'We only got Coca-Cola': Disability and the paradox of (dis)empowerment in Southeast Nigeria
NWOKORIE, Okechukwu V.
DEVLIEGER, Patrick J.
Background: Empowerment is the generic name for support services for persons with disability in Nigeria. In it, the elites of the society play leading roles. Special events such as anniversaries, Christmas seasons, wealthy people's birthdays, investiture of new titles and campaigns before general elections often provide occasions for empowerment programmes.
Objectives: This article explores discourses of empowerment of persons with disability in Southeast Nigeria. We concentrate on the relation between local elites and the disability community and how it impacts our understanding of empowerment. Conceptualising empowerment as worldmaking, and disability as something that is ambiguous, we challenge the assumption that the aim of empowerment of disabled people is to improve their (disabled people's) quality of life.
Method: This article relies on research data (collected between January 2014 and January 2017) comprising 72 interviews and participant observations from 27 persons with disability, and 13 social workers and senior government officials.
Results: We conclude that discourses of empowerment of disabled people frame disability as loss and tend to conceal the personal stories and survival operations of disabled people.
Conclusion: Empowerment discourses ironically provide the platform for local power elites to 'ride' to fame on the backs of disabled to extend their influence in society. In the current neoliberal environment of unequal access to opportunities, disabled people must 'play along' as a survival strategy. Our qualitative data provide opportunities to reflect on the tensions between the 'local and the global', thus indicating how disability issues intersect with other wider questions.
Disabled people's organisations and the disability movement: Perspectives from Burkina Faso
BEZZINA, Lara
Background: In Burkina Faso, the disability movement is rather weak, both in terms of funding and staffing – its range does not extend far outside the capital city and is largely dependent on international non-governmental organisations (INGOs). Despite the huge number of grassroots disabled people's organisations (DPOs), many of these organisations do not function beyond the occasional meeting and celebration of the International Day of Persons with Disabilities. The reasons for this are various, including dependency on external funding (such as from international organisations), lack of access to resources, being dependent on voluntary members, and lack of organisation.
Objectives: This article looks at the functioning of – and politics governing – DPOs in Burkina Faso, their significance in the lives of people with disabilities and the challenges they encounter.
Method: This article is based on research findings obtained through interviews conducted with people with disabilities, as well as INGOs working with people with disabilities and state authorities in Burkina Faso.
Results: Evidence suggests that the farther people with disabilities are from the capital, the lesser are their chances of being heard and of being involved in decision-making. However, DPOs offer a haven for many, offering people with disabilities solace in meeting other members and finding a sense of belonging in these associations. Others give importance to the role of DPOs in raising awareness and human rights advocacy.
Conclusion: Finally, the article raises the question as to what the future of DPOs in Burkina Faso might entail.
Alternative spaces of failure. Disabled 'bad boys' in alternative further education provision
JOHNSTON, Craig
BRADFORD, Simon
This article draws from an ethnographic study of a group of school-aged disabled white working-class and self-proclaimed 'bad boys' in one Alternative Provision (AP) in an English further education college. These young disabled students' disabilities contribute to the formation of their revalorised – yet stigmatised – identities. Stigma also facilitates the governance of their educational careers. The article considers how this group understands its precarious existence in and beyond AP and how these young men resist the conditions of their devaluation. Despite multiple, stigmatising experiences, the article shows how they appropriate space and (social) capital, often in tension with other students and college staff. The article suggests that there are questions about AP as an appropriate means to confer value upon young disabled students.
White, disabled, working-class male students are increasingly placed into Alternative Provisions intended for young people who would otherwise not receive suitable education for various reasons. The experiences of such students have received limited research attention.
This article is based on research conducted with young people who attend a provision located within an English further education college. The research found that these young people experience a lack of support, low trust and disregard from peers and some professionals at a crucial time in their educational careers.
It is important to understand disability in relation to other social differences – social class and gender, for example – as the combined impact of these in educational settings may undermine future career prospects and life chances.
The article emphasises the importance of education practices that develop reciprocity, trust and cooperation in improving the often oppressive circumstances young disabled people face in post-school settings.
South Korean elementary school teachers' experiences of inclusive education concerning students with a multicultural background
KIM, Soo-Kyung
RUNDGREN, Shu-Nu Chang
Due to the increase of economic immigration over the last few decades, South Korea has rapidly become a multi-ethnic society. The number of students with a multicultural background (SMBs) has increased more than tenfold in the past ten years. Research has revealed that despite physical inclusion of SMBs in general classrooms, SMBs tend to struggle at school as a result of language difficulties, academic underachievement, and social isolation. Shedding light on the Salamanca thinking, this study aims to investigate how teachers' experiences of SMBs vary according to school cultures. Thirteen teachers from three schools (with different school cultures) were invited to participate in qualitative semi-structured interviews. It was revealed that the teachers, who worked in the different school cultures, expressed differently with regard to (1) teachers' reasoning about SMBs' struggles, (2) teachers' professional knowledge and strategic practices, (3) collaboration with a multicultural education supervising teacher (MEST), and (4) dependency upon external support. The school judged to be contributing to 'true' inclusion was characterised by ample support from a MEST and the creation of an inclusive learning environment for SMBs as a whole-school approach. What can further 'true' inclusion of SMBs in elementary schools and the implications thereof are discussed.
The effect of a serious game on empathy and prejudice of psychology students towards persons with disabilities
OLIVIER, Linda
STERKENBURG, Paula
Van RENSBURG, Esmé
Background: Much has been done regarding the promotion of equality in rights in terms of legislation, but persons with disabilities remain marginalised in society. Negative attitudes and prejudice contribute towards numerous challenges for persons with disabilities.
Objectives: This study investigated the level of empathy and prejudice of students towards persons with disabilities, and the effect of the use of a serious game to enhance empathy and reduce prejudice.
Method: A randomised controlled experiment with pre-test, post-test and follow-up test was used. Availability sample (N = 83) of psychology university students (22% males; 78% females) was divided into an experimental group that played the serious game The World of Empa and two control groups. The first control group received texts on case studies and information on reacting in a sensitive and responsive way, and the second control group received no intervention.
Results: Participants have average levels of empathy (score: 32 to 52) and strong prejudice (score: 0.08 to −0.87) towards persons with disabilities. The intervention results in a slight short-term effect for prejudice and sub-scale measurements of empathy. A slight improvement was noted in participants' ability to transpose themselves imaginatively into the experience of disabled characters.
Conclusion: The findings contribute to the understanding of empathy as a dynamic component that can be positively influenced by, for example, a serious game. These results have teaching implications on the facilitation of empathy. The short-term effect on empathy and prejudice towards persons with disabilities may contribute to bridge the inequality experienced by persons with disabilities.
Development of the Wheelchair Interface Questionnaire and initial face and content validity
RISPIN, Karen
DAVIS, Abigail B.
SCHEAFER, Vicki L
WEE, Joy
Background: Because resources are limited in low- and middle-income countries (LMIC), the development of outcome measures is of interest. Wheelchair outcome measures are useful to support evidence-based practice in wheelchair provision.
Objectives: The Wheelchair Interface Questionnaire (WIQ) is being developed to provide a professional perspective on the quality of the interface between a wheelchair and its user. This article discusses the development of the WIQ and its face and content validity.
Method: During field studies in Kenya, we sought to include professional report data on the wheelchair–user interface that could be analysed to inform design changes. None of the existing measures was focused on the interface between users and their wheelchairs. The WIQ was developed to meet this need. To investigate face and content validity, 24 experienced wheelchair professionals participated in a study that included two rounds of an online survey and a focus group in Kenya.
Results: Responses were categorised by topic and the WIQ was modified following each iteration. Participants affirmed the usefulness of a brief professional report measure to provide a snapshot of the user–wheelchair interface. Participants emphasised the importance of brevity, wide applicability and provision of specific feedback for wheelchair modification or design changes. The focus group agreed that the final version provided useful data and was applicable to virtually all wheelchair users in LMIC.
Conclusion: These preliminary studies indicate initial face and content validity of the WIQ as a method for providing a professional perspective on the interface between a user and his or her wheelchair.
Provocations for Critical Disability Studies
LAWTHOM, Rebecca
LIDDIARD, Kirsty
RUNSWICK-COLE, Katherine
This article posits a number of provocations for scholars and researchers engaged with Critical Disability Studies. We summarise some of the analytical twists and turns occurring over the last few years that create a number of questions and concerns. We begin by introducing Critical Disability Studies; describing it as an interdisciplinary field of scholarship building on foundational disability studies theories. Critical Disability Studies scholarship is being produced at an exponential rate and we assert that we need to take pause for thought. We lay out five provocations to encourage reflection and debate: what is the purpose of Critical Disability Studies; how inclusive is Critical Disability Studies; is disability the object or subject of studies; what matters or gets said about disability; and how can we attend to disability and ability? We conclude by making a case for a reflexive and politicised Critical Disability Studies.
Interpretative accounts of work capacity assessment policy for young adults with disabilities
STAFFORD, Lisa
MARSTON, Greg
BEATSON, Amanda
CHAMORRO-KOC, Marianella
DRENNAN, Judy
Young adults with disabilities are a specific target of the welfare-to-work policy introduced by many OECD countries over the past decade. The implementation of these policies is a significant concern for service delivery organisations and advocates in Australia and internationally due to complex intersecting structural barriers that persist for many young adults with disabilities. A particular focus of this article is work capacity assessments. Drawing on socio-political theories and interpretive policy analysis, the 22 in-depth interviews with personnel from service delivery organisations and advocacy organisations reveal how the deemed capacity to work process is not only interpreted as flawed, but the current policy approach disables young adults, perpetuates stigma, and creates division between service users and service providers. The accounts reinforce the need to contest such assessments and instead turn towards a rights-based capability approach permitting young adults with disability self-determination over their education-to-employment pathway.
Disabled men with muscular dystrophy negotiate gender
ABBOTT, David
GIBSON, Barbara E
HASTIE, Jon
JEPSON, Marcus
SMITH, Brett
Disability is often portrayed as a one-dimensional category devoid of further intersections. Work which has addressed the intersection of disability and male gender has rarely considered different types of disability or impairment, or foregrounded the experiences of disabled men themselves. This article is based on empirical work carried out in England with men who have Duchenne muscular dystrophy (DMD). We explored with participants their sense of themselves as men and their commonalities and differences with other men. Findings suggest that men with DMD claim, reject and redefine what it meant to them to be men. Doing gender was often heavily reliant on the availability and permission of others. Our study highlights the usefulness of exploring gender with men with particular experiences of disability and of looking at how this might change over a life course, especially when the nature and extent of the life course is a precarious one.
Parental satisfaction with inclusion in physical education
WILHELMSEN, Terese
SØRENSEN, M. S
SEIPPEL, Ø
BLOCK, M. E
Knowledge is scarce on parental satisfaction with the inclusion of children with disabilities in physical education (PE). This study explored how parents' satisfaction with inclusion in PE was associated with parental and child interpersonal and intrapersonal characteristics. Seventy-two parents of children with disabilities participated in the survey-based study. The results of the ordinary least square regression (OLS) and quantile regression (QR) indicated that the parents' satisfaction with social inclusion in PE was associated with their attitudes towards inclusion in PE, perceived PE-related information sharing, and the type of disability and degree of physical inclusion. Parents' satisfaction with pedagogical inclusion of children in PE was associated with their attitudes towards inclusion in PE, PE-related information sharing, and the children's degrees of disability and physical inclusion. Furthermore, the QR estimates indicated that the explanatory strength of parental attitudes towards inclusion in PE varied with the degree of parental satisfaction with social and pedagogical inclusion of their children in PE. Practical and methodological implications of the findings are discussed.
Cultural competence in lifelong care and support for individuals with intellectual disabilities
VAN HERWAARDEN, Aniek
ROMMES, Els W M
PETERS-SCHEFFER, Nienke C
Objectives: Although an extensive amount of research has been devoted to models defining cultural competence of healthcare professionals in short-term care, there is unclarity about the cultural competencies that professionals providing lifelong care and support should have. The current study aimed to explore which cultural competencies are used by these healthcare professionals, and whether these competencies enabled them to make cultural adaptations to their regular care practices.
Design: To investigate cultural competencies and cultural adaptations, semi-structured in-depth interviews were conducted with eight professionals who provide lifelong care and support to individuals with intellectual disabilities. Five cultural competencies were explored: awareness, knowledge, skills, motivation, and encounters.
Results: A thematic analysis of the interviews revealed that professionals providing lifelong care and support used all cultural competencies in their care practices. Moreover, our analysis suggested that these competencies could be categorized as either practical or analytical cultural competencies. Although these competencies were conditional in order to make cultural adaptations to care practices, the presence of cultural competencies did not automatically lead to these cultural adaptations. Conclusions: All five cultural competencies were used by professionals in lifelong care and support. Our analysis revealed that both practical and analytical cultural competencies were essential in providing culturally sensitive lifelong care and support. We additionally suggest that the cultural competence of professionals is necessary, but not sufficient, for making cultural adaptations to lifelong care and support for individuals with intellectual disabilities. In many cases, other factors also played a role in a professional's final decision to adapt their care practices.
Conclusions: All five cultural competencies were used by professionals in lifelong care and support. Our analysis revealed that both practical and analytical cultural competencies were essential in providing culturally sensitive lifelong care and support. We additionally suggest that the cultural competence of professionals is necessary, but not sufficient, for making cultural adaptations to lifelong care and support for individuals with intellectual disabilities. In many cases, other factors also played a role in a professional's final decision to adapt their care practices.
'Power-Hurt': The Pains of Kindness Among Disabled Karen Refugees in Thailand
COLE, Tomas
In this paper I show how, for many Karen living as refugees in 'temporary-shelter-areas' in Thailand, acts of care and kindness often slipped into something painful and controlling. Drawing on fieldwork among Karen refugees disabled by landmines I show how asking for and receiving help was almost always accompanied by the visceral sensation of ana, literally, 'power hurt'. On the one hand, ana was the force driving the circulation of care and kindness, provoking people to help others. On the other hand this circulation also carried with it the constant potential to compromise not only the recipient's but also the donor's 'power', which was understood as their capacity to have an effect on the world. In this manner ana may offer us with a way to grasp the ethical-affective basis of a social arrangement that slips smoothly between lateral solidarities and vertical hierarchical relations allowing egalitarianism and hierarchy to co-exist.
Improvements in health-related quality of life and function in middle-aged women with chronic diseases of lifestyle after participating in a non-pharmacological intervention programme: A pragmatic randomised controlled trial
BARNES, Roline Y
PARKER, Romy
Background: Musculoskeletal diseases consume a large amount of health and social resources and are a major cause of disability in both low- and high-income countries. In addition, patients frequently present with co-morbid chronic diseases of lifestyle. The area of musculoskeletal disease is restricted by a lack of epidemiological knowledge, particularly in low- and middle-income countries.
Objectives: This pragmatic randomised controlled trial assessed the benefits of a 6-week physiotherapy intervention for middle-aged women with musculoskeletal conditions compared to usual care.
Method: A weekly 2-h educational programme utilising a workbook, discussion group and exercise class was presented for the intervention group, while the control group received usual care. The primary outcome was health-related quality of life. Parametric and non-parametric data were used to determine the equivalence between the groups.
Results: Twenty-two participants were randomised to the intervention and 20 to the control group. The control group demonstrated no within-group improvement in health-related quality of life items, compared to significant improvements in two items in the intervention group. The change in median utility score within the intervention group was twice as large as the change in the control group. With regard to self-efficacy, the intervention group demonstrated significant within-group changes in perceived management of fatigue and discomfort.
Conclusion: The positive impact of the intervention on the participants suggests that the programme should continue at the clinic in question, but should be presented at a more convenient time for participants who work, as recruitment to the study was less than anticipated. Primary health care systems in South Africa urgently need to put structures in place for effective management of the functional impact of chronic diseases of lifestyle and musculoskeletal conditions. It is time for physiotherapists and possibly other health care professionals to participate in the development of appropriate community level interventions to address the functioning and quality of life of individuals living with the diseases.
Training Needs of Community-based Rehabilitation Workers for the Effective Implementation of CBR Programmes
VUUREN, Julia Mary Jansen-van
ALDERSEY, Heather Michelle
Purpose: This review investigates the training needs of Community-Based Rehabilitation (CBR) workers that would enable them to effectively facilitate CBR programmes. Emphasis was placed on identifying: (a) the skills that CBR workers require (b) the training currently available for them, and (c) the gaps in current training.
Method: A scoping review was conducted using on-line database searches (Medline, Embase, Cinahl, PsycInfo, Global Health) for English articles from 2006 onwards. A combination of keywords related to CBR, personnel, and training were applied. Hand searches of reference lists and the DCID journal were also conducted. Grey literature related to training, from the World Health Organisation (WHO), CBR Regional Networks and organisations affiliated with CBR were included as secondary data. Thirty-three articles and thirty-five sources from the grey literature were included. Data was organised under the three objectives outlined above – i.e., required skills, available training and training gaps.
Results: CBR workers represent a diverse group requiring a broad range of skills. A new cadre of mid-level workers is also necessary to effectively implement the CBR guidelines. There is currently no standardised training for CBR workers and training varies widely, depending on context. CBR workers require further training in various clinical, social, management, communication, and cultural competence skills across the spectrum of the CBR Matrix, and specifically in empowering persons with disabilities and facilitating community development. They also need to develop critical reasoning, creativity, and compassion.
Conclusion: A standardised approach to training CBR workers would be beneficial to ensure basic standards and quality services, to allow meaningful comparison and evaluation across contexts, to recognise the role of mid-level CBR workers, and to strengthen the workforce. Further research is required to determine minimal competencies, define the roles of various CBR workers, and evaluate the effectiveness of training.
The Effect of Age, Gender and Socioeconomic Status on Self-esteem, Body Image and Quality of Life of Amputees: An Evaluation Seven Years after the 2008 Sichuan Earthquake
LAM, Tin-Wai J
TANG, Long-Ching L
CHAU, WW
LAW, SW
CHAN, KM
Purpose: Psychological well-being is a growing concern in society. It is starting to play a pivotal role in the treatment and care of clients. This study aimed to evaluate the effect of age, sex and socioeconomic status on the self-esteem, body image and quality of life of the 2008 Sichuan earthquake amputees. Many of them are at a significant stage in their lives, especially those who are making the transition from childhood and adolescence into adulthood.
Methods: This cross-sectional study was conducted in October 2015. Forty-five participants were recruited from clinic sessions in Sichuan. The main outcome measures were Rosenberg Self-Esteem Scale (RSE), Chinese Amputee Body Image Scale (CABIS), and WHO Quality of Life-Bref Instrument (WHO-QOL-Bref). Results were analysed using Student's T-test and Chi-square test where appropriate, and ANOVA for multi-group comparisons.
Results: Participants under 18 years of age scored higher in RSE (p=0.05), and lower in CABIS (p<0.005). They also scored higher in various QOL domains (D3: p<0.08, D4: p=0.06) and WHOQOL-Bref question 2 (p=0.06). Participants of different SES did not show any significant differences in the outcome measures. Female subjects scored higher in WHOQOL-Bref Question 1 (p=0.03).
Conclusion and Implication: Younger amputees have less body image distortion, higher quality of life and self-esteem compared to older amputees. Female amputees also appear to have a higher quality of life compared to male amputees. Socioeconomic status does not affect rehabilitation outcome and psychological well-being of amputees. However, the main factors affecting psychological well-being appear to be predominantly age and, possibly, gender.
Effect of an Aerobic Fitness Programme Intervention on the Motor Proficiency of Children with Mild and Moderate Intellectual Disabilities in India
KALGOTRA , Ritu
WARWAL, Jaspal Singh
Purpose: The study aimed to assess the effect of an Aerobic Fitness Programme intervention on children with mild and moderate intellectual disabilities in Jammu, India.
Method: In a pre-test post-test control group design, 66 children with mild and moderate intellectual disabilities, who fulfilled the inclusion and exclusion criteria, were placed in control and experimental groups. A validated tool, the Test of Motor Proficiency, was used as a pre-test and post-test measure to assess the effect of the intervention.
Results: The mean difference between the two groups of children with mild and moderate intellectual disabilities was significant. ANCOVA analysis indicated F (1,28) = 312.13, P =.00 in children with mild intellectual disabilities, and F (1,32) = 22.540, P =.00 in children with moderate intellectual disabilities. The intervention was effective in developing visual motor control, upper limb speed and dexterity, running speed and agility, balance, strength, and upper limb coordination. It was ineffective in improving bilateral coordination in both groups of children with intellectual disabilities.
Conclusion: This intervention programme can be introduced into the daily curriculum of children with intellectual disabilities at special schools. It would be helpful in compensating for the lack of physical activity due to classroom-based teaching.
Efficacy of a Low-cost Multidisciplinary Team-led Experiential Workshop for Public Health Midwives on Dysphagia Management for Children with Cerebral Palsy
HETTIARACHCHI , Shyamani
KITNASAMY, Gopi
MAHENDRAN, Raj
NIZAR, Fathima Shamra
BANDARA, Chamara
GOWRITHARAN, Paramaguru
Purpose: Over the past decade there has been a growing focus on offering appropriate training to healthcare professionals and caregivers to support safe feeding practices for children with cerebral palsy. Early and consistent multidisciplinary intervention is required to minimise the risks of aspiration pneumonia. The high incidence of complications from aspiration pneumonia among children with cerebral palsy in Sri Lanka has made it necessary to conduct low-cost multidisciplinary team-led dysphagia awareness workshops for healthcare professionals and caregivers.
Method: A group of 38 Public Health Midwives (PHMs) was offered an experiential workshop by a small multidisciplinary team (MDT). To determine changes in knowledge, a self-administered questionnaire that included a video-based client scenario was administered pre- and post-workshop. The data were analysed statistically using non-parametric within-participant t-tests.
Results: The post-workshop responses to the questionnaire indicated a significant increase in the level of knowledge. This included positive changes in the understanding and knowledge of cerebral palsy (t (37) =-7.44, p=.000), effects of cerebral palsy on eating and drinking skills (t (37) =-3.91, p=.000), positioning (t (37) = -9.85, p=.000), aspiration (t (37) =-3.46, p=.001), food categorisation (t (37), -3.85, p=.000) and client video observation (t (37)-3.91, p=.000) at a p=.05 level of significance. While there was also an increase in the knowledge on general guidelines during mealtimes, this did not reach statistical significance.
Conclusion: The low-cost MDT-led experiential workshop was effective in increasing knowledge of feeding and dysphagia-related issues in cerebral palsy among a group of PHMs. This workshop could serve as a model for training PHMs and Community-Health Workers across the country in order to reach the Sustainable Development Goal of 'good health and well-being' for children with cerebral palsy and all children experiencing feeding difficulties. Follow-up workshops and continued professional development courses for midwives on dysphagia care are strongly recommended, in addition to collaborative clinical practice.
Development, reliability, and piloting of a wheelchair caster failure inspection tool (C-FIT)
MHATRE, Anand A
LACHELL, Stephanie
PEARLMAN, Jonathan L
Wheelchair casters fail frequently in the field causing multiple user consequences and wheelchair breakdowns. To inform caster design improvement, there exists no validated tools that can collect caster failures. This need motivated the development of a user-reported, caster failure inspection tool (C-FIT).
To develop C-FIT, a multistep design and testing approach was used which included face validity testing, test-retest reliability testing and expert review. Reliability testing was conducted with two independent cohorts of wheelchair professionals who inspected caster failures physically and online through pictures. The tool was revised based on testing outcomes and expert feedback. For preliminary data collection and evaluating usability, C-FIT was piloted at wheelchair service centers in Scotland, Indonesia and Mexico.
Caster failure items reported in the literature were screened to develop the initial list of C-FIT items. Face validity testing conducted through surveys with wheelchair experts (n = 6) provided 14 items for C-FIT inclusion. The test-retest reliability was found to be high for 10 items with physical failure inspections (n = 12). For each of these items, 75% or more participants had substantial to almost perfect agreement scores (κ = 0.6–1.0). Lower reliability scores were found with online failure inspections (n = 11). C-FIT received positive usability feedback from study participants and data collectors in the field. Pilot field data (n = 31) included comprehensive details about failures useful for manufacturers, designers and researchers to improve caster designs.
The C-FIT tool developed in this study has substantial reliability and can be used for documenting caster failures at wheelchair service centers.
Mobility Analysis of AmpuTees (MAAT 4): classification tree analysis for probability of lower limb prosthesis user functional potential
WURDEMAN, Shane R
STEVENS, Phillip M
CAMPBELL, James H
To develop a predictive model to inform the probability of lower limb prosthesis users' functional potential for ambulation.
A retrospective analysis of a database of outcomes for 2770 lower limb prosthesis users was used to inform a classification and regression tree analysis. Gender, age, height, weight, body mass index adjusted for amputation, amputation level, cause of amputation, comorbid health status and functional mobility score [Prosthetic Limb Users Survey of Mobility (PLUS-M™)] were entered as potential predictive variables. Patient K-Level was used to assign dependent variable status as unlimited community ambulator (i.e., K3 or K4) or limited community/household ambulator (i.e., K1 or K2). The classification tree was initially trained from 20% of the sample and subsequently tested with the remaining sample.
A classification tree was successfully developed, able to accurately classify 87.4% of individuals within the model's training group (standard error 1.4%), and 81.6% within the model's testing group (standard error 0.82%). Age, PLUS-M™ T-score, cause of amputation and body weight were retained within the tree logic.
The resultant classification tree has the ability to provide members of the clinical care team with predictive probabilities of a patient's functional potential to help assist care decisions.
Inclusion and standards achievement: the presence of pupils identified as having special needs as a moderating effect on the national mathematics standards achievements of their classmates
KRAMMER, Mathias
GASTEIGER-KLICPERA, Barbara
HOLZINGER, Andrea
WOHLHART, David
This article investigates the relationship between the achievement level of students in classes and the presence of students identified as having special needs in inclusive settings. In particular, it examines whether the presence of students with special educational needs in inclusive classrooms has an effect on the national mathematics standards achievement of their fellow students. In order to do so, the national standard scores of approximately 75,000 fourth graders in mathematics were used as dependent variable in multi-level regression modelling. As independent variables at class level the number of students with special needs and at the individual level socio-economic, cultural and ethnic background variables were used together with gender and age. Results show only a very small effect of the presence of students with special needs on the national mathematics standard scores of their classmates. The effect can be either positive or negative depending on further class conditions.