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This chapter explores why digital participation is important for young people with intellectual or developmental disabilities, the extent of their digital participation, as well as the multiple environmental and personal challenges to developing digital competencies that allow for digital participation. The chapter explores the complexities of supporting digital participation and ways that digital competencies can be developed. Specific examples are given of research that has taken place in the UK, Sweden and Australia. Consideration is given to the response to the Covid-19 pandemic which has potentially changed the landscape of issues around digital inclusion due to the rapid move online of everyday activities.

Background: Intellectual disability (ID) is a neurodevelopmental disorder associated with a poorer health profile and higher mortality. Young people with ID have more sedentary lifestyles than their typically developing peers. Consequently, this group is at significant risk of developing lifestyle diseases (ie, noncommunicable diseases) later in life. Increasing physical activity and eating a healthier diet have been argued to be effective ways to improve the health of adolescents and young adults with ID. Digital interventions are a viable option for improving health behaviors. Objective: This research protocol describes a co-design approach using workshops to develop a digital intervention that promotes healthy behaviors, including increasing physical activity and eating a healthier diet, among adolescents and young adults with ID. Methods: A participatory design using a co-design approach will be applied as a strategy to include potential users of the digital intervention and other stakeholders in the research process, comprising research design, data collection, and data analysis. A total of 7 to 10 workshops will be conducted aimed at developing a digital intervention and will include procedures for assessing needs; facilitators and barriers to health promotion; physical, mental, and social well-being; participation; and relationships. The workshops will include 12 to 18 stakeholders with experience of clinical practice and research related to young people with ID, including relatives, as well as adolescents and young adults (aged 16-25 years) with mild to moderate ID. Participants will perform a mixture of individual and group work using whiteboards, sticky notes, felt-tip pens, cards, balls, stickers, and wireframe templates. Data analysis will take place concurrently with data collection as an iterative process. Transcribed data from the audio and video recordings of the groups discussions will be analyzed following a qualitative methodological procedure.Res, Funding Agencies|Swedish Research Council for Health, Working Life, and Welfare [2022-01303]

BackgroundA digital lag has been reported on access to the internet and performing internet activities for young people with learning disabilities in everyday life. AimThe aim of this study is to explore environmental opportunities and challenges when performing internet activities and how internet use influences social and community participation for young people with learning disabilities from the perspectives of the target group. MethodsAn inductive design was applied, with focused observations and follow-up interviews of 15 internet-using young persons with learning disabilities in their everyday settings. The data was analysed interpretatively using open coding. FindingsThe environment offered both opportunities and challenges in terms of the design of digital devices and digital support. Support from peers was often preferred. All participants performed internet activities related to social participation although not all used social media. Searching for information was performed, however, finding the information or understanding it was challenging and led to restricted participation in the community. ConclusionMore examples of internet use positively influencing social participation were found, contrary to community participation. It is indicated that concrete learning situations when using the internet for social participation were more adapted to the participants and promoted this type of participation, contrary to situations of internet use influencing community participation.

The COVID-19 pandemic has meant a rapid transfer of everyday activities to the online world. Information and communication technologies (ICTs) have become more embedded than ever in peoples lives. This investigation addresses how this change has affected the lives of people with intellectual disabilities (ID). A two-step design was used. A rapid review was conducted on empirical studies published between January 2019 and June 2021. Search terms related to ID, ICT use and COVID-19. A qualitative international bricolage was also conducted corresponding to author nationalities. Data gathered from the review and bricolage were analysed separately using thematic analysis and relationally synthesised. Digital solutions to provide access to COVID-19 information and guidance seemed inadequate but were seldom empirically studied. Digital poverty, literacy and exclusion remain significant issues for people with ID internationally. People and their carers experienced reduced and removed service provision, loneliness and impoverished daily lives during the pandemic; amelioration of which was facilitated by digital solutions. One solution often used was videoconferencing. Prior experience of digital participation, adequate finances, connection, support and digital literacy mentoring for both people with ID and those providing services and support facilitated digital inclusion. Digital exclusion during COVID-19 was exacerbated by sociopolitical, structural, individual and support-related barriers. Although awareness of digital exclusion appears to have been raised, the extent to which this has led to action and change remains unclear. Despite digital exclusion and digital participation benefitting continuation of life, social and emotional well-being and autonomy, COVID-19 has not provided the impetus to eradicate digital poverty for people with ID. Governmental support, digital education, creativity and problem solving are required to enable people with ID the human right to be

Vad handlar boken om? Den här boken är en lättläst version och handlar om hur unga med IF i Sverige använder internet. IF betyder intellektuell funktionsnedsättning eller utvecklingsstörning. Kunskapen i boken kommer från forskning. Jag som har forskat heter Kristin Alfredsson Ågren. Jag har också haft två handledare som har hjälpt mig med forskningen. Sammanfattning: Unga med IF använder internet ganska mycket Vår forskning visar att unga med IF använder internet ganska mycket. Men andra ungdomar använder internet mer. Många unga med IF spelar spel på internet. De använder oftast mobil eller surfplatta. Föräldrar till unga med IF är inte så oroliga för att det kan finnas risker med internet. Många behöver mer stöd för att delta på internet Många unga med IF tycker ändå det är svårt att till exempel använda dator. De kan också ha svårt att hitta information på internet. De flesta unga med IF behöver stöd för att använda internet. Ungdomar, föräldrar och personal kan tillsammans skapa nya stöd som gör det enklare att använda internet. Internet måste bli mer tillgängligt och information måste bli enklare att förstå. Då kan ungdomar med IF bli mer delaktiga i samhället., Lättläst version av avhandlingen: "Internet use and digital participation in everyday life: Adolescents and young adults with intellectual disabilities"

Internet use is an integrated part of everyday life, especially among young people. However, knowledge of this for young people with disabilities is scarce. This study investigates digital participation of adolescents with intellectual disabilities by comparing aspects of Internet use among adolescents with and without intellectual disabilities. Cross-sectional comparative design was used and a national survey from the Swedish Media Council was cognitively adapted for adolescents with intellectual disabilities aged 13-20 years. The results reveal that a significantly lower proportion of the 114 participating adolescents with intellectual disabilities had access to Internet-enabled devices and performed Internet activities, except for playing games, than the reference group (n = 1161). The greatest difference was found in searching for information. Analyses indicate that adolescents with intellectual disabilities are following a similar pattern of Internet use as the reference group, but a digital lag is prevalent, and a more cognitively accessible web could be beneficial., Funding Agencies|Linkoping University, Sweden; Foundation Solstickan, Stockholm, Sweden; Swedish Association of Occupational Therapy, Stockholm, Sweden

Background: In contemporary society internet and digital competencies are used to perform activities. Aim: The aim of this study is to investigate opportunities and risks of internet use as perceived by the parents of adolescents with intellectual disabilities (ID) in comparison with a national reference group of parents of adolescents. Methods: This was a cross-sectional study with group comparisons using a national survey. Analyses were carried out using Fisher's exact test and logistic regression to control for confounding factors. Results: A significantly higher proportion of parents of adolescents with ID perceive opportunities associated with internet use and playing games, and a lower proportion perceive risks with negative consequences, compared with the reference group. Significantly more parents of adolescents with ID perceive their adolescent never use smartphones and social media compared with the reference group. Fewer parents of adolescents with ID have concerns about online risks for their adolescents compared with the reference group. Conclusion and Significance: The results provide new knowledge for occupational therapists to support positive risk-taking in internet-use for adolescents with ID, in collaboration with their parents, to enable the development of digital competencies and digital participation in everyday life in a digitalised society., Funding: Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden

Background: Today everyday life depends on having access to, understand and use internet inorder to participate and take part in societal resources. This understanding can be complex forpersons with intellectual disabilities (ID) due to their cognitive impairments. It is even statedthat internet-use can be yet another part of daily life activities they are excluded from. Internet-use is claimed to involve risks, but also benefits for persons with ID, but there is a shortage inempirical studies with the target group ́s own opinion regarding this. Broader knowledge isacquired of internet-use in everyday life for adolescents with ID, as a precondition toparticipation. Aim: This study aims to explore and describe internet-use and doing internet activities at homeand at school among adolescents with mild and moderate intellectual disabilities. Method: The study has a qualitative inductive design using observations and interviews in thetwo settings; at home and at school. Participants are six adolescents with mild and moderate ID,from special schools in the middle-region of Sweden, between the ages 13-20, that use internetto some extent. Data was collected at 2 occasions/participant for about 2hours/participant/setting. The analysis was done using a qualitative content analysis. Result: Preliminary results show that adolescents with mild and moderate ID use internet both athome and in school, to a greater extent than was expected, but the doings of internet-activitiesvaries in the different settings. Both facilitating and hindering aspects are described by theparticipants. Pictures on the internet seem to be of support when using and navigating theinternet. Conclusion: Deeper knowledge regarding internet-use from the target groups own perspectivehas been gained. The results can be used in the different occupational settings and in furtherresearch to survey internet use and participation in internet-activities

Bakgrund: Strukturerna för den offentliga sektorn och hälso- och sjukvården förändras ständigt, och folkhälsorelaterade problem ökar. Exempel på detta är en ökad andel äldre i befolkningen, eller fetma och psykisk ohälsa hos unga människor. För att möta dessa förändringar och behoven hos klienter i arbetsterapeutisk verksamhet måste nya förhållningssätt användas. Ett sätt att under utbildningen utveckla studenters handlingsberedskap inför framtida insatser kan vara att medvetandegöra och främja ett entreprenöriellt förhållningssättgenom olika lärmoment. Entreprenöriellt förhållningssätt definieras som"ett sätt att se möjligheterna och göra något av dem". Syfte: Syftet är att beskriva och utvärdera lärmoment för att främja entreprenöriellt förhållningssätt hos studenter på Arbetsterapeutprogrammet. Metod: Två huvudsakliga lärmoment användes för studenterna, och uppföljande utvärderingar genomfördes via enkät med öppna och slutna frågor. Utöver detta anordnades workshop för lärare, som följdes av utvärdering. Resultat/preliminärt resultat: Lärmomenten för studenter innebar att arbeta i projektform i gruppmed ett aktivitetsproblem för en specifik målgrupp utifrån Design för alla under handledning. Uppföljande seminarium utifrån specifik litteratur genomfördes. Studenternas utvärdering visar vikten av att ha lärmoment om design och entreprenörskap i utbildningen. Många studenteruppgav att de kunde använda denna kunskap i arbetsterapeutisk verksamhet. Workshop genomfördes med lärare där begrepp inom entreprenörskap diskuterades och kreativa sätt att utveckla lärmoment för studenter inom detta lyftes. I utvärderingen uppgav merparten av lärarna entreprenöriellt förhållningssätt som viktigt inom utbildningen. Slutsats: Vikten av lärares förståelse för entreprenöriellt förhållningssätt identifierades. Entreprenöriellt förhållningssätt kan främjas genom att kombinera fler lärmoment för studenter. Genom detta kan studenter utveckla handlingsberedskap gällande utmaningar i ett

Introduction The structures of social and health care are changing, and public health related problems in Western Europe are increasing, such as an increased elderly population, obesity and mental health problems in young people. In order to meet the need of the clients in occupational therapy practice we have to look into new ways to approach the changing times. A way to support the students’ preparedness for action in the field is to encourage the use of an entrepreneurial mindset through different learning methods. An entrepreneurial mindset is defined as “a way to see the possibilities and make something out of them”. Objectives To describe learning methods to raise awareness and promote an entrepreneurialmind-set among OT students and teachers.Description/ReportThe learning methods for the students varies from working with a specific design problem in groups, discussing literature about entrepreneurship in seminars and get supervision from Innovation office. To enhance the teachers awareness about entrepreneurial mind-set workshops about how to find new non-traditional fieldwork placements in a creative way was conducted. Results/Discussion Our experiences of how the entrepreneurial mind-set can be encouraged are that entrepreneurship can be looked upon in different ways and should be seen close to the reality that one work in. Follow-up from workshops with teachersas well evaluations from the students about the entrepreneurial mind set will be presented. Primary results show that students feel more prepared for a new and creative way of thinking and that teachers have more entrepreneurial mind-set than they think in the beginning. Conclusion An increased entrepreneurial mindset can be learned/trained and used as a way of dealing with the future challengesin the health care sector for occupational therapists.

IRM är utvecklad av professor Renée Taylor, som är doktor i klinisk psykologi och professor i arbetsterapi vid University of Illinois i Chicago. Modellen beskrivs i hennes bok från 2008 The Intentional Relationship – Occupational Therapy and Use of Self. Syftet med modellen är att erbjuda en specifik begreppsapparat för ett medvetet användande av sig själv som arbetsterapeut och den behandlar händelser som förekommer i relationer mellan personer i en interventionsprocess. Dessa händelser påverkar såväl aktivitetsengagemang som utfall av intervention.

The aim of this study was to perform a literature review in order to present an overview of evaluations and interventions in occupational therapy for adults with intellectual disabilities. The search was conducted through the following data bases AMED, CINAHL, ERIC, OT Seeker, PsycINFO, PubMed and Scopus covering the period between 2000 (January) - 2010 (March). The search was limited to empirical studies in occupational therapy written in English and published in peer-reviewed journals. The search terms “developmental disability” “intellectual disability” learning disability” “mental retardation” “adults” and “occupational therapy”. The final sample that was examined was 22 papers. The result showed that eight of the papers focused on evaluation and three of these included assessments based on Model of Human Occupation (MOHO); Assessment of Communication and Interaction Skills, Assessment of Motor and Process Skills and Volitional Questionnaire. Interventions were described in 14 papers and these were categorized as focusing on function, occupation or environment. Nine of the 22 included papers were written by Swedish occupational therapists. In total six papers were related to MOHO. This shows that the model is a potential support in the implementation of evidence based occupational therapy practise for adults with intellectual disabilities.

The aim of this study was to examine the utility and content validity of the Swedish version of the Volitional Questionnaire (VQ-S). The participants in this study were thirteen occupational therapists selected because they worked with clients for whom the VQ-S is appropriate (in this case, adults with intellectual impairments) and because they had knowledge of the Model of Human Occupation. These participants completed a demographic questionnaire at the beginning of the study. Each therapist then used the VQ-S a total of six times and after each time they completed a questionnaire concerning the utility and content validity of the instrument. After having administered the instrument six times they completed a third questionnaire that assessed their perceptions of the VQ-S based on their total experience. Data from these questionnaires and the six assessment forms with the actual client ratings were analyzed using both quantitative and qualitative procedures. The findings indicate that the VQ-S has clinical relevance and potential for implementation with adults with intellectual impairments. They also support the content validity of the VQ-S.