This chapter reviews literature on intellectual disabilities, care ethics, and leisure. It identifies gaps and discusses how having a sibling with an intellectual disability may impact young women's leisure experiences. The review covers definitions of intellectual disability, needs of those affected, stresses on mothers of children with intellectual disabilities, and historical issues regarding institutionalization and advocacy that led to greater community inclusion and support services today.
Grand Rounds McMaster University Department of Pediatrics, December 2nd, 2021
Olaf Kraus de Camargo, @DevPeds
Rachel Martens, @RaeofSunshine79
Keiko ShikakoThomas, @KeikoShikako
Grand Rounds McMaster University Department of Pediatrics, December 2nd, 2021
Olaf Kraus de Camargo, @DevPeds
Rachel Martens, @RaeofSunshine79
Keiko ShikakoThomas, @KeikoShikako
A HISTORICAL AND CONCEPTUAL OVERVIEW: Using Knowledge and Technology to Impr...IJMSIRJOURNAL
Preliminary, the practical use of knowledge and technology to improve people's quality of life
with disabilities requires understanding the many meanings of disability and quality of life. It
also requires exploring whether rehabilitation services and knowledge utilization can make a
difference in life quality. Understanding the disability constructs helps increase understanding of
the relevance of the prosumer concept for people with disabilities. The knowledge utilization
literature traditionally has focused on scientific knowledge and not intuitive, meditative, or
experiential knowledge. Its emphasis has been on getting research results into practice and only
more recently expanded to include getting exemplary practices more widely known and used.
Because the literature on knowledge utilization is often intermixed with Research on the
scientific knowledge cycle, it is essential to understand what is meant by the scientific knowledge cycle. The discussion that follows leans heavily on the editorial work of Dr. Robert
Rich, past editor of the Knowledge journal, past president of the Society on Knowledge
Accessibility of Public Spaces: Case Study of Ikeja, Lagos State, Nigeriainventionjournals
T: This article is about people with different capabilities. It engages with the theoretical framework of the social model of disability about how disability and ageing issues should be considered. In doing so it pays particular attention to the accessibility of the built environment. Disability will affect the lives of everyone at some point in their life, it is time society change to acknowledge this, with the ageing population and the prevailing increases in the number of the physically disabled people, public building, community design and other environmental barriers must be re-examined. Owing to this basic knowledge that the scholars and newspaper world regards "the aged" and "the disabled" as if they are discrete groups outside the common present thought of the society, it is therefore needed to understand that ageing and disabilities is a stage in life that people will experience at one point or the other of their life. The research work inquiries into the prominent demands for accessible built environment to carter for the population growth of the senior citizen and the disabled people.
“Women are not only victims, they have driving power of changes, exclusive knowledge and skills that have crucial importance for providing solutions and managing risks”.
During the last 10 years 3 400 natural disasters took place in the world – hurricanes, floods earthquakes and other natural calamities. More than 700000 people died, more than 1,4 mln were injured and 23mln lost shelter. In general disaster affected 1,5 bln people and women, children and vulnerable people were most affected.
“Improving margins through better MI”
· Structure the key financial MI to deliver both insight and accountability
· Enable the right person to make the right decision as quickly as possible and as close to market as possible
· Align the MI to the meta level business cycle
· Develop an MI strategy around a pyramid of needs.
A HISTORICAL AND CONCEPTUAL OVERVIEW: Using Knowledge and Technology to Impr...IJMSIRJOURNAL
Preliminary, the practical use of knowledge and technology to improve people's quality of life
with disabilities requires understanding the many meanings of disability and quality of life. It
also requires exploring whether rehabilitation services and knowledge utilization can make a
difference in life quality. Understanding the disability constructs helps increase understanding of
the relevance of the prosumer concept for people with disabilities. The knowledge utilization
literature traditionally has focused on scientific knowledge and not intuitive, meditative, or
experiential knowledge. Its emphasis has been on getting research results into practice and only
more recently expanded to include getting exemplary practices more widely known and used.
Because the literature on knowledge utilization is often intermixed with Research on the
scientific knowledge cycle, it is essential to understand what is meant by the scientific knowledge cycle. The discussion that follows leans heavily on the editorial work of Dr. Robert
Rich, past editor of the Knowledge journal, past president of the Society on Knowledge
Accessibility of Public Spaces: Case Study of Ikeja, Lagos State, Nigeriainventionjournals
T: This article is about people with different capabilities. It engages with the theoretical framework of the social model of disability about how disability and ageing issues should be considered. In doing so it pays particular attention to the accessibility of the built environment. Disability will affect the lives of everyone at some point in their life, it is time society change to acknowledge this, with the ageing population and the prevailing increases in the number of the physically disabled people, public building, community design and other environmental barriers must be re-examined. Owing to this basic knowledge that the scholars and newspaper world regards "the aged" and "the disabled" as if they are discrete groups outside the common present thought of the society, it is therefore needed to understand that ageing and disabilities is a stage in life that people will experience at one point or the other of their life. The research work inquiries into the prominent demands for accessible built environment to carter for the population growth of the senior citizen and the disabled people.
“Women are not only victims, they have driving power of changes, exclusive knowledge and skills that have crucial importance for providing solutions and managing risks”.
During the last 10 years 3 400 natural disasters took place in the world – hurricanes, floods earthquakes and other natural calamities. More than 700000 people died, more than 1,4 mln were injured and 23mln lost shelter. In general disaster affected 1,5 bln people and women, children and vulnerable people were most affected.
“Improving margins through better MI”
· Structure the key financial MI to deliver both insight and accountability
· Enable the right person to make the right decision as quickly as possible and as close to market as possible
· Align the MI to the meta level business cycle
· Develop an MI strategy around a pyramid of needs.
Did you know that we all perform to the level of our self-esteem? Self-confidence and self-esteem play a huge role in almost everything that we do. Whether it’s our business or we have a job. Our health. Our relationships. Because if our self esteem is not good it can really negatively affect virtually every facet of our lives. Think about it. People with high self esteem, seem to find it easier to make friends. They tend to have better relationships. They feel happier. They deal with mistakes and disappointments and failures easier. And they’re more likely to stick with something until they succeed. They don’t give up. And also I’ve heard that people with a high self esteem do take more risks. Self esteem is a choice you can make, stretch it, and then you can turn it into a habit.
ReadySetPresent (Empowerment PowerPoint Presentation Content): 100+ PowerPoint presentation content slides. Increasing empowerment in the workplace increases self-confidence, courage, and strength in each employee. Empowerment PowerPoint Presentation Content slides include topics such as: slides on a leader's role, 7 benefits of empowerment, empowerment in practice, various guidelines, 6 slides on empowered teams, 20+ tips for empowering employees, 9 rules of empowerment, 4 empowerment dimensions, building contracts with employees, 4 keys to assisting integration, 5 slides on building employee contracts, five types of empowerment, skills needed to empower, 7 slides on empowered decision making, 5 types of managerial control, 4 slides on when to empower, how to’s and more!
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Cultural Competence and PovertyExploring Play Therapists’ AOllieShoresna
Cultural Competence and Poverty:
Exploring Play Therapists’ Attitudes
Lauren Chase and Kristie Opiola
Department of Counseling, University of North Carolina at Charlotte
This article reports the findings of a survey that investigated attitudes toward poverty
among play therapists (N � 390) and its relation to demographic information. Multi-
variate analyses of variance (MANOVA) were used to measure the relationship
between play therapists’ demographics and their attitudes toward poverty, specifically
their structural, personal deficiency, and stigma scores. Results indicated that both
region and age resulted in differing views on poverty. Participants living in the
Northeast held stronger structural views of poverty than participants in the South.
Similarly, participants in the 50 –59 and 60 plus age groups disagreed to strongly
disagree with a personal explanation toward poverty than participants in the 30 –39 age
group. The importance of play therapists’ examining their attitudes toward poverty and
the direct impact on their work is discussed. Finally, implications of the results,
including overall findings, are explained.
Keywords: play therapy, attitudes of poverty, cultural competence
Culturally competent training is an element
of credentialing requirements that ensures men-
tal health providers offer adequate and respon-
sive care to diverse populations. Although the
mental health field has embedded cultural com-
petence in their standards and guidelines, there
are discrepancies in the way the profession as-
sesses and measures competence (Sue et al.,
1996). Researchers have investigated attitudes
toward poverty in the helping professions
(Levin & Schwartz-Tayri, 2017; Noone et al.,
2012; van Heerde & Hudson, 2010; & Wit-
tenauer et al., 2015), but no study has focused
on play therapists’ attitudes toward poverty.
The purpose of this study is to fill a gap in the
literature regarding play therapist’s attitudes to-
ward poverty because awareness and knowl-
edge are key elements to implement culturally
responsive services and skills with diverse chil-
dren in a variety of settings.
Cultural Competence
Cultural competence is an important compo-
nent of professional practice, and practitioners
are expected to develop skills and understand-
ing pertaining to diverse clientele. Researchers
define cultural competence as the set of beliefs,
knowledge, and skills mental health providers
possess in order to deliver effective interven-
tions and services to members of various cul-
tures (Gilbert et al., 2007; Sue, 2006). The New
Freedom Commission on Mental Health (2003)
recognized disparities in mental health delivery
and viewed the lack of cultural competence for
minority populations as a persistent problem.
Culturally competent health care is essential to
providing effective care to all populations. To
aid practitioners in their ability to increase their
cultural competence, leading professional men-
tal health associations have published ...
DB FOR DTUDENT HOLLYMany variables exist that could create a vulLinaCovington707
DB FOR DTUDENT HOLLY
Many variables exist that could create a vulnerable population. Vulnerable populations are subsets of people from the larger community who experience disparities in health and healthcare due to racial, ethnic, economic, and chronic health conditions (Joszt, 2020). Additionally, social issues such as disability, homelessness, geographical location, sexual orientation, extreme youth, and older age are all factors that create sensitivity towards healthcare disparity (Joszt, 2020). Being part of a vulnerable population can mean many things, but it can also mean that one is part of a group that faces discrimination and reduced access to care in healthcare.
One thing a public health nurse could do to serve vulnerable populations better is to seek out federal grants that would assist in providing the needed care (grants.gov). To better serve these populations, public health nurses should first educate themselves about the available services for those populations; that way, they can inform others. One of the more significant barriers vulnerable populations face in receiving adequate healthcare is their economic status. The working poor and the uninsured often delay or neglect seeking medical care entirely (Duquesne University, 2020). Replacing the existing economic model with one that facilitates care for those that aren’t financially able to cover the costs would ultimately lead to improved health and the enhanced ability of those from vulnerable populations to return to work.
I think the vulnerable populations of the United States could be better served by being given preventative education, awarded grants that would enable the facilitation of care, and receive improved medical coverage. These three actions could theoretically place those from vulnerable populations in a position to rise above that status and live healthier lives.
DB FOR STUDENT BUKOLA
Vulnerable Populations
The vulnerable populations refer to the individuals having a higher likelihood of facing difficulties as far as health statuses are concerned; they have limited access to resources to take care of themselves compared to other members of the society. Generally, the low resilience of the vulnerable populations to health risks is exacerbated by poverty and the limited access to social, physical, and environmental resources that they require to enjoy the same level of quality of life as other demographics in the society (Palley, 2016). Additionally, vulnerable populations such as teen mothers and migrant workers are more susceptible to various health risks because of their low levels of education, illiteracy, and low-level skills. These factors prevent them from gaining access to the economic opportunities and income necessary to maintain health and well-being. The literature has also discovered that one of the reasons for the high sensitivity of the vulnerable population to health risks is their separation from core elements of society, such as the high r ...
Supporting Students With Emotional Disabilities: What Evrery Counselor Needs ...William Kritsonis
Supporting Students With Emotional Disabilities: What Evrery Counselor Needs to Know by Drs. Hott, Thomas, Abbassi, Hendricks, Aslina - NATIONAL FORUM JOURNAL OF COUNSELING AND ADDICTION, 3(1) 2014 - NATIONAL FORUM JOURNALS (Founded 1982) Dr. William Allan Kritsonis, Editor-in-Chief
1. Chapter 2: Literature Review
The following chapter will review existing literature that explores intellectual disabilities,
ethic of care, and leisure. These sections will each be broken into subsections that further
describe how these topics relate to the purpose of this research study. Gaps within the existing
research will be identified within each section. This section will provide insight to how young
women’s leisure experiences and meanings may be impacted as a result of having a sibling
whom is diagnosed with an intellectual disability.
Intellectual Disability
A person who is intellectually disabled is reported to have an IQ level of below 70,
difficulty with abstract thinking and problem solving, and trouble performing basic daily tasks
independently (Coon & Mitterer, 2010). There are varying types of intellectual disabilities and
the extremity of the intellectual disability depends on the diagnosis of the disability and the
environment in which the person lives (Chambers, 2007; Coon & Mitterer, 2010). Intellectual
disabilities have many different causes. Coon and Mitterer (2010) state that about fifty percent of
all intellectual disabilities are related to physical disorders or are as a result of natural processes
such as fetal damage, metabolic disorders, birth injuries, genetic abnormalities, malnutrition, or
exposure to toxins at a young age. Some individuals may not have any biological reasoning for
their disability at all; the disability could simply be a result of a poor living environment (Coon
& Mitterer, 2010).
Some individuals diagnosed with an intellectual disability may also have accompanying
physical characteristics such as individuals diagnosed with Down syndrome (Aksoy & Yildirim.
2008). Hames (2005) found that the behaviours of individuals who have a visible disability as
well as an intellectual disability were generally more understood and accepted in society. If
people can visibly see that a person has a disability they are more likely to understand why a
2. Chapter 2: Literature Review
person is behaving in a socially unacceptable manner (Aksoy & Yildirim, 2008; Hames, 2005).
Individuals diagnosed with intellectual disabilities that have no accompanying physical features,
such as ADHD, are harder for society members to view as disabled. As a result any socially
unacceptable behaviour associated with the individual may be open to public ridicule because the
disability is not physically visible (Aksoy & Yildirim, 2008; Hames, 2005).
The needs of people who are intellectually disabled vary depending on the severity and
diagnosis of the individual person’s disability (Coon & Mitterer, 2010). General needs of persons
with an intellectual disability vary depending on the severity of their disability (Coon & Mitterer,
2010). Individuals whom are diagnosed with an intellectual disability may encounter social
barriers (Bigby, 1997). Some individuals need assistance with networking, advocating their
rights, engaging in conversation and knowing what is and is not appropriate social
etiquette/mannerisms (Bigby, 1997; Coon & Mitterer, 2010; Mactavish, MacKay, Iwasaki, &
Betteridge, 2007). This assistance may help eliminate potential social barriers for this population
(Bigby, 1997; Coon & Mitterer, 2010). Other individuals may face different barriers related to
lack of knowledge, lack of ability, lack of access, lack of finances, lack of skill, and lack of trust
(Bigby, 1997; Mactavish, MacKay, Iwasaki, & Betteridge, 2007). These individuals may need
assistance with personal care, decision making, financial management, budgeting, finding
employment, medical administration, education on their rights, accessing trust worthy respite
services and programs, transportation, time management, and menu-planning (Bigby, 1997;
Coon & Mitterer, 2010; Mactavish, MacKay, Iwasaki, & Betteridge, 2007).
Mother’s are often the parental figure that is responsible for meeting their child’s needs
regardless if they have an intellectual disability or not (Greenberg, Seltzer, & Greenley, 1993;
Heller, Caldwell, & Factor, 2007; Trussell & Shaw, 2007). According to Heller, Caldwell, and
3. Chapter 2: Literature Review
Factor (2007) fathers spend less time providing care for their child whom has an intellectual
disability; in turn this limits their participation in supporting their child’s needs.
Mothers of a Child with an Intellectual Disability
Heller, Caldwell, and Factor (2007) determined that a mother of a child with an intellectual
disability experiences more stress as a result of her child’s additional needs when compared to
mothers of children without disabilities. Mothers who support a child with a disability are more
prone to develop health problems, such as depression, as a result of stress due to care giving
responsibilities (Heller, Caldwell, & Factor, 2007).
Four sources of stress that may impact a mother’s perceived gratification and stress of
providing care for their child whom is diagnosed with an intellectual disability are (1) external
burdens out of the mother’s control such as finances, “(2) the child’s problematic behaviours, (3)
the mother’s other, if any, care giving responsibilities, and (4) the mother’s declining health
(Greenberg, Seltzer, & Greenley 1993, p.545)”. Additional studies suggest that sufficient access
to good quality respite services, education and training for providing care to a child with a
disability, family support and social networks, the visibility of their child’s disability, the degree
of their child’s disability, as well as the amount of external access to funding impacts the
mothers gratifications and stressors associated with their care giving role (Hames, 2005;
Mactavish, MacKay, Iwasaki, & Betteridge, 2007; Mactavish & Schleien, 2004; Nankervis,
Rosewarne, & Vassos, 2011).
Nankervis, Rosewarne, and Vassos’s (2011) found that care providers cited the importance of
social networks, social support, and respite services as factors that reduced stress associated with
care giving responsibilities. These three forms of support reduced parents’ feelings of stress by
providing them with opportunities to share their child’s care with other people (Greenberg, J.,
4. Chapter 2: Literature Review
Seltzer, M., & Greenley, 1993; Heller, Caldwell, & Factor, 2007; Nankervis, Rosewarne, &
Vassos, 2011). In turn, this relieved them of some their caregiver responsibility (Greenberg, J.,
Seltzer, M., & Greenley, 1993; Heller, Caldwell, & Factor, 2007; Nankervis, Rosewarne, &
Vassos, 2011).
Respite services and strong social support networks are not always accessible as a result of
limited resources such as funding, adequate programming, social support, and well trained and
educated professionals (Emira & Thompson, 2011). This is a cause of concern for mothers of
children with an intellectual disability in relation to the future wellbeing and care provision of
their child. This is especially problematic as mother’s themselves are aging and experiencing
poor health (Greenberg, Seltzer, & Greenley,1993; Heller, Caldwell, & Factor, 2007).
Future Planning
During the early to mid-nineties, children diagnosed with a disability were
institutionalized at a young age and were not given the same social rights as non-disabled
individuals (Mactavish & Schleien, 1998; Nankervis, Rosewarne, & Vassos, 2011). Individuals
with disabilities were not valued members of society during this time period (Mactavish &
Schleien, 1998; Nankervis, Rosewarne, & Vassos, 2011). Being institutionalized at a young age
limited the social experiences persons with disabilities played within their communities
(Mactavish & Schleien, 1998; Nankervis, Rosewarne, & Vassos, 2011). This lack of inclusion
further limited a sense of belonging individuals diagnosed with a disability felt within their local
community (Mactavish & Schleien, 1998; Nankervis, Rosewarne, & Vassos, 2011). The
devaluation of persons diagnosed with a disability gained public recognition and people have
since gathered to advocate for their rights (Mactavish & Schleien, 1998; Nankervis, Rosewarne,
& Vassos, 2011). As a result of the public advocacy, institutions closed and began living at home
5. Chapter 2: Literature Review
with their families (Bigby, 1997; Greenberg, Seltzer, & Greenley, 1993; Heller, Caldwell, &
Factor, 2007; Mactavish & Schleien, 1998; Nankervis, Rosewarne, & Vassos, 2011).
Upon the elimination of institutions, individuals diagnosed with disabilities started living
longer, healthier lives (Nankervis, Rosewarne, & Vassos, 2011). Public advocates, mostly
family of the individual or close family friends, defended the rights of persons with disabilities
and demanded that they had equal opportunity to actively engage within their local communities
(Heller, Caldwell, & Factor, 2007; Mactavish & Schleien, 1998; Nankervis, Rosewarne, &
Vassos, 2011). As a result of public advocates, the general public began to recognize that
individuals with disabilities were equal members of society (Heller, Caldwell, & Factor, 2007;
Nankervis, Rosewarne, & Vassos, 2011). This realization led to the acceptance of persons with
disabilities into their local communities and access to the human rights they were entitled to
(Heller, Caldwell, & Factor, 2007; Nankervis, Rosewarne, & Vassos, 2011). This elevated level
of public acceptance allowed more opportunities for persons with disabilities to access programs
and health care/provision within their local communities (Nankervis, Rosewarne, & Vassos,
2011). These programs and health resources helped extend the lives of persons with disabilities
and aided them in enhancing their quality of life (Heller, Caldwell, & Factor, 2007; Mactavish &
Schleien, 1998; Nankervis, Rosewarne, & Vassos, 2011). For example, in institutions there was
little stimulation and persons with disabilities had minimal access to recreation activities (Heller,
Caldwell, & Factor, 2007; Nankervis, Rosewarne, & Vassos, 2011). When institutions were
closed individuals entered their local communities were several recreation activities were made
available to them (Heller, Caldwell, & Factor, 2007; Nankervis, Rosewarne, & Vassos, 2011;
Payne, Ainsworth, & Godbey, 2010). Participation in these recreation activities ultimately led to
skill development and opportunities for individuals to enhance their quality of life, overall
6. Chapter 2: Literature Review
health, and well-being (Payne, Ainsworth, & Godbey, 2010). Particularly, with individuals
physical and emotional health as they became accepted and active members of their local
communities (Heller, Caldwell, & Factor, 2007; Nankervis, Rosewarne, & Vassos, 2011; Payne,
Ainsworth, & Godbey, 2010).
Majority of individuals diagnosed with a disability will live at home with their families
well into their late adulthood (approximately seventy-five percent) (Heller, Caldwell, & Factor,
2007). Parents, as a result are now providing care for their children that are diagnosed with an
intellectually disability from home; well into their child’s late adulthood (Mactavish & Schleien,
1998; Nankervis, Rosewarne, & Vassos, 2011). Parents struggle to meet the demands of their
child’s needs as a result of their disability especially as they themselves begin to age (Greenberg,
Seltzer, & Greenley, 1993; Heller, Caldwell, & Factor, 2007; Mactavish & Schleien, 1998;
Nankervis, Rosewarne, & Vassos, 2011). Aging parents may experience health problems of
their own that limit their ability to provide care to their adult child diagnosed with an intellectual
disability (Heller, Caldwell, & Factor, 2007).
The heightened stress about the future wellbeing of their adult child is particularly
evident with mothers (Greensberg, Seltzer, & Greenly, 1993). They are concerned about who
will provide care to their child when they are no longer able meet their child’s needs as a result
of their own declining health (Greensberg, Seltzer, & Greenly; 1993; Mactavish & Schleien,
1998; Nankervis, Rosewarne, & Vassos, 2011). In current research, it has been determined that
siblings are most likely to continue the care their siblings require when their parents are no
longer able to do so (Aksoy & Yildirim, 2008; Arnorld, Heller, & Kramer, 2012; Bigby, 1997;
Heller & Arnorld, 2010; Heller, Caldwell, & Factor, 2007; Mactavish & Schleien, 1998;
Nankervis, Rosewarne, & Vassos, 2011; Orsmond & Seltzer, 2000).
7. Chapter 2: Literature Review
Siblings
Moyson and Roeyers (2012) studied the quality of life of children whom had a sibling
diagnosed with an intellectual disability and identified nine domains of quality of life. The nine
domains included: joint activities, mutual understanding, private time, acceptance, forbearance,
trust in their well-being, exchanging experiences, social support, and dealing with the outside
world (Moyson & Roeyers, 2012). The children stated that they enjoyed spending time with and
caring for their sibling, but they also desired time to be away from their sibling (Moyson &
Roeyers, 2012). This time away from their sibling was an opportunity for them to be a child
without the responsibility of being a sibling caring for their brother/sister diagnosed with an
intellectual disability (Moyson & Roeyers, 2012). Moyson and Roeyers (2012) found that
children wanted to see their siblings succeed and were concerned about their sibling’s future.
Arnold, Heller, and Kramer (2012) discovered that non-disabled children want to be
incorporated in their sibling’s, whom is diagnosed with a disability, life and future plans.
Existing studies have found that children who are not diagnosed with a disability often assist
their parents with the care of their sibling when their parents can no longer meet their siblings
needs (Aksoy & Yildirim, 2008; Arnorld, Heller, & Kramer, 2012; Bigby, 1997; Heller &
Arnorld, 2010; Heller, Caldwell, & Factor, 2007; Mactavish & Schleien, 1998; Nankervis,
Rosewarne, & Vassos, 2011; Orsmond & Seltzer, 2000). However, knowledge in regards to the
extent that children want to be involved in their siblings lives is unknown (Moyson & Roeyers,
2013). Existing research has focused solely on the parental perspective and how parents perceive
their children’s feelings and thoughts (Chambers, 2007; Moyson & Roeyers, 2012). This method
of data collection has left the perspective of the non-disabled children, within the family context,
without a voice in the research process (Aksoy & Yildirim, 2008; Bigby, 1997; Chambers, 2007;
8. Chapter 2: Literature Review
Heller & Arnold, 2010; Moyson & Roeyers, 2012). As a result, the child’s perspective of
growing up with a sibling whom is diagnosed with an intellectual disability is a gap within the
majority of existing research (Arnorld, Heller, & Kramer, 2012; Bigby, 1997; Heller & Arnorld,
2010; Heller, Caldwell, & Factor, 2007; Mactavish & Schleien, 1998; Nankervis, Rosewarne, &
Vassos, 2011; Orsmond & Seltzer, 2000). Particularly, in regards to how having a sibling with a
disability has impact the child’s life and the child’s willingness to be involved in their siblings
future plans (Heller & Arnold, 2010; Heller, Caldwell, & Factor, 2007; Orsmond & Seltzer,
2000). It may benefit children, whom have a sibling with an intellectual disability, to incorporate
them in the future planning of their siblings lives to fully prepare them for their future roles as
care providers (Bigby, 1997; Chambers, 2007; Heller & Arnold, 2010; Moyson & Roeyers,
2012). As well, including non-disabled children into future studies would provide researchers
with another valuable perspective of the demands and support children diagnosed with
intellectual disabilities require (Orsmond & Seltzer, 2000).
Ethic of Care
Men and Women encounter countless gender stereotypes on a daily basis which shape the
roles they play within society (Parry, 2007; Henderson et al., 1996). Parry (2007) refers to
gender as a “social construction....that humans produce and reproduce in their social interactions
as opposed to it being biologically determined, as sex is (p.142)”. If a person’s sex is female it is
expected, by society, that this person will portray feminine qualities and have a feminine role
within society (Henderson et al., 1996). That is, women are expected to demonstrate certain roles
and qualities within society that the patriarchal system has defined as feminine (Henderson et al.,
1996). Qualities such as; passiveness, gentleness, becoming a wife, sustaining the home,
nurturing her husband and children, obedience, frailty, being pretty, and bearing children are
9. Chapter 2: Literature Review
deemed to be essential to the construction of femininity (Henderson et al, 1996). All of these
feminine roles incorporate an aspect of providing care, meeting the needs of others, and
submissiveness. If females portray these qualities and roles they are praised for their behaviour
(Henderson et al., 1996). If women demonstrate behaviour that is not depicted as feminine by
society they may be publicly ridiculed for resisting gendered social norms (Parry, 2007).
Gilligan’s concept of ethic of care impacts women’s moral development which begins
they enter adolescents (Coon & Mitterer, 2010; Witt & Caldwell, 2005). Ethic of care explains a
female’s moral obligation to meet the needs of others prior to meeting her own needs (Henderson
et al., 1996; Jordan, 2007; Parry, 2007). Consequently, women are often limited in the time they
have to meet their own needs. For example, Trussell and Shaw (2007) found that women often
felt “constrained by their ethic of care” (p. 143). Mothers would often ignore their own needs
completely to facilitate the needs of her family (Shaw & Shannon, 2008; Trussell & Shaw,
2007). In turn, women may feel guilty if they take time to meet their own needs and may ignore
them entirely as they prioritize to meet the needs of their family prior to their own needs
(Henderson et al., 1996; Jordan, 2007; Parry, 2007; Shaw & Shannon, 2008; Trussell & Shaw,
2007).
Young Women and Ethic of Care
A person’s sex is often mistaken as an identifier of what gender characteristics the person
will portray in their daily lives (Perry-Burney & Takyi, 2002; Shannon & Shaw 2008). People
begin acquiring knowledge about the social roles and behaviours they are expected to
demonstrate, based on their sex, at a young age (Coon & Mitterer, 2010; Perry-Burney & Takyi,
2002; Witt & Caldwell, 2005). During the stage of adolescent development individuals mature
and begin forming their opinions of what is right and wrong based on their personal values
10. Chapter 2: Literature Review
(Coon & Mitterer, 2010; Jordan, 2007; Perry-Burney & Takyi, 2002). At the conventional stage
of development adolescent girls are more likely to base their moral decisions on the basis of
appeasing others, the input of a person of authority, their personal values, and societal laws/rules
(Coon & Mitterer, 2010; Witt & Caldwell, 2005).
Social media, peers, family, and daily interaction all play a role in how a young woman
perceives and understands gender (Witt & Caldwell, 2005). In our patriarchal society individuals
begin understanding the concept of gender appropriateness as young as eighteen months (Serbin,
Connor, Burchardt, & Citron, 1979). In particular, young women specifically are constrained by
an ethic of care and are encouraged to present themselves in a feminine manner (Henderson et
al., 1996; Parry, 2007; Perry-Burney, & Takyi, 2002). Prior to late adolescence, parents play
have a significant role in shaping their daughter’s moral development and gender identity (Coon
& Mitterer, 2010; Witt & Caldwell, 2005). Positive, actively engaged, supportive, and
authoritarian parents are essential for the future health and well-being of their child (Witt &
Caldwell, 2005). Youth rely on their parents for guidance, mental and physical support,
education, care provision, and role modeling (Perry-Burney & Takyi, 2002; Witt and Caldwell,
2005).
Coon and Mitterer (2010) and Jordan (2007) discuss Gilligan’s concept of ethic of care
and how it impacts women in relation to their moral development. Gilligan found that women
are more likely to make their moral decisions based on appeasing others so they can maintain
healthy relationships and stay connected to people that they care about (Jordan, 2007; Witt and
Caldwell, 2005). Shannon and Shaw (2008) found that young women viewed their mothers as
role models during their adolescents. Young women learned valuable lessons from their mothers
in regards to leisure participation and their social roles (Shannon & Shaw, 2008). Shannon and
11. Chapter 2: Literature Review
Shaw (2008) discovered that mothers of young women encouraged their daughters to partake in
various leisure pursuits. They also discovered that mothers enjoyed providing their daughters
with a variety of different opportunities so that their daughters could enhance their skills
(Shannon & Shaw, 2008). While mothers organized their daughters leisure schedules they failed
to organize their own leisure lifestyles (Shannon & Shaw, 2008). In doing so, mothers ignored
their own leisure needs and interests to provide their daughters with more leisure opportunities
(Shannon & Shaw, 2008).
When mothers would ignore their own leisure needs to put the needs of their daughters
first they unknowingly taught their daughters that this was an acceptable parental responsibility
(Shannon & Shaw, 2008). Young women observed their mother’s lack of leisure participation
while their mothers facilitated and organized family leisure pursuits (Shannon & Shaw, 2008).
Shannon and Shaw (2008) found that when these young women became mothers they abandoned
their own leisure interests to put the leisure interests of their family before their own. In turn,
these young women modeled the observed behaviour their mothers unknowingly taught them
when they became mothers themselves (Shannon & Shaw, 2008). The concept of mother’s
modeling behaviours to their daughters appears to be a cycle that continues from one generation
to the next when young women become mother’s themselves (Shannon & Shaw, 2008).
A young woman may whom has a sibling that is diagnosed with an intellectual disability
may begin modeling her mother’s behaviour prior to becoming a mother herself (Shannon &
Shaw, 2008). Young woman may feel obligated to assist her mother with her siblings care
(Moyson & Roeyers, 2012; Orsmond, & Seltzer, 2000; Shannon & Shaw, 2008). Young women
may begin performing ‘motherly duties’ (when aiding their mothers with their siblings care)
prior to becoming mothers themselves. A young woman may feel obligated to provide their
12. Chapter 2: Literature Review
sibling with care as a result of their mother’s modeled behaviour and their own ethic of care
(Moyson & Roeyers, 2012; Shannon & Shaw, 2008).
Young Women, Ethic of Care, and a Sibling Diagnosed with an Intellectual Disability
Heller and Arnold (2010) found that individuals that have a sibling with an intellectual
disability felt they were well educated about the additional needs their sibling. Individuals
expressed having a good relationship with their sibling, but were frustrated at times with their
siblings unpredictable behaviour associated with their disability (Moyson & Royers, 2011).
Heller and Arnold’s (2010) also found that female siblings were more willing to provide care for
their sibling with a disability; especially once their parents were declining in health or deceased.
Consequently, children with a sibling that is diagnosed with an intellectual disability
often internalize their own distress instead of sharing it with their parents (Giallo et al., 2011).
As they do not want to further burden their parents by demanding their time and energy (Askoy
& Yildirim, 2008; Giallo et al., 2011; Hames, 2005; Moyson & Royers, 2011). Children are well
aware of the stress and additional care their parents provide their sibling whom is diagnosed with
a disability (Giallo et al., 2011). Children that internalize their own distress may be seen as
prioritizing the needs of their sibling over their own; demonstrating an ethic of care towards their
sibling (Giallo et al., 2011). This may be particularly evident for siblings who are young women.
Young women may feel obligated to help their parents support the needs of their sibling
as a result of societal expectations, their ethic of care, and learned behaviour modeled by their
own mothers (Shannon & Shaw, 2008). The young women guilty engaging in activities that do
not include their sibling diagnosed with a disability (Henderson et al., 1996; Moyson & Roeyers,
2011). As a result, young women may have limited access to their own unobligated time due to
time spent assisting their parents in providing care for their sibling (Parry, 2007; Jordan, 2007;
13. Chapter 2: Literature Review
Moyson & Roeyers, 2011). In particular, this may impact young women’s access to their own
leisure time.
Leisure
Young women who do not have access to their own time separate from other life
obligations may not be able to engage in meaningful leisure activities (Jordan, 2007). Trenberth
(2005) defines leisure as “free or unobligated time (p.2)”. Jordan (2007) expands on this
definition stating that leisure is an activity not associated with work that an individual voluntarily
chooses to partake in based on their own personal interests. If individuals enroll in self-chosen
leisure pursuits that meet their skills level and challenge them to improve their skills then they
are more likely to experience the benefits leisure participation can provide them with
(Abuhamdeh & Csikszentmihalyi, 2011; Jordan, 2007; Payne, Ainsworth, & Godbey, 2010).
Leisure pursuits have the potential to reduce stress, strengthen relationships, develop
individuals’ skills, opportunities to learn life skills, and increase overall health and well-being
(Mactavish & Schleien, 2004; Payne, Ainsworth, & Godbey, 2010). However, barriers exist in
accessing leisure experiences can be a source of stress for some people that face these barriers
(Witt & Caldwell, 2010). Barriers include: limited accessibly to: funding, social networks,
transportation, respite services, leisure facilities, adequate programs and staff, time, social
stereotypes, social stigmas, and ability (Jordan, 2007; Payne, Ainsworth, & Godbey, 2010; Witt
& Caldwell, 2010). Leisure can be a source of stress reduction and stress creation depending on
the accessibility of the activity and the level of interest the individual has to willingly engage in
the activity (Abuhamdeh & Csikszentmihalyi, 2011).
Women and Leisure
14. Chapter 2: Literature Review
Young women who pursue self-chosen leisure activities are more likely to have healthier
lives and rank their quality of life higher than those that do not (Mactavish, MacKay, Iwasaki, &
Betteridege, 2007; Trenberth, 2005). However, many factors are associated with the limited time
women spend dedicate to self-chosen leisure pursuits. Living in a patriarchal society hinders
women’s leisure involvement (Henderson et al., 1996). Women are only supposed to engage in
activities that society depicts as feminine (Henderson et al., 1996 & Parry, 2007). If women
partake in activities that are deemed as masculine they are subjected to public ridicule and
viewed as resisting social norms (Henderson et al., 1996). Women are further constrained in
accessing leisure by obligations and responsibilities of providing care for their families
(Henderson et al., 1996; Parry, 2007; Trussell & Shaw, 2007).
According to Trussell and Shaw (2007) mothers are more likely to facilitate family
leisure than fathers. In the traditional family, father’s are more likely to be the breadwinners of
the family as their primary role to support their family economically (Heller, Caldwell, & Factor,
2007; Trussell & Shaw, 2007). In fulfilling this role many mothers abandon their leisure
interests they had prior to bearing children (Trussell & Shaw, 2007; Shannon & Shaw, 2008).
Parry (2007) stated that women do not feel obligated to their own leisure time and they often feel
guilty facilitating their own leisure lifestyles (Shannon & Shaw, 2008). Women are dedicated to
providing opportunities for their children and family to partake in leisure experiences together
(Parry, 2007; Shannon & Shaw, 2008). As a result, mothers feel guilty facilitating their own
leisure lifestyles when they could be facilitating the leisure lifestyles of their families (Parry,
2007; Shannon & Shaw, 2008).
A daughter that observes her mother’s dedication to facilitating family leisure may also
abandon their individual leisure needs to assist her mother in meeting the leisure needs of the
15. Chapter 2: Literature Review
family (Shannon & Shaw, 2008). Shannon and Shaw (2008) found that daughters observed their
mother’s limited leisure lifestyles and accepted that once becoming a mother themselves they too
would abandon their leisure interests to facilitate the leisure interests of their families. Indeed,
many mothers encouraged their daughters to actively engage in leisure pursuits, but failed to
demonstrate this concept due to their own individual leisure lifestyles (Shannon & Shaw, 2008).
Family Leisure
Parents described family leisure as an opportunity to escape the normal routine,
strengthen family bonds, an opportunity for skill development, to reduce stress, to recuperate,
positive influences on mental and physical health, creations of lifelong memories, and enhanced
overall quality of life (Mactavish, MacKay, Iwasaki, & Betteridge, 2007; Mactavish & Schlein,
1998; Mactavish & Schleien, 2004; Shannon & Shaw, 2008; Trenberth, 2005; Trussell & Shaw,
2007). Parents enjoyed providing their children with opportunities to partake in various leisure
opportunities, but most family leisure pursuits are designed to benefit the children; not the
parents (Emira & Thompson, 2011; Mactavish & Schleien, 2004; Shannon & Shaw, 2008).
Mactavish and Schleien (2004) found that families had trouble organizing everyone’s
individual schedules in order to plan family leisure activities. Parents have also voiced their
concern about finding leisure activities that were accessible to all family members and met
everyone’s interests and needs (Mactavish & Schleien, 1998; Mactavish & Schleien, 2004,
Trussell & Shaw, 2007).
Family Leisure and the Needs of a Child Diagnosed with an Intellectual Disability
Planning family leisure is often a tedious task for parents and particularly for mothers
who maintain the bulk of emotional and physical work (Mactavish & Schleien, 1998; Mactavish
& Schleien, 2004Trussell & Shaw, 2007). This may be particularly heightened for parents of a
16. Chapter 2: Literature Review
child with an intellectual disability as they must endure experience additional pre-planning and
organization (Emira & Thompson, 2011; Mactavish, MacKay, Iwasaki, & Betteridge, 2007;
Mactavish & Schleien, 1998; Mactavish & Schleien, 2004). Moreover they may experience
additional barriers in accessing leisure opportunities for their families (Emira & Thompson,
2011). Barriers such as: finding trustworthy knowledgeable staff, additional pre-planning,
locating credible programs, accessing adequate leisure programming, facilities that offer
adaptable equipment, accessible facilities, accessing funding to support their child’s assistive
equipment, social acceptance, and their own child’s unpredictability as a result of their
intellectual disability (Arnold, Heller, & Kramer, 2012; Emira & Thompson, 2011; Mactavish &
Schleien, 1998; Mactavish & Schleien, 2004, Moyson & Roeyers, 2012; Nankervis, Rosewarne,
& Vassos, 2011).
Mactavish, MacKay, Iwasaki, and Betteridge (2007) found that despite barriers
associated with planning family leisure that incorporates a child with a disability, parents view
family leisure pursuits to be beneficial for the family as a whole. Benefits associated with
engaging family leisure participation specifically for a child diagnosed with an intellectual
disability includes opportunities for family bonding, skill development, one on one assistance,
peer support, social engagement, feeling of social acceptance, increased overall health and well-
being family memories, and enhanced feelings of a good quality of life (Arnold, Heller, &
Kramer, 2012; Mactavish & Schleien, 1998; Mactavish & Schleien, 2004, Moyson & Roeyers,
2012; Nankervis, Rosewarne, & Vassos, 2011).
However, parents recognize that the additional needs of their child whom has an
intellectual disability complicates their ability to plan family leisure pursuits. Parents felt guilty
spending more one on one time with their child whom has an intellectual disability and recognize
17. Chapter 2: Literature Review
that their other, nondisabled, children may not be receive the attention they deserve (Mactavish
& Schleien, 1998). Mactavish and Schleien (2004) argued that parents felt their children without
a disability have more opportunities for social engagement and skill development within society
than their children diagnosed with an intellectual disability. Limited opportunities for
participation for their children with an intellectual disability left parents feeling obligated to
spend more time supporting their child’s individual needs (Mactavish, MacKay, Iwasaki, &
Betteridge, 2007). Mactavish and Shleien (2004) found that parents hoped providing one on one
support to their child diagnosed with an intellectual disability would help their child learn skills
that they could apply to other aspects of their lives. Thus providing their child with additional
support may impact the overall quality of their family’s leisure experiences by enhancing the
leisure experience of their child whom has an intellectual disability (Mactavish & Schleien,
1998; Mactavish & Schleien, 2004).
In summary, an intellectual disability is a result of a person’s IQ being lower than 70 and
their inability to perform adaptive behaviour tasks (Coon & Mitterer, 2010). People diagnosed
with an intellectual disability do not have a set amount of needs, but there are some general
needs that they require in addition to the needs that a person without a disability require (Bigby,
1997; Mactavish, MacKay, Iwasaki, & Betteridge, 2007). If a person has physical features that
assist a person in determining that they have an intellectual disability then that person’s
behaviour is more likely to be accepted by the public (Aksoy & Yildirim. 2008; Hames, 2005).
A person that has no visible physical features of their disability is more susceptible to public
ridicule due to no physical indicators that they have an intellectual disability (Aksoy & Yildirim,
2008; Hames, 2005).
18. Chapter 2: Literature Review
Mothers of a person diagnosed with an intellectual disabilities may experience stress
trying to meet the needs of her child whom has intellectual disabilities as well as the needs of the
rest of their family. A source of stress for aging mothers is the future planning of her child
diagnosed with an intellectual disability (Heller, Calwell, & Factor, 2007). As the mother ages
she may acquire her on health problems which hinder the level of support and care she can offer
her child who has an intellectual disability (Heller, Calwell, & Factor, 2007). There are many
gratifications and stress associated with being a mother of a child with an intellectual disability
(Greenberg, Seltzer, & Greenley, 1993). External forms of respite and social support will
minimize a mother’s stress level, but adequate forms of these supports are not always accessible.
As a result mothers may turn to their own social networks to seek assistance in caring for her
child that is intellectually disabled (Nankervis, Rosewarne, &Vassos, 2011). One source she may
access within her own social network is that of one of her non-disabled children/child
(Greenberg, Seltzer, & Greenley, 1993; Heller, Caldwell, & Factor, 2007). However, there is a
limited amount of research identifying how siblings are incorporated in the future planning
process in regards to their sibling’s future care. Current research has stated that parents and
service providers have failed to incorporate siblings of a person with an intellectual disability in
the future planning process of their sibling; despite the fact that they represent a huge portion of
the person diagnosed with an intellectual disability’s social network (Arnorld, Heller, & Kramer,
2012; Bigby, 1997; Heller & Arnorld, 2010; Heller, Caldwell, & Factor, 2007; Mactavish &
Schleien, 1998; Nankervis, Rosewarne, & Vassos, 2011; Orsmond & Seltzer, 2000).
Women often feel constrained to their ethic of care and mothers often unintentionally
model gendered stereotypes to their daughters and teach them to reproduce patriarchal
determined gender roles (Henderson et al.,1996; Parry, 2007; Shannon & Shaw, 2008). As a
19. Chapter 2: Literature Review
result, daughters themselves model feminine gender roles which further constrict them to their
moral ethic of care (Shannon & Shaw, 2008). Females put the needs of others before their own
because they value the relationships they have with others and feel obligated to nourish those
relationships; especially within a family context (Coon & Mitterer, 2010; Parry, 2007).
Women do not feel entitled to their own leisure pursuits once they become mothers or
accept a role as care provider (Henderson et al., 1996; Parry, 2007). Young women that have a
sibling diagnosed with an intellectual disability may take on role as caregiver for their sibling to
help reduce their parents stress associated with their sibling’s behaviours and additional needs.
However, there is a limited amount of research that incorporates the sibling’s perspective of
having a sibling with an intellectual disability. Most of the existing research is from the parent’s
perspective and the parents speak on behalf of their non-disabled child (Hames, 2005).
However, some parents may be unaware of their children’s perspective of what it is like to have
a sibling with a disability as a result of children internalizing their own distress because their
parents are pre-occupied with meeting the needs of their child diagnosed with an intellectual
disability (Giallo et al., 2011). More research needs to be completed from the sibling’s
perspective of what impact having a sibling has on their lives to further understand how children
with a sibling with a disability lives are impacted as a result of having a sibling with a disability.
Giallo et al. (2012) determined that siblings want to be involved in the future planning of
their siblings care but are rarely given the opportunity. Service providers are provided to help
facilitate the needs of the child diagnosed with an intellectual disability, but few services are
offered to facilitate the needs of the siblings (Giallo et al, 2012; Heller & Arnorld, 2012). More
research needs to be conducted to learn how to better understand and support the needs of
individuals whom have a sibling diagnosed with an intellectual disability.
20. Chapter 2: Literature Review
There is a gap in the current research in regards to how having a sibling with an
intellectual disability impacts the lives of their non-disabled siblings. In particular, how leisure
may be affected. More research needs to be done to determine how young women lives are
impacted as a result of having a sibling with an intellectual disability. Females are more likely to
provide care for their siblings than males due to their moral ethic of care and learned gender
roles. Thus, young women’s perspective of how their leisure lives are impacted as a result of
having a sibling with a disability is a topic that needs more attention in the leisure field. This
study aims to acquire descriptive data from its research participants. To provide detailed insight
to the lack of understanding of the sibling’s perspective in existing research.