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研究の概要(和文)：本稿では、高収益を生み出す付加価値の高い障害者施設製品の可能性について考察する。特に重度の障害者に対する工賃の低さは障害者就労支援における問題点の一つである。如何にして付加価値の高い障害者施設製品をつくり続けるかが重要な論点であると考える。付加価値の高い障害者施設製品の候補として、本稿では「伝統工芸品」を取り上げる。まず第Ⅱ節では、障害者就労の現状、障害者施設製品に関する問題点、伝統工芸品産業の地域における価値について整理する。次に第Ⅲ節では、実際に伝統工芸品を障害者施設製品として手掛ける社会福祉法人いわみ福祉会の取り組みを紹介する。いわみ福祉会では島根県の伝統工芸品である石見神楽衣裳類の製作を手掛け、全国平均を大きく上回る月額工賃の支給を実現している。第Ⅳ節以降は、知的障害者等による製作の実現可能性を踏まえ、数ある伝統工芸品の中から「江戸木目込人形」に着目して考察を進める。まず第Ⅳ節では、江戸木目込人形の産地である東京都と埼玉県の人形工房を調査して、製作工程や製品開発及び販売について整理する。次に第Ⅴ節では、重度の知的障害者に対して実際に木目込み作業の指導を行い、指導時の要点を整理する。分業体制のもとに進められる江戸木目込人形の製作において、胡粉塗り作業や木目込み作業等、知的障害者等が取り組める工程は存在する。パート等の労働力を適宜活用したり伝統工芸士等の専門家と連携したりすることで、人形市場において高い競争力を誇る製品づくりを行うことが重要であると考える。, 研究の概要(英文)：This paper considers the possibility of value-added products made by people with disabilities that generate high profits. Low wages for people with severe disabilities are one of the problems in employment support service for people with disabilities. The author thinks the important issue is how to continue to make value-added products with workers with disabilities.This paper focuses on “traditional crafts” as a candidate for value-added products made by people with disabilities. In Section II, the author summarizes the current situation of employment for people with disabilities, the problems about vocational aid centers products, and the values of traditional craft industries in the region. In Section III, the author introduces the efforts of the Iwami-Welfare Society, which produces traditional crafts with workers with disabilities. The Iwami-Welfare Society produces Iwami Kagura costumes, which are traditional crafts of Shimane Prefecture, and has realized monthly wages that greatly exceed the national average.From Section IV onward, this paper focuses on the “Edo Kimekomi Dolls” from among the many traditional crafts, considering the feasibility of production by people with intellectual disabilities. In Section IV, the author surveys the doll studios in Tokyo and Saitama prefectures, where Edo Kimekomi Dolls are produced, and describes the production process, product development, and sales. In Section V, the author instructs a person with severe intellectual disability, on how to tuck the edge of the cloth into the groove of the doll’s body. And the author describes the main points of the instruction. There are processes that people with intellectual disabilities can work on in the production of Edo Kimekomi Dolls, which work under a division of labor system. It is important to create products that are highly competitive in the doll market by utilizing part-time workers and collaborating with specialists such as traditional craftsmen.

Background: Although the current preventive measures relating to COVID-19 can lead to challenges in the daily work of direct support workers (e.g. keeping 1.5 m distance), it remains vital to uphold the principles of person-centred care when working with older people with intellectual disabilities. The current study explores the extent to which direct support workers have been able to apply a specific form of person-centred care (i.e. integrated emotion-oriented care, or IEOC) when working with older people with intellectual disabilities during the COVID-19 pandemic. Method: Six direct support workers from five facilities serving older people with intellectual disabilities in the Netherlands participated in this qualitative study. They participated in a two-hour focus group, which was transcribed verbatim, and the transcript was analysed thematically. Results: Three themes emerged: (i) the negative impact of changes due to the COVID-19 measures on service users; (ii) the adaptation of direct support workers to changes due to the COVID-19 measures; and (iii) putting the needs and wishes of service users first. Conclusion: This study provides first impressions into the experiences of direct support workers providing person-centred care to older people with intellectual disabilities during the COVID-19 pandemic.

Osobe s intelektualnim teškoćama okružene stigmom okoline bivaju socijalno isključene i ograničeno im je ostvarivanje njihovih prava. Potrebno je razviti svijest o njihovoj potrebi za intimnosti, partnerstvom i roditeljstvom te im je potrebna pomoć kako bi ostvarili te potrebe i prava. U tome se ogleda važnost uloge stručnjaka koji pružaju pomoć i podršku u rješavanju životnih problema i savladavanju životnih kompetencija. Ovim istraživanjem nastojao se dobiti uvid u stavove studenata pomažućih profesija o seksualnosti osoba s lakim i umjerenim intelektualnim teškoćama. Istraživanje je provedeno putem web ankete na uzorku od 205 studenata pomažućih profesija koji studiraju u Gradu Zagrebu. Cilj ovog istraživanja bio je ispitati stavove studenata o seksualnosti, partnerstvu i roditeljstvu osoba s lakim i umjerenim intelektualnim teškoćama te otkriti postoji li razlika u stavovima s obzirom na pojedina sociodemografska obilježja. Rezultati su pokazali razliku u stavovima s obzirom na dob, studij, fakultet, razinu studija, studentski status, religioznost, bliskost i kontakt s osobom s intelektualnim teškoćama. Istraživanje je pokazalo važnost edukacije i stjecanja što višeg stupnja obrazovanja stručnjaka te direktnog rada s osobama s intelektualnim teškoćama kako bi se osvijestila potreba osoba s intelektualnim teškoćama za seksualnosti., People with intellectual disabilities surrounded by environmental stigma are being socially excluded and their rights are being limited. It is necessary to develop an awareness of their need for intimacy, partnership and parenting, and they need help to achieve these needs and rights. This reflects the importance of the role of experts who provide help and support in solving life problems and mastering life competencies. With this research, we tried to get an insight into the attitudes of helping professions students about the sexuality of people with mild and moderate intellectual disabilities. The research was conducted via a web survey on a sample of 205 students studying in the City of Zagreb. The aim of this research was to examine students' attitudes about sexuality, partnership and parenting of people with mild and moderate intellectual disabilities and to find out if there is a difference in attitudes with regard to certain sociodemographic characteristics. The results showed a difference in attitudes regarding age, study, faculty, level of study, student status, religiosity, closeness and contact with a person with intellectual disabilities. The research showed the importance of education and obtaining the highest possible level of education of experts and direct work with people with intellectual disabilities in order to create awareness of need of people with intellectual disabilities for sexuality.

Background: Participation is often defined as taking part and being included in different areas of life. Leisure represents an important area of life for all people. People with disabilities have the right to experience leisure time in a self-determined manner. They have the right to participate in leisure activities on an equal basis with others. Due to various influencing factors, people with intellectual disabilities, especially those with severe to profound intellectual disabilities, are at risk of decreased participation. This is alarming because participation in leisure activities reflects quality of life. Purpose: The present study aims to review the empirical findings on leisure participation and its influencing factors in people with mild to moderate disabilities as compared to people with severe to profound intellectual disabilities. Method: A scoping review following the PRISMA-ScR checklist by Cochrane and the Joanna Briggs Institute (JBI) was conducted to examine research studies published in peer-reviewed journals between 2000 and 2022. The studies that were included relate to activities within the everyday leisure time of people with intellectual disabilities, regardless of age, gender, or severity of their cognitive disability. The categories of vacation and tourism were excluded so as to focus on everyday leisure. The sample was screened by two reviewers independently. In total, 27 articles met the inclusion criteria, with 21 articles referring to people with a mild to moderate intellectual disability and only six articles referring to people with a severe to profound intellectual disability. The evidence was summarized with a predefined standardized charting form, which was used by the two reviewers. Results: The results show that participation in leisure activities by people with intellectual disabilities can be limited, especially for those with severe to profound intellectual disabilities. This contradicts the guiding principle and human rights of inclusion and self-determination. Their participation in leisure time is extremely dependent on external factors, such as support people, leisure time availability, and form of living. Passive activities at home are often provided for people with severe to profound intellectual disabilities in particular; therefore, the need for interactive and self-determined leisure opportunities in the community is enormous. Various factors influencing leisure participation can be identified. Implications: The findings of this scoping review can be used to consider intervention, support, and barriers to enhancing leisure participation among people with disabilities as an important area of life.

U proučavanju povijesti intelektualnih teškoća postavljaju se pitanja u kojoj mjeri se terminologija podudara s današnjim pojmom intelektualnih teškoća i koliko su postojeći dokumenti i znanstveni radovi vjerodostojni s obzirom na to da ih nisu pisali povjesničari te da su česte greške koje se zbog sekundarnog referenciranja prikazuju kao istinite činjenice. Kroz povijest osobe s intelektualnim teškoćama su bile ubijane, korištene kao robovi, kućni ljubimci i u svrhe razonode na predstavama frikova. Prisilno su institucionalizirane, a tretmani liječenja su bili dehumanizirajući. Nad njima se provodila sterilizacija te su bile žrtve eugeničkog pokreta. Sredinom prošlog stoljeća dolazi do poboljšanja položaja i razvoja pokreta neovisnog življenja i filozofije inkluzije. No osobe s intelektualnim teškoćama se nalaze na marginama našeg društva i danas. Kvaliteta njihovog života dodatno se narušava u vrijeme pandemije kada im se oduzimaju temeljna prava i slobode. Socijalni radnici imaju ključnu ulogu u zagovaranju prava osoba s intelektualnim teškoćama, a svoj rad moraju temeljiti na znanju i aktivnom uključivanju osobe u proces donošenja odluka. Pri svemu tome moraju biti svjesni svojih kompetencija i važnosti očuvanja mentalnog zdravlja te stvaranja dobrih profesionalnih odnosa kako bi ublažili profesionalni stres i prevenirali nastanak sindroma sagorijevanja. Socijalna politika Republike Hrvatske ispred sebe ima izazov donošenja mjera kojima će se poboljšati dostupnost izvaninstitucijskih usluga u zajednici, deinstitucionalizacija provesti u praksi te poboljšati sveukupan društveni položaj osoba s intelektualnim teškoćama., While studying the history of intellectual disabilities, questions arise as to which extent the terminology coincides with todays concept of intellectual disabilities and how credible the existing documents and scientific works are. Due to the fact that they were not written by historians and that there are frequent errors that are presented as true facts due to secondary referencing. Throughout history, people with intellectual disabilities have been killed, used as slaves, pets and for entertainment purposes at freak shows. They were forcibly institutionalized, and the medical treatments were dehumanizing. They were sterilized and were victims of the eugenics movement. In the middle of the last century, there was an improvement in the position and development of the independent living movement and the philosophy of inclusion. Even tough people with intellectual disabilities are still on the margins of our society today. The quality of their life is further impaired during the pandemic period when their fundamental rights and freedoms are taken away. Social workers have a key role in advocating the rights of people with intellectual disabilities, and they must base their work on knowledge and the active involvement of the person with disabilities in the decision-making process. With all this, they must be aware of their competences and the importance of preserving mental health and creating good professional relationships in order to alleviate professional stress and the occurrence of burnout syndrome. The social policy of the Republic of Croatia faces the challenge of adopting measures that will improve the availability of extra-institutional services in the community, put deinstitutionalization into practice, and improve the overall social position of people with intellectual disabilities.

Background: We aimed to gain more insight into autonomy of older people with intellectual disabilities in a residential care facility in making choices. Methods: We performed a descriptive ethnographic study in a residential facility in the Netherlands for 22 persons, aged 54–89 years, with mild to moderate intellectual disabilities (IQ

The article considers the problem of social rehabilitation of people with intellectual disabilities: analyzes the category of «disability» as a social phenomenon, summarizes the current approaches and social practices of foreign and Russian scientific schools in the context of the problem being studied, theoretically reveals the potential of art–therapeutic methods in organizing social rehabilitation of people with disabilities in accordance with the specifics of disabilities.The article describes an empirical study, in the course of which the features of social orientation of people with intellectual disabilities, their adaptive mechanisms and creative potential are revealed. The material of the article includes a description of the author's project “Art without Borders”, aimed at the socio–cultural rehabilitation of people with intellectual disabilities and the development of their creative potential using art therapy methods. The results of the study can be the basis for designing a system of social rehabilitation of people with intellectual disabilities.

Background Overmedication of people with intellectual disabilities, particularly when psychotropic medications are used for challenging behavior (CB) in the absence of a psychiatric disorder, is a significant public health concern. Support staff play a pivotal role in influencing the prescribing process. Staff views and attitudes toward medication use for CB are therefore of paramount importance. Method We have conducted four focus groups involving support staff (n = 8), home managers (n = 5) and trainers (n = 3), two of which primarily explored participants’ experiences and views on using medication for CB and medication withdrawal. Results Some participants felt medication use was justified, but others saw that as a form of chemical restraint. Most agreed that polypharmacy of psychotropics might lead to side effects. Some acknowledged the lack of shared decision-making involving people with intellectual disabilities and their families. There was universal anxiety about withdrawing the medication. Conclusions All agreed on the need for more medication-related information.

Caregivers of people with intellectual disabilities may feel overburdened in their work and experience negative psychological consequences. The purpose of this instrumental study was to determine the evidence of internal structure and reliability of the Zarit Caregiver Burden Interview scale. A total of 398 family caregivers, including women and men, participated (M = 47.33, SD = 10.44). The structure of the scale was evaluated by factor analysis and the McDonald Omega coefficient was used to estimate reliability. Sixteen models of the scale were tested, differing in number of items and factor structures. A model of 15 items and 4 dimensions (overload, competence, social relationship, and interpersonal relationship) obtained acceptable fit (χ2 = 184.72; p < 0.001; CFI = 0.95; TLI = 0.94; RMSEA = 0.055; SRMR = 0.05) and reliability coefficients above 0.70 in their dimensions. It is concluded that the Zarit scale is valid and reliable for use in caregivers of people with intellectual disabilities.

Behaviours that challenge (BtC), such as aggression and self-injury, are manifested by many people with intellectual disabilities (ID). National and international guidelines recommend non-pharmacological psychosocial intervention before considering medication to address BtC. Support staff play a pivotal role in the prescription process. Using coproduction, we developed a training programme for support staff, called SPECTROM, to give them knowledge and empower them to question inappropriate prescriptions and ask for the discontinuation of medication if appropriate and instead look for ways to help people with ID when they are distressed without relying on medication. We have presented data from two focus groups that we conducted during the development of SPECTROM: one that included support staff, and another that had service managers and trainers. In these focus groups, we explored participants’ views on the use of medication to address BtC with a particular emphasis on the causes of and alternatives to medication for BtC. Along with the participants’ views, we have also presented how we have addressed these issues in the SPECTROM resources.

Život na margini društva nerijetko je bilo obilježje osoba s intelektualnim teškoćama. Bile su odbačene i bez prava glasa. Ni danas situacija nije puno bolja, izjednačeni su na papiru, a stvarnost i dalje zaostaje. Napretkom tehnologije pojedinac se promatra kao individua sa različitim potrebama. Osobe s intelektualnim teškoćama pokazuju najviše poteškoća u prijelazu iz adolescencije u odraslu dob. Odrastanje podrazumijeva zaposlenje, osamostaljenje, odlazak od roditelja, zasnivanje obitelji. Radna sposobnost je pretpostavka za brak, za spremnost skrbi o drugoj osobi. Izostanak posla stvara materijalnu deprivaciju koja narušava obiteljske odnose. Materijalna deprivacija je korak prema siromaštvu koje predstavlja ugrozu za samog pojedinca, a time i za obitelj. Socijalni ranik osobi s intelektualnim teškoćama može pružati pravnu pomoć u situacijama kao što je pomoć pri prikupljanju potrebnih dokumenata kako bi ostvarili određena prava ili biti posrednik u razgovoru s višim tijelima. Oni u pravilu im pomažu u informiranju o pravima i pomažu im u ostvarivanju istih., Life on the margins of society has often been a feature of people with intellectual disabilities. They were rejected and without the right to vote. Even today, the situation is not much better, they are equal on paper and the reality is still lagging behind. With the advancement of technology, the individual is viewed as an individual with different needs. People with intellectual disabilities show the most difficulty in the transition from adolescence to adulthood. Growing up means employment, independence, leaving one's parents, starting a family. Working ability is a prerequisite for marriage, for the willingness to care for another person. Absence of work creates material deprivation that disrupts family relationships. Material deprivation is a step towards poverty that poses a threat to the individual and to the family. A social worker can provide legal assistance to a person with intellectual disabilities in situations such as assistance in gathering the necessary documents to exercise certain rights or be a mediator in discussions with higher authorities. As a rule, they help them to inform about their rights and help them to exercise their rights.

Background There is evidence that psychotropic medications are overprescribed and overused to manage behaviours of concern for people with intellectual disabilities. Disability support workers and support staff lack education and training on the administration and safety of psychotropic medication use. This study aimed to test the applicability and preliminary efficacy of SPECTROM, an education programme developed in the UK, in an Australian context. Methods The training comprises two parts: Module 1 encompasses psychotropic medications, their use and side effects. Module 2 focuses on non-pharmacological interventions for supporting people with behaviours of concern. Thirty-three participants attended the training course and completed pre-training and post-training surveys on the Psychotropic Knowledge Questionnaire and Management of Aggression and Violence Attitude Scale-Revised at four time points: pre-training, 2 weeks, 3 months and 5 months post-training. Results Psychotropic Knowledge Questionnaire scores showed statistically significant post-training improvement at all post-training time points (P < 0.05). Management of Aggression and Violence Attitude Scale-Revised scores were high at pre-training and did not change significantly at any of the post-training survey time points. A 2-week post-training feedback questionnaire reported 80% agreement that the training programme was appropriate, useful and valid. Only 36% of participants completed questionnaires at all time points. Conclusions SPECTROM training increased staff knowledge of psychotropic medications, yet loss of participants was high. Further refinement of the applicability of the training for the Australian context and evaluation of the feasibility of implementation, clinical and cost-effectiveness of the programme are required.

Background People with intellectual disabilities (IDs) may be at increased risk of developing periodontal diseases and dental caries due to poor oral hygiene. Our aim was to investigate motor proficiency factors associated with presence of visible plaque and gingival bleeding in people with IDs. We were particularly interested in the level of dependence, manual coordination and fine manual control of people with ID, as well as the level of exhaustion of the primary caregiver. Methods In this cross-sectional study, 299 people with ID were evaluated for oral hygiene using the simplified Visible Plaque Index and for gum inflammation using the Gingival Bleeding Index. The Bruininks-Oseretsky Motor Proficiency Test assessed motor proficiency through fine manual control (fine motor integration and fine motor precision) and manual coordination (manual dexterity and upper limb coordination). The level of dependence was assessed by the Katz dependency index, and the caregiver was tested for exhaustion using the fatigue severity scale. Prevalence ratios [and 95% confidence intervals (CI)] were calculated using crude and adjusted Poisson regression with robust variance. Results The exhaustion of the caregiver was associated positively to visible plaque [prevalence ratio (PR) = 1.36; 95% CI 1.06-1.65]. For gingival bleeding, people with IDs that had better fine motor integration (PR = 0.49; 95% CI 0.33-0.75) and precision (PR = 0.50; 95% CI 0.26-0.94), as well as manual dexterity (PR = 0.62, 95% CI 0.49-0.77), presented better results. Conclusion Poor oral hygiene and gum inflammation were associated with motor proficiency of people with IDs and caregivers' exhaustion. Interventions to improve the oral health of people with IDs should take into account such conditions.

COST Actions are grants provided by the European Union to support the establishment of networks of expertise to explore and address a scientific or social issue that impacts across Europe. This article introduces and describes one such action that started in October 2022 - CUPID - will address issues of policy and equity of access to cancer prevention initiatives by people with intellectual disabilities compared to the general population in Europe. With 82 individual members drawn from 30 countries CUPID will establish an interdisciplinary network of stakeholders representing carers, service providers, advocacy groups, educators, healthcare professionals, researchers and people with intellectual disabilities. The CUPID COST Action will be implemented over four years and will identify what needs to be addressed by the European Union and health and social services to improve cancer prevention among people with intellectual disabilities.

BACKGROUND: People with intellectual disabilities experience persistent marginalization in relation to work and employment. The concept of work inclusion provides a way of generating a more specific understanding of the meaning of employment participation. Work inclusion of people with intellectual disabilities focuses not on mere presence, but instead emphasizes relational aspects and potential for meaningful participation. OBJECTIVE: In this paper we report on an empirical study into the experiences of people with intellectual disabilities of employment participation in the Icelandic labor market. We considered their experiences in relation to four key components of work inclusion, placing emphasis on how they perceived opportunities for inclusion related to social relations, belonging, valued contributions and trust. METHODS: This study used a qualitative research design. Data was collected with semi-structured interviews with 9 participants with intellectual disabilities who all had experience of being employed in the Icelandic labour market. RESULTS: Our findings show the role of the work environment in participants’ experiences of opportunities for having good relations at work, having a sense of belonging to the organization, being able to make a contribution to the goals of the organization, and receiving trust in one’s professional role and responsibility. When participants experienced opportunities in relation to these basic components of work inclusion, they felt more positively about their employment participation. Lack of opportunities was reported as a reason for segregation and withdrawal. CONCLUSION: This study shows the importance for work organizations and other actors in the labor market of paying attention to components of work inclusion and their relation with corporate culture.

Contains fulltext : 283542.pdf (Publisher’s version ) (Open Access) Background: Aggressive incidents are common in people with intellectual disabilities. Therefore, we aimed to assess whether supplementation of multivitamins, minerals, and omega-3 fatty acids (FA) reduces aggressive incidents. Methods: We conducted a randomised, triple blind, placebo controlled, single crossover intervention trial. People with intellectual disabilities or borderline intellectual functioning, between 12 and 40 years of age, and showing aggressive behaviour were included. Participants received either a daily dose of dietary supplements, or placebo. Primary outcome was the number of aggressive incidents, measured using the Modified Overt Aggression Scale (MOAS). Results: There were 113 participants (placebo, n = 56), of whom 24 (placebo, n = 10) participated in the crossover phase of the trial. All 137 trajectories were included in the analyses. There was no significant difference in mean number of aggressive incidents per day between those assigned to supplements and those who received placebo (rate ratio = 0.93: 95% Confidence Interval [CI] = 0.59–1.45). Conclusion: In this pragmatic trial, we did not find significant differences in the outcomes between the supplement and placebo arms. The COVID-19 pandemic started midway through our trial, this may have affected the results. 10 p.

The dominant idea in debates on social inclusion of people with intellectual disabilities is that social inclusion requires recognition of their ‘sameness’. As a result, most care providers try to enable people with intellectual disabilities to live and participate in ‘normal’ society, ‘in the community’. In this paper, we draw on (Pols, Medicine Health Care and Philosophy 18:81–90, 2015) empirical ethics of care approach to give an in-depth picture of places that have a radically different take on what social inclusion for people with intellectual disabilities looks like: places known as ‘sheltered living institutions’. We argue these places can be seen as ‘communities of difference’ catered to the specific needs and capacities of the residents. We then contend that these communities raise questions about what a good life for people with intellectual disabilities looks like and where and how it ought to be realised; questions not posed very often, as they get muzzled by the dominant rhetoric of normalisation and the emphasis on sameness.

People with Intellectual disabilities understand Pictograms that require learning has been reported to be difficult. They exhibit difficulties under-standing, including reading and writing, textual information, and often use images in the form of Pictograms to circumvent this difficulty.Against the backdrop of research by AAC (Augmentative and Alternative Communication), TEACCH (Treatment and Education of Autistic and related Communication handicapped Children), and others, Pictograms have been used as tools for communication from school age onward. Thus, Pictograms displayed in public spaces are public support tools that enable people with intellectual disabilities to understand information. / However, in Japan, when some Pictograms were revised or added in preparation for the 2020 Tokyo Olympics in 2017, and paired comparison survey was carried out by the Japanese JIS standard Pictograms committee to determine whether JIS or ISO Pictograms were easier to understand. Some people with disabilities were included in the study, but only 20 out of 121 responded (16.5%), and the data was decided to be used only as a reference. / From the results of the author's previous surveys of people with Intellectual Disabilities, pictograms they understand are also well understood by people without disabilities. / In this study, 19 adults with intellectual disabilities and Pictograms of 16items from JIS for guidance were subjected to a com-prehension survey where they recalled intended actions. As a result, graphic elements that increase comprehension were identified in each Pictogram. The study also suggested an association between comprehensible graphic elements and IQ. / Specifically, five graphic elements influence the comprehension of Pictograms: 1. person symbolizing location, 2. real orien-tation, 3. motion line (: effect line representing movement, emphasis, sound, etc.) 4. location element, and 5. arrow: the axis length affects the degree of comprehension. It was suggested that 1. lower IQ, 2. real orientation, and 3. motion line had more influence on the ease of understanding.

Mainstream economic evaluations methods may not be appropriate to capture the range of effects triggered by interventions for people with intellectual disabilities. In this systematic review, we aimed to identify, assess and synthesise the arguments in the literature on how the effects of interventions for people with intellectual disabilities could be measured in economic evaluations.We searched for studies providing relevant arguments by running multi-database, backward, forward citation and grey literature searches. Following title/abstract and full-text screening, the arguments extracted from the included studies were summarised and qualitatively assessed in a narrative synthesis.Our final analysis included three studies, with their arguments summarised in different methodological areas.Based on the evidence, we suggest the use of techniques more attuned to the population with intellectual disabilities, such sensitive preference-based instruments to collect health states data, and mapping algorithms to obtain utility values.

People with intellectual disabilities and behaviours that challenge others are living longer. This review aimed to explore what is known about the health and social care needs, experiences, service interventions and resources of and for this population as they transition to different care contexts in the UK.A rapid scoping review of published and unpublished literature was conducted based on collaborative working with key stakeholders and using systematic methods of data searching, extraction and analysis.Consistent social work support, skilled staff, suitable accommodation, creative engagement with individuals and families to plan ahead, and timely access to quality healthcare are all required to promote successful transitions as people age, and to avoid unwanted/inappropriate transitions at points of crisis.More research is needed to assess the types of services that this population can and do access as they age, the quality of those services, and the extent to which local commissioners are planning ahead for people with intellectual disabilities and behaviours that challenge others.

Background People with intellectual disabilities can be exposed to sexual abuse and they can display harmful sexual behaviour. This study aimed to identify barriers to preventing harmful sexual behaviour in people with intellectual disabilities within the support sector and the justice system. Method We conducted focus group interviews with 20 participants from hospital-based habilitation centres, community residences, schools and the criminal justice system. Results The interviews identified a lack of education and guidelines for stakeholders or carers on regulating the sexual behaviour of people with intellectual disabilities. The criminal justice system faces challenges related to prioritising, understanding and communicating. People with intellectual disabilities may lack an understanding of the concepts of sexual consent and acceptable sexual behaviour. Conclusion There is a need to improve knowledge about intellectual disability and how to prevent harmful sexual behaviour for professional caregivers in the support sector and the criminal justice system.

BackgroundPhotovoice is an arts-based participatory action research methodology that is growing in popularity. Our aim was to systematically review photovoice research with people with intellectual disabilities to describe the current ‘state of the art’ and identify areas for further methodological consideration.MethodsWe searched five databases using search terms relating to photovoice and intellectual disabilities. Thirty one studies met inclusion criteria. We used thematic analysis to identify common themes.FindingsThe themes identified—adaptations to the photovoice method, collaboration, participation and power, impact and outcomes—explored how far the ‘voice’ and agency of participants with intellectual disabilities taking part in photovoice research were supported and whether photovoice lived up to its promise as ‘action’ research.ConclusionPhotovoice creates opportunities for self-representation of people with intellectual disabilities through photography. Participants could be further supported to engage with researchers in critical reflection on findings and collaborate on tangible outcomes.

Cilj ovoga rada je analiziranje problematike seksualnog nasilja nad osobama s intelektualnim teškoćama, odnosno, dan je kritički, znanstveni, ali i stručni pregled spoznaja te pregled dostupnih inozemnih istraživanja, ali i dostupnih istraživanja provedenih u Republici Hrvatskoj na ovu temu. Seksualno nasilje je jedan od najtežih oblika nasilja koji narušava osnovna ljudska prava i jedan je od najgorih oblika diskriminacije. Posljedice seksualnog nasilja su brojne i dugotrajne, a događa se da kod osoba s intelektualnim teškoćama ostaju i neotkrivene uslijed smanjene sposobnosti osoba s intelektualnim teškoćama da iskažu emocije i pričaju o svome psihičkom stanju. Brojni su čimbenici rizika koji pogoduju većoj vjerojatnosti da će osobe s intelektualnim teškoćama biti izložene seksualnom nasilju. Neki od njih su: slabije rasuđivanje, siromašna komunikacija i socijalne vještine, veće oslanjanja na pružatelje usluga, manjak znanja o seksualnosti, niska razina svijesti o zaštiti vlastitog dostojanstva i sigurnosti u spolnom ponašanju, nisko samopoštovanje, povodljivost u ponašanju, kognitivna ograničenja koja otežavaju procjenu opasnosti neke situacije, nerazvijene vještine vlastitog donošenja odluka, nedostatak edukacije o načinu obrane od spolne zloupotrebe. Što se tiče preventivnih programa, namijenjenih i prilagođenih osobama s intelektualnim teškoćama, u našoj zemlji je stanje nezadovoljavajuće, rad s djecom na ovome području često predstavlja dobru volju stručnjaka, roditelja, učitelja, iako istraživanja ukazuju na veliku učestalost seksualnog nasilja nad djecom i osobama s intelektualnim teškoćama. Potrebno je provesti sustavna istraživanja kako bi se utvrdila jasna rasprostranjenost seksualnog nasilja, kako bi se čimbenici rizika smanjili te prema tome voditi i registar. Nadalje, neophodno je zakone i propise provesti i u praksi, protokole prilagoditi i osobama s invaliditetom, a prevenciju seksualnog nasilja temeljiti na dokazima dobivenim kroz istraživanja. Potrebno je sustavno provoditi edukaciju samih osoba s intelektualnim teškoćama, educirati i obitelj, odgojno-obrazovne djelatnike i sve druge stručnjake koji su u kontaktu s ovom populacijom, sve u svrhu postizanja maksimalne zaštite ove populacije. Ovaj rad ukazuje na potrebu kreiranja novih smjernica i preporuka za pravovremeno sprječavanje zlostavljanja i pružanje podrške žrtvama seksualnog nasilja., The aim of this paper is to analyze the issue of sexual abuse against people with intellectual disabilities, ie, a critical, scientific and professional review of knowledge and review of available foreign research and available research conducted in the Republic of Croatia on this topic. Sexual abuse is one of the most severe forms of violence that violates basic human rights and is one of the worst forms of discrimination. The consequences of sexual abuse are numerous and long-lasting, and it happens that in people with intellectual disabilities they remain undetected due to the reduced ability of people with intellectual disabilities to express emotions and talk about their mental state. There are a number of risk factors that favor people with intellectual disabilities more likely to be exposed to sexual abuse. Some of them are: poor judgment, poor communication and social skills, greater reliance on service providers, lack of knowledge about sexuality, low level of awareness about protecting one's dignity and safety in sexual behavior, low self-esteem, behavioral coherence, cognitive limitations that make assessment difficult the dangers of a situation, the underdeveloped skills of one's own decision-making, the lack of education on how to defend oneself from sexual abuse. As for prevention programs, intended and adapted to people with intellectual disabilities, the situation in our country is unsatisfactory, working with children in this area often represents the good will of experts, parents, teachers, although research indicates a high frequency of sexual violence against children and people with intellectual disabilities. Systematic research is needed to determine the clear prevalence of sexual violence, to reduce risk factors, and to keep a register accordingly. Furthermore, it is necessary to implement laws and regulations in practice, to adapt protocols to persons with disabilities, and to prevent the prevention of sexual abuse on the basis of evidence obtained through research. It is necessary to systematically educate people with intellectual disabilities, to educate the family, educators and all other professionals who are in contact with this population, all in order to achieve maximum protection of this population. This paper points to the need to create new guidelines and recommendations for the timely prevention of abuse and the provision of support to victims of sexual abuse.

SUMMARY On average, 49–63% of people with intellectual disabilities and/or autism spectrum disorder (ASD) are prescribed psychotropic medications to treat psychopathology, including psychiatric illness, behaviours that challenge and the core symptoms and associated behaviours of these developmental disorders. In many cases, psychotropics, particularly antipsychotics, are used off-label without a proper indication, particularly to manage behaviours that challenge. The RCTs show moderate evidence supporting the efficacy of low-dose risperidone and some preliminary evidence for aripiprazole in treating behaviours that challenge among children with ASD and/or intellectual disabilities. The RCT-based evidence for the other psychotropics is equivocal, so no definitive conclusions can be made on their efficacy. Polypharmacy and the use of high doses of antipsychotics are prevalent in this population, leading to the risk of adverse events and drug–drug interactions. Despite various national and international guidelines, and government initiatives encouraging reduced psychotropic use, there is little evidence of this happening; on the contrary, the use of antidepressants, mood stabilisers and benzodiazepines may be increasing. A concerted multi-agency effort is urgently needed to address this significant public health concern of the overmedication of people with intellectual disabilities and/or ASD.

The paper intends to do a scoping review of people with intellectual disabilities in emergency care where this group seems to face access barriers and discrimination. It analyses the conceptual and methodological framework for studies examining the former.A scoping review is conducted. The studies' quality is assessed via a checklist developed by the authors drawing on a compilation of common assessment tools for study quality.Fourteen quantitative studies fulfil the inclusion criteria for further analysis. Summary measures are extracted. Results are synthesized with Andersen's Behavioral Model of Health Service Use. Studies employ a combination of variables attributable to different aspects of population characteristics and health behavior.Most studies seek to quantify or predict emergency care overuse by people with intellectual disabilities. Future studies should also take patients' poor health or treatment outcomes and their perspectives into account.

Background: Little is known about how to involve people with intellectual disabilities in making decisions about treatment and care in their palliative phase. We aimed to reach a consensus about a shared decision-making (SDM) conversation aid for people with intellectual disabilities, relatives, and healthcare professionals. Methods: In a Delphi process, an expert panel of 11 people with intellectual disabilities, 14 relatives, and 65 healthcare professionals completed online questionnaires about the relevance and feasibility of a draft conversation aid. Results: In Round 1, components were rated as (very) relevant by 70–98% of participants (M = 87%). In Round 2, after amending the aid in response to feedback, relevance ratings were 67–97% (M = 90%) and feasibility ratings 66–86% (M = 77%). The final version consists of four themes: who are you; illness/end-of-life; making decisions; and evaluating the decision. Conclusion: The consensus-based conversation aid is considered sufficiently relevant and feasible to be implemented in practice.

Various changes in intellectual disability policies and practices encourage care organizations to look for new ways to provide their services. In their search, organizations often look at the possibilities of technology for shaping their service portfolio. One way in which technology can be used is to organize and deliver support remotely. The Dutch service provider organisation Philadelphia Care Foundation (PCF) developed and implemented the remote support service DigiContact as one component of a broader range of services for independently living people with intellectual disabilities. The service provides support for day-to-day living through video calls or regular (audio-only) telephone calls with a team of specially trained support workers. The service is 24/7 available and its support can be deployed on demand by people with intellectual disabilities themselves: whenever and wherever this is needed. Since the start of DigiContact, PCF has felt the need to monitor and evaluate the service in terms of its quality and usefulness. In this context, a better understanding of what the service can (and cannot) contribute to the lives of people with intellectual disabilities is essential. This thesis aims to gather knowledge regarding the added value of including DigiContact in a broader offer of services for people with intellectual disabilities who live independently in society. Five separate studies were performed that explored mainly the personal experiences of people closely involved in the DigiContact support process: support users (people with intellectual disabilities), their case workers (support workers who provide onsite support and coordinate services around support users), and DigiContact support workers. An inclusive approach to research was adopted, as this was expected to enrich both research processes and findings. This approach was shaped in the form of a collaboration between the PhD candidate and a researcher with intellectual disabilities. The findings of this thesis indicate that including DigiContact in a broader offer of services can be valuable to (supporting) people with intellectual disabilities living in their own homes in society, in several ways. To begin with, DigiContact contributes to more opportunities for providing people with professional and specialized support that is closely aligned with their personal needs and preferences. DigiContact can contribute to more tailor-made professional support by broadening the available support options, by enabling the provision of sufficient support and by enhancing the continuity in the delivery of support. In addition, DigiContact provides a unique entry point for improving people’s functioning and well-being; its support has been found to enlarge the opportunities for making choices and taking decisions, can help to prevent (larger) problems as well as an accumulation of stress, and can play a valuable role in the learning and strengthening of adaptive skills. At the same time, the findings also emphasize that there are limitations to what the DigiContact service can do for its users, and that it is not equally suitable for every person and situation. It is therefore not a ‘one size fits all’ service. The value of DigiContact support seems to lie often in its combination with onsite support (a blended care form), which enables people with intellectual disabilities to make decisions regarding which type of support suits their needs and preferences (in a given situation) best. In this respect, onsite support and DigiContact support can complement each other so that people can benefit from ‘the best of both worlds’. Based on the findings of this thesis, several implications for policy, practice and research are formulated. Although these implications are specifically related to the DigiContact service, they may also be of interest to other remote support initiatives and service organizations who are planning (or considering) to offer remote support.

Resumo O presente artigo tem como objetivo identificar a avaliação do ensino-aprendizagem no ensino regular durante a pandemia da Covid-19 (2020-2021), com enfoque na pessoa com deficiência intelectual. Neste sentido, encontram-se elementos para uma reflexão acerca da avaliação da pessoa com deficiência intelectual, contextualizando uma abordagem para sua ressignificação. Para isso, relacionam-se questionamentos pertinentes à valorização das diferenças individuais dos alunos, discutindo a avaliação do ensino-aprendizagem no contexto inclusivo. O estudo é de natureza qualitativa, com o uso de um roteiro de entrevista semiestruturado com familiares e/ou responsáveis de pessoas com deficiência intelectual, para destacar a relação entre a legislação, a avaliação do ensino-aprendizagem e a educação inclusiva no contexto da pandemia da Covid-19 (2020-2021). Os dados analisados integram a tese de Mendonça (2022). A revisão literária proporciona referencial teórico para colaborar com a discussão. Problematizou-se como foi realizada a avaliação do ensino-aprendizagem no ensino regular durante pandemia da Covid-19 (2020-2021), em relação à pessoa com deficiência intelectual. Verificou-se, por uma parcela da amostra, que a avaliação da pessoa com deficiência intelectual foi negligenciada no referido período e, entre os demais participantes da pesquisa, caracteriza-se pela utilização limitada ao uso de instrumentos quantitativos e de mensuração. Conclui-se a necessidade de repensar a avaliação do ensino-aprendizagem da pessoa com deficiência intelectual, em contexto inclusivo, em conformidade com a legislação brasileira vigente. Abstract This article aims to identify the evaluation of teaching-learning in regular education during the Covid-19 pandemic (2020-2021), focusing on people with intellectual disabilities. In this sense, we find elements for reflection about evaluating people with intellectual disabilities, contextualizing an approach for its re-signification. To this end, pertinent questions are related to the appreciation of students’ individual differences, discussing the evaluation of teaching-learning in the inclusive context. The study is qualitative, using a semi-structured interview script with family members and/or guardians of people with intellectual disabilities to highlight the relationship between legislation, teaching-learning assessment, and inclusive education in the context of the Covid-19 pandemic (2020-2021). The data analyzed are part of Mendonça’s thesis (2022). The literature review provides theoretical references to contribute to the discussion. The evaluation of teaching-learning in regular education during the Covid-19 pandemic (2020-2021) was problematized concerning people with intellectual disabilities. It was verified, by a portion of the sample, that the evaluation of people with intellectual disabilities was neglected in this period, and, among the other research participants, it is characterized by the limited use of quantitative and measurement instruments. We conclude the need to rethink the evaluation of the teaching-learning of the person with intellectual disabilities, in an inclusive context, under the Brazilian legislation in force.

This research presents the “LudoMinga” platform based on serious games designed to facilitate the learning process of people with intellectual disabilities. The platform is focused on providing an inclusive and accessible learning environment. Serious Games combines educational content with video game mechanics, and the platform aims to enhance the learning experience and promote active participation. Through an iterative development process, including user feedback and evaluations, the platform was developed using the iPlus methodology to align with the specific requirements of the target audience. Preliminary user test results indicate positive results in terms of user engagement, learning, and satisfaction. This accessible platform based on serious games promises to improve educational opportunities and outcomes for people with intellectual disabilities, ultimately fostering their personal and cognitive development. The success of the “LudoMinga” platform lies in the combination of interactive games, personalized support, and accessibility features, ultimately creating an engaging and effective learning environment. Continued advances in this area have the potential to unlock barriers for people with intellectual disabilities, fostering their growth, independence, and active participation in society.

Background Euthanasia review committees (Regionale Toetsingscommissies Euthanasie, RTE) scrutinise all Dutch cases of euthanasia and physician-assisted suicide (EAS) to review whether six legal ‘due care’ criteria are met, including ‘unbearable suffering without prospect of improvement’. There are significant complexities and ethical dilemmas if EAS requests are made by people with intellectual disabilities or autism spectrum disorders (ASD). Aims To describe the characteristics and circumstances of people with intellectual disabilities and/or ASD who were granted their EAS request; investigate the main causes of suffering that led to the EAS request; and examine physicians’ response to the request. Method The online RTE database of 927 EAS case reports (2012–2021) was searched for patients with intellectual disabilities and/or ASD (n = 39). Inductive thematic content analysis was performed on these case reports, using the framework method. Results Factors directly associated with intellectual disability and/or ASD were the sole cause of suffering described in 21% of cases and a major contributing factor in a further 42% of cases. Reasons for the EAS request included social isolation and loneliness (77%), lack of resilience or coping strategies (56%), lack of flexibility (rigid thinking or difficulty adapting to change) (44%) and oversensitivity to stimuli (26%). In one-third of cases, physicians noted there was ‘no prospect of improvement’ as ASD and intellectual disability are not treatable. Conclusions Examination of societal support for suffering associated with lifelong disability, and debates around the acceptability of these factors as reasons for granting EAS, are of international importance.

Background: Previous research has shown that people with intellectual disabilities have limited sexual knowledge, which can be essential for developing positive sexuality. This study aimed to check the validity and reliability of an assessment tool (SexKunn) for measuring the sexual knowledge of people with intellectual disabilities in Norway. Further, we aimed to identify potential knowledge gaps among the participants and highlight their potential impact. Methods: 37 people with intellectual disabilities completed one assessment. 20 participants then completed a retest. Clinicians’ (n=23) views on the assessment tool were measured to obtain face validity. Results: A weighted Cohen’s kappa for the test and retest of the overall scores was considered to be substantial. The clinicians described an acceptable face validity regarding high positive value scores and low negative burden scores. They also suggested improvements. The study identified that the participants lacked knowledge about female genitals, hygiene, appropriate touching/sexual acts with friends/ intimate partners, and contraception. Conclusions: The SexKunn is a feasible assessment tool to measure sexual knowledge in people with intellectual disabilities. A lack of sexual knowledge of people with intellectual disabilities may violate their sexual rights.

COVID-19 pandemic is a public health issue. From 2019 to 2022, 4.5 million people died from the COVID-19 epidemic. Consequently, COVID-19 has put a significant strain on every single creature in this world. COVID-19 has been associated with lockdown, thus resulting in lockdown related inequities towards most people in this world, with unanticipated consequences for people with disabilities. Building in this debate, this paper aimed to discuss on the impacts of COVID-19 on the physical health of People with Intellectual Disabilities. Based on the Prisma protocol, this systematic literature review examined 28 publications from Web Sources of Science and Scopus.The study identified three themes regarding the impact of COVID-19 on the physical environment of people with intellectual disabilities namely mental health, social isolation, severe health problems, socioeconomic and psychology. This study has significant implications in understanding how PWID are impacted by COVID 19 and urged that early preventative measures should be taken since People with Intellectual Disabilities are considered a vulnerable population, therefore it is crucial to ensure that their health status are sustained.

U radu se definiraju osobe s intelektualnim poteškoćama, sagledava ih se kao muzejske posjetitelje i analizira usluge koje im današnji muzeji pružaju. Muzejske publikacije značajan su dio muzejske djelatnosti. One komuniciraju s posjetiteljima, daju im uvid u muzejski rad i pružaju informacije. U radu se opisuju projekti, publikacije i smjernice koje svojim djelovanjem potiču prilagođavanje muzejskih publikacija svim muzejskim posjetiteljima, a posebno osobama s intelektualnim poteškoćama.. Cilj ovoga rada je naglasiti važnost lako čitljivih informacija / lako čitljivih publikacija s namjerom da muzeji u budućnosti pruže jednaku razinu pristupačnosti svim svojim korisnicima. The paper defines people with intellectual disabilities, views them as museum visitors and analyzes the services provided by today's museums. Museum publications are a significant part of museum activities. They communicate with visitors, give them insight into museum work and provide information. The paper describes projects, publications and guidelines that encourage the adaptation of museum publications to all museum visitors, especially people with intellectual disabilities. The aim of this paper is to emphasize the importance of easy-to-read information / easy-to-read publications with the intention that in the future museums provide the same level of conditions to all of their users

Emotions influence processes of learning and thinking in all people. However, there is a lack of studies in the field of emotion research including people with intellectual disabilities (ID) addressing the existing diversity. The present study investigates the emotional competence of people with ID (N = 32). The first aim was to assess the emotional development using the Scale of Emotional Development (SEED). Based on these insights, the second objective was to replicate existing findings, validating the emotional reaction of people with ID to pictures of the International Affective Picture System (IAPS) based on self-reports. In an additional pilot-like analysis, the third aim was to investigate if these self-reported emotional reactions match the emotions expressed in their faces using the automated and video-based facial expression analysis software ‘Affectiva (Affdex SDK)’. In the present study, the self-reported emotional reactions of participants with ID were in line with previous research. In addition, the present study shows the general potential of this innovative approach of using and applying commercially available automated emotion recognition software for the field of special needs and social science.

Long-COVID (also known as post-coronavirus-19 syndrome) is a term used to describe symptoms that people experience following their recovery from the COVID-19 virus. The severity of long-COVID is well recognised, with healthcare providers commissioning services to diagnose and treat those affected, as well as funded research into the condition.We performed a systematic search for relevant articles but were unable to find any research on long-COVID in people with intellectual disabilities. Due to the lack of data, we have only been able to make extrapolations from what is known about the condition within the general population.We provide an overview of long-COVID and its potential relevance to people with an intellectual disability. We have focused specifically on symptoms or signs, prevalence, risk factors and treatments of the condition in this group, highlighting areas for clinical practice and future research from a psychosocial perspective. We raise serious questions about our current understanding and the availability of the evidence-based to inform treatments tailored towards this population.This is the first report that we are aware of on the topic of long-COVID in people with an intellectual disability. The lack of research is preventing us from gaining a greater understanding of how the condition impacts people with an intellectual disability.

The current study highlights the attitude of students toward the use of film sequences, as educational resources used in the course of Psychopedagogy of people with intellectual disabilities, in the online learning environment. The participants in the study were students (N = 28) in the 2nd year, who follow the Special Psycho-pedagogy study program. The research method was a questionnaire-based survey. The working tool contains 23 questions, which were developed by the authors for this research. In the introductory part, in addition to the synthesis of the specialized literature, we briefly presented the aspects related to the management of the university course, in a pandemic context, by presenting the ways in which the film sequences were used to achieve the objectives of the discipline. The results of the descriptive study show that students show a positive attitude towards the use of film sequences in teaching, learning, and final assessment activities. Thus, the students consider that the film sequences used in the course activities facilitate the understanding of the theoretical information from the course support, about the particularities in the development of people with intellectual disabilities. Additionally, the film sequences used for assessing knowledge in the final exam took students out of their comfort zone of passively taking the theoretical information and giving an answer during the online assessment tests. The research findings highlight the practical implications and future directions of research to ensure good management of course activities in the online learning environment.

Background: \ud The promotion of physical activity and the decrease of inactivity and sedentary behaviour are crucial for a healthy lifestyle and positive quality of life. People with intellectual disabilities are at increased risk of inactivity and sedentary behaviour. Therefore, it is important to increase their physical activity by implementing physical activity guidelines in their daily life. Professional direct care providers can play a decisive role in supporting people with intellectual disabilities to participate in physical activity, but the engagement of direct care providers with this role may be reflective of their own attitudes and beliefs towards physical activity. Therefore, the link between the implementation of current physical activity guidelines for people with intellectual disabilities and direct care providers' own beliefs and behaviour with regard to physical activity is investigated.\ud \ud Method: \ud A total of 104 direct care providers completed self‐reported questionnaires about their own physical activity behaviour (IPAQ‐SF), recommendations for people with intellectual disabilities (adaption of EMIQ‐HP) and questions regarding global physical activity guidelines. They were also asked about potential barriers and facilitators for the recommendation of physical activity in open‐ended questions. \ud \ud Results: \ud Personal physical activity behaviour is related to the recommended physical activity for people with intellectual disabilities (moderate‐to‐vigorous physical activity: r s = 0.408, P = 0.005). However, recommended physical activity behaviour for people with intellectual disabilities is significantly lower than direct care providers' own physical activity behaviour (P < 0.001). 47.1% of the respondents recommended people with intellectual disabilities to participate in less than the 150 min of moderate intensity physical activity per week for that is recommended in global physical activity guidelines. \ud \ud Conclusion: \ud Direct care providers may hold stereotypical views and insecurities about the potential harms associated with people with intellectual disabilities participating in physical activity. Therefore, the dissemination of physical activity recommendations for people with intellectual disabilities should be a major target for health professionals, social workers and scientists to address direct care providers' concerns. Furthermore, we need to emphasise the benefits of regular physical activity to professional direct care providers and directly to people with intellectual disabilities.