Disability: Physical Disabilities

Research has shown that attitudes toward different disabilities form a hierarchy, with observers exhibiting more positive attitudes toward persons with physical disabilities than toward persons with psychiatric disabilities. In addition, investigations of attitudes toward persons with a disability indicate that they are often perceived as asexual. The current study examined whether involvement of persons with either a physical or psychiatric disability in a sexual relationship moderates the relation between their type of disability and attitudes toward them. After reading one of six randomly assigned vignettes, university students (N = 195) filled out a semantic differential-based attitude scale (Katz & Shurka, 1977; Kravetz, Katz, & Albez, 1994). The six vignettes consisted of a male with a physical disability/with a psychiatric disability/without a disability, who was either involved/not involved in a sexual relationship. An interaction between type of disability and involvement in a sexual relationship was found for two subscales of the attitudes scale, occupation and intelligence. Involvement in a sexual relationship was found to generate more positive attitudes when the target person had a physical disability but more negative attitudes when he had a psychiatric disability. Involvement in a sexual relationship seems to work in favor of persons with a physical disability because of the association of such a relationship with normality and adaptation. However, attributing such a relationship to persons with a psychiatric disability seems to be stigmatic.

The decline of physical function of older adults, associated with loss of independent living status, is a major public health concern. The purpose of this study was to examine the relationship of physical impairment and disability to performance of activities of daily living (ADL) among community-dwelling older adults. Eighty-three community-dwelling older men who were referred to a comprehensive outpatient geriatric evaluation program (mean age=75.5 years, SD=7.0, range=64-97) were examined. Measurements of physical impairment (muscle force production, flexibility, and fitness) and physical disability (gait speed, stride length, risk for recurrent falls, and physical function) were recorded. A stepwise linear regression was used to determine the relationship of physical impairments and disability measures with ADL. The results indicated that walking speed, fall risk, and muscle force contributed independently to the characterization of the activities of daily living of the community-dwelling older men studied (adjusted R2=.68; F=56.81; df=3,80; P<.001). Using a principal components factor analysis, 4 domains were identified that explained 68.2% of the variance in performance of ADL: (1) mobility/fall risk=26.5%, (2) coordination=15%, (3) fitness=14.7%, and (4) flexibility=12.0%. The identification of domains of physical function may be useful to physical therapists in the development of interventions targeted for physical impairments and disabilities that contribute to deficits in performance of ADL. Targeting interventions for physical impairments and disabilities related to function may improve the effectiveness of physical therapist interventions and reduce the loss of independence among community-dwelling older people.

In the Baltic States, the protection and empowerment of people with disabilities remain areas that still call for reconsideration and improvement. Persons with physical disabilities, and more particularly with mental disabilities, face various barriers that hinder enjoyment of their rights and thus their full participation in society. First and foremost, discrimination against people with disabilities still occurs and efforts should be devoted to overcoming this. Secondly, the instruments designed for the general population often fail to take account of additional measures of protection needed for this vulnerable group. Moreover, compliance with international human-rights standards and the persisting gap between these standards and practices also need to be addressed.This chapter aims to identify and examine the legal-regulation shortcomings related to the protection of the persons with physical and mental disabilities and to suggest legal means for improving the situation. It covers the three Baltic States—Lithuania, Latvia and Estonia, although the primary focus is on Lithuania. The author bases her research on the comparative analysis of legal documents, as well as on national and international reports, reports of non-governmental organisations and other available sources.KeywordsPeople with disabilitiesUN Convention on the rights of persons with disabilitiesEmpowering by lawDiscriminationAdditional measures of protection

Children with disabilities have been shown to be at greater risk of victimization than those without. Although much of the research combines disability of any type into a single disability category, recent evidence suggests that not all types of disabilities are equally associated with victimization. To date, little knowledge exists about the victimization of youth with physical disabilities. This study used data from a national school-based survey of adolescents (n = 6,749, mean age = 15.41, SD = .66) in Switzerland to investigate sexual victimization (SV) among physically disabled youth. Two subtypes of SV were differentiated: contact SV, including penetration or touching/kissing, and non-contact SV, such as exhibitionism, verbal harassment, exposure to sexual acts, or cyber SV. A total of 360 (5.1%) youth self-identified as having a physical disability. Lifetime prevalence rates for contact SV were 25.95% for girls with a physical disability (odds ratio [OR] = 1.29 compared with able-bodied girls), 18.50% for boys with physical disability (OR = 2.78 compared with able-bodied boys), and 22.35% for the total sample with physical disability (OR = 1.74 compared with able-bodied youth). For non-contact SV, the lifetime prevalence was 48.11% for girls with a physical disability (OR = 1.44 compared with able-bodied girls), 31.76% for boys with physical disability (OR = 1.95 compared with able-bodied boys), and 40.28% for the total sample with physical disability (OR = 1.67 compared with able-bodied youth). After controlling for other risk factors, physical disability was a significant predictor of contact and non-contact SV for boys, but not for girls.

The purpose of this study was to investigate the relationship among physical activity level, disability acceptance and life satisfaction of people with physical disabilities. Data were collected and analyzed for 168 persons with physical disabilities who participated in the sports club in Seoul. Existing prior questionnaires for each variable were modified and supplemented. For data processing, SPSS 22.0 and Amos 22.0 programs was used to verify the hypothesis, and the significance level was set at α=.05. The following conclusions were obtained. First, the level of physical activity of the physically disabled with participation in sports club had a significant effect on disability acceptance. Second, the level of physical activity of the physically disabled with participation in sports club had no significant effect on life satisfaction. Third, disability acceptance by the physically disabled with participation in sports club had a significant effect on life satisfaction.

Background: Leprosy is a chronic infectious disease of significant public health concern in Brazil, primarily affecting individuals in disadvantaged socio-economic conditions. This disease is caused by the bacillus Mycobacterium leprae, which primarily affects epithelial and neural cells, thereby conferring a high potential for disability to the patient. Patients with leprosy are categorized based on skin lesion count, bacterial load, and peripheral nerve involvement. Those without neural impairment are classified as grade 0 for physical disability. Grade 1 disability denotes decreased sensitivity or loss in the eyes, hands, and feet, while grade 2 applies to severe lesions in these areas. Objective: To evaluate the epidemiological profile of leprosy patients according to the degree of physical disability from 2002 to 2022 in Brazil. Methods: This is a descriptive study, prepared with secondary data obtained from the Notifiable Diseases Information System (SINAN), provided by the Department of Informatics of the Ministry of Health (DATASUS). Notifications of physical disability associated with leprosy were evaluated according to the degree of impairment during the period from 2002 to 2022, in each region of the country. Results: During the analyzed period, 254,273 cases of physical disability due to leprosy were reported in the country, with 189,357 cases classified as grade 1 physical disability and 64,916 as grade 2 physical disability. Regarding the number of physical disability cases reported per year, the highest number of notifications was observed in 2007, with 15,899 cases, and the lowest in 2020, with 8,489 cases. In terms of physical disability episodes reported by region, the Northeast region leads with 92,115 cases, of which 68,725 are grade 1 disabilities and 23,390 are grade 2. Next, the Southeast recorded 53,355 cases, including 37,882 grade 1 physical disabilities and 15,473 grade 2 disabilities. The North ranks third with 49,995 notifications, of which 37,671 are grade 1 disabilities and 12,324 are grade 2. The Central-West is fourth with 45,258 cases, including 35,450 grade 1 physical disabilities and 9,808 grade 2 disabilities. The South is fifth with 13,550 cases, including 9,629 grade 1 physical disabilities and 3,921 grade 2. Conclusion: There was a high number of notifications of grade 1 physical disabilities due to leprosy in Brazil, with the Northeast region standing out as having the highest number of cases in the country, possibly due to socio-economic conditions, limited access to health services, and climate. Followed by the Southeast, explained by higher population density, social inequality, and greater access to diagnostic methods. To achieve goals aimed at reducing disability levels associated with this disease, it is necessary to improve national health surveillance, access to quality public services, and combat the long-standing stigma associated with leprosy.

Adolescents with physical disabilities may have co-occurring chronic pain, but the prevalence and specific associated factors are unknown. The aims of this study were to determine (1) the prevalence of chronic pain in adolescents with physical disabilities and (2) whether known correlates of chronic pain in the general population are also present in young people both with physical disability and with chronic pain relative to peers. We conducted a secondary analysis of cross-sectional nationally representative data from the National Longitudinal Study of Adolescent to Adult Health. Multivariate linear regression analysis was used to identify demographic and psychosocial factors associated with chronic pain. A total of 989 (4.3%) adolescents reported physical disabilities. They had a significantly higher rate of pain (27.2%) compared with able-bodied peers (15.6%, χ2 =86.3550, p<0.001). There was no significant interaction between physical disability status and chronic pain in relation to depressive symptoms, anxiety, or insomnia. Adolescents with physical disabilities experience chronic pain at a significantly higher rate than able-bodied peers, but the comorbidity of physical disability and chronic pain is not related to depression, anxiety, or insomnia. Evaluation of chronic pain and tailored pain interventions need to be developed for this population. Chronic pain and its correlates are important problems for adolescents with physical disabilities. These adolescents present with higher rates of chronic pain than other young people. Chronic pain is associated with increased levels of depressive symptoms, anxiety, and insomnia regardless of disability status.

Depression is one of the most frequent psychological symptoms in people with physical disabilities, as the acquisition of a physical disability is a stressful situation, demanding an individual’s adjustment to a new distressing reality. While some individuals manage to adapt to their physical disability’s implications, others fail to accept this new situation, manifesting depressive symptoms. One factor that seems to facilitate adaptation process to physical disabilities and thus prevent from depression prevalence is meaning of life. Viktor Frankl has emphasized the importance of experiencing meaning of life in the maintenance of physical and psychological health, especially in painful and distressing situations. The present study focused initially on the assessment of meaning in life and depressive symptomatology in individuals with physical disabilities. Moreover, the relationship of meaning in life and depression with adaptation to physical disability was examined. A sample of 522 participants with various types of physical disabilities completed three questionnaires on depressive symptomatology, meaning in life and adaptation to disability. Our assumptions regarding the negative relationship between meaning of life and depression were confirmed. Additionally, meaning of life was found, as expected, to play in important role in facilitating individuals’ adaptation to their physical disabilities, a finding indicating the great utility of Frankl’s existential theory as a psychotherapeutic tool for people with physical disabilities.

Living with a physical disability can interfere with an individual’s ability to participate actively in economic and social life. It is imperative to comprehensively understand the entrepreneurial barriers hindering the development of entrepreneurs living with physical disabilities. In spite of the increasing research on entrepreneurship, there seems to be a paucity of studies that have investigated the entrepreneurial barriers that are faced by entrepreneurs living with physical disabilities in South Africa. This study set out to explore the entrepreneurial barriers that are confronted by entrepreneurs living with physical disabilities. In this study, data were collected within the Sebokeng Township, which is an African township located in the Vaal Triangle, south of Johannesburg in South Africa. A qualitative research approach was used to collect data for the study. The researchers gathered qualitative data by means of semi-structured face-to-face interviews and focus groups. The analysis of the qualitative data was conducted through the use of thematic analysis. The themes that emerged from the findings include lack of equipment and machinery, discrimination, business networking, hardships in obtaining start-up capital, knowledge of support centres for entrepreneurs living with physical disabilities, and lack of education and training. Each theme was discussed individually, followed by substantiating quotes. Most respondents stressed that the barriers they face hinder the survival and growth of their ventures. The paper suggested that in order to help entrepreneurs living with physical disabilities, the South African government must formulate some schemes that are most necessary for their improvement and betterment of their life.

Effects of ear acupuncture combined with cupping therapy on severity and threshold of chronic back pain and physical disability: A randomized clinical trial

The 2008 Physical Activity Guidelines recommend that the more than 53 million people living with a physical disability in the United States to participate in regular physical activities consisting of both aerobic and anaerobic components, if possible. Also, if individuals with physical disabilities are unable to meet the recommended physical activity guidelines, they are encouraged to do as much as their physical disability permits. Despite the recommended guidelines, several individuals with physical disabilities do not participate in regular physical activities. Prior research suggests that several societal and structural barriers in sport and exercise environments often negatively affect individuals with physical disabilities. Thus, it is essential for family members, healthcare practitioners, rehabilitation/recreational teams, and community leaders to encourage individuals with physical disabilities to conquer barriers that restrict participation.

There is a significant gap in the literature with regards to the synthesis of qualitative research that explores the parenting experiences of parents with physical disabilities. This systematic review aims to synthesize the evidence regarding the experiences of parents with acquired and congenital physical disabilities. This article presents a thematic synthesis of qualitative research carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified through searches of Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PubMed, Scopus, and Web of Science databases and backward snowballing. The Critical Appraisal Skills Programme qualitative checklist was used as a quality assessment tool. Eleven articles were included in this review, and all were deemed to be high quality. Seven themes were identified: stigmatization and the need to prove competence as a parent; feeling underrepresented as a parent with a physical disability; environmental limitations; experiences of accessing support; using skills and strategies to fulfill parenting role; children's roles and reactions, and changes as they grow; and safety, wellness, and health when parenting with a physical disability. The findings emphasize the adaptability and resourcefulness of parents with physical disabilities in navigating environments that can be unsupportive, while continuing to prioritize their children's safety and well-being. The need for community peer-support groups and health care professionals who can provide emotional support, further public education with regards to the capabilities of parents with physical disabilities, prioritization of accessibility in public and private spaces, and the development of adapted childcare equipment, were all highlighted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Learners with physical disabilities have been entering mainstream schools for some years now. Whereas early research on inclusive education necessitated a strong focus on the needs of the learners, there has also been a recent interest in the role of the teachers in inclusive education. By adopting constructivism as the paradigm for inquiry a study was undertaken to establish the stress factors for teachers who have to include a learner with a physical disability in their mainstream classes. The rationale for the study is threefold: i) Learners with physical disabilities are entering mainstream schools increasingly, ii) it is often assumed that inclusive education is too stressful for teachers to cope with, and iii) related research has shown that increased contact with individuals with disabilities has a positive effect on attitudes towards individuals with disabilities. In accordance with the dialectical methodology of constructivism, the Teacher Stress and Coping Questionnaire and in-depth interviews were utilised to establish the stress factors and the extent of the stress factors that may be present. The aim of the constructivist inquiry process is to promote understanding and reconstruction. In this article the quantitative results indicate overall low or non-existent levels of stress in teachers who have to include a learner with a physical disability, and the results therefore contribute to our understanding of this situation. The qualitative results reconstruct the meanings that these teachers attach to the inclusion of a learner with a physical disability and reveal some albeit limited concerns about the communication processes between parents and teachers and a perceived lack of pre-service training.

Derived from the disease-avoidance model is the hypothesis that people may direct negative cognitive and behavioural responses towards individuals with physical disfiguring conditions, including physical disabilities. According to the behavioral immune system, physical disability—a non-contagious physical disfigurement—may falsely activate cognitive disease-avoidance processes, resulting in prejudicial or negative responses toward individuals with physical disabilities. For the first time this hypothesis is put to the test by investigating whether ratings of attractiveness and comfort for a social interaction vary systematically with physical disability (Studies 1 and 2). In addition, we tested whether these ratings were associated with individual differences in pathogen disgust and perceived vulnerability to disease. In Study 3 we overcame possible methodological limitations by employing a virtual reality (VR) environment. A fourth study was conducted to extend the first two studies by using a more diverse set of avatars. Results from Studies 1 and 2 indicated that disability did not significantly impact comfort ratings for social interactions, although non-disabled stimuli were rated as more attractive. However, Study 3 showed that in a VR environment, participants preferred closer proximity to non-disabled avatars over disabled ones, a preference not mitigated by the presence of prosthetics. Study 4 replicated these findings with varied 2D avatars, showing that disability significantly affected both comfort and attractiveness ratings, with non-disabled avatars rated highest, followed by those with prosthetics, and finally disabled avatars. Despite these findings, the expected relationship between comfort ratings and individual differences in pathogen disgust or perceived infectability did not emerge, challenging the behavioural immune system proposal. The discomfort associated with physical disability may be more related to social stigma or preconceived notions than to an innate disease-avoidance response.

Quality of life is recognized as an important outcome of health care for people with all abilities. There has been a marked increase in interest and the number of oral health-related quality of life (OHRQoL) instruments. In the absence of adequate care, resulting oral diseases like dental caries and periodontal problems can have not only physical and functional but also social, psychological and economic impacts.1 However, there is no such study on people with disabilities for whom it is difficult to assess the quality of life, especially those with limited or no communication skills, who are unable to express pain and discomfort. They depend greatly on their carers for their daily activities including oral care and for seeking appropriate dental treatment that could have an impact on their quality of life. Carers play the ‘gate keeper role’ as a contact person of the care recipient making decisions on their behalf and the ‘supportive role’, assisting with oral care and making visits to the dentist.2 The most widely reported reason for dental visits is when a carer suspects that the care recipient might be experiencing pain by noting changes in behaviour particularly at mealtimes, followed by secondary reasons including halitosis, drooling and aspiration of food and/or liquids.3 It is the carer who is best placed to note small changes in behaviour and detect any problem. It is the carer’s perceived impact of conditions that will drive them to take their care recipient for treatment. Therefore, the overall aim was to assess oral health-related quality of life (OHRQoL) among adults with disabilities, from the carer's perspective. The specific aims were to: (1) compare reported negative impacts with indicators like oral health problems and treatment need; and (2) determine factors that are associated with reports of one or more negative impacts on OHRQoL. The study was a cross-sectional survey of carers of 18–44 year olds with physical and intellectual disabilities living in South Australia in three settings: family home, community housing and institutions. Ethical clearance was obtained from The University of Adelaide Human Research Ethics Committee in July 2004. In August 2004, 21 organizations were approached to seek their assistance in contacting carers of 18–44 year old care recipients with physical and intellectual disabilities registered with them. From the information received, the target sample was carers of 1448 disabled adults. However, after removing people who were deceased or out-of-scope due to age, and after reconciling duplicate responses, the adjusted target was 1280 care recipients. In February 2005, 12 participating organizations sent an information package to the primary carer of each registered care recipient in their database which included an information sheet on the study for the carer and the care recipient, a questionnaire for the carer and a reply-paid envelope. A reminder card was posted to all carers two weeks later and a final follow-up letter to all non-responders four weeks later. A mail questionnaire was completed by carers between February and June 2005. Questions included carer characteristics, care recipient characteristics, questions from oral health impact profile (OHIP),4 oral hygiene practices, oral health problems and perceived treatment need. From Locker's model of oral health,1 four conceptual dimensions of impact were explored – psychological disability, physical pain, physical disability and social disability – using four questions from OHIP. Questions from OHIP were: How often during the last year has your main care recipient … had trouble sleeping (psychological disability); had pain and discomfort (physical pain); had unsatisfactory diet (physical disability); been irritable (social disability)…because of a dental problem? These four questions were selected from the 49-item OHIP questionnaire4 with the assumption by the authors that observable domains like function (problem eating) or social issues (irritability) are more likely to be validly assessed. Studies show that proxies appear to provide better answers about more objective rather than subjective information, with validity of the information increasing with the closer personal relationship to the proxy.5 Responses were made on a Likert scale ranging from ‘never’ (code = 1), ‘rarely’(code = 2), ‘sometimes’ (code = 3), ‘fairly often’ (code = 4), and ‘very often’ (code = 5). The last three responses were coded as negative impact on quality of life. As a significant proportion of carers responded ‘don't know’, it was treated as an additional response (code = 6). Responses were received for 485 adults with disabilities (37.9%). The data were weighted to represent the South Australian population of adults with disabilities.6 Unweighted data were used to describe characteristics of carers and care recipients. Subsequent analyses were undertaken using weighted data. The characteristics of the carers are described in Table 1. Approximately one-third of carers were over the age of 55 and 82.3% were females. Carers comprised of family carers (51.9%) and non-family carers (48.1%) in institutions and community housing. Characteristics of the care recipients are described in Table 2. There were slightly more males than females (61.9% male, 38.1% female), with 47.4% of them living with family, 31.4% in the community and 21.2% in institutions. The main disabling conditions were intellectual disability (38.5%), autism (31.7%), cerebral palsy (19.5%) and others (spina bifida, quadriplegia, head injury) (10.4%). While 21.3% communicated non-verbally, almost a third (30.3%) of their care recipients had little or no effective communication. Non-verbal means of communications included sign language, use of picture cards/boards, writing, typed/computer messages. Other (Spina bifida, quadriplegia, head injury) Prevalence of negative impact from a dental problem on individual items like diet, sleep, behaviour, and pain and discomfort was low. About 9.2% reported a negative impact for pain and discomfort, 7.7% for irritable behaviour, 6.1% for trouble sleeping, and 3.0% related to unsatisfactory diet. However, more than one in 10 care recipients (13.5%) reportedly experienced one or more negative impacts (Impact 1+) during the last year. The proportion of ‘don't know’ for each question was higher (Table 3). A much higher proportion of carers thought their care recipient currently had both an oral health problem and dental treatment need (Table 4). Some 11.8% of carers reported not knowing whether their care recipient had an oral health problem and a slightly higher 14.7% responded ‘don't know’ for perceived treatment need. The most frequent oral health problem reported was bad breath followed by decay and bleeding gums (Table 5). Other problems included ulcers, infection, tartar build-up, tooth wear and wisdom teeth. Accordingly, the most frequent perceived treatment need reported was scaling (89.6%), followed by filling (21.2%) (Table 6). Other perceived treatment needs included general check-up and capping of worn teeth. Table 7 summarizes perceived negative impacts as reported by carers from family, community and institutional settings. About 13.5% of care recipients reportedly experienced one or more negative impacts (Impact 1+), with family carers reporting more negative impacts compared to carers from other settings (p < 0.05). Reported negative impacts were more among those who could communicate verbally than for those with little or no communication (Table 8). For all other associations, ‘don't know’ response was treated as ‘missing’. Binary logistic regression modelling testing bivariate associations was carried out to examine which care recipient and carer factors were associated with reporting of one or more negative impacts (Impact 1+). Family carers and one-on-one carers reported greater odds of their care recipient having one or more negative impacts compared to care recipients cared for by non-family carers and care recipients with 5+ carers respectively (Table 9). Family carers had just over two times the odds of reporting negative impacts (OR = 2.1, [0.97, 4.6]) than non-family carers. The odds of negative impacts reported for those receiving one-on-one care was almost five times more than for those cared for by five or more carers (OR = 4.8, [1.8, 12.9]). The younger age group, those with autism and those who communicate verbally were reported to have experienced more negative impacts than their older counterparts, those with other disabling conditions and those who lacked verbal means of communication respectively. Once a day toothbrushing, those with oral health problems and perceived treatment need were associated with higher odds of negative impact than twice a day toothbrushing, and those without oral health problems and no perceived treatment need. After adjusting for carer- and care recipient-characteristics, multivariate analysis showed that there were more reports of negative impacts for those who could communicate verbally, than for those with non-verbal and little or no effective communication. Also, those reported to have perceived dental treatment need had about six times the odds of reporting of one or more negative impacts (Table 10). Age, disabling condition, toothbrushing frequency, carer type, number of carers providing care and oral health problems were not statistically significant (p > 0.05). The low response rate seems to reflect the time constraints faced by carers of people with disabilities. There were several other reasons or comments for non-response to the questionnaires. Some returned blank questionnaires or with short comments like ‘thanks but no thanks’ and ‘happy with private practice’. Some called to say they were not willing to participate, giving reasons like they were sick of surveys that did not help them and that research is done only to get a degree. There was a 75-year-old female who called to say she was unable to complete the questionnaire and there was no one else to help her, highlighting yet another problem of ageing carers. One was too sick to participate and another had died. Over 30% of carers were over the age of 55 years, highlighting another problem in the near future when these ageing carers (especially parents) themselves become functionally dependent. The high prevalence of non-verbal and little or no effective communication in this population challenges both carers and health professionals in providing care. Carers, who are expected to best know their care recipients, were unable to report OHRQoL for a significant proportion (18%) of those with little or no effective communication skills. When they did, negative impacts reported were much lower than reported oral health problems and perceived treatment need, suggesting carers may be underestimating pain and suffering experienced by their care recipients. Furthermore, a retrospective study of 103 special needs patients in France has shown that dental needs of special care patients are severely underestimated by both their carers and the dental profession.3 It can be argued that the more frequently reported oral health problems like gum problems and bad breath may not be assessed as having a negative impact on the OHIP questions used in this survey. At the same time, it must also be noted that the gum problems in this population may be more on the extreme end of the scale compared to the general population and could be causing pain and discomfort. Bad breath could be putting off the carers from cleaning their care recipient's teeth and the problem could worsen with time and have additional negative impacts on social life. From the responses from this survey, perhaps more appropriate additional questions asked could have been: How often during the last year, has your main care recipient … had stale breath (functional limitation), had painful gums (physical pain) because of a dental problem? Family carers and one-on-one carers reported more negative impacts than other carers, suggesting that they may be more observant. Alternatively, those being cared for by family carers and one-on-one carers may in fact be having more oral health problems, perceived dental treatment need and therefore more reported negative impacts. More of the younger care recipients live at home and are cared for by parents and therefore the association between younger age group and higher reporting of negative impacts. Those with autism and other disabling conditions where care recipients are able to communicate verbally were more likely to report negative impacts. After adjusting for carer- and care recipient-characteristics, multivariate analysis showed that those who could communicate verbally and reported perceived dental treatment need had higher odds of reporting negative impacts than those who communicated non-verbally or had little or no effective communication skills, and did not report reported perceived dental treatment need. Carer's view of the oral health of their care recipients may differ from an oral health assessment obtained from a clinical examination. However, the objective was to assess OHRQoL among adults with disabilities from the carer's perspective and also understand negative impacts of oral health problems on their care recipents. Those who could communicate verbally had higher odds of reporting negative impacts than those who communicated non-verbally or had little or no effective communication skills. Those reported to have one or more negative impacts were more likely to be reporting perceived dental treatment need. Yet the prevalence of reported negative impacts was lower than the prevalence of oral health problems and dental treatment need. Carers were unable to report OHRQoL for a significant proportion of those with little or no effective communication skills. Therefore, carers need to be made aware of negative impacts of oral problems and trained to identify them by observing behavioural changes at an early stage to reduce the suffering caused by advanced disease and to improve OHRQoL. This report was supported by a Faculty of Health Sciences Divisional Scholarship, The University of Adelaide and the Australian Dental Research Foundation. The authors are grateful to the participating organizations and the South Australian Dental Service for their assistance. This article was prepared by Dr Archana Pradhan.