This thesis explores the physiologically-mediated interactions between children with profound disabilities and their environment. Using a structure inspired by the musical theme and variation compositional form, the concept of using physiological signals to enrich person-environment interaction will be addressed in two themes. The first theme explores how children with profound disabilities can use their physiological signals to interact with their environment. The variations on this theme: 1) appraise the literature and establish that peripheral autonomic nervous system signals can be controlled by mental activities; 2) present an algorithm that classifies an individual’s mental state using patterns of electrodermal activity to an accuracy of over 80%, and; 3) discusses the challenges with and potential solutions to creating an physiologically-based interaction pathway for children with profound disabilities. The second theme explores how physiological signals can be used to assess the effect of the environmental milieu on a child with profound disabilities. The variations on this theme: 1) demonstrate the effects of the built environment on the life activities of a severely disabled individual by developing and evaluating the effects of a custom-tailored computer access technology; 2) illustrate how the physiological signals of profoundly disabled children are influenced by their social environment by studying the effect of Therapeutic Clowns on children in a long-term rehabilitation setting; and 3) illustrate how differential physiological responses to sounds in the environmental milieu can be used to inform and improve voluntary physiologically-mediated person-environment interaction. The coda of the thesis presents a conceptual framework that has the potential to enrich the interaction between profoundly disabled children and their environment, using music generated from physiological signal patterns to modify their environmental milieu, constructs of personhood and their identity.

This thesis examines hospitalizations for ambulatory care sensitive conditions among persons with an intellectual disability living in Manitoba from 1999 to 2003. Hospitalizations for ambulatory care sensitive conditions are considered an indicator of access to, and the quality of, primary care. Intellectual disability can be defined as a disability originating before age 18 characterized by significant limitations both in intellectual functioning and in adaptive behaviour as expressed in conceptual, social, and practical adaptive skills. Between 1 and 3% of the population has an intellectual disability. This thesis addressed three objectives: 1) To identify ambulatory care sensitive conditions that are applicable to persons with an intellectual disability; 2) To compare hospitalization rates for ambulatory care sensitive conditions between persons with and without an intellectual disability in Manitoba; 3) To identify factors associated with hospitalizations for ambulatory care sensitive conditions among adults with an intellectual disability living in Manitoba. An online survey of primary care providers with experience working with persons with an intellectual disability found consensus on fifteen ambulatory care sensitive conditions applicable to persons with an intellectual disability. Large discrepancies in hospitalization rates for these conditions were found between persons with and without an intellectual disability. Controlling for age, year, sex, and region, persons with an intellectual disability were 6 times more likely to be hospitalized for an ambulatory care sensitive condition. Future research should investigate reasons for the large discrepancy in rates between persons with and without an intellectual disability. Among adults with an intellectual disability, living in a rural area (odds ratio 1.3; 95% CI=1.0, 1.8), living in an area with a high proportion of First Nations people (odds ratio 2.3; 95% CI=1.3, 4.1), and experiencing higher levels of comorbidity (odds ratio 25.2; 95% CI=11.9, 53.0) were all associated with a higher likelihood of being hospitalized for an ambulatory care sensitive condition. Dwelling in higher income areas had a protective effect (odds ratio 0.56; CI=0.37, 0.85). The results suggest that addressing the socioeconomic problems of poorer areas and specifically areas densely populated by First Nations people would likely have an impact on hospitalizations for ACS conditions for persons with an intellectual disability.

This thesis explores the physiologically-mediated interactions between children with profound disabilities and their environment. Using a structure inspired by the musical theme and variation compositional form, the concept of using physiological signals to enrich person-environment interaction will be addressed in two themes. The first theme explores how children with profound disabilities can use their physiological signals to interact with their environment. The variations on this theme: 1) appraise the literature and establish that peripheral autonomic nervous system signals can be controlled by mental activities; 2) present an algorithm that classifies an individual’s mental state using patterns of electrodermal activity to an accuracy of over 80%, and; 3) discusses the challenges with and potential solutions to creating an physiologically-based interaction pathway for children with profound disabilities. The second theme explores how physiological signals can be used to assess the effect of the environmental milieu on a child with profound disabilities. The variations on this theme: 1) demonstrate the effects of the built environment on the life activities of a severely disabled individual by developing and evaluating the effects of a custom-tailored computer access technology; 2) illustrate how the physiological signals of profoundly disabled children are influenced by their social environment by studying the effect of Therapeutic Clowns on children in a long-term rehabilitation setting; and 3) illustrate how differential physiological responses to sounds in the environmental milieu can be used to inform and improve voluntary physiologically-mediated person-environment interaction. The coda of the thesis presents a conceptual framework that has the potential to enrich the interaction between profoundly disabled children and their environment, using music generated from physiological signal patterns to modify their environmental milieu, constructs of personhood and their identity.

Support provision is a personal and important element of daily life for many people with disabilities. The study examines the ways in which organizational mandates and philosophies shape interactions between people with disabilities and support providers at two unique organizations: a L’Arche community for people with intellectual disabilities and a Independent Living Resource Centre. The project is framed with the social model of disability, the work of Titchkosky (2003) and human geography. Data was collected through semi-structured interviews, including a scenario component, with administrators at each location, people with disabilities using the services and support providers. The findings demonstrate that both organizations have strongly articulated philosophies that the participants are familiar with. The L’Arche model creates an environment that determines certain ways of interacting and while the IL participants amend the philosophy to reflect the daily reality of support provision. / October 2007

Historically, children with disabilities have been perceived as sources of stress, and disability has been portrayed in Western society as a tragedy to be avoided. This study used Appreciative Inquiry methodology and an integrated conceptual framework combining the Dynamic Ecological Systems Model, Cognitive Adaptation Theory, and components of the Affirmative Model of Disability. Qualitative interviews were conducted with ten children and sixteen parents to gain insight into their perceptions of the positive effects that a child with a disability has on the family. Findings suggest that children with disabilities can have some of the same positive effects on, and make some of the same contributions to, their families as any other child. They can also have unique positive effects and make unique contributions potentially unparalleled by their non-disabled peers. These findings may have implications for how disability is perceived by medical professionals, parents raising children with disabilities, and the public. / May 2009

Sport is a cultural phenomenon that has spread throughout the world (Harvey & Houle, 1994). For youth, sport is perceived as a context that can play a major role in person’s psychosocial development across their life-span (Danish, Petitpas, & Hale, 2007). However, despite the increase in research in this field, very little work has examined how sport may play a role in the psychosocial development of youth with intellectual disabilities (ID). Moreover, an area of study that has also grown related to the lived experiences of individuals living with a disability including ID is social inclusion (SI). Similar to research related to psychosocial development, very little research has been conducted to examine whether the context of sport can foster social inclusion for youth with ID. Special Olympics Canada (SOC) is an organization “dedicated to enriching the lives of Canadians with an intellectual disability through sport” (SOC, 2010, “SOC Mission Statement”, para.1) and may be an organization that has the potential to positively impact the lives of its youth participants. Thus, the purpose of this research was to examine whether stakeholders perceived SO as impacting the psychosocial development and social inclusion. The results indicated that SO, by all stakeholders, is perceived as an organization that is facilitating the psychosocial development of its athletes through the incorporation of strong social support networks and the development of life skills. In addition, SO was perceived as facilitating social inclusion for youth, particularly in the context of school and their surrounding community.

Risk factors tend to be negatively associated with developmental outcomes such as academic achievement and language skills. Promotive factors, on the other hand, may foster resilience in at-risk children. Some children, such as children with intellectual disabilities, experience relatively more risks than other children do. The purpose of this study was to examine the effects of risks, adaptive behavior, and an intervention on the language and reading growth of children with intellectual abilities over the course of a yearlong reading intervention in which they were participants. The results suggested that, on average, risks were negatively associated and adaptive behaviors were positively associated with initial language and reading scores. Additionally, participants evidenced significant progress on their language and reading scores over the course of the intervention, but neither adaptive behavior nor risk was related to this growth, which may suggest that students from differing backgrounds and with differing levels of adaptive skill can profit from high-quality reading instruction.

The Double Deficit Hypothesis posits that four mutually exclusive subgroups can be identified in a reading disabled (RD) sample. These subgroups are predicted to differ on reading measures, and further evidence suggests they may differ on other academic achievement (AA) and neuropsychological (NP) measures, as well as sex ratios and rate of ADHD diagnosis. Two hundred twenty six college-level adults identified as RD were evaluated, and subgroup comparisons were analyzed. Significant subgroup differences were observed in each domain. No subgroup differences were observed for sex or ADHD diagnosis. Findings suggest that patterns of linguistic ability affect the profiles of reading, AA, and NP performance that characterize adults with RD. These findings have implications for evaluations and academic accommodations.

Self-concept, or feelings about oneself, encompasses various areas including social and academic domains and has been suggested to be a predictor and mediator of other outcomes (Bryne, 1996). In this study, the relationships between achievement, intelligence scores, and self-concept in children with mild intellectual disabilities were examined. Self-concept and WISC verbal intelligence scores evidenced significant relationships. Additionally, relationships were demonstrated between gains in achievement and higher ratings of self-concept. These results suggest that relationships exist between intelligence, achievement, and self-concept in elementary school children with MID. Specifically, a positive relationship was demonstrated between achievement gains and self-concept. Associations between intelligence and self-concept also were demonstrated, where higher intelligence scores were related to both lower nonacademic self-concept and higher cognitive self-concept.

This study assessed marital quality, coparenting, and parenting stress over time for parents of children with intellectual disability by creating developmental trajectories from longitudinal data. Both mothers and fathers (N = 152 couples), with children ages 6-18 at the first wave, evaluated their relationship and parenting stress on up to 4 occasions over a 14-year period. The study provided separate models of change over time for mothers and fathers which showed that marital quality, coparenting, and parenting stress are dynamic relationship constructs that changed during the child’s development. Overall, marital quality was found to follow a curvilinear pattern, with declines when children were adolescents and increases as children entered young adulthood. Positive coparenting increased linearly over time for mothers and fathers, and negative coparenting declined linearly for mothers. With an emphasis on transition periods in the family life cycle, trajectories included indicators of the child’s development to allow for periods of discrete change in the trajectories based on the child’s entrance into adolescence and young adulthood. The child’s entrances into these developmental periods were associated with changes in levels of marital quality and coparenting for mothers only. Patterns for stress over time depended on the parent reporting, with mothers reporting decreases in parent and family problems over time and a quadratic trend for pessimism, with initial growth in reported pessimism followed by declines as the children exited adolescence. Fathers, however, did not report significant changes for parent and family problems and perceived increases in pessimism with time. The study also assessed how support in the marital and coparenting roles with time is associated with levels of parenting stress. Marital quality consistently predicted lower levels of parent and family problems for both parents, but findings for associations between marital quality and pessimism, and coparenting with both types of stress, varied depending on the parent reporting.