The Michelle P. Waiver (MPW) is the primary means of health insurance for more than 10,000 people in the state of Kentucky. The waiver is especially popular among families with young children with disabilities because it is robust in its benefit offerings and also one of the few Medicaid resources that does not include parental income as a qualifying factor in eligibility. Through the waiver, children receive a medical card as well as additional coverage for medical expenses that fall beyond the scope of traditional health insurance. For these young children to gain access to the comprehensive offerings of the MPW, their parents must apply for the waiver, negotiate the terms of service, and make critical health care decisions on their behalf, or at least until they reach adulthood—although this responsibility often extends throughout the child’s life. The present study builds upon recent research on parental uncertainty in caregiving for children with complex care needs. By combining two ecological approaches to health communication research, Brashers’s (2001) uncertainty management theory (UMT) and Ball-Rokeach, Kim, and Matai’s (2001) communication infrastructure theory (CIT), my aim in this dissertation was to explain how meso-level (e.g., community organization) interactions influenced parental caregivers’ experiences of uncertainty. I collected data through narrative interviews with 31 parents of children who are currently receiving services through the MPW and analyzed them using narrative thematic analysis. The analysis focused on the community-level communication that contributes to parent caregivers’ ability to successfully access and negotiate care within the MPW system. Findings show that parents experience unique personal, social, and medical uncertainties related to the MPW. In addition, the findings demonstrate that MPW-related uncertainty and decision making are managed with a variety of strategies aimed to decrease, increase, or maintain desired levels of uncertainty. Finally, findings showcase how one’s connectedness to community storytelling at the meso level, particularly within online communities and disability network communities supports their adaptive management of MPW-related uncertainty. This project contributes to the health communication literature theoretically by (a) expanding the conceptualization of the uncertainty in illness framework to include the means of health care (i.e., Medicaid) as a consequential element of an individual’s illness experience, (b) identifying two additional strategies of uncertainty management (i.e. advocacy and vigilance), and by (c) extending existing notions of residency, connectedness, and belongingness within the CIT framework to include membership in online and disability-specific networks. Practically, this project offers important insights that can guide future research exploring the role of meso-level communication in parent caregivers’ management of waiver-based care, such as in identifying the need for a systematic communication process that introduces potentially eligible families to the MPW.

This study furthers Alzheimer’s family literature regarding the impact of caregiver attachment, readiness to provide care, and caregiver quality of life. A sample of 33 participants caring for a parent with Alzheimer’s disease in the state of Kentucky was recruited to complete a questionnaire for the study. The questionnaire consisted of an online survey about participants’ experiences and attachments growing up with their parents, their experiences becoming caregivers to their parents with Alzheimer’s disease, and participants’ current perspectives of their own quality of life. Positive perspectives in regards to quality of life among caregivers seem to be a predictor of both stronger readiness to care and stronger attachments. These finding inform therapists about the importance of recognizing a caregiver’s presenting problems of burden and their significance to attachment and readiness to provide such care. This recognition may impact therapy to strengthen a caregiver’s positive adaption, thus it may also decrease burden.

This project explores the possibilities of implementing a critical and liberatory pedagogy within the confines of the prison. Building upon the fields of critical prison theory, literacy studies, and (dis)ability studies, I assert that implementing small, organic, and tactical changes though the principles of Universal Design for Learning allows the prison educator to make impactful moves with liberatory goals. I conclude by reimagining what a prison education mission statement that takes this perspective looks like then imagine the liberatory applications of the principles of universal design for learning within the prison.

A genealogical framework highlights the important role sexuality has played in constructing the current label of intellectual disability (ID). The genealogical framework is meant to replace the social, medical, and/or rights-based model(s) that have dominated social work and social services working in the disability field. With this framework, or perspective, I use a Foucaultian discourse analysis to read through seminal texts regarding person-centered practice. Person-centered practice is the foremost intervention used in social work, and other disciplines, to work with people labeled with intellectual disability. My research questions focus on what is revealed about ID in PCP through a genealogical framework and what implications do these discoveries hold for sexuality education and social services, including social workers? Predetermined concepts taken from the genealogical framework are used in the Foucaultian discourse analysis. These concepts (subject, government, biopower, and normalization) provide insight into how ID has been constructed and maintained through the practice of person-centered processes. Paradoxes emerge throughout the analysis, providing space for productive resistance by professionals working in sexuality education and social services to improve equity for people labeled with intellectual disability, specifically regarding their sexuality and healthy expression of it.

The understanding and treatment of challenging behaviors in individuals with Autism Spectrum Disorder is paramount to enabling the success of behavioral therapy; an essential step in this process being the labeling of challenging behaviors demonstrated in therapy sessions. These manifestations differ across individuals and within individuals over time and thus, the appropriate classification of a challenging behavior when considering purely qualitative factors can be unclear. In this thesis we seek to add quantitative depth to this otherwise qualitative task of challenging behavior classification. We do so through the application of natural language processing techniques to behavioral descriptions extracted from the CARD Skills dataset. Specifically, we construct 3 sets of 50-dimensional document embeddings to represent the 1,917 recorded instances of challenging behaviors demonstrated in Applied Behavior Analysis therapy. These embeddings are learned through three processes: a TF-IDF weighted sum of Word2Vec embeddings, Doc2Vec embeddings which use hierarchical softmax as an output layer, and Doc2Vec which optimizes the original Doc2Vec architecture through Negative Sampling. Once created, these embeddings are initially used as input to a Support Vector Machine classifier to demonstrate the success of binary classification within this problem set. This preliminary exploration achieves promising classification accuracies ranging from 78.2-100% and establishes the separability of challenging behaviors given their neural embeddings. We next construct a multi-class classification model via a Gaussian Process Classifier fitted with Laplace approximation. This classification model, trained on an 80/20 stratified split of the seven most frequently occurring behaviors in the dataset, produces an accuracy of 82.7%. Through this exploration we demonstrate that the semantic queues derived from the language of challenging behavior descriptions, modeled using natural language processing techniques, can be successfully leveraged in classification architectures. This study represents the first of its kind, providing a proof of concept for the application of machine learning to the observations of challenging behaviors demonstrated in ASD with the ultimate goal of improving the efficacy of the behavioral treatments which intrinsically rely on the accurate identification of these behaviors.

People with disabilities are likely to experience difficulties overcoming the impact of natural disasters. Few scholars have focused on this population's ability to recover and handle stress following a natural disaster. The purpose of this phenomenological study was to explore and describe coping strategies and resilience factors that people with physical or mental disabilities used in the aftermath of Hurricane Sandy. Resilience theory was used as the theoretical framework. Through face-to-face interviews, 10 persons with disabilities shared their experiences of coping and resilience. A lens of interpretative phenomenological analysis was used to identify emergent themes related to persons with disabilities' experiences of overcoming challenges and sustaining wellbeing in the aftermath of this natural disaster. According to study results, religion, recreation, and relaxation techniques were the main coping strategies used, and self-determination and independent skills were resilience factors that helped persons with disabilities remain positive and overcome challenges following the hurricane. Participants reported experiencing emotional reactions and identified the dislocation as the greatest stressor. The findings of this study have the potential to effect positive social change by informing stakeholders such as policymakers, community, and state agencies, and related professionals to help them recognize and address the health and psychological needs of persons with disabilities following a hurricane. Knowing which coping strategies and resilience factors persons with disabilities use to create awareness of the positive ways in which persons with disabilities manage the aftermath of this natural disaster.

The general aim of this thesis is to describe mortality, health and living conditions in an administratively defined county population of people with intellectual disabilities born between 1959 and 1974 (N=213). The living conditions of persons with intellectual disabilities were compared with those of the general population. Moreover, the reports of relatives and staff were compared on the living conditions of people with intellectual disabilities. Information on the living conditions of persons with intellectual disabilities was provided by proxy (relative and staff) questionnaire reports and national welfare statistics conducted by Statistics Sweden (SCB). Medical examination and medical case records were used to obtain data on health and medical services. People with intellectual disabilities lived in the community and took part in numerous common recreational and cultural activities. However, the comparison with the general population indicated clear differences in living conditions, particularly regarding employment and social life. In contrast, surprisingly little variation in living conditions was found in people with intellectual disabilities, despite varying ages and a wide range of level of disabilities. In addition, gender related differences of persons with intellectual disabilities were few when compared with those found in the general population. A wide range of physical and mental health problems were identified in the group with intellectual disabilities. Although a majority of persons with intellectual disabilities had access to a family doctor and attended regular health checks, a number of needs of specialist examinations were identified indicating shortcomings in the quality of health care. Analyses indicated differences in the reports of relatives and staff on living conditions of most domains included in the questionnaire. In general, disagreement was higher on subjective than on objective items. Relative and staff responders contribute dissimilar information that is related to varying viewpoints and different types of information.

This dissertation addresses the university student as a figure of mental health and illness. Drawing on the methods and theories of disability studies, interpretive sociology, critical, feminist and queer theory, as well as hermeneutically oriented phenomenology, my work explores the social production of this student figure or type – variously depicted as ‘ invisible’, ‘maladjusted’, ‘stressed’, ‘difficult’, sensitive’, ‘resilient’, ‘narcissistic’, and extraordinarily ‘ordinary’. This figure is addressed as a means of revealing contradictory understandings of the relationship between success and survival, as this relationship appears in the ordinary daily life of the University of Toronto, Ontario, Canada. The social and historical significance of the contemporary University’s Student Life Programs and Services is analyzed with a view to reveal the Western cultural values and practices which organize consciousness of success as a necessary condition of contemporary existence. Special attention is paid to the cultural production of knowledge concerning university student ‘mental life’, the appearance of which is located at the interstices of colonialism, global health policy, institutional ‘best practices’, cultural mores and folkways, and embodied experiences. I dwell with this appearance as an occasion to engage the materiality of Western mythologies of resilience, and with them the meaning of human agency under neoliberal governance. This engagement examines the productive power of the disciplinary and institutionalized ‘language of mental illness’ through a genealogy of the University of Toronto, a textual analyses of the University’s Student Life Programs and Services literature, and a discursive analysis of open-ended interviews with student services representatives which seeks both to understand and transgress conventional interpretations of the structure of Student Life. I demonstrate how University presentations of student bodies, minds and senses perceived to be lacking in ‘ordinary order’, can be reconceived as sites to reflect on the paramount presence of psychiatric knowledge in interpretations and responses to embodied difference within the university setting. Overall, this dissertation seeks to disrupt unexamined relations to the meaning of student types; and in the process, display how normative relations to the student as a figure of mental health and illness needs is currently and historically organized and socially achieved.

This thesis explores the possibilities of embodied writing for social inquiry. Using an examination of the social production of bodily pain to exemplify my approach, and drawing upon autobiographical writing, I develop an embodied writing practice and theorize its implications for decolonizing knowledge production. Following a phenomenologically informed interpretive sociology, I attend closely to language and the construction of meaning through reflexive engagement with pain as a social phenomenon. I also utilize mindfulness meditative practice methodologically to centre the body within social research and intervene in the mind/body split which underwrites much Western knowledge production and reproduces normative, medicalized relations to bodily knowledge. I suggest that by undoing those traditional boundaries demarcating the possibilities of knowledge production, and attending to our epistemological locations which are themselves deeply political, we might generate differently imagined relations to embodiment.

This thesis is an occasion to examine how normalcy – as a phenomenon constructed in society and so not natural but human-made – is reproduced as a hegemonic ideal through oppressive portrayals of disability in literature. Many of the fictional texts I analyze reproduce the privileging of normalcy. I therefore work to disturb normalcyʼs hold through critical analysis of a wide variety of currently popular fiction for youth and adults. Combining interpretive inquiry and personal narrative, I bring forward new understandings of normalcy, disability and culture. Along with showing how normalcyʼs supremacy is upheld within the book industry, and critiquing texts that do disability as usual (through both survey and close analysis approaches), I discuss at length several literary works that write disability in anti-oppressive, anti-ableist ways. To close this thesis, I discuss my own transformation as an author and scholar through disability studies.