Perceived disability from hearing and voice changes in the elderly

Aim: Dysphonia and hearing loss are underestimated conditions in the elderly, despite their significant prevalence (18% and 50%, respectively) and their sociopsychological implications. Previous studies have shown that the reason for this lack of consideration is related to the general misconception of a simple age-related issue, as well as to the reduced communication requirements of this population, which can result in infrequent requests/supply of care. The purpose of the present study was to evaluate, within an elderly population, the subjective perception of hearing and voice dysfunctions, the resulting changes in communication skills, and the perception of handicap and disability. Methods: Four anonymous questionnaires were administered to 400 participants (218 men, 182 women) aged older than 65 years, some of whom (276) were hospitalized and some of whom (124) were outpatients. The questionnaires consisted of questions regarding age-related changes in voice, multiple-choice questions on the qualitative characteristics of the voice, questions regarding verbo-acoustic communication (hearing), the Voice Handicap Index, and the Self Assessment of Communication regarding the perception of hearing loss-related handicap and disability. Statistical correlations were calculated for voice dysfunction between the perception of disability and the clinical assessment of voice quality obtained by the Grade, Roughness, Breathiness, Asthenia, Strain scale, and between the perception of disability and the demand for care. Results: More than half of the elderly patients reported not perceiving voice changes throughout their lives. Most of the participants were satisfied with their own voices, although 65% of them judged them to be qualitatively altered, and in 31.5% of the participants, pathology was found on phoniatric evaluation. Low scores for vocal handicap (Voice Handicap Index) were found, and the type of perceived disability was mainly physical, although the association between Voice Handicap Index scores and Grade, Roughness, Breathiness, Asthenia, Strain was statistically significant. A total of 62% of the patients perceived hearing changes over their lifetimes not related to previous ear infections, but significantly correlated with a family history of hearing problems and with the need for specialist consultations. However, the perception of hearing loss handicaps and disability showed lower mean values, showing that older patients recognized dysfunction, but did not consider it to be a disability. Conclusions: The present study showed that, despite the relevant incidence of hearing and voice disorders among the elderly population, the implications for communication abilities seems to be underestimated. Hence, it appears to be extremely important to undergo specialist screening consultations to detect eventual voice and hearing alterations, and to correct them with appropriate therapeutic strategies

Voice and speech functions (B310-B340)

The International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) domain ‘voice and speech functions’ (b3) includes production and quality of voice (b310), articulation functions (b320), fluency and rhythm of speech (b330) and alternative vocalizations (b340, such as making musical sounds and crying, which are not reviewed here)

Listening for policy change: How the voices of disabled people shaped Australia’s National Disability Insurance Scheme

Voice has become an important yet ambivalent tool for the recognition of disability. The transformative potential of voice is dependent on a political commitment to listening to disabled people. To focus on listening redirects accountability for social change from disabled people to the ableist norms, institutions and practices that structure which voices can be heard in policy debates. In this paper, I use disability theory on voice and political theory on listening to examine policy documents for the National Disability Insurance Scheme in light of claims made by the disability movement. Although my study finds some evidence of openness in the policy development stage, the scheme falls short of valuing the diverse voices of disabled people as partners in shared dialogue

Relationship between voice self-efficacy and voice-related disability

A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, June 30, 2008.Includes bibliographical references.Also available in print.Thesis (B.Sc)--University of Hong Kong, 2008.published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

Disabled Autonomy

Disability law is still undertheorized. In 2007, Ruth Colker wrote that disability law was undertheorized because it conflated “separate” with “unequal,” and because disability was largely ignored or poorly understood within theories of justice. The solution for Colker was to attach the anti-subordination perspective, which was developed to apply to race and sex, directly to disability. This Article argues that this transportation from the race and sex contexts was a partial solution, but is not sufficient to give full substance to disability law theory. Concepts from critical race theory and feminist jurisprudence have long been simply transported into the disability context, acting as an imperfect facsimile. The primary purpose of those concepts was to describe, analyze, and remedy problems primarily related to race and gender, not disability. While disability law has benefitted to some extent from inclusion in these legal theories, many of the unique features and complexities of disability law have been left on the table. This Article explores those complexities. Autonomy, usually thought of as an uncomplicated social good for other groups, is challenged in disability theory by two competing values. The value of anti-subordination is critical because it seeks to address, and redress, discrimination, sigma, and stereotyping. An anti-subordination perspective gives a voice and supplies resources to people with disabilities, and will counsel against choices that support stigma and stereotyping. An anti-subordination perspective might seek to limit a right to physician-assisted suicide, for example, because of concerns about exploitation and the messaging that disabled lives are not worth living. This runs counter to an autonomy-focused perspective, which would support the choice to end one’s life in the end stages of a terminal disease. An anti-eliminationism perspective advocates for the preservation of, and resources for, disabled lives. This comes to mean that not only are people with disabilities valued, but their disability is valued too. Instead of seeking to end Autism, for example, an anti-elimination perspective seeks to support Autistics. However, an anti-eliminationism perspective might also support the restriction of choice, and therefore come into conflict with autonomy, where there is a choice that results in the end of a disability. An anti-elimination perspective could seek to restrict the ability to selectively terminate pregnancies when a disability is found, for example. Anti-eliminationism inherently challenges the notion that getting rid of disability is a good thing. Parts I, II, and III of this Article describe the values of autonomy, anti-subordination, and anti-eliminationism in the disability context, and argue that these values are each critical components of disability law and theory. Part IV of this article provides an overview of some real-world examples where these values come into immediate conflict

From the voice of a ‘Socratic Gadfly’: a call for more academic activism in the researching of disability in postsecondary education

In this article I use the lens of voices and silences to frame my review of research in the field of disability and postsecondary education. I argue that we need to view research in this field as a necessarily political act that seeks to turn voices of silence into voices of change. Researchers therefore need to re-think their role in order to understand how they can use and direct their political voices. In order to persuade researchers to heed my call for more academic activism I draw on the arguments of Allan (2010) and adopt the role of a ‘socratic gadfly’ to identify six political areas of research where I argue that voices and silences need more critical examination. In discussing these six areas I hope to illuminate the implications for ‘genuinely investigative’ research in the future

Review of equality statistics

The Equality and Human Rights Commission (EHRC) commissioned this review as part of its remit to map the equalities landscape across England, Scotland and Wales. The report examines the extent to which data are available for the following equality strands: sex; ethnicity / race; disability; religion or belief; age; sexual orientation; and also for socio-economic status (social class). The extent to which statistics are available at different levels of geographic classification (UK, GB, England, Scotland and Wales and regional and local areas within this) is investigated. The report addresses the ten domains of equality identified in the equality measurement framework in the Equalities Review.1 These are: Longevity Physical security Health Education Standard of living Productive and valued activities Individual, family and social life Participation, influence and voice Identity, expression and self-respect Legal securit

Working Effectively with People with Attention Deficit/ Hyperactivity Disorder

This brochure on People with Attention Deficit/Hyperactivity Disorder and the Americans with Disabilities Act (ADA) is one of a series on human resources practices and workplace accommodations for persons with disabilities edited by Susanne M. Bruyère, Ph.D., CRC, SPHR, Director, Program on Employment and Disability, School of Industrial and Labor Relations – Extension Division, Cornell University. Cornell University was funded in the early 1990’s by the U.S. Department of Education National Institute on Disability and Rehabilitation Research as a National Materials Development Project on the employment provisions (Title I) of the ADA (Grant #H133D10155). These updates, and the development of new brochures, have been funded by Cornell’s Program on Employment and Disability, the Pacific Disability and Business Technical Assistance Center, and other supporters

THE INVISIBLE PEOPLE: DISABILITY, DIVERSITY, AND ISSUES OF POWER IN ADULT EDUCATION

This essay explores the location of disability in adult education by critiquing the research on power, privilege, and diversity through a critical disability theory lens. The essay includes a definition of critical disability theory, a discussion of power, privilege, and diversity in adult education, followed by an examination of three issues: function, minority group status, and language, voice and visibility. Persons with disabilities are marginalized, the intent of reasonable accommodation is misunderstood, and the existence of the minority group—people with disabilities—in adult education is barely acknowledged. Disability is often forgotten, overlooked, or dismissed by adult education as too special a category (Berube, 1998). And yet a simple car accident can make any of us a person with a disability. As we live longer, it becomes increasingly likely that we may experience disability becoming a member of this minority group. Disability rights activists refer to this phenomenon as temporarily able-bodied (TAB). The term TAB “breaks down the separateness of ‘us’ and ‘them’” (Zola, 1993, p. 171) emphasizing instead a continuum of experience. Disability is a fluid concept subject to methodological bias, the distortion of cultural bias, and a specific context. “Disability identification is a judgment on the human condition, and its statistical summary represents more than a simple enumeration of those who are disabled and those who are not” (Fujiura & Rutkowski-Kmitta, 2001, p. 69). At what point does a physical anomaly become a disability and who decides--the individual or society--when one is a person with a disability and a member of that particular minority group? Due to medical advances, there are growing numbers of the “well” disabled who are demanding access to opportunities for education and training, work, and leisure. A person with a chronic or degenerative condition may still have the capacity to perform work tasks and may wish to engage in formal learning activities. The purpose of this paper is to critique the research on power, privilege, and diversity through a critical disability theory lens. The discussion will include first, a definition of critical disability theory, second, a discussion of power, privilege, and diversity in adult education, followed by an examination of three issues: function, minority group status, and language, voice and visibility