Search

The article offers information on dedifferentiation describes a change that occurred in many developed countries during the 1990s from regarding people with intellectual disabilities as having particular needs resulting from cognitive impairment. Topics include the policy continues to shape health and social care services, and the research on the impact of dedifferentiation on people with intellectual disabilities.

BackgroundMethodResultsConclusionsShared decision-making between patients and primary healthcare professionals positively impacts health outcomes. However, people with intellectual disability face additional barriers and require supported shared decision-making (SSDM) to participate. Little is known about how healthcare professionals use SSDM with this population. This paper explores the facilitators and barriers experienced, and strategies/resources employed by healthcare professionals working with people with intellectual disability.Ten purposively sampled primary healthcare professionals participated in semi-structured interviews. This descriptive qualitative study used content analysis. Findings were compared with a proposed model of factors influencing triadic (the person with intellectual disability, their caregiver and the healthcare professional) SSDM.Five factor categories emerged: previous training/experience; engagement and trust; effective collaboration with caregivers; organisational culture and contexts; and familiarity/confidence with communication support strategies and resources.Healthcare professionals can leverage pre-existing skills and knowledge, but provision of targeted professional development may reduce anxiety and increase successful SSDM. [ABSTRACT FROM AUTHOR]

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. This study aims to understand ageing experiences among middle-aged adults with intellectual disabilities and their family carers with a focus on their perspectives of ageing well. Interviews were conducted with 10 middle-aged people with intellectual disabilities and 12 family carers; the interview data were thematically analysed. The participants highlighted the key elements of ageing well such as importance of living in a familiar place, having a reliable carer, nurturing independence, staying fit and healthy, and actively engaging in social activities. The findings suggest that middle-aged adults with intellectual disabilities can best age well through future planning, along with support services tailored to respond to their changing needs as they age. [ABSTRACT FROM AUTHOR]

Though the concept of encounter promises to move the field of social inclusion beyond the dichotomy of presence and participation, new work in political theory pushes encounter in a different direction, making freedom – not inclusion – the central value at stake. Interpretative video analysis was conducted on an online learning program "Supporting Inclusion" developed to help support workers recognise and facilitate encounters between people with intellectual disabilities and community members. Using the lens of freedom in the encounter offers an alternative framing of the significance and meaning of the online learning program's social interactions. Feminist theory can help show how unfreedom is a central problem facing people with intellectual disabilities, recasting encounter through the lens of freedom can help spark fresh insight into what makes encounter important. [ABSTRACT FROM AUTHOR]

While qualitative research on intellectual disability is on the rise, researchers have frequently reported that their methods bring methodological and ethical challenges. The authors advance shadowing as an alternative method to respond to these concerns. The authors draw on their experiences with shadowing on the basis of two separate studies respectively, involving 28 and 17 people with intellectual disabilities. Four distinct advantages of shadowing are presented: it is flexible, gives unique insight in daily life experiences, can aid in giving "voice" to people with intellectual disabilities, and can aid in the pursuit of inclusive research. Three challenges of shadowing research were also identified, relating to ethical approval, privacy and role confusion. Shadowing is a promising method for intellectual disability research, as it allows researchers to garner data virtually inaccessible with other methods. It is particularly useful for research questions about everyday life and interpersonal relationships. [ABSTRACT FROM AUTHOR]

Unpredictability, the risk of harm and possibility of rewards, are integral elements of encounter. Risk literature offers insight on the complex ways in which risk perceptions and attunements shape behaviours and interactions in encounter between people with and without intellectual disability. The paper draws on risk literature, encounter literature, and examples from the authors' previously published studies on encounter and work integrated social enterprises. Encounters between people with and without intellectual disability are shaped by perceptions of possible rewards and harms skills and experience in attunement to risk signals; disposition towards, and strategies of, risk aversion, management or enablement and environmental attributes of encounter settings. There is a need to shift community and disability services' understanding of risk in encounter, by developing a positive appreciation of encounter risk, and development of risk enablement strategies that are learned through experiential practice. [ABSTRACT FROM AUTHOR]

An editorial is presented to the article urban geographers and sociologists use ideas about "encounter" and "conviviality" to understand ways of engaging with difference in cities and ways of enabling people to step outside a fixed identity. Topics include urban geography literature on encounter has turned primarily to the front stage of this performance; and collection of papers brings together new directions of scholarship about the performance, purpose, and creation of encounter for people.

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 developing quality in services for people with intellectual disabilities who present with challenging behaviours. 159 reports on incidents from group homes and daily activities services were accessed and analysed using narrative thematic analysis. Most reports concerned altercations between service users. Analysis focused mainly on the immediate incident and attributes of service users. Amendments were not (obviously) aligned with causes, and neither sufficiently addressed structural shortcomings. Restrictive measures were described, but changes in practices were not mentioned. Reports including Self-injurious behaviour (SIB) were conspicuously absent. Reports are handled in a seemingly perfunctory manner, without any development. Quality development relying on staff reports and front-line managers' investigations requires support based on values rather than on the legal framework. [ABSTRACT FROM AUTHOR]

Background: Nurses provide technical and relational skills that are integral to the care of people with intellectual disability (ID) in Australia. However, little is known about the demographic profile of this section of the nursing workforce. Method: Administration of a survey to nurses whose primary role it is to care for people with ID nationwide Results: This brief report provides a description of the demographics of participants in the national survey. Of 101 participants, 78% were women and the mean age was 53.21 years. Participants held a variety of educational qualifications to prepare them for the care of people with ID. Conclusion: The findings suggest the need to consider the future unmet needs of people with ID given the ageing of this workforce. The ongoing support needs of people with ID depend upon the ongoing presence of nurses well prepared to meet the need of this group of people. [ABSTRACT FROM AUTHOR]

This preregistered study compares adolescents with mild-to-borderline intellectual disability (MBID) and typically developing (TD) adolescents on their susceptibility to peer influence. To understand why adolescents with MBID are susceptible to peer influence, links with inhibition, Theory of Mind (ToM) and negative interpretation bias are investigated. We assessed 163 adolescents (111 MBID, 52 TD 14–19 years; 63% boys) using experimental tasks and self- and/or teacher-reports. Adolescents with MBID and TD adolescents did not differ in their susceptibility to peer influence, inhibition, and negative interpretations. On two ToM instruments, adolescents with MBID performed weaker than TD adolescents. In a structural equation model, tested in the MBID group, inhibition, ToM and negative interpretation bias were not related to susceptibility to peer influence. This study revealed new insights by strong methods such as the multimethod approach, a full theoretical model testing relations between all constructs simultaneously, and the large sample. [ABSTRACT FROM AUTHOR]

The Developmental Behaviour Checklist (DBC) is an established, internationally used questionnaire for assessing behavioural and emotional problems among young people with developmental or intellectual disabilities (ID). The present study aims to evaluate the psychometric properties of its German teacher version (DBC-T). The German DBC-T was administered to 397 school staff members who reported twice on 1177 children and adolescents with ID over a period of 7–9 months. Data were analysed within an exploratory structural equation modelling framework. Our results supported the five-factor structure of the DBC-T and found good reliability for all scales. Analyses on the relationship of DBC-T scores with students' age, gender, and adaptive behaviour provided further evidence for the validity of the DBC-T. Our study endorses the notion that the German DBC-T is an important instrument both for research and practice. Limitations and further directions are discussed. [ABSTRACT FROM AUTHOR]

This study reports the findings from a Dutch study, exploring care workers' knowledge and perceptions of the online lives of adolescents with mild or borderline intellectual disabilities. Using an inductive research design 33 semi-structured interviews were conducted with care workers. Three themes were derived from the data: (1) The clients' online world is largely unknown to care workers. (2) The online world is a gateway to an inclusive and connected life. (3) The online world is a dangerous and challenging place. Care workers have limited knowledge of clients' online lives. Care workers show ambivalence about the good and bad of the Internet for their clients. They acknowledge the possibilities of the Internet but mostly perceive it as a place of risk and challenge. Paradoxically, care workers report little experiences of incidents of online risks. Perceptional processes might help explain why this paradox exists. [ABSTRACT FROM AUTHOR]

Background The goal of this study was to adapt a narrative reminiscence program for the special needs of ageing people with mild/moderate intellectual disabilities. Research has shown that stimulating reminiscence in the elderly can be a meaningful activity, and holds promise for positive effects on well‐being. Method In the first stage (10 weeks), the program was developed with 1 group. Evaluation and adjustments to the program were made based on video recordings, the researcher's log, and feedback from participants and support workers. Formative evaluation was performed by means of a within‐group analysis. In the second stage (3 weeks), the program was introduced to 6 other groups. Interviews with professional support workers were subjected to a cross‐case analysis. Results The final program consists of 13 sessions covering different reminiscence themes. The success of reminiscence group work relies on (a) well‐prepared and structured sessions, (b) adequate use of visual triggers, and (c) facilitating, coaching and moderating. Conclusion The program was perceived as a valuable and meaningful activity by all participants. Although reminiscence group work is not therapeutic in nature, it may have therapeutic use for ageing people with intellectual disabilities, and in this sense is worth evaluating. [ABSTRACT FROM AUTHOR]

Background: Often, people with and without intellectual disabilities do not mingle. Research has mostly focused on how to foster "convivial encounters" for social inclusion, but further thinking is needed on situations in which potential encounters do not take place. Method: Discussion of philosophical and urban sociological literature on social interaction in public. Results: In non-encounters, people give subtle non-verbal cues in situations of physical proximity. This can both lead to hurtful experiences of invisibility and positive experiences of micro-recognition. In spite of best efforts, people can position others unintendedly as "strange," which leads to hesitation. Conclusions: This analysis highlights how non-encounters can be both socially inclusive and exclusive. In spite of best intentions, interactions in public spaces also come with tensions. The question of how to transform social culture to encompass difference remains significant. [ABSTRACT FROM AUTHOR]

In forensic settings, patients with intellectual disabilities are overrepresented. A relative novel treatment approach for this population is schema therapy. The goals of schema therapy for offenders with intellectual disabilities are to reduce maladaptive emotional states and to reinforce healthy emotional states and enhancing the patient's ability to ask for help. No studies are examining the effectiveness of this approach. We examined the effectiveness of Schema Therapy for offenders with intellectual disabilities (ST-ID) in terms of emotional states, psychological complaints, and violence risk in six participants. Reliable change analyses showed significant improvements in emotional states and certain psychological complaints. While many questions remain about the effectiveness of ST-ID, our study shows that offenders with ID can benefit from this psychological treatment. [ABSTRACT FROM AUTHOR]

Background: Employment rates for Australians with an intellectual disability remain low. Effective evidence-based strategies are required to guide future interventions, to enable people with intellectual disability achieve better employment outcomes. Methods: A literature search of peer-reviewed articles published between 2001 and 2015 was conducted using four electronic databases. Articles were reviewed and sorted according to employment setting and type of support provided. Results: Twenty-two studies were identified. Four studies of open employment examined workplace level strategies and 17 investigated individual level strategies. A single study of supported employment examined individual level change. Results suggested potential strategies that can be utilised to support people with intellectual disability obtain and maintain employment. Conclusions: Existing evidence regarding open employment for people with intellectual disabilities could be enhanced through the conduct of rigorous outcomes-focused studies that attend to specific strategies at both individual and organisation levels. [ABSTRACT FROM AUTHOR]

Background: Canada was the first country to develop legal mechanisms that allow for supported decision making, and little research has explored how decision making is supported in this context. This research aimed to understand how seven people with intellectual disabilities, living in two Canadian provinces, were supported with their decision making. Method: The research used constructivist grounded theory methodology, interviewing and observing the decision making of seven people with mild to severe intellectual disabilities and 25 decision supporters. Results: A common process of decision-making support was discovered, involving dynamic interaction between the person's will and preferences and supporters' responses. This interaction was influenced by five factors: the experiences and attributes the person and their supporter brought to the process; the quality of their relationship; the decision-making environment and the nature and consequences of the decision. Conclusion: The highly individualised and contextually dependent nature of decision-making support has implications for supported decision-making practice. [ABSTRACT FROM AUTHOR]

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 likely to employ nurses than private institutions or privately operated state‐owned institutions (POSOE). However there was no statistically significant difference among the various operating structures in terms of the ratio of nurses to people with ID. Conclusions The results highlight the importance of examining the regulation of an appropriate ratio of nurses: people with ID in institutions. [ABSTRACT FROM AUTHOR]

Autistic people commonly report differing sensory experiences. This research aimed to find out about sensory issues and the sensory environments of autistic adults who did and did not have intellectual disabilities. Online questionnaires were designed to identify sensory needs. The survey was completed by 138 autistic adults who self-reported and 58 informants reporting about autistic adults who had intellectual disabilities. Autistic adults self-reported high numbers of sensory needs compared with informant reports of the needs of autistic adults who had intellectual disabilities. It is possible that informants under-reported issues for autistic adults with intellectual disabilities. Some sensory needs are harder to observe and people with intellectual disabilities may find it difficult to communicate such needs. The authors propose that better methods of supporting communication of "harder to observe" sensory needs should be developed. Further research is needed. [ABSTRACT FROM AUTHOR]

Identifying the students with intellectual disabilities and deciding the required services would not be sufficient without parental involvement. The purpose of this study was to understand the perspectives of the parents of students with intellectual disabilities about the Guidance and Research Centres (GRCs) and reveal the parents' experiences at the GRCs. In this qualitative study, unstructured interviews were conducted. Twenty-one parents who had a child with an intellectual disability were asked about their experiences during their visit to the GRCs. Content analysis with an inductive approach was used to analyse the data. Most of the parents reported problems regarding educational evaluation, and communication and collaboration. The participants provided their suggestions about evaluation procedures, professionalism, and institutional practices. The problems at the GRCs must be considered by educators and other stakeholders to better provide educational evaluation, support services, and guidance to the students and their parents. [ABSTRACT FROM AUTHOR]

People with severe to profound intellectual disabilities have particular needs for others to help them regulate stress. Such support may be hampered by difficulties in detecting and interpreting expressions of stress. This study aimed to describe and identify stress-related behaviours and sensitive, stress-regulating responses to these behaviours. Video recordings of psychotherapeutic interactions between four clients with severe intellectual disabilities and behavioural problems and two attachment therapists were analysed using a stepwise spiral of analysis approach. Stress-related behaviours were identified with a behaviour rating scale for arousal and valence. Distinct stress-related behaviours were subdivided into stress-specific, non-stress-specific, and client-specific behaviours. Additionally, examples of responsive behaviours to clients' expressions of varying arousal and valence were found. A wide variety of expressions indicative of different levels of arousal were found, with few expressions specific for stress. The descriptions of responsive behaviours might support parents and caregivers in external stress regulation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Autistic adults with intellectual disabilities (ID) seem to be particularly vulnerable to potentially traumatic experiences and post-traumatic stress disorder (PTSD). Furthermore, this population may be at risk for a different set of traumatic experiences than the general population. However, knowledge is sparse concerning PTSD symptom manifestations in individuals with severe ID. Exploration of PTSD symptom trajectories and manifestations in an adult, autistic man with severe ID. Altered arousal/reactivity and problematic avoidance were the most easily observable symptoms. Avoidance seemed to become more generalised over time, and the impact of PTSD on behaviour, level of functioning, and quality of life was severe. Negligence and coercion in services for autistic adults with ID may involve a traumatic potential for these individuals. Increased awareness of this risk is needed in service providers and mental health professionals. [ABSTRACT FROM AUTHOR]

Supporting participation in decision making is complex, dynamic and multifactorial. The aim of this study was to understand more about the difficulties parents of adults with intellectual disabilities experienced in providing decision support and their strategies for resolving them. Participants were 23 parents who regularly provided decision support for their adult with intellectual disabilities. Most of the adults (19) lived at home. Parents participated in semi-structured interviews at least three times during the study. We applied a social-constructionist theoretical perspective and a template approach for analysis. Findings fell into three core categories, making the right decision, factors that made decision support difficult, and strategies to manage uncertainty, which included controlling, influencing, expanding the adult's horizons and enabling risk. The knowledge gained will help in building the capacity of parents to provide decision support that better understands and respects the will and preferences of the person they support. [ABSTRACT FROM AUTHOR]

Body experience is an important facet of psychosocial functioning and health. However, to date no test exists to measure body experience in adults with mild intellectual disability and borderline intellectual functioning (MID-BIF). We therefore adapted the Body Experience Questionnaire (BEQ) to this group, resulting in the BEQ-mb, and evaluated its usability, comprehensibility, and reliability. The BEQ-mb was developed in five stages: concept development, focus group, verbal reports, pilot testing, and evaluation. The BEQ-mb is applicable in, and comprehensible by, adults with MID-BIF. Internal consistency is good for the total scale and the body awareness and body satisfaction subscales, but low for the body attitude subscale. Test–retest reliability is excellent for the total scale and the subscales. The BEQ-mb unlocks new opportunities for clinical examination and research on body experience. Future research is needed to investigate its structural validity. [ABSTRACT FROM AUTHOR]

The prevalence of Substance Use Disorder (SUD) in people with Mild Intellectual Disability and Borderline Intellectual Functioning (MID-BIF) is high and evidence-based treatment programs are scarce. The present study describes the development of a personalised SUD treatment for people with MID-BIF. The personalised SUD treatment is developed according to the steps of the Intervention Mapping approach, based on literature review, theoretical intervention methods, clinical experience and consultation with experts in the field of addiction and intellectual disability care. We developed a treatment manual called Take it Personal!+. Take it Personal!+ aims to reduce substance use, is based on motivational interviewing and cognitive behavior therapy and personalised based on the client's personality profile. Furthermore, an mHealth application supports the treatment sessions. Take it Personal!+ is the first personalised SUD treatment for individuals with MID-BIF. Future research should test the effectiveness of Take it Personal!+ in reducing SU. [ABSTRACT FROM AUTHOR]

The life expectancy of people with profound intellectual and multiple disabilities (PIMD) is increasing and parents express concerns about being possibly outlived by their child with PIMD. However, little is known about the nature of these concerns. We interviewed 27 parents of persons with PIMD and analysed the data thematically, to explore parents' concerns about being outlived by their child. Most parents hoped to outlive their child with PIMD and related this to the expectation of a decreased quality of life (QoL) of their child, when they would have passed away. The uncertainty about who would fulfil their parental roles in the future contributed to parents' concerns and sometimes resulted in feelings of despair. Our study provides insight into the nature and gravity of parents' concerns. The division of parents' concerns into roles helps to address future care and support gaps for people with PIMD. [ABSTRACT FROM AUTHOR]

The present study examined the psychometric properties of the Anger Bodily Sensations Interview – intellectual disabilities (ABSI-id), an adapted instrument to measure anger-related interoceptive awareness (IA) in individuals with mild intellectual disabilities or borderline intellectual functioning (MID-BIF). The ABSI-id was individually administered to 208 clients (51% male) with MID-BIF in residential facilities. An EFA and CFA showed a two-factor structure of the ABSI-id, including nine items. The ABSI-id had moderate to good reliability, with an internal consistency ranging from acceptable to good, a test–retest reliability ranging from moderate to good and an adequate convergent validity. There was no significant difference in ABSI-id scores between individuals with MID and BIF. The ABSI-id is a promising instrument for measuring anger-related IA, additional research is needed on validity and sensitivity of change. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the impact of a structured 10-didactic units intervention on promoting the school inclusion of elementary school students with intellectual disability (ID). Method: The intervention was devised for 152 Italian typically developing (TD) elementary school students that were randomly assigned to the experimental (EG) or to the control (CG) group. Specifically, we examined the positive and negative social behaviours that took place in naturalistic class settings between TD students and their classmates with ID and the positive and negative peer sociometric nominations that children with ID received from their TD classmates. Results: At post-test, the children with ID included in the classes randomly assigned to the EG, received more positive sociometric nominations and social behaviours than peers with ID of the CG, and adopted more positive behaviours towards TD peers. Conclusions: The study highlighted the potential of the intervention to promote the school inclusion of students with ID. [ABSTRACT FROM AUTHOR]

Peers living in the same group form important interaction partners for people with profound intellectual and multiple disabilities (PIMD). Given the severity of their disabilities, direct support persons (DSPs) play a significant role in facilitating interactions between these peers. This study explores the spontaneous interactions between persons with PIMD and the possibilities provided by DSPs related to physical positioning. Observational data were obtained from 14 people with PIMD for three consecutive hours in a non-controlled situation. Of all 213 observed interactions, 5.1% were with peers, 73.4% with DSPs, 14.9% with the observer, and 6.5% with others. In 61.3% of the observed timeframes, the participants with PIMD were positioned in a way that made it impossible to touch or/and to look at a peer. Generally, the observed positioning of the participants made contacts between peers nearly impossible. DSPs should create optimal conditions for interaction between peers. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to provide an overview of concepts, methods of assessment and assessors in empirical studies on quality of life (QoL) of persons with Profound Intellectual and Multiple Disabilities (PIMD). Method: A narrative literature review was conducted by searching electronic databases until December 2016, and the included studies were then analysed thematically. Results: Twenty-one articles were included in the analysis. Multidimensional concepts of QoL consisting of both subjective and objective components were found, although the articles used different distinctions for each. QoL was assessed by behavioural observations or interviews/questionnaires. Family members, primary caregivers and more distant observers (or a combination of these three) determined QoL. Triangulation of assessors and methodological pluralism were used. Conclusions: This review highlighted several components of QoL in persons with PIMD, as well as challenges in researching the QoL of persons who are not able to express themselves verbally. The distinction between objective and subjective QoL was difficult to clarify, with interpretation being both inevitable and necessary. Although triangulation is seen to be good practice in QoL assessment, the role of proxies in assessing the QoL of persons with PIMD needs further investigation. [ABSTRACT FROM AUTHOR]

Background: Proxy quality of life (QoL) evaluation has been reported to be influenced by many factors. The present study was designed to investigate the impact that the presence of severe intellectual disability (ID) may have on proxy attribution of QoL in the instrumental assessment. Methods: The "other person" form (proxy questionnaire) of the Italian adaptation of the Quality of Life Instrument Package (QoL-IP), the BASIQ [BAtteria di Strumenti per l'Indagine della Qualità di Vita] was administered to 20 first-line operators to assess their perceptions of the QoL of 92 subjects with severe ID and 34 volunteers without ID. The 54-item BASIQ measures three psychological domains (Being; Belonging; Becoming) and nine sub-domains, with each item also assessed across four dimensions (Importance; Satisfaction; Decision-making; and Opportunities). Results: Subjects with ID (as rated by proxies) had higher scores on BASIQ domains than those of non-ID subjects except for the sub-domain of Psychological Being. People with ID also received lower scores from proxies on the Decision-making dimension but higher scores on the Opportunities dimension. Differences between groups were statistically significant for most variables. Conclusions: Findings suggest that prejudicial attitudes towards the QoL of people with severe ID may be either absent in proxies or contained within the scope of the excercise. Previous research indicating that non-integrated QoL assessment may give paradoxical results was also supported. [ABSTRACT FROM AUTHOR]

Background: This study analysed parents' positive and negative appraisals of the impact of raising children with profound intellectual and multiple disabilities (PIMD) on family life. Method: Mothers (n = 52) and fathers (n = 27) of 56 children with PIMD completed a questionnaire focused on their positive and negative appraisals of the impact of childhood disability on family life. Scale means (ranging from 10 to 40) were calculated, as was the relationship between the two subscales. Results: Mothers and fathers indicated that their children affect family life both positively (M = 31.4 and 32.8, respectively) and negatively (M = 31.3 and 28.5, respectively). Only fathers showed a positive significant relationship between the positive and negative subscales. Conclusions: Parents' positive and negative appraisals co-occur. Although parents positively appraise the impact on family life, their substantial negative appraisals demand tailored support for families raising children with PIMD with a strong focus on practical support. [ABSTRACT FROM AUTHOR]

Background: After 21 years of age, adults with a profound intellectual disability (PID) have limited access to specialised services. An important concern that emerges is the potential decrease in their social participation. Knowing the benefits of social participation for adults with PID, it is relevant to address this issue. Method: This scoping review examined the literature on the social participation of people with PID in young adulthood and its influential factors. Results: Results suggest a significant lack of information concerning social participation of these adults. During adulthood, people with PID have currently two main choices to occupy their days: activities in daily activities centre and leisure in community organisation. Few options to maintain their capabilities are available, and this situation has significant impacts on young adults and their families. Conclusion: Future studies focusing specifically on adults with PID and their caregivers are needed to understand their reality when entering adulthood. [ABSTRACT FROM AUTHOR]

Background: Informal carers often play an integral role in the lives of people with intellectual disability (ID) residing in the community. In this study, we explored the extent to which carers of people with ID believe that the health care needs of the person they care for are being accommodated by general practice. Method: Semi-structured interviews were conducted with 25 informal carers to people with ID living in Australia. Results: Carers of people with ID report that they experience considerable barriers to accessing general practice care on behalf of the people they care for. Conclusions: Given the ever-increasing number of people with ID now living in the community and their vulnerability to health problems, it is imperative that future research focuses on the development of strategies to overcome the barriers identified in this study. [ABSTRACT FROM AUTHOR]

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 Québec City (Canada), as perceived by adults with ID and key individuals involved in their daily lives. Method: Semi-structured interviews were conducted, followed by an inductive thematic analysis process. Results: Twenty participants shared their perspectives on the factors that influence community participation of adults with ID in inclusive settings. Overall, they revolved around physical and financial accessibility, openness of the members of the groups attended, as well as the adaptations and support provided to promote the people's active participation. Conclusions: Offering social support and interventions that truly help adults with ID create meaningful relationships is crucial. Training community members is also fundamental to creating environments where people with ID can feel that they belong. [ABSTRACT FROM AUTHOR]

This article examines trends in the use of accommodation support services for people with intellectual disabilities in Australia. According to the article, observed changes in institutional and community living are mainly driven by "non-institutionalization," that is, people with ongoing support needs remaining in the community, rather than going into institutions. Further, it appears that the institutionalized population is ageing, primarily as a result of younger people with high support needs staying in the community. If the trends continue, they will result in a decreasing number of people with disabilities in institutional accommodation who will also be ageing. The larger group of people in group homes will also be getting older.

In this study we aimed to explore how intelligence and executive functioning are related to decision-making regarding social situations in persons with mild ID. We studied 80 vocational school students with mild ID; the controls were 80 students of a similar age. We assessed decision-making ability with the Important Life Decisions Task. Intelligence was assessed with the Wechsler Adult Intelligence Scale – Revised (WAIS-R), and executive functioning with the Wisconsin Card Sorting Test (WCST). The WAIS-R Verbal Comprehension and the Memory/Freedom From Distractibility factors predicted the decision-making score. Executive functioning was not related to decision-making. There was no interaction between the group and other variables. Verbal intellectual abilities and abilities related to short-term memory and attention play an important role in decision-making regarding social situations. The difference in performance between persons with ID and the control group should be regarded as quantitative and not qualitative. [ABSTRACT FROM AUTHOR]

Psychomotor therapy (PMT) is often applied in Dutch clinical practice to address aggressive behaviour in individuals with mild intellectual disabilities or borderline intellectual functioning. However, the literature on clients' experiences is lacking. An interpretative phenomenological analysis was used to analyse the semi-structured interviews of seven participants (19–60 years; four male, three female) who completed PMT targeting anger regulation problems. According to the participants, becoming aware of increasing tension and/or learning to downregulate the tension were the main goals of PMT. They emphasised both the possibility to learn by doing and the therapeutic alliance as essential to create a safe context, where participants can experiment with alternative behaviour. After completing PMT, participants perceived fewer aggressive outbursts and an increased self-esteem. Participants in our sample experienced PMT as being helpful in targeting anger regulation problems and aggressive behaviour. The experiential nature of the program was perceived as a valuable aspect of PMT. [ABSTRACT FROM AUTHOR]

We examined the association between intellectual disabilities (ID) and pneumonia severity at admission. We extracted patients admitted to hospital for pneumonia from July 2010 to March 2018 using the Diagnosis Procedure Combination database. We measured pneumonia severity using the A-DROP system. After 1:4 cohort matching between patients with and without ID, we conducted conditional logistic regression and mediation analyses. Of 1,141,158 patients, 531 had ID, and they had more severe pneumonia at admission (24.5% vs. 9.5%; P < 0.001). ID was significantly associated with severe pneumonia at admission (OR = 3.50; 95% CI: 2.68–4.58) and activities of daily living (ADL) mediated 73.8% (95% CI: 50.9%–105.0%) of the total association. Social barriers caused by reduced ADL may prevent patients with ID from accessing health care before their pneumonia becomes severe. Removing these barriers may decrease mortality from pneumonia among patients with ID by improving health care access. [ABSTRACT FROM AUTHOR]