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Background: Emotional distress has received less attention as an explanatory factor for self-injury in people with intellectual disabilities, with research and practice primarily focusing on biobehavioural factors. This systematic review examines the self-reported explanations for self-injury by people with mild or moderate intellectual disabilities, and discusses how the findings contrast with those from self-reported studies of people within the general population who self-harm. Methods: Five databases (PsychINFO, IBSS, CINAHL, Web of Science and Medline) were systematically searched to find qualitative, empirical research since 2000 about self-reported reasons for self-injury. Results: Four studies were found which conducted research with people with intellectual disabilities. Three primary themes are discussed: relief from overwhelming emotions; trauma and loss; and difficulty in articulating emotions. Conclusion: This review found a paucity of research asking people with intellectual disabilities about their own self-injury. However, the research available suggests that explanatory factors for self-injury typically reported in the general population should be considered for those with mild or moderate intellectual disabilities.

Aim: This project sought to ascertain views and experiences of people with intellectual disabilities, their carers', and specialist intellectual disability psychiatrists as to use of telepsychiatry consultations. Background: During the COVID-19 pandemic specialist psychiatrists in intellectual disability services in the United Kingdom (UK) have explored and adopted use of telepsychiatry for psychiatric consultations. Method: An easy-read co-designed questionnaire was sent to potential respondents N = 590 potential respondents (N = 280 patients, N = 280 carers), and a separate questionnaire was sent electronically to N = 30 specialist intellectual disability psychiatrists. Findings: Responses were received from N = 192 respondents (N = 68 (24%) patients, N = 98 (35%) carers, and N = 26 (90%)) psychiatrists. Advantages of telepsychiatry cited were flexibility, and it being less disruptive to patients' routines, offering convenient practice and saving travel time and cost. Disadvantages reported included loss of rapport and relationship with patients, and an inability to conduct an effective mental state examination. Conclusion: This survey has produced equivocal evidence as to acceptability of telepsychiatry for all people with intellectual disabilities, carers and psychiatrists cannot be assumed. Some patients may need significant support to enable them to engage with such an approach.

Primary care health checks, screenings and GP consultations are often the gateway for people with intellectual disabilities to access their physical and mental healthcare. For a population who experience greater levels of health difficulties alongside significant health inequality, improving care quality and access is of major importance. This meta-ethnographic, qualitative review aims to explore people with intellectual disabilities experiences of health checks, screenings and GP visits, while assessing the quality of the current literature and synthesising findings to consider clinical and research recommendations based on third order constructs. A systematic search identified 20 studies that met inclusion criteria. Quality assessment of each paper was conducted. Meta-ethnography methods were used to analyse and synthesis findings. One overarching concept was identified: Include Me, along with seven core concepts; Empowerment and Disempowerment, Communication and Interpersonal Factors, Access and Adaptations and Biased Narratives and Shifting Perspectives. Implications for practice and future direction are discussed.

Background: People with intellectual disabilities (ID) experience many health and social inequalities. Increasing physical activity is a proven intervention to address such inequalities, yet the physical activity rates of this population are substantially lower than the general population. Aim: Research has been growing to understand why this is and how to intervene to increase the physical activity levels of people with ID. Method: Using a behavioural epidemiological framework, the research in this area from barriers and facilitators of physical activity to translational research testing interventions within natural settings is reviewed. Findings from a total of 14 reviews and eight empirical studies and protocols were included. Results: Whilst there are multiple investigations into what promotes or enhances physical activity for people with ID, findings from intervention studies show few successful outcomes. Gaps within the existing research are identified and recommendations about how intervention efficacy might be improved are provided to inform future research and practice. Conclusion: Findings from previous research on barriers and facilitators can be further capitalised on and intervention studies should be underpinned by better links to theory and more systemic approaches.

The COVID-19 pandemic has had significant consequences for all areas of human life. This particularly applies to people with intellectual disability (ID) whose functioning and living environment are associated with many specific risk factors. The review is to determine what difficulties and changes in the psychosocial functioning of people with ID have been brought about by the COVID-19 pandemic and what factors may be important in dealing with them. Twenty studies focused on the experiences of people with ID during the COVID-19 pandemic were analyzed. All of these were qualitative (n = 16) and mixed-method studies (n = 4). The COVID-19 pandemic has caused significant changes in the lives of people with ID, mainly in the organization of support and services. This has had important consequences for their psychosocial functioning. There has been a decrease in competencies and social integration, and an increase in difficult behaviors and mental problems. The challenges related to the COVID-19 pandemic have also resulted in positive changes: people with ID have developed technology skills and personality traits such as responsibility for themselves and others. People with ID have mastered safety habits to a varying degree. It is important to support them in the time of the COVID-19 pandemic, maintaining a balance between protecting them from risk and ensuring their autonomy.

People with intellectual disability (ID) generally tend to have difficulties expressing their thoughts and feelings verbally. Art-based therapies rely less on cognitive ability and verbal skills and aim to promote mental health. Drama therapy provides a playful framework to communicate problematic issues and to foster social skills. Improvisational theatre (improv) methods applied in therapy settings were reported to show positive effects on social competences and self-esteem. This pilot study investigates the feasibility (N = 24) and appropriateness (n = 12) of an intervention using improv methods in people with mild to moderate ID. Feasibility was measured on the basis of the average participation period, while appropriateness was assessed through a standardised patient satisfaction questionnaire (CSQ-8) and a self-developed questionnaire. The frequency of the applied methods was compared in two subgroups with participants requiring different support. The average participation rate of 19 months indicated a good feasibility. High CSQ-8 scores (M = 27.6/max. 32) and positive feedback on the self-developed questionnaire indicated the overall appropriateness. The frequency analysis of the applied methods reflected the adaptive nature of the intervention. Further research on the efficacy of improv methods contributing to mental health in people with ID is recommended.

Background: People with intellectual disabilities (ID) experience many health and social inequalities. Increasing physical activity is a proven intervention to address such inequalities, yet the physical activity rates of this population are substantially lower than the general population. Aim: Research has been growing to understand why this is and how to intervene to increase the physical activity levels of people with ID. Method: Using a behavioural epidemiological framework, the research in this area from barriers and facilitators of physical activity to translational research testing interventions within natural settings is reviewed. Findings from a total of 14 reviews and eight empirical studies and protocols were included. Results: Whilst there are multiple investigations into what promotes or enhances physical activity for people with ID, findings from intervention studies show few successful outcomes. Gaps within the existing research are identified and recommendations about how intervention efficacy might be improved are provided to inform future research and practice. Conclusion: Findings from previous research on barriers and facilitators can be further capitalised on and intervention studies should be underpinned by better links to theory and more systemic approaches. [ABSTRACT FROM AUTHOR]

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.

Aim: This project sought to ascertain views and experiences of people with intellectual disabilities, their carers', and specialist intellectual disability psychiatrists as to use of telepsychiatry consultations. Background: During the Covid-19 pandemic specialist psychiatrists in intellectual disability services in the United Kingdom (UK) have explored and adopted use of telepsychiatry for psychiatric consultations. Method: An easy-read co-designed questionnaire was sent to potential respondents N = 590 potential respondents (N = 280 patients, N = 280 carers), and a separate questionnaire was sent electronically to N = 30 specialist intellectual disability psychiatrists. Findings: Responses were received from N = 192 respondents (N = 68 (24%) patients, N = 98 (35%) carers, and N = 26 (90%)) psychiatrists. Advantages of telepsychiatry cited were flexibility, and it being less disruptive to patients' routines, offering convenient practice and saving travel time and cost. Disadvantages reported included loss of rapport and relationship with patients, and an inability to conduct an effective mental state examination. Conclusion: This survey has produced equivocal evidence as to acceptability of telepsychiatry for all people with intellectual disabilities, carers and psychiatrists cannot be assumed. Some patients may need significant support to enable them to engage with such an approach. [ABSTRACT FROM AUTHOR]

Emotional distress has received less attention as an explanatory factor for self-injury in people with intellectual disabilities, with research and practice primarily focusing on biobehavioural factors. This systematic review examines the self-reported explanations for self-injury by people with mild or moderate intellectual disabilities, and discusses how the findings contrast with those from self-reported studies of people within the general population who self-harm. Five databases (PsychINFO, IBSS, CINAHL, Web of Science and Medline) were systematically searched to find qualitative, empirical research since 2000 about self-reported reasons for self-injury. Four studies were found which conducted research with people with intellectual disabilities. Three primary themes are discussed: relief from overwhelming emotions; trauma and loss; and difficulty in articulating emotions. This review found a paucity of research asking people with intellectual disabilities about their own self-injury. However, the research available suggests that explanatory factors for self-injury typically reported in the general population should be considered for those with mild or moderate intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background: The importance of understanding the needs of older people with intellectual disabilities (IDs) is obvious, but the research available is limited. This study identifies the self-reported needs of older adults with IDs and compares them with staff reported needs regarding the same older adults with ID, therefore specifying and explaining agreements and disagreements. Method: The needs of 96 older adults with IDs were assessed through the Inventory of Identification of Needs (informant and self-report versions). Results: Both older people with IDs and staff reported quite diverse needs related to all the domains assessed by the IIN: physical health, literacy, information, meaningful activity, participation in the community, mental health, basics needs and accommodation. All the mean scores of the informant version of the IIN were higher than the ones of the self-report version. Agreement amongst informants was influenced by the prominence of needs, the accessibility to and the subjectivity of the information, and social desirability. Conclusions: A consumer-driven approach implies that services should be based on the needs identified.

Background: There is a need for promoting exercise practice among people with intellectual disabilities (ID). Aquatic exercise (AE) could be a viable option in this regard.Objective: To identify and critically analyze the best available evidence concerning the effects of AE in the physical and mental health of people with ID. Methods: A systematic review of randomized controlled trials (RCTs) and comparative studies was performed after searching within several databases up to March 2021. Results: A total of 4 RCTs and 3 comparative studies were found. Their methodological quality ranged from high to low. Aquatic interventions had positive effects on cardiorespiratory, muscular fitness and balance. Mixed effects were seen on parameters related to obesity and cognition. Scant information regarding feasibility and intervention fidelity was provided. In general, interventions details were not discussed in deep. Conclusion: Preliminary evidence shows that aquatic exercise can be prescribed to people with ID in order to improve their physical health. The impact of aquatic exercise on motor skills, cognitive function and mental health remains unclear. Further research on this topic should provide a detailed description of the interventions carried out, including information on the feasibility and intervention fidelity.

Primary care health checks, screenings and GP consultations are often the gateway for people with intellectual disabilities to access their physical and mental healthcare. For a population who experience greater levels of health difficulties alongside significant health inequality, improving care quality and access is of major importance. This meta-ethnographic, qualitative review aims to explore people with intellectual disabilities experiences of health checks, screenings and GP visits, while assessing the quality of the current literature and synthesising findings to consider clinical and research recommendations based on third order constructs. A systematic search identified 20 studies that met inclusion criteria. Quality assessment of each paper was conducted. Meta-ethnography methods were used to analyse and synthesis findings. One overarching concept was identified: Include Me, along with seven core concepts; Empowerment and Disempowerment, Communication and Interpersonal Factors, Access and Adaptations and Biased Narratives and Shifting Perspectives. Implications for practice and future direction are discussed. [ABSTRACT FROM AUTHOR]

Given the crucial role professionals play in maintaining the well-being of people with intellectual disabilities, their views on work satisfaction are relevant to analyse. A comparative analysis that takes into account the support provided in different welfare organisations can be of certain importance. The aim is to analyse the most common aspects of professional work satisfaction in work with people with intellectual disabilities in schools, healthcare, and social services, and to apply a comparative analysis of such experience taking into account respondents' organisational affiliations. Data were collected using a digital questionnaire. Given the aim of the study, we drew on one open-ended question: 'describe aspects of your work that are most satisfactory for you'. The analysis shows that respondents associated positive work experience with seven aspects: autonomy, competence, nature of the work, collaboration, trust and recognition, work environment, and service users. Findings indicate that discretion is an important facet of work satisfaction among respondents in all three organisations. Flexibility, autonomy in decision-making, the ability to plan and act within certain institutional and legal frameworks, and the ability to prioritise among daily work assignments are empirical examples of this.

Social change towards inclusion is a very common topic, but progress is slow. Because of its importance in the current educational context, knowing how to speed up this transformation is fundamental. A multiple regression analysis with a transversal quantitative designed survey (n = 245) was conducted. The aim was to identify internal and external factors predicting attitudes towards people with intellectual disability in undergraduate students at the University of Murcia (Spain). According to the expected estimate, the variables 'empathic concern' and 'chosen degree' predict good attitudes towards people with intellectual disability among university students. On the other hand, external variables such as 'previous knowledge about disability' or 'contact with people with disabilities' are not explanatory factors. These findings contribute to the existing knowledge about predictive variables for attitudes towards people with intellectual disabilities in the future Spanish education professionals.

People with intellectual disability (ID) generally tend to have difficulties expressing their thoughts and feelings verbally. Art-based therapies rely less on cognitive ability and verbal skills and aim to promote mental health. Drama therapy provides a playful framework to communicate problematic issues and to foster social skills. Improvisational theatre (improv) methods applied in therapy settings were reported to show positive effects on social competences and self-esteem. This pilot study investigates the feasibility (N = 24) and appropriateness (n = 12) of an intervention using improv methods in people with mild to moderate ID. Feasibility was measured on the basis of the average participation period, while appropriateness was assessed through a standardised patient satisfaction questionnaire (CSQ-8) and a self-developed questionnaire. The frequency of the applied methods was compared in two subgroups with participants requiring different support. The average participation rate of 19 months indicated a good feasibility. High CSQ-8 scores (M = 27.6/max. 32) and positive feedback on the self-developed questionnaire indicated the overall appropriateness. The frequency analysis of the applied methods reflected the adaptive nature of the intervention. Further research on the efficacy of improv methods contributing to mental health in people with ID is recommended. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had significant consequences for all areas of human life. This particularly applies to people with intellectual disability (ID) whose functioning and living environment are associated with many specific risk factors. The review is to determine what difficulties and changes in the psychosocial functioning of people with ID have been brought about by the COVID-19 pandemic and what factors may be important in dealing with them. Twenty studies focused on the experiences of people with ID during the COVID-19 pandemic were analyzed. All of these were qualitative (n = 16) and mixed-method studies (n = 4). The COVID-19 pandemic has caused significant changes in the lives of people with ID, mainly in the organization of support and services. This has had important consequences for their psychosocial functioning. There has been a decrease in competencies and social integration, and an increase in difficult behaviors and mental problems. The challenges related to the COVID-19 pandemic have also resulted in positive changes: people with ID have developed technology skills and personality traits such as responsibility for themselves and others. People with ID have mastered safety habits to a varying degree. It is important to support them in the time of the COVID-19 pandemic, maintaining a balance between protecting them from risk and ensuring their autonomy. [ABSTRACT FROM AUTHOR]

Background: The importance of understanding the needs of older people with intellectual disabilities (IDs) is obvious, but the research available is limited. This study identifies the self-reported needs of older adults with IDs and compares them with staff reported needs regarding the same older adults with ID, therefore specifying and explaining agreements and disagreements. Method: The needs of 96 older adults with IDs were assessed through the Inventory of Identification of Needs (informant and self-report versions). Results: Both older people with IDs and staff reported quite diverse needs related to all the domains assessed by the IIN: physical health, literacy, information, meaningful activity, participation in the community, mental health, basics needs and accommodation. All the mean scores of the informant version of the IIN were higher than the ones of the self-report version. Agreement amongst informants was influenced by the prominence of needs, the accessibility to and the subjectivity of the information, and social desirability. Conclusions: A consumer-driven approach implies that services should be based on the needs identified. [ABSTRACT FROM AUTHOR]

Background: While socioeconomic status (SES) has been shown to be an important determinant of sedentary behaviour (SB) and moderate-to-vigorous intensity physical activity (MVPA) in typically developing children, similar data on those with intellectual disability (ID) are lacking. This study explored the association of SES with SB and MVPA among Chinese children with ID. Method: Data were collected from 275 children aged 7-16 with mild to severe ID. Children's Leisure Activities Study Survey assessed SB and MVPA for a week. SES was assessed using the six indicators. Multiple linear regression was used to analyse the associations of SES variables with SB and MVPA on schooldays and on weekends. Results: Parental education level was positively associated with SB on weekends, and MVPA on schooldays and weekends; family's combined annual income was positively associated MVPA on schooldays and weekends; parental occupation was positively associated with SB on schooldays and weekends; Family Affluence Scale was positively associated with SB on schooldays (all p < 0.05). Conclusion: SES plays a significant role in influencing SB and MVPA in children with ID. Results suggest that interventions should focus on increasing MVPA for children with lower SES, while families with higher SES should limit their children's SB. [ABSTRACT FROM AUTHOR]

Socio-interpersonal factors have a strong potential to protect individuals against pathological processing of traumatic events. While perceived social support has emerged as an important protective factor, this effect has not been replicated in people with intellectual disabilities (ID). One reason for this might be that the relevance of socio-interpersonal factors differs in people with ID: Social support may be associated with more stress due to a generally high dependency on sometimes unwanted support. An exploration of the role of posttraumatic, socio-interpersonal factors for people with ID is therefore necessary in order to provide adequate support. The current study aims to explore the subjective perception of social reactions to disclosure of sexual violence in four women with mild to moderate ID. The study was conducted in Austria. The women were interviewed about their perception of received social reactions as benevolent or harmful, their emotional response, and whether they perceived being treated differently due to their ID diagnosis. The interviews were analysed using qualitative content analysis. First, the interviews were coded inductively, and social reactions were then deductively assigned to three categories that were derived from general research: positive reactions, unsupportive acknowledgement, turning against. Findings on the perception of social reactions were in line with findings from the general population. Overall, participants reported that they did not feel that they were treated any differently from persons without disabilities. However, the social reactions they received included unjustified social reactions, such as perpetrators not being held accountable. A possible explanation may be a habituation and internalisation of negative societal attitudes towards women with ID. Empowerment programmes and barrier-free structural support for women with ID following trauma exposure should be improved. [ABSTRACT FROM AUTHOR]

Various health problems of people with intellectual disabilities (ID) are associated with their physical inactivity. The present study aimed at the understanding of physiological and psychological responses toward exergaming in seven young adults with mild to moderate ID after a single-session and a multiple-session condition, respectively. Their heart rate (HR), the rating of perceived exertion (RPE), and physical activity enjoyment scale (PACES) were measured on control and exergaming sessions. The significant increased HR, which may represent the increased physical activity levels that led to energy expenditure, was observed after a single-session and a multiple-session condition. In addition, the significant increase in RPE and PACES were evident after a single-session condition but a multiple-session condition. The feeling of physical fatigue seems to be distracted by external motivators (e.g. music). However, the positive affectivity to exercise was not noted when exercise was scheduled as their daily routines. This phenomenon might explain the high prevalence of physical inactivity among this population. [ABSTRACT FROM AUTHOR]

Background: Making decisions about feelings and relationships is a challenge for many people with intellectual disabilities (ID). The aim of this article is to explore their opinions regarding the difficulties they experience in relation to having a partner and living together. Method: Nine advisers with ID with experience in inclusive research discussed issues about having a loving partner during 8 meetings. Discussions were recorded, and a thematic content analysis was conducted. Results: The results show that the network of social relationships, control over one's own intimate relationships, obtaining the right support and having training in couple relationships are key elements in people with ID having a satisfying couple relationship. Conclusions: The research gives visibility to the difficulties that people with ID encounter in having intimate couple relationships and sheds light on the need to undertake actions that contribute to their right to intimate citizenship. [ABSTRACT FROM AUTHOR]

Background: Balanced and adequate nutrition is important to improve the quality of life of children with intellectual disability but most of these children are negatively affected by nutritional problems. Objective: This study was conducted to determine the nutritional status and effect of the severity of intellectual disability on nutritional status of children and adolescents with intellectual disabilities. Methods: One hundred twenty-two intellectually disabled children aged 4–18 years from five different special education and rehabilitation centers were included in the study. Their socio-demographic characteristics, body weight, height, body mass index (BMI), mid-upper arm circumference (MUAC), and skinfold thickness were examined, and their three-day food consumption record was taken. Results: Anthropometric scores did not differ significantly according to the severity of intellectual disability. According to evaluations made based on the World Health Organization's 2007 percentile curves, 61.4% of the subjects with mild intellectual disability (MID), 57.1% of those with moderate intellectual disability (MOID), and 53.3% of those with severe intellectual disability (SID) were within the normal BMI range for their age. Conclusion: Rates of malnutrition and shortness in children and adolescents with SID were found to be higher than among children with MID and MOID, though the differences were not statistically significant. [ABSTRACT FROM AUTHOR]

Aims: Athletes in the general population report higher satisfaction of basic needs when coaches are providing an autonomy supportive sport climate (ASSC). Our study aims at investigating whether ASSC is associated with satisfaction with life in athletes with intellectual disabilities (ID) and whether this association is mediated by basic need satisfaction. Method: During the Special Olympics World Winter Games 2017, 168 athletes with ID (M = 33.86 years; SD = 10.47) completed questionnaires measuring ASSC, basic need satisfaction (autonomy, competence, and relatedness), and satisfaction with life. Multiple linear regression analyses and mediation analyses were performed. The mediation model was controlled for the potential impact of participating in team vs. individual sports. Additionally, gender effects were explored. Results: ASSC was significantly associated with satisfaction with life (β =.38, p <.001). This association was mediated by competence (indirect effect: ab1 =.15; CI [.05;.32]) but not by autonomy or relatedness. No effects were found related to participating in team vs. individual sports or gender. Conclusions: Our study provides evidence that an ASSC is associated with athletes perceiving themselves as more competent and reporting more satisfaction with life. [ABSTRACT FROM AUTHOR]

In 2005, Saudi high schools began providing transition services for students with intellectual disability. However, recent studies have found that these services need improvement. Therefore, this study explored current transition services to help identify challenges that weaken these services and to recommend improvements for them. Eleven teachers of students with intellectual disability were interviewed, and data were analyzed qualitatively. Study findings concluded that four main issues must be addressed to advance Saudi transition services: (1) special education teacher preparation programs, (2) transition services' policies and regulations, (3) Individualized Transition Plans, and (4) collaborative practices. [ABSTRACT FROM AUTHOR]

This review analyzes studies carried out between 2008 and 2018 which examined the educational impact of interventions based on the Universal Design for Learning (UDL) for students with Intellectual Disabilities (ID). The review aims to determine the research designs and methods of these studies, and their interventions and effectiveness. Seven studies met the inclusion criteria used in this review. The review demonstrated the diversity of research designs and methods used, which included quantitative, qualitative and mixed methods. The interventions included the use of digital environments, e-books, shared stories, audio systems, software and educational activities; all based on the principles of UDL. The reviewed studies confirmed the effectiveness of these interventions in educating such students, whether in academic, social or behavioral aspects. The study recommends further research to give greater clarification of the impact of UDL on the academic, social and behavioral aspects of the education of students with ID. It also recommends increasing the number of research participants and using a qualitative approach to better understand the lived experience of applying these interventions. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the relation between subjective quality of life and quality of vocational education services from the view of students with intellectual disability who participate in public special vocational education schools in Greece. The level of quality of life and quality of special vocational education services was explored. The article presents a functional description of service quality in special vocational education and operationalizes quality of life for students with disability. Instruments were developed and adapted in line with the participatory research paradigm. Convenience sampling was used. Data was gathered from 131 students with intellectual disability. All measures showed good evidence of internal consistency and construct validity. The findings suggest relationship between quality of life and quality of special vocational education services received by students with intellectual disability. Low levels of self-determination are highlighted. Practical implications concerning the application of the instruments in special education settings as measures for the quality assessment and the evaluation of educational interventions are discussed. [ABSTRACT FROM AUTHOR]

Participation in enjoyable activities is instrumental to improving individuals' quality of life. Previous studies have indicated engagement in community-based activities and physical exercise are beneficial to individuals with intellectual disabilities (ID). The purpose of this study was to understand, from their perceptions, fun activities in which individuals with ID engaged. One hundred and sixty-nine participants with ID provided 561 responses, which described what they do for fun. A multidisciplinary research team utilized a Consensual Qualitative Research (CQR) approach to differentiate responses into a list of categories that fit into six central domains. Domains (with frequency of responses) included: Community and Relationship Building Activities (130), Sports and Other Physical Activities (123), Technology and Gaming (105), Music and Other Preforming Arts (69), Mentally-Stimulating Activities (51), and Categories Outside of a Domain (82). These findings indicate that individuals with ID have a variety of interests. Our discussion, which reviews literature on individuals with and without ID, suggests similar leisure activity engagement among both groups. This literature also suggests individuals with ID experience similar benefits to their peers without ID when engaging in leisure activities. Our results provide a framework to explore self-care routines that can improve quality of life for individuals with ID. [ABSTRACT FROM AUTHOR]

Background: Physical activity has been proposed as a context to foster the healthy development of individuals and reduce the risk of many chronic problems. This study evaluates the impact of badminton lessons on health and wellness in young adults with intellectual disabilities (ID). Methods: Eighteen participants with ID (14 males and 4 females, aged 19-26) and with little or no experience in badminton were assigned to an exercise group and a control group. The curriculum selected was Shuttle Time Starter Lessons. The exercise group practiced for 50 min each session, twice a week for 10 lessons with peers, while the control group maintained a regular life schedule. Physiological measures, motor performance, Special Olympics Individual Badminton Skills Assessment; and psychological measures were conducted before and after the program. A Wilcoxon signed-rank test was conducted to compare pre- and post-tests in each group. Results: The significantly reduced resting heart rate, longer walking distances in the 6-minute walk test, and better performance in badminton skills were evident in the exercise group. Further, a significantly increased left frontal alpha asymmetry was seen in the exercise group with participants expressing positive effects after the inclusive badminton program. Finally, resting EEG frontal asymmetry seemed to be reflective of emotion in persons with ID. Conclusions: Shuttle Time Badminton Lessons could be feasible for adults with ID. School teachers and coaches may adapt it to improve health and wellness and acquire badminton skills in adults with ID. In addition, the inclusive environment can motivate their participation. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effect of mother's perception of child's maladaptive behaviour and types of child's neurodevelopment disorder on maternal parenting stress, and examine the role of types of child's neurodevelopmental disorder in moderating the relationship between mother' perception of child's maladaptive behaviours and maternal parenting stress. The mother' perception of child's maladaptive behaviours tested included internalizing and externalizing maladaptive behaviours, while the types of child's neurodevelopmental disorder included intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). A total of 163 mothers of children with different types of neurodevelopmental disorders were included in this study. The data were analysed with regression analysis, t-test, and ANOVA. The results showed that 1) there is an influence of the mother's perception of child's maladaptive behaviours and types of neurodevelopmental disorders on parenting stress; 2) types of child neurodevelopmental disorders moderate the relationship between the mother's perception of child's maladaptive behaviour and maternal parenting stress; 3) mothers of children with ASD experience higher levels parenting stress than mothers of children with ADHD and ID. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative study is to explore experiences of naturalistic interpersonal contact with persons with intellectual and developmental disabilities (IDD) and attitudes toward persons with IDD among Korean American adolescents and young adults. In interviews with 12 Korean American high school and college students, Korean American participants reported six common themes regarding their experiences of interpersonal contact with persons with IDD: 1) affective attitude, 2) behavioral attitude, 3) cognitive attitude, 4) communication with persons with IDD, 5) moments of having a positive attitude, and 6) comparisons of attitudes in the United States and Korea. Recommendations for research and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Executive functions (EF) impairments have long been observed in children and youths with autism spectrum disorders (ASD). Until very recently, little attention has been paid to examine EF profiles of adults with ASD. Given the importance of EF to cope with the demands of daily life and participate in society (e.g. maintaining an employment), this study reports on a preliminary investigation aimed at exploring planning skills and cognitive flexibility in a sample of adults with ASD and without intellectual disability. A secondary aim was to explore the contribution of both intellectual functioning and socio-demographic variables on efficiency of EF. Method: Twenty-nine autistic adults (age range 18-50) were assessed using the Tower of London (ToL) test and the Wisconsin Card Sorting Test (WCST). Intellectual functioning was assessed with the Wechsler Adult Intelligence Scale - IV. Results: From the evaluations emerged poor performances in sub-processes related to planning skills as assessed by ToL (number of Moves, Correct Reponses, and Execution time). In contrast, WCST performance did not result impaired in any of the indicators considered. Exploratory analyses revealed a strong relationship between the time needed to complete the planning tasks and visuo-spatial reasoning. Further, strong inverse associations were found between global intellectual functioning and chronological age in the WCST. Conclusions: The results of this study highlight mixed EF profiles in a sample of adults with ASD. Future investigations may build on the results of the present study to understand whether evaluating planning abilities of adults with ASD by means of measures that do not require a time-limit would yield different results compared to time-constrained assessment procedures. [ABSTRACT FROM AUTHOR]

This study explored the experiences of families in navigating the Ghanaian health system to address the general health needs of their children with intellectual and developmental disabilities (IDD). The sample involved 22 primary caregivers of children with IDD aged 3-18 years who participated in a semi-structured interview. The interviews were analyzed using the constant comparison analytical method. The findings highlighted key enablers and barriers related to three overarching themes: entry into the health system; consultation with health professionals; and service coordination. The findings showed that the families and their children gained entry into the health system in many health facilities. However, the families revealed that some facilities denied the children services, either because the children had difficulties following entry processing protocols or there were no health professionals willing to address the children's needs. Although health professionals perform their duties professionally during consultation and care administration in many cases, the families reported on some challenges. Service coordination was seamless in some facilities; however, the families reported on other facilities they accessed where service coordination was not seamless. The study findings illustrate that the experiences of families and their children with IDD in the Ghanaian health system may be mixed. [ABSTRACT FROM AUTHOR]

Objectives: Aminoacidopathies are inborn errors of metabolism (IEMs) that cause intellectual disability in children. Luckily, aminoacidopathies are potentially treatable, if diagnosed earlier in life. The focus of this study was the screening of aminoacidopathies in a cohort of patients suspected for IEMs. Methods: Blood samples from healthy (IQ > 90; n = 391) and intellectually disabled (IQ < 70; n = 409) children (suspected for IEMs) were collected from different areas of Northern Punjab, Pakistan. An analytical HPLC assay was used for the screening of plasma amino acids. Results: All the samples (n = 800) were analyzed on HPLC and forty-three out of 409 patient samples showed abnormal amino acid profiles mainly in the levels of glutamic acid, ornithine and methionine. Plasma concentration (Mean ± SD ng/mL) were significantly high in 40 patients for glutamic acid (patients: 165 ± 38 vs. controls: 57 ± 8, p < 0.00001) and ornithine (patients: 3177 ± 937 vs. controls: 1361 ± 91, p < 0.0001). Moreover, 3 patients showed abnormally high (53.3 ± 8.6 ng/mL) plasma levels of methionine. Conclusion: In conclusion, biochemical analysis of samples from such patients at the metabolites level could reveal the underlying diseases which could be confirmed through advanced biochemical and genetic analyses. Thus, treatment to some of such patients could be offered. Thus burden of intellectual disability caused by such rare metabolic diseases could be reduced from the target populations. [ABSTRACT FROM AUTHOR]

Introduction: People with an intellectual disability (ID) are at risk of developing challenging behavior. Although previous research provided important insights into how to support people with an ID and challenging behavior, it remains unclear what various stakeholders consider to be the most essential aspects to further improve their support. Method: Statements regarding aspects perceived necessary to improve the support to people with an ID and challenging behavior were collected in focus groups. Afterwards participants individually prioritized and clustered these statements, resulting in concept maps for people with an ID, direct support workers, and psychologists. Since only three relatives participated in the entire concept mapping procedure, no concept map could be composed based on their input. Results: Participants generated 200 statements. In the concept map of clients, statements were mentioned regarding relational aspects, providing clarity and structure, characteristics of support staff, and professional attitude of direct support workers. Direct support workers provided statements related to their own personal competencies, the necessity of feeling supported and appreciated, and a physical safe environment. Psychologists provided statements regarding their support for direct support workers, the support for the clients, the perspective on the client, and their role as psychologists. Conclusion: The results of this study may be a starting point to foster increased evidence based practice for the support for persons with an ID and challenging behavior. Moreover, it provides opportunities to create care founded on mutual attunement, based on listening to each other's ideas and insight into perspectives and needs of various stakeholders. [ABSTRACT FROM AUTHOR]

Background. The COVID-19 pandemic is expected to have a substantial impact on people with an intellectual disability. The goal of the current study was to explore the experiences and needs of people with a mild intellectual disability during the COVID-19 lockdown period in the Netherlands. Method. A descriptive qualitative methodology was conducted, using semi-structured individual interviews with six people with a mild intellectual disability. Data were analysed thematically. Results. Three overarching themes were found: (i) Missing social contact and having people close; (ii) Being housebound has changed my daily life; and (iii) Hard to understand the preventive measures. Conclusions. Important insights into the experiences and needs of people with a mild intellectual disability during the COVID-19 lockdown period were gained. These insights are valuable with respect to a potential second COVID-19 wave or a future infection-outbreak. [ABSTRACT FROM AUTHOR]

Problem and Objective: Transition to adulthood for young people with intellectual or developmental disabilities (IDD) is challenging for both youth and parents. Prospection, an important human adaptive tool and critical for independent living, involves constructing, encoding, and remembering the future. It may be jointly enacted between parents and young people as they discuss the future. This study identified and described evidence of prospective content in parent-youth conversations about the transition to adulthood. Method: This study involved the content analysis is of eight parent-youth conversations about this transition. Two mother-daughter, three father-daughter, and three mother-son dyads, representing a range of IDD diagnoses, provided 790 min of joint conversations and reflection on them. These conversations were examined for the following characteristics of prospection: simulation, reasoning about counterfactuals, constructing multiple possible futures, and episodic memory of the past. Findings: Among the four characteristics, simulation and episodic memory of the past were used most frequently and reasoning about counterfactuals the least. Giving advice and scaffolding were additional strategies that emerged from the data. Conclusion: Identifying how prospection may be fostered in joint parent-youth conversations provides a step toward future research. [ABSTRACT FROM AUTHOR]

Objectives: The present study evaluated a new smartphone-based program to help 12 participants with intellectual disability plus visual and motor impairments to self-regulate their stimulation input (thus avoiding their dependence on staff) through simple non-verbal responses. Method: Nonconcurrent multiple baseline designs across participants were used to assess the effects of the program. The technology used for the program involved a Samsung J4 Plus smartphone with Android 9.0 operating system, two voice recording devices, smart-plugs, and a mini speaker. The smartphone was provided with a Google account and Internet connection, which allowed the participants to access Google Assistant and Google Play Music. The participants could make requests for two different types of stimulation (e.g. songs and familiar voices or noises) by activating via hand pressure the two voice recording devices. The verbal request messages emitted by the devices were recognized by the Google Assistant, which led the smartphone to deliver the related stimulation. Results: During the baseline sessions (without the support of the voice recording devices), the participants failed to access any stimulation. During the intervention and post-intervention phases (with the support of the voice recording devices), all participants managed to access the types of stimulation available independently. The mean frequency of responses (i.e. activations of both voice recording devices) per session ranged between about 8 and 14. Conclusion: The new smartphone-based program can be viewed as a useful resource to enable individuals like the participants of this study to access preferred stimulation independently. [ABSTRACT FROM AUTHOR]

Background: Data from sex offender treatment programmes (SOTP) on the re-offending of convicted sex offenders from the prison service in England and Wales was recently reviewed and found to be associated with no change in sexual reoffending. While this result is at variance with a number of other reviews it does give rise to concern as most programmes for individuals with intellectual disabilities adopt similar treatment methods. It is therefore important to consider the treatment outcomes for this client group by conducting a meta-analysis to examine treatment effects. Method: A systematic search of PsychINFO, EMBASE, MEDLINE and CINAHL was conducted in February 2019 using specific inclusion and exclusion criteria. Eighteen papers were identified, and their quality was assessed using a risk of bias framework. Scores on cognitive distortions, sexual knowledge and victim empathy measures as well as reports of further sexually abusive behaviour were pooled together to run a meta-analysis which yielded effect sizes for each outcome. Results: A large treatment effect was found for reducing cognitive distortions and increasing victim empathy, with a moderate effect found for improvements in sexual knowledge. This meta-analysis also found that 11.5% of individuals with intellectual disabilities who have completed these programmes will go on to display further sexually abusive behaviours. Conclusions: The findings suggest that cognitive distortions are significantly reduced following treatment, there are also significant improvements in sexual knowledge and victim empathy. A rate of 11.5% for further reported sexually abusive behaviour during follow up periods was found, which is higher than the rate found for mainstream SOTP completers. Problems regarding the recording of sexually abusive behaviour are considered. [ABSTRACT FROM AUTHOR]