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Universities and their employability-related staff must address the inequities that claim diversity as a disadvantage and a barrier to securing work integrated learning and graduate employment. With increases in equity groups enrolling at university there is a need to ensure access to employability opportunities. Graduate employability should be an accolade for students however it is not accessible, and ubiquitous for all. Student parents and carers are an invisible cohort that needs to be identified, and supported with their employability as they are a significantly growing population in higher education. This provocation will present the current landscape at university and offer three recommendations: the integration of career development learning and work experiences; data-informed systems and procedures; and collaboration and research into 'employability for inclusion.' This is required to build staff capability and organisational capacity and prepare our future workforce that is representative of today's society.

Background: Early childhood development (ECD) is pivotal in addressing educational inequality and reducing income disparities in South Africa. Government initiatives to integrate ECD into the education system underscore a positive trajectory. Aim: This study assesses the impact of relocating ECD to the Department of Basic Education (DBE) in South Africa on practitioner employment. Specifically, it investigates the challenges ECD practitioners face concerning compliance with DBE norms and standards, including qualifications, professional body registration and adherence to educator conditions outlined by the Education Labour Relations Council (ELRC). Setting: The study is conducted in South Africa, focussing on Gauteng, to examine the ramifications of relocating ECD to the DBE. Methods: Conducted as a qualitative study, this research examines the potential implications for practitioner employment by conducting interviews with practitioners from both formal and informal settings. Results: The study indicates that the anticipated policy shift has created uncertainty regarding their employment status among ECD practitioners. This uncertainty may compound sectoral challenges, underscoring the urgent need for government intervention and support. Conclusion: Addressing the concerns highlighted by this study is imperative before the transition of the ECD sector to a new ministry in South Africa. Additionally, government initiatives to formalise informal ECD centres and broaden access to subsidies are crucial for enhancing sectoral performance. Contribution: This research sheds light on the challenges confronting ECD practitioners amid policy changes in South Africa, stressing the necessity of government backing in formalising the sector and bolstering subsidy accessibility for improved performance within the South African ECD landscape.

Concerned with the ongoing youth mental crisis in the United States, researchers intentionally planned for positive youth development (PYD) practices in nature. Educators, appreciating the critical importance of youth developing relationships and a sense of belonging, may regard this model as a powerful tool to enhance existing programs. Both youth and parents report this as ahigh quality PYD program, resulting in thriving youth. Youth participants feel welcome, supportively challenged, and passionate about the topic; resulting in a growth mindset, hopeful purpose, and openness to challenge and discovery. The program inspired an affinity for nature in both youth participants and associated adults. 97% of youth and 95% of adult caregivers report being inspired to spend more time in nature as a result of the program. The program also inspired increased youth interest in science college and career opportunities.

SATB2-associated syndrome (SAS) is a genetic syndrome characterised by intellectual disability, severe speech delay, and palatal and dental problems. Behaviours that challenge (BtC) are reported frequently; however, there is limited research on specific forms of BtC and the correlates of these behaviours. The current study explores correlates of well-defined BtC, self-injury, aggression, and property destruction, in SAS. Eighty-one parents/caregivers of individuals with SAS (53.1% male, M[subscript age] 10.12 years) completed questionnaire measures of health, behavioural, emotional, and autism characteristics. Individuals with SAS were grouped based on caregiver responses to the presence or absence of self-injury, aggression, and property destruction on the Challenging Behaviour Questionnaire. Rates of self-injury, aggression and property destruction were 42%, 77% and 49%, respectively. Between-group comparisons were conducted to compare characteristics between behaviour groups. Significantly differing characteristics were entered into separate hierarchical logistic regressions for each form of BtC. Behavioural comparisons indicated variation in the characteristics associated with each behaviour. All hierarchical logistic regression models were significant (p < 0.001): self-injury (X[superscript 2](5) = 38.46, R[superscript 2] = 0.571), aggression (X[superscript 2](4) = 25.12, R[superscript 2] = 0.414), property destruction (X[superscript 2](4) = 23.70, R[superscript 2] = 0.346), explaining between 34.6% and 57.1% of the variance in behaviour presence. This is the first study to identify correlates of self-injury, aggression, and property destruction in SAS. Variability in the characteristics associated with each behaviour highlights the importance of specificity when examining BtC. Understanding correlates of specific forms of BtC has important implications for informing SAS-associated pathways to behavioural outcomes and the implementation of tailored behavioural interventions.

Purpose: To investigate the perceptions of parents/caregivers about the impact of oral conditions on the oral health-related quality of life (OHRQoL) of children/adolescents with autism spectrum disorder (ASD) compared to the perceptions of parents/caregivers of children/adolescents without ASD. Methods: A comparative cross-sectional study was conducted involving 80 children/adolescents with ASD three to 16 years of age matched by sex and age with 80 children/adolescents without ASD and their parents/caregivers. Clinical examinations were performed for the diagnosis of dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), visible plaque (VPI), bleeding on probing (BPI), malocclusion and traumatic dental injury (TDI). Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ), which measures OHRQoL from the perspective of parents/caregivers. Data analysis involved the Wilcoxon test, chi-squared test and Poisson regression. Results: Dental caries experience impacted OHRQoL in the group with ASD regarding the total P-CPQ score (p < 0.001) as well as the "oral symptoms" (p = 0.011) and "wellbeing" (p < 0.011) domains. No differences were found between the perceptions of parents/caregivers of children/adolescents with ASD and perceptions of parents/caregivers of children/adolescents without ASD (p = 0.721). Conclusion: Dental caries experience can have a negative impact on the OHRQoL of children/adolescents with ASD.

Previous research has supported selecting development-matched targets rather than age-matched targets to teach play skills to children with autism spectrum disorder. However, few studies have been conducted, and replications and extensions of this research are needed. The current study replicated Pane et al. (2022) by comparing the acquisition of development-matched and age-matched play targets when teaching play skills to four children with autism. No contrived prompts or consequences were used to teach play skills in either condition. Extensions included identifying targets via a newer version of the Developmental Play Assessment, targeting different play categories, assessing additional imitation skills, and conducting a caregiver assessment to identify socially valid toys, play actions, and vocalizations based on each participant's common experiences and preferences as well as their caregiver's values and preferences. As in Pane et al., participants demonstrated a higher level of scripted play actions in the development-matched condition.

Background: Child care quality rating and improvement systems exist to inform child care decisions and improve the quality of care. While previous research has shown QRIS have effects on quality, less is known about how child care providers vary in engagement and improvement within QRIS. In a voluntary QRIS, it is important to understand how providers vary in motivation, engagement, and progress within the system. Objective: Identify provider characteristics and attitudes that predict QRIS quality advancement. Identify and describe provider subgroups whose rates of quality improvement were different. Method: A random sample of providers (N = 179) and their coaches were interviewed five times over 2 years. The outcome was change in QRIS levels. Predictors were type of care, personal/professional characteristics, QRIS motivation, and coach perceptions of provider motivation and likelihood to advance. Linear regression was used to model change in QRIS level over five time points. Latent profile analysis was used to sort providers into classes. Results: Significant overall predictors of QRIS change were providers' education level and fewer years of experience, and coach's perception of the provider's likelihood to advance. Four subgroups in the latent profile analysis varied by rate of advancement, type of care, education, experience, professional engagement, QRIS motivation, and general readiness to change. Conclusions: Results point to the importance of assessing early and continuing attitudes, engagement, professionalization, and education of participating child care providers. The incentives and needs of providers in most QRIS will vary widely. Technical support geared to provider characteristics will be more effective in improving within QRIS.

Background: The aim of this feasibility study was to adapt and model a behavioural intervention for anxiety with autistic adults with moderate to severe intellectual disabilities. Method: Twenty-eight autistic adults with moderate or severe intellectual disabilities, 37 carers, and 40 therapists took part in this single-group non-randomised feasibility study designed to test intervention feasibility and acceptability, outcome measures, and research processes. Results: The intervention was judged as feasible and acceptable by autistic adults with intellectual disabilities, carers, and therapists. Minor intervention revisions were suggested. Carers completed 100% of outcome measures and the missing data rate was low. Complying with legislation governing the inclusion of participants who lack capacity to decide whether they wanted to take part in this study led to an average 5-week enrolment delay. Conclusion: The intervention and associated study processes were judged to be feasible and acceptable and should now be tested within a larger randomised trial.

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: Across the life course, women and girls with learning disabilities and their carers report difficulties in accessing information and support with menstruation, yet their experiences are often overlooked in initiatives to improve menstrual health and wellbeing. Our aim was to collaborate with women with learning disabilities to co-produce future research priorities in a UK context. Methods: We undertook a two-part scoping exercise to explore what is known about this topic from a life course perspective, beginning pre-menarche and extending to post-menopause support. This combined a rapid scoping review of the literature since 1980 with a stakeholder consultation where people with learning disabilities, family carers, advocacy groups and staff working across education, health and social care were invited to share their experiences of menstruation support. Findings: UK and international literature provided insight across five narrative themes. Seventy stakeholders took part in our consultation, enabling the identification of five key themes. Findings across both highlight examples of supportive practice and valued resources alongside enduring health inequalities and barriers to menstruation support faced by women and girls with learning disabilities across the life course. Conclusion: Our scoping exercise identified multiple gaps in research and practice, ongoing reproductive health inequalities and a need for improved access to peer support, resources and training that take a life course approach. The scoping exercise indicates the need for further empirical research on menstruation and learning disability, with a particular focus on collating people's lived experiences.

Kids SIP"smart"ER is a 6-month behavioral and health literacy intervention effective at reducing sugar-sweetened beverage (SSB) intake among middle school students and their caregivers in the rural Appalachian region. This exploratory mixed methods study utilized a convergent parallel design to assess participant acceptability of a school-based curriculum for students and a text messaging program for caregivers. Acceptability was assessed using surveys (873 students and 453 caregivers), five focus groups (34 students) and telephone interviews (22 caregivers). Quantitative data were analyzed descriptively, and qualitative data were content coded. On a 5-point scale, average quantitative survey acceptability ratings ranged from 2.7 to 3.3 among three student-rated questions and 4.1 to 4.2 among four caregiver-rated questions. Qualitative focus group findings suggested that students preferred curricular activities that were hands-on and involved social interaction, while caregiver interview results showed high acceptability of the text messaging program's design, including usability, content messages and personalization. Students and caregivers reported similar program benefits: increased knowledge of SSBs and health risks, increased awareness of SSB behaviors and support to make beverage behavior changes. Results from this study can be used to understand Kids SIP"smart"ER's effectiveness data, communicate the intervention's acceptability with stakeholders and plan for future implementation studies.

This study identified custodial grandparents' perception of sources of stress that may affect their health and better understand their needs. Findings from this qualitative study are based on thematic analysis of interviews with 10 custodial grandparents. The following themes emerged: (1) grandparents' stress from perceived lack of readiness to care for grandchildren; (2) need for effective communication between and among family members; (3) sufficiency of financial and legal resources; (4) access to community resources, and (5) raising grandchildren reenergizes and revitalizes grandparents' physical and mental health. These findings provide insight into the stressful aspects of the role of raising grandchildren. Understanding stressors affecting custodial grandparents and their grandchildren will help school nurses, social workers, teachers, school administrators and other professionals collaborate to address their challenges.

Challenging behavior (CB) is a common occurrence in early childhood and frequently occurs in young children with disabilities. CB is also culturally perceived and includes differences in how caregivers understand and define the topography of CB. Despite the cultural interpretation, CB is known to impact the child and their family but there has been little exploration of what marginalized caregivers perceive as the impact of the CB that their young children with disabilities exhibit. We used semi-structured interviews to explore the perceptions of 24 caregivers, who identified as Black, Mexican American, and White, about the impact of their child's CB. Caregivers shared how the CB impacted themselves, their families, their child, and others. Although much of the impact was similar among caregivers, we discuss nuanced differences across ethnic groups.

Caregiver coaching in early intervention (EI) can lead to positive outcomes for young children with delays and disabilities and their families. In response to the COVID-19 pandemic, some EI providers reported coaching caregivers more frequently. However, EI providers' use of caregiver coaching is inconsistent, and there is a need for more effective personnel preparation in this area. In this qualitative study we explored EI providers' beliefs about what factors contributed to their increased use of caregiver coaching during the pandemic. Participants reported two areas that contributed to their use of caregiver coaching: service delivery (e.g., telepractice, role changes, and caregiver expectations for services) and learning opportunities (e.g., personal growth and reflection, educational resources, and collaboration). Implications include the need for policies that allow and promote access to telepractice services and the importance of using a variety of adult learning strategies when delivering in-service and pre-service preparation related to caregiver coaching.

Childcare providers experience a variety of mental and physical challenges that impact their personal wellbeing as well as the quality of care they provide for children. Rural family childcare (FCCH) providers--an individual who professionally provides care to children within their home--may especially need resources to support their physical and mental wellbeing. An existing program, Here For You, For Them (HERE), may be able to support these providers; however, previous testing of the program has only been conducted in childcare centers. Therefore, the purpose of this pilot study was to assess the acceptability and feasibility of the HERE program for rural FCCH providers. 27 rural FCCH providers took part in a 16-week pilot study of the HERE program focused on mindfulness techniques and practices. Participants attended a monthly virtual training and received an activity pack consisting of different activity ideas including breathing techniques, mantras, yoga poses, and yoga stories. Participants completed bi-weekly implementation surveys and a post-intervention survey and semi-structured interview. Overall, the breathing activities were one of the most implemented activities and took the least amount of time (< 5 min). Providers stated they enjoyed the flexibility of the program and the activities but felt some of the yoga poses and stories were difficult to implement. Common barriers included challenges with children's behavior and the age of children as well as time constraints. Overall, the HERE program appeared feasible and acceptable for rural FCCH providers. Future efforts should consider providing additional wellbeing support for FCCH providers.

It is known that infant-directed speech (IDS) plays a key role in language development. Previous research, however, has also identified significant variability across societies in terms of how often IDS occurs. For example, some studies report very little IDS in non-western, small-scale societies -- including children growing up in small-scale societies in Tanna, Vanuatu. This is surprising given that IDS is widely assumed as a common feature of human caregiving based on research conducted in urbanised populations which are more well-studied. Here, we propose that IDS is only one of a suite of important caregiving behaviours that are produced during interactions with infants, which may vary by culture, perhaps being replaced by other, non-verbal infant-directed behaviours (IDB). We will examine previously collected data consisting of 94 semi-structured 10-min video observations of caregivers and their 18--24 month-old children in rural Tanna, Vanuatu and urban Vancouver, Canada to identify and compare the proportion of time caregivers spend engaging in IDS and IDB during these interactions, both within and between societies. We define IDS as caregiver speech or vocalisations during the interaction with the infant, and we define IDB as non-verbal behaviours that are produced with the infant during the interaction. This study aims to take a step towards a more generalised understanding of language development in children, moving beyond the urban and western societies in which our understanding of development is currently based, and the predicted results will aid in recognising different developmental pathways within multi-cultural communities.

CDKL5 deficiency disorder (CDD) results in early-onset epilepsy and lifelong cognitive and motor impairments. With no validated measure for communication in CDD, this study evaluated the psychometric properties of the Communication and Symbolic Behavior Scales-Developmental Profile Infant Toddler Checklist (CSBS-DP ITC). Caregivers (n = 150; affected individuals aged 1-29 years) completed the CSBS-DP ITC. Distribution of scores indicated a floor effect. There was poor divergent validity for the three-factor model but goodness of fit and convergent validity data were satisfactory for the one-factor model. Individuals with poorer overall functional abilities scored lower on the CSBS-DP ITC. Test-retest reliability was excellent. The floor effect could explain the very high reliability, suggesting problems as a sensitive outcome measure in clinical trials for CDD.

Attending a concert may prove difficult for individuals with exceptionalities or disabilities and those who support them. While traditional performance environments may not feel welcoming or amenable for individuals with exceptionalities and their families, arts organizations have recently made efforts to produce concerts that address barriers to accessibility. These adaptive concerts, most frequently labeled as Sensory-Friendly Concerts, attempt to create environments suitable for diverse communities, supporting individuals and groups who are frequently underrepresented as audience members in performance contexts. This article explores adaptive music performances, contributing a model for sensory-friendly adaptive concerts supported by caregivers' perspectives through a post-concert survey. The model proposed includes four areas of adaptation: pre-show work, environment audit, extra-musical aids, and programming adjustments. The authors outline the various modifications with data points from a sample of adaptive concert caregiver attendees (n = 15), aligning the theoretical model with practice to provide practical examples and tangible outputs for researchers, presenters, musicians, educators, and policymakers.

Objective: The purpose of this paper was to examine variables associated with food insecurity among community college caregivers during the COVID-19 pandemic. Methods: We used data from a multi-institutional survey of 15,051 caregivers enrolled at 130 community colleges in 42 states in fall 2020. We used a logistic regression to examine whether demographic, academic, caregiving-related, financial, or COVID-19-related variables were associated with caregivers' food insecurity. Results: Over half (52%) of community college caregivers experienced food insecurity. Transgender caregivers, first-generation caregivers, and caregivers who were divorced or single, had multiple disabilities, were previously in foster care, and had a family that experienced trouble making ends meet growing up had significantly (p < 0.05) higher probabilities of experiencing food insecurity. Community college caregivers who used childcare and those with at least one child up to 12 years old also had increased probabilities of experiencing food insecurity. Moreover, caregivers who felt childcare was not affordable and believed that they did not earn enough money to make employment worthwhile after paying for childcare expenses had higher probabilities of experiencing food insecurity, as did those who experienced housing insecurity and used Pell grants, student loans, and support from friends or family to pay for college. Losing a job, experiencing cuts to work hours or wages, employment as a frontline worker, and contracting COVID were associated with higher probabilities of food insecurity. Contributions: Community college caregivers experienced high rates of food insecurity during the pandemic and some caregivers were at greater risk of exacerbated probabilities of food insecurity. We advocate for targeted interventions, wraparound services, and increased advocacy for legislation to support student caregivers.

We aimed to identify unique constellations of sensory phenotypes for genetic etiologies associated with diagnoses of autism spectrum disorder (ASD) and intellectual disability (ID). Caregivers reported on sensory behaviors via the Sensory Profile for 290 participants (younger than 25 years of age) with ASD and/or ID diagnoses, of which [approximately] 70% have a known pathogenic genetic etiology. Caregivers endorsed poor registration (i.e., high sensory threshold, passive behaviors) for all genetic subgroups relative to an "idiopathic" comparison group with an ASD diagnosis and without a known genetic etiology. Genetic profiles indicated prominent sensory seeking in "ADNP," "CHD8," and "DYRK1A," prominent sensory sensitivities in "SCN2A," and fewer sensation avoidance behaviors in "GRIN2B" (relative to the idiopathic ASD comparison group).

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: Despite humanistic declarations regarding the rights of people with intellectual disability to live a full, meaningful life, in practice, resulting from dilemmas experienced by direct support provides, support is often limited to a focus on functional independence. The aim of this research was to define the theoretical principles by which the gap between humanistic declarations and practice can be overcome. Method: The research focused on the role perception of 30 direct support providers who participated in semistructured interviews. A case study methodology was used applying an interpretative phenomenological analysis (IPA). Findings: The interviews revealed that a humanistic perspective has been partially incorporated into the general attitudes of direct support providers. In practice, however, they indicated that they face dilemmas that challenge them in their daily work. Conclusion: To assist direct support providers in resolving their dilemmas, by adhering to humanistic principles, a 'humanization' model is offered. The theoretical principles underlying the model focus on meaningful life as the aim of support, enhancing recipients' autonomy, adhering to a holistic perspective and conducting dialogues acknowledging the abilities of people with intellectual disability to understand, choose and face challenges. Further examination of the model and its application in practice is recommended.

Family child care professionals are a critical sector of the early care and education workforce. Utilizing critical race theory and Yosso's Community Cultural Wealth model, the current study seeks to examine the strengths and assets that family child care professionals of color bring to their early care and education work and to the children and families in their programs. The authors identified evidence of four types of cultural capital (aspirational, familial, navigational, and resistant) in the focus group narratives of family child care professionals of color across four regions in the USA. Their narratives describe an orientation to caring for children and families that counters exclusionary and biased systems. The family child care professionals of color envision themselves as educators and supporters of community advancement in opposition to racialized stereotypes of home-based child care work as babysitting (aspirational capital); they leverage the home as a place for racial healing and sustain intergenerational connections with families through practices of othermothering and an ethic of love (familial capital). The family child care professionals of color describe the ways they enact navigational and resistant capital in their perseverance and participation in licensing and quality systems, despite inequities. The family child care professionals' counternarratives of family child care work suggest their essential role in societal functioning and well-being. The study's findings hold implications for (re)defining early care and education quality and (re)designing systems that celebrate and recognize the strengths, resilience, and capacity of family child care professionals of color to support equitable futures for children, families, and communities.

The telehealth model can allow for cost-effective supports in areas where limited applied behavior analysis (ABA) services are available. As a result, e-learning programs for parents of children with autism have become part of the telehealth paradigm. In the Czech Republic, one of the many places where there are limited ABA supports and no available ABA e-learning courses for families, the development of an e-learning course that is freely available, and linguistically and culturally appropriate, is needed. It was anticipated that this course could mirror some of the free e-learning materials available to English-speaking caregivers and provide foundational knowledge to later support more intensive ABA services. Therefore, a pilot study was developed to assess an ABA e-learning course for caregivers in the Czech Republic with the aim of validating its efficacy and assessing whether a synchronous component was needed for the best outcomes. The materials were not meant to replace best practices in more intensive caregiver training but provide foundational skills for later more successful local services. Results demonstrated that a total of 33 caregivers completed the course, making statistically significant gains in their ABA knowledge and rating the course highly. Interestingly, the addition of the synchronous component only impacted the knowledge gain outcome. Suggestions for supporting caregivers in e-learning course completion and directions for future research are additionally explored.

We are developing the Equitable Screening to Support Youth (ESSY) Whole Child Screener to address concerns prevalent in existing school-based screenings that impede goals to advance educational equity using universal screeners. Traditional assessment development does not include end users in the early development phases, instead relying on a psychometric approach. In working to develop the ESSY Whole Child Screener, we are integrating a mixed methods approach with attention to consequential validity from the outset of measure development. This approach includes end users in measure development decisions. In this study, we interviewed a diverse sample of school staff (n = 7), administrators (n = 3), and family caregivers (n = 8) to solicit their perceptions of the usability of the initial draft of the ESSY Whole Child Screener. We identified three overarching themes: (1) paving the road for implementation of a whole child screener, (2) potential roadblocks to use, and (3) suggested paths forward to maximize positive intended consequences. "Paving the road for implementation of a whole child screener" includes subthemes related to alignment with existing initiatives, comprehensive yet efficient design, and potential positive consequences of assessing the whole child. "Potential roadblocks to use" includes subthemes of staff buy-in, family comfort with contextual screening items, teacher accuracy, and school capacity to provide indicated supports. "Suggested paths forward to maximize positive intended consequences" include clear and precise messaging to staff and families, optimizing instrumentation and data collection procedures, and strengthening connections to data interpretation and use. We discuss next steps in the design and testing of the initial measure as well as assessment development more broadly.

The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (M[subscript age] = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha = 0.93) and test-retest (ICC = 0.95) reliability. Scores were normally distributed and sensitive to age (r = - 0.19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = - 0.35), and challenging behaviors (r = 0.57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children.

Background: Despite the enactment of disability laws/policies in India, research shows that caregivers of adults with intellectual and/or developmental disabilities experience inadequate formal supports/services due to dissemination barriers and lack of awareness about them. To address discrepancy between caregivers' support needs and the professionals' understanding of their needs, the study proposed to conduct a caregiver needs assessment so that culturally-tailored programs are developed. Method: A strengths-based mixed methods needs assessment was conducted with a convenience sample of 100 caregivers in Hyderabad, India. One hundred caregivers completed the survey and 15 caregivers participated in semi-structured interviews. Results: Caregivers needed more and improved formal supports/services, particularly from the government. Caregivers faced systemic and attitudinal barriers, and personal impediments to accessing them. Needs differed by care recipients' intellectual disability level, gender, and intellectual disability related conditions. Conclusions: Researchers, service providers and policymakers need to adopt innovative strategies to improve formal supports/services access.

This article presents the findings of a qualitative study of foster carers' and multidisciplinary practitioners' perceptions of foster carers' needs and existing practices in foster care in Ireland. This study explored participants' perceptions of the development of a trauma-informed care (TIC) psychoeducational intervention for foster carers. From a purposive sample of foster carers and multidisciplinary practitioners, four focus groups were carried out. Thematic analysis revealed three themes: The Need for Trauma-informed Care, Development of Trauma-informed Care and Implementation of Trauma-informed Care. The findings have informed the development of a culturally sensitive TIC intervention for foster carers that reflect the needs and practices of the Irish foster care context.

Early childhood home visiting programs are well positioned to improve equity and reduce health disparities for families headed by caregivers with intellectual disabilities and other learning differences. Early identification of learning differences through screening may help home visiting staff tailor services and thus improve family engagement and outcomes. Using a mixed methods design, this study assessed potential determinants and outcomes related to implementation of a screening tool for learning differences adapted for the home visiting context. Participants were six home visiting staff and nine caregivers from multiple home visiting programs in one state. Staff completed surveys at enrollment and each time they conducted a screen with a caregiver. Staff also completed semi-structured interviews after conducting screens with at least two caregivers. Caregivers completed semi-structured interviews after taking part in a screen. At study enrollment, staff felt it was important to know if caregivers had learning differences, yet some believed caregivers would not like being asked about them. Survey and interview data aligned with theoretical determinants of implementation success, including staff competencies related to screening (e.g., knowledge, skills), perceived fit of screening with staff role and organizational context, and beliefs that the screening would improve engagement of caregivers and service delivery. Staff perceived the tool to be acceptable, feasible, and useful, although some acknowledged that caregivers might feel uncomfortable if the tool was not used carefully. Overall, caregivers found the tool to be acceptable and most believed it was helpful for the home visitor to have information about their learning experiences and needs. Findings lend initial support for the use of an adapted screening tool to identify potential learning differences.

Despite the importance of family-centered practice in the Individuals with Disabilities Education Act Part C, a federally funded program for birth to two-year-old children with disabilities, there is a lack of research on Asian families who participate in early intervention in the U.S. This study examined the experiences of two Korean families and one Chinese family in early intervention in the U.S. Interviews were conducted and analyzed by bilingual researchers using ecological systems theory. As a multiple-case design study, the caregiver roles, beliefs, practices, and experiences related to their participation in early intervention were reported through within-case and cross-case analysis.

For caregivers of people living with major neurocognitive disorders (MNCD), adapting and applying methods optimizing learning (MOL) to a specific situation, based on preserved cognitive skills, can be challenging. This study aimed to 1) co-develop workshops, a web application and accompanying materials to support the operationalization of MOL; 2) better understand the factors influencing caregivers' use of MOL, and 3) evaluate the perceived effects of the workshops. A participatory action research study was conducted in collaboration with family caregivers of people living with MNCD and healthcare and community organization workers (HCOW). Qualitative questionnaires and interviews were conducted and transcribed in verbatim. Thematic content analysis was conducted. Workshops and accompanying materials were co-developed and continuously improved based on conceptual framework and feedback from the participants. The final version of the workshops consisted of seven two-hour sessions structured around the type of cognitive deficits affecting the realization of activities. Facilitators (e.g. help to identify the person's capabilities) and barriers (e.g. fluctuation of MNCD symptoms) for caregivers' use of the MOL were reported. The identification of the cause of reactive behavioral expressions could be challenging for some family caregivers, reducing the use of MOL. Caregivers mentioned their increased preparedness to support and relationship with the person living with MNCD and feeling of competence for analyzing the reactive behavioral expressions and to use MOL. This participatory action research has shown that caregivers can acquire abilities to adapt and apply MOL in specific situations with people living with MNCD.

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.

Studies on the COVID-19 pandemic highlight detrimental effects of social distancing on mental health. These effects were also observed among caregivers of people with intellectual and developmental disabilities (IDD), who undergo particular challenges in this context. This study aimed to identify the coping strategies adopted by caregivers of people with IDD in the period of social isolation during the COVID-19 pandemic and their relationship to signs of mental illness. Forty-eight caregivers of people with IDD who were users of a non-governmental organization for the assistance of people with IDD and their families in southeastern Brazil undertook an on-line survey. Data analysis included descriptive statistics, Pearson's correlation, multiple regression, and the word cloud technique. Results indicate that most caregivers employed healthy coping strategies and used negative words to describe their feelings towards the pandemic. Confrontation, withdrawal, self-control, social support, acceptance, and escape correlated with psychological symptoms (stress, depression, or loneliness). Those symptoms were more prevalent among participants using escape as a coping strategy. These findings indicate that caregivers of people with National Deworming Day (NDD) used mostly positive coping strategies to face the COVID-19 pandemic, which may have contributed to the low prevalence of psychological burden in this population.