Category: Disabilities

Introduction

The determination of the Employment Equity Act was generated to guarantee that there are one and the same chances for all people that exist in Canada. The Employment Equity Act primarily aims four assemblies of the population that involve females of the country, aboriginal peoples, individuals with disabilities, and observable subgroups of the population. Furthermore, the Employment Equity Act assists as a significant part of the employees because it traces any discernment and eliminates it efficiently.

If the Employment Equity Act is applied appropriately, the Act will guarantee that people in the labour force are given the opportunity of the equivalent admission to job openings along with identical management in the place of work. A lot of entities accept as true that managers are not very expected to encounter the conditions of discernment as they go through the acquisition procedure, along with correctly applying the Act in a specific labour force. As a result, the complication of the Employment Equity Act is reasonable; though it is not obligatory to ensure the Act is applied in countless places of work in Canada.

The following report aims to evaluate the effectiveness of the Employment Equity Act, especially focusing on the section written for Aboriginal Peoples and Person with Disabilities. In order to do so, several features should be included in the paper. First of all, the history of the legislation will be discussed in order to begin to assess the law from the moment of its implementation. Furthermore, various articles of legislation and their applicability to human resources will be considered. Moreover, challenges that the Employment Equity Act has posed will be observed along with the recent changes that have been made to the legislation and their effectiveness. The last section of the report will provide several recommendations to advance the Employment Equity Act.

History of the Employment Equity Act

The Employment Equity Act of Canada was first conceived in 1986 by Judge Rosalie Silberman Abella, Commissioner of the Royal Commission (SOURCE) and aimed to protect specific groups in the labour market against discrimination. The EEA aims to allow equity in the workplace for women, persons with disabilities, aboriginals and visible minorities. This Act is enforced in not only the public sector but also in portions of the federal public administration (schedule I to IV and V). Ontario enacted their EEA two years later in 1988. In Ontario, the EEA covers both the public and private sectors of the workforce.

In order for an employer to conduct and uphold the standards of the EEA, they are expected to run job and workplace analyses regularly. They are obligated to make sure if there is a sector lacking one of the protected groups, that they find out the reason behind it and find a way to fix the problem. The EEA states that each employer must state clear and positive policies that the employer must follow in every stage from recruitment to acceptance of the job, and in the workplace. In accordance with paragraph 9(1)(b), employers are obligated to remove any barriers that would discriminate against employees, to the point of undue hardship.

Two years later, in 1988, groups who were all interested in the equality of the workplace created a coalition. The coalitions mission was to convince the federal government that the equality program in place needs to become more effective. For years after the creation of the EEA, it seemed as if it was not going to go anywhere or get any better, but that was until 1993 when the EEA began to cover both public and private sector workplaces.

At this time there was also an agreement formed with the government of Nunavut. It became Article 23 in the Agreement: each government organization shall prepare an Inuit employment plan to increase and maintain the employment of Inuit at a representative level. (SOURCE) By 1996 representation of Aboriginal Persons had finally been pushed forward. The federal government, the assembly of Manitoba Chiefs and also the Canadian Human Rights Commission had finally come to an agreement; increase the representation of our Aboriginal Persons.

The beginning of the 2000s brought on more changes to the Employment Equity Act. Another push towards hiring 1-in-5 minorities was created by the Embracing Change Initiative, included in this was funding towards reaching the goal, which never managed to achieve their goals, even though this became the first voluntary act by employers. In 2004 the Senate Standing Committee on Human Rights decided it was time to interview different witnesses of Employment Inequality.

Finally, by 2006, the Federal Government released the Public Service Employment Act; it contained rules and regulations towards employment and staffing in the public sector. In 1995, when the Conservatives took control of the government, they placed a cap on public sector pay equity funding, which ran out in 1999.

In the end, Canada is trying to make sure that every one of its citizens is treated fairly and equally, including employers, who are only obligated to follow this Act to the point of undue hardship, at which point excluding one of the protected groups no longer becomes discrimination.

Legislative Provisions and Its Applicability to Human Resources

The main applicable provisions from the Employment Equity Act, which need to be considered by Human Resources are under articles I to IV of the Act. These articles specifically involve principles, interpretation, obligations, and audit and enforcement by the Commission, pertinent for ensuring that the public sector engages in employment practices that will increase the representation of women, visible minorities, Aboriginal persons and persons with disabilities, to ultimately have workforces that truly represents its society (Employment Equity Act (S.C. 1995, c. 44)). An overview will be discussed below to the significances of the articles for guiding human resources to advise employers and ensure policies and practices are in accordance with the Act.

Article I: Employment Equity

Article I of the Act, outlines five principles of employment equity applied throughout the public sector, which are: duty to ensure recruitment and employment is free of barriers, including systemic and deliberate discrimination against members of the four designated groups; assurance that positive and supportive measures are taken without causing undue hardship to the employer; and making certain efforts are made to reflect the four designated groups within all occupational categories and at all levels of employment (Employment Equity Act (S.C. 1995, c. 44)).

Section 9 & 10

The article also outlines obligations when implementing employment equity initiatives. Under section 9 of the Act, an employer needs to analyze and review the representation of the designated groups employed in the workforce, to which the review will enable the employer to remove barriers, including procedures and policies that are unfavourably affecting the designated groups.

Further to the review and analysis, an employer is obligated to prepare an employment equity plan which will include the information on eliminating barriers, the necessary measures that will be taken to correct the underrepresentation, and specify the goals and timetables for short-term and long-term for the matters discussed, in addition to the composition for increasing the representation of persons in the designated groups (Employment Equity Act (S.C. 1995, c. 44)).

Section 18

Under section 18 of the Act, reports of private-sector employers outlines the responsibility of private-sector employers to prepare an annual report which will contain: industrial sector; location; the total number of applicants; and with appropriate qualifications along with information for applicants from the designated groups and the number employed in all occupational groups, highlighting the designated groups within; the salary ranges of employees highlighting the designated groups within; and the number of employees promoted and terminated for all designated groups. The report shall then be filed with the Canadian Human Rights Commission on or before June 1 in each year, in addition, made available to employees representatives and employees (Employment Equity Act (S.C. 1995, c. 44)).

Thus, it is the responsibility that Human Resources encourages and is committed to implementing employment equity practices and policies, guided by article I, to ensure administration of recruitment and selection, and employment practices comply with legislation.

Article II: Compliance

Article II of the Act, dictates the duty of the Canadian Human Rights Commission to assure that employers are complying with an article I of the Act. The Commission will audit organizations with more than 500 employees, which indicate the representation of the members of the designated group below the average with a comparison with its sector. The Commission will inform these employers about a possible audit, in which the employer has two weeks to provide the Commission with a workforce analysis.

If the analysis indicates a good demonstration of the designated group, they will receive a report from the Commission regarding accomplishments and challenges. However, if the employer fails to demonstrate good representation, an audit will be conducted that will include an on-site visit that includes interviews with employees, managers and union representatives, with an overall duty to provide a report specifying actions the employer will take to comply with the Act (Employment Equity).

The aforementioned are applicable to Human Resources as it is a shared responsibility with the employer to investigate any failures and communicate strategies to ensure efforts to upgrade the employment equity program to be in good practice by creating formalized and objective policies, provide training on employment equity to personnel that are involved with workforce decisions, and deliberation on strategies to increase diversity.

Article III: Violations

As having the traditional roles of obtaining, maintaining, and retaining an optimal workforce it is the duty of Human Resources to not only ensure that a productive workforce is maintained but to participate in ensuring the organization is not in violation with regarding laws governing the employment relationship (Schwind, 2013). Thus it is of great importance that Human Resources reviews and understands article III of the Act, which outlines what constitutes a violation of the employment equity legislation.

Under section 35 of the Act, violations are described as failing to file an employment equity report, exclusion of essential information as outlined in section 18, and providing false or misleading information in the report that employer knows, to be untrue (Employment Equity Act (S.C. 1995, c. 44)). If a violation is found the employer will have an opportunity to present evidence and make representations to the alleged violation, therefore, it is critical that Human Resources maintains appropriate records of human resource management endeavours.

Article VI: General

Under section 42 (3), it is important to note that the Minister makes available labour market information of the designated groups in the Canadian workforce in order to assist employers in fulfilling their obligations (Employment Equity Act (S.C. 1995, c. 44)). Accordingly, the Government of Canada provides tools, resources, publications and databases to assist employers and Human Resources in fulfilling their obligations. It should also be noted that section 44(1), review of the operation the of Act, states that at the end of every five years, a committee of the House of Commons will conduct a comprehensive review of the provisions and operation of the Act. As a result, employers and Human Resources need to be vigilant of any changes to the Act that may arise from the review.

Overall it is of importance that human resource professionals are aware of all provisions of the Employment Equity Act to ensure company policies and practices, in regards to employment relation management, are inclusive, non-discriminatory, free of violations, valid, and up-to-date, to integrate the principles and goal of the Act fully.

Challenges that the EEA has posed

There is the good intention behind the Employment Equity Act, but like every other legislation, it does not come without challenges. A few of the main challenges that the Employment Equity Act creates is the lack of understanding surrounding the Act, it is federally regulated, and there is a lack of punishment for those who do not follow the legislation. The positive thing about these issues is that they can be improved for the future.

The first main challenge in relation to the Employment Equity Act is the ignorance surrounding the Act. More specifically, entry-level employees may not be informed on how the Act is applied within an organization. This happens when CEOs and government officials neglect to inform employees about how a certain percentage of the workforce should include the disadvantaged groups. As a result, entry-level employees may feel reverse discrimination and resent the practice within the company (Falkenberg & Boland, 1997). Not only are these employees impacted by ignorance surrounding the Act, but employers are also subjected to a lack of knowledge and understanding. This maybe because of how unspecific the legislation is in regards to the extent of changes that need to be implemented by employers (Falkenberg & Boland, 1997).

The second issue in relation to the Employment Equity Act is that it is regulated at a federal level. With a focus on federal employers, this disregards provincial employers requiring a separate form of legislation altogether. As far as regulation goes, the Act is tracked** by the Commission when they conduct random audits on companies with 500 or more employees (Canadian Human Rights Commission, 2015). This, in itself, poses an issue. If organizations with less than 500 employees are not even subjected to being audited, then there is a large number of companies possibly not following the legislation. Thus, it is difficult to regulate who is actually applying the Act (Government of Canada, 2015).

The third challenge of the Employment Equity Act is that there is a lack of punishment for organizations who do not follow the law. Consequences for employers are carried out by the Commission when they conduct random audits on the company ensure they are complying with the Act (Canadian Human Rights Commission, 2015).

The problem is that the punishment is very weak. If an employer is not abiding by the legislation, then the Commission will issue a letter to the employer so that changes can be made within four months (Canadian Human Rights Commission, 2015). If no action has been taken to correct the equity discrepancy, then the Commission will impose corrective measures (Canadian Human Rights Commission, 2015). Ultimately this random audit lacks incentive for employers to apply the Employment Equity Act within their organizations. Especially if they are caught, they have four months to start to change their practices.

Overall the challenges of the Employment Equity Act arise out of systemic issues that include a lack of knowledge and understanding, the federal focus, and the lack of consequence. The fortunate thing about these challenges is that steps can be taken to combat these issues.

Recent Changes that Have Been Made to the Legislation

The Canadian government adopted a report in 2000 that was released by the Task Force on the Participation of Visible Minorities in the Federal Public Service. It offered a three-year funding plan to shape a federal public service that is representative of its citizenry. The government set up different developmental programs to assist visible minorities in the workplace (or lack thereof). With the help of these developmental programs, 3000 visible minorities were hired between 2003 and 2004.

On April 3, 2001, Deputy Minister Ranald A. Quail became the head of the Task Force on Modernizing Human Resources Management. This program was developed to update modern policies, legislations and institutional framework. Bill C-25 was passed on November 7, 2003. This Bill (Public Service Modernization Act) changed how recruiting and hiring was done.

The duty to accommodate became part of the Employment Equity Act in 2002. The Act aimed to rid the workplace of any barriers workers with disabilities may face, and to allow them an equal opportunity just like any other employee. Different guidelines (Guidelines for Fair Assessment in a Diverse Workplace: Removing Barriers to Members of Visible Minorities and Aboriginal Peoples and Guide for Assessing Persons with Disabilities in the Appointment Process) were published in 2002 to help employers, and HR Managers understand how and what to do when dealing with accommodating disabled workers.

While a small amount of progress had been made since the Employment Equity Act was implemented, in 2004 the Federal Pay Equity Task Force took a look at Canadas statistics and noticed protected groups were still suffering pay discrepancies, and that tougher action in the law must be taken to protect them. The Canadian Centre for Policy Alternatives report, A Living Wage as a Human Right explains how this discrimination and lack of strict laws makes it harder for many average workers to make a living.

In 2006 Canada passed a Public Service Employment Act (S.C. 2003, c. 22, ss. 12, 13) which contained provisions on the Employment Equity Act in the public service. During 2007, and again in 2010, the Senate Standing Committee on Human Rights developed two different reports. The first one, entitled Employment Equity in the Federal Public Service  Not There Yet stated that there was not enough progress being made towards Employment Equity.

The second report the Senate released in 2010 had more research into the topic. It detailed the failure of the federal public service to achieve employment equity after 15 years under the Act (Public Service Alliance of Canada, 2013). In 2012, the Federal government removed legal requirements for Federal contractors and left the Minister to decide requirements. Then in 2013, again, the Federal government reduced the number of employers that were covered and reduced any requirements.

Recommendations to Improve the Legislation

The first recommendation that can be made to improve the Employment Equity Act is to increase its scope. Currently, it only applies employers under federal jurisdiction with 100 or more employees. This means the majority of Canadians are employed in organizations not covered by the Act. Increasing it beyond just federally regulated businesses, so it represents a greater proportion of the Canadian workforce, would have better results for the affected groups.

Another recommendation for improving the legislation would be to increase the level of government involvement. Henry and Jain (1991) suggested inequality has been prevalent for so long that current voluntary programs wont work, and the only remedy would be increased government intervention. There are currently no incentives for employers to comply with the Act, and few sanctions are ever imposed on employers who do not adhere to the rules of the Act.

The Employment Equity Review Tribunal may impose fines of up to $50,000 for continued violation of policies, but this does not pose a meaningful deterrent to a lot of employers. (Mentzer, 2002) There needs to be increased monitoring of how programs are implemented within businesses, incentives for complying with all program requirements, which would compel organizations to develop and regulate their own equality programs (Falkenberg & Boland, 1997), and meaningful penalties for continual non-compliance.

There is also currently insufficient monitoring of equity programs. The government Evaluation of Employment Equity Programs, published in September this year, found that the performance measures in place to monitor the effectiveness of the programs were being underused. There needs to be better, and more frequently produced, evaluations of how the Act is working in order to determine improvements that can be made to the programs more accurately. Further, these performance measures do not provide an accurate idea of program outcomes because they focus more on compliance with reporting than on whether the business is actually adhering to the standards the Act is designed to promote. (Evaluation, 2015)

A final suggestion of how to improve the legislation is to increase understanding and change employer and employee perceptions of the Act. Falkenberg and Boland (1997) argue that employee participation is vital to the success of programs. They propose educating workers to change their attitudes and prejudices towards designated groups, as well as about the reasons for the Act, and discriminations faced by the target groups. Without this, and an understanding of the reasons behind the policy, they say employees will be resentful of what they may perceive as reverse discrimination within the Act.

With regard to the Aboriginal population, the government Evaluation of Employment Equity Programs (2015), found that it is increasing at twice the rate of the general population, and this obviously, in turn, means that there will be soon more Aboriginal peoples looking for work. The report stated that policymakers do not currently consider Aboriginal communities to be a source of skilled workers. Therefore they and employers need to be educated that Aboriginals skills and potential are being underused, and should be more actively explored, particularly in times of skills shortages.

With relation to people with disabilities, the need to accommodate goes beyond hiring requirements and covers the job itself. Vital to the employment of people with disabilities was the degree to which employers were willing and able to accommodate them. The report found that employers were focused on obvious disabilities and needed more education on less obvious ones, such as hearing, learning, and mental disabilities and the accommodations they might require, such as the provision of interpreters or tele-typewrites, as well as a better recognition and understanding of mental health problems. Many employers cited the cost of accommodation as the main barrier to hiring someone with a disability. However, the report suggests the estimated cost of providing the necessary accommodation would be less than $500 per person.

The forecasted increase in the rate of growth in all designated groups over the coming years will almost certainly increase the number of those people in need of support, meaning we have to correct these policies now, to ensure smoother transitions into the workforce for disadvantaged groups in the future.

Conclusions

The insinuations of the Employment Equity Act appear to be reasonable, and if applied properly, the Employment Equity Act could and will be operative and efficient. Nonetheless, in a case, if the Act is not being applied reliably, the inferences could be observed that it appears to be not essential in Canada. The Employment Equity Act is covered with decent objectives because it strives for eliminating the obstacles that females of the country, aboriginal peoples, individuals with disabilities, and observable subgroups of the population are facing; although discernment is made deceptive up to this day. As they go through the acquisition procedure, the managers are obliged to search for and discover the best applicant for the occupation rather than employing a person based on the evaluation of their gender or position in the society.

The Quality that is proposed by a singular person should reproduce the way they are able to donate an affirmative development and affluence among the employees. These qualities should have a leading role and be searched for while employing a person. Due to the fact that the Employment Equity Act is not correctly applied and exposed to have defects, variations should be implemented to the Act to make it work efficiently and assist the manager along with the workplace surroundings. The changes should be made in accordance with the historical past of the Employment Equity Act. The existing Employment Equity Act has to be adapted so that it can be applied appropriately, constructing it the way it would be essential to apply.

References

Canadian Human Rights Comission. (2015). Employment Equity. Web.

Cornish, M., Yao-Yao Go, A., & Rae, J. (2013). Employment equity laws ensure workplace fairness | Toronto Star. Web.

Employment Equity. (2013). Web.

Employment Equity Act (S.C. 1995, c. 44). (2014). Web.

Employment Equity and Workplace Rights. (n.d.). Web.

Equity in Canada, Policy Options 14(2), 3-7. Henry, E and H. Jain: 1991, When Inequity is Built Right into the System, Globe and Mail, p. A15. Web.

Evaluation: Employment Equity Programs. (2015). Web.

Falkenberg, L., & Boland, L. (1997). Eliminating the Barriers to Employment Equity in the Canadian Workplace. Women in Corporate Management, 16(9), 963-975. Web.

History of Employment Equity in the Public Service and the Public Service Commission of Canada. (2011). Web.

Mentzer, M. (2002). The Canadian Experience with Employment Equity Legislation. International Journal of Value-Based Management, 15(1), 35-50. Web.

Peng, P., & Singh, P. (2009). Pay equity in Ontario: The case of a non-profit seniors service organization. Canadian Public Administration, 52(4), 613-625. Web.

Public Service Alliance of Canada. (2013). Web.

Public Service Employment Act (S.C. 2003, c. 22, ss. 12, 13 ). (2003). Web.

Schwind, H., Das, H., Wagar, T., Fassina, N., & Bulmash, J. (2013). Legal Requirements and Managing Diversity. In Canadian Human Resource Management: A Strategic Approach, 10th Edition (10th ed., p. 129-164). McGraw-Hill Ryerson. Web.

Summary

A person with a disability is an individual who has certain limitations of his abilities, who cannot actively participate in all spheres of social activity. He or she should have equal rights and opportunities with other members of society. Throughout the world, the social movement of people with disabilities to protect their rights to freedom of choice, self-determination, and open access to participation in all areas of society is growing.

The state bill of interest is AB-196 Paid family leave, which wishes to amend Section 3301 of the Unemployment Insurance Code. The latter is related to the issue of paid family leave, where one gets paid for taking care of a person with a disability, for example, a family member. The current law obliges a disability insurance program to pay a person, who is taking care of a person with a disability, a certain percentage of the wage. The calculation process involves determining the quarter with the highest wages and paying an employee a portion of the given sum. The bill wishes to amend the existing law to pay 100% divided by 13 as a wage to employees on temporary family paid leave, who are taking care of people with disabilities.

The main change in section 3301 of the Unemployment Insurance Code is 3301b2, which mandates to pay 100% of the highest base wage during the paid leave divided by 13 and not the portion of the sum, as it is now. The weekly benefit is provided for no more than six weeks, which can be paid for 12 months (AB-196 Paid family leave, 2019). It is important to note that the amount cannot exceed the weekly benefit on maximum workers compensation temporary disability indemnity established by the Department of Industrial Relations.

If the bill passes, people with disabilities will get paid more than usual, because the amendment removes loopholes for reducing the total weekly benefit amount. The family, the immediate environment of a person with disabilities, is the main link in the system of his or her care, socialization, the satisfaction of needs, support, and career guidance. The problems of families with the advent of a person with disabilities are increasing. In the first place, these are material, domestic, financial, and housing problems. In such families, sometimes insurmountable tasks arise associated with the acquisition of food, clothing, shoes, the simplest furniture, and household appliances. Housing is usually not suitable for a person with a disability because there is no separate room or special facilities for this individual. Services for people with disabilities in such families are mostly paid. All this requires large sums of money, and the majority of families have a modest income, which consists of the caregivers wage and the persons social disability benefits.

The social protection of families with people with disabilities is based on an appropriate regulatory framework. The law should encourage and differentiate the benefits provided to a person with a disability and his family, that is, all family members living together. Additional benefits for caregivers are provided by law for them to provide a person with a disability with complete care. The social protection of a family with such an individual should be focused not only on solving specific problems, but, first of all, on strengthening and developing their potential. In this process, the role of social services and specialists working in these institutions becomes especially significant. In addition, the law should not only help the family overcome daily difficulties but also provide sufficient funds, help them build their life scenarios by the highest possible level of quality of life.

This process must begin with the family since the role of the family in the rehabilitation of people with disabilities is simply difficult to overestimate. The involvement of family members, especially the caregiver, is crucial in the outcome of the rehabilitation. However, the significance of the family can be not only positive but also negative in case of insufficient funds. Because of this, this law must be implemented to provide caregivers with the necessary financial resources. Parents should be prepared for the rehabilitation of people with disabilities at home. The role of the social worker in these cases is extremely great since it is from him that they expect advice and help. The lack of faith in caregivers in security during care hurts the lifestyle of a person with a disability. Whereas the belief in security forms a positive psychological climate, the socio-economic activity of caregivers, which, in turn, contributes to the adaptation, success of care, and the entire process of integrating a person with a disability into society.

References

AB-196 paid family leave. (2019). Web.

Abstract

The targeted study seeks to explore caregivers perceptions of intellectually disabled persons and their impact on the quality of care. Current literature shows that many mentally disabled persons have been ignored in different healthcare delivery systems. The study will use focus groups and constant comparison analysis to come up with quality research findings. Such findings will be used to develop effective healthcare policy for supporting the needs of intellectually disabled persons. The proposed study will present new approaches and practices that can be used to support the health needs of many patients with mental disabilities.

Introduction

Background Information

Past studies have presented mixed views regarding the view of direct caregivers perception of people with intellectual disabilities and their impact on the level of medical care. These results have made it impossible for many medical professionals to propose better policies that can avail better care to mentally disabled persons. Many patients with mental disabilities have been discriminated in different healthcare settings (Thornicroft, Rose, & Kassam, 2007). Many healthcare policies have failed to transform the health outcomes of many individuals with mental disabilities.

Purpose Statement and Public Health Implications

That being the case, the proposed study seeks to explore the view of direct caregivers perception of people with intellectual disabilities. This knowledge will outline the impact of such perceptions on the level and quality of care provided to such persons. The ultimate goal is to propose evidence-based practices and approaches that can improve the health outcomes of every mentally-disabled patient (Thornicroft et al., 2007). This knowledge will result in better health practices that can address the health needs of these persons.

Rationale

Mentally disabled groups should receive equal healthcare and support. However, this has not been the case because of discrimination and negative perception among healthcare providers. Current literature does not offer conclusive analyses to explain the complexity, origin, and challenges associated with intellectual disability (Corrigan, 2004). The study will, therefore, outline the perceptions of healthcare providers and how they affect the quality of care available to such patients. A powerful qualitative research approach will be used in order to complete a successful study. The members involved in every focus group will outline the major gaps affecting the quality of care delivered to patients with mental disabilities.

Definition of terms

• Intellectual disability: This is a disability known to affect a persons adaptive behavior and intellectual functioning (Corrigan, 2004).
• Health care policy: A specified model or action plan aimed at achieving specific healthcare goals.
• Satisfaction: Ability to receive content and desirable health care.

Literature Review

Individuals with intellectual disabilities are categorized as a vulnerable group when it comes to the issue of care (Corrigan, 2004, p. 615). Such persons have poor health outcomes and lifestyles. Lin, Yen, Li, and Wu (2005) argue that the health needs of many people with mental disabilities are ignored by different societies and caregivers.

These people encounter a wide range of health challenges that require continued hospitalization. Lin et al. (2005) indicate that such people tend to die early and spend much time in healthcare institutions. This issue has encouraged more scholars to focus on the best strategies that can improve the health outcomes of these mentally disabled persons.

Patients with various mental problems encounter numerous barriers in getting appropriate health services (Corrigan, 2004). The individuals lack proper health delivery models. They also encounter numerous challenges whenever looking for better solutions to their health challenges. Many disabled persons experience barriers in getting support for better lifestyle choices (Lin et al., 2005, p. 231).

Many healthcare providers argue that they work hard to deliver quality care to patients with different mental disabilities. However, studies have indicated that such patients receive compromised or delayed healthcare services. The quality of care available to many people with mental disabilities remains questionable in many parts of the world. For very many years, individuals with various mental problems have been omitted from various healthcare agendas and campaigns (Corrigan, 2004). This fact explains why the problem of healthcare disparity continues to affect many societies. Different healthcare systems fail to embrace the power of evidence-based research in an attempt to support more persons with mental disabilities.

Medical professionals and theorists have been focusing on the best strategies to eliminate these health disparities. This is the case many caregivers have negative perceptions about mentally disabled individuals. Consequently, the malpractice has continued to affect the quality and level of care delivered to such patients (Lin et al., 2005). Better healthcare delivery models can be proposed in an attempt to improve the quality of care and health support available to these vulnerable groups.

Methodology

Proposed Research Methodology

A powerful qualitative approach will be used to undertake this study. During the study, a focus group will be used in order to get the most desirable results. The use of a focus group will ensure the relevant information regarding the perception of different healthcare providers is obtained. The focus group will include several caregivers, nurse practitioners (NPs), and medical professionals. The professionals will present quality views regarding the issue of mental disability and how it affects the quality of care available to the targeted patients (Lin et al., 2005).

The study approach will present meaningful insights and ideas that can be used to develop the most appropriate healthcare policy. The research objectives and goals presented below will be used to guide the study.

Research Goals/Objectives

The following research objectives will be used to conduct targeted interviews. The goals will also be used to come up with the best findings and discussions.

• To examine the competencies and experiences of caregivers providing medical support to mentally incapacitated patients.
• To propose a new policy capable of promoting the health outcomes of mentally disabled patients.
• To explore the views of direct caregivers perception of people with intellectual disabilities and their impact on the level of care provided.

Research Questions

The questions presented below will be used to undertake and complete the study.

• What issues and factors dictate the quality of care delivered to mentally disabled persons?
• How do caregivers perceptions of people with intellectual disabilities affect the quality and level of care provided to them?
• What new measures and policies can be promoted in order to safeguard the nature of care available to persons with intellectual disabilities?

Data Collection and Analysis

As mentioned earlier, several focus groups will be used in order to get quality information from more respondents. Every focus group will be expected to present the most desirable information and themes that can be used to come up with meaningful conclusions (Creswell, 2007). The themes will play a significant role in producing a powerful health care policy that can make a difference for many mentally disabled persons.

After collecting relevant information using these focus groups, a powerful qualitative data analysis technique will be used. The proposed technique is a constant comparison analysis (Onwuegbuzie, Dickinson, Leech, & Zoran, 2009). This model was developed by Glaser and Strauss in 1978 (Onwuegbuzie et al., 2009, p. 11). This model has been used extensively to analyze data obtained using focus groups. The analytical technique requires the use of three major stages. These stages will be used in order to produce quality information.

The first stage is known as open coding whereby the collected data from the focus groups is grouped into smaller units (Onwuegbuzie et al., 2009, p. 12). A code or descriptor is used to identify each of the data units. The second stage will be the axial coding whereby the descriptors will be grouped to form several categories (Onwuegbuzie et al., 2009, p. 12). The third stage is usually known as selective coding.

During the third stage, several themes are obtained from the information presented by members of each focus group. The use of focus groups will ensure several themes are obtained during the study (Ulin, Robinson, & Tolley, 2005). The next step will be to examine if the gathered themes from different groups are similar or different. The use of several focus groups will make it easier for researchers to test the collected themes. Such themes will be used to understand how different caregivers perceive patients with intellectual disabilities.

Recruitment and Inclusion of Participants

Competent caregivers from diverse backgrounds will be requested to be part of the targeted focus groups. Caregivers from various mental health units and departments will be part of the study. This approach will make it easier for the study to produce meaningful discussions. Every individuals willing to be part of the study will be included in the focus groups. The individuals should also be willing to offer evidence-based data and information.

Policymakers, social workers, and mental health specialists will be encouraged to participate in the focus groups (Creswell, 2007). These strategies will ensure the study approach gathers quality information. As well, members of the community and mentally-disabled patients can be involved throughout the study process (Onwuegbuzie et al., 2009). Such groups will present meaningful insights that can be used to design the most desirable healthcare policy for mentally-disabled persons.

Ensuring Trustworthy of Data and Ethical Considerations

The other important consideration is to ensure quality data is obtained from the study. The focus groups will be composed of competent practitioners who are capable of providing quality information and data. The respondents will be encouraged to provide evidence-based ideas and information in order to increase the level of validity (Thornicroft et al., 2007). The focus groups will be characterized by scientifically-guided questions. The research approach will also be collaborative in nature. This strategy will increase the trustworthiness of the gathered data.

The consent of different participants will be sought before undertaking the study. Human subjects will be treated with dignity throughout the study process (Onwuegbuzie et al., 2009). The concept of reflexivity will be embraced in order to ensure the gathered information can be used to propose a new healthcare policy. The healthcare policy will also encourage more caregivers are ready to offer quality services. Additionally, the targeted mentally disabled patients will be able to receive quality health care.

Appendix

Questions for a Focus Group on Caregivers Perception of People with Intellectual Disabilities

Engagement Questions

1. What is the importance of delivering quality care to individuals with mental disabilities?
2. What is the role of a caregiver in delivery quality care?

Exploration Questions

1. What is your take about persons with mental disabilities?
2. What is your view regarding these patients?
3. What makes it impossible for these mentally disabled persons to get quality nursing care?
4. What structural, cultural, social, and economic factors hinder the care availed to them?
5. What positive measures can be undertaken to transform the care available to these groups?
6. What is the implication of poor care for persons with intellectual disabilities?

Exit Questions

1. What is the role of future caregivers towards improving the care of these patients?
2. How can multidisciplinary teams improve the health outcomes of these patients?

Reference List

Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614-625.

Creswell, J. (2007). Qualitative inquiry and research design: choosing among five approaches. Thousand Oaks, CA: Sage.

Lin, J., Yen, C., Li, C., & Wu, J. (2005). Caregivers perceptions of accessibility, satisfaction, and policy priorities of health care for people with intellectual disabilities in Taiwan. Journal of Medical Science, 25(5), 229-236.

Onwuegbuzie, A., Dickinson, W., Leech, N., & Zoran, A. (2009). A qualitative framework for collecting and analyzing data in focus group research. International Journal of Qualitative Methods, 8(3), 1-21.

Thornicroft, G., Rose, D., & Kassam, A. (2007). Discrimination in health care against people with mental illness. International Review of Psychiatry, 19(2), 113-122.

Ulin, P., Robinson, E., & Tolley, E. (2005). Qualitative methods in public health: a field guide for applied research. San Francisco, CA: Jossey-Bass.

The Special Olympics is a premier sporting organization that provides adults and children with physical and intellectual disabilities an opportunity to train and compete among themselves. From the organizations webpage, inclusive health is one of the tasks they are involved in. Together with partners, the Special Olympics aspires to improve the health outcomes for people with physical and mental disabilities to close the gap with the healthy population who are more advantaged in terms of access and affordability. They recognize that people with Intellectual Disabilities encounter problems in healthcare and have thus come up with multiple initiatives to mitigate the problem.

From the MD Presentation video, it is apparent that an individual suffering from profound intellectual and multiple disabilities is unable to communicate verbally and requires constant supervision. Their movement and coordination of body organs are also impaired and they require lifetime care by others. Despite the Special Olympics being specifically designed for people with intellectual difficulties, the severe case of profound intellectual and multiple disabilities complicates her participation in any activity or initiative. Interestingly, her parents have given her some freedom by getting having her in her own house. However, she is under constant care and observation of the people she lives with.

Consequently, the appropriate type of accommodation, according to Miller, is a substitute curriculum. Under a substitute curriculum, she will be provided with different materials and instructions. The provision of these items is especially important because her learning abilities are compromised by her limited to no speech. However, this arrangement should not turn into a geographical inclusion where the special needs students are placed with regular students but the topic they are learning has nothing to do with the goals of the class. Geographical inclusion might give normal students the impression that special needs students are different from them.

Introduction

The first mention of developmental disability (DD) at the state legislative level is given in the last century. In 1975, the government signs The DD Act, ruling those conditions that affect the possibility of human development. They cause varying degrees of functional limitations regarding learning, group behavior, language, communication, socialization or mobility of a person. The most common conditions in the world include Down syndrome, autism or cerebral palsy. It is important to note that in families with a special child, the environment and his psychological well-being play a significant role in development. Since the main influence on a child with special needs is the family, the situation in the house should be appropriate. Family therapy in such cases helps parents and other family members accept what happened and work through the grief. Thus, attending support groups and treating the problem through family therapy can create a healthier environment for a child with special needs to develop more successfully.

Treatment for a Developmental Disability

The question of family therapy and the creation of support groups for families with similar problems has arisen relatively recently. The origins of support for families with special needs date back to around the 1950s after the end of World War II (Hanna, 2018). Medicine throughout the country was improving, the economy was getting stronger, and the entire territory was marked by the struggle for civil rights. These factors in the political, economic and social spheres set the stage for the emergence of family therapy and support groups.

Later, a wider movement to help families began, which became a turning point in therapy. In the 1960s, more active participation of parents with children with disabilities in the social life of society began. There was an association of parents who saw their goal as helping their children with developmental disabilities. They proclaimed the idea that their children are just like everyone else and do not need to be taken away for treatment in specialized institutions. This parental movement was the first to address the authorities, educators and psychologists with the problems of segregation of children with disabilities from society and the lack of psychological support. They put forward the idea that a society needs to create a system that would allow them and their children to receive the necessary assistance.

Often, society strongly repelled and did not accept children with special needs. This interfered with their socialization, and put moral pressure on all family members. Living in a limited society contributed to the emergence of many psychological problems in parents, including depression. This situation meant that the morally unstable family environment impaired the childs capacity for rapid development. Parents moved away from their children and did not pay them due attention.

Often, society strongly repelled and did not accept children with special needs. This interfered with their socialization, and put moral pressure on all family members. Living in a limited society contributed to the emergence of many psychological problems in parents, including depression. This situation meant that the morally unstable family environment impaired the childs capacity for rapid development. Parents moved away from their children and did not pay them due attention. Thus, the idea of family therapy was born, aimed at making children feel supported within the family. Moreover, long-term limitations in society led psychologists to create support groups. As part of this, families could share their experiences and support those who have just encountered a childs illness.

Evidence-Based Practice

Family therapy and the creation of support groups seem to be an effective method for children with disabilities and their environment. Many researchers agree that they should fully characterize the changes that have occurred in the client (McGoldrick & Hardy, 2019). It should be seemed not only immediately by the end of therapy, but protractedly  in the follow-up in three areas: somatic, psychological and social. This assessment should be made both from an objective position  preferably by an outside researcher, and not by the psychotherapist himself, and from a subjective one  by the patient himself.

However, family therapy has been shown to be successful in teaching parents how to communicate with a child with special needs. First of all, this is due to the fact that many couples are not ready for the appearance of such a child. As a result, they do not have a prepared base for his upbringing (McGoldrick & Hardy, 2019). Therapy is aimed at facilitating and helping family members understand the characteristics of the child. Moreover, therapy establishes the necessary environment for the child in which he can develop. Support groups, which help parents understand the mission of raising a special child, have a similar effect. Married couples share experiences and comfort each other when difficulties arise. As a result, people feel relieved and their thought of grief recedes.

Conclusion

Thus, family therapy is aimed at helping couples with a child with developmental problems. The main reasons for the emergence of this direction in therapy and support groups is the long-term separation of families with such children from the main part of society. Moreover, they could not share their grief and problems with others. This issue was resolved with the emergence of family therapy, which aims to help people raise a special child.

References

Hanna, S. M. (2018). The practice of family therapy: Key elements across models. Routledge.

McGoldrick, M., & Hardy, K. V. (Eds.). (2019). Re-visioning family therapy. Guilford Publications.

Introduction

Natural supports can be defined as personal connections and associations that improve the quality of a persons life; these primarily include family relationships and friendships and constitute the first line of supports, followed by informal and community supports (Duggan & Linehan, 2013, p. 200). Identifying natural supports and recognizing them as sources of assistance can help people improve their everyday lives at home and at work.

In my life, the primary natural support is my family. In a general sense, having an understanding family environment, in which concerns can be shared and discussed, and solutions can be suggested, is very helpful. Even the mere awareness that there are people who are close to you, care about you, and will help you with any problems you may face without judging you or demanding anything in return is very comforting and encouraging.

Main body

In a narrower sense, family support can come in various forms. Duggan and Linehan (2013) argue that a major role of family members as natural supports is that they help individuals achieve personal goals and do so unconditionally, on the basis of personal ties, rather than in exchange for anything (e.g., other types of support for people with disabilities can come from paid caregivers). For me, family support is not limited to home but also extends to my work; I know that my family members want me to succeed and are ready and willing to assist me when I am overwhelmed.

A specific form of family-related natural supports is family events. We may not even discuss problems or seek solutions during such meeting (but rather simply celebrate), but the very idea that many people give up their plans to attend these meetings (because they realize how important family is and often put it first) makes me feel like there are always people I can ask for help and receive it.

Another type of natural supports is friendship. I have noticed that the company of friends is a very supportive environment regardless of what you are doing together. When I am stressed or frustrated (e.g., from work), I can meet my friends and complain to them, and it makes me feel better, or I can meet them and simply have fun talking about something completely different than my personal problems, and it makes me feel better, too. I think it is important that friends are not only supportive but also can be critical; they will comfort you, but then they will tell you that perhaps you were wrong in a certain situation or you did something unwise and maybe you should fix it. Since those are friends who I know want the best for me, I can easily take criticism from them.

Conclusion

Not only current friendships are natural supports but also new ones. Duggan and Linehan (2013) stress the importance of making friends in the context of natural supports. I think that friendships can be much harder to maintain than family ties; only extremely dramatic events can make two family members drift apart, while friends are much more easily lost.

Making new friends, getting to know each other better, sharing personal stories, and maintaining good relationships despite differences have always been meaningful and enjoyable experiences for me. Having friends at work is especially helpful because working environments can often be pressuring, and being able to simply talk about work to a colleague who is also a friend is an important source of support.

Reference

Duggan, C., & Linehan, C. (2013). The role of natural supports in promoting independent living for people with disabilities: A review of existing literature. British Journal of Learning Disabilities, 41(3), 199-207.

Introduction

Writing is one of the basic elements used in learning or education processes. Instructors use it as a basic method to evaluate their students; therefore, students without the ability to write well have difficulties in reading and passing examinations. Correct spelling of words and grammar usage are some of the essential skills in writing. Unfortunately, some students within the society lag behind in their education mainly because they have writing disabilities.

Dysgraphia is the common writing disability while other disorders include speech impairment, lack of attention, and deficiency in coordination, which occur during development. Luckily, sociologists, psychologists, and educationists are ever-devising ways of managing writing disabilities. The next discussion expounds the causes and characteristics of writing disabilities highlighting management strategies for a child suffering from the disorder.

Definition of writing disability

Learning disorder is among the defects, which interferes with the writing abilities of a person or a child. A person with learning disabilities will also present writing disabilities. Therefore, writing disability is the inability to distinguish and identify letters correctly; poor word coordination, spelling mistakes, grammar, reading, and poor mathematicians. Eventually, the student fails in the examination because of low level of memory, which leads to presentation of poor work.

Statistically, children with learning disabilities are hard to identify. However, a combination of observational skills from the instructor and assessment of their performance in both class work and extracurricular activities will lead to their identification. The next discussion gives the analysis on how to identify a child with writing disabilities.

Dysgraphia

Dysgraphia is the commonly known writing disability. A child or person suffering from this disability lacks both transcriptional and writing skills. Differentiation of words and lack of coherency in ones writing is a clear indicator of the disability. However, a person who suffers from Dysgraphia may also be unable to perform other tasks, which involve the use of fingers.

Experts in special education classify Dysgraphia into three groups. Sociologists associate dyslexic Dysgraphia with both transcriptional skills and the inability to identify letters correctly. Although the handwriting may be legible, the sentences contain many grammatical errors. The solution is to give them thorough practice to improve their transcriptional skills.

Secondly, motor Dysgraphia occurs due to a defect in the motor neurones. Consequently, the person suffering from the same is unable to coordinate his/her fingers, which affects his/her writing ability.

The problem may arise due to either brain damage or through genetics. Finally, spatial Dysgraphia is whereby the individual is unable to allocate or arrange his/her work uniformly. Eventually, the person produces poorly arranged work, but the words have the correct spelling. Treatment of Dysgraphia is through the strategies expounded at the end of this paper.

Identification of writing disability in children

The first way to identify children with writing disabilities is through observation of their behaviour. Most children with writing disabilities tend to be under pressure to perform, which leads to stress, or depression. Due to frustration and underestimation from their fellow students, the children tend to withdraw from their social lives. They are always found in lonely places, unhappy and always seem dissatisfied. Some of them have low self-esteem because of their presentation as failures.

On the other hand, in case of inability to perform a difficult test, they may defend themselves to fulfil their ego while others may fake sickness to avoid attention or attending the class. Secondly, is through observation of their consistency in their academic performance or examinations. Normally, learning institutions use examination to assess the comprehension level of their students. A student with writing disability may not only fail the tests but also may be unable to answer any of the questions presented to him or her.

Thirdly, a child may love books, but eventually is unable to reproduce what he or she has gone through, which leads to failure. The inability to remember is due to poor memory; fortunately, parents, teachers, and guardians can assist their children through assessing their memory skills. Therefore, observation of both behavioural and class performance levels of children will enable a teacher to differentiate those with writing disabilities.

Sometimes diagnostic tools can enable an instructor to identify children with writing disabilities. For instance, the use of writing, oral, reading, and comprehension test to assess the students ability in writing. There are different tests like the Wood-Johnson III, Stanford, achievement tests, and Weschler individual Achievement test among others, which enable an instructor to evaluate the writing skill of children (MacArthur & Graham, 1987, p.42).

Sometimes the correlation of the IQ with the achievement level also assists in evaluating children writing skills. All the diagnosis process should include other age mates to ensure accuracy. All children within the same age bracket should be at the same level in their writing, reading, and comprehension levels.

Causes of writing disability

Although there are no clear causes of writing disability, some clinicians and psychologist relate the disorder to defects in the brain, ear or eyes while other relate it to problems with the nervous system. Automobile or any other form of trauma enacted on the brain may lead to deformities or defects. Occasionally, poor brain development during childhood also leads to writing disability. The brain is the centre of memory; therefore, any defect will undoubtedly interfere with a childs learning or writing process.

The nervous system coordinates body movements while the sensory and motor neurons communicate with brain when a person is performing physical activities. A defect in both the brain and the nervous systems disrupts the physical ability of the hands, eyes and fingers, which eventually leads to writing disability. Due to disability in the hands and eyes, the child may be unable to organize his/her work. Furthermore, visual and speech impairment interferes with a childs writing ability.

For instance, a stammer may be unable to communicate effectively because of fear or embarrassment. Most people always laugh at stammers, and this may instil fear in children especially when communication with their teachers. Eye defects lead to poor reading skills while hearing impairment reduces the learning ability because they cannot communicate with the instructor or teacher. Therefore, such individuals lack effective expression skills leading to writing disability.

In addition, writing disability may arise due to genetic identity or heredity. Children inherit different traits from their parents and writing disability is not an exception. Poor coordination and inversion of words are some of the writing traits a child may inherit, which lead to writing disability. Sometimes, defects in brain development arise due to genetic identification, and this may lead to writing disability.

Characteristics of writing disabilities

There are different characteristics of writing disabilities. The most common writing disabilities include inability to complete assignments on time, poorly done work, avoiding writing at all costs, and constantly failing in school. A student who has poor writing skills cannot perform any task, which involves writing. Poor letter and word coordination with inability to comprehend the relationship between them is an outstanding characteristic of writing disability.

The children also lack basic reading skills because of inability to comprehend words, letters, and sentences. Sociologists cite a deficiency in the transcription skills as another characteristic of writing disability (Graham, Harris, Fink-Chorzempa, & MacArthur, 2001, p.177). Due to poor memory, the affected children cannot integrate any assignment given to them, and this leads to failure. For example, computation activities like mathematics are some of the assignments, which a person with the disability is unable to perform.

According to Mason et al, the inability to comprehend the writing process plus difficulties in producing ideas and topics (2002, p.496) are some of the characteristics of writing disability. Composition writing requires a person to have creative skills; however, most of children with the disability cannot only devise a title for their paper, but also are unable to construct a sentence, which is free from errors.

The lack of planning skills during writing and reluctance in revising work after a writing assignment is also among the features of writing disabilities (Mason et al, 2002, p.496). Lack of motivation in class work, learning, and writing is one of the features a teacher may associate with the disability. If a child is aware of his or her problem, s/he will not solve it, but will avoid it, and this occurs commonly in children with disabilities in a bid to fulfil their ego.

Moreover, a child whose performance is not uniform in all subjects suffers from writing disability. While they can perform well in extracurricular or outdoor activities, they are unable to pass their English and mathematics papers. Reading and writing are the essential aspects in education, which the disability interferes with (Graham, Harris & Fink-Chorzempa, 2002, p.686). Nevertheless, a factor like the inability to follow the basic instructions both on paper and from the teacher may also lead to inconsistency in the performance.

However, the children may be reluctant to follow instructions because they are inattentive, and all directions by the teacher pass them unknowingly, hence failure. In all areas of learning strict adherent to the rules and regulations correlates with a good performance (Graham, Harris, & Fink-Chorzempa, 2002, p.690). Children with writing disability have a low span of attention mainly because of brain defects or lack of interest in the class activity, which is in progress.

When reading these children will have difficulties in mastering sequence of words presented in a sentence and this leads to incomprehension contributing to their failure. The coordination of hands and eyes is poor because of defects in the nervous system (Jones & Christensen, 1999, p. 45). Physically, hands and eyes are essential in education or learning activities especially during the writing process. The organization skill of children with writing disability is below average because of the unattractiveness of the work.

Management and treatment of the disorder

Treatment and management of writing disability involves various strategies. Strategies are ways, which psychologists have established to assist children to improve their writing skills. There are different schemes drawn to aid in writing as expounded next. The first scheme recommended by Mason et al is Self-Regulated Strategy Development (SRSD) (Harris, Graham, &Mason, 2003, p.3). SRSD strategy is efficient in solving reading, mathematics, and spelling problems.

The teacher maximizes on the student strengths and weakness to improve their performances (Kellogg, 1987, p.257). This strategy combines the effective academic strategies with self-regulation measures such as, goal sitting, self instruction, self monitoring and self reinforcement (Mason, Harris, Graham, 2002, p.496). There are several strategies within SRSD, which the instructor should follow to accomplish his or her aim.

The first step involves the introduction of the strategy to the child who is in the program (Mason et al, 2002, p.496). Prior to the initiation stage, the instructor should evaluate the performance background of the child. There is an application of two schemes P (pick an idea) O (organize) and W (write) and W (what)-W (how)-W (write) (Mason, Harris, Graham, 2002, p.496). Before accomplishment of the first step, the instructor should assess the childs previous academic performance and establish or set a goal for the child.

The student should analyze and memorize the two strategies, POW and W-W-W and discuss with the teacher any challenges he or she faces in accomplishing them. Practical lessons in reading and writing will improve the performance ability of the child. The teacher can also assemble children with writing disability and assign them a group task. Through monitoring of their performance, the instructor will establish if their skills are improving or not. In case the child is not grasping the directions, then the instructor can use cue cards.

In step three, the student starts to practice the second strategy in the absence of the instructor. Using the given pictures, the student selects an idea and builds on it to form a story. Through the application of the aforementioned strategies, the teacher should allow students to write a detailed story. While giving instructions, the instructor should be loud and clear to ensure the child comprehends the instructions. Eventually the student should construct his or her own instructions and recite the previous instructions.

The next step should be collaboration between the teacher and student. Both of them should work to write a story while strictly adhering to the previous steps. The age of the child and the level of their writing, skills are critical at this stage. At this level, a child may either skip or repeat words, letters, or sentences; nevertheless, the teacher can rectify the problem by making them redo the exercise until they perform well (MacArthur & Graham, 1987, p.27).

After excelling the fourth step the student proceeds to the next level, which involves the use of graphs in the writing process. Initially, the teacher guides the student during the practice, but as they get deeper into the exercise, the instructor withdraws leaving the student to be independent. Through self-motivation and keenness, the student should improve at this level. The sixth step involves independent performance whereby the student writes without assistance from cards, graphs and the instructor. Age is critical in this strategy.

Experiment on the SRSD model

Harris and Graham introduced the planning-strategy instruction as away to improve the writing ability of children who are below average (2005, p.27). However, they also apply the SRSD model to improve the writing abilities of poor students. While Graham and Harris practically test the effectiveness of the SRSD model, Mason et al. give the essential elements and methodology of the model.

The experiment involved locating children who perform poorly mainly because of the inadequacy in instructional tools and ineffectiveness on the part of the instructors. Harris and Graham conducted their research in four schools located in the urban school. The number of children under the study was 73 (in grade three), from mixed races although the black were the majority. In the planning strategy, there were three groups of children each with different conditions (Harris and Graham, 2005, p.27).

The first group had SRSD exclusively while group two SRSD with peer support and a third group used the renowned method of instruction called the writers workshop (Pritchard 1997, p.10). Before commencing the program, all the children had to write narratives, which included persuasive, personal, or informative essays (McCutchen, 1988, p. 308), after which the instructors analyzed their performance.

After the exercise, the children under SRSD condition learned writing skills using the strategy POW while the control group used their common writing program (writers workshop). All the groups spend at least six hours a week under the supervision of an instructor. A week later the students who were under investigation used POW to write their stories without assistance from the instructor. Harris and Graham realized that students who were using SRSD model performed better than those with writers workshop model did.

The second time the student under instruction used both the POW and TREE strategies to learn the writing skills. They learned how to write persuasive essays, and the step lasted five hours. After the treatment, the students who participated in an independent writing exercise but under SRSD model produced better results (well-constructed and complete essays) when compared to their counterparts who were under control conditions.

In the second and third level of investigation, Harrison and Graham randomly chose second grade students with poor writing skills or struggling writers. The second group had six students while the third group had sixty-six students. In the second and third study, the students were younger than in the first study. All the conditions were similar to those in the first study. The students received SRSD treatment. However, the class teacher had to assess the writing skills of students under the study before and after exercise.

The second difference is that, the external instructor had to teach the students while in their classrooms. After instructing them using the SRSD model, and the writers workshop (control), the children under SRSD model produced positive results than those in the control. However, in comparison to study one, the essays of the students in the second and third study had low quality.

Therefore, due to the difference in age, the younger students were unable to integrate and comprehend the sophisticated instructional method applied by the SRSD mode (Mason et al 2002, p. 496). Depending on the age, the younger students should have more exercise and practice to meet the requirements of the SRSD model.

In the final study, both teachers and students participated in the program. Although the number of students differed from the previous studied, the teachers had to assess their students before and after the program and give their reports. After the exercise, most of the teachers accepted that the SRSD model is easier and effective than the writers workshop model, which has been running in schools for more than twenty years.

Conclusively, Graham and Harris recommended a change in the instruction method in schools, where students produced poor results. An explicit and systemic method of instruction like SRSD model instils both excellent writing and transcription skills (Meyer & Booker, 1991 p.80).

Conclusion

In brief, writing disability in students correlates with poor performance. Parents, guardians, and teachers should carefully assess their students to rate them on their writing skills. Secondly, teachers/parents should observe the behavioural changes of their children especially when in class to make sure all of them are comfortable in their class work. Psychologists and special educators recommend the use of SRSD model as the method of instruction exclusively in the lower grades.

References

Graham, S., Harris, K. R., & Fink-Chorzempa, B. (2002). Contributions of Spelling Instruction to the Spelling, Writing, and Reading of Poor Spellers. Journal of Educational Psychology, 94, 669686.

Graham, S., Harris, K. R., Fink-Chorzempa, B., & Macarthur, C. (2001). Teacher Efficacy in Writing: A Construct Validation with Primary Grade Teachers. Scientific Study of Reading, 5, 177202.

Graham S., & Harris, K. (2005). Improving the Writing Performance of Young Struggling Writers: Theoretical and Programmatic Research from the Centre on Accelerating Student Learning. Journal of Special Education, 39(1), 19-33

Harris, K. R., Graham, S., & Mason, L. (2003). Self-Regulated Strategy Development In The Classroom: Part of a Balanced Approach to Writing Instruction For Students with Disabilities. Focus On Exceptional Children, 35, 116.

Jones, D., & Christensen, C. (1999). The Relationship between Automaticity In Handwriting and Students Ability to Generate Written Text. Journal of Educational Psychology, 91, 4449.

Kellogg, R. (1987). Effects of Topic Knowledge on the Allocation of Processing Time And Cognitive Effort To Writing Processes. Memory & Cognition, 15, 256266.

Macarthur, C., & Graham, S. (1987). Learning Disabled Students Composing With Three Methods: Handwriting, Dictation, and Word Processing. Journal of Special Education, 21, 2242.

Mason, L. H., Harris, K. R., & Graham, S. (2002). Every Child Has a Story to Tell: Self Regulated Strategy Development For Story Writing. Education & Treatment of Children (ETC), 25(4), 496.

Mccutchen, D. (1988). Functional Automaticity In Childrens Writing: A Problem Of Metacognitive Control. Written Communication, 5, 306324.

Meyer, M., & Booker, J. (1991). Eliciting and Analyzing Expert Judgement: A Practical Tour. London: Academic Press

This paper is about the problems and barriers encountered by young adults with disabilities after they complete secondary school education. It examines the often confusing and staggering process linked to accessing services and support options by young adults with disabilities as they join postsecondary education and their impact on the young adults as they exit secondary schools.

The problems tackled in the paper include examples from historical case studies, for instance, a report by National Longitudinal Transition Study-2 conducted on young adults with disabilities aged between 19 to 23 years who had completed secondary education within the previous six years.

A macro and meso-level solution has been provided based on a conceptual model that addresses the barriers identified. It also highlights and discusses the current practice regarding synchronization and management of services and sustainability of students with disabilities.

Recommendations for further research and practice that refer to the disability problems are presented at the end of the paper with the purpose of enabling the interaction of services. A commentary conclusion has been provided to give the general stance.

Disability is a broad term that refers to a non-normative way of life and the departure from that which is believed to be ideal. It is a social term constructed from the undervaluing of bodies that do not conform to the cultural standards.

However, the concept of disability has been natured by language, institutions, politics and social cultural practices. People with disabilities have a myriad of conditions including physical, sensory, cognitive, psychiatric, and developmental or multiple conditions.

People are socialized to think and feel differently about disability and this usually affects life satisfaction and the quality of life of people with disabilities (Mackelprang &Salsgiver, 2009). For instance, the disabled have been discriminated against due to negative opinions, attitudes, beliefs and perceptions held against them.

People hold different assumptions and practices that promote unfair treatment of people with disabilities on basis of dissimilarities that are physical, behavioral or mental in nature.

The differences may either be apparent or assumed. Individuals with disabilities are perceived as violent, aggressive and destructive and hence viewed as a physical threat to the safety of people without disabilities.

In other instances, the perceptions may be over generalized and this may lead to such individuals being discounted or underrated, something which may be a cause for ambiguity, discomfort, interaction strain and stigma.

This essay demonstrates a comprehension of the principles of a diversity model approach to disability by critically analyzing the needs and problems associated with adults with disabilities in post education systems. A macro and meso-level solution based in disability theory has been developed in order to address the barriers and facilitate greater participation for persons with disabilities.

The access to and full involvement of disabled students in postsecondary education has been a key challenge. Postsecondary has been associated with increased earning potential for both young adults who continue with college education as well as with those who have not attained a degree, but the number of young adults with disabilities with access to postsecondary education is greatly diminishing.

A report by National Longitudinal Transition Study-2 conducted on young adults with disabilities who had completed secondary education for the last six years aged between 19 to 23 years revealed that about 55 percent of such individuals had continued on to postsecondary education after completion of high school as opposed to their same-age peers without disabilities whose representation in postsecondary school attendance was slightly higher with about 62 percent (Sanford et al., 2011,p. 14).

The same report revealed that about 39 percent of the young-disabled adults were less likely to be enrolled in postsecondary schools than their same-age peers (who had 62 percent representation). Young adults were more likely to have been enrolled in four-year colleges than were young adults with disabilities hence 37 percent versus 28 percent.

Conversely, the probability of young adults with disabilities being enrolled in community colleges and vocational schools was slightly higher compared to young adults in the general population.

During the time of interview, young adults with disabilities were less likely to be enrolled in postsecondary schools than were their counterparts in the general population, that is, 21 percent versus 41 percent (Sanford et al., 201, p. 15).

However, the tread was different in terms of enrollment in community colleges and vocational schools during the time of interviews, with the variations not differing significantly, that is, 10 percent for young adults with disabilities and 4 percent for their age-peers in the general population.

The overall postsecondary enrollment varied differently across disability categories. For instance, young adults who had visual and hearing impairments were more likely to be enrolled in postsecondary schools (71 percent) than were adults with autism (47 percent) (p.17).

The provision of better services and support for people of all backgrounds is increasingly becoming a critical issue of concern to human service professionals. Students with disabilities are finding it a very difficult and confusing task, if not astounding and overwhelming, accessing supports and services in postsecondary schools.

For instance, organizing for shipment to and from campus is baffling and very much complex: Will the means of transport be by public means? Will they drive or will they use Para transportation?

Does the school have a college transport system? If not, are the neighboring vocational rehabilitation agencies ready to offer support in terms of either a vehicle or a driver, or is the student entitled to medical transportation? (Hart & Zaft, 2011).

In order to come into terms with this nature of complexity, the methods of transportation require further analysis and application concerning eligibility standards. It may also call for registration with an external financial support agency, approval of the funding agency as the client and finally identification of the provider of transport in order to receive the service required.

The source of the service may have certain demands that, in turn, also need to be somehow registered. Students with disabilities therefore see these documentation as conflicting and repetitive, something that demotivates their transition into postsecondary education.

They have reported that steering the red tape may take long period of time since it is disempowering and offers different reactions and messages to the students (Hart & Zaft, 2011, p. 2).

Therefore, for them to be accepted by the agencies that have been mentioned above, the disabled students should have certain abilities, have a prospective future in their post secondary education, be registered and possibly be clients of the agency or a sick person with the right of having medical shipment and be unable to solely navigate the campus (Hart & Zaft, 2011, p. 2).

The last two decades have witnessed considerable federal and state resources being allocated and efforts enumerated to create seamless transitions especially for the disabled students (Hart & Zaft, 2011, p. 2). However, these efforts have not been seen to yield fruits as intended on the students with disabilities.

Studies have shown that about 27 percent of young adults with disabilities proceed with postsecondary education compared to a 66 percent fro those without disabilities (Hart & Zaft, 2011, p. 3). In the Unite States of America, for instance, students with more significant disabilities include those from diverse cultures.

Such ethnically and culturally diverse students receive less attention and disability-related services compared to majority of their peers. The demised access is as a result of ethnical and language differences, and lack of the knowledge towards the provided services and options.

Thus, unfortunately, people with disabilities are measured in life taking into account not only private but social aspects of life as well, not only in postsecondary education but also in community and work places.

There is growing evidence that the current service systems are serving as impediment to the creation of comprehensive and well coordinated state and local systems approach to serve young adults with disabilities in postsecondary education (Sanford et al., 2011).

However, there were created new state laws and policies that ae supposed to deal with the problems of the barriers linked to postsecondary education for individuals with disabilities.

A number of barriers to effective administration and synchronization of support options and services have also been found to develop individual barriers which all together combine to undermine the transition for disabled students who have complex needs and who may have admittance to multiple agencies.

They include a lack of resource mapping both at the state and local levels, failure to identify service gaps and the inability to address the service gaps, uncoordinated mechanisms for sharing information, lack of coordination for support services across agencies and few partnerships to set up interagency collaboration at both state and local levels.

In order to address the problems and barriers so as to facilitate greater participation for persons with disabilities in postsecondary education, an ideal macro and meso-level solution based on disability theory has been developed. This program if implemented will serve as a solution to improve education experiences, social and community involvement in postsecondary education for people with disabilities.

This program incorporates the use of a conceptual model in order to effectively manage and coordinate supports and services for individuals with disabilities in postsecondary options.

The programs of the created people with disabilities should be carefully ad properly worked out for them to be affective and organized especially for this or that individual in particular in order to reach the maximum success in the process. The conceptual model embodies the three elements.

The conceptual model is designed to bring about individual empowerment. In order to address the key barriers mentioned earlier, I will discuss a few theories that support the conceptual model. Teaming, for instance, is an important element in this model because it brings about the principles of shared decision making, empowerment and self determination.

The work of a team is to bring new ideas, process them and give an output (Hart & Zaft, 2011, p. 4). Information is shared and partnerships are created. Teaming brings change to communication, partnerships and organizational alignment at both macro and meso levels.

The implementation of services for young adults with disabilities needs an inclusive and open framework centered towards the street level, usually the meso level of an open system theory.

Macro programs for individuals with disabilities employ the residual theory whereby delivery of services occurs when individuals are unable to function. However effective support and delivery of services for people with disabilities cannot be dictated at either the micro level or the macro level but should rather be aligned at all heights of the social framework open system (Hart & Zaft, 2011, p.5).

The open systems theory is interdependent towards the environment whereby resources are imported from the environment, they are processed and the output given. Likewise, secondary schools should partner with post secondary schools to ensure delivery of an intervention.

The choice, control and individual-centered planning assert that a person has ownership of the planning process (Hart & Zaft, 2011, p.5). Here, individuals with disabilities should be allowed and supported by all means to make decisions.

In general, to provide effective management and synchronization of supports and services for young adults moving from secondary schools to postsecondary education, there is need to apply a social context theory together with an open system theory.

This encompasses the partnering of people at each level of systems, sharing of mechanisms of information at each level and mapping and aligning resources and service gaps identified. At the meso-level, there is need to mediate with the outside world.

There is need to recognize the macro-level agencies that provide support and control resources for the individuals with disabilities. Thus, it is worth noting that the conceptual model highlights the aspects regarding the aspect that concern collaboration, and information sharing.

Some of the emerging promising practices include institutions at state and local levels are applying partnerships and interagency cooperation. New laws have been implemented that standardize the language of supports and services and facilitate transition from secondary school to postsecondary school (Shapiro, 1993).

Rehabilitation counselors are quite important in all these problems under consideration and actively involved in the process of strategic planning regarding people, especially youths, to think and determine about the purposes of life and set goals of the people with disabilities, both in daily and social aspects of life.

It goes without saying that such step from the side of the helping organizations are quite important and work as a great support for such people. Bodies such as the Cooperative Agreement Group have been tasked with the identification of service gaps and the improvement of the services with intentions of addressing the gaps (Hart & Zaft, 2011,p. 14).

For effective provision of supports and services for individuals with disabilities at postsecondary education, the services should be flexible, individualized and compassionate for consumer choice and transformation. There is need to develop research strategies that bring about interagency partnerships.

There is a need to ensure that academic values can be achieved with proper and accessible standards. There is need to develop clear and consistent mechanisms for sharing information (Hart & Zaft, 2011, p. 21).

In a nutshell, in order to prepare young adults with disabilities for postsecondary education, the coordination of services and supports must be flexible, student centered and culturally and linguistically responsive in order to help the disabled individuals and their family members to supports and services required (Shapiro, 1993).

References

Hart, W., & Zaft. (2011). Comments From Peer Reviewers. Web.

Mackelprang, R., & Salsgiver, R. (2009). Disability: A diversity model approach in human service practices. 2nd ed. Belmont, CA: Brooks/Cole.

Shapiro, J. (1993). No pity: People with disabilities forging a new civil rights movement. New York: Three Rivers Press.

Sanford, C., Newman, L., Cameto, R., Knokey, A.M., Shaver, D. (2011). The Post-High School Outcomes of Young Adults With Disabilities up to 6 Years After High School. Web.

Working with children with Retinopathy of Prematurity (ROP)

Children diagnosed with ROP have poor vision because the condition affects the retina part of the eye. Blood vessels in this region experience poor development. They are owing to ROP complication, scar tissue forms around the retina (Ramani, Police, and Jacob 112). Second, magnifying aids and high illumination are required to assist students with this visual complication. In fact, some students experiencing ROP complication may be partially blind and hence cannot see clearly unless numbers and letters are made larger or brightened.

Helping a child who has a neurological vision impairment

A child with neurological vision impairment should be accommodated alongside other normal learners, especially when visual perceptual tasks are being carried out. In other words, the teacher should not exclude or pay little attention to such a child. This is vital so that the learner can concentrate the available energy on the on-going task. Second, it is vital for the teacher to understand that epilepsy is a common brain condition for children diagnosed with neurological vision impairment. Before the occurrence of neurological vision impairment, a teacher should exercise reasonable seizure control (Ramani, Police, and Jacob 111).

The teacher should also assist such a child in maintaining a perceptual continuum than learners who are not handicapped. In addition, children with neurological vision impairment may take quite a longer time than other normal learners to analyze small bits of information. Hence, it is the duty of a teacher to grant them additional time to thin and give their feedbacks. They should not be quickly dismissed before they take adequate time for analysis and response. Third, such children experience overload quite easily. They even find it cumbersome to maintain flow in long conversations. In most cases, their postures take a significant amount of energy among children suffering from neurological vision impairment. Worse still, they involuntarily lose visual targets. If they fail to support their heads well, they easily experience poor head maneuver. From these weaknesses, a teacher should assist such children in sitting properly in the class. The most comfortable posture should be preferred for such visually handicapped children. On the same note, the teacher should not give the amount of work similar to children who are not disabled. Short and relatively straightforward assignments should be advanced for children with neurological vision impairment. However, teachers should make sure that tasks are carried out repetitively so that the affected children in this category can grasp and fully understand lesson contents (Ramani, Police, and Jacob 113).

Strategies for working with children with cochlear implants

Regular entries should be made in a notebook concerning communication between parents/guardians and the school. This implies that a teacher should maintain a constant flow of communication regarding the progress of the child. When talking, the conversation should be moderate enough. Hence, shouting should be avoided even though voice projection is necessary. When communicating with such children, the back of the teacher should not face the class. Stillness is also necessary because children with cochlear implants are easily affected by random movements. They tend to concentrate more on the movements at the expense of what is being said. While speaking, the teacher should make sure that his or her face can be vividly seen by learners. Adequate lighting is also necessary in order to enhance communication.

Second, a teacher can help such learners to comprehend lesson contents by the vivid introduction of new content, summarizing core learning points, writing all the vital information on the board, and offering learners a list of vocabularies to learn and master (Ramani, Police and Jacob 114).

Working with children with multiple disabilities

Learners with multiple disabilities can only benefit when a range of learning and teaching skills are embraced. A video and narrative may be used to achieve literacy in language. Other approaches include specific child-guided instructions, experiential-based literacy, home-school journal, and daily schedule on the progress of a child. Individualized lessons are also highly encouraged.

Works Cited

Ramani, Krishna Kumar, Shailaja Reddy Police, and Namita Jacob. Impact of Low Vision Care On Reading Performance in Children With Multiple Disabilities And Visual Impairment. Indian Journal of Ophthalmology 62.2 (2014): 111-115.

Review Of Literature

The purpose of this review is to examine the available literature on the effectiveness of using therapeutic vests, weighted vests, and pressure vests on children with Autism spectrum disorders (ASD), Attention deficit disorder (ADHD), Pervasive Development Disorder (PDD), other developmental disabilities and sensory processing abnormalities. The use of therapeutic vests is a commonly accepted practice throughout the special educational and occupational fields.

Scopes and types of design

The scope of this review began with an article by Ayers in (1972), but the main review covered the period beginning from 1999 to date. The types of designs vary from one article to another. Two of the articles were literature reviews: one by Morrison (2007) and another by Stephenson &Carter (2008). Morrison (2007) included five articles in the review. Stephenson (2008) examined seven studies.

The studies that were reviewed used experimental design conducted using only a small number of participants. Two different research studies by Reichow, Barton, Sewell, Good, and Wolery, (2010); and Cox, Gast, Luscre, and Ayes, (2009) studied three participants in an alternating treatment design with the following conditions: no vest (A), vests-no weighted (B), and weighted vests (BC) Cox (2009). Riechow, Barton, Good, and Wolery, (2009) studied one participant and used an experimental design A-B-A withdrawal design (A), weighted vests (B), vests with no weight, and (C) no vests. Hodgetts (2010) studied ten participants and used a single-case, A-B-C-B-C study design with A= baseline behavioral ratings without a vest or heart monitor; B=a vest without weights and a heart monitor; C=weighted vest and a heart monitor Hodgetts (2010). VandenBerg (2001) studied four participants and in his study; two males and two females were receiving school-based occupational therapy. Each of the children had been diagnosed with ADHD. The participants were aged between 5 to 6 years. Fertel-Daly, Bedell, and Hinojosa (2001) studied five participants in a research design using an A-B-A single-subject reversal design:

1. baseline,
2. weighted vest was worn
3. no weighted vests were worn (Fertel et al.2001).

Defination Of Disabilities

Autism is characterized by social interaction impairment witnessed in poor eye gaze and gestures and limited personal relationships. The victim is not at ease communicating verbally and non-verbally in correlation with the age already attained. They delay acquiring a language and at times show a lack of ability to speak and the inability to engage in make-believe play. Their interests and activities are restricted and are not at par with their level of development. Their movements are stereotyped and quite often they flap their hands (Frith, 2003).

Pervasive development disorder is an attention deficit hyperactive syndrome. Children with this disability have problems with focussing their attention appropriately. The victims have a very high degree of physical activity. The victims have a set of characteristics peculiar to them and hence they are different from their peers (Quinn and Malone, 2000).

Attention deficit disorder is a mental disorder that involves high-level portions of the brain. The disease even persists into adulthood and all through the lifespan of a human being. The occurrence of this disability is attributed to a condition known as hypofrontality, a condition characterized by a lack of activity in the front region of the brain (Fisher and Beckley, 1999).

Children with sensory processing abnormalities over-respond when exposed to offending external stimuli. This makes them shut down, withdraw or become aggressive due to fear or anxiety occasioned by misinterpretation of the signal to mean danger. Children with such an abnormality do not attain developmentally appropriate skills and have bad temparament (Nelson, 2000).

The use of weighted vests on children suffering from autism has been researched on by very many scholars. Reichow and colleagues (2010) underscored the need for noting that no protocol has been approved yet for the effective use of weighted vests. Therefore resorting to the use of weighted vests without proper knowledge on it may result into improper usage and therefore a failure to realize the desired relief for patients with autism. Studies that have been advanced on the use of weighted nets are flawed both in their methodology and the fact that their results are difficult to interpret and confirm (Reichow et al., 2010).

Studies initiated by Reichow et al (2010) incorporated three participants. One participant level of engagement was not interfered with even after using weighted vests. The participant therefore completed his task. When the participant had put the weighted vest on, his challenging behaviors kept on changing. However, the stereotypic behaviors displayed kept declining. When the participant put on the weighted vests, the other two participants exhibited noticeable changes in their level of engagement, challenging behavior and more importantly, the stereotypic behaviors. The study also had its inherent limitations and its results were less than perfect.

A study that was carried out by Cox and colleagues (2009) dealt with the use of weighted vests and how they can improve the behavior exhibited by children with special needs when travelling in a car. This study did not find behaviour shown by these children with the special needs improve because of putting on weighted vests. The study however showed that there was a likelihood of improvement if the children were able to use their preferred materials. Despite the fact that the Cox study also had limitations, it is worth noting that the results attained were uniform for all the participants who took part in the study. Other studies have shown that the effects of weighted vests on children with autism changed from participant to participant.

Stephenson and Carter (2008) critically looked at the seven studies that had earlier on been done on the use of weighted vests on children with special needs and concluded that there is no evidence that validates the use of weighted vests on children with special needs. Morrison, in 2007 also concurred with this view.

Olson and Moulton (2004) conducted a survey on occupational therapists using weighted vests on children with special needs ranging from autism, ADHD, and sensory integration disorder. The study concluded that weighted vests help children with special needs by contributing to a decrease in challenging behaviors and record increase in positive behaviors. 70 per cent of those who took part in this study were convinced that the changes they witnessed in their clients were occasioned by the use of weighted vests. Other participats felt that the weighted vests indeed helped children with special needs. However, this is only possible if they were part of the children sensory program. A few participants did not believe there was a correlation between the use of weighted vests and a childs behavior.

On whether the use of weighted vests on children with special needs should be wolesomely adopted or dismissed, Olson and Moulton (2004 p.60) reckons that it is not prudent for someone to make a decision in two or three treatment sessions. They recommend trying some alternative means to use of weighted vests like the use of weighted blanket or blankets.

Fartel-Daly and colleagues (2001) intended to assess effects of weighted vests and pressure vests on increasing attention and decreasing self stimulatory behavior in child suffering from autism. Weighted or pressure vests as has always been reccommended by occupational therapists have limited research that support their usage. Fartel-Daly and colleagues formulated a hypothesis that stipulated that the use of pressure or weighted vests increases attention to tasks and decreases self stimulatory bahaviors in children with such defects. The study made use of alternating treatment design. The participant was a four year old boy who attended school in a self contained classroom. Neither the pressure vest nor the weighted vest increased the childs attention. However, the childs stimulatory behaviors did not decrease. This study recommended that further studies should focus on the usefulness of using weighted vests on children showing self stimulatory behaviors. Fartel-Daly et al further note that educators ought to be aware that there is no substantive research that has been done on the area of usage of pressure and weighted vests and should therefore consider developing some foresight before allowing these devices to be used in classroom. The methods that were used include subject and setting. The participant in the study was a four year old boy who had been diagnosed with Autism Spectrum Disorder. The boy also had strbismus in both his eyes. He had self stimulatory related behaviors and occasionally mouthed his hands, jumped up and down, tapped both himself and other objects. He attended a private school with a self contained class.

The materials used were the pressure vests and the weighted vest. The weighted vest used was the Bear Hug Vest with bear hug weighted wrap manufactured by Southpaw Enterprises. The bear hug weighted wrap distributes half pound weight across the chest regions. The vest was worn for 30 minute increments after every two hours for the whole school day. The participant was closely monitored.

The pressure vest was purposely used to apply pressure on Kyles torso and on the same areas that weighted vest applied pressure on. It was worn for 30 minutes increments every two hours throughout the school day. Careful observations were made on the participant for the whole time he was having the pressure vest on.

Two variables: attention to task and self stimulatory behaviors were identified. Attention was engaged on the participants ability to answer the questions he was asked, taking part in academic activities and thevparticiopants ability to set his eyes on the leader of activity for a particular time interval.

Self stimulatory behaviors involved the tendency by the participant to break the plane of his mouth by the fingers for a record two seconds. Tapping or hittingn objects, repeted jumping up and down more than once.

Alternative treatment vest intervention entailed alternating the use of weighted vests, pressure vests and no vest during the morning cycle time of activity. Teachers were informed on when to put weighted or pressure vests on the participant and when not to put them on. The participant was given the vests 15 minutes before the cycle commenced and they were then removed 15 miutes later after completion of data collection. Obervational sessions were videotaped and stop watch used to take time intervals. Attention to task and self stimulatory behaviors were recorded after every 10 minutes and non occurrence done for the whole interval.

Reichow et al (2009) study examines the effects of wearing pressure vests for young boys with delays in their development. An A-B-A withdrawal design was used to look into the relation that is there between wearing of pressure vests and the behavior of child during the pre school art exhibitions. Despite the fact that data showed variability, there was no notable difference in child engagement when the child puts on the vest and when the vest was never completely worn. The problem behavior however persisted when the vest was worn.

Ayers (1972) maintained that sensoy integration treatment had gained popularuty over the past two decades especially that which involve treating of children with autism and development disorders (Schaaf and Miller 2005; Smith et al., 2005). Children with abnormalities relating to sensory processing are thought to benefit from the integration of their sensory processing abnormalities. Sensory integration helps in processing and sensory information regulation. This results in increased attention, adaptive behaviors and reduction in stereotypic behaviors. Therapy include provision of deep pressure in form of massage (Escalona et al., 2001), weighted vests( Cox et al., 2009; Fartel- Daly et al., 2001; Kane et al., 2005), pressured vests or weighted blankets (Olson and Moulton, 2004). Emperical support for sensory integration is normally very scarce owing to poor fidelity and weak experimental designs. Despite the popularity of therapeutic vests, only one emprical study examining the effects of pressure vests has so far been documented. This study explores the relationship between pressure vests and self stimulatory behaviors in an eight year old girl diagnosed with autism. The study did not establish experimental controls despite its efforts in trying to show decreased self stimulatory behaviors. This made it very difficult to arrive at confident conclusions. The study intended to expand research on pressure vests.

It is very crucial that ASDs should be identified early enough. Children and members of their family should be referred to appropriate services as soon as these diseases are detected. Because of absence of aetiology based intervention for autism, there is still specific treatment for it. Informed choice should be made on the fate of children affected by this disease. There has been widespread misunderstanding over the treatment methods to be involved. New approaches that have been promoted have no enperical support. Francis (2005) said that cure for autism has currently not been developed. The word teaching used to reflect interventions geared towards helping peiple with ASDs to effectivel adjust in the environment. Evidenced basedtreatments for children with autism is still politically and scientifically manipulated. Evidence based treatment that is still being emphasized still attracts a lot of debate as to what type of research method produces credible evidence. Owing to the fact that the study uses different methods, there is difficulty in comparing results and issues bordering on where the resources should be directed and the evidenced that are supposed to be produced before treatment or practice is supported and endorsed. The publications on interventions like early intensive behavioral intervention and sensory integration therapies are receiving most attention.

Rogers and Vismara (2008) while assessing the native reviews of evidence based comprehensive treatments for young children with autism posited that randomized controlled trials show positive effects in long term and short term. The evidence proposes that early intervention programs are remunerative for children with autism, improving their developmental functioning. They decrease maladaptive behaviors and severity of symptoms. The study never shows improvements in developmental functioning on whether it can lead to significant improvement in vocational and social functioning in adulthood.

Rogers and Vismara (2008) allude to the fact that following the few randomized controlled treatment trials carried out, few models must have been tested. Large differences in interventions that have been published show that the prospect of arriving at interventions is still early in autism.

Howlin, Magiati and Charman (2009) reviewed eleven studies that met inclusion criteria. At group level, EIBI gave improved outcomes in comparison to other groups, but at individual level, variability was evident with some inference that the initial IQ was related to progress. They reported that immediate impact of EIBI reduced over time. They concluded that the review they conducted povided an evidence for effectiveness of EIBI on children with autism.

Reichow and Wolery (2009) reviewed EIBI research and arrived at similar conclusions that Howlin et al had also made. There findings suggested effectiveness of EIBI treatment on children sufferring from autism. They further alluded to the fact that EIBI cannot be wholesomely effective for all children suffering from autism. They suggest that chilren that do not respond to EIBI treatment should be identified early enough so that other forms of treatments can be reccommended to them (Reichow and Wolery, 2009 p.39).

Meta-analysis was also conducted- this is the integration of research body on a clinical practice. This involved looking into changes in intelligence scores and noon controlled studies. Their study has limitations bordering on the small sample size of the meta analysis that was conducted. Another nootable limitation was the interpretation of the mean magnitude that was solely based on mean effect size without paying attention to a comparison or a control group (Reichow and Wolery, 2009 p.38).

Spreckley and Boyd (2009) on their meta- analysis sum up their study by noting the inadequacy of evidence that ABI is favored than the other standard care mechanisms for children living with autism. They recommend appropriate clinical trials that are bound to have broader outcomes. This study only incorporated 4 studies in the analysis.

Eledevik et al., (2009 p.441) recently attempted to replicate and major on Reichow and Wolerys meta- analysis. They instead focused on ways with which to improve the methodologies that were used by these two researchers.Their mata- analysis supported the use of EIBI for treating children suffering from autism. This study had a serious limitation and the researchers warn that conclusions from their study should be done with caution and that all conclusions should be treated as tentative (Eledevik et al., 2009 p.448).

The mata-analys studies infer that large, randomized trials that compare EIBI to other interventions are still relevant and are therefore needed. Howlin et al., (2009) decision not to include meta- analysis in their review of EIBI was justified. Researchers should employ use the use of wide range of outcome measures in establishing and evaluating goals of interventions. They note that variables like parental coping ability, family relationships have not been systemically integrated and have a potential of posing methodological challenges to future researchers (Howlin et al., 2009 p.35).

Green et al., (2006) posited that sensory integration is a therapy that is popular and widely used to treat children with autism. Sensory integration therapy (SIT) depends on theory that states that functional performance deficits are related to problems that arise due to difficulty in processing sensory information. Treatment should be directed at changing underlying neurological processing (Ottenbacher, 1982; Schaaf and Miller, 2005). Treatment sessions involved provision of controlled sensory stimuli like brushing or rubbing the body. Sensory diets have now been introduced. They provide children with activities and environmental adjustments to suit the needs of the children. There is no sufficient evidence to allow for reccommendation of sensory integration therapy as a primary intervention method for treatment of autism in children. A number of children with autism have notable sensory amd motor impairments. Aspects of sensory integration therapy can be used to develop specific treatment plans. Recent sensory integration treatment involves wearing of weighted vests. The associates inattentiveness and steriotypic behaviors to undersensitivity or oversensitivity to sensory input. Weighted vest provide sensory input that control inattentiveness and steriotypic behaviors (Olson and Moulton, 2004). It is widely believed that weighted vests exert pressure which calm and organize effects of nervous system.

Cox et al., (2009) studied effects of weighted vests on in-sit participants. These vests had no effect on the participants. The study noted that non contingent reinforcement had optimal effect on participants in seat behavior.

Francis (2005) infered that there was inadequate scientific evidence and that sensory integrated treatment can be used together with proven therapies. Careful evaluation was done to ensure that SIT does not interfere with proven therapies. Major challenges to the researhers were the ability to assess what treatment works for which children, identification of individual characteristics predicting responsiveness to specific programmes and approaches (Howlin et al, 2009), and initial testing and replication of existing models.

Cox et al (2009) do a study whose main aim was to evalute the impacts of weighted vests on the amount of time 3 elementary age school children with autism, intellectual disabilities, and sensory processing abnormalities in in-seat behavior participants. Alternating treatment design helped in examination of duration of appropriate in-seat behavior under the following conditions: baseline or no vests designated (A), vests with no weights designated (B), and weighted vests designated (BC). Owing to the fact that weighted vests never had effect on appropriate in seat behavior for any participant, a subsequent test was conducted. Non contingent reiforcement was assessed within the context of a withdrawal design. Non contingent reinforcement had notable effect on participants in- seat behavior.

In Hodgetts (2010) review of research done on weighted vests and sensory modulation dysfunction, she revisited Olson and Moulton (2004) that surveyed 340 occupartional therapists by mail. The study wanted to establish the participants experience with the weighted vests and whatever they felt about the effectiveness of the vests in specific behaviors. Participants noted that vests were commonly used on children attending elementary schools or those who were in pre-school. Autism spectrum disorder was very common. A total of 82 per cent of respondents confessed to have used weighted vests with such children. Commonly tergeted behavior was staying on task, staying in seat and increasing attention span. There was remarkable variation in practice trends with 62 percent of respondents frequently using two pounds of weight, 73 percent using vests for less than one hour in a session, and 34 per cent of participants recommending that children should wear the vests twice.

The study by Olson and Moulton acted as source of information on general practice patterns on use of weighted vests in paediatric occupational therapy practice. Therapists were however unable to comment on individual practice patterns. With the telephone interview that Olson and Moulton (2004) conducted on further 51 participants, they ellicited qualitative information on individual practice patterns and opinions on weighted vests based on each childs characteristics. In this sample, 68 per cent of participants worked in school settings, where as 92 per cent used weighted vests with children having autism. Attention increase, staying on task and following instructions, decreased rockings, tantrums and wandering were the reported targeted outcome from the children having autism. Vest use protocol varied, with amount of weight starting low and increasing until positive effects are achieved. Many respondents said that there were notable changes upon putting on of weighted vests.

The Edmonton and area Occupational therapy pediatric interest group (2005) did a survey that involved more than 50 participants regarding use of weighted vests in practice. despite the fact that wide range of responses were provided, there consensus supported Olson and Moulton study in the sense that weighted vests were most frequently used with children having autism spectrum disorders; therapists began with 2 pounds of weight and progressed to up to 5 per cent body weight; a wearing schedule of not more than 20 minutes was adhered to.

These surveys showed that, even though weighted vests are commonly used, there is notable lack of consistency regarding amount of weight and the wearing schedule. However, there was unanimity that weighted vests are a very common recommendation for children suffering from autism and therefore weighted vests are deemed beneficial to such children.

Studies on participants descriptions included 21 participants identified with ASD. Studies by Cox, Gast, Luscre, and Ayres, (2009); Kane, Luiselli, Dearbon and Young, (2004-2005); and Myles et al., (2004) provide information on how diagnosis was made. None of the participants had their diagnosis confirmed with the ADOS or ADI-R. Participants age ranged from 2 to 11 years. Sixteen of the 21 participants were aged below 7 years. Studies on four chilren with ADHD conditions included information aboutdiagnosis. The participants were aged between 3 to 6 years.

Reported effects for children with autism or ASD included increased on task behavior in 6 out of the 14 participants who were examined for this behavior, decreased stimulatory bahavior in 6 out of 13 participants who formed part of the study and no effect for increased sitting, joint attention, decreasing competing or problem behaviors. All the four participants with ADHD exhibited increased on task behavior.

All the researches were single case design, with overall positive trend in design strength used over time. Initially studies were reported to have used relatively weak AB (VandenBerg, 2001), ABA (Fertel-Daly, Bedell and Hinojosa, 2001) and ABC (Kane et al, 2004-2005) designs. Recent studies have used stronger, single case designs including ABAB (Myles et al., 2004), multiple baselines (Stein, 2007), and alternating treatments (Barton, Reichow and Woley, 2007; Carter, 2005; Cox et al., 2009; Deris, Hagelman, Schilling and DiCarlo, 2006) designs.

Blinding of treatment condition increases onfidence oone can have on the result of a treatment study as it removes an observers expectancy bias. Weighted vests are prone to the effects of blinding, however, only one study employed blinding of rateers to treatment condition. Details were however not provided on how the blinding occurred (Barton et al., 2007). Barton and the colleagues presented their study as double blind placebo trials to enable them analyze effects of treatment guarding against participants and observer biases. Owing to the fact that participants who were wearing weighted vests could not be blinded to treatment condition, it is assumed that it was reported as double-blind because the participants were non blind.

Intervention studies have a very important component called treatment fidelity which actually refer to degree to which treatments were implemented as required during the process of study. When the protocol of weighted vest for example is not adhered to, the study is bound to have poor internal validity hence an imposssibilityn in knowing whether the effect was actually due to weighted vests. This aspect was encountered in Cox et al., (2009) study.

Hodgetts (2009) say there was no standard protocol for vest use in research a view that was consistent with Olson and Moultons (2004) study. Fertel-Daly et al., (2001) used only one pound of weight regardless of the weight of the participants. They bserved that use of weighted vests was effective in minimising number of responses to distractions and increasing attention to task for the five participants in the study.

References

Ayres, A. J. (1972). Sensory integration and learning disorders. Los Angeles, CA: Western Psychological Services.

Baranek,G. (2002). Efficacy of sensory and motor interventions for children with autism J Autism Dev Disord 32:397-422

Childrens Mental Health Ontario, (2003). Evidence-Based Practices for Children and Adolescents with Autism Spectrum Disorders.

Cox, A.L., Gast, D.L., Luscre, D., & Ayres, K.M., (2009). The effects of weighted vests on appropriate in-seat behaviors of elementary-age students with autism and severe to profound intellectual disabilities. Focus on Autism & Other Developmental Disabilities, 24(1):17-26).

Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child and Adolescent Psychology, 38: 439-450.

Fertel-Daly, D.; Bedell,G.; Hinojosa,J. (2001) Effects of a weighted vest on attention to task and self-stimulatory behaviors in preschoolers with pervasive developmental disorders. American journal of occupational therapy, 55 (6): 629-640

Francis, K. (2005). Autism interventions: a critical update. Developmental Medicine & Child Neurology, 47:493-499

Frith, U. (2003). Autism: explaining the enigma. London: Blackwell Publishing.

Fisher and Beckley, 1999, Attention Deficit Disorder: practical coping methods. San Francisco: CRC Press.

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