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Background: People with intellectual disabilities remain disadvantaged in many aspects of everyday life. Capability approach is an underused approach in social care research and has at its core the importance of having capabilities or opportunities to do what we value. We use this approach to explore how people with intellectual disabilities can be supported to lead flourishing lives. Methods: Interviews and focus groups were conducted with 50 people with intellectual disabilities and 28 family carers. Data were analysed using an adapted template approach and conceptual analysis. Results: Our analysis led to the identification of one overarching theme; 'Doing what you love and growing' and sub-themes; 'Choice, opportunity and empowerment', 'Being out in the world' and 'Lowered expectations and static lives'. Conclusion: People with intellectual disabilities can lead capability-deprived lives. Methodological and practice innovation is needed to better understand what people value and ensure they have capability sets that enable flourishing lives.

Background: Active Support is a staff practice that aims to increase engagement of people with intellectual disabilities. This study seeks to: (1) identify the outcomes of staff using Active Support and how these are measured; (2) identify how the views of people with intellectual disabilities have been included in Active Support research. Method: A scoping review was conducted of peer-reviewed articles about Active Support published between 2009 and 2023. Results: Sixteen articles were identified. Outcomes included engagement, the quality of staff support, choice and challenging behaviour. Structured observations were the most frequently used measurement method. Only two studies explored people with intellectual disabilities' perspectives about Active Support. Conclusions: Consistent use of similar measures is a strength of Active Support research. Including perspectives of people with intellectual disabilities may provide insight into dimensions of support not been measured and assist in further developing these measures and Active Support practice.

Background: There is established evidence of complicated grief among people with an intellectual disability. This paper describes the process of adapting complicated grief therapy (CGT) for this population. Method: Action research documented the adaptation of CGT. Qualitative methods included analysing meeting notes, reflective interviews with two members of the team involved in adapting the materials, and interviews with six professionals working in disability settings who reviewed the adapted materials. Results: Key processes included adapting the standardised tools that form part of CGT and developing adapted approaches to abstract concepts related to death, dying and bereavement. Key therapeutic components such as imaginal revisiting and the role of significant others required adaptation for implementation with people with intellectual disabilities. Conclusion: The importance of adapting evidence-based therapies for people with intellectual disabilities is emphasised. This research provides an adapted form of an established therapy for piloting with this population.

Background: Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities. Method: We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data. Results: We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability "overshadows" other possible diagnoses. Conclusion: This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group.

Introduction: Easy Read health documents prepared for people with intellectual disabilities are often generated from Standard Texts. Language in Easy Read versions is typically assumed to be simpler. However, simplification of language may have unintended consequences. This study aimed to explore the differences in language used between Easy Read health material and the Standard Text versions of the same material produced for the general population. Methods: Five Easy Read/Standard Text pairs were sampled and analysed using Systemic Functional Linguistics. This addressed: how people with intellectual disabilities and others were represented by language, the author stance in relation to the reader and the overall organisation of the text. Results: The Easy Read versions often used language that was less empowering and inclusive. Conclusion: Increased awareness of author power and better knowledge of the impact of language choice could help to redress these issues.

Background: Talking therapy for people with intellectual disabilities is often specifically adapted. One adaptation is the involvement of significant others in therapy, however, there is no systematic description of the use of this adaptation in routine clinical practice. Method: An online survey of UK psychologists regarding the inclusion of significant others in individual therapy with people with intellectual disabilities. Data were analysed using qualitative content analysis. Results: Ninety-five psychologists who work with people with intellectual disabilities provided responses to questions regarding the decision to include significant others in therapy, factors that make including significant others more or less likely and how the role of significant others is explained to them. Conclusions: Psychologists consider a range of factors in deciding the involvement of significant others. We discuss implications for training of therapists working with people with intellectual disabilities, issues of consent and how the roles of significant others are understood.

Background: People with intellectual disabilities commonly experience multiple barriers to 'going out'. Aims: This paper explores what barriers prevented people from going out, and if the extent and nature of going out changed over time for people with intellectual disabilities as the COVID-19 pandemic progressed. Methods: Data are drawn from a wider study that explored, at four time points, the experiences of people with intellectual disabilities through the COVID-19 pandemic in the United Kingdom. Findings: The number of people leaving the house for almost all reasons increased over time through the pandemic, except for some outdoor participation and exercise. However, there was a significant decrease in outdoor exercise at the final time point of the study. Reliance on other people and a lack of availability of support were identified as barriers. Conclusion: A combination of factors restricted the extent to which people were going out even after COVID-19 protections were lifted.

Introduction: Hypothyroidism is a chronic health condition which causes physical, cognitive and psychiatric symptoms. The prevalence of hypothyroidism in adults with intellectual disabilities is under researched., Method: Hypothyroidism was examined among 463 patients within an outpatient intellectual disability psychiatric team. Clinic records were utilised for this study, including sociodemographic, psychiatric and physical health diagnoses., Results: Among the 463 patients, 43 (9%) had hypothyroidism. Compared to those without hypothyroidism, the hypothyroid group were significantly older, more likely to be female, and had increased rates of high cholesterol, diabetes, Down's Syndrome and dementia., Discussion: Rates of hypothyroidism within this cohort of patients with intellectual disabilities were high (9%). The results suggest hypothyroidism in intellectual disability should be the focus of prospective research, in larger, more representative samples. This study indicates a need for increased awareness of, and resources for hypothyroidism in health services., (© 2024 John Wiley & Sons Ltd.)

Background: Given the current sociopolitical climate, people with intellectual disabilities are spending more time at home. Much housing-related research focuses on informant-completed measures and quantifiable outcomes. By contrast, this article explores the perspectives of adults with intellectual disabilities concerning what they liked or disliked about their homes., Method: Data is drawn from 53 semi-structured interviews with people with intellectual disabilities in supported living or residential care in England., Results: Three themes were generated: space and place; people make or break a home; and day-to-day autonomy. These highlight the importance of belonging and the significance of other people in the creation of 'home'., Conclusion: If people are to flourish, attention must be paid to aspects of the home that provide comfort, enjoyment, and a sense of belonging. These findings can benefit professionals, family members and people with intellectual disabilities, when considering current or future living arrangements., (© 2024 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: There are increasing numbers of ageing family carers of older (40+) adults with intellectual disabilities who convey behaviours that challenge others in the UK. It is important to understand the needs and experiences of these carers as they support their older family member to transition to different care contexts., Method: A rapid scoping review of published and unpublished literature, using systematic methods of data searching, extraction and analysis., Results: Exhaustion, reluctance to burden others, distrust of alternative living arrangements and deep interpersonal ties with their family member with intellectual disabilities mean ageing carers can avoid planning ahead. There is a lack of appropriate information, support and professional advice available. Developing trust in services is critical, as is a 'whole family' approach to planning., Conclusions: More research is vital to understand the support ageing carers receive to make choices, and how it meets their needs., (© 2024 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

People with Intellectual Disability (ID) were more likely to contract COVID-19 infection and more likely to die from the consequences. However, there is no evidence on the long-term impact of COVID-19 infection in people with ID. Post-Covid Syndrome (PCS) is an established diagnosis that requires specialist clinical support. To date there is no data on how common PCS is in people with ID, or how symptoms present. Dysphagia is identified as a clinical marker because of the known association with PCS, and the clear objective diagnostic criteria applicable through specialist assessment. This investigation presents a cohort of people with ID, who developed dysphagia/worsening of dysphagia post diagnosis with COVID-19. Cases were identified through support from the Royal College of Speech and Language Therapists. Data was collected by electronic survey, including application of the COVID-19 Yorkshire Rehabilitation Scale-modified (C19-YRSm). The C19-YRSm is a validated assessment tool for PCS and it's impact upon functional disability. This case series identifies that symptoms consistent with PCS are present in people with ID, post-COVID-19 infection. The risk of diagnostic overshadowing or misdiagnosis is high due to the subjective nature and the quality of PCS symptoms. People with ID who develop PCS may not be readily identified by clinical services and therefore not be accessing the specialist medical support required. Furthermore, changes in behaviour secondary to PCS may lead to unnecessary increased prescribing of psychotropic medication which in itself risks worsening dysphagia. Dysphagia could be an important bellwether to identify PCS in people with ID., Competing Interests: Declarations. Conflict of interests: No author has any direct disclosure/conflict of interests related to the submitted work. RL has been chief investigator in studies for Janssen and Boehringer-Ingelheim Ltd. RS has received institutional and research support from LivaNova, UCB, Eisai, Veriton Pharma, Bial, Angelini, UnEEG and Jazz/GW pharma outside the submitted work. He holds grants from NIHR AI, SBRI and other funding bodies all outside this work. No other author has declared any conflict of interest., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: People with intellectual disabilities are less likely to have access to palliative care, and the evidence shows that their deaths are often unanticipated, unplanned for, and poorly managed. Within the general population, people from minoritised ethnic groups are under-represented within palliative care services. End-of-life care planning with people with intellectual disabilities from minoritised ethnic groups may be a way to address these issues. There is a huge gap in the evidence regarding intersectionality of intellectual disability and ethnicity within end-of-life care planning. This study explored the characteristics of effective and preferred end-of-life care planning approaches and resources for people with intellectual disabilities from minoritised ethnic groups., Methods: Nine focus groups and three semi-structured individual interviews were held with 41 participants from minoritised ethnic groups (11 family carers; 25 support staff; and five people with intellectual disabilities). Session recordings were transcribed verbatim and analysed using the framework analytical approach., Results: Participants thought that end-of-life care planning practices were dependent on the person's culture, ethnicity, and religion, and that it was important to follow these at the end-of-life. They deemed it important to discover and respect (and not assume) the individual's perspectives, values, needs, and wishes through a person-centred approach. Cultural attitudes to talking about death could hinder end-of-life care planning as participants perceived it as taboo. Disagreement was described as hindering end-of-life care planning, particularly when strong feelings about cultural and religious practices were involved. Staff highlighted the need for cultural and religious awareness, which could involve seeking information and receiving training. Opening the conversation about death and dying was seen as a potential facilitator for exploring end-of-life care planning., Conclusions: The study was committed to addressing issues of equity, diversity, and inclusion. It is the first study to explore perspectives on end-of-life care planning with people with intellectual disabilities from minoritised ethnic groups. It was deemed important that staff did not assume but discovered and respected the views and preferences of people with intellectual disabilities regarding culture and religion. There is an urgent need for more research into end-of-life care planning with people with intellectual disabilities from minoritised ethnic groups., Competing Interests: Declarations. Ethics approval and consent to participate: The study received ethical approval from West Midlands – Coventry & Warwickshire Research Ethics Committee (22/WM0026) on 22/04/2022. All study participants had to read and understand a detailed Participant Information Sheet and provided informed written consent to participate in the study. People with intellectual disabilities received support to understand the study information with local support staff. Personal identifiers in quotes included in this paper have been anonymised. Consent for publication: Participants provided consent to have their anonymised quotes used for publication. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Social enterprises have the potential to address some of the current barriers that people with an intellectual disability experience in transitioning to open employment opportunities. However, it is unknown in detail how social enterprises are able to facilitate this transition, which limits ability to scale-up these organisational characteristics and strategies., Method: Twenty-seven in-depth interviews were conducted with staff, supported employees and partner organisations of a social enterprise to understand the organisational characteristics that enables successful transitions., Results: The organisational characteristics of the social enterprise that enabled transitions included offering a variety of roles and workplace environments for people with intellectual disabilities. Organisational characteristics also included having dedicated staff roles to support people with intellectual disabilities to develop skills to transition and for these support staff to network with open employers to facilitate the transition., Conclusions: The results provide an adaptable model for other social enterprises in how to structure their organisation to facilitate transition to open employment opportunities., (© 2024 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: The COVID-19 pandemic precipitated a rapid roll-out of virtual health care services to people with intellectual disabilities. Limited evidence is available for clinicians to guide virtual care delivery., Method: Twenty-three studies were identified through systematic searching of 16 databases. Extracted data were mapped to the NSW Virtual Health Strategy., Results: Evidence exists to support the use of virtual care for screening, diagnosis, assessment, and review of people with intellectual disabilities, with benefits for clients, carers, and clinicians. Evidence mapped well to the priority areas of the NSW Virtual Health Strategy, highlighting the need for clinician training and specific supports and adaptations to ensure accessibility for people with intellectual disabilities., Conclusions: The use of virtual care to assess the health needs of people with intellectual disabilities across the lifespan is nascent. An opportunity exists for co-design with people with intellectual disabilities to reduce barriers to accessing and engaging in virtual care., (© 2024 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Objective: People with intellectual disabilities (ID) have difficulty in accessing oral or written health information presented in a conventional manner what compromises prevention. This study aims to develop accessible information on breast, cervical and colorectal cancer screening for people with ID., Method: The instructional material has been developed collaboratively by a team involving representatives from different scientific disciplines (medical and psychoeducational) and people with ID. Five principles guided its elaboration, i.e. coconstruction, multimodality, phasing, socio-cognitivism and accessibility., Results: The material created is a 5-component module including a 20-minute easy-toread and understand oral presentation with a slideshow, a workshop that encourages manipulation and discussion, a booklet to take away, a film to consolidate information and a questionnaire., Conclusion: Providing accessible information is considered a key action in reestablishing equality in access to cancer health care and preventing a cascade of consequences. The co-construction of the module ensures its social and ecological validity. An interventional study is underway to verify its efficacy., Practical Implication: The best practices for cancer prevention endorse spending enough time to discuss screening. This accessible module can be used to provide people with ID basic information about screening, increase their adherence, and facilitate the discussion on this issue., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: People with intellectual disabilities experience health inequalities at a greater level than their non-disabled peers. Notably, while general health status is starting to receive some attention, the reproductive health and rights of people with intellectual disabilities continue to be understudied from a policy and research perspective. The objective of this review is to elucidate the complex interplay between individual, social and structural factors that influence reproductive health outcomes for this population. The findings will be used to develop a theoretical framework to explain how and why reproductive health inequalities persist for people with intellectual disabilities and to identify gaps in the knowledge base to inform future research on this topic., Methods and Analysis: A six-stage meta-narrative review will be undertaken to synthesise the available evidence that seeks to explain the reproductive health inequalities experienced by people with intellectual disabilities and the factors contributing to these inequalities. The protocol for this review was developed in accordance with the Realist And MEta-narrative Evidence Syntheses: Evolving Standards publication standards, and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol guideline is completed to ensure transparency., Ethics and Dissemination: This meta-narrative review protocol does not require formal ethics review because it will be based on published studies. The findings from this review will be submitted to a peer-reviewed journal and presented at national and international conferences. We will also produce our findings in a range of accessible and easy-to-read formats., Prospero Registration Number: CRD42024495199., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: People with intellectual disabilities may find difficulties in their school-to-work transition. The current study aimed to determine which factors have been investigated and which are relevant to this transition process., Method: A systematic review was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included studies published between 2011 and 2023 on initiatives that facilitate the school-to-work transition., Results: Four broad types of interventions were encountered: career and vocational guidance, training for the development of key competencies, school-based transition programs, and work-based learning. Most studies were quantitative and included key competencies in training activities that focus on specific skills that facilitate the school-to-work transition process., Conclusions: In order to enable the continuity of processes related to school-to-work transition and to improve inclusive employment and social skills for people with intellectual disabilities, there is a clear need to collect initiatives across countries.

Background: Despite growing recognition of their right for inclusion in society, people with intellectual disabilities are often excluded from mainstream services, or experience poor service outcomes., Method: Taking a relational approach that considers the interpersonal relations and interactions that occur in mainstream service settings in Australia, this paper examines the features of services that research participants considered more inclusive., Results: Relations between service users with and without intellectual disabilities, mainstream service staff and disability support workers in inclusive mainstream services were characterised by; respect; warm, welcoming and convivial interpersonal engagement; active listening; proactive assistance; flexibility; mediation to create a safe environment; and collaboration and shared responsibility by both mainstream staff and disability support workers in supporting a service user with intellectual disability., Conclusions: Building on these results, we put forward a set of principles for facilitating inclusion of people with intellectual disabilities in mainstream services.

People with intellectual disabilities (IDs) face health issues and barriers to physical activity. Health promotion programmes targeting this group are often short-term. Few programmes have been designed for people with IDs who live in supported housing staffed by social care workers (SCWs). The potential that SCWs hold as health promoters has recently come into focus within literature with a setting approach. Drawing on an ethnographic study, this article explores how SCWs articulate health promotion and enact health promoter roles at supported housing for adults with moderate to severe IDs. Our findings show that SCWs perceive sport and diet as health promotion activities. Because of their background within social education and not health promotion, few perceived themselves as health promoters. However, using the holistic concept of active living, which focuses on everyday lifestyle rather than short-term programmes, our ethnographic data reveal the more unspoken and unconscious practices that SCWs enact to 'build' customized active living routines among residents. Our results suggest that this 'silenced' capacity of SCWs to build healthy routines adds to previous findings by emphasizing that, rather than lacking a health promotion ethos, employees may have the potential to promote health by adapting a more holistic approach to health promotion. We argue the active living approach can contribute to building such a holistic health approach. Such an approach may help SCWs identify with and strengthen their enactment of health promotion roles., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

While mental disorders have been broadly researched in people with intellectual disabilities (ID), comparatively less attention has been given to the conceptualisation of good mental health for this population. To capture existing concepts, definitions and measurement approaches of good mental health a systematic literature review was conducted following PRISMA guidelines. The search was carried out in eleven databases, using various synonyms of (i) intellectual disability, (ii) mental health, (iii) wellbeing, (iv) definition, and (v) assessment. A total of 2,046 datasets were identified, of which 37 met the inclusion criteria and were analysed using reflexive thematic analysis and content analysis. Results show four main themes: (1) environment, (2) absence of mental illness, (3) physical health, and (4) psychosocial functioning. The fourth was the most dominant theme and was further divided into five sub-themes: (1) emotionality, (2) interpersonal relations, (3) realise own potential, (4) personal resources, and (5) overall appraisal of life. Our findings reveal different conceptualisations of wellbeing, which is a vital part of good mental health, but highlight a notable research gap in the actual definition and conceptualisation of good mental health for people with ID.

Background: Acceptance of health care professionals is of paramount importance for the uptake and implementation of eHealth. The Unified Theory of Acceptance and Use of Technology (UTAUT) model is a widely used framework for studying health care professionals' acceptance and actual use of eHealth among general client populations. However, there is limited understanding of the eHealth acceptance of health care professionals working with people with intellectual disabilities (ID)., Objective: This study aimed to explore the applicability of the UTAUT model toward understanding the acceptance, intention to use, and actual use of eHealth among support staff and therapists working with people with ID., Methods: A total of 2 cross-sectional survey studies were conducted among health care professionals from 5 health care organizations for people with ID in the Netherlands in 2018 (n=311) and in 2021 during the COVID-19 pandemic (n=326). In addition to confirmatory and exploratory factor analyses to evaluate both the original UTAUT model and an extended version, descriptive analysis was used to explore participants' characteristics, acceptance levels, and eHealth usage. Moderator analysis and multiple regression analysis were also used., Results: A confirmatory factor analysis indicated a poor fit for both the original 4-factor UTAUT model and the extended version. An exploratory factor analysis was then conducted, resulting in a more satisfactory 5-factor model after removing 1 item with a factor loading <.40. Internal consistency of the 5 factors ranged from acceptable to good (Cronbach α=.76-.85). Collectively, all factors predicted the intention to use eHealth in 2018 (R 2 =0.47; F 5,305 =54.885; P<.001) and in 2021 (R 2 =0.43; F 5,320 =49.32; P<.001). Participants scored moderately on all 5 acceptance factors in both 2018 and 2021. Moderator analysis indicated that age and voluntariness influence the relationship between factors that determined acceptance and intention to use eHealth., Conclusions: The findings from 2 cross-sectional studies conducted in 2018 and 2021, using an extended UTAUT model, gave a deeper understanding of eHealth acceptance among health care professionals who work with people with ID., (©Cathelijn Oudshoorn, Noud Frielink, Heleen Riper, Petri Embregts. Originally published in JMIR Formative Research (https://formative.jmir.org), 12.11.2024.)

In people with intellectual disabilities research and policy are often still focused on risks or the prevention of risks. Research on the process of resilience is in its infancy in the care for people with intellectual disabilities. In the current study, applying a guided photovoice procedure, people with intellectual disabilities were asked what helped them to deal with adverse events. Additionally, informants from their social network were asked to reflect on this question. The following sources of resilience were identified: acceptance, autonomy, beautiful memories, perseverance, physical wellbeing, positive emotions, social skills, spirituality, activities, a home and the social network. Our findings provide practical guidelines for clinicians to talk about resilience with people with intellectual disabilities. Suggestions for future research are made that will contribute to the process of resilience and inclusion of people with intellectual disabilities.

Background: People with intellectual disabilities are more likely to be prescribed psychotropic medication than the general population and are frequently prescribed multiple medications. Understanding people with intellectual disabilities and carer perspectives is essential to improving the quality of psychotropic medication prescribing and usage. Method: A rapid review explored people with intellectual disabilities' understanding of psychotropic medications, as well as family members and paid carers, and how this understanding can be improved. Results: Twenty-one journal articles were included. Lack of understanding of medication was universal, with participants often unaware of adverse effects, alternatives, and rights around medication. There was also a lack of involvement in decision making for all participants. Some interventions aimed at people with intellectual disabilities or paid carers helped to improve knowledge. Conclusion: Evaluating how best to improve psychotropic medication understanding for people with intellectual disabilities, family members and paid carers should be a focus for future research.

Background: People with intellectual disabilities are rarely involved in research on quality of life. The study sought to answer the question: what do people with intellectual disabilities believe improves or hinders their quality of life? Method: Using an inclusive, accessible research design, 18 participants met in small groups to answer the study's question using their choice of arts-based media. Participants completed the analysis collaboratively, identifying key themes among their responses. Results: The participants concluded that supports, well-being, hobbies, and activities contribute to quality of life. Lack of accessibility, assumptions, negative behaviours, stress, and negative people (staff, roommates, people in general) were identified as detractors of quality of life. Conclusions: To continue to make progress in improving the quality of life of individuals with intellectual disabilities, the voice of those with intellectual disabilities is key. The results suggest key areas of focus to make these improvements.

This study analyzes the relationship between the employability competencies acquired after completing an employment training program at university and the subsequent access to employment of young people with intellectual disabilities. To do this, the employability competencies of 145 students were analyzed at the end of the program (T1) and information was gathered on their career path at the time of the study (T2) (n = 72). Sixty-two per cent of the participants have had at least one job since graduation. Job competencies increase the probability of accessing and retaining employment in students who graduated at least 2 years before (X[superscript 2] = 17.598; p < 0.001; r[superscript 2] = 0.583). These results compel us to complement employment training programs with new opportunities and greater job accessibility.

Background: Implementation issues often hinder reaching the potential of care technology to improve daily lives of people with intellectual disabilities. We investigated barriers to and facilitators of implementing different technology modalities (app/social robot/sensor/domotics) in long-term care. Method: Care professionals (N = 83) from 12 Dutch disability care organisations completed a customised measurement instrument for determinants of innovations (MIDI) questionnaire. Results: Out of 27 determinants, 20 were identified as facilitators and 16 as barriers. We highlight common barriers: few colleagues who work with the technology; no (awareness of) formal ratification of technology use; no arrangements regarding turnover of staff using the technology; unsettling organisational changes; technological defects and limited IT preconditions. Conclusions: The results, which could be combined and compared across study sites, provide insight into which implementation determinants were already well addressed, and where there is ground to gain when implementing care technology in disability care organisations.

Background: Violence against people with intellectual disabilities is unfortunately a reality all over the world, as they are one of the populations most vulnerable to various forms of aggression. Assertive prevention and control measures are crucial to tackle and reduce this problem. The aim of this study was to map and summarize the main measures for preventing and controlling domestic violence against people with intellectual disabilities.  METHODS: This was a scoping review conducted in accordance with the JBI guidelines. The databases consulted were: National Library of Medicine (PubMed); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science; Excerpta Medica DataBASE (EMBASE); Latin American and Caribbean Health Sciences Literature (LILACS) and SCOPUS. Studies included in this review reported on strategies to address domestic violence against people with intellectual disabilities, published in  the last ten years, in Portuguese, Spanish or English., Results: A total of 11 studies were included in this review. Six studies had high methodological quality and five had moderate. Cognitive-behavioral intervention programs, educational  technologies and/or auxiliary tools, along with the full participation of people with intellectual disabilities in domestic violence prevention measures are appropriate strategies for dealing with this issue., Conclusion: Domestic violence against people with intellectual disabilities is relatively unexplored in the health-field scientific literature. Prevention and control measures should be developed with the active involvement of people with intellectual disabilities, generating engagement and knowledge. Preventive measures should be adapted to the personal context and conditions of individuals with special needs, such as those with persistent or chronic mental disorders., (© 2024. The Author(s).)

Introduction: There is growing recognition that healthcare inequalities faced by people with intellectual disabilities extend to their experiences at the end of life, resulting in calls for more inclusive research to help address these inequities. Our study aimed to address this through the co-design of a toolkit for supporting end-of-life care planning with people with intellectual disabilities. To inform the co-design process, we undertook an evidence review to identify existing tools, resources and approaches that were already being used in practice., Methods: Our evidence review comprised three components: (i) a rapid scoping review of the academic literature, (ii) a desk-based search of the grey literature and (iii) an online survey to capture unpublished resources that were distributed to services, professionals, third-sector organisations and family members. A longlist of existing materials was appraised using an adapted version of the AGREE II instrument, resulting in a shortlist that was shared with the co-design team., Results: The evidence review played a critical role in the co-design of a new toolkit of end-of-life care resources for people with intellectual disabilities. However, AGREE II proved to be limited for our purposes., Conclusions: The survey was particularly useful in helping us identify resources, tools and approaches in current use. We identified evidence review processes that served to support co-design team activities and elements that were more problematic. We argue that evidence review practices might be enhanced to better aid co-design activities in health and care research, particularly for studies involving people with intellectual disabilities., Patient or Public Contribution: This article reflects on an evidence review that was conducted as part of The Victoria and Stuart Project. People with intellectual disabilities were deeply involved at every stage of project design, delivery and dissemination. The project employed people with intellectual disabilities as members of the core research team. People with intellectual disabilities and family carers were members of the project co-design team and the project Advisory Group. The evidence review process itself was led by academic members of the research team with contributions from colleagues with intellectual disabilities via the Advisory Group and core research team. The findings from the evidence review were used by the co-design team to inform the development of an end-of-life care planning toolkit for people with intellectual disabilities., (© 2024 The Author(s). Health Expectations published by John Wiley & Sons Ltd.)

Background and Aims: People with intellectual disabilities are more likely to have epilepsy than the general population. A picture-based book, Getting on with Epilepsy, may help to improve their epilepsy management and quality of life. The present study aimed to explore how the book could be best used in routine clinical care., Methods: Twenty people with epilepsy and intellectual disabilities were video-recorded using the Getting on with Epilepsy book with a nurse or doctor. This was analysed using conversation analytic methods. Eighteen patients and five clinicians took part in interviews to explore their views on book use, which were thematically analysed. All data were then synthesised to form themes., Results: Three themes were identified which demonstrated the importance of (1) understanding the book depicted seizures (2) relating the book to the participants' experiences (3) using the book as an education and information tool. The themes highlighted the techniques and approaches that clinicians used to facilitate understanding. Some tensions and differences were noted between training and implementation in routine practice, particularly around prompts in themes 1 and 3 intended to correct or change participants' interpretation of the book., Conclusions: The Getting on with Epilepsy book can be used in routine clinical practice to support people with intellectual disabilities and epilepsy. There was a balance between exploring patients' narratives and understanding with the need to convey clinical information, and this may also apply to the use of other accessible resources., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Prescribing of psychotropic drugs (PDs) and applying restrictive measures are both frequently used in managing challenging behaviour of people with intellectual disabilities (ID), which is not always according to guidelines or good clinical practice., Aims: This study aimed to investigate the potential triangular relationship between challenging behaviour, the application of restrictive measures and PD prescription., Methods and Procedures: In this cross-sectional study, data on challenging behaviour, PD prescription and restrictive measures were collected. We defined and compared four mutually exclusive groups of participants., Outcomes and Results: Challenging behaviour in the group in whom one or more PD were prescribed as a restrictive measures (PDRM) was more severe than in the other three groups. More severe challenging behaviour, a higher number of antipsychotics, antidepressants and anxiolytics/hypnotics prescriptions, a lower dosage, and more application of domotics as restrictive measure was shown in the PDRM compared to the group in whom PDs were prescribed according to guidelines (PDNRM)., Conclusions and Implications: We did not find indications for a triangular relationship of challenging behaviour, the application of restrictive measures and PD prescriptions. Future longitudinal research is needed to better understand this complex relationship and should investigate the indication and the effect of treatment. WHAT THIS PAPER ADDS?: This study is a first exploration of the potential triangular relationship between symptoms of challenging behaviour, psychotropic drug (PD) prescription, and the application of restrictive measures. Prescribing PDs and applying restrictive measures are two interventions which are commonly used to manage challenging behaviour in people with intellectual disabilities. Both have been subject of research separately in recent years. However, it is conceivable that the PD prescription in treatments for challenging behaviour could be a substitute for another form of a restrictive measure, for example a physical or mechanical restraint. For this purpose, we defined and compared four mutually exclusive groups of participants. We found no indication for this triangular relationship. On the other hand, we found the highest severity of challenging behaviour in the group who used PDs as restrictive measure next to other restrictive measures. Our results may suggest that both prescribing PDs and applying non-pharmacological restrictive measures are used simultaneously in managing challenging behaviour, are not sufficiently implemented or effective., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Competing Interests: Competing interests: None declared.

Background: Relationships and sexuality education (RSE) programmes are widely taught in schools, however for children and young people with intellectual disabilities, these programmes appear to be limited regarding information on relationships, informed choices and decision making. The purpose of this study was to seek the views and understanding of children and young people with intellectual disabilities, and those involved in their care and education, to identify best practice and approaches to the delivery on relationships and sexuality education., Methods: This study used a qualitative design with 37 pupils from five special schools from across the United Kingdom (UK) participating. In-depth semi-structured interviews were held online, or in person. All interviews were recorded and transcribed verbatim. Transcripts were anonymised, assigned a pseudonym and subjected to inductive thematic analysis., Findings: Four themes emerged from the data: (i) enthusiasm and inquisitiveness to acquire knowledge; (ii) dynamics of positive friendships; (iii) experiences and understanding of supportive relationships and sexuality; and (iv) valuing the exchange of knowledge and information. The findings highlight that children and young people with intellectual disabilities want education, support and information on matters relating to their relationships and sexuality., Conclusions: This is the largest study to date providing a voice to children and young people with intellectual disabilities regarding their relationships and sexuality. While special schools provide relationships and sexuality education, there is a requirement for a programme and resources specific to the needs of pupils with intellectual disabilities to be developed and evaluated. Such education should continue beyond school and be embedded in adult services., (© 2024. The Author(s).)

Background: This study explores the perceptions of supported accommodation staff and their managers of the support needs of residents ageing with intellectual disabilities, and their experiences of adjusting services for this group in the context of individualised funding., Method: Qualitative interviews were conducted with 21 staff working in Australian supported accommodation services., Findings: Four themes emerged. The first captured the staff's limited understanding of ageing and the medicalisation of support needs. The second identified staff practices and adjustments to service provision to facilitate residents' healthy ageing. The third described staff commitment to facilitating ageing residents to age in place, and the fourth identified staff challenges and opportunities in supporting ageing residents in the context of the National Disability Insurance Scheme (NDIS)., Conclusions: Findings may inform the development of practice guidelines and training for supported accommodation staff, protocols for intersections between disability, aged care and health sectors, and adequate policy responses to support older residents' healthy ageing.

The aim of the creation of this cohort was to investigate patterns of health and health care utilisation before and during the COVID-19 pandemic, overall and in relation to specific diagnoses, among people with intellectual disabilities (ID) compared to the general population. People living in Skåne, the southernmost region of Sweden, on 1st of January 2014 with at least one diagnosis of ID (ICD-10 codes F70-F79) or Down syndrome (DS; Q90), or support and/or services according to the LSS act comprised the ID cohort (n = 14 716). People living in the same family and/or household as a person in the ID cohort constituted the ID family cohort (n = 31 688), and those remaining comprised the general population cohort (gPop; n = 1 226 955). Data has been collected for all three cohorts from several national and regional registers. These include registers for health care (2014-2021), deaths (2014-2021), COVID-19-related health care (vaccinations, intensive care, palliative care, 2020-2021). The prevalence of ID was 1.2%. In the ID cohort, 77.9% had at least one measure of support, 5.8% at least one Q90-diagnosis and 63.8% had at least one F7-diagnosis (26.9% mild (F70), 7.4% moderate (F71), 2.8% severe (F72), 1.4% profound (F73), and 25.4% other/unknown (F78/F79)). Compared to the gPop there were more people in the younger age groups in the ID cohort. At this point, no additional collection of data will be carried out. However, there is a possibility to add data from the registers to include years after 2021 or from additional registers. Future publications will explore relevant research questions and report key findings in relation to health among people with ID. Future results will be used to inform policy and practice on people with ID., (© 2024. The Author(s).)

The present study aims to test a model in which basic psychological needs (BPN) satisfaction in physical-sport activity contexts is associated with self-determined motivation, which, in turn, would predict the social inclusion of people with intellectual disabilities. A total of 286 people with intellectual disabilities (53.5% men) who reported engaging in physical-sport activities responded to a validated questionnaire about the satisfaction of their BPN, motivation (using the Self-determination index [SDI]), and social inclusion. A Pearson's bivariate correlation and structural equation modeling were conducted. The resulting model was reanalyzed in a multigroup analysis to test its invariance across self and proxy reports. Positive associations were found between the satisfaction of the BPN and the SDI. However, the SDI and social inclusion were positively associated only in proxy reports (βself = 0.07 vs. βproxy = 0.30). The tested model established positive relationships between the BPN and SDI in autonomy (βself = 0.21 vs. βproxy = 0.18), competence (βself = 0.47 vs. βproxy = 0.53), and relatedness (βself = 0.21 vs. βproxy = 0.23). Further research is needed to understand the factors leading to discrepancies between participants and proxies when relating the SDI to social inclusion in the context of physical-sport activity. However, the results obtained suggest that it would be optimal to develop contexts of practice for people with intellectual disabilities in which the satisfaction of their BPN is favored and that this has a positive impact on their motivation and social inclusion., (© 2024 The Author(s). European Journal of Sport Science published by Wiley‐VCH GmbH on behalf of European College of Sport Science.)

Introduction: Support staff within social care settings have expressed a need for resources to facilitate end-of-life care planning with people with intellectual disabilities. This study aimed to co-design a preliminary toolkit of end-of-life care planning approaches and resources that can be implemented in adult social care services for people with intellectual disabilities., Methods: An adapted Experience-Based Co-Design process was applied to develop a toolkit for end-of-life care planning with people with intellectual disabilities. A co-design group (the 'All Together Group') met six times from January to October 2023. The group comprised nine people with intellectual disabilities (including four researchers with intellectual disabilities, who also co-facilitated the workshops), five family members, five intellectual disability support staff, two intellectual disability service managers, and five healthcare professionals., Results: The All Together Group tested resources for and approaches to end-of-life care planning with people with intellectual disabilities, based on findings from a scoping review and a focus group study. Easy-read end-of-life care planning forms were deemed overwhelming and complicated, whilst visual and creative approaches were welcomed. Three new visual resources to support illness planning and funeral planning with people with intellectual disabilities were developed: (i) 'When I'm ill' thinking cards; (ii) 'Let's Talk About Funerals' conversation-starter pictures; and (iii) 'My funeral' planning cards. These three resources, alongside three positively evaluated existing resources, were included in a new toolkit for end-of-life care planning with people with intellectual disabilities., Conclusion: Through an iterative, flexible, inclusive, and comprehensive co-design process, a toolkit of three newly developed and three existing resources was created to facilitate support staff in doing end-of-life care planning with people with intellectual disabilities. Following a trialling process with support staff, the final toolkit was made freely available online., Patient or Public Contribution: The research team included four researchers with intellectual disabilities (A.C., D.J., L.J., and R.K.-B). Researchers with intellectual disability have been part of every step of the research process; from study design to data collection and analysis to dissemination of study findings.Intellectual disability service provider representatives (M.W., N.P., and S.S.) were part of the co-design group as well. Two of these representatives were also co-applicants in the overall project (N.P. and S.S.). The co-design group included people with intellectual disabilities, families, intellectual disability support staff and health and social care professionals. The study was supported by a Research Advisory Group comprising a variety of stakeholders, including people with intellectual disabilities families, intellectual disability researchers, representatives from intellectual disability organisations, and policymakers., (© 2024 The Author(s). Health Expectations published by John Wiley & Sons Ltd.)

Background: Special attention is required when considering any educational intervention aimed at its promotion and development. Our objective is to conduct an umbrella review of systematic reviews that gather evidence from relationships and sex education programmes tailored for individuals with intellectual disabilities. Methods: The protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocol. Systematic reviews were identified through a search in Web of Science, SCOPUS and PsychINFO, using the descriptors: 'intellectual disab*' AND 'sex*'AND 'systematic'. Findings: The results of the nine reviews included in the meta-review yield relevant outcomes related to 50 sex education interventions carried out with people with intellectual disabilities. This provided the opportunity to delve into the characteristics of these interventions to ascertain the accomplishments achieved to date. Conclusions: The findings serve as foundation to propose and promote new research on this important area of life, addressing the inequalities identified concerning the sexuality and affective-sexual education of people with intellectual disabilities. It offers valuable information for the educational, social and healthcare fields, facilitating the design of more effective and rights-respecting initiatives.

Background: People with intellectual disabilities may experience frailty earlier than the general population. This scoping review aimed to investigate how frailty is defined, assessed, and managed in adults with an intellectual disability; factors associated with frailty; and the potential impact of COVID-19 on frailty identification and management. Method: Databases were searched from January 2016 to July 2023 for studies that investigated frailty in individuals with intellectual disabilities. Results: Twenty studies met the inclusion criteria. Frailty prevalence varied between 9% and 84%. Greater severity of intellectual disability, presence of Down syndrome, older age, polypharmacy, and group home living were associated with frailty. Multiagency working, trusted relationships and provision of evidence-based information may all be beneficial in frailty management. Conclusion: Frailty is common for people with intellectual disabilities and is best identified with measures specifically designed for this population. Future research should evaluate interventions to manage frailty and improve lives.

The need to foster resilience amongst young people with intellectual disabilities is increasingly recognised within policy. Critically, understanding of the actual means by which this aspiration might be most sensitively and effectively met is considered weak. This paper reports on an exploratory case-study of a social enterprise community café -- "The Usual Place" -- that through the promotion of employability, seeks to promote resilience amongst its young 'trainees' with intellectual disabilities. Two research questions were set: "how is 'resilience' conceptualized within the organisation" and "what features within the organisation are significant in fostering resilience"? We identify a range of significant features associated with being able to successfully foster resilience -- the need for a foundational 'whole organisation'(settings) approach based on high levels of participation and choice; the negotiation of a constructive dynamic tension between 'support' and 'exposure'; and the embedding of these actions in embodied actions and day-to-day organisational activities.

Background: In people with intellectual disabilities and mental disorders and/or challenging behaviours, rates of psychotropic drug prescription are high. In clinical treatments and evaluations, all stakeholders should be involved in a process of shared decision-making (SDM). We aimed to investigate the perspectives of clients and their carers on clients' treatments with psychotropic drugs. Methods: We conducted a survey among adults with intellectual disabilities in a Dutch mental healthcare centre providing community, outpatient and inpatient care. Data were collected between January and June 2022. Questions focused on experiences with the provision of information, treatment involvement and SDM and participants' wishes in this regard. Findings: Respondents (57 clients and 21 carers) were largely satisfied with the overall care from their clinicians, and with how information on the pharmacological treatment was provided verbally, but written information was insufficient or not provided. Seventy per cent of clients and 60% of carers reported being involved in medication decision-making. However, over 75% of participants desired greater involvement in SDM and over 60% in medication reviews. Conclusions: Service users and representatives were satisfied about the treatment and verbal information on their psychotropic drug use. The provision of written information, the SDM process and ongoing evaluation of psychotropic medication use could be improved.

Background: Research into befriending for people with intellectual disabilities is limited. This study aimed to explore the impact, mechanisms of change, and limitations of a befriending scheme for adults with intellectual disabilities and/or autism. Methods: Participants were recruited using convenience sampling. Thirteen individuals with intellectual disabilities and/or autism were interviewed and data thematically analysed. Results: Four themes were generated: 'Something fun for me'; 'A good connection'; 'Increasing independence'; and 'A life less quiet'. Befriending had direct benefits through the activities undertaken and the befriending relationships themselves being fun and reducing isolation. Befriending facilitated belonging, improved access to mainstream activities, and fostered independence by providing safety and support. The importance of shared interests and external support for the relationship was highlighted. Conclusions: Positive outcomes of befriending were found, supporting existing literature and revealing new information from the voices of participants with intellectual disabilities themselves.

Background: We investigated the prevalence of swallowing difficulties and associated factors in people with intellectual disability. Methods: We included people aged 50+ receiving care for people with intellectual disabilities. The Dysphagia Disorder Survey (DDS) was used to assess swallowing difficulties. We determined the agreement between the DDS and swallowing difficulties in medical records. We used logistic regression analyses to explore associated factors. Results: One thousand and fifty people were included. The prevalence of swallowing difficulties was 43.8%. Swallowing difficulties were not reported in the medical records of 83.3% of these cases. Frailty (odds ratio (OR) = 4.22, 95% CI = 2.05-8.71), mobility impairment (OR = 2.50, 95% CI = 1.01-6.19), and mealtime dependency (OR = 3.05, 95% CI = 1.10-8.47) were independently associated with swallowing difficulties. Conclusion: Swallowing difficulties are prevalent in older people with intellectual disability but may be under-recognised. Frailty may be a good indicator for population-based screening for swallowing difficulties.

Background: Studies have found that presence of challenging behaviours and mental health problems limits employment for people with intellectual disabilities. This study investigates the associations between age, gender, living condition, level of intellectual disability, diagnoses, behaviour, mental health, and employment in adults with intellectual disabilities in Norway. Method: A cross-sectional community-based survey including 214 adult participants (56% men) with intellectual disabilities. Results: In our sample, 25% had no organised day activity, 27% attended non-work day care, 19% attended sheltered employment, or day care with production, without pay and 29% worked in paid sheltered employment. One participant attended mainstream employment. Moderate and severe/profound level of intellectual disability, possible organic condition and irritability significantly reduced the odds of employment (paid and unpaid). Conclusion: Findings suggest unequal access to the sheltered employment that was meant to be inclusive. More individualised evaluation of prerequisites is suggested to further facilitate employment for this group.

Background: Little is known about how health issues identified at the annual health check (AHC) are followed up and addressed, how participants self-manage their health in between AHCs, and what support they receive. This research aimed to explore this. Methods: People with intellectual disabilities (n = 12), and/or their supporters residing in Wales, were interviewed following their AHC and again at 6 and 11 months. A recurrent cross-sectional thematic analysis was undertaken. Results: Five main themes emerged from interview one: going for a health check, issues identified, and actions taken, supporting the self-management of health, the personal context, and addressing health inequities. Four main themes emerged from follow-up interviews: follow-up, supporting the self-management of health, the need for reasonably adjusted health services, and going for another health check. Conclusion: A broader system of support around the AHC is required if people are to achieve or maintain the best possible health.

Background: To improve the quality of palliative care, six evidence-based tools were implemented in 10 care services specialised in care for people with intellectual disabilities. Contextual differences were taken into account by using a participatory action research approach. Method: The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) structured the evaluation. Data sources were online questionnaires completed by 299 professionals at baseline (response 45.2%) and 250 professionals after 2.5 years (35.1%), 11 semi-structured group interviews with 43 professionals, field notes and implementation plans. Results: A total of 767 professionals and 43 teams were reached. The effectiveness of the intervention was demonstrated in an improved knowledge of palliative care policy and increased competences among professionals. 79% of the professionals adopted tools in the toolbox. The participatory action research method was perceived as valuable in driving change. Conclusions: Improving palliative care needs a context-specific, flexible approach, with involvement of all stakeholders.

Background: This study examines the extent of exposure to verbal violence experienced by people with intellectual disabilities and whether it differs based on their housing situation: living in the community, with family, or in a residential facility., Method: One hundred and eighty-nine people with intellectual disabilities were interviewed about their experience with verbal violence., Results: Eighty-six percent reported experiencing verbal violence in their lifetime and approximately 77% experienced it the past week. Participants were most likely to be yelled at, and friends were the most common perpetrators. While there were few differences by setting, people living with their families were more likely to be laughed at and marginally more likely to experience rude comments., Conclusions: Verbal violence is prevalent in the lives of people with intellectual disabilities in Israel. Interventions are necessary to assist people with intellectual disabilities to deal with such incidents, with possible additional supports needed for those living with family., (© 2024 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Previous systematic reviews of the relationships of people with intellectual disabilities have included consideration of intimate relationships. In this paper, we report a systematic review of papers describing friendship only., Method: A systematic qualitative meta-synthesis of the research exploring experiences of friendship as reported by people with intellectual disabilities., Results: Seven papers met the inclusion criteria for analysis. Three superordinate themes were identified. (1) Reciprocity, 'Someone who helps me, and I help them'. (2) The building blocks of friendships, 'I can tell her some secrets'. (3) Managing friendship difficulties, 'In real life it's much harder'., Conclusion: People with intellectual disabilities value friendship and actively engage in reciprocal exchanges. We explore the strengths and limitations of current research, clinical implications, and directions for future research., (© 2024 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Caring for people with intellectual disabilities poses substantial challenges. Nursing students' emotions, thoughts, and behaviors during their education in the context of people with intellectual disabilities, remain relatively unexplored., Objectives: To examine nursing students' emotions, thoughts, competence, and expected professional behaviors in care provision for people with intellectual disabilities, as well as to identify factors associated with their expected professional behaviors with this population., Design: A cross-sectional study using a closed self-report questionnaire and one open-ended question., Setting: The largest academic nursing department in Israel., Participants: Of 245 sophomore nursing students, 177 agreed to participate (71.4 % response rate)., Methods: The study measured feelings, thoughts, competence, and expected professional behaviors in care provision for people with intellectual disabilities based on the Multidimensional Attitudes Scale. One open-ended question addressed how students believe their competence in caring for people with intellectual disabilities could be improved during their nursing studies. A hierarchical linear regression analysis was performed to investigate the contribution of emotions, thoughts, and competence to explaining expected behaviors in care provision. The significance of the model and the R 2 were calculated. The open-ended question was analyzed by the constant comparative method., Results: Negative emotions and thoughts (β = -0.37, 95 % CI -0.47; -0.15 and β = -0.33, 95 % CI -0.39; -0.13, respectively), along with positive emotions (β = 0.25, 95 % CI 0.07;0.33), showed significant associations with expected professional behaviors. Qualitative analysis revealed three key themes: communication concern, knowledge gap, and curiosity. The findings of the open-ended question corroborate the quantitative findings., Conclusion: It is important to realize that in order to develop quality professional skills for caring for people with intellectual disability, nursing educators must adopt a deep discussion of negative emotions and thoughts with their students regarding people with intellectual disabilities. Ignoring these negative emotions and thoughts can exacerbate the neglect of people with intellectual disabilities' health needs., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Self-determination is associated with lifelong positive outcomes. Students with intellectual disabilities typically have lower self-determination than their peers. Universal basic education access offers schools the opportunity to rectify this disparity. This is the first systematic review investigating the school-based practices that target self-determination development for students with intellectual disabilities., Method: The review follows the PRISMA guidelines, spanning five databases (ProQuest databases, EMBASE, Scopus, Sage Journals, Taylor and Francis Online) from 2006 to 2021., Results: Across the 18 studies, the most used practice is the SDLMI. Research focuses on United States-based transition-aged students with mild to moderate intellectual disabilities. Social validity tends to be assessed in summative and informal ways. Students are not generally involved in decision-making about practices and individualisation of support., Conclusions: Self-determination development for this population can begin before puberty. Future research should critically investigate social validity and holistic integration of student self-determination learning opportunities throughout the pedagogical cycle., (© 2024 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: There is a critical need for the development of dependable and valid anxiety assessment tools suitable for people with moderate to severe intellectual disabilities, particularly those who speak few or no words. Distinguishing anxiety from distress caused by physical discomfort (pain) or characteristics associated with autism, prevalent in this population, necessitates specialised assessment tools. This study (a) developed a parent-report anxiety questionnaire tailored for individuals with severe to moderate intellectual disabilities, potentially with a co-diagnosis of autism, and (b) evaluated the psychometric attributes of this novel measure., Methods: A comprehensive approach involving literature reviews, inspection of existing tools, and interviews with clinicians and parents guided the creation of the Clinical Anxiety Scale for People with Intellectual Disabilities. The tool was completed by parents or caregivers (N = 311) reporting on individuals aged 4 or older with intellectual disabilities., Results: Exploratory factor analysis indicated a four-factor structure encompassing anxiety, pain, low energy/withdrawal, and consolability. The anxiety factor explained the most variance in scores (26.3%). The anxiety, pain, low energy/withdrawal subscales demonstrated robust internal consistency (α = 0.81-0.92), and convergent, divergent, and discriminant validity. Robustness of these subscales was further evidenced by test-retest reliability (ICC = 0.79-0.88) and inter-rater reliability (ICC = 0.64-0.71). Subgroup analyses consistently demonstrated strong psychometric properties among individuals diagnosed with non-syndromic autism (N = 98), children (N = 135), adults (N = 175), and across diverse communication abilities within the sample. Moreover, individuals diagnosed with both autism and anxiety exhibited significantly higher scores on the anxiety subscale compared to those without an anxiety diagnosis, while showing no difference in autism characteristic scores., Conclusions: The findings indicate that the Clinical Anxiety Scale for People with Intellectual Disabilities is a promising measure for use across diverse diagnostic groups, varying communication abilities, and with people with moderate to severe intellectual disabilities., (© 2024. The Author(s).)