Perspectives on quality of life among disability-related organization leaders serving individuals with paralysis.

Understanding how the Christopher & Dana Reeve Foundation Quality of Life grant recipients define quality of life has value in helping to further develop and refine the literature on this topic for individuals with spinal cord injury and/or organizations working to serve and/or support individuals with spinal cord injury. The purpose of this organizational evaluation project's evaluation activities was to engage with Quality of Life (QOL) Grant recipients, namely leaders at disability-related organizations across the United States, to better understand their definitions and operationalization of the term, "quality of life". To do so systematically, researchers compiled a list of all QOL grant recipients from two 2016 grant cycles and divided them into three categories based on the award amount. From these categories, we randomly selected organizations to invite to provide input. Phone interviews were completed with 19 grant recipients. A thematic content analysis was completed across the resulting transcripts using MAXQDA software. The sub-themes identified by researchers included: community connection, independence, self-determination, caregiver communication, and including caregivers in programs. Our analysis demonstrates the importance of both community and caregiver relationships to organizations that focus on QOL for people with SCI. Novel findings suggest the importance of community and connection as well as a reframing of both the constructs of independence and control within QOL. Lessons for evaluators are also provided.

"I'm a security professional, a counselor, a leader, and sometimes a father figure": Transformative social emotional learning through the eyes of school security professionals.

Schools are increasingly hiring full-time, unarmed school security professionals (SSPs), who are different from School Resource Officers (SROs), to help facilitate safe and supportive school climates. However, there is a paucity of literature about how they describe and engage with social emotional learning (SEL), particularly equity-focused or transformative SEL. The current study is a secondary data analysis using qualitative responses to content embedded in two online professional development (PD) modules created for school security: SEL and cultural competence (CC). Forty-eight SSPs completed the SEL module and 18 of these SSPs also completed the CC module. Informed by the Collaborative for Academic, Social, and Emotional Learning's transformative SEL literature, researchers sought to understand how SSPs describe SEL and how they apply transformative SEL in their work. A qualitative transcript analysis was performed, and transformative SEL's five subthemes were identified through this iterative process: working collaboratively, equity and inclusion, cultural humility, ties to identity, and advocacy. Findings demonstrated that SSPs who completed the modules apply transformative SEL principles in various, overlapping ways, illustrating their capacity to support student SEL. However, some SSPs struggled to make ties to their own identity, highlighting the need for widespread training and additional emphasis on self-awareness in transformative SEL PD.

The Utopia of Disability Inclusion in the Rehabilitation Sciences: An Insider's Perspective.

The inclusion of people with disabilities has historically been, and continues to be, challenging work. In the health professions, the practice of inclusion should promote and advance the dissemination of efforts to decrease the impact of societal and physical barriers on the lives of people with disability, as well as promote innovative approaches to effectively foster an inclusive society. In addition to a focus on concepts such as the intact abilities of people with disabilities and the facilitation of community participation, an important shift in inclusion-related research requires listening to the lived experience of individuals with disabilities. Listening to their lived experiences and including the valuable insights gleaned from their insider's perspective can enrich efforts to evaluate clinical and educational programs, define population needs, and set research agendas and rehabilitation goals. Building on seminal work from Tamara Dembo, Beatrice Wright, and Margaret Brown, this communication from the Disability Representation Task Force at the American Congress of Rehabilitation Medicine also explores how healthcare providers living with a disability can make a significant contribution to rehabilitation treatment by analyzing how their own experience applies to clinical practice.

Psychometric properties of the Disability Identity Development Scale: Confirmatory factor and bifactor analyses.

PURPOSE/OBJECTIVE: This work provides comprehensive analyses targeting the factor structure and dimensionality of the Disability Identity Development Scale (DIDS). In Forber-Pratt et al., 2020, disability was defined broadly to include individuals with visible or hidden disabilities across many disability groups (i.e., physical, intellectual, learning, or chronic illness). RESEARCH METHOD/DESIGN: Retained items from previous exploratory factor analysis were administered to a sample of adults with disabilities (n = 1,126) ranging in age from 18-78 years. Confirmatory factor analytics (CFA) including traditional CFA, and bifactor confirmatory analyses were used to examine the dimensionality and structure of the DIDS. RESULTS: Traditional CFA provided lack of evidence in support of the oblique four-factor structure previously reported. Bifactor confirmatory analysis revealed items on the DIDS are consistent with unidimensional, and to a lesser degree multidimensional solutions (i.e., items lacked a level of content diversity to substantiate a complex, reliable multifactor structure). DISCUSSION/CONCLUSION: Analytic results on the DIDS revealed reasonable psychometric properties as a measure of disability identity. Our results support using a sum or total score of disability identity. Results of this work are an important contribution to a growing body of literature supporting, and investigating, disability identity development. Furthermore, the DIDS measure with its resulting composite score of disability identity has the potential to inform clinicians in the field of rehabilitation psychology as well as informing future targeted interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Perspectives about COVID-19 vaccination among the paralysis community in the United States.

PURPOSE/OBJECTIVE: We sought to explore perspectives among the paralysis community and caregivers or persons with paralysis (PWP) about the COVID-19 vaccination. Research Method/Design: Data were collected via online survey with multiple choice and open-ended questions from adult PWP and family members and/or caregivers (FC) of PWP. Multiple choice questions were analyzed using descriptive statistics and chi-square analyses were conducted to compare the two groups (PWP and FC); open-ended responses were coded using Hamilton's rapid assessment process. RESULTS: A total of 1,017 respondents (831 PWP, 186 FC). PWP shared the same levels of COVID-19 vaccination hesitancy and received similar levels of information about the vaccine as the general population. Unique concerns about the COVID-19 vaccine expressed solely by PWP included fear of death after the vaccine, concerns about vaccine efficacy, and concerns about Federal Drug Administration approval. At the time, the majority of PWP plan to seek a COVID-19 vaccination and were vaccinated at a higher rate than was the general population. CONCLUSIONS: Although PWP share many similar concerns to the general population, there are some concerns unique to PWP that must be noted to ensure that the paralysis community is considered fully and equitably in public health efforts related to the COVID-19 pandemic and beyond. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exploring disability identity with adolescents.

PURPOSE/OBJECTIVE: The purpose of this study was to qualitatively explore how adolescents conceptualize disability identity and what factors may influence adolescent disability identity development. Research Method/Design: These data were collected through semistructured in-depth interviews with 24 middle and high school adolescents with disabilities. The participants had a wide range of disabilities, including physical disabilities, learning disabilities, ADHD, Autism, and others. Analyses started with Hamilton's Rapid Assessment Process followed by identifying structural and in vivo codes using a computer-assisted qualitative data analysis tool to allow for multiple coders and memo writing across the research team. RESULTS: The results indicate that adolescents are undergoing a heterogeneous and complex process to develop their disability identity. Additionally, the salience of the participants' disability identity often varied depending on the environmental context. Furthermore, social connections to peers with and without disabilities played an important role in the development of many participants' disability identities. CONCLUSIONS/IMPLICATIONS: These findings suggest that adolescents with disabilities are engaging in a multifaceted meaning-making process to develop a sense of disability identity. Rehabilitation Psychologists and other practitioners can support disabled adolescents by helping them to discuss and develop a positive disability identity. Furthermore, practitioners can help disabled adolescents successfully develop their disability identity in a variety of different settings and contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Disability community and mental health among college students with physical disabilities.

PURPOSE/OBJECTIVE: College students with physical disabilities are often at a higher risk for mental health problems. In addition, some universities have created disability community spaces, but it is not known whether these spaces are associated with social support or increased mental health and well-being among students who use them. This study investigated differences in feelings of perceived social support, depressive symptomatology, and well-being between students with physical disabilities who live in general student housing and students with physical disabilities who live in a disability community. Research Methods/Design: A mixed-methods online survey was used to collect data from students with physical disabilities who lived in a disability community and from those who did not. Of the participants, 27 college students self-identified as having a physical disability (n = 27), 11 participants lived in the disability community (n = 11), and 16 did not (n = 16). RESULTS: The quantitative results indicated statistically significant differences between the two groups on all three measures. The open-ended responses revealed that those who lived in the disability community setting felt more connected to other students with physical disabilities. However, the results also showed that many students with physical disabilities felt socially disconnected for a myriad of reasons. CONCLUSIONS/IMPLICATIONS: These findings suggest that living in a disability community may be associated with feeling socially supported and improved mental health outcomes among college students with physical disabilities. Universities and other stakeholders should consider implementing programs to foster disability community among students with physical disabilities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The COVID-19 pandemic, stress, and trauma in the disability community: A call to action.

PURPOSE: To inform the field of rehabilitation psychology about the impacts of the 2019 novel coronavirus (COVID-19) on the disability community in the United States and the additional sources of stress and trauma disabled people face during these times. METHOD: A review of the literature on disability and COVID-19 is provided, with an emphasis on sources of trauma and stress that disproportionately impact the disability community and the ways in which disability intersects with other marginalized identities in the context of trauma and the pandemic. We also reflect on the potential impacts on the field of psychology and the ways in which psychologists, led by rehabilitation psychologists, can support disabled clients and the broader disability community at both the individual client and systemic levels. RESULTS: The COVID-19 pandemic introduces unique potential sources of trauma and stress within the disability community, including concerns about health care rationing and ableism in health care, isolation, and the deaths and illnesses of loved ones and community members. CONCLUSIONS/IMPLICATIONS: Rehabilitation psychologists and other professionals should be aware of the potential for trauma and stress among disabled clients and work with them to mitigate its effects. Additionally, psychologists should also work with the disability community and disabled colleagues to address systemic and institutional ableism and its intersections with other forms of oppression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Initial factor exploration of disability identity.

PURPOSE/OBJECTIVE: This article describes the initial factor exploration of disability identity and preliminary psychometric characteristics based on an adult self-report tool. Disability was defined broadly, and the sample included individuals with visible and/or hidden disabilities across many disability groups (i.e., physical, intellectual, learning, mental illness). METHOD: Items were developed (n = 102) and a pilot measure was administered to a sample of adults with disabilities (n = 566). An exploratory factor analysis (EFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator was conducted. The resulting items were sent to expert reviewers for evaluation. RESULTS: Following the exploratory analyses, 37 items were retained that made up four factors: internal beliefs about own disability and the disability community, anger and frustration with disability experiences, adoption of disability community values, and contribution to the disability community. The pilot measure aligned well with the theoretical framework that guided its development. DISCUSSION/CONCLUSION: This factor exploration is a contribution to a growing body of literature supporting, and investigating, disability identity development. This work presents a more comprehensive understanding of disability identity development. Armed with a better understanding, this will serve as a basis to inform future scale development and validation. After this validation work is completed, there is the potential to apply findings to tailor interventions and clinical work, so that psychologists and rehabilitation professionals may be better prepared to meet the developmental needs of disabled clients. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Cognitive processing following acquired disability for para sport athletes: a serial mediation model.

Purpose: To understand the cognitive processing that occurs in relation to a disabling life event among para sport athletes, as well as the role of para sport participation in shaping these cognitions, and subsequent perceptions of posttraumatic growth or distress.Methods: Participants were 75 para sport athletes with acquired disability. Serial multiple mediation analysis was conducted to identify the various pathways through which posttraumatic growth or distress is experienced.Results: Findings suggested that a disabling event initiated challenges to one's core beliefs which influenced subsequent perceptions of posttraumatic growth and distress through cognitive processing at two separate time frames. Moreover, the utility of deliberate rumination (at both time points) was evident in experiencing posttraumatic growth, while intrusive rumination only appeared beneficial if it prompted deliberate ruminations.Conclusions: As several unique paths to posttraumatic growth were found, results suggest that a multitude of paths to growth may be possible. Para sport participation may have utility in facilitating deliberate ruminations and subsequent posttraumatic growth for those unable to deliberately ruminate in the immediate disability aftermath.Implications for rehabilitationAs challenges to core beliefs triggered ruminative thoughts that ultimately facilitated PTG, practitioners are encouraged to explicitly ask patients about how the adverse event might have influenced patients' self-perceptions and views about the meaning of life. Such questions may be revisited from injury onset throughout recovery and rehabilitation.Rehabilitation specialists should inform patients that intrusive ruminations may be salient in the post-trauma aftermath, but that such rumination may be facilitative if it gives way to more deliberate forms of rumination.Attempts to understand the meaning of a traumatic event may be instrumental in alleviating distress.Health practitioners should encourage individuals suffering physically disabling events to engage in activities such as para sport, given its potential to facilitate deliberate rumination and subsequent posttraumatic growth.

#SaytheWord: A disability culture commentary on the erasure of "disability".

PURPOSE: To inform the field of rehabilitation psychology about the sociocultural implications of the term "disability," and explain the rationale behind the #SaytheWord movement, a social media call to embrace disability identity. METHOD: Review of the literature on disability terminology, the history of language use, and the relationship between attitudes toward disability and language. We reflect on the role of disability within the field of psychology and within the American Psychological Association (APA), including the underrepresentation of disabled psychologists and trainees with disabilities and the lack of mentorship opportunities available in the field. IMPLICATIONS: The authors argue that erasure of the word "disability" can have unintended and adverse consequences. We describe how erasure of disability identity in the context of current sociopolitical efforts to reduce and eliminate public services and supports for people with disabilities is especially threatening to members of the disability community. To move forward, the authors postulate that the disability movement must reconcile its own history of exclusion and adopt a disability justice framework. CONCLUSION: The field of psychology has a rich tradition of appreciation of cultural diversity and individual difference; yet, disability has largely been left out of these efforts. The disability movement is moving toward the status of a diverse cultural group with a social justice agenda parallel to those of other marginalized communities. The authors posit that psychology must play a stronger role in advancing the human rights of people with disabilities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

From core belief challenge to posttraumatic growth in para sport athletes: moderated mediation by needs satisfaction and deliberate rumination.

Purpose: To examine how deliberate rumination and psychological need satisfaction interact to facilitate posttraumatic growth for para sport athletes with acquired disability. Methods: Utilizing a sample of 70 para sport athletes, the hypothesized mediating role of deliberate rumination was examined via a simple mediation model. The interaction between needs satisfaction and deliberate rumination and their effect on posttraumatic growth was examined utilizing a moderated mediation procedure. Results: Disruption to one's core beliefs was significantly associated with posttraumatic growth. This relationship, was in part, explained by the deliberate rumination engaged in soon after the trauma. Needs satisfaction, while a significant predictor of posttraumatic growth, did not moderate the indirect effect. Conclusions: Although deliberate rumination at both timeframes and needs satisfaction were independently associated with posttraumatic growth, they did not interact in the hypothesized manner to influence posttraumatic growth. There remains a need to better understand how the experience of posttraumatic growth is achieved amongst individuals with acquired disability, and the role that para sport may play in this process. Implications for rehabilitation The disruption to one's core beliefs caused by acquiring a physical disability is not only a natural experience but also a necessary antecedent to posttraumatic growth. As such, rehabilitation practitioners ought to normalize these types of challenges when working with individuals with acquired disability. Practitioners may help to facilitate growth outcomes by encouraging individuals to deliberately ruminate about their acquired disability. That is, practitioners can help those with acquired disability to seek meaning and understanding about their disability or the precipitating event. For those who struggle to deliberately ruminate in the immediate disability aftermath, practitioners may encourage para sport participation to potentially prompt constructive cognitive processing. Individuals with acquired disabilities would also be well served by rehabilitation practitioners and para sport organizations that provide opportunities for basic psychological needs satisfaction. Specifically, individuals with acquired disabilities should be given the opportunity to demonstrate physical competence, make meaningful relationships, and feel a sense of volitional control over their rehabilitation or para sport participation. For example, practitioners and para sport organizations could establish mentorship programs wherein individuals with more recent disabilities can be mentored by those with greater disability experience.

Understanding posttraumatic growth of paratriathletes with acquired disability.

PURPOSE: To examine the relevance of key components of Organismic Valuing Theory of Growth through Adversity in understanding posttraumatic growth amongst paratriathletes with acquired disability. METHODS: Semi-structured interviews informed by organismic valuing theory of growth through adversity were conducted with 14 elite paratriathletes (eight male, six female). To increase the likelihood that participants had experienced posttraumatic growth, a short form of the Posttraumatic Growth Inventory was completed prior to interview participation. Interview data were analyzed using directed content analysis. RESULTS: Although the initial response to disability was largely negative, paratriathlon experiences were reported to be a mechanism through which growth was facilitated. In particular, participants suggested that social, competence, empowerment, and identity development processes were instrumental in facilitating posttraumatic growth. CONCLUSIONS: Analysis identified themes largely consistent with the main tenets of organismic valuing theory of growth through adversity, supporting its utility in understanding response to a traumatic event and subsequent growth. These findings also suggest that para sport may be an efficacious means for promoting posttraumatic growth, especially for individuals with severe initial reactions to their disability. Lastly, findings suggest that fostering perceptions of competence, autonomy, and social connection may promote posttraumatic growth. Implications for Rehabilitation Acquiring a physical disability may have a detrimental impact on the satisfaction of an individual's fundamental psychological needs. In order to foster posttraumatic growth, the para sport environment should allow for participants to feel competent, autonomous, and to have meaningful interactions with fellow athletes and coaches. Para sport may be particularly beneficial for individuals with previous sporting backgrounds and for those with severe initial reactions to their disability.

Disability identity and allyship in rehabilitation psychology: Sit, stand, sign, and show up.

PURPOSE/OBJECTIVE: The purpose of this conceptual paper was to put forth a call for rehabilitation practitioners to consider their role in developing disability identity in their clients, and to understand this action as a form of allyship toward the disability community. METHOD: This conceptual paper is organized to engage existing disability and disability-identity literature and its clinical implications. Practical tools and skills are offered for rehabilitation practitioners to develop disability identity and engage in disability allyship. RESULTS: An overview of disability identity and its relationship to clinical practice is presented by way of a literature review. Conversation starters and two activities are presented for rehabilitation practitioners to develop and engage with clients about their disability identities. Descriptions of allyship actions for practitioners are presented. DISCUSSION/CONCLUSION: In this conceptual paper, we framed disability in terms of both the medical and social models and argues that thinking about disability identity requires attention to the social model of disability. This attention is important, because it allows practitioners to think about themselves as allies to a particular community, rather than experts who must only "fix" clients' disabilities to elicit positive identity development. This shift toward allyship requires attention, engagement, and openness to see clients simultaneously as individuals and as members of a powerful, diverse community with a unique identity experience. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Disability identity development: A systematic review of the literature.

PURPOSE/OBJECTIVE: The purpose of this systematic review was to synthesize existing empirical research on disability identity development. This review is organized to present the demographics of participants and types of disabilities represented in the existing data, measures of disability identity development and theoretical models of disability identity development. METHOD: Electronic databases (EBSCO, PsycINFO, ERIC, and Sociological Abstracts) were searched for all peer reviewed empirical studies published between 1980 and 2017. Articles were excluded if they were theoretical and/or did not include participants with disabilities, or focused on a disability-specific community identity rather than general disability identity. RESULTS: Empirical articles (N = 41) were included in the final review. An overwhelming majority (75.6%) were qualitative in nature, with only 22% of the articles reviewed being quantitative and only 1 that utilized a mixed methods design. The results suggest that disability identity can be considered a unique phenomenon that shapes persons' ways of seeing themselves, their bodies, and their way of interacting with the world. CONCLUSIONS/IMPLICATIONS: Disability identity development has the potential to become an important factor in developing effective interventions and/or therapies. Identity development is a fundamentally social process, and identities are formed through mirroring, modeling, and recognition through available identity resources, and so it is imperative that able-bodied professionals (i.e., rehabilitation professionals, therapists, teachers and caregivers) working with individuals with disabilities become aware of this developmental process to be able to better support individuals along this journey. (PsycINFO Database Record

Disability identity development model: Voices from the ADA-generation.

BACKGROUND: For persons with disabilities, 2015 was a historic year, marking the 25th anniversary of the Americans with Disability Act (ADA) and the 40th anniversary of the passing of the Individuals with Disabilities Education Act (IDEA). It is important to consider the effects of this fundamental shift towards equal opportunity and participation on persons with disabilities' identity development. In practice, however, there are few empirical studies that have looked at this phenomenon and even fewer models of disability identity development. OBJECTIVE: We conducted a qualitative study to explore the disability identity development of college students with disabilities. METHODS: At two research sites, we conducted individual interviews and observations with 17 college students with varying disabilities, and used in vivo and structural coding analysis to identify and develop themes. RESULTS: The results of this study led to establishing a model of psychosocial identity development for individuals with disabilities. The model highlights four developmental statuses: acceptance, relationship, adoption and engagement. Sharing voices from the participants themselves, we also provide commentary on the possible impacts of this work for healthcare professionals and areas for future research. CONCLUSIONS: Our findings suggest that this model of psychosocial disability identity development can help to provide an understanding of the psychological processes that individuals with disabilities go through. The model also has application as a framework for healthcare professionals and psychologists who are working with individuals with disabilities.

Do developmental communication disorders exist in the signed modality? Perspectives from professionals.

PURPOSE: This study focused on whether developmental communication disorders exist in American Sign Language (ASL) and how they might be characterized. ASL studies is an emerging field; educators and clinicians have minimal access to descriptions of communication disorders of the signed modality. Additionally, there are limited resources for assessing ASL acquisition. This article is designed to raise clinicians' awareness about developmental communication disorders in ASL and categorize types of atypicality that have been witnessed. METHOD: We conducted 4 focus groups and one 1-on-1 interview with a total of 22 adults (7 Deaf, 15 hearing) who work at bilingual-bicultural (ASL-English) schools for the Deaf. Experiences of these educators and language professionals were analyzed qualitatively using a combination of grounded theory (Charmaz, 2001; Strauss & Corbin, 1998) and a modified van Kaam approach (Moustakas, 1994). RESULTS: Participants confirmed observations of children with suspected communication disorders and considered the prevalence, possible etiologies, and psychosocial aspects of such disorders in ASL. They reported frustration at the lack of diagnostic tools for reliable identification and intervention strategies to be used in educational settings. CONCLUSION: This work provides us with practitioner accounts proving that developmental communication disorders do exist in ASL. Future reports will describe primary data from signers with atypical language attributes.