Resilience Fatigue: The Unseen Struggle of Individuals with Disabilities

Resilience, often hailed as a cornerstone of mental health, is the ability to adapt and recover from adversity, stress, or trauma. While celebrated in social work and psychology, this focus on resilience can unintentionally undermine empowerment for individuals with disabilities by neglecting the need for systemic support.

This article delves into the complexities of resilience for people with disabilities, using Justin’s story to highlight how the pressure to embody resilience impacts mental health, identity, and well-being, and argues for a balanced approach that values both personal strengths and systemic support.

Navigating Systemic Barriers: Justin’s Experience

Born with Cerebral Palsy, Justin faced a world not designed for his needs. From a young age, he had to navigate an environment that did not accommodate him. In his small town, schools lacked the resources to support children with disabilities. His parents, Sarah and Michael, advocated persistently for the accommodations he needed to participate in school.

Despite their efforts, Justin often felt isolated, struggling to keep up with his peers using outdated materials and inaccessible technology. For instance, the school did not have accessible textbooks or proper assistive devices, which made learning an uphill battle for Justin. “Mom, why don’t they have the books I can read?” Justin asked one evening, frustration evident in his voice. His mother, Sarah, explained yet again that the school’s budget constraints and lack of awareness were to blame. “It’s not fair,” Justin muttered, feeling the weight of isolation.

Justin’s achievements were often celebrated as examples of resilience, with teachers and peers praising his ability to navigate challenges. However, this praise often overlooked the systemic issues that made his experience so difficult. Researchers argue that focusing too much on resilience can perpetuate discrimination by ignoring the need for broader changes that promote inclusion and support (Goodley, 2014).

Emotional Toll and Identity Challenges

Psychological literature highlights the emotional burden of projecting resilience. For Justin, the ongoing pressure to exhibit resilience resulted in emotional strain and burnout. Countless late nights were spent compensating for the absence of accessible resources, leaving his body and mind drained. As Justin matured, expectations mounted.

Teachers and friends often praised his perseverance, yet these compliments started to feel superficial and hollow. They celebrated his ability to “overcome” challenges without addressing the underlying systemic inequities. Late nights became a routine for Justin as he felt an intense pressure to prove his capability and succeed against all odds. This relentless pursuit isolated him, leading him to internalize blame for systemic failures.

Erevelles’ research (2002) highlights the potential harm of glorifying resilience, as it can stigmatize vulnerability and increase isolation among individuals with disabilities. Emphasizing resilience may also hinder their access to essential support networks. Understanding this dynamic is crucial for developing effective support systems that truly validate the experiences of individuals with disabilities.

Research by Shakespeare (2018) delves into the concept of “resilience fatigue,” the emotional strain from the perpetual expectation to display resilience, often leading to feelings of inadequacy and self-blame. Justin’s experience exemplifies resilience fatigue, where the constant need to appear resilient started to wear him down, leading to feelings of isolation and exhaustion. “I’m so tired, Em,” he confided in his friend Emma, a psychology student. “Everyone expects me to be resilient, but I feel like I’m breaking.”

Understanding resilience fatigue from her studies, Emma reassured him, “Justin, it’s not just about being strong. The system needs to change too.”

Policy Implications and a Call for Balanced Approaches

Policy discussions often rely on resilience rhetoric, often minimizing the need for systemic support. However, maintaining a balanced perspective is crucial. For instance, inclusive education policies in states like Massachusetts prioritize accessible learning materials and assistive technologies as norms, leading to notable improvements in outcomes for students with disabilities. Masten’s (2001) research underscores the value of this balanced approach, highlighting the significance of comprehensive changes in fostering resilience.

Emphasizing only resilience can ignore the varied needs within the disability community and reinforce existing inequalities. Masten (2001) suggests that resilience should be seen as a continuous process supported by inclusive policies and widespread systemic changes. This view aligns with the social model of disability, which emphasizes the role of social structures in shaping individual experiences and fostering true empowerment.

Understanding these dynamics is crucial for establishing fair and supportive environments for individuals with disabilities. Integrating perspectives from policy and social models reveals that true resilience encompasses more than individual strength alone—it necessitates environments that enhance individual capabilities.

Integrating Personal Resilience with Systemic Support

Justin’s experience highlights the importance of balancing personal resilience with systemic support. Resilience here refers to an individual’s ability to withstand and recover from challenges. While personal resilience is valuable, relying exclusively on it can be limiting, especially for individuals with disabilities who encounter unique obstacles.

Accessible technology and disability awareness training, played a vital role in Justin’s academic journey by reducing systemic barriers (Llewellyn & Hogan, 2000). Accessible technology ensures that educational tools and resources are accessible to all students, regardless of their physical abilities. Disability awareness training educates peers and educators about the challenges and needs of individuals with disabilities, fostering a more inclusive environment.

Addressing structural inequalities involves establishing policies and practices that dismantle barriers and create opportunities. By nurturing supportive environments, genuine and sustainable empowerment for individuals with disabilities can be cultivated.

This approach not only benefits individuals like Justin but also shifts the focus from personal responsibility to collective accountability. It acknowledges that empowerment is a shared objective requiring contributions from individuals and the broader community.

References

  • Erevelles, N. (2002). Disability and the dialectics of difference. Disability & Society, 17(5), 525-539.
  • Goodley, D. (2014). Dis/ability Studies: Theorizing disablism and ableism. Routledge.
  • Kittay, E. F. (2001). Love’s Labor: Essays on women, equality, and dependency. Routledge.
  • Llewellyn, G., & Hogan, K. (2000). The changing face of parenting: Exploring the lives of parents with learning difficulties. Journal of Applied Research in Intellectual Disabilities, 13(4), 243-262.
  • Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227-238.
  • Shakespeare, T. (2018). Disability: The basics. Routledge.

Anxiety and Disabilities: Understanding the Intersections

As I prepared to deliver my presentation, choosing to remain seated to avoid any unnecessary spectacle—I felt the weight of my responsibility keenly. This moment was crucial; I was not only representing the achievements of many but also advocating for a cause close to my heart.

This conference marked the culmination of a year’s dedicated efforts to promote inclusion and accommodations. My team and I diligently gathered data, created resources, and advocated for change across various institutions. We developed workshops, consulted with experts, and interviewed individuals facing the challenges we aimed to address. Our objective was clear: to foster a more inclusive environment that meets everyone’s needs.

Public speaking is a common trigger for anxiety, but for me, it’s more than just nerves. It manifests as a flood of overwhelming sensations that can feel paralyzing. Despite countless rehearsals, the physical symptoms of anxiety make me doubt my preparedness. My mind races, replaying worst-case scenarios and what-ifs, making it difficult to focus on the task at hand (American Psychiatric Association, 2013).

Anxiety isn’t confined to high-stakes moments; it permeates everyday situations, creating a constant undercurrent of tension. From making a simple phone call to attending a social event, the anticipation of anxiety can be as debilitating as the anxiety itself, illustrating its pervasive nature (National Institute of Mental Health, 2016).

Personal Experience with Anxiety

Anxiety is an unwelcome guest that arrives unannounced and overstays its welcome. It starts subtly, a whisper of doubt that quickly escalates into a chorus of fear. My throat tightens, as if an invisible hand is squeezing it, making each breath a conscious effort. It feels like I’m swallowing around a lump that won’t go away—a constant reminder of my unease.

The knot in my stomach is a familiar companion, twisting and turning with every anxious thought. It is a physical manifestation of my worry, leaving me unsettled. In moments of heightened anxiety, my mind goes blank, and I struggle to find the right words. Sentences that once flowed effortlessly now come out in disjointed fragments, if at all. This frustrating experience compounds my anxiety, heightening my fear of making mistakes.

Research indicates that individuals with anxiety often report muscle tension, which can lead to chronic pain (American Psychiatric Association, 2013). Anxiety also leads to hypervigilance, where heightened senses are constantly on the lookout for potential threats. This state of heightened awareness is mentally exhausting and physically draining.

Sleep disturbances are another common symptom. An anxious mind races with thoughts, making it difficult to fall asleep. Even when sleep comes, it’s often restless and filled with unsettling dreams, leading to fatigue and decreased functionality during the day. This lack of restorative sleep further intensifies anxiety symptoms, perpetuating a challenging cycle (National Institute of Mental Health, 2016).

Causes of Anxiety in the Context of Disabilities

Understanding the causes of anxiety in the context of disabilities involves examining multiple factors:

Biological Factors: Genetics and brain chemistry play significant roles in anxiety development. Individuals with a family history of anxiety disorders are more susceptible. Imbalances in neurotransmitters such as serotonin and dopamine can contribute to anxiety symptoms (National Institute of Mental Health, 2016).

Psychological Factors: Trauma and stress are major contributors. For individuals with disabilities, trauma may stem from medical procedures, social stigma, or bullying, exacerbating susceptibility to anxiety (American Psychological Association, 2013).

Contextual Factors: Living with a disability presents unique challenges that intensify anxiety. Social pressures to prove oneself can lead to perfectionistic tendencies, where fear of making mistakes or not meeting expectations becomes overwhelming. This constant striving can take a toll on mental health.

Studies highlight how intersecting disabilities with other marginalized identities, like race or gender, compound anxiety effects. Discrimination and accessibility barriers in education, employment, and healthcare can contribute to heightened anxiety levels among individuals with disabilities (Goodley, 2014).

Implications of Anxiety for Individuals with Disabilities and Their Families

Anxiety profoundly impacts daily life, relationships, and the ability to seek help and support.

Impact on Daily Life and Routines: Anxiety can make even simple tasks seem insurmountable, complicating routines that may already be challenging for individuals with disabilities. The energy needed to manage both physical aspects of disability and mental strain of anxiety can be overwhelming, leading to fatigue and burnout.

Strain on Relationships and Family Dynamics: Anxiety affects relationships with family, friends, and colleagues. Family members may struggle to grasp the extent of anxiety, causing frustration and miscommunication. This strain can create a cycle of stress and anxiety within the family unit (Preece, Becerra, Robinson, & Gross, 2020).

Challenges in Seeking Help and Support: Seeking help for anxiety can be daunting, especially for individuals with disabilities who may feel marginalized or misunderstood. There may be fear of judgment or not being taken seriously.

Anxiety, especially for individuals with disabilities, is a complex condition characterized by both physical and emotional symptoms. It stems from various biological, psychological, and societal factors, with social and societal pressures often intensifying perfectionistic tendencies. Understanding this multifaceted nature is essential for effective intervention.

Conclusion

Anxiety in individuals with disabilities is complex, influenced by biological, psychological, social, and societal factors. The additional stressors and stigma faced by people with disabilities exacerbate anxiety symptoms, impacting daily functioning and relationships.

Effective intervention requires inclusive policies and supportive practices that acknowledge and address these specific needs. By fostering understanding and implementing appropriate supports, we can empower individuals with disabilities to navigate and overcome the challenges posed by anxiety.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  • American Psychological Association. (2013). Publication manual of the American Psychological Association (7th ed.). Washington, DC: Author.
  • Goodley, D. (2014). Dis/ability studies: Theorizing disablism and ableism. Routledge.
  • National Institute of Mental Health. (2016). Anxiety disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
  • Preece, D., Becerra, R., Robinson, K., & Gross, J. (2020). Family functioning in families with a member with a disability: Implications for social work practice. Journal of Social Work Practice, 34(3), 279-292. https://doi.org/10.1080/02650533.2020.1729815

Reevaluating Equitable Access: A Perspective on Social Inclusion

Equitable access is often viewed as the cornerstone of social inclusion, yet it brings its own challenges and limitations that warrant closer examination. The idea that systemic changes alone can ensure engagement for individuals with disabilities in school, work, and community settings is overly simplistic. Tackling the deeper social, societal, and structural issues necessitates a more nuanced approach to inclusion (Darling & Heckert, 2016).

Educational Shortcomings: Beyond Adaptive Technologies

Educational institutions have made significant progress with inclusive curricula and tailored learning aids, but much work remains. Adaptive technologies and accommodations often appear as surface-level solutions, failing to integrate fully into the broader educational framework. This can leave students with disabilities feeling isolated and underserved. A holistic restructuring of educational environments is essential to genuinely cater to all students’ needs (Emerson et al., 2020).

Workplace Inclusion: The Reality Check

In workplace settings, adaptive technologies and flexible work arrangements are crucial but insufficient on their own. These measures support employees with disabilities but often do not address the underlying biases and systemic barriers that impede professional growth. Despite positive efforts, many workplaces continue to focus on meeting minimum legal requirements rather than fostering a truly inclusive environment. Shifting towards a culture where diversity is celebrated and nurtured is key for real progress (Friedman, 2019).

Community Programs: A Closer Look

Community programs that prioritize inclusive recreational activities and adaptive sports are excellent for fostering a sense of belonging. However, these initiatives often lack the necessary resources and support to be fully effective. Without sustained funding and commitment, such programs can become more symbolic than substantive, failing to provide consistent opportunities for participation and engagement. A comprehensive strategy, including long-term investment and community involvement, is essential to ensure these programs’ success (Shakespeare, Ndagire, & Seketi, 2019).

Challenging Attitudes: More Than Awareness

Shifting social and societal attitudes toward disabilities is a complex and ongoing challenge. While promoting positive portrayals through media and public campaigns is crucial, it is not a cure-all. These efforts often encounter resistance and can be undermined by deep-seated prejudices and misconceptions. Integrating disability awareness training into educational curricula is beneficial but should be part of a broader strategy that includes policy reforms, advocacy, and continuous dialogue to achieve meaningful change (Goodley, 2017).

Active Engagement: Moving Beyond Rhetoric

Active engagement in social, cultural, and recreational activities is essential for meaningful inclusion. However, the emphasis on physical accessibility often overshadows the need for social inclusion. Environments designed to be physically accessible must also cultivate a sense of community and belonging. This involves creating spaces where individuals with disabilities can form meaningful relationships and fully participate. Efforts to promote inclusion must extend beyond infrastructure to address the social dynamics that can exclude individuals with disabilities (Hall & Wilton, 2017).

Rethinking Aine’s Story: A Broader Perspective

Aine’s story highlights the journey toward social inclusion but also reveals the limitations of current approaches. By focusing solely on equitable access, we risk overlooking the multifaceted nature of inclusion. True progress requires a comprehensive and integrated approach that addresses physical, social, and systemic barriers. This involves not only prioritizing access but also fostering a culture of acceptance and respect, challenging social and societal norms, and promoting active engagement at all levels (Darling & Heckert, 2016). Achieving true social inclusion requires a holistic approach. Key steps include:

  1. Rethinking Current Strategies: Ensure inclusion principles and strategies are built into every level from the start.
  2. Fostering Genuine Inclusion: Promote inclusion education and workplaces.
  3. Supporting Community Programs: Invest in long-term, sustainable community initiatives.
  4. Changing Attitudes: Engage in continuous, multifaceted efforts to shift perceptions.
  5. Promoting Active Engagement: Encourage active participation for individuals with disabilities.

By focusing on these areas, we can make significant strides towards genuine inclusion.

References

  • Darling, R. B., & Heckert, D. A. (2016). Disability and identity: Negotiating self in a changing society. Lynne Rienner Publishers.
  • Emerson, E., Llewellyn, G., Stancliffe, R. J., Badland, H., & Kavanagh, A. (2020). Inclusive arts practice and research: A critical manifesto. Routledge.
  • Friedman, C. (2019). Inclusive practices in community-based services: Shifting from accessibility to equity. Disability & Society, 34(7), 1034-1048. https://doi.org/10.1080/09687599.2018.1563524
  • Goodley, D. (2017). Disability studies: An interdisciplinary introduction (2nd ed.). SAGE Publications.
  • Hall, E., & Wilton, R. (2017). Towards a relational geography of disability. Progress in Human Geography, 41(6), 727-744. https://doi.org/10.1177/0309132516659705
  • Shakespeare, T., Ndagire, F., & Seketi, Q. E. (2019). An intersectional analysis of gender, disability, and poverty. World Development, 113, 168-179. https://doi.org/10.1016/j.worlddev.2018.09.008

From Access to Belonging

The concept of inclusion, for individuals with disabilities, has been a significant focus in education, work, and community environments. Efforts through laws, educational practices, and advocacy have aimed at fostering a culture where everyone feels welcomed and valued. However, the reality often falls short of true inclusion, highlighting a persistent gap between access and genuine participation.

Contrast in Access vs. Inclusion:

  1. Physical Access vs. Emotional Inclusion: While physical access, such as ramps and accessible facilities, is a foundational aspect of inclusion, it does not inherently ensure a sense of belonging. Many individuals with disabilities find themselves physically present in environments but emotionally isolated, feeling like outsiders due to the visible markers of their disabilities, such as walking devices. This reflects a “separate but not equal” scenario where mere presence does not equate to acceptance, integration, participation or inclusion.
  2. Inclusion in Concept vs. Practice: True inclusion, by definition, should go beyond physical adjustments and create an environment of mutual respect and participation. Research suggests that genuine inclusion involves active engagement and equal participation in activities alongside peers. However, the reality is often different, with many individuals with disabilities experiencing social exclusion, even in settings designed to be inclusive. This invisibility of separateness can be more damaging as it undermines the very goal of inclusion.
  3. Cultural Shifts and Language: Language plays a crucial role in shaping perceptions. Terms like “the disabled” can be dehumanizing, emphasizing difference rather than individuality. Moving towards person-first language and fostering environments where individual talents, interests, and personal experiences, are recognized beyond diagnoses can help combat this invisible separateness. Research findings support the idea that inclusive language and environments contribute to a more profound cultural shift towards true inclusion.
  4. Social Interaction and Peer Relationships: True inclusion is not just about being in the same space but engaging meaningfully with others. Observations over decades reveal that social dynamics often remain unchanged, with individuals with disabilities still facing social isolation. This highlights the need for intentional practices and programs that promote interaction and understanding among peers.

Moving Forward:

To bridge the gap between access and true inclusion, a multifaceted approach is necessary:

  • Educating peers and professionals about disability awareness fosters empathy and understanding (Smith, 2021).
  • Encouraging environments that promote interaction, not just coexistence, by designing activities that promote inclusion and participation of individuals with and without disabilities (Johnson, 2020).
  • Challenging existing norms and language that categorize individuals based on disabilities, moving towards a culture that values diversity and individual contributions (Brown, 2019).

By addressing these areas, we can create an environment where separateness is a thing of the past, replaced by authentic cultures of inclusion and belonging (Smith, 2022; Johnson, 2021; Brown, 2023).

References:

  • Brown, T. (2019). The Language of Inclusion: Moving Beyond Labels. Inclusion Journal.
  • Johnson, L. (2020). Designing Inclusive Environments: A Practical Guide. Community Publishers.
  • Smith, R. (2021). Empathy in Action: Education for Disability Awareness. Learning Press.

Navigating Questions About Disability: Building Bridges of Understanding

While enjoying a peaceful afternoon at a local café, my mother and I exchanged smiles with a couple who had just settled beside us. Suddenly, the serene ambiance was disrupted when the woman asked, “What happened to you? What’s your diagnosis?” This moment demonstrates the complexity of responding to direct questions about disability in public settings. Such interactions require a nuanced understanding of both personal experiences and broader social contexts, offering opportunities for education and the establishment of personal boundaries.

These moments, though potentially awkward, can be transformed into meaningful exchanges that challenge misconceptions when approached thoughtfully. This piece explores various strategies for responding to questions about disability, integrating insights from psychology, sociology, and social work to promote understanding and respect.

The café story serves as a real-life example of the challenges faced when disability becomes a topic of public inquiry. The woman’s question, though well-intentioned, was abrupt and invasive, illustrating the discomfort that can arise. Initially, such questions can evoke a range of emotions, from surprise and discomfort to frustration and even anger. These feelings are natural, as the individual with a disability is put on the spot, forced to navigate a sensitive conversation without warning.

However, these moments also present a unique opportunity to educate and foster understanding. By responding thoughtfully, individuals can shift the narrative, using the interaction as a platform to challenge misconceptions. Several practical strategies can be employed to navigate these conversations effectively. These strategies aim to balance personal comfort with the potential to educate and foster understanding.

One approach is to redirect with positivity. For instance, responding with, “I appreciate your concern. I’m enjoying my day here. How about you?” shifts the focus to a positive aspect, encouraging a more pleasant and less intrusive dialogue. It acknowledges the question without delving into personal details, maintaining the individual’s comfort.

Another strategy is to educate gently. Saying, “It’s a long story, but I’m happy to share a bit if you’re interested,” subtly invites curiosity while respecting personal boundaries. Alternatively, one can set boundaries directly with a response like, “That’s a personal question. I’d prefer not to discuss it right now.” This response firmly yet politely establishes boundaries, protecting personal space and communicating that some topics are off-limits while maintaining respect for the other person’s curiosity.

Empathizing and inquiring is another effective technique. A response such as, “I understand your curiosity. What made you ask?” shows empathy and opens a dialogue that explores the other person’s perspective. This can lead to a deeper conversation about disability and societal perceptions, fostering mutual understanding. Additionally, inviting broader discussions can be beneficial.

Psychological research highlights how empathetic listening and measured responses can significantly impact interactions with individuals with disabilities. Studies emphasize the importance of understanding and compassion in these exchanges. Davis (2018) found that empathetic responses often lead to increased understanding and reduced stigma.

When individuals with disabilities respond to intrusive questions with empathy, they create opportunities for meaningful dialogue. Acknowledging the curiosity behind a question and sharing a brief, empathetic explanation can diffuse potential tension and foster mutual respect. Similarly, Brown (2020) emphasizes that a calm and considerate approach can mitigate discomfort, promoting more positive interactions.

By responding with understanding, individuals can transform abrupt questions into opportunities for meaningful exchange. These findings highlight the transformative power of empathy in conversations about disability.

Sociological research delves into the social dynamics surrounding disability, examining how social and societal perceptions and stereotypes shape interactions. Understanding these dynamics helps individuals navigate conversations more thoughtfully. Research by Miller (2022) highlights that social and societal norms often dictate the curiosity or discomfort people feel towards disabilities. Awareness of common stereotypes enables individuals to anticipate certain types of questions and prepare thoughtful responses. Addressing stereotypes directly can challenge misconceptions and promote a more nuanced understanding of disability.

Social work offers practical strategies for respectful engagement, encouraging the sharing of experiences while maintaining personal boundaries. Williams (2023) suggests techniques such as setting clear limits on personal questions while inviting dialogue on broader issues related to disability. This approach allows for meaningful exchanges without compromising personal comfort.

Combining insights from psychology, sociology, and social work provides potential approaches for handling conversations about disability. By handling these conversations with care, individuals can challenge misconceptions and promote a culture of respect.

Effectively responding to questions about disability involves empathy, social awareness, and clear communication. Insights from psychology, sociology, and social work underscore the importance of informed, compassionate responses. By fostering respectful dialogues, we can enhance understanding and promote inclusion in everyday interactions.

References

  • Brown, R. (2020). The transformative power of empathy in conversations about disability. Journal of Disability Studies, 45(3), 123-139.
  • Davis, L. (2018). Empathetic responses and the reduction of stigma in disability interactions. Psychological Review, 98(2), 234-250.
  • Miller, A. (2022). Societal norms and the dynamics of curiosity towards disabilities. Sociological Inquiry, 67(4), 301-315.
  • Williams, T. (2023). Practical strategies for respectful engagement in social work. Social Work Review, 72(1), 56-68.

From Intrusion to Inclusion: Understanding Respectful Dialogue Around Disabilities

While enjoying a peaceful afternoon at a local café, my mother and I exchanged smiles with a couple who had just settled beside us. The serene ambiance was abruptly disrupted when the woman asked, “What happened to you? What’s your diagnosis?”

Understanding Misconceptions and Challenging Stigma

Such interactions reflect broader social and societal misconceptions about disabilities, closely aligning with Erving Goffman’s concept of stigma. In his seminal 1963 work, Goffman argues that perceptions of “normalcy” and “deviance” shape our interactions with those perceived as different. Historically, ignorance and fear have shaped perceptions of disability, leading to exclusion and stigmatization. Individuals with visible disabilities frequently encounter forward and potentially intrusive questions, which not only highlight physical differences but also perpetuate stigma.

Reflecting on my own experiences in middle and high school, I vividly recall the weight of hesitant glances and whispered conversations among my classmates. These moments echo the experiences of many others with disabilities and illuminate broad and common misunderstandings regarding disability. They serve as stark reminders of deeply ingrained ableist beliefs embedded in our culture.

Promoting Respectful Dialogue and Inclusive Environments

Social workers, guided by the National Association of Social Workers (NASW, 2017), advocate for empathetic and respectful approaches. Dr. Jane Smith, a clinical psychologist specializing in disability studies, emphasizes the importance of empathetic listening and person-centered questions as crucial tools for fostering inclusive environments.

Such approaches promote understanding and support individuals across diverse backgrounds and needs. By using empathetic listening and open-ended questions like “How can I best support you?” instead of intrusive ones that delve into personal medical details, professionals can uphold dignity and foster inclusion (NASW, 2017; Hall, 1999).

Challenging Ableist Attitudes: Empowering Change

To cultivate respectful interactions, it is crucial for both people with disabilities and those without to confront ableist attitudes. Effective strategies such as setting boundaries, redirecting conversations, and educating others help navigate intrusive questions with dignity and also raise awareness.

These efforts contribute to fostering environments that acknowledge individuals with disabilities as whole and capable persons, diminishing stigma and advancing inclusion.

Conclusion

Navigating interactions like the one at the café highlight the persistence of societal misconceptions about disabilities, rooted in historical stigma and perceptions of “normalcy” versus “deviance.”

These encounters highlight the importance of challenging ableist attitudes and promoting respectful dialogue. By setting boundaries, and educating others, we can foster inclusive environments where individuals with disabilities are recognized for their full capabilities. Such efforts not only diminish stigma but also pave the way for greater understanding and change towards true inclusion.

References

  • Goffman, E. (1963). Stigma: Notes on the Management of Spoiled Identity. Prentice-Hall.
  • Hall, E. (1999). The Social Inclusion of Disabled People: A Study of Experiences and Attitudes. University of Leeds.
  • National Association of Social Workers. (2017). NASW Code of Ethics. NASW Press.

Beyond Expectations: Navigating the Challenges of Overachievement and Inclusion

Navigating the world with a disability presents a myriad of personal, social, and societal challenges. As the manager of Wiley’s Walk, a blog dedicated to sharing the diverse experiences of individuals with disabilities, I aim to raise awareness and foster understanding of these unique journeys. Many of us feel pressured to overachieve to be seen as equals, a theme that permeates our shared stories.

Our community encompasses a wide array of experiences, including physical disabilities and neurodiversity, all of which consistently reveal themes of underestimation and resilience. From a young age, many of us learn that exceeding expectations is often necessary to be perceived as capable.

The Psychology of Overachievement

The psychology of overachievement among individuals with disabilities often stems from “stereotype threat,” a concept introduced by Steele and Aronson (1995). Stereotype threat occurs when people become aware of negative stereotypes about their disabilities, driving them to disprove these biases through extraordinary effort. For example, a student with a physical disability might feel compelled to excel academically to counteract assumptions about their capabilities. However, the intense effort to counteract stereotypes can lead to significant stress and even burnout.

Recent research highlights the critical role of positive reinforcement and inclusive practices in mitigating these detrimental effects. Studies conducted by Smith and Andrews (2020) suggest that supportive environments play a crucial role in alleviating the pressures associated with stereotype threat. Similarly, research by Wang et al. (2019) demonstrates that inclusive and supportive academic and professional settings can substantially alleviate the mental burden on individuals with disabilities.

A Case Study of Overachievement: Jane’s Experience

Jane, a visually impaired student, excels academically, driven by a determination to defy low expectations. Despite her achievements, she is often marginalized in group projects and must continually prove her capabilities. Jane’s ongoing struggle serves as a poignant reminder of the systemic barriers prevalent in educational and professional environments, which often fail to recognize and adequately accommodate diverse abilities.

Research underscores the persistence of these challenges. Robinson’s (2018) findings reveal that students with disabilities frequently encounter implicit biases from educators, exacerbating the pressure to overachieve. Similarly, research by Thompson and Jenkins (2021) sheds light on the heightened levels of anxiety and depression experienced by individuals with disabilities due to the pervasive pressure to excel.

Advocating for Systemic Change

Entrenched stereotypes equating disability with incompetence are harmful and pervasive, affecting everything from educational opportunities to workplace accessibility. Despite legislative advancements, many still face inaccessible environments and unaccommodating policies. Research points to the need for both policy revision and a cultural shift in understanding disabilities. Legislative reviews, such as those by Hernandez (2022), argue for more stringent enforcement of existing disability rights laws to ensure true accessibility and equity.

Educational settings often become arenas where pressures to overachieve are the most pronounced. Students with disabilities face lowered expectations, undermining their confidence and academic outcomes. Inclusive education practices are essential, not just in providing necessary accommodations but also in fostering an environment where high expectations are the norm and matched with appropriate support. Lawson and Beckett (2023) highlight the importance of teacher training in fostering an inclusive and supportive learning environment.

Conclusion

The journey toward recognizing and respecting the abilities of people with disabilities is fraught with personal and systemic challenges. Shifting the focus from individual overachievement to systemic inclusion can help dismantle the biases that underpin many of the obstacles faced by the disability community. It is imperative that educators, policymakers, and community leaders work together to implement and advocate for policies that support the rights and needs of all individuals, enabling everyone to achieve their potential without the undue burden of proving their worth.

References

  • Hernandez, J. (2022). Legislative reviews and disability rights enforcement. Journal of Disability Policy Studies, 33(4), 231-245.
  • Lawson, A., & Beckett, A. (2023). The importance of teacher training in inclusive education. Educational Research Review, 29, 100-118.
  • Robinson, T. (2018). Implicit biases in education: Challenges for students with disabilities. Journal of Inclusive Education, 12(3), 215-228.
  • Smith, L., & Andrews, K. (2020). Positive reinforcement and inclusive practices: Reducing stress in individuals with disabilities. Journal of Psychological Research, 54(2), 174-189.
  • Steele, C. M., & Aronson, J. (1995). Stereotype threat and the intellectual test performance of African Americans. Journal of Personality and Social Psychology, 69(5), 797-811.
  • Thompson, P., & Jenkins, R. (2021). Anxiety and depression in individuals with disabilities. Disability and Health Journal, 14(1), 45-59.
  • Wang, X., Chen, Y., & Liu, Z. (2019). Supportive settings in academic and professional environments for individuals with disabilities. Journal of Applied Psychology, 104(3), 243-256.

Finding Solace in Words

Leaving the lively city where I’d grown up, I found myself in a small town that felt like a different world. As a high school senior with Spastic Cerebral Palsy, every step I took carried more than just physical exertion; it bore the weight of isolation and scrutiny. The unfamiliar rural surroundings made my struggle to find my footing even more pronounced.

Narrow hallways, antiquated buildings without ramps, and staircases lacking elevators constantly reminded me of my limitations. Yet, amid these challenges, one place provided solace—Mrs. D’s English class.

Understanding and Encouragement

Mrs. D’s English class was where I felt understood. She once told me, “You have a gift with words. Your poetry can touch hearts and change minds.” Her words ignited a fire within me, driving me to refine my work late into the night. With her guidance, I channeled my experiences into my writing. Supported by family and friends, I gained confidence in myself. Through dedication, I reached a significant milestone: my writing was published.

Social Barriers

My journey mirrors findings from social work and psychology literature. From a sociological perspective, Goffman’s (1963) work on stigma highlights the social barriers individuals with disabilities encounter. These barriers, including negative stereotypes, discrimination, and social exclusion, can lead to internalized stigma, which undermines self-esteem and aspirations. However, positive social interactions and inclusive environments can mitigate the effects of stigma, promoting a sense of belonging and self-worth. These supportive environments are crucial for individuals with disabilities to overcome prejudice and achieve their goals (Link & Phelan, 2001).

Mrs. D’s support exemplified the strength-based approaches highlighted by Mishna (2003). She recognized potential in me that others often overlooked, offering encouragement and recognizing my ability to write and create. Her belief ignited my aspirations, helping my words rise beyond perceived limitations.

Self-Efficacy and Support

Living with a disability requires adaptation, resilience, and determination. These qualities shape a distinct perspective that fuels creativity and perseverance. Belief, like that of Mrs. D, is crucial; it serves as the foundation for pursuing aspirations despite obstacles. The journey of pursuing dreams with a disability is marked by setbacks, barriers, and doubts, but also by achievement, creativity, and self-discovery.

Psychological research highlights the importance of self-efficacy in achieving personal goals. Self-efficacy, as defined by Bandura (1994), is the belief in one’s ability to succeed in specific situations or accomplish tasks. This belief drives both motivation and achievement.

For individuals with disabilities, cultivating self-efficacy is essential. This belief can be strengthened through mastery experiences, social modeling, and social persuasion. Mastery experiences involve successfully completing tasks, which builds confidence. Observing others overcome similar challenges reinforces one’s capacity to succeed. Additionally, supportive relationships that provide encouragement and constructive feedback enhance self-efficacy (Schwarzer & Luszczynska, 2007).

Encouraged by Mrs. D, I pursued poetry and sought publication despite challenges. Eventually, my work was published, affirming the power of belief and determination.

Conclusion

Reflecting on my journey, I recognize the significant impact of support and belief—both from myself and others. Mrs. D’s encouragement helped me build confidence, allowing me to leverage my experiences in my writing and achieve my goals. Her support demonstrates how positive social interactions and inclusive environments can overcome stigma and isolation.

Living with a disability has taught me resilience, creativity, and determination. Challenges in a small town showed how important accessibility and understanding are, and the importance of perseverance and self-belief. Psychological studies support the idea that believing in oneself is key to overcoming obstacles and achieving success. Through mastering skills, observing others, and receiving support, people with disabilities can build the confidence they need to pursue their goals.

References

  • Bandura, A. (1994). Self-efficacy: The exercise of control. Journal of Cognitive Psychotherapy, 8(3), 289-310. [Article]
  • Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Simon & Schuster. [Book]
  • Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363-385. [Article]
  • Mishna, F. (2003). Learning disabilities and bullying: Double jeopardy. Journal of Learning Disabilities, 36(4), 336-347. [Article]
  • Schwarzer, R., & Luszczynska, A. (2007). Self-efficacy. In M. Gerrard & K. D. McCaul (Eds.), Handbook of Health Behavior Research II: Provider Determinants (pp. 157-174). Springer. [Book Chapter]

Creating Accessible Communities: The Power of Reasonable Accommodations

Sarah navigated her wheelchair through the community park, illuminated by the setting sun. Children’s laughter echoed as they enjoyed the newly installed accessible pathways and inclusive playground equipment. These changes were more than mere improvements; they provided Sarah with the freedom to actively participate in her community. This narrative exemplifies the significance of reasonable accommodations in community settings, facilitating equal engagement for individuals with disabilities.

The Importance of Reasonable Accommodations

Reasonable accommodations are essential for ensuring inclusion and encompass a wide range of adjustments, from physical modifications in public spaces to changes in policies and practices that remove participation barriers. These accommodations are not only a matter of legal compliance but also a crucial support for including people with disabilities in various settings. Reasonable accommodations often involve making practical adjustments to environments or procedures to ensure accessibility for individuals with disabilities. For instance, installing ramps and elevators in public buildings facilitates entry and movement for those with mobility impairments. Similarly, providing sign language interpreters at public events ensures that individuals with hearing impairments can fully participate and engage. These accommodations aim to remove barriers, allowing everyone to enjoy public spaces and activities.

Creating sensory-friendly spaces in public venues caters to individuals with sensory processing disorders, allowing them to enjoy community experiences in a comfortable environment. Libraries, theaters, and museums are now offering sensory-friendly hours with dimmed lights and reduced noise, creating a welcoming atmosphere for individuals with Autism or other sensory sensitivities.

Visual accommodations, like tactile paving and audible signals at crosswalks, play a crucial role in assisting individuals with visual impairments as they navigate public spaces safely and independently. Additionally, accessible public transportation, which includes features like lifts and priority seating, is essential for enabling people with disabilities to travel autonomously and actively participate in community activities.

Impact and Benefits of Accommodations

For those with mobility impairments, modifications like ramps, elevators, and accessible public transportation are crucial. These accommodations allow individuals to move freely within their communities, accessing public buildings and recreational facilities. Imrie and Wells (1993) highlight the role of accessible environments in enhancing inclusive opportunities for individuals with mobility impairments.

The implications of reasonable accommodations are profound, breaking down systemic barriers for people with disabilities. For those with visual impairments, features like tactile paving and audible signals promote independence and safety. Research by Bentzen, Barlow, and Franck (2013) highlights the importance of tactile guidance in navigating urban environments safely. Similarly, offering information in Braille and large print demonstrates a commitment to accessibility, ensuring access to public services and community activities.

Sensory accommodations, such as sensory-friendly spaces and adaptive technologies, play a crucial role in supporting individuals with sensory processing disorders. Research by Pfeiffer et al. (2011) found that sensory-friendly environments significantly improve the involvement of individuals with Autism in community activities. Introducing sensory-friendly hours in venues like libraries, theaters, and museums can expand access to cultural and recreational experiences for people with all types of disabilities, promoting inclusion within communities.

For individuals with hearing impairments, accommodations such as sign language interpreters and captioning services are vital for effective communication and community participation. Research by Napier and Kidd (2013) revealed that the presence of sign language interpreters significantly influences the inclusion of deaf individuals in public events and educational settings. These accommodations facilitate access to information, engagement in discussions, and integration within communities, reflecting a commitment to accessibility and inclusion and promoting the importance of sign language as a communication tool.

Challenges and Solutions in Implementing Accommodations

However, the provision of these accommodations is not without challenges. Financial constraints, lack of awareness, resistance to change, logistical complexities, and insufficient enforcement of accessibility regulations are significant barriers.

Modifying infrastructure and providing specialized services can be costly, and communities may struggle to allocate sufficient resources. According to findings from Schur, Kruse, and Blanck (2013), the costs associated with accessibility modifications can be a deterrent, especially in underfunded public sectors. However, research by the Job Accommodation Network (2020) indicates that the benefits of providing accommodations often outweigh the initial costs, as they increase community engagement and economic participation by individuals with disabilities.

Lack of awareness and understanding about the needs of people with disabilities can also hinder progress. Public education and awareness campaigns are crucial in fostering a culture of inclusion. Shakespeare (2006) notes that attitudes toward disability significantly impact the effectiveness of inclusion efforts. Resistance to change is another formidable obstacle, requiring a combination of legislative action and grassroots advocacy to ensure that the voices of people with disabilities are heard in decision-making processes.

Logistical complexities in implementing accommodations require planning and coordination among various stakeholders. These efforts must be guided by accessibility standards and best practices, as highlighted by the World Health Organization (2011). Insufficient enforcement of accessibility regulations also remains a critical issue. Blanck et al. (2004) note that inconsistencies in enforcement and a lack of penalties for non-compliance can undermine the goals of these laws.

Addressing these challenges requires a multifaceted approach.

  • Expanding public education and awareness about disability and accessibility can shift attitudes and build support for accommodations.
  • Fostering a culture of collaboration among stakeholders can facilitate the implementation of accommodations, ensuring that the needs of people with disabilities are considered in planning and decision-making processes.
  • Simplifying logistical processes through technology and innovative solutions can help overcome complexities.
  • Strengthening the enforcement of accessibility regulations through increased funding, regular compliance audits, and penalties for non-compliance can ensure effective implementation.

Reasonable accommodations extend beyond individual experiences, fostering inclusion and community unity. Whether it’s improving transportation or creating sensory-friendly spaces, these efforts promote safety, independence, and community engagement. Yet, challenges like financial limitations and awareness gaps persist, necessitating collective action.

Prioritizing education, collaboration, technological progress, and strict enforcement of accessibility standards can overcome these hurdles, ensuring fair access to opportunities for all.

References

  • Bentzen, B. L., Barlow, J. M., & Franck, L. (2013). Assessing the impact of audible pedestrian signals: An update. Journal of Visual Impairment & Blindness, 107(3), 168-176.
  • Blanck, P., Schur, L., Kruse, D., Schwochau, S., & Song, C. (2004). Calibrating the impact of the ADA’s employment provisions. Stanford Law & Policy Review, 15(2), 267-290.
  • Imrie, R., & Wells, P. (1993). Disabling barriers: Access to disabled people. Urban Studies, 30(2), 333-346.
  • Job Accommodation Network. (2020). Workplace accommodations: Low cost, high impact. Retrieved from https://askjan.org/topics/costs.cfm
  • Napier, J., & Kidd, M. (2013). English language literacy as a barrier to health care information for deaf people who use Auslan. Australian Family Physician, 42(12), 896-899.
  • Pfeiffer, B., Koenig, K., Kinnealey, M., Sheppard, M., & Henderson, L. (2011). Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. American Journal of Occupational Therapy, 65(1), 76-85.
  • Schur, L., Kruse, D., & Blanck, P. (2013). People with disabilities: Sidelined or mainstreamed? Cambridge University Press.
  • Shakespeare, T. (2006). Disability rights and wrongs. Routledge.
  • World Health Organization. (2011). World report on disability. Retrieved from https://www.who.int/disabilities/world_report/2011/report.pdf

Understanding the Role of Familial Support in Combating Social Isolation

Social isolation can severely impact emotional, psychological, and physical well-being. However, familial support provides essential connections during these times. Inspired by Shannon, a person living with Cerebral Palsy (CP), this article explores how families can play a critical role in combating social isolation. By examining familial advocacy and social inclusion, defined as improving the terms on which individuals and groups participate (World Bank, 2013), we demonstrate how families can mitigate the adverse effects of social isolation.

Defining Social Isolation and Its Effects

Social isolation, defined as having minimal contact with others, leads to a lack of social support and engagement (Cornwell & Waite, 2009). This absence of interaction can be detrimental, affecting both mental and physical health, contributing to chronic illnesses, and increasing the risk of mortality. Hawkley and Cacioppo (2010) demonstrate that these adverse conditions can significantly worsen over time.

A meta-analysis by Holt-Lunstad et al. (2015) found a strong link between social isolation and higher mortality rates, highlighting its serious impact on overall health and well-being. Research by Leigh-Hunt et al. (2017) further emphasize that loneliness intensifies feelings of isolation and contributes to emotional distress.

Consider an elderly individual who lives alone and seldom engages with friends. They may experience significant emotional distress, often culminating in depression. This emotional upheaval can compromise their immune system, rendering them more vulnerable to illnesses (Hawkley & Cacioppo, 2010).

Similarly, imagine a young adult grappling with social anxiety. Avoiding social interactions, they increasingly feel isolated, exacerbating their anxiety and fostering feelings of despair, illustrating the profound psychological consequences of social isolation (Holt-Lunstad et al., 2015).

Familial Advocacy

Familial advocacy is crucial in supporting individuals facing social isolation. In Shannon’s case, her family’s support is vital in navigating social exclusion and building resilience. Research shows that familial support can buffer against the negative effects of social isolation, particularly for individuals with disabilities (Russell & Cutrona, 1991).

Families provide emotional support, facilitate access to healthcare, and advocate for inclusive educational and recreational opportunities (Heller et al., 2017). Proactive familial involvement creates a nurturing environment that helps individuals thrive despite challenges (Bogossian et al., 2019).

For instance, parents who advocate for their child with CP to receive suitable accommodations in school—like physical therapy and specialized educational plans—can greatly improve the child’s sense of inclusion and support. This proactive involvement helps diminish feelings of isolation and cultivates a sense of belonging (Russell & Cutrona, 1991).

Similarly, when a family arranges regular social events and gatherings for their child with Autism, they ensure the child has chances to engage with peers and establish meaningful relationships, effectively addressing social isolation (Heller et al., 2017).

Social Connectivity Beyond the Family

While familial support is crucial, social connectivity beyond the family circle also plays a vital role in combating social isolation. Social connectivity encompasses the relationships and interactions individuals cultivate beyond their immediate family, including friendships, community involvement, and engagement in group activities. This broader network of social ties is instrumental in addressing social isolation and enhancing overall well-being. Active participation in local communities and inclusive activities fosters meaningful connections and a sense of belonging.

Community-based interventions, such as support groups and recreational programs, provide invaluable resources for individuals with disabilities and their families. These initiatives foster a sense of belonging and support, helping to mitigate the challenges of social isolation. Research by Pistrang and Barker (2015) highlights how family-based interventions improve communication, coping skills, and familial bonds, promoting resilience and well-being within families.

For example, local recreation centers that offer adaptive sports programs enable individuals with disabilities to participate in physical activities alongside their peers. This approach not only facilitates social interaction but also promotes physical health (Pistrang & Barker, 2015).

Community centers that host inclusive events, such as art classes, music sessions, and gardening clubs, ensure that people of all abilities can participate and feel valued. These inclusive environments foster a sense of belonging and significantly reduce feelings of isolation (Bartolomei et al., 2016).

Practical Aspects of Familial Advocacy

Expanding beyond emotional support, familial advocacy includes practical assistance and proactive involvement. This can range from facilitating access to necessary services to actively participating in advocacy efforts to promote inclusion in the broader community.

Parents of children with disabilities often take on the role of advocates, tirelessly working to secure suitable accommodations in educational environments and ensure tailored access to healthcare services. This advocacy extends to collaborating with school administrators to develop Individualized Education Plans (IEPs), wherein they play a crucial role in ensuring their children receive personalized support. These IEPs encompass specific accommodations, targeted learning strategies, and access to resources essential for both academic progress and social integration, as highlighted by research from Heller et al. (2017).

Also, families advocating for accessible public transportation options significantly contribute to facilitating the participation of individuals with disabilities in community activities. This advocacy not only reduces feelings of isolation but also enhances the overall independence and engagement of individuals with disabilities in community life, as noted research findings from Heller et al. (2017).

The Role of Siblings in Familial Advocacy

Siblings play a vital role in reducing isolation for individuals with disabilities through crucial support. They possess an understanding of their sibling’s communication and behavior, facilitating connections with others and promoting inclusion. This understanding acts as a bridge, fostering a strong sense of belonging and bridging social gaps.

Siblings often engage in advocacy efforts, ensuring their family member’s needs are addressed both at home and in various settings. This involvement may extend to accompanying their sibling to social events, where they facilitate interactions and advocate for their inclusion and support.

Additionally, when siblings participate in advocacy groups or awareness campaigns, they play a crucial role in challenging the stigma surrounding disabilities. Through their multifaceted support and advocacy efforts, siblings significantly contribute to enhancing social connectivity and community engagement, ultimately diminishing isolation for individuals with disabilities.

Conclusion

Social isolation profoundly impacts emotional, psychological, and physical well-being. Familial support, especially through dedicated advocacy, is crucial in mitigating these adverse effects.

By fostering both strong familial bonds and active community participation, the adverse effects of social isolation can be effectively mitigated, promoting overall well-being and inclusion. Creating inclusive environments and supporting those facing social isolation requires the collective effort of families and communities.


References

Bartolomei, L., Corkery, L., Judd, B., & Thompson, S. (2016). Urban agriculture: A valuable practice for freemen’s gardens and community wellbeing. International Journal of Environmental Research and Public Health, 13(2), 214–225. https://doi.org/10.3390/ijerph13020214

Bogossian, A., Wilkes, L., & Jackson, D. (2019). Resilience in families of children with disabilities: A mixed methods study. Journal of Pediatric Nursing, 44, e26–e36. https://doi.org/10.1016/j.pedn.2018.10.002

Cornwell, E. Y., & Waite, L. J. (2009). Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior, 50(1), 31-48. https://doi.org/10.1177/002214650905000103

Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40(2), 218–227. https://doi.org/10.1007/s12160-010-9210-8

Heller, T., Caldwell, J., & Factor, A. R. (2017). Aging family caregivers: Policies and practices. Journal of Disability Policy Studies, 28(2), 87–95. https://doi.org/10.1177/1044207317726845

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352

Leigh-Hunt, N., Bagguley, D., Bash, K., Turner, V., Turnbull, S., Valtorta, N., & Caan, W. (2017). An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health, 152, 157–171. https://doi.org/10.1016/j.puhe.2017.07.035

Pistrang, N., & Barker, C. (2015). Family therapy: An overview (9th ed.). Brooks/Cole.

Russell, D. W., & Cutrona, C. E. (1991). Social support, stress, and depressive symptoms among the elderly: Test of a process model. Psychology and Aging, 6(2), 190–201. https://doi.org/10.1037/0882-7974.6.2.190

World Bank. (2013). Inclusion matters: The foundation for shared prosperity. New Frontiers of Social Policy. Washington, DC: World Bank. https://doi.org/10.1596/978-1-4648-0010-0