Search

Background:The multi-disciplinarity of long-term care for people with intellectual disabilities makes organisations seek stability and predictability, complicating implementing innovations. Interventions to implement a method for reducing restrictive measures were analysed through the lens of Normalisation Process Theory to understand the social mechanisms at play.Methods:Process notes, collected during a trial in which a method to reduce restrictive measures was implemented, were analysed guided by implementation interventions defined by Cochrane Effective Practice and Organisation of Care Review Group. These interventions were mapped to social mechanisms of Normalisation Process Theory.Results:Implementation interventions were widely used in which clients’ perspectives were expressed (client-related-interventions), and consensus processes were held with care professionals. These interventions initiated NPT’s social mechanisms’ Coherence, Cognitive Participation and Collective Action.Conclusions:The emphasis on consensus and clients’ perspectives when methodically reducing restrictive measures reflects some unique implementation challenges in long-term intellectual disability care.

Organisational culture in group homes for people with intellectual disabilities has been identified as an influence on service delivery and staff behaviour. The aim was to examine patterns of cultu...

Background: This paper presents the findings from a qualitative research project that explored what ten people with intellectual disabilities who receive care and support in a residential care faci...

There is a need to systematically compare and contrast mortality predictors and disparities in people with intellectual disabilities (ID) for global prevention strategy development. Bibliographic d...

Background: The co-production concept holds out the promise of forging new relationships between professionals and service users with intellectual disabilities. However, little empirical research e...

Background: Social vulnerability refers to the ways in which an individual is at risk of being victimised. The Test of Interpersonal Competences and Personal Vulnerability [TICPV] is an Australian assessment tool designed for adults with intellectual disabilities (ID) [Wilson et al. (1996). Vulnerability to criminal exploitation: Influence of interpersonal competence differences among people with mental retardation. Journal of Intellectual Disability Research, 40, 8–16. https://doi.org/10.1111/j.1365-2788.1996.tb00597.x]. It aims to evaluate their social vulnerability. This study aims to conduct a preliminary cross-cultural validation of the TV-22, the French-language, enhanced and accessible version of the TICPV. Method: Twenty-nine French-speaking adults with ID answered the TV-22. The reliability and validity of this measure were assessed. Results: Performance on the test was shown to be internally consistent (Cronbach’s α = .89; McDonald’s Ω = .93), stable over time (r s(29) = .81, p

Background: There is limited Australian research investigating health practitioner knowledge and/or confidence in the diagnosis and treatment of mental health disorders in people with intellectual ...

There is growing international concern that people with intellectual disabilities, many of whom have compromised health, are particularly vulnerable to infection by COVID-19. Yet marginalisation ec...

© 2018 Australasian Society for Intellectual Disability, Inc.Background: People with intellectual disabilities are one of the most disadvantaged and marginalised groups in contemporary Australian society and until relatively recently, the history of intellectual disability in Australia has been neglected. Methods: Using semi-structured, life story oral history interviews, the life stories of three people with intellectual disabilities were analysed and the importance of intellectual disability in Australia as a subject for further historical analysis highlighted. Results: In this article it has been argued that embedded in the historical detail of these life stories, we can ascertain some of the key structural patterns that have shaped the experiences and forged the identities of people with intellectual disabilities in Australia. Conclusion: By analysing and comparing the narrative structures and dominant themes in life stories of individuals with intellectual disability, this article demonstrates something of the changing and immensely varied experience of people with intellectual disabilities in Australia over the last 50 years.

The aim of the study was to elucidate the barriers experienced by general practice registrars in their provision of health care to people with intellectual disabilities. A questionnaire was sent to 289 general practice registrars employed in practices across Australia. The responses indicated that 90% of registrars find it harder to provide good quality care for their patients with intellectual disabilities compared to their non-disabled patients. More specifically, a number of important barriers were identified, including difficulties in assessment and communication factors, limitations in consultation time, inadequate training and education in the field of intellectual disability, problems maintaining continuity of care, and uncertainties relating to resources available for people with intellectual disabilities. Identification of these barriers allowed a number of possible solutions to be explored, such as improved training of registrars and the development of a handbook about intellectual disabilities.

This paper uses recent developments in services in the UK as a case study to identify some of the challenges facing the provision of residential supports to people with intellectual disabilities. Three main areas are discussed: (1) responding to existing levels of unmet need and increasing levels of demand; (2) reducing inequalities in access to and the quality of services; and (3) obtaining and demonstrating “best value”. In particular, discussion is focused on the relationships between needs, resources, process and outcomes in residential services for people with intellectual disabilities and the implications of these relationships for obtaining “best value”.

Background Little attention has been paid to the healthcare workforce in determining healthcare management for people with intellectual disability (ID) in institutions in Taiwan. This paper investigated the profile of the healthcare workforce among institutions caring for people with ID, and examined differences, particularly in relation to nursing staff numbers, between the various types of settings providing care.Method Data were provided by 121 institutions caring for people with ID in Taiwan. Structured questionnaires were completed at these institutions, providing a cross‐sectional survey.Results Nurses were the main health professionals employed in institutions. Even so, more than half the institutions (52.1%) did not have a nurse on their staff. The larger the size of the institution, the more likely it was that nursing staff were employed there. With regard to the relationship between institutional operating structure and the employment of nursing personnel, public institutions were more l...

Background Research evidence suggests that investigation of workplace culture assists in enhancing social inclusion of and job retention by people with intellectual disability.Method This research ...

This paper provides a review of relevant research concerning the development and use of spoken pragmatic language skills by people with intellectual disabilities. The development of pragmatic language skills in childhood, the use of such skills in adulthood, and links between pragmatic language use and quality of life are discussed. Despite the variety of participants and methodologies used, research findings are broadly consistent. First, people with intellectual disabilities can and do acquire basic pragmatic language skills, although more subtle aspects of conversational competence are less commonly displayed. Second, the communicative environments of children and adults with intellectual disabilities appear to inhibit the acquisition and display of pragmatic language skills. Third, different service settings can have an impact on the pragmatic skills of people with intellectual disabilities. Fourth, intervention programs can improve the pragmatic language skills of people with intellectual disabilitie...

Various care approaches have been offered to people with intellectual disabilities over time. Amongst these approaches, deinstitutionalization has been considered to be the most crucial development in delivery of services for people with intellectual disabilities. Although families’ ongoing participation is regarded as a key element in achieving successful deinstitutionalization, it seems little attempt has been made in Australia to examine families’ perspectives on institutionalization and deinstitutionalization. This study examines families’ perspectives and attitudes about institutionalization and deinstitutionalization. The sample of the study consisted of 22 families whose relatives were living in an institution. Based on a qualitative study, a semi‐structured interview was undertaken for collecting data, and the NUD*IST computer software package was used to code and analyze the data in the current study. Families’ views about institutionalization and deinstitutionalization were discussed. Families e...

Despite the increasing longevity of people with intellectual disability, community care systems are ill prepared to support the choices of people with intellectual disabilities for ageing well. Thi...

It is mandatory for staff in Swedish community services for people with intellectual disabilities to report incidents of error or malpractice.The aim is to study if incident reports contribute to d...

Dedifferentiation describes a change that occurred in many developed countries during the 1990s: away from regarding people with intellectual disabilities as having particular needs resulting from ...

Background: This article aims to present the results of a study on the facilitators and obstacles to community participation in inclusive settings for people with intellectual disabilities (ID) in ...

Background: People with intellectual disability may be at elevated risk of adverse consequences of substance use. This study outlines the prevalence of, and factors associated with, substance use in young people with and without intellectual disability. Method: Secondary analysis was undertaken of the Next Steps annual panel study, which follows a cohort through adolescence into adulthood and contains self-report data on smoking, alcohol and drug use. Results: Young people with mild to moderate intellectual disabilities were generally less likely to use substances than young people without intellectual disabilities. The pattern of association with socio-demographic factors was mixed. Overall, matching participants on between-group differences in exposure to extraneous risk factors did not impact on between-group differences in substance use. Conclusions: Young people with mild to moderate intellectual disability are less likely to use substances than their non-disabled peers. Prevention and intervention programs need to be adapted for those in this population who do use substances.

BACKGROUND: The PAS-ADD Checklist is designed to screen for likely mental health problems in people with intellectual disabilities (ID). The specificity of recommended subscales derived from diagnostic criteria is unclear. This paper therefore investigates the factor structure of the PAS-ADD Checklist to determine the adequacy of empirically derived subscales. \ud METHOD: A total of 1,115 informants who had known service users for a median of 24 months completed the PAS-ADD Checklist on 1,155 adults with ID living either in the community, in residential care, or in hospital settings in a county in North-East England. \ud RESULTS: The sample was randomly divided into two, with all item scores dichotomised. An exploratory principal components factor analysis with varimax rotation was conducted on Subsample A, producing an optimal 7-factor solution. However, a confirmatory factor analysis using this factor structure for Subsample B revealed a mediocre to poor fit. Further exploratory and confirmatory factor analyses also indicated that empirically derived PAS-ADD Checklist subscales were inconsistent. \ud CONCLUSION: Given the inconsistency of empirically derived subscales, we do not recommend using the PAS-ADD Checklist to identify specific types of psychopathology. The Checklist may have more utility as a screening tool for general psychopathology and subsequent referral for more detailed assessment.

Palmtop computers provide a promising mobile platform to address barriers to computer-based supports for people with intellectual disabilities. This study evaluated a specially designed interface to make navigation and features of palmtop computers more accessible to users with intellectual disabilities.The specialised cognitively accessible interface was compared with a standard Windows CE interface. Participants completed a structured set of navigation/computer use tasks using both the experimental and control conditions. Measurements included the amount of assistance needed and errors made in completing the navigation/computer use tasks.Participants (N = 32) made significantly fewer errors (p.001) and required significantly fewer prompts (p.001) while using the specialised software interface compared to the mainstream Windows interface.The research demonstrates the feasibility of using special software design methods, such as linear program flows, error minimisation and the incorporation of repetition and consistency, to improve access to palmtop computers for individuals with intellectual disabilities. Issues related to designing cognitively accessible interfaces are discussed.

Background Over the last decade increased attention has been paid to identifying and responding to the mental health needs of children and adolescents with intellectual disabilities. There is, however, little information available on the use of self‐report scales by young people with intellectual disabilities. This study sought to determine the reliability and validity of the child, carer and teacher versions of the extended Strength and Difficulties Questionnaire (SDQ) when used with this population.Method Secondary analysis was undertaken of a nationally representative survey of the mental health of 4,449 children between 11 and 15 years of age in Great Britain. Data were extracted on an operationally defined sub‐sample of 98 children with intellectual disabilities, and on 4,074 children without intellectual disabilities.Results All scales on the SDQ proved to be internally consistent. Acceptable levels of validity were found by examining: (1) correspondence between parallel child, carer and teacher ver...

The experience of poverty has a pervasive impact on the health (including mental health) of children and their parent(s), on family functioning and on the life course of children. The aim of this paper is to consider the relevance of poverty to our understanding of the health (and mental health) of children with intellectual disabilities in the world's richer countries. It is suggested that poverty is of considerable relevance to this area as: (1) young people with intellectual disabilities are at greater risk than their non‐disabled peers of experiencing poverty; (2) the experience of poverty is likely to be associated with poor parental health and well‐being and consequently poorer parenting practices; and (3) the experience of poverty is likely to be associated with poor child health and well‐being. Implications for future research, policy and practice are discussed.

While there is extensive evidence on the overall benefits of deinstitutionalisation, the move from institutional care to providing accommodation and support in small to medium sized dispersed housing schemes has not gone uncontested. Recently, a number of commentators have argued for the development of cluster housing on the basis that it may provide a “connected” community of people with intellectual disabilities. In the present study, comparisons were made, controlling for a range of participant characteristics, on a range of input, process and outcome variables between 169 adults with intellectual disabilities living in cluster housing and 741 adults with intellectual disabilities living in dispersed housing. Participants supported in cluster housing were more likely to live in larger settings, be supported by fewer staff, be exposed to greater changes/inconsistencies in living arrangements (their home also being used for short‐term care for others and greater use of casual/bank staff), be exposed to m...

The aim of this study was to investigate general practitioners’ (GPs) beliefs about the importance of addressing nine health care issues for people with intellectual disabilities, and their roles in providing this care. GPs’ current level and intended future level of addressing these health care issues were also determined. Questionnaires were mailed to 912 GPs Australia wide, with a 58% response rate. The vast majority of respondents agreed that the nine issues are important health care issues for people with an intellectual disability. Most respondents also agreed that it is the GPs’ role to facilitate or ensure these health issues are addressed. Although having broad attitudes about their roles, GPs indicated significant deficiencies in their current level of health care provision for many of the health issues. However, they also indicated their intentions to increase the frequency of addressing these health issues in the future as a result of issues raised in previous questions on the questionnaire. T...

Coronary heart disease (CHD) is the most common cause of death in the United Kingdom. People with an intellectual disability are especially prone to CHD and cardiovascular problems. Research in the United Kingdom has shown that people with intellectual disabilities do not access their general medical practitioners (GPs) as often as the rest of the population. Difficulties surrounding communication and low expectations mean that the processes of consultation, diagnosis and treatment are problematic. A process of health screening for people with an intellectual disability began in Birmingham early in 1995 to facilitate equal access to health services. One hundred and twenty people with intellectual disability accepted a health check, including an assessment of diet, smoking habits and alcohol consumption, relevant family history, physical activity levels, blood pressure, body mass index, urinalysis, and blood tests (including thyroid function and cholesterol). The results from these health checks provide ev...

Research has established that people with intellectual disabilities are overrepresented amongst samples of suspects being interviewed by police, and in prison populations in many Western jurisdicti...

The goal of community-based care is rhetorically constructed as promoting independence, participation in community and the enjoyment of rights as citizens. Although this philosophy is now widely accepted, debate still continues about the outcomes of this model of care. Whereas studies to date have relied on a small, consensual, set of objective indices of “engagement”, ability levels, and community activity to make external judgments about the quality of service users' lives, the inclusion of users' subjective perceptions has recently come to be seen as an important component of evaluation methodology. The formalised assessment of “quality of life” has emerged as an organising construct in service evaluation practice, and has been proposed as a key criterion for assessing the success of community-based services. This study examines a community-based service, accommodating thirty-four people with intellectual disabilities in a regional Australian city and small rural towns, using both established measures ...

As older adults with intellectual disabilities live longer and reside in community-based accommodation, the availability of support programs and services becomes important to the maintenance of independent living. One hundred and sixty-two community-based organisations in Brisbane, Australia, that assist older adults or people with intellectual disabilities were surveyed regarding the types of programs offered to older adults with intellectual disabilities. The results showed that only 36% of the organisations had provided assistance to an older adult with an intellectual disability in the past 12 months. Agencies assisting people with disabilities were more likely to have provided services to this group than organisations assisting the general older population. None of the agencies surveyed reported that they provided specialised programs or services to older adults with intellectual disabilities.