Factors Associated with Self-Worth in Young People with Physical Disabilities‪.‬

Biomedical advances have dramatically improved the lives and life spans of young people with chronic health conditions and physical disabilities (Suris, 1995). Although these young people have the same aspirations as those of their peers (Court, 1991), three decades of epidemiological studies consistently report significantly greater psychosocial adjustment difficulties (Breslau, 1985; Cadman, Boyle, Szatmari, & Offord, 1987; Pless & Roghmann, 1971; Rutter, Tizard, & Whitmore, 1970; Werner, 1989). Young people with mobility limitations are at greatest risk (Cadman et al.). Having a positive sense of self is associated with success in important social domains such as school performance (Bandura, Barbaranelli, Caprara, & Pastorelli, 1996) and forming friendships (Harter, 1990). Social support, a key component of social work practice, has been recognized for some time as an important protective factor (Alloway & Bebbington, 1987; Rutter, 1979; Hatter, 1990) and has more recently emerged in the disability literature (Wallander, Varni, Babani, Banis, & Wilcox, 1989). A social model of disability is in keeping with a social work perspective that situates individual experiences in a larger context. Advanced by scholars who are disabled, a social model of disability proposes that the difficulties faced by people with disabilities are more powerfully influenced by their social world than the physical realities of their disability (Longmore, 1995; Oliver, 1990, 1996). (Note to readers: Oliver's preferred label is "disabled." He challenges the person-first strategy of "people with disabilities" arguing that this clouds the significance of his disability in his life and his thinking.) Perceptions of self-worth are conceptualized as evolving through a complex interplay of individual development, social relationships, and the perceptions of important others (Harter, 1990, 1999). Young people and their families continue to face stigma and public misperceptions of physical disability (Baiter, 1999; Harper, 1999; Hebl & Kleck, 2000; Oliver, 1996), and parental attitudes and perceptions are particularly influential for children and adolescents (Case, 2000; Germain, 1994; Harter, 1990).