1. Issues in Disability Measurement: A Comparison of Survey Methods
Vidya Sundar, PhD, OTR/L
Assistant Professor of Occupational Therapy
Andrew J. Houtenville, PhD
Associate Professor of Economics
Kimberly G. Phillips, MA, PhD
Project Director
University of New Hampshire 1

2. Defining disability
Disability: Interaction between the person and the environment (WHO, 2000)
Conceptualizing disability
Capacity, ability
Performance
Choice
Self-reported disability
Stigma, disclosure
Self-perception

3. Identifying people with disabilities in population surveys

4. Evolution of Census Questions
1970
Long Form
1980
1990
2000
& ACS
2008
ACS
Limit work ü
Prevent work
Self-care
Ind. Living
Hearing
Vision
Ambulatory
Cognitive
Duration
Public trans.

5. 6-question sequence
Hearing difficulty  deaf or having serious difficulty hearing (DEAR).
Vision difficulty  blind or having serious difficulty seeing, even when wearing glasses (DEYE).
Cognitive difficulty  Because of a physical, mental, or emotional problem, having difficulty remembering, concentrating, or making decisions (DREM).
Ambulatory difficulty  Having serious difficulty walking or climbing stairs (DPHY).
Self-care difficulty  Having difficulty bathing or dressing (DDRS).
Independent living difficulty  Because of a physical, mental, or emotional problem, having difficulty doing errands alone such as visiting a doctor’s office or shopping (DOUT).

6. 6-Questions & Other Surveys
BRFSS; CPS work limitation Q
Evidence that 6QS understate disability prevalence
Use of SSDI/SSI in working-age population
Does not fully consider participation within a context 6

7. Prevalence rate of non-institutionalized civilians, ages 25-61
Based on 2010 CPS data
Work limitation (B+C) (8.3%)
Six question sequence (A+B) (7.9%)
Work limitation only (C)
(3.7%)
Six question sequence only (A) (3.3%)
Both six question sequence and work-activity limitation (B) (4.6%)
Six question sequence and/or work-activity limitation (A+B+C) (11.6%)
Burkhauser, Fisher, Houtenville, Tennant (2012)

8. Conceptual issues in measuring disability
In-depth interviews of persons with disabilities
6Qs are not comprehensive
Functional limitation not always associated with impairment
Independent living difficulty  Because of a physical, mental, or emotional problem, having difficulty doing errands alone such as visiting a doctor’s office or shopping (DOUT).
(Do you/Does anyone in this household) have a health problem or disability which prevents (you/them) from working or which limits the kind or amount of work (you/they) can do?

9. Testing Alternate Questions

10. 2015 Kessler Foundation National Employment & Disability Survey
Kessler Foundation, UNH Institute on Disability, UNH Survey Center
Purpose: Document ways in which people with disabilities are “striving to work”
Long term goal: Reduce disparities in employment between people with & without disabilities
Dual-frame RDD sample of 3,000 adults with disabilities 10

11. Disability Screen
Developed a disability screen to identify people eligible for survey
Needed to be fast and comprehensive
Used ACS questions and then asked additional “prompting” questions based on “no” responses.
These “prompting” questions allow us to investigate who is saying “no” to the ACS questions! 11

12. Disability Screen: Vision & Hearing
Hearing difficulty:
Deaf or having serious difficulty hearing
Yes No
Vision difficulty: 
Blind or having serious difficulty seeing, even when wearing glasses

13. Disability Screen: Physical disability
Do you or any of the adults in your household have a serious difficulty walking or climbing stairs?
Do you or any of the adults in your household have any difficulty walking a quarter of a mile - about 3 city blocks? No
Do you or any of the adults in your household have any difficulty doing physical activities such as lifting, carrying, bending or manipulating small objects?

14. Disability Screen: Cognitive difficulty
Because of a physical, mental, or emotional problem, do you or any of the adults in your household have any have difficulty remembering, concentrating, or making decisions (DREM).
Do you think you or any of the adults in your household have a condition that makes it difficult to learn? Such conditions include attention problems (ADD), hyperactivity (ADHD), dyslexia and others No
Do you or any of the adults in your household have any emotional, psychological or mental health conditions? These may include anxiety, depression, bipolar disorder, substance abuse, anorexia, as well as other conditions No
Do you or any of the adults in your household have a developmental disability or disorder? This may include Down syndrome, autism, or Asperger syndrome, as well as other conditions” No

15. Multi-method comparison
Testing using an RDD telephone survey (n=3013); 6 Qs & 10 Qs
Replication through web survey using an opt-in panel (n=3022); 6 Qs & 10 Qs
Replication through a convenience, self-selected panel (n=630); 6 Qs & 10 Qs

16. Comparison of RDD 10 Qs with ACS prevalence estimates
Hearing
Vision
Ambulatory
Cognitive
Kessler Survey (10Qs RDD)
30.6
30.4
56.6
45.1
ACS Estimate
(6 Qs)
57.1
54..1
31.0
27.1

17. Disability %: 6 vs 10 Questions
Why is hearing % higher in RDD

18. Findings: Mobility Prompts
RDD
39.2
9.1
10.7
ACS Question
Mile
Upper
Body 18

19. Findings: Cognitive Prompts
RDD
32.1
12.8
18.8
ACS Question
Learning
Mental
Health
IDD = .5

20. Findings: Other Disability (RDD)
Do you have any other type of disability?
Yes: n = 1,010 (33.59%); n = 547 (54%) specified
36.6% - Chronic illness (e.g., arthritis, heart disease, diabetes, fibromyalgia)
29.1% - Repeated an existing category
9.3% - Back problems, injury, pain
15% - Other (e.g., PTSD, brain injury, sleep disorder, seizures)
10% - Unspecified (e.g., medical, disabled vet) 20

21. Near-Term Next Steps
Iterative testing to identify the most efficient set f question; minimal prompts
Test questions separating mental health, learning, and intellectual disabilities.
Test questions to identify chronic conditions that influence fatigue, stamina, and pain. 21

22. Longer-Term Next Steps
How to collect information on date of onset
How to collect information on severity
Reliability and validity testing 22

23. Questions/Comments?
 Contact Information
Vidya Sundar, Ph.D, OTR/L
Assistant Professor
Occupational Therapy Department
University of New Hampshire
4 Library Way
Durham, NH
Phone: (603) 23