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This paper describes methods and findings from student cognitive labs, teacher cognitive labs, and test administration observations as evidence evaluated in a validity argument for a computer-based alternate assessment for students with significant cognitive disabilities. Validity of score interpretations and uses for alternate assessments based on alternate academic achievement standards (AA-AAAS) for students with the most significant cognitive disabilities require nontraditional sources of evidence about student-item interactions and the influences teachers have on those interactions. Our findings provide evidence that the assessment has been designed so students can show what they know and can do on multiple choice, technology-enhanced, and teacher administered item types and that teachers administer the assessments in a way that allows students to respond as intended. We conclude with a discussion on how the findings inform future test development, limitations, and implications for the use of these research methods for gathering validity evidence for an AA-AAAS.

This study looks at the career choices of early adult girls with intellectual disability. Trade of vocation refers to the types of vocational environment and location i.e., open employment, sheltered employment and home-based employment. The present study aims to investigate the preferred trade of vocation for early adulthood girls with intellectual disability (mild & moderate). Survey method is used in the study. 28 early adulthood girls with intellectual disability (n=16 mild, n=12 moderate) between the age range of 18-25 years taken as a sample for the study. The researcher designed a questionnaire to identify preferred trade of vocation of early adulthood girls with Intellectual Disabilities. An unpaired t-test was utilized to perform statistical analysis on the data. The findings of the study shows that there is no significant difference between the preferred occupation for early adult girls with intellectual disability in relation to age and there is a significant difference in relation to the severity of the disability. And sheltered employment was preferred by most of the girls over open employment and home-based employment. In conclusion, it can be said that knowing the preferred vocation of occupation for early adult girls with intellectual disability can help them in better placement in employment.

The aim of this study is to examine the opinions of prospective teachers about biology and nature-related activities for mentally disabled students. The survey method was used in this quantitative study. Attitude scale towards biology and nature-related activities for mentally disabled students was used as a data collection tool. The scale was applied to a total of 258 (183 females, 75 males) prospective teachers studying at the education faculty of a state university and taking special education courses. According to the findings, prospective teachers expressed their positive opinions about all the activities specified in the scale. However, a few prospective teachers stated that some of the activities, especially interaction with animals, were not applicable for their mentally disabled students. However, when the findings are evaluated in general, it is concluded that biology and nature-related activities are very valuable for mentally disabled students.

This qualitative study examined supports in inclusive postsecondary education programs (IPSE) that facilitate the development of academic-related behaviors, or academic enabling behaviors (AEB; i.e., interpersonal skills, academic engagement, motivation, and study skills). The researchers interviewed 10 IPSE staff using semi-structured interviews and analyzed data using Consensual Qualitative Research (CQR). AEB supports existed at the individual, IPSE program, and university levels. Some supports addressed a single academic enabling behavior, and some addressed multiple areas. Six types of support spanned two or more academic enablers: (a) support from peer mentors; (b) support provided by IPSE and other university staff; (c) support related to courses/instruction; (d) opportunities for practice, reinforcement; (e) support related to social/emotional supports; and (f) executive function support. IPSE students can compensate for academic challenges by developing their enabling behaviors, and strong academic enabling behaviors can result in improved academic performance and assist IPSE students in employment and throughout life.

Students with intellectual disability should be able to engage in the same robust, authentic college experiences as their peers without disabilities. As opportunities for inclusive postsecondary education (IPSE) for students with intellectual disability have grown, the field has worked to understand the application of evidence-based practices in secondary transition and supports, such as promoting self-determination. The authors conducted a scoping review on self-determination and IPSE, with findings indicating a small but growing body of literature. Much of the literature addresses the topic generally through practice-based descriptions, and the authors provide recommendations for future directions in research and practice.

Little is known about OCD in people with learning disabilities (LD) in general and in terms of current and professional support. In this study, we examined caregivers' perceived challenges and strategies practiced in institutionalized settings in managing OCD in people with LD and derived implications for research and practice. We studied individual cases of people with LD (n = 7). Each case included group discussions (n = 28) and semistructured interviews with caregivers (n = 20). We used qualitative content analysis to analyze the data. Our findings reveal the following challenges for caregivers: recognizing and classifying ambiguous behaviors, recognizing emotional well-being and needs through nonverbal signals, finding and applying effective strategies, being unqualified regarding additional needs, managing inappropriate institutionalized conditions, and lacking external specialization. We identified five strategies for dealing with compulsive behavior: tolerating and allowing, accepting and supporting, involving, limiting the compulsive act, and stopping the act. Collaboration among psychiatric, therapeutic, and caregivers in institutionalized settings is critical for early identification and support of OCD. Challenges arise from caregivers' lack of training on the additional needs of people with LD and OCD, highlighting the urgent need for disorder-specific guidelines for identification and support.

College opportunities now exist for young adults with intellectual disability. Because of this, it is common for these individuals' parents to express a desire for increased student agency (Miller et al., 2018). Yet, little is known about how parents feel about how to best support agency development for their young adult child. In the current study, authors surveyed 64 parents with a student attending an inclusive postsecondary education program to examine their perceived level of confidence related to supporting their student in developing agency. Further, we looked at parents' responses to their perception of the most important skills related to supporting agency development. Findings showed that parents felt least confident in supporting students' financial independence and felt supporting navigation of intimate relationships to be least important. Implications for practice and directions for future research are presented.

This study aimed to identify the reality of the rehabilitation of people with intellectual disabilities and their employment from the point of view of their parents in the city of Mecca, where a questionnaire was designed as a tool for collecting data, and the sample of the study consisted of (142) parents of persons with intellectual disabilities enrolled in vocational rehabilitation programs in schools of intellectual education and institutes of intellectual education in the Holy City of Mecca, and were selected in a random way. The results of the study indicated that the reality of rehabilitation and employment of persons with intellectual disabilities came at a moderate level. The results showed that the obstacles to rehabilitation and employment came at a high level. The results also showed that there were no statistically significant differences ([alpha less than or equal to]0.05) in the following variables (gender, age, educational qualification), while there are statistically significant differences ([alpha less than or equal to]0.05) attributable to the variable (level of disability) where they appeared in favor of fragile syndrome in the level of reality of rehabilitation and employment, while in favor of Down syndrome in the obstacles that prevent rehabilitation and employment.

This study is a needs assessment of Extension staff in the state of Iowa to implement inclusive programming for individuals with intellectual and developmental disabilities (IDD). Electronic surveys were completed by Extension staff on their attitudes and beliefs toward people with IDD, inclusive programming, and training needs. Results showed that Extension staff had positive views, but that staff reporting personal experience with people with IDD had more positive attitudes and beliefs (p < 0.05). The greatest training need was instructional techniques. The study highlights the importance of direct experience in addition to knowledge- based workshops for training Extension staff to implement inclusive programming.

This study examines the multiplicative problem-solving strategies used by a 14-year-old student with autism spectrum disorder and intellectual disabilities during an instructional process based on the Conceptual Model-based Problem Solving (COMPS) approach. The instruction aimed to enhance conceptual comprehension of problem-solving by the use of model diagrams representing mathematical relations involved in word problems. These diagrams aid in selecting the appropriate operation for each type of multiplicative problem, including equal-groups, multiplicative comparison, and combination problems. We further discuss how the instructional process promoted conceptual understanding for the three problem types, highlighting the development of strategies (modeling, counting, and operations) and the pivotal role of the COMPS methodology components in this progression. The results indicate that the student adeptly adopted the COMPS approach, facilitating the transition from informal modeling to written operations, with his choice of strategies varying depending on the type of problem. While there was a higher utilization of modeling strategies in equal-groups and combination problems, modeling was not as frequently employed in comparison problems. We speculate how this differentiated strategy preference could be associated with certain characteristics of the disorder.

Background: Attitudes towards intellectual disability play an important role in the social inclusion and well-being of persons with intellectual disability. Few studies have examined attitudes of staff working in the specialised service industry, which may have an even greater impact. This study aimed to better understand these attitudes. Methods: A sample of 157 direct support professionals and 38 managers working with persons with intellectual disability completed the Attitudes Toward Intellectual Disability Questionnaire (ATTID; Morin, Rivard, et al. (2013). "Journal of Intellectual Disability Research," 57, 279-292). Attitudes were assessed along affective, cognitive, and behavioural dimensions. Results: Results revealed generally positive attitudes in both groups, but more paternalistic attitudes among managers and less positive attitudes in the general population. Positive attitudes were associated with level of education, frequency and quality of contact, and knowledge about intellectual disabilities. Conclusion: Workplace training programs addressing the aetiology of intellectual disability and interventions promoting self-determination may help enhance staff attitudes towards intellectual disability.

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: 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: 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: There is a paucity of theory-informed physical activity research with adults with intellectual disabilities. This study aimed to address this by synthesising existing literature and applying the COM-B model to understand capabilities, opportunities and motivations. Methods: A qualitative evidence synthesis was conducted and reported in accordance with PRISMA guidelines and the ENTREQ. Three databases were systematically searched up to and including February 2022. Qualitative research relating to the physical activity of adults with intellectual disabilities were included. Thematic synthesis was conducted with themes mapped onto the COM-B model. Results: Twenty-five studies were included. Influences of physical activity were identified and mapped onto the COM-B model, which also included COM-B influences of social support provided by caregivers. Conclusions: There are many complex influences of physical activity for adults with intellectual disabilities. Researchers should consider the influences contributing to caregivers' capacity to support physical activity.

Background: This exploratory study aimed to enhance the understanding of practitioners' experiences within LGBTQ+ community organisations when providing interventions for LGBTQ+ individuals with intellectual disabilities. Three specific objectives were outlined: to document the situations and challenges encountered by practitioners; to identify perceived needs among LGBTQ+ individuals with intellectual disabilities and to elicit their suggestions for recommendations to improve services. Method: A qualitative approach, involving in-depth interviews with 12 Québec-based LGBTQ+ community practitioners, underwent content analysis. Results: Findings were organised around three themes: perceived support needs of LGBTQ+ people with intellectual disabilities; challenges experienced in intervention and recommendations to improve services. Findings reveal that practitioners frequently face significant challenges when supporting LGBTQ+ individuals with intellectual disabilities, who often struggle with multiple daily challenges and insufficient support. Conclusions: The study highlights the need to empower LGBTQ+ organisations with essential skills and foster partnerships with public service staff to ensure a more inclusive, intersectional approach.

Background: Services for adults with intellectual disabilities in Hong Kong have a hierarchical staffing structure. Professional social workers, who performed as mid-level employees, work with frontline support workers to deliver services to clients. Methods: This qualitative study explored social workers' experiences of working with support workers through in-depth interviews with 13 participants. Findings: The study revealed that social workers perceived a significant variation between themselves and support workers in terms of working motivation, values and attitudes towards clients with intellectual disabilities. Despite the hierarchical relationships, social workers and support workers share the power of service decision-making. Social workers used firm and gentle approaches to facilitate changes in practices to uphold service values. These findings were compared with Western literature on this topic, indicating similarities and differences. Conclusion: The organisations need to facilitate an effective collaboration between social workers and support workers to enhance the quality of services for adults with intellectual disabilities in Hong Kong.

Background: Many people view people with intellectual disability primarily as needing help. That perspective limits relationships and can promote discrimination. We sought to better understand social relationships among young adults with intellectual disability. Method: Seven postsecondary students with intellectual disability participated in a photovoice study, sharing photos and stories about giving and receiving help. They participated in individual interviews, a group meeting, and a photo exhibition, and helped identify results and conclusions. Results: Participants viewed themselves as helpers and recipients of help. Themes were: foundational importance of families; openness to being helped; personal growth through challenging experiences; and tension between wanting to help and risks of helping others. Participants wanted to raise awareness that people with disabilities can help others, educate them about disability, and contribute to research. Conclusions: Many young adults with intellectual disability want to contribute to relationships, which are often limited by others' expectations about disability.

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: 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.

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: The review aimed to investigate the effectiveness of parent-child relationship interventions for families of children with intellectual disability up to 12 years old. Methods: Quasi-experimental or randomised controlled trials (RCTs) of interventions targeting the parent-child relationship where =50% of children had an intellectual disability were included. Meta-analyses of parent-child relationship outcomes and child outcomes used standardised mean difference as the effect size. Results: Twenty-seven papers were included (N = 1325). Parent-child relationship outcomes improved significantly (n = 1325; g = 1.08, 95% CI: 0.64, 1.52) with a large effect size that was robust to sensitivity analyses. Child developmental outcomes improved significantly (n = 1082; g = 0.65, 95% CI: 0.23, 1.07), and indicated a large effect size for child socialisation and communication. Conclusions: Findings suggest that interventions targeting parent-child relationship quality are associated with substantial improvements in parent-child relationship and may improve child outcomes related to socialisation and communication.

This study investigated how the school experiences and personal characteristics of youth with Intellectual Disabilities (ID) contribute to their longitudinal trajectories of anxiety. To this end, we relied on a sample of 390 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged from 11 to 22 (M = 15.70), and recruited in Canada (n = 140) and Australia (n = 250). Across three yearly time points, all participants completed self-report measures of anxiety, school climate, and victimization. Our results revealed a slight normative decrease in anxiety over time and showed that experiences of school victimization were associated with higher levels of anxiety (initially and momentarily) and increases in victimization were accompanied by increases in anxiety over time. Perceptions of attending a school that fosters security and promotes learning also tended to be accompanied by lower levels of anxiety (initially and momentarily). Momentary increases in perceptions of attending a school that fosters positive peer interactions were associated with momentary decreases in anxiety, whereas momentary increases in perceptions of attending a school characterized by positive teacher-student relationships and an equitable treatment of all students both led to small momentary increases in anxiety once all other components of student school experiences were considered. The theoretical and practical implications of these results are discussed.

Children with intellectual and developmental disabilities (IDDs) require intensive multicomponent interventions to learn to read. Parent-implemented interventions have been shown to be effective for children with disabilities and are one potential method for providing intervention. This study used a multiple probe single case design to evaluate the effectiveness of an early multicomponent reading intervention implemented by parents in the home. This study was designed as a conceptual replication of Lemons et al. in response to concerns with the overall quality of instruction during schooling at home during the COVID-19 pandemic. Three U.S. parents of children with IDD (ages 4-7 years) participated in this study. Results indicated that with systematic training, coaching, and feedback, parents were able to positively impact their child's reading abilities and implement the intervention with fidelity.

Physical health habits including physical activity and nutrition are essential for numerous health benefits. However, beginning in childhood, individuals with intellectual disability engage in lower levels of physical activity and healthy nutrition habits compared to individuals without intellectual disability, a trend that carries on into adulthood. Researchers continue to examine the effectiveness of interventions to increase engagement in physical health habits and improve health outcomes for individuals with intellectual disability, with an increased focus on technology-based interventions. This scoping review aimed to describe how technology was being utilized within interventions to improve health-related outcomes for adults with intellectual disability. We described the technology being used, who used the technology, and the feasibility of the interventions. Forty-one studies met criteria, with a total of 698 adult participants with an intellectual disability. While no studies on nutrition were located, technology was used in various physical activity interventions, with the most common being preferred stimulus access, exergaming, and video-based instruction. Most studies took place at day or rehabilitation centers, were implemented by research teams, and either did not discuss cost or were vague in their description related to cost. Implications, limitations, and future research directions are discussed.

Timely diagnosis of dysphagia is important for people with an intellectual disability. Periodic screening of each individual by speech-language therapists is barely feasible with respect to limited resources. Therefore, preselection of individuals with an increased dysphagia risk through screening by caregivers is crucial. This study aimed to develop the novel "Screening instrument for Dysphagia for people with an Intellectual Disability" (SD-ID).The SD-ID was developed, validated and optimised in two rounds. Version 3, consisting of nine risk factors and 20 items concerning eating/drinking behaviour, was thoroughly studied for feasibility, concurrent validity and reliability, and then optimised. The SD-ID (version 3) was filled out in an average of four minutes (feasibility). A strong positive association was found between scores on SD-ID and Dysphagia Disorder Survey (concurrent validity). Test-retest and interrater reliability were very good. Two additional risk factors were added and two items removed to yield the final version 4. The most optimal cut-off score appeared to be either 4 or 5.The SD-ID is a reliable instrument to screen for an increased risk of dysphagia in people with an intellectual disability. Ideally it is part of a cyclic work process: Screening with SD-ID (step 1), diagnostic work-up if necessary (step 2), recommendations (step 3), and evaluation (step 4).

Word problem solving is the premise for students to generalize their problem solving skills to real world problems. This includes students with autism spectrum disorder (ASD) and intellectual disability (ID). Modified Schema-based Instruction (MSBI) is one strategy that research has shown is effective for teaching students with ASD/ID to acquire and generalize problem solving skills. The key word strategy is an ineffective strategy for teaching students to problem solve, especially since problems in everyday life do not contain key words. This article provided a practitioner friendly 7-step strategy for implementing MSBI with learners who have ASD/ID

Learning Disability Liaison Nurses have been shown to improve hospital experiences and this is an emerging role in Ireland. This research qualitatively explored the impact of a Clinical Nurse Specialist Acute Hospital Liaison from the perspective of staff in an intellectual disability community organisation. Participants identified significant challenges with supporting people attending hospitals including accessing and understanding information, anxieties and not being prepared for transitions through the hospital. The findings demonstrate the introduction of this role is a supportive, positive step with reports of improved information sharing, feeling better prepared and alleviating anxieties related to supporting someone in hospital. The findings clearly identify that this role has considerable benefits when set in a community organisation. This role has had a positive impact on service users and staff when interacting with hospitals, providing evidence of the value of this role in Ireland and also of they having a specialist qualification in the role.

This study aimed at analyzing the differences in challenging behaviors between adults with intellectual disability and ASD and those who only had intellectual disability, as well as to explore associations between transdiagnostic and clinical variables to these differences. Therapists and educators of 163 adults with intellectual disability (83 with additional ASD diagnosis) completed the test battery. Mean difference analysis and univariate analyses of covariance were performed to determine the impact of clinical variables and transdiagnostic variables on the frequency and severity of challenging behaviors. Results showed that adults with ASD and intellectual disability presented higher frequency and severity of these behaviors. A significant effect of the diagnosis of ASD on the frequency and severity of self-injuries and stereotypies was found. Also, some transdiagnostic variables influencing the presence of these behaviors were highlighted. These factors should be considered when planning and designing interventions for behavioral problems in this population.

Aggressive and violent behaviour is a challenging psychiatric emergency to manage, especially among vulnerable categories such as patients with Intellectual Developmental Disorder. Although there is some evidence that clozapine may be useful as an anti-violence compound, its use is limited by common metabolic complications. An adult patient presented with obesity, type II diabetes mellitus, compulsive food intake, severe Intellectual Developmental Disorder, and a treatment-resistant aggressive behaviour. Clozapine was administered resulting in reduced aggressive behaviour. Unexpectedly, a reduction in the food craving as well as a sustained improvement in both anthropometric parameters and glycemic control were observed during the clozapine treatment. Our case report, describes these findings for the first time, highlighting the need for more clinical research to investigate both the efficacy of clozapine in the Intellectual Developmental Disorder populations and its long-term effects with special regard to the metabolic outcomes in this type of patients.

This study examines how intellectual disability nurses employed in residential living services for persons with intellectual disabilities, in Norway, deal with medication management for these individuals. Using a qualitative study, a total of 18 intellectual disability nurses were interviewed as part of four focus groups. The results demonstrate six main challenges: First, Being alone with the responsibility of medication management - a challenge; Second, The need for further competence development; Third, Teaching and supervising unskilled colleagues in safe medication management; Fourth, Interpreting residents with little or only nonverbal communication; Fifth, The need to act as advocates when residents require hospitalization; Sixth, Deficient systems for medication management on several levels. The findings point to several major flaws in the system of medication management, which necessitates the need for highly qualified intellectual disability nurses. Managers must ensure that there is a secure system to mitigate errors and promote patient safety.

Transition outcomes for Black youth with intellectual and developmental disabilities are especially dire, lagging even further behind already poor outcomes among their White peers. Self-determination is a key factor in predicting better outcomes, but it is unclear how self-determination is fostered or hindered within the transition process for Black youth and their families. This study used the DisCrit framework to analyze interview data from Black students with intellectual and developmental disabilities and their parents regarding self-determination and effective transition services. Analysis resulted in four major themes: historical undertones, proxies for racial bias, spacialization of racialization, and interest convergence. Implications for future research, policy, and practice are discussed.

The employability of the intellectually challenged has received little attention in the past. In order to fill this research gap, the present study was undertaken. The study is centered on the experiences of six intellectually challenged individuals who received employability training at a non-governmental organization. A focus group discussion along with a case study was conducted. The researchers employed the Rigorous and Accelerated Data Reduction (RADaR) technique to analyze the data from the focus group discussion. Results from both the focus group discussion and the case study revealed that the training program has had a significant impact on the lives of the participants and has aided them in becoming economically empowered and independent.

This study reports on a five-year data set about the deaths of 599 individuals in New South Wales Australia, who at the time of their death were living in out-of-home care. Analysis aimed to: i) gain a clearer understanding of place of death for people with intellectual disability; and ii) identify and analyse associated variables to investigate how well they predict place of death for this population. Hospital admissions, polypharmacy and living situation were the strongest standalone predictors of place of death. A hospital death was more likely if the target population were subject to polypharmacy, lived in a group home, had a moderate intellectual disability or had GORD. Death, and place of death, is an issue requiring individual consideration. This study has identified some of the variables that need attention when supporting people with intellectual disability to have a good death.

People with intellectual disabilities (ID) have high levels of sedentary behaviour and co-morbid health conditions. There is also increased longevity for this group which is an incredible success story but one which also poses challenges to the health system. For the first time, the mainstream health system needs to plan for and address age related health needs of people with ID. It also demands consideration of age-appropriate health-promotion efforts to support this ageing population with life-long disability. A physical activity programme, People with Intellectual Disability as Physical Activity Leaders (PPALs), was co-designed and co-developed with older adults (40+ years) with intellectual disability (ID). The process, content and outcomes of the pilot are presented in this paper. Expertise from three sectors: non-statutory academic and people with intellectual disabilities and their supporters worked collaboratively for successful completion of the project.

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.

In Ireland, the provision of behavior support services has developed following the introduction of Health Information and Quality Authority (2013) standards and the regulation of Positive Behavior Support (PBS) under the Health Act (2007). The purpose of this study was to explore what factors facilitate and act as barriers to implementation of behavioral recommendations in Intellectual Disability organizations from the practitioner's perspective. Twelve interviews were carried out, audio recorded, transcribed and analysed using Braun and Clarke's (2006) Thematic Analysis. One superordinate theme (administrator support), four themes (values, resources, relationships and implementation of consequences) and five sub-themes (staff turnover and burnout, training and knowledge, time and physical contact, relationships between practitioners and staff and staff and service users) were identified, all interconnected in the implementation process. A common thread reflected throughout the themes, was the practitioner's acknowledgment of barriers overpowering facilitation which resulted in a less than optimum implementation of PBS.

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.

The construct of belonging has been studied in many marginalised student groups yet has been understudied among students with intellectual disability. The present study used a large dataset from the United States to quantitatively investigate the construct of belonging among 7th to 12th grade students with the educational classification of "intellectual disability" (n = 670) who responded to a set of questions related to belonging in a nationally representative survey. The purpose of the study was twofold: (1) to identify the latent factors of belonging among students with intellectual disability to create a preliminary model and (2) use the preliminary model to compare belonging among students with intellectual disability with different demographic factors (e.g., race, sex, English proficiency). Exploratory factor analysis revealed a four-factor model of belonging and confirmatory factor analysis suggested the model was a good fit for the data, X[superscript 2] = 622.81, p < 0.001, RMSEA = 0.049, CFI = 0.879, TLI = 0.868. The study has implications for future avenues of research, including measurement development, exploring the developmental pathway of belonging, and the consequences of not belonging.

Many international organizations have called on governments to make inclusive schooling for children with disabilities a priority. Although the number of children with disabilities enrolled in France's mainstream schools has doubled over the last 15 years, inclusion rates vary according to type of disability and educational stage. Another important parameter is the efficacy of inclusive schooling, which may depend on teachers' attitudes toward working with students with disabilities. In the present study, we used measures of 440 in-service teachers' and 135 pre-service teachers' attitudes toward inclusive education to investigate possible links between these attitudes and three variables: teacher status (pre-service vs. in-service), educational stage, and type of disability. Participants completed the Multidimensional Attitudes Toward Inclusive Education Scale between January and April 2021, giving responses with respect to inclusive education in general and to five categories of disabilities. In-service and pre-service teachers had similar attitudes toward inclusive education in general, but pre-service teachers had significantly more positive attitudes than in-service teachers toward students with cognitive disabilities, sensory disabilities, and motor disabilities. Our findings suggest ways for promoting the inclusion and well-being at school of both non-typically developing and typically developing children.

It is important that educators understand how to adapt their health education lessons to ensure they are inclusive of all students. This article provides six strategies for teaching health education to students with intellectual disabilities, both in the classroom and in physical education class, to improve their health literacy.

Preliminary evidence from the Childhood Joint Attention Rating Scale (C-JARS; Mundy et al., 2017) suggests symptoms related to diminished joint attention and the spontaneous sharing of experience with others can be assessed with a parent-report measure in children and adolescents with autism. This study was designed to expand on the previous study by examining the validity of both a Social Symptom (SS) and a Prosocial (PS) scale of the C-JARS in a study of school-aged autistic children (n = 89) with and without co-occurring intellectual disability (ID), as well as an age matched neurotypical sample (n = 62). Results indicated that both C-JARS scales were sensitive and specific with respect to identifying the diagnostic status of the children. In addition, the PS scale was sensitive to differences in cognitive abilities (IQ) and sex differences in the autism group. These results are consistent with the hypothesis that joint attention and spontaneous sharing of experience symptoms are not only characteristic of preschool children with autism but may also constitute a developmentally continuous dimension of the social phenotype of autism that can be measured in school-aged children.

Purpose: The heterogeneity of autism is well documented, but few studies have studied the heterogeneity of gesture production ability in autistic children. The present study aimed to identify subgroups of autistic children who displayed heterogeneous gesture production abilities and explore the underlying factors, including autism characteristics, intellectual ability, and language ability, that were associated with the heterogeneity. Methods: A total of 65 Chinese autistic children (mean age = 5;3) participated. Their autism characteristics and intellectual ability were assessed by standardized measurements. Language output and gesture production were captured from a parent-child interaction task. Results: We conducted a hierarchical cluster analysis and identified four distinct clusters. Cluster 1 and Cluster 2 both had low gesture production whereas Cluster 3 and Cluster 4 had high gesture production. Both Clusters 1 and 2 had relatively strong autism characteristics, in comparison to Clusters 3 and 4. Conclusions: Our findings revealed that children with stronger autism characteristics may gesture less often than those with weaker characteristics. However, the relationship between language ability and intellectual ability and gesture production was not clear. These findings shed light on the directions of intervention on gesture production for autistic children, especially those with stronger autism characteristics.

Little is known about care providers' expectations for children with autism spectrum disorders (ASD) and intellectual disabilities (ID) in Ghana. This study used group concept mapping (n = 9) and a quantitative survey (n = 128) to explore and compare service providers' and parents' expectations for children with ASD or ID. Data were analyzed using hierarchical clustering procedures and Multivariate Analysis of Variance (MANOVA). Concept mapping results revealed several expectation clusters, including "independence," "love and acceptance," "equal social rights and opportunities," and "professional and caregiver training." MANOVA results revealed significant differences between parents, teachers, and healthcare providers in their perceptions of the importance and likelihood of a child achieving these expectations. Results are discussed in reference to the cultural context, and implications are outlined.

Background: Long-term care services are funded primarily by Medicaid long-term services and support in the United States, where eligibility is based on care needs of the individual with intellectual and developmental disability alone. Impact of Medicaid waiver services on self-reported caregiver needs is not well understood. Method: Caregivers (n = 405) of individuals with intellectual and developmental disabilities across four states (NY, OH, TX, and PA) completed an online survey. Results: Caregivers reported a moderate degree of burden and susceptibility of stress-induced health breakdown. Despite controlling for the activities of daily living of the care recipient, caregivers of individuals with Medicaid Waiver services reported greater difficulty managing medications (p = 0.013) and finding paid help (p < 0.001) than caregivers of individuals without services.

Background: Tailored sexuality education for adolescents with intellectual and developmental disabilities is a crucial, yet unmet, need as this population is particularly at risk for sexual abuse and victimisation. However, there are no evidence-based interventions to specifically address this need. This paper presents the development of an intervention framework to address equity in sexuality education and support adolescents with intellectual and developmental disabilities to understand and provide sexual consent, a foundational aspect of sexuality education and sexual health. Methods: The Sexual Health Equity Project team used a Community-Based Participatory Research approach to develop a four-module sexual consent intervention for adolescents with intellectual and developmental disabilities. We leveraged a diverse, interdisciplinary team in a suburban Midwestern school district, and used Backward Design to create objectives and assessments which were rooted in findings from qualitative data by special education teachers. Results: The resulting sexual consent intervention, "Ask Me First--Choices," is comprised of four modules covering topics including definition of sexual consent; decision-making strategies and practice; communicating consent and refusal, identifying situations of consent and non-consent; and legal issues surrounding consent. Each module is divided into five components for content delivery: (1) introduction, (2) lecture, (3) supplemental activity, (4) assessment, and (5) conclusion. We detail the intervention's unique aspects, emphasising areas where we used Universal Design for Learning principles to support teachers' instruction and students' learning. Conclusion: Our efforts to create a sexual consent intervention directly address sexuality education equity issues. We offer commentary on our design process and decisions, as well as recommendations for future groups who want to develop sexual health interventions in similar contexts for students with intellectual and developmental disabilities. Next steps include further testing and validation of the sexual consent intervention to build the evidence-base of sexuality education for adolescents with intellectual and developmental disabilities.

Background: Children with intellectual and developmental disabilities are at a higher risk of developing dental caries. Few scoping reviews have been conducted in India to understand their issues. We aimed to summarise the distribution and risk factors of dental caries among children and adolescents with intellectual disabilities in India. Methods: A scoping review was conducted based on the Arksey O Malley framework. Quality assessment of studies, descriptive and thematic analyses were also conducted. Results: We charted, collated, and summarised from four databases. Thirty-one studies met the study criteria consisting of children and adolescents with intellectual disabilities. Median caries prevalence was 70%, decayed missing and fIlled permenant teeth (DMFT) was 2.4, decayed missing and filled decidous teeth (dmft) was 2.36, and DMFS was 3.7. Major determinants were the severity of disability, socioeconomic status and parents' education. Oral care and dental visits were inadequate. Conclusion: Further exploration is required to improve access and reduce caries experience and prevalence among children with intellectual and developmental disabilities in India.

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: Research suggests that a better awareness of how staff who directly support people with intellectual disabilities experience their working relationships, will contribute to understanding staff wellbeing and the quality of care they offer. This study aimed to gain insights into the lived experiences of support workers in supported living services in England. Method: Six support workers participated in semi-structured interviews, about their working relationships with service-users and colleagues. Data was analysed using interpretative phenomenological analysis. Results: Six interconnected themes emerged: The essence of good relationships; a trusting relationship as the vehicle for meeting service-users' needs; belonging to the support team; the organisational context of relationships; the social context of relationships; 'a fine balancing act'. Conclusions: The findings provide insights into staff wellbeing, indicating that developing supportive, trusting relationships with both service-users and colleagues, plays an important role in delivering effective care. Potential implications for service providers are discussed.