Response to Intervention and Specific Learning Disability Identification: Evidence From Tennessee.

Response to intervention (RTI) is a method for providing academic support to students and for identifying specific learning disabilities (SLDs). Using interrupted time series and hazard models, we examined if statewide RTI adoption was associated with changes in rates of SLD and first-time SLD identification in elementary schools, and if these associations varied across student groups. Response to intervention was associated with an initial decline in the percentage of students with SLD in the state that continued over time, with larger decreases for students who were Black or economically disadvantaged. Response to intervention was associated with a 61% average decrease in the odds of first-time SLD identification by third grade (about a 0.006 change in the predicted probability), with greater declines for students who were Black or economically disadvantaged. We discuss these results in the context of disproportionality in special education and the need for research examining whether declines in SLD were due to improved academic outcomes, as opposed to delays in identification.

Identifying women with a disability in Australian maternity services: Time for a change.

It is estimated that over 1 billion people worldwide have a disability. In Australia, 9% of women of childbearing age have a disability, but data on disability status for women accessing maternity services are not routinely collected and data collection processes are inconsistent. Maternal disability may affect perinatal outcomes, but to understand what factors might be amenable to interventions to improve outcomes, accurate data collection on disability status is essential. This opinion piece reflects on disability identification within maternity services in Australia, identifying areas for policy and practice change.

Exploring disability prevalence among childbearing women attending a tertiary maternity service in Melbourne, Australia using an audit and cross-sectional survey.

BACKGROUND: Although there is an estimated rate of 10% of women of childbearing age in Australia who have a disability, there is a lack of accurate prevalence data, with the true rate unknown. The timing and questions used to collect women's disability status in pregnancy vary, and there is limited knowledge on how women accessing maternity services in Australia would like to be asked about their disability status. OBJECTIVE: To explore the prevalence of women with a disability receiving maternity care using a direct and indirect disability identification question. Secondary aims were to explore how women would like to be asked about their disability status and to examine the difference between self-reported and clinician-documented disability status within medical records. RESEARCH DESIGN/SETTING: The study was conducted at a tertiary maternity hospital in Melbourne, Australia, and included two components. Component one used a cross-sectional survey with two different cohorts of women administered face-to-face on the postnatal ward (Cohort 1 - February 2019, Cohort 2 - December 2019). In Cohort 1, a specific disability identification question asked: 'Can you please tell me if you identify as someone who has a disability?'. In Cohort 2, an indirect disability identification question asked: 'Do you require additional assistance or support?'. Other questions explored women's views on disability identification. Component two consisted of an audit of the medical records to compare disability documentation in the medical records of the women who participated with women's disability self-identification status. RESULTS: 371/467 (79%) of eligible women that were approached participated in Cohort 1 and in Cohort 2, 295/346 (85%) of eligible women that were approached participated in the study. In Cohort 1, 5% (17/371) of women self-identified with having a disability. In Cohort 2 16% (46/295) of women reported needing additional assistance/support, however of these, only nine women viewed this as a disability. In Cohort 1, of the women who self-identified as having a disability, 82% had this recorded in their medical record. An additional 12% (43/354) of women in Cohort 1 who may have had a disability according to the Australian Bureau of Statistics classification, did not self-identify as having a disability. In Cohort 2, 37% (17/43) of women who self-identified as needing additional support did not have these needs documented in the medical record. Less than a quarter of women in both cohorts were asked about their disability status during their maternity care. Women with a disability or additional support needs suggested both direct and indirect ways of being asked about their disability status, and their responses were similar to women who did not self-identify with having a disability or additional support needs. CONCLUSIONS: Disability prevalence data is highly dependant on the wording of the disability identification question. It may be appropriate to ask about disability both indirectly, in terms of additional support needs, and directly, to enable disclosure for those who do identify with a disability. Disability questioning should be routine and standardised guidelines around disability identification should be developed to allow for tailored adjustments to care on an individual level.

Developing self-report disability questions for a voluntary patient registration form for general practice in Australia.

OBJECTIVE: This article reports on research undertaken to develop self-report disability questions for a patient registration form that may be implemented in general practices across Australia as part of a voluntary patient registration program. METHODS: There were four research components: rapid review of approaches for capturing disability information; expert informant interviews (n=19); stakeholder consultation via virtual focus groups (n=65); and online survey (n=35). Findings from each component informed development of materials for subsequent components in an iterative research process. RESULTS: Three disability questions were developed: two alternative questions for identifying disability, conceptually aligned with the operational definition of disability in Australia's national disability survey; one question to determine the patient's disability group/s. CONCLUSIONS: Knowledge and perspectives from a variety of sources informed the development of self-report questions to identify patients with disability. Implementing these questions represents an opportunity to test new ways of capturing disability information suited to mainstream service provision contexts. It will be essential to evaluate the quality of the data produced during the initial period of implementation. IMPLICATIONS FOR PUBLIC HEALTH: The collection of self-report patient disability information within general practice, using standard and conceptually-sound questions, has the potential to support improved provision of health care to patients with disability.

How are women with a disability identified in maternity services in Australia? A cross-sectional survey of maternity managers.

BACKGROUND: Women with a disability have poorer perinatal outcomes, but little is known about the prevalence of women with a disability accessing maternity services, how they are identified and what care and services are available. Estimates suggest that nine percent of women of childbearing age have a disability. AIM: To explore how public maternity services in Australia identify pregnant women with a disability, what (if any) routine disability identification questions are used, and to examine availability and adequacy of services for women. METHODS: Cross-sectional online survey of maternity managers in Australian public hospitals. FINDINGS: Thirty-six percent (70/193) of eligible hospitals responded including all states and territories. Overall, 71 % routinely asked women about disability status (usually as part of routine history taking), however there was wide variation in how this was asked. Most (63 %) did not have standardised documentation processes and two thirds (65 %) were unable to estimate the number of women with a disability seen at their hospital. Most (68 %) did not offer specialised services, with only 13 % having specialised training for staff in disability identification, documentation and referral pathways. Only a quarter of respondents felt that there were adequate services for women with a disability related to maternity care. CONCLUSION: This is the first study to explore disability identification in maternity services in Australia. How women were asked was highly varied and documentation not standardised. National guidelines on disability identification for women accessing maternity services should be developed and collection of disability identification data should be routine.

Health and Access to Health Services for People with Disability in Australia: Data and Data Gaps.

The right of people with disability to enjoyment of the highest attainable standard of health without discrimination on the basis of disability is enshrined in the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Among its obligations as a signatory to the CRPD, Australia is required to collect appropriate information, including statistical and research data, to inform development and implementation of policies to give effect to the Convention. In this commentary, we first describe how the International Classification of Functioning, Disability and Health (ICF) conceptual model of disability can be operationalised in statistical data collections, with a focus on how this is achieved in key Australian data sources such that people with disability can be identified as a population group. We then review existing statistical data on health and health service use for people with disability in Australia, highlighting data gaps and limitations. Finally, we outline priorities and considerations for improving data on health and access to health services for people with disability. As well as conceptual, practical, and ethical considerations, a key principle that must guide future disability data development is that people with disability and their representative organisations must be involved and participate fully in the development of disability data and statistics, and in their use.

Disability-Related Questions for Administrative Datasets.

High rates of unemployment among people with disability are long-standing and persistent problems worldwide. For public policy, estimates of prevalence and population profiles are required for designing support schemes such as Australia's National Disability Insurance Scheme; for monitoring implementation of the United Nations Convention on Rights of Persons with Disabilities; and for monitoring service access, participation, and equity for people with disability in mainstream systems including employment. In the public sector, creating a succinct identifier for disability in administrative systems is a key challenge for public policy design and monitoring. This requires concise methods of identifying people with disability within systems, producing data comparable with population data to gauge accessibility and equity. We aimed to create disability-related questions of value to the purposes of an Australian state and contribute to literature on parsimonious and respectful disability identification for wider application. The research, completed in 2017, involved mapping and identification of key disability concepts for inclusion in new questions, focus groups to refine wording of new questions, and online surveys of employees evaluating two potential new question sets on the topic of disability and environment. Recommendations for new disability-related questions and possible new data collection processes are being considered and used by the leading state authority.

Comparative Analysis of Visual System Disability Evaluation Criteria between China and the United States.

ABSTRACT: Gradation of Disability in Human Body Injuries （hereinafter referred to as Gradation） has been released and used since January 2017, and has become the most widely used standard in forensic science practice. This paper calculates and rates the visual system evaluation provisions of the current domestic disability evaluation criteria represented by the Gradation which used the methods of Guides to the Evaluation of Permanent Impairment （hereinafter referred to as GEPI） issued by American Medical Association （AMA）. Through comparing, a good correlation between the provisions in Gradation and whole person impairment rating index in GEPI was shown. On the basis of this, suggestions are put forward to amend some provisions of Gradation, in order to provide reference for the revision and further improvement of domestic standards and provisions.

Comparative Analysis of Visual System Disability Evaluation Criteria between China and the United States / 法医学杂志

Gradation of Disability in Human Body Injuries （hereinafter referred to as Gradation） has been released and used since January 2017, and has become the most widely used standard in forensic science practice. This paper calculates and rates the visual system evaluation provisions of the current domestic disability evaluation criteria represented by the Gradation which used the methods of Guides to the Evaluation of Permanent Impairment （hereinafter referred to as GEPI） issued by American Medical Association （AMA）. Through comparing, a good correlation between the provisions in Gradation and whole person impairment rating index in GEPI was shown. On the basis of this, suggestions are put forward to amend some provisions of Gradation, in order to provide reference for the revision and further improvement of domestic standards and provisions.

Validation of the Polish version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) in an elderly population (60-70 years old).

PURPOSE: To assess the reliability and validity of the Polish version of the 36-point World Health Organization Disability Assessment Schedule (WHODAS 2.0) in an elderly population. METHOD: One thousand randomly selected individuals, aged 60-70 years, living in south-eastern Poland were assessed using the Polish version of the WHODAS 2.0. RESULTS: The analysis confirmed the high reliability and validity of the tool. Cronbach's α index was 0.89. The tool had high stability, and the correlation between test and retest results was high. The relevance of the domain selection was high or very high. A factor analysis confirmed the relevance of assigning questions to domains. High theoretical relevance was also demonstrated. Statistically significant differences between those who were and were not suffering from health problems were observed. An analysis of the internal structure of the WHODAS 2.0 revealed strong correlations between the components of each domain and the final result. CONCLUSION: The Polish version of the WHODAS 2.0 showed high reliability and validity; thus, it can be used to assess health, functioning and disability in the elderly population of Poland.

Development of traditional Chinese version of World Health Organization disability assessment schedule 2.0 36--item (WHODAS 2.0) in Taiwan: validity and reliability analyses.

BACKGROUND: World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) provided a standardized method for measuring the health and disability and the traditional Chinese version has not been developed. AIMS: To describe the process of developing the traditional Chinese version of the WHODAS 2.0 36-item version and to evaluate the concurrent validity and test-retest reliability of this instrument. METHODS: The study was conducted in two phases. Phase I was the process of translation of WHODAS 2.0 36-item version. Phase II was a cross-sectional study. The participants were 307 adults who were tested the validity and reliability of draft traditional Chinese version. RESULTS: The reliability of Cronbach's α and ICC in the WHODAS 2.0 traditional Chinese version were 0.73-0.99 and 0.8-089, respectively. The content validity was good (r=0.7-0.76), and the concurrent validity was excellent in comparison with the WHOQOL-BREF (p<0.5). The construct validity, the model was explained total variance was 67.26% by the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) illustrated the traditional Chinese version was good to assess disability. There was a valid and reliable measurement scales for evaluating functioning and disability status. CONCLUSION: For disability eligibility system of Taiwan government to measure the disability, the traditional Chinese version of the WHODAS 2.0 provided valuable evidence to design the assessment instrument.

Adjusted Norm of WAIS-RC Short Forms in Identification of Intellectual Disability / 中国康复理论与实践

@#Objective To investigate the application validity of the adjusted norm of WAIS-RC in the identification of intellectual disability.Methods128 patients with mental retardation (MR) were chosen for identification of the intellectual disability, measured their full scale IQs (FIQ) according to the original norm, calculated their four-subtest short forms FIQ respectively by Tellegen way according to the original standard norm and the new adjusted norm, then compared and analyzed the outcomes.ResultsThe short forms FIQ according to the original and the new norm had high correlation to full forms FIQ (P<0.01). The average of the short forms FIQ was higher than full forms FIQ according to the original norm (P<0.01), showing no significant difference according to the new norm(P＞0.05). In severe intelligence defected group according to full forms IQ, the grade classification corresponding rate of short forms FIQ according to the new norm was 0.00%, as well as the original norm. That in medium and mild intelligence defected groups was higher than that of original norm(P＜0.01).ConclusionThe test validity of adjusted norm short forms of WAIS-RC is superior to the original norm, but not suitable for severe intelligence defected.