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Trainees with disabilities are chronically underrepresented in psychology and face many barriers throughout their training. Directors of Clinical Training and supervisors within the Veterans Administration Healthcare System (VAHCS), one of the largest employers of trainees with disabilities, have a unique opportunity to address this area of critical need. However, they must first understand the barriers facing psychology trainees with disabilities in VAHCS settings, including discrimination in trainee selection, barriers to obtaining reasonable accommodations, and attitudinal and cultural barriers. In this article, we illustrate how those barriers may present in VAHCS settings specifically and provide suggestions and frameworks for how the VAHCS can create accessible, disability-affirmative training environments in which trainees can truly thrive. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

In this commentary, I call for rehabilitation psychologists to support and advocate for trainees and psychologists with disabilities across the profession as an extension of the foundational principles of the study.I reviewed the literature on psychologists and psychology trainees with disabilities, as well as the foundational principles of rehabilitation psychology.A growing body of literature documents both the presence of psychologists and psychology trainees with disabilities and the barriers that they often encounter in the field. One of the foundational principles of rehabilitation psychology and the acknowledgment of the insider-outsider perspective of disability, which holds that disabled individuals, by nature of their lived experience, have unique perspectives on disability that enrich our overall understanding of it.Through their combination of lived experience and professional expertise, disabled psychologists and trainees bring a critical insider-professional perspective to the field, both inside and outside of rehabilitation psychology. It is both important and in line with our foundational principles that rehabilitation psychologists advocate for psychologists and trainees with disabilities in all settings, so that their important insider-professional perspective on disability can continue to advance the field. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

OBJECTIVE This article describes the use of community-based participatory research (CBPR) to foster bidirectional and equitable academic-community partnerships in two studies related to interpersonal violence and disability. METHOD We analyzed our methods and experiences in conducting these studies to focus on the ways in which CBPR methodology was used to jointly promote and enhance research and advocacy surrounding violence and disability in the research processes themselves and the resulting assessment and intervention products. RESULTS Our use of CBPR methodology allowed us to identify and address critical issues related to violence in the disability community, such as disability-related forms and experiences of violence, concerns and barriers linked to mandated reporting laws, and inaccessible measures and interventions, and to address them in research products. Additionally, our bidirectional academic-community partnerships led us to address overall accessibility of the research process itself as a means by which to amplify advocate voices in science. CONCLUSIONS Full, meaningful, and equitable participation of people with disabilities at every stage of the research process allows for the creation of partnerships that jointly advance research and advocacy around violence and disability. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Graduate students and faculty with disabilities are underrepresented in psychology and face many barriers in graduate education and training. Teaching is a major component of graduate training and faculty preparation, but there is a dearth of research on the teaching experiences of psychology graduate students with disabilities. The objective of this study was to explore the teaching experiences of psychology graduate students with disabilities.We conducted semistructured interviews with 12 disabled psychology graduate students who had teaching experience as part of their graduate programs. Interviews were analyzed using phenomenological coding.Common themes among participants were lack of disability disclosure; lack of accommodations for teaching and guidance of how to receive them; and supportive and nonsupportive resources and mentors in their graduate teaching experiences.Disabled graduate student teachers often lack environments and resources where they can receive disability-specific support and accommodations for teaching. Faculty and programs should develop and promote disability-affirmative training cultures that actively support graduate student teachers with disabilities, including departmental cultures that de-stigmatize disability disclosure and accommodations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Disability is an important facet of diversity. Although diversity in clinical training in health service psychology has improved considerably, training often neglects accessibility and inclusion for individuals with sensory disabilities. The limited research to date documents that trainees with sensory disabilities (TSD) report extensive barriers and are consistently under-represented in clinical settings. Further, few resources have been developed to guide accommodating TSD in clinical training. Accordingly, our goals in this article are two-fold: (1) to highlight the barriers in clinical training faced by TSD and (2) to provide recommendations for trainees, supervisors, clinical leadership, and directors of clinical training to improve accessibility and inclusion for TSD. We offer vignettes to illustrate barriers faced by TSD and suggest guidelines to improve access for TSD.

In response to concerns about liability and safety, many colleges and universities have instituted Behavior Intervention Teams (BITs) to help assess and intervene with students who may pose a risk of harm to self or others. Students, lawyers, and advocates have raised concerns about some aspects of the implementation of BITs and related institutional policies, particularly with regard to students who are suicidal and those who engage in self-injurious behavior. Specifically, BITs are on complicated legal ground regarding confidentiality, disability civil rights law, and potential discriminatory or disparate treatment of students with psychiatric disabilities. In addition to reviewing the nature and background of BITs, this article reviews the professional, ethical, and legal issues surrounding confidentiality in the context of university intervention with students who are at risk for harm to self and the potentially applicable of disability civil rights law to BIT intervention with students who are suicidal. Suggestions for alternative and supplemental interventions, especially widespread use of suicide gatekeeping, are provided. Finally, the need for advocates who are knowledgeable in disability civil rights law is highlighted.

PURPOSE/OBJECTIVE Women with disabilities are typically expected to work in underpaid positions and earn much less when compared with men with disabilities or women without disabilities. In this study, we interviewed women who are at the other end of this spectrum-women with disabilities who were engaged in a high-skilled professional sector. We report their lived experiences and how the intersections of their identities impact, contradict, and collide with the aforementioned assumption. We use feminist disability theory and Crenshaw's theory of intersectionality to inform our research. Research Method/Design: In-depth semistructured qualitative interviews adopting a phenomenological framework were conducted with 37 women with disabilities who hold advanced degrees and work in higher-paying professions. RESULTS Some of the themes generated from our analysis of the interviews included isolation and hopelessness, a sense of tokenism or de-legitimization, limitations of provided accommodations, the intersection of gender and disability, and how multiple layers of identity fuel marginalization. CONCLUSIONS/IMPLICATIONS Despite their success in placement, women with disabilities in the United States still experience numerous barriers in professional sectors. It is imperative to better understand the implications of intersectionality and how discrimination and marginalization can also impact those with successful employment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

BACKGROUND Many transgender and nonbinary (TNB) people face significant treatment barriers (e.g., healthcare discrimination) when seeking help for gender dysphoria. Technology-delivered interventions for TNB people can be used discretely, safely, and flexibly, thereby reducing such treatment barriers. Technology-delivered interventions are beginning to incorporate machine learning (ML) and natural language processing (NLP) to automate intervention components and tailor intervention content. A critical step in using ML and NLP in technology-delivered interventions is demonstrating how accurately these methods model gender dysphoria. OBJECTIVE The present study sought to determine the preliminary effectiveness of modeling gender dysphoria with ML and NLP. METHODS Six ML models and 949 NLP-generated independent variables were used to model gender dysphoria from the text data of 1,573 Reddit posts created on TNB-specific online forums. Qualitative content analysis was used to determine whether gender dysphoria was present in each post (i.e., the dependent variable). NLP transformed the linguistic content of each post into predictors for the ML algorithms. RESULTS Results indicated that a supervised ML algorithm (i.e., optimized extreme gradient boosting; XGBoost) modeled gender dysphoria with a high degree of accuracy (.84), precision (.83), and speed (1.23 seconds). Of the NLP-generated independent variables, DSM-5 clinical keywords (e.g., dysphoria, disorder) were most predictive of gender dysphoria. CONCLUSIONS These preliminary findings and initial validation evidence suggest ML- and NLP-based models of gender dysphoria have significant potential to be integrated into TNB-specific technology-delivered interventions.

Research has shown that rates of domestic violence generally increased during the coronavirus 2019 (COVID-19) pandemic, likely related to mitigation efforts that promoted staying at home and lockdown protocols. However, the link between pandemic-related domestic violence victimization and mental health outcomes has been less explored. The present study examined the possible association between exposure to domestic physical and psychological violence during the COVID-19 pandemic and depressive and post-traumatic stress symptoms (PTSS) in an online sample of American adults recruited in December 2021. Data from 604 participants were analyzed. Forty-four percent of participants (n = 266) reported experiencing physical domestic violence, psychological domestic violence, or both during the pandemic, with psychological violence more commonly reported than physical violence. Exposure to both forms of violence was associated with higher rates of depressive and post-traumatic stress symptoms. Given the high rates and negative associations between psychological domestic violence and mental health symptoms in this sample, healthcare providers should assess for domestic violence exposure even if no indications of physical abuse are present or if there were not concerns about domestic violence exposure prior to the pandemic. Potential psychological sequalae should also be assessed if a patient has a positive history of domestic violence victimization.

Individuals with disabilities comprise one of the largest marginalized groups in the United States and experience systemic barriers in health care. In Westernized communities, disability has historically been conceptualized via the medical model, which considers disability an individual-level deficit in need of correction. Although other models of disability (e.g., social model) have been developed to address the medical model's ableist shortcomings, these fail to consistently acknowledge intersectionality. Specifically, these models fail to consider that (a) a disabled individual may hold other marginalized or oppressed identities and (b) these intersecting oppressions may exacerbate health inequities. Intersectionality, which originates from Black feminist literature, describes the ways that systems of power and oppression (e.g., racism, sexism) interact to form an individual's unique experience. To date, the intersection of disability and other marginalized identities has been neglected in psychology and related fields, leaving little guidance for how scholars, clinicians, and other stakeholders can address disability via an intersectional lens. The present article discusses how a

Introduction People with disabilities are under-represented among psychology faculty and graduate students and are more likely than their non-disabled peers to attrite from psychology graduate programs. They face numerous barriers in graduate training. Statement of the Problem Teaching experience is a core experience for psychology graduate students, especially those pursuing faculty positions. Disabled graduate students face many barriers that may make it difficult for them to obtain high-quality graduate student teaching experience. This contributes to the continuing under-representation of disabled faculty in psychology programs. Literature Review I review key empirical and conceptual articles on the experiences of disabled psychology trainees and how to best support them. Teaching Implications I provide evidence-based suggestions and strategies for supporting graduate students with disabilities as they obtain teaching experience. Conclusion By actively supporting graduate students with disabilities in their teaching endeavors, psychology faculty can help stem the leaky pipeline and increase the numbers of psychology faculty with disabilities.

The ongoing novel coronavirus 2019 (COVID-19) pandemic has had considerable effects on the disability community. As the pandemic has progressed and changed, the manifestations of these effects have differed, and yet the underlying causes-ableism including the devaluation of disabled lives-have remained consistent. In this commentary, we explore the impact of the pandemic on the disability community in the United States, conceptualizing four distinct but overlapping "waves" of discrimination: 1) healthcare rationing and missed opportunities for disability inclusion, 2) access to resources, supplies, and accommodations; 3) vaccine access; and 4) long COVID and disability identity. Throughout our discussion of these waves, we detail the discrimination faced by people with disabilities, the underlying ableism that perpetuates it, and the resilience shown by the disability community. We end with a call for combating systemic ableism in healthcare and public health systems.

Gender and sexual minority individuals face considerable physical and mental health disparities, health risk factors, and barriers to care. These disparities are rooted in systemic and interpersonal prejudice, discrimination, and violence toward lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) individuals and communities that place LGBTQ+ individuals at increased risk for negative social determinants of health. While also advocating for systemic change, individual providers and clinics have an ethical duty to promote an openly affirming, culturally competent health care environment that can help to address these disparities on an individual patient level.

The present, exploratory study examined retrospective and current peer victimization in a multi-university sample of 58 college students with disabilities, 18 (31%) of whom identified as sexual minorities. Fifty-seven participants reported peer victimization during childhood, and approximately half reported experiencing peer victimization in the past 2 months. Students who identified as sexual minorities reported more retrospective victimization but current victimization did not differ between the two groups. Current and retrospective peer victimization were significantly correlated with present psychological distress. Professionals who work with students with disabilities should be aware of the high prevalence of peer victimization and its psychological correlates in this population.

Parents of young children with disabilities may experience high levels of stress and psychological distress that may put them at higher risk for experiencing suicidality. Thus, early childhood home visitors (e.g., professionals who work for home-based early intervention programs) may serve as important gatekeepers for identifying and referring parents who are experiencing psychological distress, including suicidal thoughts. However, most early childhood home visitors do not receive training on identifying or intervening with distressed and potentially suicidal caregivers. Therefore, early childhood home visitors would benefit from acquiring evidence-based, accessible strategies for identifying and responding to caregivers who they know or suspect are experiencing suicidal thoughts—a class of knowledge and skills that can be obtained through “suicide gatekeeper” training. In this article, we provide evidence-based information about suicide risk among parents of young children with disabilities, the intervention of suicide gatekeeping, and how suicide gatekeeping can be incorporated into the early childhood home visitor role.

Introduction: Employed applicants for vocational rehabilitation need timely services to improve the likelihood of their successful job retention or career advancement. Little research exists that examines timeliness of services among employed applicants, particularly for applicants with visual disabilities. This study investigated time from vocational rehabilitation application to a signed Individualized Plan for Emplolyment (IPE) for employed applicants with visual disabilities. Method: The sample of 5,096 competitively employed vocational rehabilitation applicants from the FY2015 RSA-911 report was combined with survey responses from 51 vocational rehabilitation agencies about services to persons with visual disabilities. Multilevel modeling was used to examine effects of state-level and individual-level characteristics and cross-level interactions on the length of waiting time from vocational rehabilitation application to signed IPE. Results: The time from application to IPE was shorter for employed applicants with visual disabilities who received services from separate vocational rehabilitation agencies compared to that of combined vocational rehabilitation agencies. Employed vocational rehabilitation applicants with visual disabilities waited longer if they were younger, non-White, or received disability benefits. Official job-retention policies in state vocational rehabilitation agencies appeared to reduce the delay of IPE implementation for persons with secondary disabilities, for applicants who received disability benefits, and for persons who worked more hours per week. Discussion: Additional research to determine how vocational rehabilitation can provide services to employed persons as soon as possible after application is indicated, particularly for persons applying to combined agencies. Implications for practitioners: Vocational rehabilitation providers should explore ways to expedite service delivery, particularly for persons who are younger, non-White, or receiving disability benefits. Implementing official vocational rehabilitation policies for addressing job-retention and career-advancement cases may be one avenue to expedite services to some employed applicants.

Objective: The objective of this study was to analyze the match rates of psychology predoctoral internship applicants by disability type. Method: Through the use of publicly available data from the 2008, 2011, 2012, 2015, and 2016 Association of Psychology Postdoctoral and Internship Centers internship applicant surveys, differences in match rate for applicants with different types of disabilities, as compared with nondisabled applicants, were analyzed. Additionally, trends in match rates for applicants with different disability types over time were analyzed. Results: Across disability type, applicants with disabilities tended to have lower match rates than did applicants without disabilities. These differences were particularly large in applicants with physical/orthopedic disabilities and learning disabilities. These gaps in match rates were narrowing for some types of disabilities but widening for others. Conclusion: Disabled internship applicants experience consistent, negative disparities internship match rates compared with their nondisabled peers. Psychologists must take action to identify and ameliorate the causes of these disparities and address the chronic underrepresentation of psychologists with disabilities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The purpose of this study was to examine the utility of the theory of planned behavior (TPB) in explaining employers’ hiring intentions of people who are blind or visually impaired (B/VI). Participants were 388 hiring managers who completed an online survey that included the four TPB construct measures (attitudes, subjective norms, behavioral control, and intent to hire). Confirmatory factor analysis (CFA) was used to determine the suitability of the measurement model, and structural equation modeling was used to test the structural model. The proposed TPB structural model provided good data fit; attitudes about productivity, subjective norms, and perceived behavioral control accounted for more than 61% of the variance in intent to hire people who are blind. Attitudes about productivity of a blind employee had the strongest relationship with intent to hire, followed by subjective norms and perceived behavioral control. Rehabilitation professionals who work with B/VI individuals should educate employers about how this population can perform the employers’ jobs to improve attitudes about productivity. They should consider employers’ subjective norms and perceived behavioral control, which could be influenced by providing disability awareness presentations to company employees and maintaining a relationship with employers, thus enabling employers to have access to qualified applicants.

Introduction: The purpose of this article was to conduct a systematic review of peer-reviewed studies on factors related to employment in consumers who are visually impaired using Rehabilitation Services Administration (RSA-911) Case Service Report data. Methods: We used database, hand, and ancestral search strategies to systematically identify peer-reviewed studies published between 1990 and August 2018 where researchers used RSA-911 data to address the target question. All included articles were coded by two reviewers for study and participant characteristics, quality indicators, and outcomes. Results: Nine articles consisting of 14 analyses were included. Twelve analyses concerned employment outcomes; two concerned earnings. Researchers in most studies used large samples of 3,000 or more consumers and used multivariable analyses, most commonly multilevel logistic regression. Factors that consistently predicted lower employment across studies included presence of a secondary disability and legal blindness; higher education level consistently predicted higher employment, as did earnings and self-support at vocational rehabilitation application. Few analyses included state- or agency-level variables or specific vocational rehabilitation services. Discussion: These results indicate that certain groups of vocational rehabilitation consumers with visual impairments may be at greater risk of unsuccessful closures; researchers should examine specific strategies that may improve outcomes in these groups. These results also highlight the importance of education in securing employment among people with visual impairments. Researchers should examine state- and agency-level variables that may affect outcomes as well as the effects of specific services on outcomes. Additionally, researchers should analyze factors that may affect employment quality as well as employment outcomes. Implications for practitioners: Practitioners who are working with visually impaired people who do not have a postsecondary degree should encourage and assist their clients in obtaining one; practitioners may also wish to provide more targeted support for consumers from potentially high-risk subpopulations.

Purpose To inform the field of rehabilitation psychology about the sociocultural implications of the term "disability," and explain the rationale behind the #SaytheWord movement, a social media call to embrace disability identity. Method Review of the literature on disability terminology, the history of language use, and the relationship between attitudes toward disability and language. We reflect on the role of disability within the field of psychology and within the American Psychological Association (APA), including the underrepresentation of disabled psychologists and trainees with disabilities and the lack of mentorship opportunities available in the field. Implications The authors argue that erasure of the word "disability" can have unintended and adverse consequences. We describe how erasure of disability identity in the context of current sociopolitical efforts to reduce and eliminate public services and supports for people with disabilities is especially threatening to members of the disability community. To move forward, the authors postulate that the disability movement must reconcile its own history of exclusion and adopt a disability justice framework. Conclusion The field of psychology has a rich tradition of appreciation of cultural diversity and individual difference; yet, disability has largely been left out of these efforts. The disability movement is moving toward the status of a diverse cultural group with a social justice agenda parallel to those of other marginalized communities. The authors posit that psychology must play a stronger role in advancing the human rights of people with disabilities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Purpose/objective The purpose of this conceptual article is to discuss the minority stress model and its potential applicability as a model for examining the higher rates of suicidality in people with disabilities. Method This conceptual article is based in the empirical literature on the minority stress model and the literature exploring the experiences of both proximal (e.g., internalized stigma, self-concealment) and distal (e.g., harassment, violence, and discrimination) minority stress among people with disabilities. It also draws from the literature on suicidality and disability. Results After establishing the higher rates of suicidality among people with disabilities as evidenced in the existing literature and discussing our gaps in the knowledge about the factors that drive this phenomenon, I discuss the minority stress model, which posits that elevated rates of suicidality among individuals with disabilities can be explained by a combination of proximal and distal stressors related to one's marginalized status. I then discuss the ways in which this model could be applied to suicidality and psychological distress in individuals with disabilities, drawing on research that establishes that they experience these proximal and distal stressors at high rates. Conclusions The minority stress model is potentially useful for conceptualizing the higher rates of suicidality among people with disabilities, both alone and in conjunction with other models of suicide, in a manner that addresses disability justice and the experiences and effects of chronic, pervasive marginalization. Recommendations for research, and policy, including strategies for addressing both internalized ableism and disability-related discrimination and harassment, are provided. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

BACKGROUND The purpose of this study was to estimate the risk of death by suicide for those with amyotrophic lateral sclerosis (ALS) seeking care within the Veterans Health Administration (VHA). METHODS This was a retrospective, cohort study. Extended Cox regression models were used to compare the hazard of suicide between the ALS and the unexposed groups. RESULTS The hazard of suicide was 3.98 times higher for those with ALS than for those without (95% confidence interval [CI] , 2.64-6.00; P

LGBTQ+ people have faced violence, discrimination, and harassment throughout their lives as well as social isolation and stigma in their identities due to widespread heterosexism. This cohort of elders faced the AIDS crisis, institutional heterosexism, and homophobia in employment, housing, and personal affairs. Despite progress in policy and law, these pioneers still frequently face similar challenges in healthcare, housing, and supportive services as they progress into old age. These elders describe fear of going back into the closet due to harassment and discrimination in long-term care and housing facilities, healthcare services, and even public health and aging programs. This chapter will illustrate many of the challenges this cohort of LGBTQ+ elders may face as they age despite the progress of LGBTQ+ rights movements. Limitations in research as well as clinical and policy considerations will also be explored.

Asexual individuals—people who experience little or no sexual attraction to individuals of any sex or gender—comprise approximately 1% of the population but are often left out, medicalized, and dehumanized in both sexual and gender majority and minority spaces. This chapter introduces the concepts of asexuality and the asexual spectrum and discusses key forms of violence and marginalization that asexual individuals experience: medicalization and pathologizing of asexuality, isolation and erasure, and unwanted sexual experiences and corrective rape. The importance of validation and intersectionality in working with asexual individuals is also discussed.

This chapter introduces the topics of systemic and interpersonal violence against LGBTQ+ persons, a complex and multifaceted area that is marked by a variety of distinct but co-existing types of victimization. We describe this broad range of victimization, which spans from childhood to adulthood, covert to overt, and interpersonal to systematic, and discuss the cumulative effects of both acute and chronic victimization on the health and well-being of sexual and gender minority persons. We also highlight the importance of truly intersectional and culturally responsive care in working with LGBTQ+ clients who have experienced violence.

Both people with disabilities and people who are gender and sexual minorities (GSM; i.e., LGBTQ+) experience elevated rates of violence victimization across the lifespan. However, there has been very little research on violence against people who are members of both the disability and GSM communities despite evidence that these individuals may be at even greater risk of victimization as a result of intersecting marginalized identities. In the present chapter, I provide an overview of the research on GSM people with disabilities, explore considerations specific to violence against people with disabilities, review the small body of literature on violence against this GSM people with disabilities, and discuss the challenges inherent in conducting this research. I also provide suggestions for research-supported best practices in working with GSM clients with disabilities.

As the preceding chapters detail, violence against LGBTQ+ individuals is a serious and critical issue that must be addressed at all levels—individual, community, and policy. The pervasive marginalization and victimization of LGBTQ+ people span nations, cultures, race, ages, genders, gender identities, sexual orientations, and a myriad of other communities and demographic variables. It is a deep and far-reaching issue with complex cultural, religious, medical, and social and historical roots, and yet its consequences are often profoundly personal, harmful, and even deadly. This final chapter details several considerations in the theory, study, and practice of understanding, treating, and ultimately ending violence against LGBTQ+ people as well as some strategies for continuing to advance this difficult but critical mission.

Asexuality—defined as the lifelong and nonpathological lack of sexual attraction to people of any sex or gender—is increasingly being recognized as a valid sexual orientation. For gay, lesbian, and bisexual individuals, this questioning phase is often triggered by feeling sexual attraction to someone of the same sex or gender; however, for asexual individuals, questioning may start with the realization that the person does not feel—and has never felt—sexual attraction to anyone, regardless of sex or gender. Thus, psychotherapists and other counselors have an ethical duty to respect their clients’ sexual orientation and not to discriminate against, deny service to, or demean clients on the basis of sexual orientation. Because asexuality is newly recognized as a sexual orientation, however, relatively few resources exist on cultural competency with asexual or potentially asexual clients. Finally, asexual individuals may have to navigate the implications of their asexuality in terms of cultural and social expectations for sex, relationships, and childbearing.

Objective/Purpose: The objective of this article is to provide information about the ways in which the novel coronavirus 2019 (COVID-19) pandemic may affect the ongoing public health issue of violence against people with disabilities and how rehabilitation psychologists and other providers can address these concerns in their practice. Method This article reviews the literature on violence against people with disabilities as well as emerging literature on the COVID-19 pandemic and its social and medical consequences. Results The COVID-19 pandemic magnifies existing issues and barriers facing people with disabilities who are experiencing interpersonal violence. These issues include reliance on the perpetrator for care and assistance, barriers to reporting abuse and seeking help, fear of retaliation and other negative consequences if abuse is reported, emotional abuse related to disability, and exacerbation of secondary physical and mental health sequalae of abuse. Conclusions/implications The COVID-19 pandemic and its consequences enhance the already increased risk for abuse among people with disabilities. Providers who work with individuals with disabilities should address these issues at both the individual client and systems levels. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

In addition the general stressors occurring as a result of the COVID-19 pandemic, individuals who are members of marginalized racial or ethnic minority groups in the United States may face addition...

Despite growing appreciation of the need for research on autism in adulthood, few survey instruments have been validated for use with autistic adults. We conducted an institutional ethnography of two related partnerships that used participatory approaches to conduct research in collaboration with autistic people and people with intellectual disability. In this article, we focus on lessons learned from adapting survey instruments for use in six separate studies. Community partners identified several common problems that made original instruments inaccessible. Examples included: (1) the use of difficult vocabulary, confusing terms, or figures of speech; (2) complex sentence structure, confusing grammar, or incomplete phrases; (3) imprecise response options; (4) variation in item response based on different contexts; (5) anxiety related to not being able to answer with full accuracy; (6) lack of items to fully capture the autism-specific aspects of a construct; and (7) ableist language or concepts. Common adaptations included: (1) adding prefaces to increase precision or explain context; (2) modifying items to simplify sentence structure; (3) substituting difficult vocabulary words, confusing terms, or figures of speech with more straightforward terms; (4) adding hotlinks that define problematic terms or offer examples or clarifications; (5) adding graphics to increase clarity of response options; and (6) adding new items related to autism-specific aspects of the construct. We caution against using instruments developed for other populations unless instruments are carefully tested with autistic adults, and we describe one possible approach to ensure that instruments are accessible to a wide range of autistic participants. Lay summary Why is this topic important? To understand what can improve the lives of autistic adults, researchers need to collect survey data directly from autistic adults. However, most survey instruments were made for the general population and may or may not work well for autistic adults. What is the purpose of this article? To use lessons learned from our experience adapting surveys—in partnership with autistic adults—to create a set of recommendations for how researchers may adapt instruments to be accessible to autistic adults. What did the authors do? Between 2006 and 2019, the Academic Autism Spectrum Partnership in Research and Education (AASPIRE) and the Partnering with People with Developmental Disabilities to Address Violence Consortium used a participatory research approach to adapt many survey instruments for use in six separate studies. We reviewed records from these partnerships and identified important lessons. What is this recommended adaptation process like? The adaptation process includes the following: (1) Co-creating collaboration guidelines and providing community partners with necessary background about terminology and processes used in survey research; (2) Collaboratively selecting which constructs to measure; (3) Discussing each construct so that we can have a shared understanding of what it means; (4) Identifying existing instruments for each construct; (5) Selecting among available instruments (or deciding that none are acceptable and that we need to create a new measure); (6) Assessing the necessary adaptations for each instrument; (7) Collaboratively modifying prefaces, items, or response options, as needed; (8) Adding “hotlink” definitions where necessary to clarify or provide examples of terms and constructs; (9) Creating new measures, when needed, in partnership with autistic adults;(10)Considering the appropriateness of creating proxy report versions of each adapted measure; and(11)Assessing the adapted instruments' psychometric properties. What were common concerns about existing instruments? Partners often said that, if taking a survey that used the original instruments, they would experience confusion, frustration, anxiety, or anger. They repeatedly stated that, faced with such measures, they would offer unreliable answers, leave items blank, or just stop participating in the study. Common concerns included the use of difficult vocabulary, confusing terms, complex sentence structure, convoluted phrasings, figures of speech, or imprecise language. Partners struggled with response options that used vague terms. They also felt anxious if their answer might not be completely accurate or if their responses could vary in different situations. Often the surveys did not completely capture the intended idea. Sometimes, instruments used offensive language or ideas. And in some cases, there just were not any instruments to measure what they thought was important. What were common adaptations? Common adaptations included: (1) adding prefaces to increase precision or explain context; (2) modifying items to simplify sentence structure; (3) substituting difficult vocabulary words, confusing terms, or figures of speech with more straightforward terms; (4) adding hotlinks that define problematic terms or offer examples or clarifications; (5) adding graphics to increase clarity of response options; and (6) adding new items related to autism-specific aspects of the construct. How will this article help autistic adults now or in the future? We hope that this article encourages researchers to collaborate with autistic adults to create better survey instruments. That way, when researchers evaluate interventions and services, they can have the right tools to see if they are effective.

The selection and adoption of culturally appropriate targets and practices, especially for home-based or parent-supported services, is an emerging interest in the field of applied behavior analysis (ABA). Variations in cultural norms, caregivers' ability to participate in home-based service delivery, and family and practitioner linguistic competencies are some of the areas that the culturally competent ABA therapist must consider when designing a home-based program of therapy. Given the paucity of empirical research related to cultural competency in ABA service provision, the goal of the current article is to provide practitioners, their supervisors, and researchers with information to overcome many perceived barriers to successfully working with clients whose home languages or cultures differ from that of the dominant U.S. culture. Practical examples, integration of research from ABA and allied fields, and terminology are used to support these points and provide actionable guidance grounded in empirical literature.

This study examined experiences with and knowledge of non-suicidal self-injury (NSSI) among a multistate sample of 253 vocational rehabilitation (VR) counselors. Over 90% of counselors reported working with clients who had expressed thoughts or behaviors related to NSSI, and over 20% reported doing so once a month or more. Only 44.7% reported having received training on NSSI. Scores on a brief NSSI knowledge questionnaire demonstrated generally accurate responses but also some gaps in knowledge. These findings indicate that rehabilitation counselors in public VR settings frequently work with clients who display thoughts and behaviors related to NSSI and may benefit from training and support in this area.

State and national educational leaders encourage the use of an integrated multitiered system of supports (MTSS) to improve services to students with academic and social behavior problems. Implementing and sustaining MTSS is facilitated by support from leaders in state education agencies (SEAs). The purpose of this study was to identify the specific events, resources, and supports that help or hinder the work of scaling up an integrated MTSS approach from the perspective of MTSS leaders in SEAs. Researchers interviewed leaders in 27 U.S. states using the critical incident technique, a qualitative methodology to identify critical incidents associated with changes in practice. Eight helping incident, seven hindering incident, and nine “wish list” categories were identified. Helping categories included multidisciplinary leadership, access to professional development, consistent language and/or practices, consultation with external partners, and a focus on student outcomes in evaluation and planning. Seven hindering categories included competing philosophies, high personnel turnover, varying levels of readiness, and inadequate data systems. Participants also identified two unique categories associated with the items they wished had happened or could happen in the future including access to personnel with high-level MTSS training and access to more effective interventions.

We examined the contribution of disability status to suicidality when accounting for depression and sociodemographic risk factors in 438 American adults, 82 (18.7%) of whom identified as having disabilities. Participants with disabilities had significantly higher depression scores and were more likely to be unemployed and unpartnered, all of which were also associated with increased suicidality. However, disability remained a significant predictor of suicidality even when depression and sociodemographic risk factors were accounted for in a linear regression. Other significant predictors of suicidality in this regression were female gender, depression symptoms, and family and friend suicide history; identifying as a member of a religion was a significant protective factor against suicidality. Our findings suggest that the contribution of disability to suicidality goes beyond that which can be explained by increased depression symptoms and sociodemographic vulnerability.

This study examined experiences with and knowledge of non-suicidal self-injury (NSSI) among a multistate sample of 111 vocational rehabilitation (VR) support staff. Over 80% of support staff reported working with clients who had expressed thoughts or behaviors related to NSSI, with over 15% doing so at least once a month. However, only about a quarter (27.0%) reported having received training on NSSI. Participants generally scored well on three true/false NSSI knowledge items but also demonstrated some gaps in knowledge. Support staff commonly work with individuals with NSSI in VR settings but may benefit from additional training and support in this area.

Purpose/objective The rejection-identification model (RIM) argues that the negative impacts of stigma, such as decreased self-esteem, may be mitigated when members of the stigmatized group choose to identify with each other rather than with the majority culture. A previously unstudied potential RIM stigma-reduction mechanism is disability pride, which views disability as a source of valuable, enriching, and positive experience. Impairment, personal, and environmental factors based on the International Classification of Functioning, Disability and Health (ICF) predict whether people will categorize themselves as disabled, but predictors of pride have received little examination. The purpose of this study was to (a) explore whether ICF factors predict disability pride, and (b) assess whether disability pride mediates a relationship between stigma and self-esteem, supporting RIM. Research Method/Design: Participants completed an Internet-based survey assessing pride, self-esteem, and ICF factors. Disability was not mentioned in recruitment materials to prevent selection biases. People who reported at least 1 impairment (n = 710) were included in analyses. Results ICF personal and environmental factors (stigma, social support, and being a person of color), but not impairment factors, predicted disability pride. Supporting RIM, disability pride partially mediated the relationship between stigma and self-esteem. Conclusions/implications Disability pride is a promising way to protect self-esteem against stigma. Disability pride is still a rare phenomenon. Given that pride is associated with social support, stigma, and, to a lesser extent, ethnicity, but not impairment characteristics, interventions might focus on personal and environmental factors like these to promote pride. (PsycINFO Database Record