The purpose of this study was to investigate perceptions of visually impaired learners and their teachers regarding the extent to which the teaching and learning needs of learners with visual impairment are addressed in inclusive classrooms. The first phase of the study was characterized by a literature review. A literature review was undertaken to elucidate the concept visual impairment and to highlight the magnitude of visual impairment in South Africa. Attention was also paid to the place of visual impairment in the context of an inclusive education and training system. Furthermore, the literature study explored the characteristics and causes of visual impairment, provided insight into the curricular considerations that underpin the teaching, learning and assessment of visually impaired learners and highlighted the problematic nature of language development, cognitive development, social development and self-esteem development among learners with visual impairment. The second phase of the study comprised empirical research. Within a positivist framework, quantitative research by means of non-experimental descriptive survey research was undertaken to collect data in order to determine to what extent the teaching and learning needs of visually impaired learners are accommodated in inclusive classrooms. This was achieved by administering a closed questionnaire to a purposively selected sample of teachers (n = 80) and learners (n = 92) from the Fezile Dabi District in the Free State Department of Education to determine their perceptions regarding the characteristics of classroom teaching, learning and assessment for visually impaired learners. In addition to this, the questionnaire administered to the teachers also set out to determine whether the teachers possess adequate knowledge to identify learners with visual impairments in their classrooms. The data analysis revealed that general teaching and learning needs of visually impaired learners are addressed to a certain extent, but developmental needs related to language, cognitive, social and self-esteem development, appear to be underemphasized. In this regard, the benefits of a mediated learning approach in the context of teaching visually impaired learners was investigated and utilized in the design of learning activity examples that could be included in a curriculum-based teaching and learning programme for Grade 7 Natural Sciences classrooms. In the absence of curriculum-based teaching and learning programmes that address the language, cognitive, social and self-esteem development of visually impaired learners in inclusive classrooms, this research makes a distinct contribution. / Thesis (Ph.D. (Learning and Teaching))--North-West University, Vaal Triangle Campus, 2011

The purpose of this study was to investigate perceptions of visually impaired learners and their teachers regarding the extent to which the teaching and learning needs of learners with visual impairment are addressed in inclusive classrooms. The first phase of the study was characterized by a literature review. A literature review was undertaken to elucidate the concept visual impairment and to highlight the magnitude of visual impairment in South Africa. Attention was also paid to the place of visual impairment in the context of an inclusive education and training system. Furthermore, the literature study explored the characteristics and causes of visual impairment, provided insight into the curricular considerations that underpin the teaching, learning and assessment of visually impaired learners and highlighted the problematic nature of language development, cognitive development, social development and self-esteem development among learners with visual impairment. The second phase of the study comprised empirical research. Within a positivist framework, quantitative research by means of non-experimental descriptive survey research was undertaken to collect data in order to determine to what extent the teaching and learning needs of visually impaired learners are accommodated in inclusive classrooms. This was achieved by administering a closed questionnaire to a purposively selected sample of teachers (n = 80) and learners (n = 92) from the Fezile Dabi District in the Free State Department of Education to determine their perceptions regarding the characteristics of classroom teaching, learning and assessment for visually impaired learners. In addition to this, the questionnaire administered to the teachers also set out to determine whether the teachers possess adequate knowledge to identify learners with visual impairments in their classrooms. The data analysis revealed that general teaching and learning needs of visually impaired learners are addressed to a certain extent, but developmental needs related to language, cognitive, social and self-esteem development, appear to be underemphasized. In this regard, the benefits of a mediated learning approach in the context of teaching visually impaired learners was investigated and utilized in the design of learning activity examples that could be included in a curriculum-based teaching and learning programme for Grade 7 Natural Sciences classrooms. In the absence of curriculum-based teaching and learning programmes that address the language, cognitive, social and self-esteem development of visually impaired learners in inclusive classrooms, this research makes a distinct contribution. / Thesis (Ph.D. (Learning and Teaching))--North-West University, Vaal Triangle Campus, 2011

One in nine North American women will be diagnosed with breast cancer in their lifetime and most will receive chemotherapy as part of their treatment. Although advances in treatment have increased survivorship, some research suggests chemotherapy results in cognitive deficits in a subset of recipients, a condition known as chemo-fog, thereby compromising quality of life. However, inconsistencies in methodology and neuropsychological assessment have complicated comparison of findings. The first objective of this thesis was to review the methodological issues with an emphasis on the quantitative techniques typically employed. A comparison of group and individual based analyses found negligible effects for both univariate and multivariate approaches while individual based analyses identified severe declines in function in a subset of participants. A standardized-regression based (SRB) approach was recommended as the method of choice. Furthermore, it was recommended that the number of tests be limited since comprehensive batteries can complicate identification due to increased risk of misclassification. Therefore, the second goal of the thesis was to evaluate the sensitivity of a reduced battery to the declines associated with chemo-fog. A comprehensive neuropsychological battery comprising 23 tests was compared to a subset of nine tests. SRB analyses demonstrated that a more selective battery was equally useful and may be appropriate for identification of chemo-fog. Given the variability in the composition of neuropsychological test batteries, the final aim of this thesis was to compare the structure of the theoretical cognitive domains with ones identified through exploratory factor analyses (principle axis factoring) to evaluate the convergence between the two. The results demonstrated there is statistical support for the conceptual framework that underlies the composition of the domains. The contributions of this thesis include providing methodological guidelines for those conducting future research in this area to ensure that results are comparable across studies and are meaningful, and evaluating the utility of a screening battery to facilitate identification of chemo-fog. In addition, it was demonstrated that despite the lack of professional guidelines informing the selection and construction of neuropsychological test batteries, there is statistical evidence to support the practice of grouping tests into domains based on theoretical grounds.

Cognitive impairment no dementia (CIND) is conceptualized as a stage of cognitive decline between normal aging and onset of dementia. As persons with CIND are at high risk of developing dementia, efforts to determine early predictors of cognitive decline are warranted to advance both clinical knowledge and practice. Recent evidence suggests persons with CIND may have changes in vascular function compared to non-impaired peers, which may have clinical potential to differentiate those with and without CIND. The purpose of this study is to determine whether vascular functioning, examined both by individual indicators and as an aggregate vascular factor, will be associated with cognitive impairment. It is expected that the individual vascular indicators of hypertension, diabetes, stroke, and heart problems will be related to cognitive status classification, with poorer vascular function being more strongly associated with CIND as compared to the control group. Further, it is expected that examining the aggregate vascular factor in a multivariate approach will be more strongly associated with cognitive status than examining the vascular indicators individually. Data for this study were collected in the Victoria Longitudinal Study (VLS), a large-scale longitudinal, sequential study of community-dwelling older adults in Victoria, British Columbia. Cognitive group status was determined by a distributional approach based on scores on 5 cognitive reference measures. The associations between all vascular factors and cognitive status groups were assessed using chi-square analyses. Univariate analyses were then carried out using ordinal logistic analysis. A multivariate approach using discriminant analysis was then used to determine if cognitive status group membership was associated with vascular function based on linear combinations of vascular indicators. Contrary to expected results, we did not find a significant association between any of the vascular indicators (i.e., blood pressure classification, severity of stroke, severity of heart troubles, and severity of diabetes) and the cognitive status classifications. Further, group membership was not associated with any of the individual vascular markers, or by a multivariate combination of the indicators. Several reasons for this study’s findings include discrepant definitions of cognitive impairment in the literature, sample characteristics (i.e. high education, low base rate of vascular problems), and methodological considerations. Future research objectives should address the longitudinal association of vascular function and cognitive status. / Graduate

The ability to represent the mental states of others (i.e., Theory of Mind, ToM) is vital for social interaction. There is limited information on ToM knowledge in children with specific language impairment (SLI). These children have deficient language abilities that cannot be explained by hearing, cognitive, or neurological problems. Furthermore, children with SLI experience difficulty in initiating and maintaining social pretend play. Language, pretend play, and ToM typically develop in concert, which may indicate that they share an underlying capacity for representation. Given that language is deficient in children with SLI, these children may have problems with ToM, which might be related to their social behaviors during pretend play. This study was the first to investigate the association between ToM and pretend play in children with and without SLI. Twenty-two children with SLI and 22 with typical development (TD), between 48-71 months of age, participated in this study. Children engaged in a variety of ToM tasks and participated in two pretend play assessments: a standardized pretend play assessment and a role play activity. Children with SLI scored significantly lower on ToM tasks and engaged less often in some sophisticated forms of pretend play than their age-matched peers with TD. After controlling for language and SES, there were no significant associations between ToM and pretend play in children with and without SLI. When language groups were analyzed individually, different patterns of associations emerged for children with and without SLI. ToM was positively associated with pretend play in children with TD but negatively associated in children with SLI. Moreover, inconsistent patterns of associations were observed for some children with SLI (i.e., poor ToM understanding but sophisticated pretend play or vice versa). This study demonstrated that children with SLI may also have concomitant problems in ToM and pretend play, which may have implications for clinical assessment and intervention. The study contributes to the literature by investigating the link between ToM and different forms of sophisticated pretend play in children with and without SLI. Given the different patterns of partial correlations, future investigation of the relationship between ToM and pretend play relationship is warranted.

Elöverkänslighet är ett officiellt funktionshinder. Enligt Socialstyrelsens Miljöhälsorapport 2009 uppger 3,2 procent av befolkningen i åldrarna mellan 18 och 80 år att de är känsliga/överkänsliga eller allergiska mot elektriska och magnetiska fält, vilket motsvarar drygt 200 000 personer. 0,4 procent uppger att de har svåra besvär. Detta motsvarar knappt 30 000 personer som får svåra sjukdomsliknande symptom som exempelvis yrsel, illamående, huvudvärk, sömnproblem och hudbesvär när de vistas i elintensiva miljöer som större delen av befolkningen inte besväras av. Avhandlingen består dels av teoretiska studier över radiofrekvent strålning och hur denna kan avskärmas, dels av en enkätundersökning för att undersöka hur landets kommuner, försäkringskassekontor och tre landsting bemöter dessa personer. Genom den arkitektorienterade forskningsmetoden ”research by design” har ett förslag på ett elfritt typhus, som även kan avskärma de högre frekvenserna från den radiofrekventa strålningen, utformats men ännu inte byggts. Utifrån enkätundersökningen framgår att personer med funktionsnedsättningen elöverkänslighet ytterst sällan får hjälp med den tillgänglighetsanpassning i bostaden de enligt svensk lag har rätt till. Avhandlingen visar på vad som byggtekniskt kan utföras för att förbättra boendemiljön för personer med funktionsnedsättningen elöverkänslighet. / Electrohypersensitivity in Sweden is an official functional impairment. According to The National Board of Health and Welfare’s questionnaire from 2009, 3.2 percent of the population aged between 18 and 80 answered that they are sensitive / hypersensitive or allergic to electric and magnetic fields, which represents just over 200 000 people. 0.4 percent said they have severe problems. This corresponds to nearly 30 000 persons who receives severe sickness-like symptoms such as dizziness, nausea, headaches, problems with sleeping and skin disorders when they are visiting electricity-intensive environments that are not bothering most of the population. The thesis consists of theoretical studies of radio-frequency emissions and how these can be shielded as well as a survey to investigate how the country's municipalities, social insurance offices and three county councils are receiving these persons. By the architect-oriented research methodology “research by design” a proposal for a type-building free from electricity, which also can shield the higher frequencies from the radio-frequency radiation, is designed but not yet built. The questionnaire survey indicates that persons with the functional impairment electrohypersensitivity very rarely receive the dwelling accessibility adaptation assistance they, according to Swedish law, are entitled to. The thesis shows what can be done by building construction to improve the living for persons with the functional impairment electrohypersensitivity. / QC 20111114

The development of reading competency is one of the most significant pedagogical achievements during the first few years of schooling. Although most children learn to read successfully when exposed to reading instruction, up to 18% of children experience significant reading difficulty (Shaywitz, 1998). As a group, young children with speech impairment are at risk of reading impairment, with approximately 50% of these children demonstrating poor acquisition of early reading skills (Nathan, Stackhouse, Goulandris, & Snowling, 2004; Larivee & Catts, 1999). A number of variables contribute to reading outcomes for children with speech impairment including co-occurring language impairment, the nature and severity of their speech impairment as well as social and cultural influences. An area of research that has received increasing attention is understanding how access to the underlying sound structure or phonological representations of spoken words stored in long-term memory account for reading difficulties observed in children (Elbro, 1996; Fowler, 1991). Researchers have hypothesised that children with speech impairment may be at increased risk of reading disability due to deficits at the level of phonological representations (Bird, Bishop, & Freeman, 1995). Phonological representation deficits can manifest in poor performance on tasks that require children to think about the sound structure of words. Knowledge about the phonological components of words is commonly referred to as phonological awareness. Identifying and manipulating phonemes within words are examples of phonological awareness skills. Some children with speech impairment perform poorly on phonological awareness measures compared to children without speech difficulties (Bird et al., 1995; Carroll & Snowling, 2004; Rvachew, Ohberg, Grawburg, & Heyding, 2003). As performance on phonological awareness tasks is a strong predictor of early reading ability (Hogan, Catts, & Little, 2005), there is an important need to determine if children with speech impairment who demonstrate poor phonological awareness, have deficits at the level of phonological representations. This thesis reports a series of studies that investigated the relationship between phonological representations, phonological awareness, and word decoding ability in children with moderate to severe speech impairment. A child with complex communication needs (CCN) who used Augmentative and Alternative Communication (AAC) was also examined to determine how the absence of effective articulation skills influences the development of phonological representations. The study employed a longitudinal design to compare the performance of nine children (aged 3:09-5:03 at initial assessment) with moderate to severe speech impairment and 17 children with typical speech development on novel assessment measures designed to determine characteristics of children's phonological representations. The tasks required children to judge the accuracy of spoken multisyllable words and newly learned nonwords. The relationships between performance on these tasks and measures of speech, phonological awareness and early print decoding were also examined. Four assessment trials were implemented at six-monthly intervals over an 18-month period. The first assessment trial was administered approximately 6 to12 months before children commenced school. The fourth trial was administered after children had completed 6 to 12 months of formal education. The child with CCN completed three assessment trials over a period of 16 months. Data analyses revealed that the children with speech impairment had significantly greater difficulty (p<0.01) judging mispronounced multisyllable words compared to their peers with typical speech development. As a group, children with speech impairment also demonstrated inferior performance on the judgment of mispronounced forms of newly learned nonwords (p<0.05). No group differences were observed on the judgment of correctly pronounced real and nonword stimuli. Significant group differences on speech production and phoneme segmentation tasks were identified at each assessment trial. Moderate to high correlations (i.e., r = 0.40 to 0.70) were also observed between performance on the phonological representation tasks and performance on phonological awareness and speech production measures at each trial across the study. Although no significant group differences were observed on the nonword decoding task, 4 of the 9 children with speech impairment could not decode any letters in nonwords (compared to only 1 child without speech impairment) at the final assessment trial when children were 6-years-old. Two children with speech impairment showed superior nonword decoding ability at trial 3 and 4. The within-group variability observed on the nonword decoding task highlighted the heterogeneity of children with speech impairment. The performances of four children with speech impairment with differing types of speech error patterns were analysed to investigate the role of phonological representations in their speech and phonological awareness development. The child with delayed speech development and excellent phonological awareness at trial 1, demonstrated superior phonological awareness and word decoding skills at age 6 years, although his performance on phonological representation tasks was inconsistent across trials. In contrast, a child with delayed development and poor early phonological awareness demonstrated weak performance on phonological representation, phonological awareness, and decoding at each successive assessment trial. The child with a high percentage of inconsistent speech error patterns generally demonstrated poor performance on phonological representation, phonological awareness and decoding measures at each of the 4 assessment trials. The child with consistent and unusual speech error patterns showed increasingly stronger performance on the phonological representation tasks and average performance on phonological awareness but limited word decoding ability at age 6. The 11-year-old girl with CCN, whose speech attempts were limited and unintelligible, demonstrated below average performance on phonological representation tasks, suggesting that an absence of articulatory feedback may negatively influence the development of well-specified phonological representations. This thesis provides evidence for the use of receptive tasks to identify differences in the phonological representations of children with and without speech impairment. The findings also provide support for the link between the representation of phonological information in long-term memory and children's speech production accuracy, phonological awareness and print decoding ability. The variable performance of some children with speech impairment and the child with cerebral palsy demonstrate the need to consider individual characteristics to develop an understanding of how children store and access speech sound information to assist their acquisition of early reading skills.

Children with Specific Language Impairment (SLI) often present with difficulties in learning new words compared to age-matched children with typical language development. These difficulties may affect the acquisition, storage, or retrieval of new words. Word-learning deficits impact on children’s vocabulary development and impede their language and literacy development. Findings from a wide range of studies investigating word-learning in children with SLI demonstrated that semantic and phonological knowledge are crucial to the word-learning process. However, intervention studies designed to improve the word-learning abilities in children with SLI are sparse. The experiments described in this thesis addressed this need to understand the effects of interventions on word-learning abilities. Further, the thesis describes the first investigation of word-learning abilities of New Zealand school-aged children with SLI. Specifically, the following three broad questions are asked: 1. What are the word-learning skills of New Zealand school-aged children with SLI compared to children with typical language development and which underlying language skills influence word-learning? 2. What are the immediate and longer term effects of phonological awareness and semantic intervention on word-learning and language skills in children with SLI? 3. What are the error patterns of children with SLI compared to children with typical language development when learning to produce new words and do these patterns change following phonological awareness and semantic intervention? The first experiment compared the word-learning abilities of 19 school-aged children with SLI (aged 6;2 to 8;3) to age-matched children with typical language development and revealed that children with SLI presented with significant difficulties to produce and to comprehend new words. After repeated exposure, children with SLI caught up to the performances of children with typical language development in learning to comprehend new words, but not on production of new words. Correlation analyses demonstrated that there were no correlations between the word-learning skills and other language measures for children with SLI, whereas the word-learning abilities of children with typical language development were correlated to their phonological awareness, semantic, and general language skills. In the second experiment, it was investigated whether there were also qualitative differences during word-learning between children with and without SLI additionally to the quantitative differences as revealed in the first experiment. Children’s erroneous responses during the word-learning tasks were categorised into phonological, semantic, substitution or random errors. A comparison of the children’s error patterns revealed that children with SLI presented with a different error pattern and made significantly more random errors than children with typical language development. However, after repeated exposure, children with SLI demonstrated a similar error pattern as children without SLI. Furthermore, it was examined whether a specific combination of phonological and semantic cues facilitated children’s learning of new words or whether there were word-specific features that facilitated children’s word-learning. No facilitative word-specific features could be identified. Analysis revealed that there were no significant effects of cueing on learning new words, but specific patterns could be derived for children with SLI. Children with SLI learned to comprehend more words that were presented with two semantic cues or one phonological and one semantic cue and learned to produce more words that were presented with two phonological cues. In the third experiment, the effectiveness of a combined phonological awareness and semantic intervention to advance children’s word-learning abilities was examined. Nineteen children with SLI (same participants as in experiment 1) participated in this intervention study that implemented an alternating treatment group design with random assignment of the participants. Children in group A received phonological awareness intervention followed by semantic intervention, whereas children in group B received the same interventions in the reverse order. Children’s word-learning abilities were assessed at pre-test, prior to the intervention, at mid-test after intervention phase 1, and at post-test, immediately following the completion of the second intervention phase. Each intervention itself was effective in significantly improving children’s fast mapping skills, however, gains in children’s word-learning abilities were only found for children in group A for production of new words. Extending the findings of the intervention effectiveness of phonological awareness and semantic intervention on word-learning as reported in experiment 3, it was investigated in experiment 4, whether the implemented intervention additionally influenced the error patterns of children with SLI. The erroneous responses of children with SLI on all word-learning probes at pre-, mid-, and post-test were categorised into the same error groups as described in the second experiment (semantic, phonological, substitution, and random errors). The error analyses revealed that children’s error profiles changed during the course of intervention and treatment specific effects on children’s erroneous responses were found. Post-intervention, children who received phonological awareness followed by semantic intervention displayed the same error patterns as children with typical language development, whereas children who received the same interventions in the reverse order maintained the same error pattern as displayed at pre-test. The final experiment examined the longer-term effects of the combined phonological awareness and semantic intervention reported in experiment 3 on the language and literacy development of children with SLI. Eighteen of the 19 children with SLI, who received the intervention reported in experiment 3, were available for re-assessment 6 months after the completion of the intervention. The children (aged 7;1 to 9;2 years) were re-assessed on a range of standardised and experimental measures. Data analysis revealed that 6 months post-intervention, all children were able to maintain their gains in phonological awareness, semantic, and decoding skills as displayed immediately after the intervention. Children’s general language and reading skills significantly improved following the intervention; however, children who received phonological awareness intervention followed by semantic intervention displayed significantly better reading outcomes than the children who received the same interventions in the reverse order. This thesis revealed that a combination of phonological awareness and semantic intervention can enhance the word-learning abilities of children with SLI. The combined intervention approach was also effective in additionally improving children’s general language skills and the reading of single non-words and real words, as well as connected text. The immediate and longer-term intervention effects provide evidence that advancing the semantic and phonological awareness skills is an effective intervention approach to support children with SLI in their word-learning and to furthermore promote their language and literacy development. However, the order of the implemented interventions played a significant role: Children in the current study profited most when they received phonological awareness intervention first, followed by semantic intervention.

The function of accounting is to provide users with useful information in making economic decisions. Information regarding goodwill, a major constituent of the value of many listed companies, is likely to be useful in making decisions relating to those companies. A historical review of accounting literature, including professional standards, relating to methods of accounting for purchased goodwill showed that none of them has stood the test of time. The current trend towards an impairment paradigm will not resolve the issue satisfactorily because it produces, at best, a partial solution. The difficulty in accounting meaningfully for goodwill is compounded because, given its foundation in historical cost principles, accounting has been unable to present any information at all with regard to internally generated goodwill within the confines of the traditional Balance Sheet. This, in turn, has led to the evasion of the reality that the two forms of goodwill are inextricably merged. Trying to account satisfactorily for goodwill has been a prime example of R.R. Sterling�s �issues conceived in a way that they are in principle unresolvable�. The problem was accordingly redefined as being to find a method by which the current level of information relating to goodwill in the financial statements contained in a company�s Annual Report could be improved. This thesis seeks to identify a logically defensible method of accounting for goodwill which addresses the redefined problem. It builds upon the historical research undertaken, combined with a priori reasoning, to propose an additional financial statement which is a modification of nineteenth century �double accounting� in a modern context. This statement, which goes far to solve the redefined problem, also furnishes information regarding the company�s market capitalization at balance date and is termed the Market Capitalization Statement (�MCS�). While the idea of furnishing market capitalization data to readers of the Annual Report is not new, it is believed that this is the first time such data has been systematically linked with the Balance Sheet to provide an objective, integrated and meaningful view of goodwill in the financial statements. The practical application and simplicity of the MCS are illustrated by a range of examples drawn from Australian �dot-com� companies over a period of time which saw considerable fluctuation in both goodwill and market capitalization, supplemented by examining data relating to some of Australia�s largest listed companies over the same period. These examples demonstrate that the MCS has the potential to provide significant information not available in conventional financial statements, while freeing the traditional Balance Sheet and Profit and Loss Account to present information in a more meaningful and less distorted way. Finally, the MCS is noted as still being subject to certain problems and distortions in the context of the historical cost basis of the remaining financial statements. It is shown that, if used in the context of an exit price based system, Chambers� CoCoA, many of these distortions are removed. The MCS also complements the information provided by CoCoA as originally formulated.

Doctor of Philosophy / This study addresses the situation of adults who become deafblind. To date, their everday lives have received little attention in the research literature. Of the few studies conducted many involve surveys, the findings of which present the characteristics of people who are deafblind such as their rates of employment, need for support, or use of equipment. There are also a small number of qualitative studies that have explored the effects of having dual sensory impairment, and particularly in relation to communication and psycho-social wellbeing. Important as these research efforts have been, there is little empirical information available about the everyday lives of people who become deafblind and their concerns, nor any systematic attempt to theorise their experiences. There are however many personal anecdotes typically presented at conferences or through community publications and newsletters. This project aimed to redress the gap in the literature by developing a theoretical framework to explain the everyday experiences of adult who become deafblind. In doing so, it built upon the research and anecdotal literature with an overall purpose of presenting, through rigorous research, the experiences of adults who become deafblind and to do so within the broader discourse on disability and disablism. The study was informed by the social relational understanding of disability developed within the Nordic countries. Grounded theory was the method of choice to examine the lives of adults who become deafblind from their own perspective.Participant observation was employed through direct engagement in shared experiences with adults who have become deafblind both at a social group and via an e-mail list group. Mulitple in-depth interviews were undertaken both face to face and by e-mail with a smaller group of eight participants.The core finding from this study is that people who become deafblind are rendered interactionally powerless in a society predicated on seeing and hearing. The powerlessness that they experience comes from having this dual impairment in a world in which being able to see and hear are expected both in the physical and social environment. The inability of people who become deafblind to 'know and be' in the world in the same way as others results in them feeling, and experienceing, interactional powerlessness. In response, people who become deafblind actively engage in trying to minimise or remove their powerlessness. They do so by working to negotiate a place in this hostile world. They adopt four interrelated strategies, namely, doing things differently, managing support relationships, survivings others' perceptions and presenting sides of self.This study, with its central tenet that interactional powerlessness drives ongoing attempts to negotiate a place makes a theoretical contribution to understanding the experience of becoming deafblind. The findings support the concept of disbaility as social relational. Disability is not the same as the sensory impairment, rather it is expressed in the organisation of personal relations in society which render some more powerful than others and in this case, some less powerful due to their inability to use the natural means of communication of hearing and sight. Moreover, the study findings propose that professionals working with people with this dual sensory impairment must endeavour to reduce their part in the hostile world by providing information about options and support available; recognising the complexity of these adults support requirements; and considering the link between psycho-emotional issues and disablism. Further research is needed to understand empirically and theoretically the relative contribution of personal relationships vis a vis organisational or structural relationships in disabling people who become deafblind.