription opioid use (52.3% for those with disabilities compared to 32.8% of those without), misuse (4.4% compared to 3.4%), and use disorders (1.5% compared to 0.5%). People with disabilities were significantly more likely to misuse opioids for pain (Risk Ratio = 1.5, p < 0.001) and to receive opioids from a healthcare provider (Risk Ratio = 2.0, p < 0.001). Among people with opioid use disorder, people with disabilities were less likely to receive treatment for prescription opioid use (Risk Ratio = 0.6, p = 0.067). CONCLUSION: In the U.S., a substantial population with disabilities using and misusing prescription opioids exists that has not been well characterized. Persons with disabilities experience disparities in reason and source for last opioid misuse. Healthcare and substance abuse prevention, intervention and treatment providers must collaborate to address the needs of this population.

Beyond residential mobility: A broader conceptualization of instability and its impact on victimization risk among children.

Predictability in a child's environment is a critical quality of safe, stable, nurturing relationships and environments, which promote wellbeing and protect against maltreatment. Research has focused on residential mobility's effect on this predictability. This study augments such research by analyzing the impact of an instability index-including the lifetime destabilization factors (LDFs) of natural disasters, homelessness, child home removal, multiple moves, parental incarceration, unemployment, deployment, and multiple marriages--on childhood victimizations. The cross-sectional, nationally representative sample of 12,935 cases (mean age = 8.6 years) was pooled from 2008, 2011, and 2014 National Surveys of Children's Exposure to Violence (NatSCEV). Logistic regression models controlling for demographics, socio-economic status, and family structure tested the association between excessive residential mobility, alone, and with LDFs, and past year childhood victimizations (sexual victimization, witnessing community or family violence, maltreatment, physical assault, property crime, and polyvictimization). Nearly 40% of the sample reported at least one LDF. Excessive residential mobility was significantly predictive of increased odds of all but two victimizations; almost all associations were no longer significant after other destabilizing factors were included. The LDF index without residential mobility was significantly predictive of increased odds of all victimizations (AOR's ranged from 1.36 to 1.69), and the adjusted odds ratio indicated a 69% increased odds of polyvictimization for each additional LDF a child experienced. The LDF index thus provides a useful alternative to using residential moves as the sole indicator of instability. These findings underscore the need for comprehensive supports and services to support stability for children and families.

Injuries From Physical Abuse: National Survey of Children's Exposure to Violence I-III.

INTRODUCTION: Official data sources do not provide researchers, practitioners, and policy makers with complete information on physical injury from child abuse. This analysis provides a national estimate of the percentage of children who were injured during their most recent incident of physical abuse. METHODS: Pooled data from three cross-sectional national telephone survey samples (N=13,052 children) included in the National Survey of Children's Exposure to Violence completed in 2008, 2011, and 2014 were used. RESULTS: Analyses completed in 2016 indicate that 8.4% of children experienced physical abuse by a caregiver. Among those with injury data, 42.6% were injured in the most recent incident. No differences in injury were observed by sex, age, race/ethnicity, or disability status. Victims living with two parents were less likely to be injured (27.1%) than those living in other family structures (53.8%-59%, p<0.001). Incidents involving an object were more likely to result in injury (59.3% vs 38.5%, p<0.05). Injured victims were significantly more likely to experience substantial fear (57.3%) than other victims (34.4%, p<0.001). CONCLUSIONS: A substantial percentage of physical abuse victims are physically hurt to the point that they still feel pain the next day, are bruised, cut, or have a broken bone. Self-report data indicate this is a more common problem than official data sources suggest. The lack of an object in an incident of physical abuse does not protect a child from injury. The results underscore the impact of childhood physical abuse and the importance of early prevention activities.

Victimization and adversity among children experiencing war-related parental absence or deployment in a nationally representative US sample.

This study compares children and youth who have experienced lifetime war-related parental absence or deployment with those having no such history on a variety of victimization types, non-victimization adversity, trauma symptoms, and delinquency; and assesses whether cumulative adversity and victimization help to explain elevated emotional and behavioral problems among children of parents who have experienced war-related absence or deployment. The National Surveys of Children's Exposure to Violence (NatSCEV) are comprised of three cross-sectional telephone surveys conducted in 2008, 2011, and 2014. Data were collected on the experiences of children aged one month to seventeen years. In each survey, interviews were conducted with youth 10-17 years old and with caregivers of children 0-9 years old. The analyses use pooled data from all three U.S. nationally-representative samples (total sample size of 13,052). Lifetime parental war-related absence or deployment was a marker for elevated childhood exposure to a wide array of victimization and adversity types. Cumulative past year exposure to multiple forms of victimization and adversity fully explained elevated trauma symptoms and delinquency in this population of children. Given the breadth of victimization and adversity risk, children with histories of parental war-related absence or deployment, as well as their families, represent important target groups for broad-based prevention and interventions to reduce exposure and ameliorate consequences when it does occur.

Family abduction in a national sample of US children.

This study examined the prevalence and characteristics of family abduction episodes occurring in a nationally representative sample of US children ages 0-17. It drew on the experiences of 13,052 children and youth from the aggregation of three cross-sectional waves (2008, 2011, and 2014) of the National Surveys of Children Exposed to Violence. The overall prevalence rate was 4.1% for a lifetime and 1.2% for a past year episode. Rates were higher for younger than older children. Parents constituted 90% of the abductors with females outnumbering males 60% to 40%, although men outnumbered women as perpetrators for certain types of abductions. A bit less than half of the episodes (43%) were reported to police. The experience of a lifetime family abduction had an independent association with traumatic stress symptoms independent of exposure to other kinds of victimization including child maltreatment and witnessing family violence.