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PubMed1990

Characteristics of employers of handicapped individuals.

We surveyed 1,000 randomly selected employers of handicapped individuals in the state of Washington. Overall, 64 of the 671 responding companies reported employing 166 handicapped people. The proportion of urban and rural employers hiring handicapped people did not differ significantly, but proportionally more large employers had handicapped employees. In terms of numbers of handicapped people employed, 66 worked for large companies, 39 worked for medium companies and 61 worked for small companies. Proportionally more public administration, transportation, and service industries hired handicapped people than other industries. Proportionally speaking, service and sales industries in urban settings were the most likely to have handicapped employees and hire the largest absolute number of handicapped individuals.

Humans↗

PubMed1989

[Measurement of handicap in the community: a micro survey in a French village].

Handicap is the result of a process initiated by an underlying disease, an accident or an abnormality, which leads to a functional deficit in various situations of everyday life. This definition, derived from the International Classification of Impairments, Disabilities, and Handicaps (ICIDH), reflects the desire of the elderly and the handicapped for social integration. It may also form the conceptual basis for analysis of the capacities of individuals and populations. To this end, a micro-survey was conducted in a homogeneous village community of 532 people aged 1-92 years. This study was of the ergonomic type, accompanied by a questionnaire on perceived restrictions and handicaps, and carried out transversely over a period of one month (94.7% participation). The specific objectives of the study were to obtain a reliable functional representation of the population of the village, comparing self-assessment of functional capacity with observed performance, and analysing the effects of age on capacity. The copious data collected in the areas of locomotion, prehension and communication have provided a detailed functional profile of the population studied. These data may be transposed to particular environments, such as transport, housing, school or work, and may serve as a basis for comparisons. The difficulties encountered by subjects in the tests were closely correlated with the situations simulated by the tests. Subjective estimation of handicap proved to be reliable in comparison with actual performance, especially for tests of mobility and highly demanding situations. Estimation of the presence of a handicap increased with age. The deterioration in performance observed was proportional to age, but can be perceived to begin early, at about 30-40 years. Disability-free life expectancy (DFLE) could be an interesting indicator in so far as it appears to be sensitive to the confrontation of individual functional capacities with the environment. However, it is important that any disability used as a basis for calculation should be measured with maximum precision. A community survey of this kind is thus particularly useful for ergonomic purposes, but is also valuable for the planning of medical and social assistance at the local level in the areas of disability and handicap. The combination of observation and listening to people, with an interview, appears to be fruitful and reliable. Single studies of well-targeted samples of the population, or, alternatively, of larger and more significant populations, would be desirable in public health, since the epidemiological approach to handicap has hitherto been essentially focused on diagnosis and medical evaluation.

Activities of Daily Living↗

PubMed1988

[Handicaps and maladjustment: evaluation of social policies].

This article examines various methods of assessing social policies with regard to the integration of handicapped or maladjusted children and adults in France. It begins with an account of the existing system of policies and services for handicapped or maladjusted children and adults in France today. By following the progress of an educationally retarded child (with minor mental handicap or retardation plus behavioural problems), noting the various instructions with which the child is involved, the reader will come to realise the limited nature of the facts available concerning the effectiveness of social integration schemes for the handicapped and maladjusted. The paper then examines the statistical data issued by the ministries of health and education as well as from separate institutions. These data indicate a lack of awareness of the various passages from childhood to adulthood, a bridge between institutions coinciding with the passage into adult life. Educational statistics are completely independent of other statistics on adult services. Measurements focus on institutional activity and often ignore the effects on the individual of the various measures taken. In 1975, France passed legislation concerning integration but little has been done to evaluate the effects of this law. Based on observations in one department of France, the author has found unequal development of the policy for educational integration on the one hand and vocational rehabilitation on the other. Such inequalities are producing increasing difficulties. Integration of physically handicapped children into an ordinary school environment has met with some success. However educational maladjustment, as manifested by children with minor mental handicap or retardation and those with behavioral problems, remains largely beyond the scope of legislation on educational integration. Increasingly, educationally maladjusted children are sent so special schools. Since job opportunities for the handicapped and maladjusted are in short supply, employment inequalities exist. As a result transitional measures or other programmes designed to occupy time have increased whereas employment in ordinary work settings has declined. More often than not, women are employed in "Centres d'Aide par le Travail" (Employment centres for the handicapped). Access to ordinary jobs tends to be mainly available to men whereas specialised employment is mainly for women.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1983

Technology--an unfulfilled promise for the handicapped.

Rehabilitation engineering emphasizes the application of the physical, medical, allied health and social sciences to ameliorate the handicaps of persons with disabilities. A handicap is the consequence of a disability that interferes with a person's life goals in daily living, vocation, avocation and recreation. The degree of a handicap depends on the interaction of a disability and a particular environment as well as on the nature of the life goals of persons with a disability. Thus, technology can reduce a handicap by overcoming functional barriers, but it may increase a handicap by raising a person's life goals to a level that cannot yet technically be achieved, or if developed, effectively delivered. The design-development-production process and the special problems inherent in the development and distribution of technical devices for handicapped persons are discussed. The dependence of the service-delivery system on adequate information and effective evaluation of devices in meeting the needs of handicapped persons is critically examined. Recommendations to overcome barriers that interfere with the availability of the products of technology for persons with disabilities are presented. A description of research areas of technology for the handicapped is also presented.

Persons with Disabilities↗

PubMed1981

[Social integration of mentally handicapped persons (author's transl)].

It was the establishing of associations of parents and friends of mentally handicapped persons that started, above all in the 50's and 60's, in many countries direct and intensive endeavours for the improvement of their social situation. In this context the major goals are the normalisation of their living conditions and the realisation of the human rights due to them as well. Since that time the overall program drawn up by the National Society for the Mentally Handicapped LEBENSHILFE in 1959 set the standards for the work with mentally handicapped persons of all ages. The earliest possible beginning of longterm developmental training, including social training goals, underlies the social integration of mentally handicapped people. In adult life special aids and services must be offered in the fields of working, living and recreation. The participation of handicapped people themselves is a significant prerequisite for achieving an optimal degree of independence. In this context the role of the parents is of special importance as well. Trends towards bureaucratization and onesided professionalization in the work for the handicapped endanger all endeavours for integration. But the attitude of the society towards their handicapped citizens is decisive, too. Direct contact with handicapped persons can reduce prejudices and uncertainties, and open ways to their integration into society.

Community Mental Health Services↗

PubMed1999

Good parent and good genes models of handicap evolution.

We previously studied a good genes handicap model in which male quality was heritable and improved offspring viability. We extend our analysis to species in which males provide direct benefits (e.g. parental care, better resources, the absence of contagious diseases). Male quality now affects female fitness by increasing female reproductive success. For this good parent handicap to work, the male signal must have condition-dependent expression. The equilibrium strength of female preference is controlled by the product of signal transmission efficiency, phenotypic variance of male quality and the effectiveness of male quality in improving female reproductive success. The equilibrium resulting from the good parent handicap has exactly the same form as with the good genes handicap. This allows us to compare the relative importance of these two forces in the evolution of female preferences. The handicap models (both good genes and good parent) also show cyclic evolution, as happens with the pure Fisherian model. However, we predict that the handicap process is often strong enough to lead to a stable equilibrium. This leads to the conclusion that cyclic evolution is less likely to occur for handicap than Fisherian traits.

Animals↗

PubMed1979

[Some aspects of early education of handicapped children in Switzerland].

Early education for young handicapped children is an aid both for the children and their parents. It has been propagated for centuries, and due to a serious research-programme it has also been developed and institutionalized in Switzerland during the last twelve years. The whole of Switzerland is included in this programme. The results of the investigation presented hereby are as follows: 65% of the children are reached after their third year of age only, and only 80% are referred by doctors. Of the 1.2% severely handicapped the 4- to 6-year-old children are well represented, the 0- to 3-year-old children as well as the 2.8% slightly handicapped 0- to 6-)ear-old children are badly represented. Combined methods are proposed for improving the early detection of the Mentally Handicapped. The fact that early education for young Mentally Handicapped is necessary and important has been proved by thorough scientific research. The aim and method of early education for young mentally handicapped children (diagnosis, education, councellinf for parents) are sketchily represented. The principal aim is: improvement of the parental competence concerning the education of mentally handicapped children.

Child↗

PubMed1998

[Eye and general illnesses in the public school for blind and visually handicapped students in Saarland. Developments in the last 20 years].

BACKGROUND: The aim of the study was the evaluation of how ophthalmological diagnoses and the proportion of multiply handicapped children has changed within the last 20 years at a state school for visually handicapped and blind children. PATIENTS AND METHODS: A profile investigation was conducted on all 105 children at the Landesschule für Blinde und Sehbehinderte des Saarlandes and compared to the results of an examination from 1975. RESULTS: The predominant ophthalmological diagnoses were: optic atrophy (17.5%), ocular albinism (11.9%), scar-stage IV and V of retinopathy of prematurity (11.1%), as well as tapetoretinal dystrophies with related syndromes (8.7%) and myopia magna (7.9%). Blind: 10.3% (1975: 36.4%); visually handicapped: 47.1% (1975: 49.2%); multiply handicapped: 42.5% (1975: 14.4%). CONCLUSIONS: (1) The diseases that dominated in earlier years in schools for the visually handicapped have become rare (cataract, aphakia, buphthalmia, macular dystrophy--all less than 5%); (2) the proportion of completely blind pupils has become much smaller; (3) there is an increasing tendency to educate visually handicapped pupils in regular schools with integrative aids; (4) there is also an increasing proportion of multiply handicapped children (school and kindergarten: 42%, early patronage 74%).

Blindness↗

PubMed1985

Assessment of social skills in visually-handicapped adolescents.

The present study provided a comprehensive behavioral assessment of social skill in visually-handicapped adolescents. Role-play tests, standardized interviews, parent ratings and judgements of physical attractiveness were employed to evaluate level of social functioning among: (1) 18 visually-handicapped adolescents in a residential school; (2) 17 visually-handicapped adolescents in public schools; and (3) 17 sighted adolescents in public schools. Results indicated that visually-handicapped adolescents exhibited deficits on selected verbal components of social skill. Moreover, these deficiencies were most apparent in visually-handicaped Ss from a residential setting. Findings are discussed in terms of the utility of social skills training for a subset of visually-handicapped adolescents and the importance of additional controlled research with visually-handicapped persons.

Adolescent↗

PubMed2004

[Normative study and reliability of French version of the dizziness handicap inventory].

GOAL: To determine the normality per age group of the "Echelle du Handicap lié aux Troubles de l'Equilibre et aux Vertiges" (EHTEV) French version of the "Dizziness Handicap Inventory" (DHI) and to assess the effect of sex on the scores and the reproductibility. SUBJECTS AND METHODS: The normative scores and the effect of the sex were determined in a group of 120 subjects without any instability disorder. Sixty-three women and 57 men, aged 20-79 years were graded by age section of 10 years. After 8-10 weeks the same questionnaire was submitted again to 47 individuals of this same group to assess the reproductibility. RESULTS: The scores of the instability showed that handicap increased with the age. The mean score for the 50-79 year-old group is almost four times greater that of the 20-49 years old. Correlation between scores and age is 0.70 for physical handicap, 0.76 for emotional handicap, 0.69 functional handicap and 0.83 for global score. There is no significant influence of sex. The reproductibility coefficient is 0.98. CONCLUSION: The scores of the EHTEV increase with age. There is no significant influence of sex on scores and the coefficient of the reproductibility is good. But the translation of this handicap scale, need a study of validity and reliability.

Activities of Daily Living↗

PubMed2006

Patient versus partner perception of voice handicap.

The primary purpose of this study was to compare patient's and communication partner's perceptions of handicap secondary to dysphonia. A secondary purpose was to compare patient health-related quality of life (HRQOL) to that of speakers with normal voice. Participants were 20 adults (mean age=69.15 years) with dysphonia and their communication partners. Patients completed the Voice Handicap Index (VHI), a questionnaire of self-perceived voice handicap, and the Short-Form 36 (SF-36), a general health questionnaire. Partners completed the Voice Handicap Index-Partner (VHI-P), a questionnaire derived from the VHI for this pilot study, to gauge partner perception of voice handicap. Patients in this study viewed themselves as only moderately handicapped by their dysphonia and their partners were in close agreement. Patients and their partners were also in close agreement on each of three VHI subscales (physical, functional, and emotional), and in all cases the physical domain was perceived by both patients and their partners to be most handicapped. Patients had lower SF-36 mean scores than those of persons with normal voice from the general U.S. population on scales assessing physical functioning, physical role, general health, vitality, social functioning, emotional role, and mental health. The results of this study are consistent with previous studies examining patient-partner agreement, which consider proxy ratings to be a useful alternative or collaborative source of patient's self-perception. Further research regarding the reliability of patient and partner agreement is necessary to most effectively assess and manage patients with dysphonia.

Adult↗

PubMedDate not supplied

New handicap scale for elderly in hospital.

The new handicap scale, consisting of 12 questions based on ICD classification of handicap, was developed as an outcome measure and assessed in 29 in-patients and 27 day hospital attenders. Results show that the handicap score obtained using this new instrument correlates significantly with the score obtained using the London handicap scale. In addition the score correlated with the Nottingham extended activities of daily living, the functional autonomy measurement system, two of the commonly used measures of outcome, and some of the parameters of SF-36. In the 29 inpatients the results show improvement in handicap with treatment including rehabilitation. For assessment of reproducibility and stability over time the handicap scale was administered twice to 10-day-hospital attenders over a three days period end the results revealed a high coefficient (0.98) and kappa (0.92) values. Thus the results obtained from this small study suggest that the questionnaire is a useful tool for assessment of handicap in elderly patients receiving treatment in hospital.

Journal Article↗

PubMed2004

Healthy living does not reduce life satisfaction among physically handicapped persons.

Smoking, drinking, over-eating and sedentary living may be regarded as ways of compensating for losses inflicted by physical handicaps. Therefore, promoting healthy life-styles among physically handicapped persons may amount to reducing their life satisfaction. This article examines the life-style and life satisfaction of all self-reported somatically handicapped respondents 25-50 years of age in a mid-Norwegian county. Persons with physical handicaps had more unhealthy habits than the general population. But life-style was not related to degree of physical handicap. And quality of life among the physically handicapped was not associated with life-style. Efforts to promote healthy living may not threaten the quality of life of physically handicapped persons.

Activities of Daily Living↗

PubMed2004

How well does club head speed correlate with golf handicaps?

The velocity at which a golf club impacts with a golf ball is known as club head speed. Although club head speed has been used to measure performance changes in a number of golf studies, it has not been validated as a golf performance measure. As handicap is the usual measure of performance, the purpose of this study was to investigate the relationship between club head speed and handicap, and to determine whether club head speed at impact is a valid measure of golfing performance. Forty-five male golfers aged 18-80 years, all with registered golfing handicaps (2-27), participated in this study. Each golfer performed 10 golf swings captured by a high-speed camera. Golfers' club head speeds were determined using Video Expert 2, a biomechanical computer program. Golfers with a lower handicap (i.e., a better skill level) had faster club head speeds than higher handicap golfers. Linear regression analysis found club head speed to be highly correlated with handicap (r = 0.950). This relationship was described by the equation: In (club head speed)= 4.065 - 0.0214 x handicap. In conclusion, this study has shown that club head speed is a valid indicator of performance in golfers and may therefore be a useful performance measure in future laboratory-based studies.

Adolescent↗

PubMed1995

Incidence of handicaps in multiple births and associated factors.

This study investigated the degree of risk of handicap in twins, triplets, quadruplets and quintuplets and associated factors, and examined the clustering tendency of handicaps. The sample was recruited from the Kinki University Twin and Higher Order Multiple Birth Registry. This panel consisted of 705 pairs of twins (1410 twins), 96 sets of triplets (287 triplets excluding 1 infant death), 7 sets of quadruplets (27 quadruplets excluding 1 infant death), and 2 sets of quintuplets (10 quintuplets), all of whom were born after 1977. The incidence of handicap was 3.7% in twins, 8.7% in triplets, 11.1% in quadruplets, and 10.0% in quintuplets. The risk of producing at least 1 handicapped child was approximately 1 in 13 pairs of twins (7.4%), 1 in 4 or 5 sets of triplets (21.6%), and 1 in 2 sets of quadruplet and quintuplets (50%). There was a significantly higher clustering tendency of handicaps in twins and triplets compared with the expected frequency calculated from the incidence rate of handicap. Four significant risk factors for subsequent handicap were found by logistic regression: gestation number, shortening of gestational age, premature rupture of the membrane, and toxemia during pregnancy.

Cluster Analysis↗

PubMed2000

Correlation between ICIDH handicap code and Gross Motor Function Classification System in children with cerebral palsy.

The aim of this study was to apply the International Classification of Impairments, Disabilities and Handicap (ICIDH; WHO 1980) parallel to the Gross Motor Function Classification System (GMFCS; Palisano et al. 1997) in a population-based series of children with cerebral palsy (CP). Of the 116 children studied, birth characteristics, data on gross motor function, and level of handicap at 5 to 6 years of age, were retrospectively collected from medical records and documentation made by rehabilitation team members. Low handicap scores and mild levels of gross motor disability were present in children with hemiplegic CP, moderate scores in children with diplegic CP, simple ataxia, and athetotic CP, and high scores in children with dystonic CP and tetraplegic CP. A significant correlation was found between high handicap scores as well as high levels on the GMFCS and the presence of learning disability, epilepsy, and obvious aetiology of CP. A strong correlation was found between the handicap code and the GMFCS, the strongest concerning the dimension of mobility (r = 0.95,p<0.0001). A striking similarity in the grading of disability was present between the ICIDH handicap code and the GMFCS. The GMFCS is considerably less time-consuming and can be evaluated retrospectively. The handicap code requires more detailed information and is more useful for a comprehensive profile of the child.

Cerebral Palsy↗

PubMed2003

Characteristics of disability and handicap among Toxic Oil Syndrome (TOS) cohort patients: a cross-sectional study, 17 years after the original food intoxication.

PURPOSE: In 1981, a progressive multi-systemic disease called Toxic Oil Syndrome (TOS) appeared in Spain as an epidemic that affected 20,000 people. The International Classification of Impairments, Disabilities and Handicaps (ICIDH) was chosen to characterize the health status of patients more severely affected by TOS. METHODS: A random sample of 292 with permanent disability was selected. Disability was assessed with a questionnaire based on ICIDH and the Stanford Health Assessment Questionnaire. Handicap was measured using London Handicap Scale. Distributions of the proportions and 95% confidence intervals for disabilities, handicaps were calculated and stratified by dimensions, age and sex. The chi2 test was used for inter-group comparisons. RESULTS: Two hundred and fourteen patients were interviewed. Mobility-related and behaviour disabilities were most prevalent. Disability rose with age and was higher among women, except for behaviour disabilities which were more frequent in young men. Mean handicap score was 78.0 +/- 12.7. Handicap dimensions most affected were physical independence and economic self-sufficiency. CONCLUSIONS: The health profile of the population hardest hit by TOS is characterized by the presence of important functional and psychosocial disabilities that limit performance of daily living activities and social role, and are in accord with the handicap that such persons suffer.

Activities of Daily Living↗

PubMed2002

Objective and subjective handicap following spinal cord injury: interrelationships and predictors.

OBJECTIVE: To investigate the relationship between objective and subjective indicators of handicap or community participation among people with spinal cord injury (SCI) 1 year postinjury. DESIGN: Longitudinal correlational study of quality of life indicators linked to Northern New Jersey SCI System database. SETTING AND PARTICIPANTS: A total of 126 (80% male) participants was assessed at 1 year post-SCI. Age ranged from 14-83 years (median age = 34 years); 47% had tetraplegia, and 53% had paraplegia. PRIMARY MEASURES: Objective (or normative) handicap was measured using the Craig Handicap Assessment and Reporting Technique and the Community Integration Questionnaire. Subjective feelings about each area of handicap or community participation were assessed using the Andrews Delighted-Terrible scale. RESULTS: Significant correlations were found between objective and subjective indicators of handicap in work life, social life, mobility, and economic status. Subjective handicap also correlated modestly with severity of impairment and length of hospitalization. These correlations were, however, weak or inconsistent across individuals. Subjective quality of life was not related to preinjury economic or social handicap. Some participants spontaneously reported dissatisfaction with items outside of the standard outcomes scales used (eg, sexuality and personal relationships). CONCLUSIONS: The weakness and inconsistency of relationships between objective and subjective appraisals of areas of community participation is a challenge to outcomes measurement and has implications for the targeting of interventions. More research is needed to understand relationships between objective indicators of community participation and subjective appraisals of these areas.

Adolescent↗