Quality of life ADULTS WITH DISABILITIES - UNDERSTANDING - National Council of Social Service
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UNDERSTANDING
THE
Quality of life OF
ADULTS WITH
DISABILITIES
This publication is also available online at https://www.ncss.gov.sg/Press-Room/Publications
CONTENTS
06 18 64
PRESIDENT'S Studies What Can You Do?
FOREWORD 18 Q
uality of Life Study
by Mr Hsieh Fu Hua, on Persons with 65
NCSS President Disabilities Acknowledgements
32 Needs Assessment
07 on Respite Care for 66
FOREWORD Caregivers of Persons References
by Dr Gerard Ee, with Disabilities Annexes
Chairman of the NCSS
42 Study on Public 67 A: Glossary of Quality
Advocacy and Research
Attitudes Towards of Life Domains and
Panel
Persons with Facets
08 Disabilities 68 B
: Glossary of
MESSAGE Disability Services
from Mr Leo Chen Ian, 50
Founder and Partner, Insights And Ideas
Copyright © 2017 by National Council of Social Service Insight N Access Pte Ltd
ISBN: [978-981-11-3870-6] 62
All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any
09 The Disability
An Overview Of Service Landscape
means, electronic or mechanical, including photocopying, recording, or by any information storage Disability 62 Persons with
system and retrieval system, without the written permission of the copyright owners. Disabilities
Designed and Printed in Singapore by
14 63 Caregivers
Introduction
Oxygen Studio Designs Pte Ltd
www.oxygensd.com
Please address all queries regarding this publication to:
Advocacy and Research Team
National Council of Social Service
170 Ghim Moh Road, #01-02
Singapore 279621
Tel: 6210 2500
Fax: 6468 1012
research@ncss.gov.sg
Before I became President of NCSS, I used Regardless of ability, condition or age, our lives
to volunteer for a charity, handing out food are made up of many diverse facets, aspects and
provisions to vulnerable families. Many recipients experiences intricately woven together. Even as
were kind and invited me into their homes. What individuals, we are shaped by the ecosystem we
struck me during these visits was the sight of live in, be it the people close to us, community or
stacks of unconsumed and even expired food. wider society. Hence, focusing on a few aspects
They explained to me that when social service rather than the whole – the individual rather than
organisations offered help, it was usually food. his or her interactions with the entire ecosystem –
prevents us from seeing meaningful linkages that
While well-intentioned, gifts of food address contribute to who a person is.
hunger as opposed to what keeps people hungry.
That food goes uneaten and families remain With this in mind, NCSS carried out a series of
vulnerable tells us that hunger is but one need studies to examine the quality of life of various
among many. It also reminds us that people’s real vulnerable populations and seniors through
needs can be very different from what we believe a person-centred and holistic approach. To
them to be. understand their aspirations, needs and well-being
from their perspective, we adopted the World
In addressing these issues, NCSS advocates Health Organisation’s framework on Quality of Life,
a quality of life approach to understanding conducting surveys, interviews and discussions.
needs. Areas such as psychological well-being,
independence and having social support are vital This is one in a series of publications that presents
to living well. This entails encouraging people the results of those findings to practitioners, social
to express what they need, and to be active service professionals, volunteers and service users
participants in addressing their own needs. for their application. Each contains rich information
that can be used to guide social service providers,
PRESIDENT'S FOREWORD
The Quality of Life Study has shed valuable funders and other stakeholders in the social
insights on how all individuals can hold onto service ecosystem, to dive into understanding
their aspirations, use their abilities and be active
FOREWORD
and developing solutions so as to empower service
in society. While we have taken steps towards Dr Gerard Ee users towards achieving their fullest potential.
inclusion for persons with disabilities by improving Chairman of the NCSS Advocacy and
MR Hsieh Fu Hua the infrastructure and opportunities for training Research Panel Among numerous applications, the insights
NCSS President and employment, we now need to draw upon their gleaned from these findings have contributed
participation and contribution in the journey to towards national initiatives such as the Enabling
further better their lives. Masterplan 3, the nation’s disability blueprint,
"Regardless of ability, as well as the Social Service Sector Strategic
"That food goes uneaten and Ultimately, it is my hope that every contributor to condition or age, our lives Thrusts, a five-year strategic roadmap for the
families remain vulnerable tells this sector can join NCSS in taking a person-first
are made up of many diverse sector developed in partnership with the public,
perspective, seeing individuals beyond recipients private and people sectors.
us that hunger is but one need of help alone and empowering all to live with facets, aspects and experiences
among many." dignity in a caring and inclusive society.
intricately woven together." I am extremely grateful to our advisors. They are
experts in the field of statistics, psychology, social
work, disability, mental health and seniors and
research. I am also thankful to each and every
respondent who participated in the study, along
with the many who helped ensure that their
opinions were heard.
6 7
AN OVERVIEW OF DISABILITY
It must be unimaginable that someone with
cerebral palsy could be married with two beautiful
children, run his own consultancy firm and
complete a kayaking expedition around Singapore
to raise funds. Indeed, I would have never achieved AN OVERVIEW OF DISABILITY
these milestones if my mother had sent me to an
institution when I was born, on the advice of the
paediatrician, as there was “nothing much she
could do” – that my life wasn’t worth the effort.
Growing up under preconceived notions remains
very much a part of my life. When I was in school, my
teachers would constantly advise me not to take P.E.
lessons and look after my schoolmates’ belongings
instead. I was also told to quit kayaking as a CCA,
Restrictions to
because I would “injure myself and die out there”.
participation
Even though human beings are made up of Defining Disability1 Problem being involved
countless possibilities, society often fails to look Disability reflects the interaction in life situations
beyond what they see as a disabling condition. As between features of a person’s
a result, the self-worth of a person with disability body, and the society in which
takes a beating from young, snowballing over time he or she lives in.
into a lens of pity, helplessness and resignation, both
for the person and the people around him or her. It is an umbrella term that
covers three main aspects:
an Library I hope that the studies presented here will inform
it: The Hum
Photo cred
service providers and the community towards a
vision of empowerment and solidarity, rather than
MESSAGE liability. As long as we put in the effort, we will
discover beyond a single difference that there are
far more similarities which we share. With time, it is
Mr Leo Chen Ian my wish that prejudiced lenses will be shed away.
Founder and Partner, Insight N Access Pte Ltd
An ideal world is certainly not unreachable. It is
simply about being able to perform the everyday
tasks that most of us can do, be it shopping for
"As long as we are willing groceries, doing one’s laundry, having friends and
Impairments Limitations
to put in the effort, we will romantic relationships and being treated just like
Problem in body in activity
function or Difficulty performing
anyone else.
soon discover beyond a structure a task or action
single difference that there The next time you meet a person with a disability,
resist the urge to judge what they can do, who they
are far more similarities are and how different they might be. Instead, start
which we share." a conversation about what they want to do, who
they aspire to be and most of all, how you can
journey with them to achieve it.
As for me, I continue to take life’s challenges in my
stride, and strive constantly to lead a meaningful 1 World Health Organization. (n.d.). Disabilities. This definition reflects a bio-psycho-social model of disability.
life and to contribute back to Singapore.
8 9AN OVERVIEW OF DISABILITY AN OVERVIEW OF DISABILITY
Some Types of Disabilities
Learning
Cognitive deficits that impact academic achievement.
Dyscalculia Dyslexia
Difficulties in the reception, comprehension Difficulty in reading skills such as word
or production of quantitative and spatial reading, comprehension and overall
information. fluency.
Dyspraxia Dysgraphia
Difficulties in movement, balance and Difficulty in writing, resulting in work that
coordination that often result in an may be illegible or inaccurately spelt.
appearance of clumsiness.
Physical
Total/partial loss of bodily function (e.g. walking, motor skills) or a part of the body (e.g. amputation).
Developmental
Muscular Dystrophy Spina Bifida Diverse group of conditions that occur in the developmental period
An umbrella term for a group of muscular A birth defect of the spine that manifests of a child, resulting in difficulties in personal, social, academic or
disorders characterised by muscle in various forms of severity. Spina bifida occupational functioning2.
weakness, wasting and contractures, occulta is the mildest form, having no
which are usually progressive in nature signs and symptoms or neurological
and sometimes even life-threatening. problems. More severe manifestations Autism Spectrum Disorder Down Syndrome
These disorders result from inherited gene include meningocele or the potentially A range of developmental disorders A genetic condition caused by the
abnormalities. life-threatening myelomeningocele characterised by difficulties in social presence of an extra chromosome, it
(open spina bifida). interac tion, language and social is associated with a range of physical
Spinal Cord Injury communication as well as flexibility of impairments and developmental
Injuries to the spinal cord that result often in Paralysis thought and behaviour. Some examples delays, including delayed motor and
weakness in both lower limbs (paraplegia) The loss of the ability to move (and on the spectrum are Autism, Asperger cognitive skills.
or in all four limbs (tetraplegia) with sometimes to feel anything) in part or syndrome and Childhood Disintegrative
potentially life- threatening complications. most of the body, typically as a result of Disorder. Intellectual Disabilities
illness, poison or injury. Having significant limitations in adaptive
Polio Cerebral Palsy functioning along with an IQ below 70.
A viral infection typically recognised by Amputation A group of non-progressive disorders It is characterised by impairments in
weakness, paralysis or reduced muscle tone. Surgical removal of all or part of a limb, occurring in young children in which academic and social functioning as well
an organ, or projecting part or process injury to the brain causes impairment of as skills needed for daily living.
of the body. motor function.
Sources: Cerebral Palsy Alliance Singapore, Down Syndrome Association (Singapore), Dyslexia Association of Singapore, Institute of Mental Health,
Ministry of Health, Muscular Dystrophy Association (Singapore), National University Hospital, NCSS, NUH Women's Centre, Singapore National Stroke
Association, Society of Rehabilitation Medicine (Singapore).
2 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM- 5.
10 11AN OVERVIEW OF DISABILITY AN OVERVIEW OF DISABILITY
Sensory People, including those with disabilities, are living longer. As the nation faces an ageing population, the
When one of the senses – sight, hearing, smell, touch, taste and spatial number of persons with disabilities acquired from accidents and illnesses is likely to rise. In addition,
awareness – is impaired. there will be less familial support for persons with disabilities.
Deafness/Hearing Impairment Visual Impairment
The partial or complete loss of hearing in Moderate to severe visual loss that
one or both ears. Ranges from moderate cannot be corrected to a normal level
hearing loss, in which conversations may by medication, operation or the use of
be hard to hear, to profound hearing loss optical lenses (e.g. spectacles).
where no sound is audible. Resident Old-Age Support Ratio
16
13.5
14
KEY TRENDS 11.3
10.5
s t - 18
po
12
9.0
Under-18 Rising demand for 10
Old-Age Support Ratio
7.4
longer-term 8 6.0
More children are 5.7 5.4
being diagnosed with
care services, as
persons with disabilities 6
developmental age and seniors acquire
issues disabilities 4
Increasing numbers 2
of children diagnosed Greater demand for
quality and diverse 0
with Autism
service arrangements 1970 1980 1990 2000 2010 2014 2015 2016
Spectrum for persons with
Disorder moderate to
severe disabilities
Source: Enabling Masterplan 3. Source: Department of Statistics.
12 13INTRODUCTION
When thinking about disability, attention is often drawn to the
condition rather than the person who bears it. From then on, it
becomes the primary lens with which needs, and the solutions to
address them, are conceived. Subsequently, efforts are focused on
rehabilitating the condition alone, which may skim across broader
contexts that persons with disabilities are part of.
To meet needs in a more effective, collective and sustained manner,
NCSS supports a person-centred and ecosystem approach towards
helping individuals achieve quality of life. This is also the value which
underlies the Social Service Sector Strategic Thrusts (2017-2021), a
5-year roadmap for the social service sector.3
Person-Centred
A person-centred approach operates on the belief that
an individual has the capacity to understand, articulate
and work through problems, making decisions on how to
overcome them.4
Ecosystem
Addressing individuals holistically also means seeing them
as enmeshed in different, interrelated contexts that influence
every aspect of an individual's life - an ecosystem5 comprising
caregivers and family, community and wider society. In practice,
this means that understanding the needs of persons with
disabilities necessitates taking into account their interactions
with the ecosystem, towards more holistic understanding and
solution creation.
Quality of Life
Taking a multi-faceted approach to individual well-being,
an essential outcome is that individuals' quality of life is
optimised in the form of a core set of diverse, essential needs.
These needs are evaluated from individuals' own point of
view, which gives credence to peoples' own awareness of
what they need. This is important because researchers agree
that the assessment of quality of life is subjective 6, and
because individuals perceive needs and give importance to
them in different ways.
3 T he Social Service Sector Strategic Thrusts document may be found on NCSS' website at http://
www.ncss.gov.sg/4ST.
4 The term 'person-centred' was first introduced by the psychologist Carl Rogers in the 1940s. Further
information about the person-centred approach can be found at http://adpca.org/content/history-0.
5 Bronfenbrenner, U. (1986). Ecology of the Family as a Context for Human Development: Research
Perspectives.
6 Blatt, B. (1987). The Conquest of Mental Retardation; Taylor, S. & Racino, A. (1991). Community
Living: Lessons For Today.
14 15Domains
facets
The World Health Organisation Physical
defines Quality of Life as such7: 1 Pain and Discomfort 2 Energy and Fatigue 3 Sleep and Rest
Level of
An individual’s Independence 1 Mobility 2 ACTIVITIES OF 3 DEPENDENCE ON MEDICAL 4 WORK CAPACITY
DAILY LIVING TREATMENT / MEDICATION
perception of their
position in life in the Social
context of the culture Relationships 1 PERSONAL RELATIONSHIPS 2 SOCIAL SUPPORT 3 SEXUAL ACTIVITY
and value systems in
which they live and Environment
1 SAFETY AND SECURITY 2 HOME ENVIRONMENT 3 FINANCIAL ADEQUACY 4 HEALTH AND SOCIAL CARE
in relation to their
goals, expectations, 5 OPPORTUNITIES 6 RECREATION AND 7 PHYSICAL 8 TRANSPORT
TO ACQUIRE NEW LEISURE ENVIRONMENT
standards and INFORMATION AND SKILLS
concerns.
Psychological
1 POSITIVE FEELINGS 2 THINKING, LEARNING, 3 SELF-ESTEEM 4 BODY 5 NEGATIVE
It conceptualises Quality of Life
MEMORY AND IMAGE AND FEELINGS
in six constituent domains, sub-
CONCENTRATION APPEARANCE
divided into 24 facets. More details
on the domains and facets may be
found in Annex A. Personal Beliefs
1 PERSONAL BELIEFS,
SPIRITUALITY/ RELIGION
Society Study on Public Attitudes
With this in mind, NCSS conducted towards Persons with Disabilities
three major studies to better To ascertain public attitudes
understand the needs of persons
Caregiver Needs Assessment on Respite Care for
with disabilities in Singapore. Each
Caregivers of Persons with Disabilities
corresponds to an agent within
To understand the needs of caregivers
the disability ecosystem:
Individual Quality of Life Study on
Persons with Disabilities
To examine their needs, from
their perspective 7W
orld Health Organization. (1993). Study Protocol for the World
Health Organization Project to Develop a Quality of Life Assessment
Instrument (WHOQOL).
16 17STUDIES STUDIES
QUALITY OF tracked over time. This helps social service stakeholders to assess
the impact of their initiatives and identify trends for future planning.
RESPONDENT BREAKDOWN BY DISABILITY TYPE RESPONDENT BREAKDOWN BY HOUSING TYPE
LIFE STUDY ON Physical
Impairment
Sensory
Impairment
Intellectual
Disability/
Multiple
Disabilities
1-2 Room 3 Room
15.4% 29.3%
4 Room
34.7%
5 Room/
Executive/
PERSONS WITH Research Objectives 23.1% 13% Autism 23.2% Others
DISABILITIES • T o identify the needs of persons with disabilities from their
Spectrum
Disorder
15.4%
Private Apartment/
perspective, across six domains of quality of life9: Adult Residential/
36.7%
Nursing Home Condominium
Introduction 1.6%
1 Physical 4 Environment 2%
In 2016, NCSS completed the Others
Quality of Life Study on persons 2 Level of independence 5 Psychological (e.g. learning Hostel/
with disabilities in Singapore, a disabilities) Community
3 Social Relationships 6 Personal Beliefs 4%
nationwide survey which sought Group Home
to ascertain what areas they felt • To obtain a quantitative baseline for the quality of life for 1.6%
contributed most to their well- persons with disabilities
being and could be improved • To surface priority areas for intervention
upon. It is the first large-scale
quantitative study that highlights Method
what persons with disabilities Participants were obtained through random sampling from SG Enable's
themselves consider important database10, and administered a survey face-to-face which they had to
to their well-being. complete by themselves as far as possible. The final sample comprised
981 responses. Respondents were asked to complete the survey on RESPONDENTS WHO HAVE USED/ARE ACCESSING SERVICES^
Collectively, these findings their own (with clarifications where necessary), failing which a proxy Disability Schemes (e.g. Car Park 571
support existing knowledge (main caregiver) answered on their behalf.11 Label Scheme)
and feedback, and will help the
sector in deeper research, service KEY DESCRIPTIVES Financial Assistance (e.g. public 366
planning efforts, public education assistance, grants, ComCare)
and policy recommendations. In 3.4% of 2.1% of 13.3% of 30.4% Early Intervention Programme for 271
particular, the latest Enabling Singaporeans students aged Singaporeans have >1 Infants and Children (EIPIC)/Special
Masterplan, a 5-year roadmap aged 18 to 7 to 18 have a aged 50 and disability type* Education School
that guides initiatives for the 49 have a disability+ above have a Assistive Devices 249
disability sector, adopted both disability*^ disability*^
the Quality of Life framework and Employment-Related Services (e.g. 213
49% 55.6% 12.6% skills upgrading, job support)
findings in its strategic directions
and recommendations8. have a have a chronic have a Sheltered Workshop 174
moderate disease (e.g. mental health Day Activity Centre 141
The results from this inaugural to severe heart disease, condition*
study serve also as a baseline disability* diabetes, Counselling and Case Management 106
for future comparison, allowing stroke and Support Groups 77
changes in quality of life to be asthma)*^
Other Disability Services 41
*
Findings are self-reported. Residential Homes/Residential Care 30
^
Includes those who acquired disabilities from accidents and illness.
+
Source: Ministry of Education. Based on number of reported cases of students with sensory impairment, physical impairment, Autism Befriending Services 27
Spectrum Disorder and intellectual disability. The total student population is put at approximately 460,000.
Helplines 27
8 The Enabling Masterplan 3 document can be found on NCSS' website at https://www.ncss.gov.sg/NCSS/media/NCSS-Documents-and-Forms/EM3-Final_
Report_20161219.pdf.
Hostel/Community Group Home 25
9 More details on the domains, and facets under each domain, in Annex A.
10 SG Enable captures persons with disabilities (aged 18 and above) who have accessed services in government-funded social service organisations, special
0 200 400 600
education schools or other schemes and support services administered by SG Enable at least once in their life. No other more representative national registry Number of Respondents
for persons with disabilities currently exists. Response Rate = 75.4%. Of 1,300 surveys distributed, 1,000 were completed and 981 responses used after cleaning. ^
Respondents were allowed to indicate their attendance of more than one service.
11 5 0.9% were proxy responses.
18 19STUDIES STUDIES
RESPONDENT BREAKDOWN BY EDUCATION In this survey, three World Health Organisation Quality of Life (WHOQOL) instruments were used. Further
questions were asked on their satisfaction of services accessed, the types of services they would like as
None Primary Secondary Graduated Institute of
well as the Quality of Life domains in which they desired the most improvement. All items were translated
12.2% School School from SPED Technical
into Chinese, Malay or Tamil where necessary.
17.2% 13.3% 42.1% Education
4.8%
Polytechnic Junior University Others Quality of Life WHOQOL-BREF13
4% College/Pre- Degree 0.6% This is a 26-item scale that asks respondents to rate their state of well-
University Holders being in the last two weeks. Questions are answered on a five-point
1.6% 4.2% scale, and comprise:
WHOQOL-DIS • 24 facet-level questions that correspond with six domains of
Quality of Life
• Two questions that ask about perception of life and health overall
Specific to Persons with
RESPONDENT BREAKDOWN BY EMPLOYMENT AND DISABILITY TYPE
0% 31 In addition to the sample of persons with disabilities, the WHOQOL-
Disabilities
23
BREF was administered to that of the general population as well.
70 WHOQOL-BREF
43
20% 44 WHOQOL-DIS
133 An add-on module of WHOQOL-BREF that surveys respondents on
17 three areas of life regarded as important to persons with disabilities –
40% 10 44 Open Employment
26 10 Autonomy, Discrimination and Social Inclusion14. Similarly, questions
Sheltered were answered on a 5-point scale and based on respondents'
WHODAS 2.0
89 Workshops^ experiences in the last two weeks. There were 13 questions in total,
60% including:
Accessing
65 Education/
114 117 Day Activity • One question asking about the effect of the disability on one's
80% 107 Centres^/Others life overall
None Other Areas Surveyed • 12 questions on aspects of Autonomy, Discrimination and Social
by NCSS Inclusion, including:
100%
Facet Areas Covered
Autonomy Feeling in control of one's life
1. Demographics Being able to make day-to-day choices and big
2. D esired Areas of decisions in life
Improvement Discrimination Unfair treatment
Physical Sensory Intellectual Multiple
Impairment Impairment Disability/Autism Disabilities 3. P
erception of Health Needing to stand up for oneself
(n=227) (n=128) Spectrum Disorder (n=228) Status and Health Worries about the future
(n=360) Social Inclusion Feeling accepted and respected in society
Conditions
Ability to communicate effectively with people
^
For more information on what these terms refer to, please refer to Annex B. 4. Service-Related
Opportunities to be involved in social and local
Questions
activities
Feeling that dreams, hopes and wishes will be
COMPARISON TO THE GENERAL POPULATION realised
As a basis for comparison, NCSS also obtained a representative sample (n = 942) of the general population
through the Department of Statistics12. 12 R
esponses from the general population sample which indicated that they had mental health conditions or disabilities were removed so that the general
population sample could be used as a control group for comparison with the other target groups. 1,400 surveys sent out. Response rate: 67.3%.
13 According to WHOQOL Group (1998), the WHOQOL-BREF has been validated cross-culturally for various populations worldwide. An example may be
found on the WHO's website at http://www.who.int/mental_health/media/en/76.pdf.
14 Items were generated from focus group discussions, tested and validated across 15 countries (Power, Green & The WHOQOL-DIS Group, 2010).
20 21STUDIES STUDIES
WHODAS 2.0 (WHO Domain Areas Covered Finding #2
Disability Assessment Cognition Understanding and communicating
Schedule)15 Persons with disabilities scored lower than the general population across all quality of life domains^,
This 36-item instrument Getting Along Interacting with other people especially on level of independence, personal beliefs and social relationships, particularly in the area of
measures functioning levels Life Activities Domestic responsibilities, leisure, work and social support from friends.
in six domains of health and school
disability. Responses are General Population
indicated on a five-point scale Mobility Moving and getting around
Quality of Life Score by Domain Persons with Disabilities
to measure intensity and extent Participation Joining in community activities,
of respondents' difficulty in participating in society 100 75.9
69.0 62.7** 70.2 69.0 69.8 67.6 69.8
performing these activities:
Self-Care Attending to one's hygiene, dressing, eating 80
Quality of Life Score
53.7** 57.0** 53.3** 53.4**
and staying alone 48.7** 45.3**
60
40
Key Findings
20
Finding #1
0
Physical Level of Social Environment Psychological Personal Overall QOL
Persons with disabilities experienced a lower quality of life than the general population. Independence Relationships Beliefs
It was even lower for persons with disabilities who had complex needs (i.e. having a disability or being ** p < 0.01. A Multivariate Analysis of Variance was performed on the six domains related to quality of life (DV) and group membership (IV).
over the age of 65).
Quality of Life Score by Presence of Complex Needs At the facet level^, persons with Quality of Life Score by Facet
disabilities reported the: Physical Environment 69.0
Pain and Discomfort 67.7
100 Top 5
• Worst scores in financial Home Environment 65.6 facets
Negative Feelings 65.1
adequacy and thinking, Safety and Security 64.5
80 General learning, memory and Health and Social Care 64.1
concentration Sleep and Rest 62.3
Population: 69.8
Transport 61.9
55.0 Dependence on Medication or Treatments 59.4
Quality of Life Score
• Best scores in physical
WHOQOL-BREF Facets
60 45.9 Persons with * Energy and Fatigue 58.0
Disabilities: 53.4 environment and pain and Personal Relationships 56.0
discomfort Mobility 55.8
Activities of Daily Living 54.7
40 Body Image and Appearance 54.2
Self-Esteem 52.5
Positive Feelings 50.4
Complex Needs Opportunities to Acquire Information and Skills 47.8
20 Personal Beliefs 45.3
No Complex Needs Social Support 45.2
Work Capacity 45.0
0 Sexual Activity 44.8
Recreation and Leisure 44.4 Bottom 5
*p < 0.05 Persons with Disabilities Thinking, Learning, Memory and Concentration 44.3
facets
Financial Adequacy 38.6
0 20 40 60 80 100
Quality of Life Score
15 The WHODAS 2.0 has been tested in different cultural settings and health populations and has robust psychometric properties (Gold, 2014). ^
For more information on the Quality of Life domains and facets, please refer to Annex A.
22 23STUDIES STUDIES
Finding #3 Finding #5
When asked about which areas they wished to see improved, persons with disabilities prioritised level of Regardless of disability type, persons with moderate-severe disabilities experienced lower quality of life
independence, followed by psychological well-being and in their environmental resources. than those with mild disabilities.
Quality of Life Score by Disability Type
*
Despite social
* *
relationships
100 *
scoring low, Seven of 10 64.8
respondents would like to 80 59.7 62.3
58.2
Quality of Life Score
did not have greater
100 independence 48.8
desire to see
62.7 60 42.1 42.6 40.5
80 45.3 improvements
53.3
in their lives.
in this area. Physical
Quality of Life Score
Personal Psychological
60 Beliefs 40
40 57.0 53.7 20
48.7 Mild
Environment Level of
20 Social Independence Mod-Severe 0
0 Relationships
Physical Sensory Intellectual Multiple
*p < 0.05 Impairment Impairment Disability/ASD Disabilities
Smallest desired improvement Greatest desired improvement
Finding #6
Persons with disabilities felt that they lacked autonomy and control over their lives and in life decisions.
Finding #4
They also felt excluded from contributing meaningfully to society, and did not feel that they could fulfil
their personal potential.
Depending on disability type, respondents reported slightly different needs: WHOQOL-DIS Scores by Area
• Those with physical or sensory impairments experienced lower quality of life in terms of their Best Discrimination 69.3
personal beliefs, social relationships and psychological well-being
Social Acceptance 69.0
• Those with intellectual disability and Autism Spectrum Disorder experienced lower quality of life in
the domains of personal beliefs, level of independence and social relationships Future Prospects 60.2
Choice 48.6
Quality of Life Score by Disability Type
Advocacy 47.2
WHOQOL-DIS Areas
Physical 100 Respect 47.1
80
67.3 Communication Ability 46.6
Independence 57.2 56.8 57.1
Quality of Life Score
51.4 55.7 49.0 52.8 55.6 51.3
Psychological 60 42.2 45.2 Social Network and Interaction 38.0
Personal Beliefs 40 Autonomy 34.4
Social Relationships Control 33.0
Bottom
20 5 areas
Environment Personal Potential 30.9
0
Physical/Sensory Impairment Intellectual Disability/ASD Worst Social Inclusion and Contribution 29.1
0 20 40 60 80 100
WHOQOL-DIS Score
24 25STUDIES STUDIES
Respondents who participated in sports or physical recreation reported higher quality of life than
24-year-old full-time national serviceman Samuel those who did not.
aspires to find work in the financial sector and boost Quality of Life Score by Frequency of
his employability by earning a degree. Having had Participation in Sports/Physical Recreation
positive working experiences with Mount Alvernia 100 *
Hospital and in the Air Force, he sums up his thoughts *
about how persons with disabilities can be better At least 3 times a week 80
Quality of Life Score
56.4 55.2 52.4
included in society: At least 1 time a week 60
“Having an inclusive society means that everyone 123 Non-participants 40
is given an equal opportunity to have a try on 20
*
pSTUDIES STUDIES
Finding #9
Persons with disabilities who were not engaged in a main daily activity, particularly employment, experienced Social Relationships Personal Beliefs
lower quality of life. * *
100 100
Quality of Life Score by Daily Activity Type
* 80 80
52.4 51.5 49.3 52.5
Quality of Life Score
Quality of Life Score
* 46.0 45.1 44.8 42.9
100 60 60
80 63.3 60.6 40 40
52.1 46.7
Quality of Life Score
60 20 20
40 0 0
Open Sheltered Education/ None Open Sheltered Education/ None
20 Employment Employment Day Activity Employment Employment Day Activity
Centre/Others Centre/Others
0
Occupation/Main Activity Occupation/Main Activity
Open Sheltered Education/ None
*p < 0.05 *p < 0.05
Employment Employment Day Activity
Centre/Others
Finding #10
*p < 0.05 Occupation/Main Activity
Those in employment reported a higher level of independence.
They reported diminished psychological well-being, social relationships and sense of meaning in life.
Level of Independence
Psychological Well-being
*
*
100 *
100
80 63.5
80 58.9 53.1
56.1
Quality of Life Score
47.4
Quality of Life Score
45.1 44.8 42.9 60
60
40
40
20
20
0
0
Open Sheltered Education/ None
Open Sheltered Education/ None Employment Employment Day Activity
Employment Employment Day Activity Centre/Others
Centre/Others
*p < 0.05
Occupation/Main Activity
*p < 0.05 Occupation/Main Activity
28 29STUDIES STUDIES
Finding #11
However, those in open employment tended to feel discriminated against.
Discrimination Many were not engaged in any activities even if they were higher functioning (e.g. can move, get around
* by themselves, can care for themselves, can communicate well), could care for themselves and were able
* to communicate well.
100
80 61.7 65.0
57.6 WHODAS 2.0 Score by Occupation/Main Activity
Each dot represents
WHOQOL-DIS Score
55.6 one respondent.
60 100
The WHODAS 2.0
40 domains are (p.22):
• Cognition 75
WHODAS 2.0 Score
20 • Getting Along
• Life Activities 50
0 • Mobility
Open Sheltered Education/ None • Participation
25
Employment Employment Day Activity • Self-Care
Centre/Others
0
*p < 0.05 Occupation/Main Activity
Open Sheltered Education/ None
Several faced interpersonal issues as well, though this was not limited to employment alone. Employment Employment Day Activity
Centre/Others
Occupation/Main Activity
Getting Along (WHODAS 2.0) Score by Occupation/Main Activity
Each dot represents
one respondent.
The WHODAS 2.0 100
domains are (p.22):
• Cognition
• Getting Along 75
WHODAS 2.0 Score
• Life Activities
• Mobility
• Participation 50
• Self-Care
25
0
Open Sheltered Education/ None
Employment Employment Day Activity
Centre/Others
Occupation/Main Activity
30 31STUDIES STUDIES
NEEDS Comprising both a survey and focus group discussions, it sought to KEY DESCRIPTIVES
unearth caregivers' understanding of respite care, their views and
ASSESSMENT ON preferences of respite care services as well as their need for such services 123
RESPITE CARE in relation to various predictors (e.g. stress levels, characteristics of
care recipients).
Age of Caregiver RELATION OF CAREGIVER TO CARE RECIPIENT
FOR CAREGIVERS 65
8.3%
Parent
90%
Sibling
6.0%
Grandparent
1.0%
Others
3.0%
OF PERSONS Findings of the study revealed suggestions to alleviate caregiver
stress. In particular, these recommendations informed the Enabling
WITH DISABILITIES Masterplan 3, and it was announced in the Singapore Budget 2017 that
the government would set up a disability caregiver support network to
Introduction provide information, planned respite, training and peer support, and
Caregivers16 are often the main work together with social service organisations to strengthen caregiver
pillars of support for persons support for caregivers of people newly diagnosed with disabilities20.
with disabilities. As instrumental
agents in the latter's quality of Research Objectives
life, they have a direct impact on
the well-being of care recipients. • To unearth caregivers' understanding and views of respite care
• To ascertain their need for such services in relation to various
While they play a crucial role in predictors (e.g. stress levels, characteristics of care recipients)
the disability support ecosystem,
little research has been done on
these individuals, nor on their Method
respite care needs. It is important This assessment comprised a quantitative survey as well as pre-survey
that we understand caregivers focus group discussions.21 Education Level of Caregiver Household Income
better as they bear tremendous
responsibilities that affect their Focus Group Discussions Primary Secondary Junior Tertiary $6000
own lives – and those of their Six focus group discussions were held with caregivers22 of pre-schoolers 13.2% 44.3% College 34.8% 15.5% $3000 $6000 22.7%
7.8% 36.3% 25.5%
care recipients – in equally with special needs (0-6 years), students (7-21 years) and adults (21
consequential ways, be it higher years and above). Each session had five to six participants, totalling 33.
levels of guilt or worry17, stress18
or decreased work participation The discussions captured ideas of what respite care meant to caregivers,
in general19. existing service gaps, services received and the adequacy of services
in meeting caregiver needs. These inputs went into the subsequent
Following up on feedback quantitative survey, which concentrated on gathering data on the
received during the Enabling profile of caregivers and their care recipients, current knowledge of
Masterplan 2 (2012-2016) as respite care and preference for respite care services.
well as that obtained from
caregivers and members of the Quantitative Survey
public, NCSS conducted a study Social service programmes were stratified first according to the various
to understand the respite care age groups served23, and then by service type24. Random sampling
needs of caregivers of persons was then carried out on each stratum. Based on calibrated numbers,
with disabilities. a total of 1,600 surveys were distributed. The achieved sample size
was 78925.
19 C
han, Ostbye, & Malhotra (2013) noted that in Singapore, 47% of caregivers are not working and of those who did, 29% indicated that they had to leave
work at least once in six months for care recipients' doctor's appointments.
20 L am, L. (2017, February 20). Singapore Budget 2017: Integrating Disabled into Workforce and Supporting Caregivers Focus of New Govt Masterplan.
16 A caregiver is an individual who assists others with medical tasks and activities of daily living. Formal caregivers perform this role in institutional settings 21 Where real stories, accounts or quotes are used, names have been changed for reasons of privacy.
while informal caregivers, usually unpaid, care for others at home, in public and other more informal settings. 22 C aregiver contacts were provided by relevant social service organisations.
17 S torch et al. (2009) found that caregivers who are often very personally attached to the care recipient suffer from strong feelings of guilt and worry. 23 0-6 years old, 7-21 years, 19 years and above.
18 Goh, Chong & Chan (2010) noted that 54% of parents with children in Early Intervention Programmes for Infants and Children (EIPIC) experience clinically 24 Early Intervention Programme for Infants and Children, Special Education as well as training places such as Day Activity Centres and Sheltered Workshops.
significant levels of stress. 25 Response Rate: 49.3%. Of 1,600 surveys distributed, 967 surveys were returned, of which 178 were considered invalid (12 nil returns, 166 incompletely filled).
32 33STUDIES STUDIES
Caregiver Support Services Accessed^ CARE RECIPIENT'S DISABILITY TYPE SEVERITY OF CARE RECIPIENT'S DISABILITY
Physical Sensory Intellectual Mild Moderate Severe
Family Support Impairment Impairment Disability 39.4% 49.1% 11.5%
14 13% 3% 32%
Autism Multiple
Spectrum Disabilities
Caregiver Training Disorder 22%
from Hospitals 21
29%
Others
CARE
43
Home Help Services
44
The sur vey probed into Social and Time. Positive responses to 7 or more items indicate a
Religious Support Groups respondents' caregiving and care high level of strain that may warrant clinical attention.
62 recipient profiles as well as his or
her knowledge, perception and General Health Questionnaire-12 (GHQ-12)27
utilisation of respite care. Three In this tool, 12 questions are asked that identify common psychiatric
Caregiver Programmes instruments were also included conditions in both clinical and general populations. It assesses the
from Social Service 64 in the questionnaire. severity of mental disturbances over the past few weeks on a 4-point
Organisations scale (from 0 to 3), with a higher score representing greater levels of
Caregiver Strain mental distress.28
Mutual Help/Support Index (CSI)26
Groups 102 A 12-question tool measuring Kessler-6 (K6)29
strain related to care provision, Developed for use in the US National Health Interview Survey (NHIS),
t h e C S I i s u s e d to a s s e s s K6 comprises six questions on a scale of 1-5, to distinguish cases of
individuals on the following serious mental illness from non-cases. A case would be defined if the
Counselling
149 domains affecting well-being: sum of all six items is greater than or equal to 13.
Financial, Employment, Physical,
0 20 40 60 80 100 120 140 160
26 F rom Robinson (1983). More information on the scale can be found at https://consultgeri.org/try- this/general-assessment/issue-14.pdf. The CSI has
been found to be internally consistent when used with different family caregivers (Blake et al., 2003, Khan et al., 2007). In this study, Cronbach α = 0.87.
27 From Goldberg & Williams (1988). The GHQ-12 is known for its brevity and use in clinical settings and has been translated and validated in at least
two languages in addition to English. It has been found to be psychometrically viable in countries as diverse as Germany (Romppel, Braehler, Roth &
Glaesmer, 2013), Spain (Sanchez-Lopez & Dresch, 2008) and Iran (Montazeri, Harirchi, Shariati, Garmaroudi, Ebadi & Fateh, 2003). More information
on the scale can be found at http://www.psicothema.com/pdf/3564.pdf. In this study, Cronbach α = 0.93.
28 0 -1 re-scoring also provides a total score, for which a 3-4 cut off point is commonly used to indicate caseness.
29 A truncation of K10 (Kessler et al. 2003). More information on the scale can be found at https://www.gem-measures.org/public/DownloadMeasure.
^
Caregivers were allowed to select more than one service. aspx?mid=35In this study, Cronbach α = 0.91.
34 35STUDIES STUDIES
Finding #2
Key Findings
Finding #1 Factors Contributing to High Caregiver Stress
Close to half of caregivers of persons with disabilities experienced caregiver strain, with 4 in 10 being
1 Disability of care recipient is severe
psychologically distressed.
8.2
Strain Index Score (CSI)
More than 6 in 10 felt burdened by the weight of their caregiving duties.
Average Caregiver
6.5
4.8
Petrina is mother to 17-year-old Jayden, who
has Autism Spectrum Disorder. As a freelance
4 in 10 are
psychologically
distressed Mild Moderate Severe/Profound
editor, she home-schools Jayden, and faces Severity of Care Recipient's Disability
many challenges caring for him on a daily basis.
She has had to borrow money from her father
to get by. Jayden is also often aggressive, be
it with her or other people. As a result, she 6 in 10 feel burdened
by caregiving Maybe I was still in a
2 Care recipient is young
7.2
Strain Index Score (CSI)
experiences what she terms as “stress and denial stage, I cannot
Average Caregiver
tension” on a daily basis. 5.9
understand that he 5.7
“I’ve had a stressful episode where my son has this problem
attacked me for about less than one minute.
Do you know what it feels like to be attacked
‘cause he looks so
by somebody bigger than you, someone you normal…that’s 0-6 7-21 Above 21
have been taking care of? He’s grabbing at you,
kicking you…it only happened for less than a
the thing I cannot Age of Care Recipient
minute, but it will take a few days for the scars accept…
to recover. Every time I pick up my shirt or my 3 Presence of chronic illness in either
handbag, it’s going to hurt my back because Caregiver of child with Autism caregiver or care recipient
Strain Index Score (CSI)
of the way he attacked me.” Spectrum Disorder 7.6
Average Caregiver
5.6
No Chronic Either or Both have
Illness Chronic Illness
Presence of Chronic Illness
4 Care recipient has Autism Spectrum
Disorder or intellectual disability
5 Low average household income
6 High education
36 37STUDIES STUDIES
Having a degree did not shield Anne from the struggle
of caring for her son, 7-year-old Cody. She treasures
spending time together with Cody, whether at picnics,
running and biking, or bringing him to parties where While hiring a foreign domestic worker might seem
she frequently tells family and friends about him. helpful, Helen constantly worries about her helper.
However, there was a time when she had high hopes There is perpetual uncertainty on whether she would
for her first son – hopes that were crushed after he stay on the job and be able to care effectively for
was diagnosed with Autism Spectrum Disorder. 16-year-old Cedric, who has special needs. Holding
a full-time job, she is especially concerned that her
“The first year was difficult for me. ‘Cause he helper would leave on short notice, leaving her short-
was my oldest son so when he came I was very handed and with no immediate options to turn to.
idealistic…I want to be a perfect, cool mum…and
then when we found out that he had Autism the “[My previous helper said] mum, I get another new
world crumbled. Within a year, we were so busy employer, staying in a private house, condo, I’m
with therapies and trying to learn everything that sorry to tell you ah, that I would want to transfer
I closed off. I think [that] my coping [period] was there. And [even after] I paid for everything for
one year, after that I came out publicly, talk[ed] her to come…After she (new helper) came in, I
about it on Facebook, Twitter, what have you. I [started to] monitor her even when I’m in office.
advocate for people with disabilities. I fight for But she’s not keen at all to look after special
people who don’t understand…I tell everybody needs children!”
about him, and for me it helped a lot.”
Finding #3 Finding #4
Profile of Caregiver Needing Respite Care Most caregivers were not aware of the term “respite care”, with nearly 6 in 10 not having heard about it.
Participants understood respite care mostly in terms of temporary relief from caring for those in their
02
charge (e.g. babysitting, child care, day care centre).
Higher
income or
education
Those who have encountered the term "respite care" found out
01
about it through social service providers
Has a 03
chronic Employs
illness a foreign
domestic
worker^
Others came to know of it through the media or personal contacts
^
ontrasts with the Singapore Survey on Informal Caregiving (Chan, Ostbye, Malhotra & Hu, 2013), which observed that caregivers of
C
elderly care recipients experienced less stress when receiving help from a foreign domestic helper.
38 39STUDIES STUDIES
Finding #5 Finding #6
Caregivers regarded child safety, affordability and having trained personnel as important in respite Caregivers expressed greatest need for respite care during situations of emergency.
care services.
In general, respite care was perceived as temporary and reactive, rather than constant and preventive.
Components of Respite % of Caregivers Who
Care Services Rated as Important
Child Safety 68%
64% Situations Requiring Respite Care
Affordability 64%
Trained Personnel 55%
64% feel that respite carers should
Convenience/Proximity 33% Change of
be trained/social workers. Have to care
Home Security 32% domestic
worker for another ill
Easy Access to Public Transport 26% 48% dependent
Feature Support Services for Caregivers 24% Crisis situation 72%
Feeling
(e.g. death of
Go on physically
family member) holiday unwell
Caregivers were more in favour of centre-based respite (e.g. day care centres, residential homes) of caregiving 71% 49%
as opposed to informal or home-based care. 81%
Overseas
trip
Acceptance of Types of Respite Care 54% Need a
short break/
Informal 31 69 breathing time
Exhaustion or 65%
Trained worker at 49 51 burnout
your own house
75% Psychologically
Residential Home
overwhelmed
59 41
72%
Day care centre 86 14
0 20 40 60 80 100
% of Caregivers who indicated "Yes"
% of Caregivers who indicated "No" or "Uncertain"
40 41STUDIES STUDIES
STUDY ON Permanent Residents aged 18 to 69 years old to uncover the societal Method Education Level
attitudes towards persons with disabilities. The study was conducted in three No formal Secondary/ Junior Degree/
PUBLIC stages, comprising a quantitative education/ Institute of College/ Postgraduate
ATTITUDES A multidimensional survey sought to understand what members of
the public understood and knew about persons with disabilities. It
survey as well as pre- and post-
survey qualitative components30.
Primary
16.4%
Technical
Education
Polytechnic
21.6%
Degree/
Others
TOWARDS also looked at the level of acceptance and exposure to persons with 36.8% 25.3%
PERSONS WITH disabilities in general and revealed domain-specific perceptions in
key areas such as social interaction, education and employment.
Pre-Survey Qualitative
Five focus group discussions
DISABILITIES and an in-depth discussion were
To better understand the survey findings, focus group discussions were conducted with persons across
Introduction carried out subsequently with persons across all types of disability, to a range of disabilities31. To seek
Individuals live and relate to shed further light on needs and perspectives identified in the survey. the perspectives of caregivers, a
others, and are in turn influenced It also touched on topics such as how they felt the public perceived focus group discussion was held
by them. Invariably, the society them, how they wished to be treated as well as barriers to inclusion. with caregivers of persons with
that a person exists in exercises Autism Spectrum Disorder and Age
a profound impact on the way Down syndrome as well. 18-34 35-49 50-69
that person behaves, thinks and 31.1% 30.9% 38%
feels – whether towards him or The objectives of these
herself, and others. discussions were to understand
the pain points of persons with
A society that looks upon a person disabilities, how the public views
differently for his or her disability them and to guide the formation
has significant bearing on the of the quantitative survey.
affected individual's quality of The See The True Me campaign educates the public on communication tips and support strategies for
life. In the face of a dominant persons with disabilities, and encourages them to see persons with disabilities for who they are and Quantitative Survey
include them in society.
narrative that associates disability To find out what members of the
with challenge, persons with Insights from this study informed strategies for NCSS to work towards public thought about persons
disabilities face everything from building a more inclusive society, such as NCSS' 5-year disability with disabilities, a representative,
casual insensitivities, reduced awareness and public education campaign supported by Tote Board randomised sample of 1,500
career opportunities and even entitled “See The True Me”. Singaporeans was obtained from Ethnicity
cultural aversion. On the contrary, the Department of Statistics32. The Chinese Malay Indian Others
a community that is caring and Research Objectives final sample achieved was 1,400, 74.7% 12.4% 10.4% 2.5%
inclusive towards persons with of which half were surveyed on
disabilities significantly improves • To establish a baseline for the public's perception of, and Autism Spectrum Disorder and
their quality of life, as it provides understanding towards, persons with disabilities sensory impairment, while the
resources necessary for their • To understand the perception of opportunities and other half, on physical impairment
acceptance in society. discrimination towards persons with disabilities in the areas and intellectual disability.33
of education, employment, social interaction and access to
Recognising the importance of services and facilities The survey was done face-to-face
community and society in the • To examine relationships between respondents' demographic and self-administered34. Beyond
disability support ecosystem, characteristics and their attitudes towards persons with demographics such as age and
33 Out of 1,500 contacts. Response Rate = 93.3%.
NCSS conducted a study on disabilities ethnicity, a composite instrument 34 In cases where participants were illiterate, responses were assisted. The “next birthday” method
Singaporean Citizens and was constructed based on of random respondent selection was used to select a member of each household whose birthday
will come up next.
questions from a variety of scales35 35 Scales consulted:
30 Where real stories, accounts or quotes are used, names have been changed for reasons of privacy. and pilot-tested for reliability and Instruments Study
31 Participants had a range of physical and sensory impairments as well as Autism Spectrum Disorder, and acquired them at birth. They were adults who validity (n = 200). Disability Social Distance Scale (DSDS) Tringo (1970)
are home-based and not institutionalised, as they would have ample chance to interact with the general population. Scale of Attitudes Toward Disabled Persons (SADP) Antonak (1982)
32 Randomised sampling was performed on the 50 geographical areas that are equally distributed across Singapore, following which quotas were set by Issues in Disability Scale (IDS) Makas, Finnerty-Fried, Sigafoos & Reiss (1988)
the respective house types within each area. Only Singapore Citizens and Permanent Residents aged 18 to 69 years old were sampled. Multidimensional Attitudinal Scale (MAS) Findler, Vilchinsky & Werner (2007)
42 43STUDIES STUDIES
Key Findings
Finding #1
Respondents were queried on their attitudes, perceptions of, exposure to and knowledge regarding
persons with disabilities. In particular, attitude scores were measured along on three dimensions: Affect,
Behaviour and Cognition36. Public attitudes towards persons with intellectual disability or Autism Spectrum Disorder were less favourable
than those with physical or sensory impairment.
Dimension Description Example
Affective How the individual feels towards persons “I am comfortable with a person who is Attitude Score by Disability Type
with disabilities. with Autism Spectrum Disorder to be my *
supervisor.”
*
Behavioural How the individual acts towards persons “If I were an employer, I would hire
with disabilities. persons who are with physical *
impairment.” *
7
Cognitive How the individual thinks about the role “I think that companies can benefit from
of persons with disabilities. hiring persons with disabilities.” 5.4 5.42
6 5.11 5.25
As a basis for comparison, participants were also asked to respond on the above categories with regard to a control group of persons
^
without disabilities.
5
Attitude Mean Score
In addition, they were asked on
Physical Intellectual Visual
the extent that they would be 4
Impairment Disability Impairment
comfortable relating to a person 40 29 10
with disability, as a measure of 3
social distance (e.g. as speaking Hearing Multiple
acquaintances, close friends or Impairment Disabilities 2
to keep them out of Singapore). 6 3
1
Post-Survey Qualitative
Post-Survey Qualitative Respondent Breakdown Physical Sensory Intellectual Autism Spectrum
To better understand the needs *p < 0.05 Impairment Impairment Disability Disorder
and perspectives of persons with
disabilities, NCSS commissioned a
series of focus group discussions Discussions with persons with disabilities revealed that they felt treated differently because of their disability,
and interviews among persons be it in terms of:
across all types of disability. These
were conducted with the help of
Stereotypes, ver-protectiveness
O Pity, and having
various social service organisations
including Bizlink, MINDS, DPA and
Cheshire Home.
1 judgements and 2 and differential 3 “support” imposed
misconceptions treatment upon them
A total of 88 respondents “…they think (I) cannot “…my mother wouldn’t let “They don’t see us as able
participated in the dialogues, contribute to society…when me do anything by myself, bodied…sometimes the
which helped provide a better they talk to me, they won’t not even wash the dishes, just lecturer will pity…and will
understanding of barriers to talk directly to me but to my because I don’t have an arm.” give good grades.”
the inclusion of persons with sister or parents…but I’m
disabilities as well as potential only physically challenged, – Focus group participant – Focus group participant
solutions in specific domains such not mentally challenged.” with physical impairment with hearing impairment
as employment.
– Focus group participant
In addition, the perspectives of with physical impairment
33 sponsors, partners and other
stakeholders were sought in a 36 A
multi-faceted approach to attitude. The underlying theory sees the construct of attitude in terms of what we feel (Affect), how we behave
half-day workshop. (Behaviour) or how we think (Cognition). (Olson & Zanna, 1993).
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