Perceptions of Self

01

AMERICAN ACADEMY OF DEVELOPMENTAL MEDICINE & DENTISTRY

BY H. BARRY WALDMAN DDS, MPH, PHD, STEVEN P. PERLMAN DDS, MSCD, DHL (HON)
AND MATTHEW COOKE, DDS, MD, MPH

“Prior to the twentieth century, social attitudes reflected the view that persons with disabilities were unhealthy, defective and deviant. For centuries, society as a whole treated these people as objects of fear and pity. The prevailing attitude was that such individuals were incapable of participating in or contributing to society and that they must rely on welfare or charitable organizations.”1

Many legislative and societal changes in the second half of the last century have had a great influence on the treatment of, and attitudes toward, people with intellectual and/or physical disabilities. The results of a poll conducted in the 1990s emphasized these changes.
• “… 98% of individuals questioned believe that all people, regardless of one’s ability, should have an opportunity to participate in mainstream society…
• 92% polled believed that employment of persons with disabilities would be economically beneficial to society.” 1 By contrast, a study published in Great Britain in 2014 reported:
• 67% of the British public feels uncomfortable talking to people with disabilities.
• 36% of people tend to think of people with disabilities as not as productive as everyone else.
• 85% of the British public believes that people with disabilities face prejudice.
• 21% of 18-34 years old admit that they have actually avoided talking to persons with disabilities because they weren’t sure how to communicate with them.2

There is another side to this equation; how do individuals with disabilities view their disabilities? A study by the National Center for Special Education Research, Perceptions and Expectations of Youth with Disabilities provides important basic information for the interaction between family members, educators, potential employers and the young men and women with disabilities between 15 and 19 years of age.3 The large majority of information reported in this study comes from responses of youth with disabilities, either during a telephone interview or by a  self-administered mail survey, which contained a subset of key items from the telephone interview. It is important to note that the subgroup of youth who could respond for themselves differs in several ways from youth who were unable to respond, according to their parents. For example, youth respondents are significantly more likely to have higher cognitive and self-care skills and are less likely to have sensory, physical, or communication difficulties.

YOUTH WITH DISABILITIES’ DESCRIPTIONS OF THEMSELVES AND THEIR LIVES

“Between 59% and 83% of youth with disabilities say that each of five positive attributes are “very much” like them—being nice, being proud of themselves, being able to handle challenges, feeling useful and important, and feeling that life is full of interesting things to do.
• About 60% reported that in the previous week they “rarely or never” felt depressed, lonely, or disliked by others.
• In contrast, almost 1 in 10 youth with disabilities do not consider themselves to be useful or important “at all,” and 12% say they “rarely or never” feel hopeful about the future.
• Fewer than one-third of those who had received special education services when they were ages 13 through 16 consider themselves to have a disability or special needs by the time they are 15 through 19 years old.

SELF-EVALUATIONS OF STRENGTHS AND COMPETENCIES

More than half of youth with disabilities report they are at least “pretty good” in the areas of performing arts, creative arts, mechanical tasks, computer use, and physical or athletic performance.
• A comparison of parents’ and youth’s perceptions indicates that, overall, parents tend to hold higher opinions of their children’s strengths than youth hold of themselves.
• More than half of youth with disabilities report being able to tell peers their feelings when peers upset them, and almost two-thirds say they can get adults to listen to them and get information they need.
• Half of youth with disabilities score in the high range on the measures of personal autonomy, and more than 8 in 10 have high scores related to psychological empowerment.

VIEWS OF SECONDARY SCHOOL

On virtually all measures, positive views of school predominate, and strongly negative views are held by a minority of youth with disabilities.
• The majority of youth with disabilities report not finding school particularly hard, and most report having no more than occasional problems completing homework, paying attention, or getting along with teachers or other students.
• The most negative views (e.g., having daily problems at school, finding school very hard or not liking or feeling part of school “at all”) are held by 1% to 11% of youth with disabilities.

PERSONAL RELATIONSHIPS

Personal relationships can be “protective factors” against a variety of adolescent risk behaviors.
• For the most part, youth with disabilities report having strong, positive relationships with their parents. Parents also are the people youth with disabilities are most likely to turn to for support.

• About half of youth with disabilities report they feel very cared about by friends, and three-fourths say they can find a friend when they need one and can make friends easily.
• Despite these overall positive findings, a small minority of youth with disabilities report quite negative views of their personal relationships.

EXPECTATIONS FOR THE FUTURE

Most youth expect they will graduate from high school with a regular diploma. They are less confident they will attend a postsecondary school. The majority of youth with disabilities expect they will get a paid job, but they are less certain that these jobs will pay enough for them to be financially self-sufficient.
• Girls are more likely than boys to report being very sensitive to others’ feelings, whereas boys are more likely to report being good athletes and having strong mechanical abilities.
• Adolescent girls with disabilities are more likely than boys to say they frequently turn to friends and to siblings for support.
• Regarding their relationships in general, youth with disabilities are more likely than others without disabilities to report pervasive feelings of loneliness and of being disliked by others.

Nonetheless, compared with youth in the general population, those with disabilities are more likely to say they receive ‘a lot’ of attention from their families and to report enjoying life and feeling hopeful about the future most or all of the time.”3 (emphasis added)

SELF-ESTEEM IS HOW WE VIEW OURSELVES

001It is how we view our worth as a person. “Healthy or positive self-esteem does not mean that someone has an inflated or self-righteous view of him or herself. One added challenge for a person with a disability may be viewing him or herself as a person first. A disability is only one fact of a person… Another issue for people with disabilities may be dealing with discrimination and stereotypes from society. Our society places emphasis on looks, speed, and being the same as everyone else.” 4

“Parents may provide a crucial role in shaping a child’s concept of him or herself. Parents can convey attitudes that the child is independent and successful or inadequate, incapable, and inferior. Thus, lack of confidence does not necessarily equal lack of ability. It may just be a false set of belief that a person holds about him or herself. Friends and society can also powerfully influence a person’s concept of him or herself. (Remember), you have become an expert at playing on a field that is not level as a result of dealing with your disability and peoples’ attitudes toward your disability” 4

COMMENTS POSTED REGARDING THE ARTICLE ON SELF-ESTEEM

• “I believe in accepting my disability as for what it is and make the best of it.”
• “… I realized that it is not what my disability allows me to do, it is what I don’t allow my disability to do.”
• “Disability is not my life but part of my life.” 4 •

ABOUT THE AUTHORS:
H. Barry Waldman, DDS, MPH, PhD – Distinguished Teaching Professor, Department of General Dentistry at Stony Brook University, NY; E-mail: h.waldman@stonybrook.edu
Steven P. Perlman, DDS, MScD, DHL (Hon) is Global Clinical Director, Special Olympics, Special Smiles and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine, Private pediatric dentistry practice – Lynn MA.
Matthew Cooke, DDS, MD, MPH is Associate Professor, Departments of Anesthesiology & Pediatric Dentistry University of Pittsburgh School of Dental Medicine Pittsburgh PA; Assistant Clinical Professor, Departments of Oral & Maxillofacial Surgery and Pediatric Dentistry Virginia Commonwealth University School of Dentistry, Richmond, VA.


2The American Academy of Developmental Medicine and Dentistry (AADMD) was organized in 2002 to provide a forum for healthcare professionals who provide clinical care to people with neurodevelopmental disorders and intellectual disabilities (ND/ID). The mission of the organization is to improve the quality and assure the parity of healthcare for individuals with neurodevelopmental disorders and intellectual disabilities throughout the lifespan.


References
1. Burtner P. Society’s Attitude toward people with disabilities. Available from: http://paul-burtner.dental.ufl.edu/oral-health-care-for-persons-with-disabilities/societys-attitude-toward-people-with-disabilities
Accessed May 3, 2016.
2. Scope about disability. Current attitudes towards disabled people. Available from:
http://www.scope.org.uk/Scope/media/Images/Publication%20Directory/Current-attitudes-towards-disabled-
people.pdf Accessed May 3, 2016.
3. Wagner M, Newman L, Cameto R, et al. National Center for Special Education Research.
Perceptions and expectations of youth with disabilities: A special topic report of findings from the
National Longitudinal Transition Study-2 (NLTS2). Available from: http://ies.ed.gov/ncser/pdf/20073006.pdf
Accessed May 3, 2016.
4. Voigt RJ. Who me? Self-esteem for people with disabilities. Available from:
http://www.brainline.org/content/2009/05/who-me-self-esteem-for-people-with-disabilities.html Accessed
May 4, 2016.