Attitudes toward people with disabilities in the social context of dating and marriage: a comparison of American, Taiwanese, and Singaporean college students. (Attitudes Toward Disability).

Studies on attitudes toward disability have continued to be an important research component in the field of rehabilitation counseling. Chubon (1992) stated that negative societal attitudes toward people with disabilities could be viewed as "invisible barriers" to successful rehabilitation. Chan et al. (1988, 2002) and Leung (1990, 1993) indicated that it is important to study attitudes toward people with disabilities because societal attitudes have been assumed to be a significant factor in defining the life experiences, opportunities, and help-seeking behaviors of people with disabilities. The constrictive effects of negative societal attitudes in preventing individuals with disabilities from mainstreaming into society are well documented in the rehabilitation literature (Arokiasamy, Rubin, & Roessler, 2001; Brodwin & Orange, 2002; Cook, 1998; DeLoach, 1994; Moore & Feist-Price, 1999; Orange, 2002; Yuker, 1994, 1995).

Assistive technology (AT) has helped people with disabilities in becoming full, participating members of society, including the critical area of employment. AT provides more viable options and choices, helps improve quality of life, independent functioning, and empowerment for people with disabilities. As such, changes brought about by technology improve the visibility and integration of people with disabilities and affect attitudes in positive ways. Through greater productivity and improved self-sufficiency, AT replaces or extends capacities to cope with social, educational, vocational, and daily living demands (Reed, 2002; Rubin & Roessler, 2001).

Research studies on attitudes toward disability are numerous. Yet, little has been published in the area of dating and marriage. For full integration in society, more open attitudes need to exist in all areas, including those of an interpersonal nature. Often, researchers have found that societal attitudes have become more positive in the vocational and educational arenas, but not within the personal and social domains. Little research has been conducted to measure societal attitudes toward dating and marriage of persons with disabilities. By assessing these attitudes, researchers can determine how negative attitudes are toward dating and marriage, and assess ways to modify these attitudes.

The majority of research on attitudes toward disability has a focus on: (a) psychometric assessment of attitudes toward persons with disabilities; (b) personal and demographic correlates of attitudes toward persons with disabilities; and (c) strategies for changing attitudes toward people with disabilities (Grand, Bernier, & Strohmer, 1982; Moore & Feist-Price, 1999). Most studies were conducted in western countries, and the generalizability of these results to other countries is relatively unknown (Chan et al., 1988, 2002).

As many of the Pacific Rim countries with a high concentration of Chinese residents (e.g., Hong Kong, Taiwan, and Singapore) have become more affluent through industrialization during the past three decades, the governments of these countries have begun to set policy objectives to improve and expand rehabilitation services. To foster more positive societal attitudes toward the provision of rehabilitation services in Chinese communities, it is imperative for researchers to explore ways to uncover factors influencing attitude formation (both latent and manifest), which could then be used to form the basis for modifying negative attitudes toward people with disabilities in Asian countries.

Asian Americans, including Americans of a Chinese descent, represent a large minority group in the United States, and many are recent immigrants or first generation Americans. According to Census figures, in 1990, almost one in four Americans had African, Asian, Hispanic, or Native American ancestry, in contrast to only one in five in 1980 (Leung, 1993; Yang, Leung, Wang, & Shim, 1996). The proportion of Americans identifying themselves as White declined in the 10 years and now make up 80.3% of the population. The numbers and percentages of change in these minority populations were the following:

* 30 million African Americans, an increase of more than 12% since 1980;

* 7.3 million Asian Americans, an increase of 107.8%;

* 22 million Hispanics, an increase of 53%; and

* 2.0 Native Americans, an increase of almost 38%.

The overall rate of disability in the United States population is 19.4%, according to the Survey of Income and Program Participation (SIPP), Census Bureau, 1991-1992 (U. S. Department of Commerce, Bureau of the Census, 1993). This rate is highest for Native Americans (21.9%), followed closely by African Americans (20.0%), and Whites (19.7%). Hispanics and Asian Americans have appreciably lower rates of 15.3% and 9.9%, respectively. However, it should be noted that Hispanics and Asians are made up largely of immigrant groups. Many of these immigrant groups (e.g., refugees from Southeast Asian countries such as Vietnam, Laos, and Cambodia) are quite similar to other members of ethnic and racial minorities in terms of likelihood to experience disability. Although data are lacking, factors related to increased probability for disabilities include: poor prenatal and perinatal care, inadequate diet and nutrition, greater risk of injury because of lesser quality living conditions and kinds of employment, inaccessible health care, and a lack of proper health care education and knowledge. The lower reported disability rates for Hispanics and Asians also can be partially attributed to their intense fear of government agencies. Most importantly, their understanding of legislation may be markedly different than people who are well acquainted with Western standards and practices. Rehabilitation professionals working with Chinese people need to have a thorough understanding of their societal attitudes, both positive and negative, toward people with disabilities. From a practical standpoint, knowledge about such attitudes would help in the understanding of the behavior of their clients (and family members) with disabilities that may have a positive or negative influence on rehabilitation outcomes. Such knowledge would also suggest ways to modify negative attitudes by drawing upon those factors-that support positive attitudes and contribute to the development of successful rehabilitation programs in Chinese and Chinese-American communities. From a theoretical perspective, cross-cultural research in this topical area may contribute to a better understanding of the universality versus cultural specificity nature of the construct of attitudes toward disability. This latter consideration, although it is only a secondary interest of this study, is an important aspect of cross-cultural research concerning psychological constructs (Chan et al., 2002; Hui & Triandis, 1986; Leung, 1990).

Chan and his associates (Chan, Hua, Ju, & Lam, 1984; Chan et al., 1988; Chan, Lee, Yuen, & Chan, in press; Tsang, Chan, & Chan, in press; Wang, Chan, Thomas, Larson, & Lin, 1997; Wang, Thomas, Chan, & Cheing, in press) have conducted a series of studies to examine Chinese high school and college students' attitudes toward disabilities. Specifically, they found that Chinese students in Hong Kong and Taiwan were more positive toward people with physical disabilities than toward those who have developmental disabilities and mental disorders. They also found that Chinese did not make any significant differentiation in their attitudes toward people with mental retardation and individuals with psychiatric disabilities. One of the explanations is that in Chinese culture, persons with severe mental retardation and mental illness are often viewed as a source of shame by their parents and may be kept at home, away from public attention (Cheung, 1990; Yang, Leung, Wang, & Shim, 1996).

As a result of cultural stigma toward persons with mental illness and mental retardation, Hong Kong and Taiwanese students probably have more opportunities to interact with persons with physical disabilities than with persons who have mental illness and mental retardation. Conversely, more positive attitudes toward people who are mentally retarded than toward persons with a history of psychiatric disabilities are generally found in the western literature (Chen & Brodwin, 1999; Rubin & Roessler, 2001). From a cross-cultural perspective, Chan et al. (1988) and Chan, Lee, Yeun, & Chan (in press) also found that Chinese students hold less positive attitudes toward people with disabilities (both physical and mental) than do American students.

Although research on attitudes towards disability has a strong emphasis on societal attitudes in the general context, Wright (1988) and Chan et al. (2002) made strong criticisms regarding decontextualizing disability in disability research. Grand et al. (1982) suggested that realistically, attitudes toward disability should be examined on the basis of social context and specific disability. They found that attitudes of Americans toward disability varies significantly according to social contexts, with more positive attitudes held toward people with disabilities in work situations, than in dating and marriage. Recently, Tsang et al. (in press) surveyed a group of Hong Kong students in an occupational therapy training program to study their attitudes toward placing a community-based rehabilitation facility in their neighborhood. They were asked to indicate their preference for the types of clients to be served by the facility in the neighborhood, using conjoint analysis, an indirect attitude measurement method. Conjoint analysis results revealed that when it comes to placing a facility in the students' own neighborhoods, their attitudes were no different than the general public. The rank order of disability preference was physical disabilities, developmental disabilities, and mental illness. A major factor that exerts significant influence on their preference formation, however, is not disability-specific factors (e.g., disability type and severity of disability), but cultural-specific factors related to concern about perceived threat posed by the different disability groups in terms of possible violent behavior.

The present study expanded upon previous studies conducted by Chan and his associates (1984, 1988, in press) to compare the attitudes of American, Taiwanese, and Singaporean college students' attitudes toward people with disabilities in the social context of dating and marriage. As mentioned, one of the limitations in attitudes toward disability research is the decontextualizing of disability in rehabilitation research (Chan et al., 2002; Grand et al., 1982; Wright, 1988). The present study expanded upon previous studies of general attitudes conducted by Chan and his associates (1984, 1988, 2002) to compare the attitudes of American, Taiwanese, and Singaporean college students' attitudes toward people with disabilities in general context as well as the specific social context of dating and marriage.

Method

Participants

The Taiwanese sample consisted of 212 college students (107 males, 105 females) enrolled in an introductory psychology course at National Taiwan University. The mean age of the participants was 22.3 (SD=3.57). Approximately 43% of the participants had prior contact with persons with disabilities. Prior contact is defined as having at least a family member, relative, or a friend with a disability. A total of 115 Singapore undergraduate students (54 males, 61 females) at Southeast Asia Union College enrolled in an introductory psychology course were recruited for this study. The mean age of the participants was 23.5 (SD= 5.99). Approximately 50% of the participants had prior contact with individuals with disabilities. The American sample consisted of 186 undergraduates (82 males, 104 females) at California State University, Los Angeles. They were students likewise enrolled in an introductory psychology class. The mean age of the participants was 20.15 (SD= 3.95). Approximately 52% of the participants had prior contact with people with disabilities.

In all, a total of 513 participants were included in this study. There was no significant difference among the three student groups in terms of gender and prior contact. However, the Taiwanese and Singaporean students were significantly older than the American students.

Instruments

Instruments used in this study included a demographic questionnaire, the Attitudes Toward Disabled Persons Scale (ATDP-A) and the Attitudes Towards Dating and Marriage Scale (ATDMS). The demographic questionnaire gathered information relative to each participant's gender, age, country of citizenship, and prior contact with persons with disabilities.

Attitudes Toward Disabled Persons Scale--Form A (ATDP-A). The ATDP-A (Block, 1974; Yuker, 1994; Yuker & Block, 1986) is composed of 30 items, and was developed to assess respondents' beliefs about people with disabilities in general situations. Each item on this instrument either expresses the concept that persons with disabilities are, or are not similar to persons that are nondisabled, or that they should or should not be treated the same as persons who are not disabled. A six-point Likert-type scale was used to rate the items: strongly disagree (-3 -2 -1) to strongly agree (+1 +2 +3). The items were summed to yield a total score; a score of 90 was added to the total score to eliminate negative scores, resulting in a possible range of 0-180. The original ATDP-A scale has a Cronbach's alpha of .85. Test-retest ranged from .74 to .91. Split-half reliability ranged from .73 to .89. (Ozer, 1985). Cronbach's alpha for the ATDP-A in this study was computed to be .75.

Attitudes Towards Dating and Marriage Scale (ATDMS). Because no instrument has been developed to measure social attitudes towards dating and marriage with people who have disabilities using the ATDP format, the ATDMS was developed specifically for purpose of this study. The ATDMS consists of 14 items assessing the specific attitudes of respondents towards dating and marrying people with disabilities. The statements used in the ATDMS were very similar to the ATDP-A. For example, the ATDP-A consists of items such as "People with disabilities are often less intelligent than people without disabilities" and "The way people with disabilities act is irritating." Examples of ATDPMS items include "People with disabilities should date/marry their own kind" and "I would date a person with a disability if he or she is well educated and employed." Similar to the ATDP, a six-point Likert-type scale was used to rate the items: strongly disagree (-3-2-1) to strongly agree (+3+2+1). The items were summed to yield a total score. To eliminate negative scores (14 x -3 = -.42), a score of 42 was added to the total score, resulting in a possible range of 0-84. The internal consistency reliability coefficient (Cronbach's alpha) was computed to be 0.77 in this study.

A translated version of the ATDP-A and the ATDMS was used in this study to measure the general and specific attitudes of the Taiwanese students. To ensure accuracy of the translated version, the researchers employed a double-translation method commonly used in cross-cultural research (Brislin, Lonner, & Thorndike, 1973; Chan et al., 2002; Chen & Brodwin, 1999; Pederson, 1983). The ATDP-A and the ATDMS were first translated from English to Chinese by the senior author, two physicians at the National Taiwan University, and a social worker in Los Angeles; the Chinese version was then translated back to English. A comparison between the translated and English versions indicated no significant loss in meaning across the two scales. Students in Singapore took the English version of the instrument.

Procedure

The senior author contacted three psychology professors, one each in Taiwan, Singapore, and California to help recruit participants for this study from their introduction to psychology courses. The professors were provided a script to explain the purpose of the research to the participants, and potential benefits of this study to help researchers develop a better understanding of societal attitudes toward people with disabilities in terms of dating and marriage. The students were told that their participation in this research was totally on a voluntary basis. Students who volunteered to participate were given the research packets in class. The completed surveys were submitted to the senior author.

Results

Two 2 x 2 x 3 (contact x gender x country) ANOVAs were performed. The first analysis assesses the effects of contact, gender, and country/culture on the ATDP-A scores, and the other on the ATDMS scores. The first ANOVA results revealed three significant main effects; no interaction effects were found. Students who had a family member or friend with a disability (M=112.60, SD=19.52) had higher ATDP-A scores than students who did not have contact with people with disabilities (M=105.71, SD=17.46), F(1,513)=12.22, p<.01. Female students (M=111.81, SD=19.30) had a higher mean ATDP-A score than males students (M=105.94, SD=111.81), F(1,513) =8.30, p<.01. The country effect was also significant, F(1,513) =17.07, p<.01. Post-hoc comparisons using the Bonferroni procedure indicated that American students (M=115.53, SD=19.86) had higher ATDP scores than Taiwanese (M=106.85, SD=16.81) and Singaporean students (M=102.52, SD=17.33). There was no difference between Taiwanese and Singaporean students. Table 1 presents the means and standard deviations of the ATDP-A scores.

The second ANOVA examined the effect of gender, contact, and country on attitudes toward dating and marriage with people with disabilities. The results revealed two significant main effects, the gender and country effects; the contact effect was not significant. There was a significant gender by university interaction effect. The ATDMS scores of students who had family members or friends with disabilities (M=59.33, SD=12.73) did not differ significantly from students who reported having had no contact with people with disabilities (M=62.34, SD=11.56), F(1, 513) =2.93, n.s. There was a significant country effect, F(1, 513) =34.70, p<.01. Post-hoc comparisons using the Bonferroni procedure indicated that American students (M=66.33, SD=13.44) had a significantly higher ATDMS score than Singaporean students (M=60.35, SD=11.52), and Singaporean students had higher scores than Taiwanese students (M=56.15, SD=9.27). Female students (M=62.41, SD=12.17) were found to have a significantly higher mean ATDMS score than male students (M=58.97, SD=12.13), F(1, 513) =9.07, p<.01. Yet, there was a significant interaction effect. A close examination of the interaction effect revealed that female American students (M=70.11, SD=10.97) had higher ATDMS scores than their male counterparts (M=61.54, SD=14.77). The scores of the male American students were similar to both male and female Taiwanese and Singaporean students. Table 2 presents the means and standard deviations of the ATDMS scores.

Discussion

The results revealed major differences in attitudes toward individuals who have disabilities among college Students from the three countries in both general and specific social contexts. According to Yuker, Block, & Campbell (1960), ATDP-A scores should be interpreted in terms of the operational definition of the items used in the scale (i.e., in terms of perceived differences between people with and without disabilities). Thus, relatively high scores indicate the respondents perceive individuals with disabilities as similar to people who do not have disabilities; low scores mean the respondent perceives people with disabilities as different from people without disabilities. Many items on the ATDP-A suggest that where a difference is perceived, the difference has negative connotations. This implies that low scores reflect the perception of persons with disabilities as both different and inferior or disadvantaged to some degree. Thus, low scores imply negative attitudes.

In the general context, Yuker and Block (1986) reported the mean ATDP score for American subjects based on the average of 29 studies was 117.1. In the present study, the mean ATDP-A score for American students was 115.53, as compared to 106.85 for Taiwanese students and 102.52 for Singaporean students. The results that American students had a higher attitude score than Asian students are consistent with the findings of Chan et al. (1988) with Hong Kong high school students over a decade ago. In terms of gender effect, female American students had a significantly higher ATDP-A score than their male counterparts. Conversely, there is no gender difference for the two Asian groups. Chan et al. also reported that no significant gender difference was observed in the mean rating across three disability groups in a study with Chinese students. The finding of no gender difference among Asian students in this study was consistent with other cross-cultural studies in Asia (Chan et al., in press; Chen & Brodwin, 1999; Wang et al., 1997; Yang et al., 1996). Yuker and Block (1986) suggested some gender differences have been found in the United States. Yet, no consistent theoretical explanation has been found to explain these varying differences across cultures.

In terms of the contact effect, American and Taiwanese students with prior contact with people with disabilities expressed more positive attitudes than students with no prior contact with individuals who have disabilities. There was no difference in terms of ATDP-A scores between the contact and the no contact group in the Singaporean sample. Chan et al. (1988, in press) indicated that Chinese students who reported at least some contact with persons with disabilities were more optimistic, had greater concern about human rights, and showed fewer behavioral misconceptions about people with disabilities. In the western literature, the effects of contact on societal attitudes toward people with disabilities varied according to the context (Ajzen & Fishbein, 1980), structure (i.e., structured /non structured contact) (Donaldson, 1980), and presentation (i.e., manifest coping behavior and personal responsibility) (Shurka, Siller, & Dvonch, 1982) of people with disabilities. In this study, the context of general societal attitudes was examined to provide a point of reference for examining and comparing specific societal attitudes toward dating and marriage across three cultures.

In the context of dating and marriage, American students were found to be more positive than Singaporean students and Taiwanese students; Singaporean students were more positive than Taiwanese students. However, in the general context, there was no significant difference in attitudes between Singaporean and Taiwanese students. It appears that Taiwanese students hold the most conservative attitudes toward people with disabilities in the context of dating and marriage. In Chinese culture, the perceived stigma of disability is especially strong and frequently associated with the belief in past or current sins of the parents. Lack of knowledge about disability, especially about mental disabilities, also contributes to the misperception about the effect of disability on one's offspring. Hence, this may explain the adversity of Chinese students to the idea of dating and marrying people who have disabilities. From this perspective, the attitudes of participants in this study toward dating and marriage varied according to the degree of westernization, with Americans most positive, followed by Singaporeans (formerly a British Colony), and then Taiwanese.

There was found a country-by-gender interaction effect. The ATDMS scores obtained for American students were highly skewed by high scores of female students. Scores between males and females were not significant for both Singaporean and Taiwanese students. In terms of contacts, having a family member or friend with a disability did not improve the respondents' attitudes toward dating or marrying individuals who have disabilities. The differential findings between the general and specific context is consistent with the Grand et al. (1982) study. They suggested that, to be realistic, attitudes toward disability should be examined on the basis of social context and specific disability. They found Americans' attitudes toward disability varied significantly according to social contexts, with more positive attitudes being evident when referring to a work environment, than in the context of dating and marriage.

Attitudes toward people with disabilities, in the general context, differed between American college students and Asian students. In terms of the specific context of dating and marriage, the differences in attitudes appear to vary across a continuum based on degree of westernization, with American students manifesting the most positive attitudes, followed by Singaporean students, and then Taiwanese students. Singapore also has a predominant Chinese population; it is strongly influenced by the west because of its former status as a British colony. Implications of this study can be examined from a practical perspective. Rehabilitation professionals working with Asians in Asian countries or Asian Americans in the United States need to have a thorough understanding of societal attitudes, both positive and negative, toward people with disabilities.

Implications for this study can be examined from a practical perspective. As many of the Pacific Rim countries with high concentrations of Chinese residents (e.g., Hong Kong, Taiwan, Singapore) have become more affluent during the past two decades through industrialization, the governments of these countries have begun to set policy objectives to improve and expand rehabilitation services. Studies like this one can be used to gauge public acceptance of social service programs for people with disabilities. To increase the societal optimism toward rehabilitation services in Chinese communities and other immigrant communities in the United States, it is imperative for researchers to move beyond the description of attitudes toward disability and focus on the next logical research step of exploring ways to uncover positive attitudes, both latent and manifest, which could then be used to form the basis for modifying negative attitudes toward people with disabilities. Ways to modify negative behaviors of people with and without disabilities toward disability become important because knowledge in this area could be very useful in planning, implementing, and evaluating rehabilitation services programs in Asia and Asian immigrant communities within the United States.

Summary

For full acceptance of people who have disabilities into mainstream culture, there needs to be positive attitudes not only in areas such as employment and education, but within the interpersonal domains, including social and personal relationships. Negative attitudes toward dating and marriage indicate that persons with disabilities still are not fully accepted within society. When researchers find positive attitudes in these areas, perhaps full inclusion and integration will have become realized.

This study revealed that a more traditional society has further to go in accepting dating and marriage relationships with people who have disabilities. Rehabilitation practitioners can benefit from these results as they provide services to their clients and the families of these clients. As counselors and other rehabilitation service providers work with individuals with disabilities, especially those from cultures different than their own, knowledge about attitudes can help them function more effectively. As the Asian American population expands in the United States, knowledge about attitudes become even more relevant to the work of rehabilitation service providers. As practitioners reach a greater understanding of Asian American cultures and provide services in more culturally competent ways, perhaps Asian Americans will find it easier to request counseling and related health and human services, eliminating a major "invisible barrier" to provision of successful rehabilitation.

From a theoretical perspective, cross-cultural research in this topical area could contribute to a better understanding of the universality versus cultural specificity nature of the construct of attitudes toward disability. This latter consideration, although it is only of secondary interest in this present study, is an important aspect of cross-cultural research concerned with evaluation of psychological constructs (Hui & Triandis, 1986).

Table 1
Means and Standard Deviations of ATDP-Form A Scores by Gender, Contact,
and Country

                                                Country
                      Taiwanese        Singaporean      American
                      M (SD)           M (SD)           M (SD)

Gender
  Male                104.50 (15.99)   102.09 (16.44)   110.35 (19.87)
  Female              109.25 (17.36)   102.90 (18.20)   119.62 (18.98)

Contact
  No Contact          103.50 (15.70)   101.95 (16.06)   111.11 (19.37)
  Contact             111.22 (17.29)   103.09 (18.61)   119.59 (19.54)

Gender x Contact
  Male without        100.95 (15.78)   100.12 (15.84)   106.33 (18.41)
    contact
  Male with contact   109.20 (15.17)   105.45 (17.29)   114.19 (20.65)
  Female without      106.14 (15.30)   104.65 (16.35)   115.02 (19.43)
    contact
  Female w/ contact   113.24 (19.13)   101.84 (19.37)   123.71 (17.76)

Total                 106.85 (16.81)   102.52 (17.33)   115.53 (19.86)

                      Total
                      M (SD)

Gender
  Male                105.94 (17.72)
  Female              111.81 (19.30)

Contact
  No Contact          105.71 (17.46)
  Contact             112.60 (19.52)

Gender x Contact
  Male without        102.33 (16.70)
    contact
  Male with contact   110.44 (18.00)
  Female without      109.20 (17.60)
    contact
  Female w/ contact   114.27 (20.54)

Total                                    109.03 (18.78)

Note. The score for ATDP Form A range from 0 to 180.

Table 2
Means and Standard Deviations of ATDMS Scores by Gender, Contact,
and Country

                                             Country
                      Taiwanese      Singaporean     American
                      M (SD)         M (SD)          M (SD)

Gender
  Male                56.82 (9.42)   59.31(11.89)    61.54 (14.77)
  Female              55.47 (9.11)   61.26(11.21)    70.11 (10.97)

Contact
  No Contact          54.41 (9.14)   60.72(12.39)    65.08(14.48)
  Contact             58.42 (8.99)   59.98(10.69)    67.47(12.38)

Gender x Contact

  Male without        55.08 (9.04)   58.50(13.17)    60.20 (15.24)
    contact
  Male with contact   59.13 (9.51)   60.70(9.47)     62.81(14.37)
  Female without      53.71 (9.27)   64.00(10.58)    69.06 (12.63)
    contact
  Female w/ contact   57.71(8.48)    59.61(11.38)    71.04 (9.27)

Total                 56.15 (9.27)   60.35 (11.52)   66.33 (13.44)

                      Total
                      M (SD)

Gender
  Male                58.97 (12.13)
  Female              62.41 (12.17)

Contact
  No Contact          59.33 (12.73)
  Contact             62.34 (11.56)

Gender x Contact

  Male without        57.46 (12.33)
    contact
  Male with contact   60.85 (11.66)
  Female without      61.26 (12.90)
    contact
  Female w/ contact   63.50 (11.39)

Total                 60.78 (12.26)

Note. The score for the ATDMS range from 0 to 84.

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Roy K. Chen
Michigan State University

Martin G. Brodwin
California State University, Los Angeles

Elizabeth Cardoso
Hunter College

Fong Chan
University of Wisconsin-Madison

Roy K. Chen, Michigan State University, Office of Rehabilitation & Disability Studies, 237 Erickson Hall, East Lansing, MI 48824-1034. Email: [e-mail]