Planning for motherhood: fertility attitudes, desires and intentions among women with disabilities.

CONTEXT: An estimated 10% of U.S. women of reproductive age report a current disability; however, the relationship between disability, motherhood attitudes and fertility intentions among these women is largely unknown. METHODS: Data from the 2006-2010 National Survey of Family Growth were used to examine attitudes toward motherhood and fertility intentions among 10,782 U.S. women aged 15-44. A series of regression models assessed, separately for mothers and childless women, associations between disability status and women's attitudes and intentions. RESULTS: Women with and without disabilities held similar attitudes toward motherhood. Among women without children, women with and without disabilities were equally likely to want a child and equally likely to intend to have one. However, childless women with disabilities who wanted and intended to have a child were more likely to report uncertainty about those intentions than were childless women without disabilities (odds ratio, 1.7). Mothers with disabilities were more likely to want another child (1.5), but less likely to intend to have a child (0.5), than were mothers without disabilities. CONCLUSIONS: Deepening understanding of the reproductive health desires, needs and challenges of women with disabilities is essential if the highest quality reproductive health services are to be provided for all.

Child and adult disability in the 2000 Census: disability is a household affair.

BACKGROUND: Survey data indicate that individuals with disabilities in the United States often experience less advantageous economic and social resources than individuals without disabilities. Furthermore, they often reside with other individuals with disabilities in the same household. However, less is known about resource availability when multiple child and adult household members have a disability. OBJECTIVE: We use child-level data from the 2000 Census to examine the relationship between aggregation of disability in households with children and education, labor force participation, poverty level, and inadequate housing. METHODS: We utilize tabular analysis and Kruskal-Wallis tests to examine how resources in education, employment, income, and housing adequacy compare for children with disabilities who are the only member of their household with a disability, children with disabilities who live in a household with at least one other member with a disability, children without disabilities who live in a household where no other member has a disability, and children without disabilities who live in a household where at least one other member has a disability. RESULTS: Among children without a disability, 86% live in a household in which no other member has a disability. Among children with a disability, 53% live in a household in which no other adult or child has a disability. Poverty, inadequate housing, and low adult education were more than two times more likely - and adult unemployment over five times more likely - in households with multiple members with disability versus households without disability. CONCLUSION: There is a high prevalence of aggregation of adults and children with disability in households of children with disability. These households have substantially fewer resources than households who do not have children or adults with disabilities.

Delinquency Among Adolescents with Disabilities.

This study expands upon previous research by utilizing nationally representative data and multivariate analyses to examine the relationship between an adolescent's disability status and their likelihood of engaging in a spectrum of delinquent behaviors through age 16. Logistic regression models of 7,232 adolescents from the National Longitudinal Survey of Youth 1997 are used to investigate the association between the presence of a learning disability or emotional condition, chronic health condition, sensory condition, physical disability, or multiple conditions and ten delinquent acts, including violence-related delinquency, property crimes, drug offenses, and arrest. Additional analyses explore differences in delinquency prevalence by more specific types of limiting conditions. Results indicate that adolescents with learning disabilities or emotional conditions are particularly at risk of committing delinquent acts. Findings suggest that disability status is important to consider when examining adolescent delinquency; however, not all youth with disabilities have equal experiences.

The Educational Attainment Process Among Adolescents with Disabilities And Children of Parents with Disabilities.

This article uses data from the National Longitudinal Survey of Youth 1997 (NLSY97) to examine the relationship between disability, parental and youth university expectations in 1997, and youth high school completion and university enrolment by 2003. Results indicate that educational attainment is not equal for young adults with and without disabilities in the United States. Parents-but not adolescents-are likely to reduce their educational expectations when adolescents have a mild or serious disability, net of school performance. These parental-but not adolescent-expectations are significantly associated with high school completion. Finally, even after controlling for educational expectations and school performance, youth with serious disabilities are much less likely to graduate from high school than youth without disabilities. Despite the considerable strides made in the implementation of the Individuals with Disabilities Education Act, students with disabilities are not achieving educational parity in graded schooling.

PARENTING A CHILD WITH A DISABILITY: AN EXAMINATION OF RESIDENT AND NON-RESIDENT FATHERS.

Children with disabilities often require more extensive family involvement and greater paternal support than other children. Yet these children are the children least likely to live with their fathers. This paper uses data from the National Longitudinal Survey of Youth 1997 from the United States to examine the association between child disability and resident and non-resident biological fathers' supportiveness, relationship, and monitoring of their children. Regression analyses indicate significant challenges for all fathers of children with disabilities. Children of resident fathers report more positive interactions than children of non-resident fathers. However, earlier co-residence and more frequent contact significantly improve the quality of father-youth relationships among men who do not live with their children.

School-to-work program participation and the post-high school employment of young adults with disabilities.

Previous research on the education-to-employment transition for students with disabilities has suggested that participation in school-to-work programs is positively associated with post-high school success. This article utilizes data from the National Longitudinal Survey of Youth 1997 (NLSY97) to extend these findings in several ways. First, we assess the efficacy of specific types of school-based and work-based initiatives, including job shadowing, mentoring, cooperative education, school-sponsored enterprise, technical preparation, internships, and career major. Next, we extend the usual focus on the employment outcomes of work status and financial compensation to consider job-specific information on the receipt of fringe benefits. Overall, results from longitudinal multivariate analyses suggest that transition initiatives are effective in facilitating vocational success for this population; however, different aspects of school-to-work programs are beneficial for different aspects of employment. School-based programs are positively associated with stable employment and full-time work while work-based programs most consistently increase the likelihood that youth with disabilities will be employed in jobs that provide fringe benefits. Analyses also indicate that - once individuals with disabilities are stably employed - they can be employed in "good" jobs that provide employee benefits.

Distressed neighborhoods and child disability rates: analyses of 157,000 school-age children.

The aim of this study was to assess rates of childhood disability as indicated by functional limitation of motor, sensory, or self-care skills in children living in severely-distressed neighborhoods. For a neighborhood in the US Census Track to be considered severely distressed, three of the following four characteristics need to be present: >27% of children live in poverty, >23% high school drop-out rate, >34% male unemployment rate, and >37% of households headed by females alone. In the 2000 US Census, 157 000 children between ages 5 and 15 years resided in the State of Rhode Island. Severely-distressed neighborhoods were found in 12.6% of Rhode Island Census Tracks. These areas accounted for 14.5% of the school-age population, 25% of children with motor disabilities, 29% of children with self-care disabilities, and 14% of children with sensory disabilities. For each increasing level of neighborhood distress, rates of child disability increased. Child disability rates in moderately distressed neighborhoods were 3.7%, compared with 1.1% in advantaged neighborhoods. Children in distressed neighborhoods had disproportionately high rates of disability, especially in motor and self-care functioning. Comprehensive interventions aimed at children in distressed neighborhoods are crucial to reduce health disparities for vulnerable children.

Family developmental risk factors among adolescents with disabilities and children of parents with disabilities.

This paper investigates how the learning environments and family dynamics differ if households have a child with a disability or a parent with a disability. Using data from the National Longitudinal Survey of Youth 1997, results indicate that children with disabilities experience similar learning environments as other children, but have somewhat weaker relationships with their parents. In two-parent families, maternal disability lowers parents' school involvement and is associated with a less enriching home environment. Paternal disability reduces maternal monitoring and positive family activities possibly because mothers divert care-giving resources from their children to their male partners. Children in mother-headed households experience learning environments and family dynamics that are similar regardless of their own disability status or that of their mothers, but these outcomes are markedly inferior to those of children growing up in two-parent households. Future research on adolescent development should consider the disability status of children and parents, with particular attention to patterns of gendered care-giving in American families.

Social identity and community effects on contraceptive use and intentions in southern Ethiopia.

In this study, data gathered in southern Ethiopia are used to explain how ethnic and religious identities affect current or intended contraceptive use. The only compositionalfactors that increase the likelihood of birth limitation are having a member of the family with a higher level of education and community access to health services. Compositional factors by themselves do not explain Muslim and ethnic variations in contraceptive use and intentions. Village health and economic crises do not promote birth limitation. One normative economic factor--the practice of sons' inheritance of land from their fathers--considerably reduces the likelihood of contraceptive use, but does not account for religious and ethnic differentials. No evidence is found of a minority-status effect on contraception. Exposure to ethnic and religious diversity in the community of residence substantially increases the likelihood of emergent birth limitation, especially among the predominant Muslim Silte population.

Child disability and mothers' tubal sterilization.

CONTEXT: The needs of children with disability can be substantial, leading some parents to consider contraceptive sterilization to prevent additional births. METHODS: Matched records from the 1993 National Health Interview Survey and the 1995 National Survey of Family Growth were used to investigate the relationship between child disability and mothers' sterilization. Data included the birth records of 8,711 children, information on older children in the household, and the mothers' background and reproductive characteristics. Logistic and Cox regression models were used to estimate the effect of the birth of a child with a disability on the risk of mothers' sterilization. RESULTS: The birth of a child with disability has no effect on the likelihood that a mother will undergo sterilization within the next month; however, women who have an older child with severe disability are more likely than those whose older children are nondisabled to undergo sterilization within a month after the birth of another child (odds ratio, 2.6). Severe disability in a newborn significantly increases the risk of sterilization 1-36 months after birth (risk ratio, 1.7); severe disability among older children also appears to increase the risk of sterilization 1-36 months after birth (1.5), although this result was only marginally significant. CONCLUSIONS: Women often respond to the birth of children with disabilities by changing their fertility plans, although usually not immediately unless they have older children with severe disability. These findings are consistent with parents'desire to have a nondisabled child and with their need to care for an exceptional child by forgoing additional births.

The proximate determinants of the decline to below-replacement fertility in Addis Ababa, Ethiopia.

Between 1990 and 2000, the total fertility rate (TFR) in Ethiopia declined moderately from 6.4 to 5.9 children per woman of reproductive age. During the same period, the TFR in the capital city of Addis Ababa declined from 3.1 to 1.9 children per woman. Even more striking than the magnitude of this decline is that it occurred in the absence of a strong and effective national family planning program. In this study, the components of this fertility decline are identified using the Bongaarts framework of the proximate determinants of fertility. The results of a decomposition analysis indicate that a decrease in the age-specific proportions of women who are married, followed by an increase in contraceptive use are the most important mechanisms by which fertility has declined in Addis Ababa. Poor employment prospects and relatively high housing costs are likely factors that encourage couples to delay marriage and reduce marital fertility.

Functional disability and school activity limitations in 41,300 school-age children: relationship to medical impairments.

OBJECTIVE: Our purpose was to examine the contribution of medical impairments to functional disability and school activity limitations in 41,300 school-age children participating in the 1994-1995 National Health Interview Survey. METHODS: The 1994 and 1995 National Health Interview Survey and Disability Interview Supplement samples provide International Classification of Diseases, Ninth Revision medical impairment codes for children with functional limitations or school activity limitations in a nationally representative US sample. Functional limitations were distributed as follows: mobility 12.4/1000 (95% confidence interval [CI]: 11.1-13.6), self-care 8.8/1000 (95% CI: 7.7-9.8), communication 52.9/1000 (95% CI: 50.2-55.5), and learning 104.6/1000 (95% CI: 100.7-108.4). Functional disability status was classified as 4.1% mild, 5.9% major, and 1.9% multiple. School activity limitations included 4.1% needing or receiving special education, 0.7% unable to attend, and 0.9% limited attendance. We categorized International Classification of Diseases, Ninth Revision impairment codes reported in conjunction with medical usage as physical disorders (n = 1251; eg, leukemia, diabetes), asthma (n = 916), neurodevelopmental disorders (n = 802; eg, cerebral palsy, epilepsy, mental retardation, autism, blindness, deafness), and learning-behavior disorders (n = 806; eg, attention-deficit/hyperactivity disorder, learning disability, anxiety) for children with functional or school activity limitations. Of children with multiple functional disabilities, 29.9% had neurodevelopmental disorders, 27.1% had learning-behavior disorders, 18.1% had physical disorders, 4.2% had asthma, and 20.8% did not have an identified medical impairment because they had not received medical services in the past year. Among children requiring special education, physical disorders accounted for 9.4%, neurodevelopmental disorders for 16.7%, learning and behavior disorders for 17%, asthma for 3.4%, and 53.4% did not have an identified medical impairment because they had not received medical services in the past year. CONCLUSIONS: Chronic health impairments, neurodevelopmental disorders, learning-behavior disorders, and functional limitations in essential activities are required to understand the complexity of disability in school-age children. A large number of children with functional disability or school activity limitations have not received ongoing medical services.