The lifestyles of people with disabilities have been changing rapidly during the last two decades. While in the past people with disabilities tended to remain within the confines of institutions for most of their lives, disabled citizens are now participating in all aspects of community life. Today disabled women and men are marrying, raising families, pursuing a variety of career options, doing volunteer work, and travelling. Many disabled people who lead challenging lifestyles also require personal services which are provided by readers, attendants, homemakers, resource facilitators, and job-site coaches. Consumers are finding that existing delivery systems either fail to meet their needs or unduly constrain their lifestyles. Consequently, people with disabilities have developed a strategy for how personal services should be delivered, and the Coalition of Provincial Organizations of the Handicapped's (COPOH) perspective on this issue is elucidated in this article. This report attempts to convey the concerns which have been raised at various consumer forums in personal testimonies by men and women with disabilities. This is in keeping with COPOH's role as the disabled consumer's voice in Canadian society.

The integration of people with disabilities into the community challenges us to offer these citizens a quality of life comparable to that of the rest of society. Until now, quality of life in the community has been assessed using measures which compared it to life in institutional settings. Today we are beginning to recognize that the quality of life of handicapped persons should be evaluated using the standards applied to others living in the same neighbourhood. The assessment of quality of life varies over time and is influenced by the family circle, community interactions, and personal development. Thus, quality of life should be measured using criteria which respect human and social ecological principles. The issue of quality of life for handicapped persons is a collective responsibility, representing a major challenge in this decade.

L'accucil d'un enfant atteint d'une déficience provoque chez les parents un stress psychologique intense et ceux-ci sont alors confrontés à une situation de crise. C'est par le cheminement à travers le processus de deuil de l'enfant désiré «parfait» que les parents parviennent à s'adapter à la situation, plusieurs auteurs ont décrit une séquence de réactions normales par laquelle doivent passer les parents qui donnent naissance à un enfant atteint d'une déficience. Cette situation difficile affecte les parents dans les différentes sphegres d'adaptation, c'est-à-dire en tant qu'individu, conjoint, parent et en relation avec l'entourage. Des difficultés d'adaptation, qui ne sont pas nécessairement reliées à la gravité du probléme, sont susceptibles de se manifester chez les parents et la famille entière. De méme, la facon de réagir de chacun des membres aura un impact sur tout le système familial.

The development of integrated school programs in Canadian schools is described. The article identifies three factors that have produced progress which is unique to Canada (i.e., the application of law, advocacy, and innovation). The legal factors are linked to the Charter of Rights and Freedoms, the Schools Act in New Brunswick, and two cases, the Elwood case in Nova Scotia and the Robichaud case in New Brunswick. Developments in New Brunswick since the passage of Bill 85 in 1986 that mandates integration are recounted. Advocacy is described in relation to the vision parents have articulated for their children's futures and the collective and individual advocacy of those committed to integrated education. The innovative changes made in a number of schools and school districts and factors linked to districts that have implemented innovative programs are described. Recommendations are made for collaborative action by parents and professionals to achieve exclusionary school programs.

This paper reports on the findings of a qualitative study of supported employment. The purpose of the study was to trace the process whereby people with a developmental handicap entered supported employment and became employed in regular jobs, and to consider the quality of life of those individuals. The quality of life of all participants was considerably enhanced as a result of the supported employment experience. The study also identified several problem areas and strategies for improving supported employment, particularly with respect to providing unobtrusive support in the workplace and facilitating social integration of the employee.

Canadians who have disabilities are generally poor and have little if any significant attachment to the paid labour force. Income level and work have both been identified as critical factors in health and mental health. This article critically examines some of the key systemic factors responsible for the close bond that fuses disability, low participation in employment, and poverty. It outlines alternative principles for policy and program design, and examines in some detail the concrete implications of these principles as applied to the area of income programming. These alternatives could, it is argued, contribute to more inclusive workplaces and to an income system around disability that is more rational and equitable.

There is growing evidence that leisure is an important aspect of people's lives. The satisfactions gained from leisure often outweigh those gained from employment or other work activities. Individuals with disabilities are no exception to this phenomenon. Opportunity to engage in leisure activities of one's choosing is paramount to a disabled person's health and well-being. The purposes of this article are to: (a) describe the potential benefits of participation in recreation and leisure to individuals with disabilities, (b) describe what is currently known about leisure and disability, and (c) suggest research directions. An enabling model of leisure and mental health is offered.

This paper is a review of the state of the art in the field of computer-assisted cognitive intervention with people with cerebral dysfunction. A sharp distinction is drawn between the “special education” and “neuro psychological” models of rehabilitation. This facilitates a better understanding of the fact that microcomputers were initially introduced into the general field of cognitive clinical intervention in a brash and unfortunately atheoretical manner. The early published estimations of efficacy of such practices have not been very encouraging. However, it becomes obvious that within a context of intelligent application of microcomputers by professionals well trained in cognitive and neural science, certain highly specific but clearly interesting clinical results have been obtained and should be on the increase. The advantages and disadvantages of using computers in clinical congnitive intervention are discussed. A brief survey of currently useful hardware and software is provided, and developments expected to occur in the near and more remote future are discussed.

This paper presents data about the demographics of disabled seniors in Canada and the range of economic, social, and environmental barriers which they confront. Issues are highlighted connected with the independent living paradigm, marginalization, and the multiple social problems of being elderly, disabled, female, and/or a member of a visible minority. The author then describes the implications for future action research, theory development, policy formulation, and social change.

Since the mid-1970s the development of a specific conceptual framework for the consequences of disease and trauma has been occurring at the international level. A growing awareness among health professionals of the chronic physical, intellectual, and emotional problems which are reducing the abilities and social autonomy of a large percentage of the population have led the World Health Organization (WHO) to work on this matter. In this paper, the author explains the conceptual evolution of the field of disabilities. He defines the challenges and potential uses of an international classification of consequences of disease and trauma. This article proposes an interactive conceptual framework for the identification of handicaps and directions for the revision of the WHO's International Classification of Impairments, Disabilities, and Handicaps (ICIDH). It is an invitation for the Canadian mental-health field to express points of view on the present process of the harmonization of terminology and concepts on the Canadian and international scenes. The English version of the proposal to revise the third level of the ICIDH (handicaps) can be obtained from the Canadian Society for the ICIDH, 1399, rue Thibodeau, Lac St-Charles, Québec GOA 2H0, Canada.

It is generally agreed that policy for developmentally handicapped people in Ontario has been more successful than mental-health policy. The reasons for this are explained in terms of nine key variable which have a major impact on policy: language, money, pressure groups, the press, opposition political parties, the bureaucracy, the minister of health, the professions, and the law. No ranking of these variables is attempted because, it is argued, is it impossible to capture the flow of politics by establishing a hierarchy of influences.