Search

IntroductionMaintaining healthy weight is a challenge for all children, and particularly for children with IDD compared to nondisabled children and for Latino children compared to non-Latino White children. Parenting practices related to food intake and physical activity have been found to be important in maintaining children's weight. In this study, we describe the prevalence of overweight and obesity status among Latino children with IDD and their maternal caregivers and determine the relationship between food and physical activity parenting practices and childhood obesity among Latino children with IDD.MethodsWe interviewed 94 Latino parent/child dyads and collected information about parenting practices, home environment, and parent and child height and weight using standardized measures. Parent body mass index (BMI) and child BMI percentile were calculated from height and weight.ResultsThe combined overweight/obesity status for children in our sample was high (60.3%) compared to national rates among nondisabled Latino children (56%) and non-Latino White children with autism (37%). Contrary to research on nondisabled children, we found that greater parental use of controlling dietary strategies was associated with lower BMI percentile in Latino children with IDD. These findings may be indicative of the fact that children with IDD tend to have unique dietary behaviors that warrant more disability and culturally sensitive strategies.DiscussionOur findings suggest that overweight and obesity is especially prevalent for Latino children with IDD and that more research is needed on family factors that promote health in Latino families of children with IDD.

Objective: This article describes the demographic distribution of, and association between, neighborhood disorganization and mental health diagnosis by race in a large cohort of urban children with chronic medical conditions. Methods: Data for this study were from Coordinated Healthcare for Complex Kids (CHECK), a health care demonstration project funded by the Center for Medicare and Medicaid Innovation. We conducted regression analyses to examine the relationship between neighborhood disorganization and mental health diagnosis among 6,458 children enrolled in CHECK. Results: The most common mental health diagnoses were mood disorders (8.6%), Attention-Deficit/Hyperactivity Disorder (7.4%), conduct disorders (6.1%), and anxiety disorders (4.8%). Black children had the highest neighborhood disorganization scores compared with other racial/ethnic categories. However, Black children had the lowest proportion of mental health diagnoses. Lower neighborhood disorganization was associated with having a mental health diagnosis; however, when adding race/ethnicity to the model, neighborhood disorganization no longer was significant. Conclusions: Level of neighborhood disorganization was highly correlated with racial/ethnic composition of the neighborhoods, and Black children disproportionately resided in highly disorganized neighborhoods compared with other groups. Neighborhood disorganization may not have sufficient variability within the racial/ethnic categories, which may explain the absence of an interaction between race/ethnicity and mental health diagnosis.

Global migration has contributed to greater language diversity in many parts of the world. Many migrants experience language barriers in their adopted countries. Language barriers hinder access to healthcare, including mental health. There exists little research on the extent of communication difficulties during language discordant mental health services. A cross-sectional observational study design was used to examine prevalence of communication challenges, use of communication best practices, and training needs among mental health providers and interpreters working with immigrants with Limited English Proficiency (LEP) in the United States. Using snowball sampling methods, 38 providers and 34 interpreters were recruited to complete online surveys. Challenges reported by interpreters pertained to technicalities of communication, while those reported by providers pertained to content of communication. Communication best practices such as pre-session briefings and post-session debriefings were used infrequently by providers in the sample. Providers with higher education levels were more likely to endorse some best practices. Fifty-four percent of the providers and 84% of the interpreters were interested in additional training in working with patients with LEP. Findings suggest the need for customized trainings for providers and interpreters to improve the quality of mental healthcare for patients with LEP.

BackgroundDeafblindness, also known as dual sensory loss, is a varying combination of visual and hearing impairment in the same individual. Interest in this topic has increased recently due to evidence suggesting an increase in prevalence of this condition among older adults. Persons with deafblindness frequently experience participation barriers and social isolation. Developing an understanding of their experiences can inform the design of programs and policies to enhance participation of people with deafblindness in society.ObjectiveTo identify and summarize available research literature on participation experiences of people with deafblindness or dual sensory loss.MethodsA comprehensive literature search of eight databases (CINAHL/EBSCO, Embase, ERIC, Global Health, MEDLINE, ProQuest, PsycINFO, PubMed) was performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) during January 2017 and last updated in June 2017. In addition, non-peer reviewed (grey) literature was also retrieved in the form of online published reports of research projects by 16 deafblind-specific organizations across the globe. To be included, sources had to be published after 1990, had persons with deafblindness as the focal population, and focused on their participation experiences.ResultsA total 1172 sources were identified of which 54 studies were included. The findings reveal that persons with deafblindness, regardless of origin of their impairment, experience difficulty in communication, mobility, daily living functioning, and social interactions. While these experiences may vary between individuals with congenital versus acquired conditions, they generally feel socially isolated, insecure and uncertain about their future.ConclusionParticipation experiences of persons with deafblindness are shaped by dynamic interactions between personal factors (such as onset and type of impairments) and environmental influences (such as attitude, technology, and supports). A better understanding of participation experiences may help professionals in placing emphasis on affected participation domains to design services to enhance participation of people with deafblindness.

Effective communication between occupational therapists (OTs) and their clients is key to quality, client-centered services. Most OTs can expect to work with clients with Limited English Proficiency (LEP). Language barriers may negatively impact client safety and client satisfaction. Working with language interpreters is a key means for OTs to best serve clients with LEP; however, few OT curricula provide adequate training in working with interpreters. This paper presents a new, innovative online training for preparing OT students to work with clients with LEP and interpreters. The brief online training used informational slides, video role plays and written case studies to prepare OT students to provide and advocate for quality services for clients with LEP. The training was evaluated by 26 second year MSOT students at a large, urban university. Student learning was assessed with a pre-test/post-test questionnaire. Pre-test results indicated that while most students (86%) reported working with LEP clients on fieldwork, few (less than 27%) felt well prepared to do so. A majority (60%) of students were unaware or unsure of how to access interpreter services at their fieldwork site. Post-test results indicate that the training significantly improved student knowledge, skills and attitudes for working with LEP clients and interpreters. The implications for OT education, including the importance and feasibility of training entry-level OT students to work with interpreters, are discussed. Opportunities for increased emphasis on cultural competence and language access education within future entry-level OTD curricula are highlighted.

Despite preference for community-based living, large numbers of people with psychiatric disabilities live in nursing homes throughout the US. Community-based services for this population are limited by public policy and service system barriers. This paper summarizes these barriers and presents the second phase of a participatory action research project jointly developed by university-based researchers and two Centers for Independent Living. A qualitative case study methodology was used to understand the experiences of three individuals with psychiatric disabilities reintegrating into the community from nursing homes. Findings revealed themes of social isolation, participation in virtual communities, variability of impairment experiences and unmet needs for community supports. In addition to thematic findings, action products were generated for the benefit of community partners. These products included national best practice resources and a needs assessment survey tool. Study findings and products point to specific systems change and policy recommendations to better support community reintegration for this population. These recommendations are discussed in light of U.S. healthcare reform and broader disability advocacy efforts.

Over the past few decades there have been some positive (albeit inconsistent) changes in US refugee admissions policy as well as in UNHCR’s guidelines for resettlement, especially relating to refugees with disabilities.