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Objective: Psychosocial rehabilitation has been established as a critical component of client-centered recovery-oriented services for people with serious mental illness. Despite its importance, the implementation of mental health rehabilitation services in low- or middle-income countries has not been well studied. In this study, the authors document the regional challenges of planning and implementing mental health rehabilitation services in clubhouses in Hunan Province in the People's Republic of China.Methods: Participants were purposively selected and consisted of diverse stakeholders, including rehabilitation directors and psychiatric hospital leaders in Hunan Province, China. Information was collected from 33 individuals by using three focus groups, 23 semistructured interviews of key informants, and participant observation. Interview transcripts were coded and analyzed by using standard qualitative methods.Results: Implementation challenges were characterized by four themes: skepticism toward psychosocial rehabilitation services, resource shortage, insufficient system integration and incentives, and stigma of mental illness.Conclusions: Psychosocial rehabilitation is an emerging public health priority in China. This study on clubhouses in Hunan Province used qualitative methods to inform future directions for service development and research. Early identification of regional implementation challenges is a first step in assessing the applicability of psychosocial rehabilitation services locally in Hunan Province. Successful implementation of clubhouse psychosocial rehabilitation services will benefit not only from strong government commitment but also from developing standard evaluations of evidence-based practices, tackling stigma, and addressing low resource investment. [ABSTRACT FROM AUTHOR]

Background: Despite its importance within behavioural intervention, it remains unclear how best to achieve high procedural fidelity. This paper reviewed studies on improving procedural fidelity of behavioural interventions for individuals with intellectual and developmental disabilities (IDD). Method: A systematic literature search was conducted, which identified 20 studies meeting inclusion criteria. Data were extracted on study design, participant characteristics, intervention, target behaviours, effect sizes, maintenance, generalization and social validity. A quality rating was also applied. Results: A total of 100 participants took part in the included studies. Most participants were teachers working with children in school settings. There was a significant positive correlation between level of procedural fidelity and client outcomes. Feedback was the most commonly employed intervention to improve procedural fidelity. Conclusions: More research should be conducted in environments with high levels of variability such as community homes to determine how to reach and maintain high levels of procedural fidelity. [ABSTRACT FROM AUTHOR]

Background: The aim of this work was to assess the effect of neurological bandages (Kinesio Taping) for managing saliva flow in patients with drooling and intellectual disability. Methods: Quasi‐experimental study included 30 patients (20 male and 10 female participants) mean age of 15 years with intellectual disability and drooling [Public Special Education Centre in Cartagena (Murcia, Spain)]. Treatment consisted of the application of a strip of neuromuscular bandage applied in the suprahyoid area for a 3‐month period. Efficacy was assessed by means of three clinical scales: the Sialorrhea clinical scale, the drooling rating scale and the drooling impact scale. These evaluations were performed at baseline, after 1 and 3 months of intervention. Results: Clinical improvements were obtained, showing statistically significant reductions in drooling after 1 month (P < 0.001) and 3 months (P < 0.001). Conclusions: The application of neuromuscular bandages in the suprahyoid muscle area can be a useful option for managing drooling in patients with intellectual disability. [ABSTRACT FROM AUTHOR]

One in seven children with an impairing mental health disorder has intellectual disability (ID). Despite the ubiquity of ID, many clinicians are less confident in the assessment and management of mental disorders in youth with ID. Key to determining how to modify these is a good understanding of the child's developmental/cognitive strengths and weaknesses. There is very limited evidence for mental health interventions specific to children with ID. In this context, NICE guidelines generally recommend the same interventions identified for typically developing children. However, psychological interventions should be adapted for developmental level and communication ability. Medication should be selected carefully taking account of co‐existing conditions, drug interactions and the greater sensitivity to adverse effects in this population. Assessment and intervention should always take account of the child's wider context, including education. There is little evidence regarding the best service models in relation to efficacy and efficiency, but the high prevalence of ID amongst youth with mental health problems suggests that all mental health professionals should have competence in working with youth with milder levels of ID. [ABSTRACT FROM AUTHOR]

Aim To evaluate the effect of a 12-week mindfulness-based stress reduction (MBSR) course adapted for people with an intellectual disability (ID). Methods Ten participants with ID completed measures of well-being and understanding of the concepts of mindfulness before and after the course, provided information about additional practice and gave feedback on the perceived benefits of the course. Findings No significant difference was found between mean well-being or understanding scores before and after the course. A significant relationship was found between additional practice and post-course well-being scores. Perceived benefits of mindfulness included reduced stress, increased self-control and confidence. Conclusion MBSR may be effective for people with ID but the benefits may not always be reflected in changes in questionnaire scores. The amount of practice of mindfulness exercises may be an important component of increasing well-being. [ABSTRACT FROM AUTHOR]

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

Objectives: Students with intellectual and developmental disabilities often require augmentative and alternative communication (AAC) to fully meet their academic and social potential. AAC supports can be challenging for some educators to implement. This study sought to bring light to these challenges. Methods: A qualitative interview approach was utilized to examine the perspectives of 14 special education teachers who supported students using AAC systems. Participants described their experiences regarding providing AAC services. Results: Despite receiving some supports, the majority of teachers identified challenges, including inadequate training, lack of comprehensive assessment, inadequate preparation time, and inconsistent AAC implementation across team members. Conclusion:This study highlighted key factors that impacted AAC access and outcomes of students with complex communication needs. Practical implications and future research needed to enhance the communication outcomes of students were discussed. [ABSTRACT FROM AUTHOR]

Purpose Participation in regular paid jobs positively affects mental and physical health of all people, including people with limited work capacities (LWC), people that are limited in their work capacity as a consequence of their disability, such as chronic mental illness, psychological or developmental disorder. For successful participation, a good fit between on one hand persons' capacities and on the other hand well-suited individual support and a suitable work environment is necessary in order to meet the demands of work. However, to date there is a striking paucity of validated measures that indicate the capability to work of people with LWC and that outline directions for support that facilitate the fit. Goal of the present study was therefore to develop such an instrument. Specifically, we adjusted measures of mental ability, conscientiousness, self-efficacy, and coping by simplifying the language level of these measures to make the scales accessible for people with low literacy. In order to validate these adjusted self-report and observer measures we conducted two studies, using multi-source, longitudinal data. Method Study 1 was a longitudinal multi-source study in which the newly developed instrument was administered twice to people with LWC and their significant other. We statistically tested the psychometric properties with respect to dimensionality and reliability. In Study 2, we collected new multi-source data and conducted a confirmatory factor analysis (CFA). Results Studies yielded a congruous factor structure in both samples, internally consistent measures with adequate content validity of scales and subscales, and high test-retest reliability. The CFA confirmed the factorial validity of the scales. Conclusion The adjusted self-report and the observer scales of mental ability, conscientiousness, self-efficacy, and coping are reliable measures that are well-suited to assess the work capability of people with LWC. Further research is needed to examine criterion-related validity with respect to the work demands such as work-behaviour and task performance. [ABSTRACT FROM AUTHOR]

Background Care and support for people with intellectual and developmental disabilities (IDD) in natural community contexts are increasing. Many people with IDD use physical therapy services to support their community participation. Medicaid Home- and Community-Based Services (HCBS) 1915(c) waivers are the largest providers of long-term services and supports for people with IDD. However, little is known about physical therapy provision under this program. Objective The aim of this study was to compare the operational definitions of physical therapy service under the HCBS 1915(c) waiver system and to describe projected physical therapy service utilization, spending, and reimbursement for people with IDD across states. Design This was a cross-sectional, descriptive study. Methods This study analyzed fiscal year 2015 HCBS IDD waivers from across the nation (N = 111), focusing on physical therapy utilization (total projected spending, total participants, reimbursement rates, and average annual service provision per participant). Service definitions were also analyzed to determine trends across waivers. Results Fifty-one waivers (45.9%) provided 61 different types of physical therapy services in fiscal year 2015. States utilized waivers to provide long-term remedial care rather than the acute short-term physical therapy. HCBS waiver physical therapy services were often provided in participants' homes and communities to expand physical therapy access and secure the benefits of providing physical therapy services in natural environments. Although most states have adopted similar definitions of physical therapy service, procedures and services vary. Limitations Medicaid HCBS waivers are state projections made to the federal government rather than actual utilization data. Conclusions Physical therapy service definitions, projected service utilization, spending, and reimbursement for people with IDD who use Medicaid HCBS waivers vary greatly between states. Physical therapy may be utilized less than expected given the reported benefits for people with IDD. [ABSTRACT FROM AUTHOR]

Introduction Adults with intellectual developmental disorders may have difficulties undertaking activities of daily living. This study aimed to identify changes in independence in activities of daily living following learning support using individualized everyday technologies. Method A double-baseline case study design explored the use of everyday technology applications and devices to support functional performance of three men aged 32, 33, and 55 years, with mild to moderate intellectual disabilities. Performance of selected tasks was video-recorded and analysed on four occasions for each participant. Baselines were recorded twice before intervention to ensure the participant’s performance of the selected task was consistent. The intervention video was recorded at the midpoint of the participant’s engagement in the study. Post-intervention video was recorded approximately 1 month after the intervention ended. Results All three participants’ functional performance of an activity of daily living task improved in accuracy and efficiency as cues from support workers were gradually faded. After the learning support ceased, technology continued to provide environmental support of participants’ ongoing independence and efficient performance of the activity. Conclusion Everyday technology applications and devices can be utilized together with a guided and structured client-centred approach and task-specific training with individuals with disability and learning difficulties. [ABSTRACT FROM AUTHOR]

Purpose: In typical development, distributional cues--patterns in input--are related to language acquisition processes. Statistical and implicit learning refer to the utilization of such cues. In children with intellectual disability, much less is known about the extent to which distributional cues are harnessed in mechanisms of language learning. Method: This tutorial presents what is known about the process of language learning in children with language impairments associated with different sources of intellectual disability: Williams syndrome, autism spectrum disorder, Down syndrome, and fragile X syndrome. Results: A broad view is taken on distributional cues relevant to language learning, including statistical learning (e.g., transitional probabilities) and other patterns that support lexical acquisition (e.g., sensitivities to sound patterns, cross-situational word learning) or relate to syntactic development (e.g., nonadjacent dependencies). Conclusions: Critical gaps in the literature are highlighted. Research in this area is especially limited for Down syndrome and fragile X syndrome. Future directions for taking learning theories into account in interventions for children with intellectual disability are discussed, with a focus on the importance of language input. [ABSTRACT FROM AUTHOR]

Aim: Project TEAM (Teens making Environment and Activity Modifications) teaches transition-age young people with developmental disabilities, including those with co-occurring intellectual or cognitive disabilities, to identify and resolve environmental barriers to participation. We examined its effects on young people's attainment of participation goals, knowledge, problem-solving, self-determination, and self-efficacy.Method: We used a quasi-experimental, repeated measures design (initial, outcome, 6-week follow-up) with two groups: (1) Project TEAM (28 males, 19 females; mean age 17y 6mo); and (2) goal-setting comparison (21 males, 14 females; mean age 17y 6mo). A matched convenience sample was recruited in two US states. Attainment of participation goals and goal attainment scaling (GAS) T scores were compared at outcome. Differences between groups for all other outcomes were analyzed using linear mixed effects models.Results: At outcome, Project TEAM participants demonstrated greater knowledge (estimated mean difference: 1.82; confidence interval [CI]: 0.90, 2.74) and ability to apply knowledge during participation (GAS: t[75]=4.21; CI: 5.21, 14.57) compared to goal-setting. While both groups achieved significant improvements in knowledge, problem-solving, and self-determination, increases in parent reported self-determination remained at 6-week follow-up only for Project TEAM (estimated mean difference: 4.65; CI: 1.32, 7.98). Significantly more Project TEAM participants attained their participation goals by follow-up (Project TEAM=97.6%, goal-setting=77.1%, p=0.009).Interpretation: Both approaches support attainment of participation goals. Although inconclusive, Project TEAM may uniquely support young people with developmental disabilities to act in a self-determined manner and apply an environmental problem-solving approach over time.What This Paper Adds: Individualized goal-setting, alone or during Project TEAM (Teens making Environment and Activity Modifications) appears to support attainment of participation goals. Project TEAM appears to support young people with developmental disabilities to apply an environmental problem-solving approach to participation barriers. Parents of young people with developmental disabilities report sustained changes in self-determination 6 weeks after Project TEAM. [ABSTRACT FROM AUTHOR]

Both scripted lessons and unscripted task analyzed lessons have been used effectively to teach science content to students with intellectual disability and autism spectrum disorder. This study evaluated the efficacy, efficiency, and teacher preference of scripted and unscripted task analyzed lesson plans from an elementary science curriculum designed for students with intellectual disability and autism spectrum disorder by evaluating both lesson formats for (a) student outcomes on a science comprehension assessment, (b) sessions to criterion, and (c) average duration of lessons. Findings propose both lesson types were equally effective, but unscripted task analyzed versions may be more efficient and were preferred by teachers to scripted lessons. Implications, limitations, and suggestions for future research are also discussed. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to outline the historical background and policy context of mental health services for people with intellectual disability (ID) in Ireland. It then considers recent implementation and lessons from the Irish experience.Design/methodology/approach The policy background and research literature relevant to the development of mental health services for people with ID in Ireland was reviewed and discussed.Findings Mental health services in Ireland remain in a state of change, moving towards the implementation of specialist multi-disciplinary teams in the community, alongside previous models of care and service.Research limitations/implications This paper summarises recent advances and research regarding mental health services for people with ID in Ireland.Practical implications The paper illustrates the process of delivering changes to mental health services with practical implications for mental health services internationally.Originality/value This is the first paper in many years to summarise the development of mental health services for people with ID in Ireland. There has been considerable recent change and it is therefore important to provide a useful reference for the current status of services. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe the mental healthcare system for people with intellectual disabilities (ID) in Switzerland. It covers the current provision of mental healthcare services as well as educational and research aspects, and summarises both the historical development and the current data on demography, health economics, legislation and national policy.Design/methodology/approach The authors performed an extensive literature research and evaluated the (very sparse) literature, conducted some interviews with recognised experts and carried out extensive internet-based research on the topic.Findings There are numerous, well-funded, well-staffed and well-equipped facilities for people with ID. These facilities have highly trained special education teachers and social education workers. Legislation, the insurance system as well as the policies and strategies on a national level are basically in line with people’s with ID needs. On the other hand, there are too few specialist physicians and psychologists, not enough training centres and too few specialist psychiatric services, both inpatient and outpatient. Medical and psychological research in this field is also insufficient.Practical implications In Switzerland, the development of treatment facilities typically does not start with a decision by a central authority to implement a policy in a top-down process. Usually, these organisations develop on the basis of some local initiatives and spread throughout the country. The process is likely to be similar in the case of services for people with mental health and intellectual disabilities (MHID), and the situation can be expected to be much better throughout the country within a few years. Furthermore, specific training programmes are expected to be created for physicians and psychologists of various disciplines, to promote an interdisciplinary approach.Originality/value This review fills a gap in that there are very few published reviews on the provision of MHID services in Switzerland. [ABSTRACT FROM AUTHOR]

Purpose Services for people with intellectual disabilities in the UK have evolved over the years from hospital-based care to more community provision. There are multiple reasons for these changes, however, often it was due to changes in social policy or following a scandal in provision. The paper aims to discuss these issues.Design/methodology/approach Providing services to meet the health and social care needs of people with intellectual disabilities is well-established in the four countries of the UK with support from legislation. There are often specialist mental health and social care teams. Dedicated professionals work with people with intellectual disabilities who experience mental health problems with a focus on support in the community. A range of services for children and adults and for offenders exist across the UK that often vary in composition and structure.Findings The challenges in providing mental health services for children and adults with intellectual disabilities in the future include recruitment and training of the workforce with the remit of enhancing community support and reduced in-patient care.Practical implications This paper helps the reader to understand how ID mental health services are organised in the UK.Originality/value This paper gives a summary of the ID mental health services in the UK. Even though there are various papers looking at different aspects of mental health services for people with ID in the UK, this paper brings all that information together to help reader get a better understanding of the mental health services for people with ID. [ABSTRACT FROM AUTHOR]

Purpose In The Netherlands, curative mental health care and supportive care for people with an intellectual disability (ID) are organised in separate domains. Prevalence of mental health problems is known to be high among people with borderline intellectual functioning (BIF) or mild intellectual disabilities (MID). By contrast, according to recent findings, prevalence of BIF and MID is high among patients in mental health care (17.5–58 per cent). In The Netherlands, a new quality standard of care (QSOC) on mental health care for people with BIF or MID is developed. It is designed to supplement existing guidelines on mental health care so that they can be used appropriately in people with BIF or MID and meant for use in both mental health care organisations (MHCO) as in organisations for ID care. To a large extent, the QSOC should describe the existing practice. This paper aims to discuss these issues.Design/methodology/approach To assess the existing practice in current mental health care for people with BIF or MID in The Netherlands, the authors examined the views and accessibility of MHCO on the mental health care for patients with and IQ<85. In addition, the authors reviewed published criteria for in- and exclusion of all 39 top clinical mental health care departments for criteria on BIF or (mild) ID.Findings The authors found there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. Dutch MHCO estimate the prevalence of BIF and MID among their patients to be around 30 per cent. Nonetheless, most MCHO surveyed (76 per cent) indicated they do not routinely estimate or measure IQ among their patients and 53 per cent of MHCO indicated not having knowledge and expertise on the dual diagnoses of mental health problems and BIF or MID. Fitting in with the new QSOC most of the MHCO (59 per cent) agreed on the statement in the survey that professionals should be able to treat patients with BIF or ID and all but one of the MHCO stated to have some form of collaboration with an institute for ID care.Originality/value The authors concluded there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. The new QSOC on mental health care for people with BIF or MID can help improve accessibility and quality of mental health care for these patients. [ABSTRACT FROM AUTHOR]

BACKGROUND:Day and employment services provided by state intellectual and developmental disabilities (IDD) agencies, with funding from Medicaid Home and Community Based Services (HCBS), have shown little growth in the employment rate of people with IDD. In attempt to prepare individuals with IDD for employment, prevocational services may be provided. The goal of prevocational is to develop or improve the job and non-job skills, develop work tolerance, and increase preparedness to have a job in a community based and/or competitive setting. OBJECTIVE: The aim of this study was to examine how prevocational services were allocated in HCBS 1915(c) waivers for people with IDD across the United States in fiscal year (FY) 2014. METHODS: 111 HCBS IDD waivers were examined to determine if and how they provided prevocational services. Prevocational services were then compared to determine projected expenditures and service utilization. RESULTS: In FY 2014, approximately $750 million of funding was projected for prevocational services of approximately 87,500 participants; projected allocation varied widely by state and service. CONCLUSIONS:Without a clear pathway to competitive integrated employment, the very notion of prevocational services does not necessarily fit well within shifting policy paradigms that prioritize inclusion, competitive wages, and funding for integrated employment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adults with neurodevelopmental disability (NDD) have poor employment outcomes when compared to their peers without disabilities. Examining employment outcomes beyond common dichotomous descriptive metrics (i.e., employed versus unemployed) depends on the use of standard measures and structured procedures. OBJECTIVE: This review of vocational research literature focused on identifying measures of employment outcomes for adults with NDD. METHODS: Searches were conducted across five databases - ERIC, MEDLINE, CINAHL, HaPI, and PsycINFO. Screening was conducted in duplicate, with all disagreements adjudicated by the senior researcher. RESULTS: A total of 45 articles met inclusion criteria, and data extraction revealed that 64 different employment measures were used in these vocational research studies. CONCLUSIONS: This work summarizes the employment measures for people with NDD utilized in the literature. Descriptions of these measures were provided and coding by person and environment themes, which is a useful resource for planning future vocational research for people with NDD. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess how accessible, acceptable, and effective psychodynamic psychotherapy (PP) is perceived to be by service users. Method: Interviews were conducted with 10 participants, who had finished, or were attending, PP. Transcripts were analyzed using thematic analysis. Results: Most participants understood how they had accessed PP. However, a minority were unsure. Some found traveling to sessions anxiety-provoking and appreciated a friendly greeting upon arrival. Participants highlighted feeling listened to. However, many participants were unhappy about therapy ending and struggled to share what they had learned. Some were surprised by the content of sessions. Finally, most participants highlighted problems that had improved because of therapy. Implications: Clinicians should ensure that service users understand the nature of PP before starting sessions and identify clear goals. Support traveling to sessions may improve attendance, Finally, the importance of planning the ending of therapy was highlighted. Originality value: The paper captures the views of those with ID on the accessibility, acceptability, and effectiveness of PP. [ABSTRACT FROM AUTHOR]

Abstract: Many studies have shown that music therapy improves patients' symptoms. However, interventions using music creation as their core await further development for patients with severe mental illness (SMI). The current study investigated the effect of a music‐creation programme on the anxiety, self‐esteem, and quality of life of patients with SMI. A quasi‐experimental design using convenience sampling was adopted to recruit patients with SMI from a psychiatric day care centre. Participants were grouped based on their willingness to undergo an intervention (26 patients in the experimental group and 23 patients in the control group). The control groups participated in conventional mental rehabilitation therapy activities. The experimental group participated in a music‐creation session for 90 min every week over a 32‐week period. The outcome indicators before and after the intervention were assessed using the Hamilton Anxiety Rating Scale (HAM‐A), Rosenberg Self‐Esteem Scale (RSES), and World Health Organization Quality of Life‐BREF (WHOQOL‐BREF). Finally, the intervention effect was determined using generalized estimating equations (GEEs). After 32 weeks of intervention activities, the experimental group showed significant improvements in their HAM‐A total scores (P < 0.001) and RSES total scores (P = 0.005). Regarding quality of life, the improvements of the experimental group in terms of the psychological (P = 0.016) and social relationship domains (P = 0.033) were superior to those of the control group. Music‐creation programmes are recommended for inclusion in the routine rehabilitation activities of patients with SMI. [ABSTRACT FROM AUTHOR]

This study assessed a technology-aided program (monitoring responding, and ensuring preferred stimulation and encouragements) for promoting physical activity with 11 participants with severe/profound intellectual and multiple disabilities. Each participant was provided with an exercise device (e.g. a static bicycle and a stepper) and exposed to the program according to an ABAB design, in which A and B represented baseline and intervention phases, respectively. Data recording concerned (a) the participants' responses with the exercise device (e.g. pedaling) during baseline and intervention phases and (b) their heart rates during the last intervention phase. The results showed that all participants had significant increases in responding with the exercise devices during the intervention phases. Heart-rate values during the intervention sessions indicated that the participants' responding during those sessions mostly amounted to moderate-intensity physical activity, with potential benefits for their overall physical condition. Implications of the findings and questions for future research in the area were discussed. [ABSTRACT FROM AUTHOR]

This study utilized a mixed methods approach to examine the feasibility and acceptability of group compassion focused therapy for adults with intellectual disabilities (CFT-ID). Six participants with mild ID participated in six sessions of group CFT, specifically adapted for adults with ID. Session-by-session feasibility and acceptability measures suggested that participants understood the group content and process and experienced group sessions and experiential practices as helpful and enjoyable. Thematic analysis of focus groups identified three themes relating to (1) direct experiences of the group, (2) initial difficulties in being self-compassionate and (3) positive emotional changes. Pre- and post-group outcome measures indicated significant reductions in both self-criticism and unfavourable social comparisons. Results suggest that CFT can be adapted for individuals with ID and provide preliminary evidence that people with ID and psychological difficulties may experience a number of benefits from this group intervention. [ABSTRACT FROM AUTHOR]

Understanding the resilience of parents is gaining importance in the field of intellectual disability as a process of making quality adaptations involved in raising a child with intellectual disability. The present study investigated the variations in resilience with respect to locus of control orientations of 57 parents. They were assessed using Connor Davidson Resilience Scale and Internal-External Scale. Results indicated that parental locus of control orientations significantly influenced their resilience. The internal locus of control acted as a protective mechanism of resilience. The findings have specific relevance in nurturing a community of resilient parents so that they will be active participants in the rehabilitation process of their children. [ABSTRACT FROM AUTHOR]

Inappropriate sexual behavior (ISB) is a common, but understudied, issue for individuals diagnosed with developmental disabilities (DD), intellectual disability (ID), and/or acquired brain injuries (ABI). We conducted a systematic review to identify, analyze, and synthesize published behavior-analytic approaches to intervention for ISB in DD, ID, or ABI populations. Twenty-three studies employing single-subject research methodology were identified and evaluated using quality indicators described by Horner et al. (2005) . Results of our analysis suggest insufficient evidence exists to consider any specific response-suppression technique an overarching treatment for decreasing ISB using the Horner et al. criteria. However, broadly speaking, behavior analytic approaches have been highly effective. Practitioners should consider function-based intervention and draw from studies identified as having strong supporting evidence. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the effectiveness of a hopping and jumping training programme (HJP) versus a sensorimotor rehabilitation programme (SRP) on postural performances in children with intellectual disability. Methods: Three groups of children with intellectual disability participated in the study: the HJP group, the SRP group and a control group. Postural capacities were tested with the Berg Balance Scale (BBS) and the Tinetti tests. The HJP and the SRP groups participated in the training programmes for eight weeks. Then, all participants were retested. Results: Results showed that before the training period, there are no significant differences between the three groups. After the training period, the BBS and the Tinetti scores increased significantly in the HJP group and the SRP group with greater extent in the HJP group than in the STP group. Conclusion: We suggest that HJP training is more recommended to improve postural capacities in children with intellectual disability. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity and obesity among children with physical and cognitive disabilities is an emerging public health issue. Children's motor skill development is a determinant of lifelong physical activity and obesity.Aims: The purpose of this article is to critically evaluate motor skill intervention literature among children with physical and cognitive disabilities.Methods and Procedures: Electronic searches were completed to identity research articles published from 1984 to 2014. Major findings were categorized among subtopics including characteristics of intervention studies, research designs, diagnostic method, motor skill interventions and motor skill outcome.Outcomes and Results: 21 studies were found and included participants with developmental delay (42.8%), autism (19.0%), cross-disability (19.0%), intellectual disability (4.8%), cerebral palsy (4.8%), developmental coordination disorder (4.8%), and learning disabilities (4.8%). Only one study was a randomized controlled trial.Conclusions: and implications: The current literature on motor skill intervention research is broad in scope and has limited generalizability within and across disability groups. Future research is needed to develop cross-disability intervention methods adaptable to disability and function-specific needs, including the utilization of rapidly developing technology. Researchers are encouraged to utilize sound methodology with robust theoretical foundations. Family and community engagement is encouraged in intervention delivery. [ABSTRACT FROM AUTHOR]

Objective:The current study aimed at examining the correlations between challenging behaviors, difficulties in functioning, and quality of life in institutionalized adults with intellectual disabilities. Methods:A sample of 53 people with intellectual disabilities and challenging behavior who resided in a large institutional care facility was recruited. The research questionnaire included the following instruments: (1) The challenging behavior scale; (2) The World Health Organization Disability Assessment Schedule 2.0; and (3) The Personal Well-Being Index. Results:No significant correlation was found between challenging behavior and quality of life. However, more challenging behavior found to be correlated with greater difficulties in functioning. Furthermore, a weak correlation was found between difficulties in functioning and quality of life. Participants who had greater difficulty functioning tended to exhibit lower levels of quality of life. No significant associations were found between the sample’s personal characteristics (gender, age, and the severity of intellectual disability) and challenging behavior, difficulties in functioning, and quality of life. Conclusion:Empowering personal functioning of people with intellectual disabilities is important in planning rehabilitation interventions. Such interventions are likely to promote a higher quality of life. There is the need for future research to further investigate the relationship found in this study. [ABSTRACT FROM PUBLISHER]

Purpose Although intellectual disability (ID) and criminal offending have long been associated, the nature of this link is obfuscated by reliance on historically unrigorous means of assessing ID and fractionating social cognitive skills. The purpose of this paper is to review and report current findings and set an agenda for future research in social perception, social inference and social problem solving in ID violent offenders.Design/methodology/approach The literature is reviewed on comorbidity of criminal offending and ID, and on social cognitive impairment and ID offending. In an exploratory case-control series comprising six violent offenders with ID and five similarly able controls, emotion recognition and social inference are assessed by the Awareness of Social Inference Test and social problem-solving ability and style by an adapted Social Problem-Solving Inventory.Findings Violent offenders recognised all emotions except “anxious”. Further, while offenders could interpret and integrate wider contextual cues, absent such cues offenders were less able to use paralinguistic cues (e.g. emotional tone) to infer speakers’ feelings. Offenders in this sample exceeded controls’ social problem-solving scores.Originality/value This paper confirms that ID offenders, like neurotypical offenders, display specific deficits in emotion recognition – particularly fear recognition – but suggests that in ID offenders impairments of affect perception are not necessarily accompanied by impaired social problem solving. The implication for therapeutic practice is that ID offenders might be most effectively rehabilitated by targeting simpler, low-level cognitive processes, such as fear perception, rather than adapting treatment strategies from mainstream offenders. [ABSTRACT FROM AUTHOR]

Background: This article explores the literature on social connectedness and music for young people with disability. It then critically examines the level of congruence between the reported literature to date and current rights-based disability studies discourse.Method: A critical interpretive synthesis was used to examine 27 articles referencing the use of music for social connectedness. Areas of focus in the review are the nature of connections being fostered in music programs, the use of voice and collaboration.Results: The majority of music programs reported on closed groups. Outdated 'expert' models of working persist. The use of participants' voice in the literature is growing, although there is a lack of collaboration and negative reporting.Conclusion: A shift in thinking heralds greater collaboration with participants, although this could be broadened to include decisions on research agendas, planning and evaluation. There is also need for active fostering of broader socio-musical pathways. [ABSTRACT FROM AUTHOR]

Loss of functioning and age-related health problems tend to appear earlier in individuals with intellectual disability (ID) than in their non-disabled peers. The Feldenkrais method (FM) is a movement-based form of learning that enhances body balance and physical functioning. We carried out an intervention based on Awareness Through Movement, a form of the FM. Thirty-two middle-aged (48.94±6.01years old) adults with ID who were in supported employment were recruited and randomly assigned to the experimental group (EG) or control group (CG). The EG received 30 Awareness Through Movement classes while the CG did not receive any movement-based intervention. Physical functioning (body balance, gait speed and chair stands) was assessed with the Short Physical Performance Battery (SPPB) and balance by stabilometry. After 30 FM classes, individuals in the EG had significantly improved their chair stand test score (p<0.005) and SPPB total score (p<0.005), and reduced their sway area (p<0.05) in the stabilometric test. These results indicate that the FM could be a good tool for the prevention of loss of functioning and body balance in middle-aged individuals with ID. [ABSTRACT FROM AUTHOR]

Background: Findings suggest approximately one in six people with intellectual disability engage in 'challenging behaviours', which include aggression towards others/property and self-injurious actions. In residential settings, actions of staff members can make challenging behaviours more likely to occur, or make these behaviours worse. In particular, negative attitudes from members of staff and lack of understanding about the reasons for challenging behaviour are contributory factors. 'Who's Challenging Who?' (WCW) training is designed to emphasise the role of staff in residential settings as a challenge also to people with intellectual disability. The course is delivered jointly by a trainer with intellectual disability who has been labelled as having challenging behaviour, along with a trainer without intellectual disability.Methods: This is a cluster randomised two-arm trial of WCW training versus a waiting list control. Overall, 118 residential settings will be recruited and randomised on a 1:1 ratio. Within each setting, two members of staff will be invited to take part in the trial. Participants will complete assessments at baseline and at 6 and 20 weeks. WCW is a half day initial training course with some follow-on coaching to ensure implementation. The primary outcome is changes in staff empathy towards people with challenging behaviour. Secondary outcomes at the staff level include confidence, attitudes and work-related well-being. Secondary outcomes at the residential setting level include recorded incidents of aggressive challenging behaviour, and use of any restrictive practices.Discussion: If the results of the cluster randomised trial are positive, we will disseminate the findings widely and make all training manuals and materials freely available for anyone in intellectual disability services (and beyond) to use. Our training approach may have wider implications in other areas of social care. It may also provide a generally applicable model for how to train people with intellectual disability to act as co-trainers in intellectual disability social care settings. People with intellectual disability and challenging behaviour have already been involved centrally with the design, development and pilot evaluation of WCW and will also be fully involved throughout this trial.Trial Registration: Registered on the International Standard Randomised Controlled Trial Number registry on 8th December 2015: ISRCTN53763600 . [ABSTRACT FROM AUTHOR]

Background: Families that have children with disabilities face numerous difficulties related to the lack of services support, social isolation and poverty in Serbia. Mostly due to the prolonged effect of social and economic crisis, there are insufficient adequate and diverse community-based services for those families.Aims: The aim of the study was to examine the effect of newly introduced services on the quality of families' life.Methods: A pretest/posttest study was conducted at the beginning of service and one year later to evaluate the effect of services measured by Family Quality of Life Scale (Hoffman et al., 2006). The sample consists of 153 families of children with disabilities from 35 different places in Serbia.Results: The results show that the services generally improved the families' quality of life, particularly in the aspects targeted by services, but also had significant positive effect on family interaction and parenting. The services had the highest impact on the families that perceived the lowest life quality before using them. The life quality was improved, regardless of the type of services, but the effectiveness is affected by the severity of child disability.Implications: The results might be useful for further steps in developing and evaluating individually and flexible tailored service that support families' needs and suits them the best. [ABSTRACT FROM AUTHOR]

Project Panther LIFE is an inclusive postsecondary transition program for students with intellectual disabilities providing university access and participation with the primary goal of employment at program completion. Students in the program receive support from their academic mentors and peer coaches during the academic year. This study examines the skills and activities mentors use during their weekly sessions with students with intellectual disabilities and identifies areas in which mentors may require further support or training. Data analysis revealed major themes related to inclusion, self-determination, and adaptive behavior skills. Upon review of the data, we suggest that mentors need ongoing support from transition programs especially in areas related to encouraging self-advocacy and supporting time management. [ABSTRACT FROM AUTHOR]

Most people with profound intellectual and multiple disabilities (PIMD) have limited social contact and it is unclear what is done to maintain or increase these contacts. Individual support planning (ISP) can be used in the systematic enhancement of social contacts. This study analyses the content of ISPs with respect to the social contacts of people with PIMD. ISPs for 60 persons with PIMD in the Netherlands were inductively coded and illustrated with quotations. It turned out that every ISP contained information about social contacts. Of all the quotations extracted, 71.2% were about current conditions, 6.2% were about the future and less than 1% concerned actual goals. The social contacts of people with PIMD are mentioned in their ISPs, but this is rarely translated into goals. The results of the current study suggest that attention should be paid to ensuring that professionals understand the importance of social contacts and their application in practice. [ABSTRACT FROM AUTHOR]

Background: Adults with disabilities are employed at a significantly lower rate than adults without disabilities. Of adults with disabilities in the workforce, more individuals work in a facility setting rather than a community setting, despite efforts to improve community inclusion. Choice-making has been proposed as a predictive factor for employment for individuals with disabilities.Aims: The purpose of this research was to examine the current state of employment for three groups of adults with intellectual disability (ID): individuals with autism spectrum disorder (ASD), individuals with Down syndrome (DS), and individuals with idiopathic ID. Choice-making and its relation to improved employment outcomes was explored.Methods: This study used National Core Indicator's Adult Consumer Survey datasets from years 2011-2012 and 2012-2013. Factor analyses revealed latent variables from six choice-making questions in the Adult Consumer Survey. Ordinal logistic regression was used to identify factors related to employment status.Results: Adults with DS had the highest rates of paid community jobs, but adults with ID had the highest rates of choice-making. ID severity level and short-term choice-making had the greatest effects on employment status in all three groups.Conclusions: Employment rates remain low despite national efforts to find jobs for people with disabilities. Choice-making is a unique factor that was found to be associated with employment status and provides a target for interventions to increase employability. [ABSTRACT FROM AUTHOR]

Background and Aim: Physical activity (PA) has myriad benefits for children with disabilities (CWD). Information and messaging campaigns can promote PA among CWD. The overall purpose of the study was to gain an understanding of the development of PA information and messages targeting parents of CWD. The specific objectives were to identify parents' preferences regarding PA information and messaging content and preferred methods and sources of communication.Method: Focus groups were conducted with parents of CWD (N=28). Qualitative data were collected and transcribed. Inductive content analyses were employed to identify key themes.Results: Three key thematic areas were identified: 1) Preferred content (e.g., targeted information, self-regulatory strategies, inclusive images), 2) Challenges (e.g., lack of information and language clarity), 3) Preferred sources (e.g., other parents, reliable organizations, central information hub).Conclusions and Implications: Parents' needs and preferences regarding PA information could be incorporated into campaigns to enhance parent PA support and PA among CWD. Stakeholders (e.g., PA organizations, programs and practitioners) can employ these strategies in campaigns and resources targeting parents of CWD. Research is necessary to empirically develop and evaluate PA information and messaging campaigns targeting parents of CWD. [ABSTRACT FROM AUTHOR]

Background The purpose of this research was to examine effects of a therapeutic recreation (TR) program designed to increase executive function (EF), social skills, adaptive behaviours and well-being of adults with autism spectrum disorder (ASD) and intellectual disability (ID). Method A preliminary pre-test, post-test randomized control group experimental design was used to measure effects of a 40-week TR program designed to increase EF (TR-EF). The TR-EF used instructional electronically based games delivered during 200 1-h sessions (5/week). Results Participants (experimental group, n = 19; wait-list group, n = 18) were evaluated at baseline and 10 months later. There was a positive and direct impact of the program on several EF and indirect effect on social skills, adaptive behaviour and personal well-being. Conclusions Findings provide support for inclusion of EF enrichment as a way to enhance effects of TR interventions for adults with ASD and ID. Preliminary results of this study can be considered in planning TR services in the future. In addition to TR-EF program primary effects on EF, there were indirect benefits on adaptive behaviours, personal well-being and social skills. [ABSTRACT FROM AUTHOR]

Disability is a restrictive and limiting mental-physical disorder in individual's life activities. It is also the limitations and lack of status in the individual's ability and power. Disability is not only a health problem. It reflects the interaction between a subject's body characteristics and features of the complex phenomenon experienced by society. It is known that people with disabilities face many barriers in accessing social services. People with disabilities are being ignored by non-disabled people can have the same needs. In this research, the life expectancy of disabled persons, their dreams, their fears, the activities they enjoy, the future is conducted to determine the relevant thoughts. This research were held in the provinces of Istanbul with the service area of the Physical Treatment and Disabilities Rehabilitation Center for disabled people. The study group was selected randomly from disabled persons participating in workshops at this Center. Semi-structured interviews were conducted with 10 persons consisting of mental, orthopedic, visual and chronic disability groups. Participants talked about hopeful expectations that all people could ask for, such as being healthy, running, walking, helping people, changing conditions that are not appropriate for the disabled, participating in work that will provide social benefits, finishing school. [ABSTRACT FROM AUTHOR]

Initial intervention processes for children with intellectual disabilities (IDs) largely focused on direct efforts to impact core cognitive and academic deficits associated with the diagnosis. Recent research on risk processes in families of children with ID, however, has influenced new developmental system approaches to early intervention. Recent risk and resilience processes are reviewed that connect stress, family process, and the high rates of behavioral problems in children with ID that have substantial influence on child and family outcomes. These models are linked to emerging evidence-based intervention processes that focus on strategic parent skill training and mindfulness interventions that reduce parental stress and create indirect benefits for children's behavioral competencies. A family-focused developmental systems approach (M. J. Guralnick, 2011) is emphasized. [ABSTRACT FROM AUTHOR]

This article addresses the economic effects of mental disabilities by analyzing contemporary data in the context of micro- and macroeconomic thought and relevant statistical literature. Within the parameters of these conceptual and statistical reference points, the authors seek to discern current trends in the direct, indirect, and opportunity costs posed by mental disabilities, not only to the individuals who suffer from them, but also to their families, to employers, and to society as a whole. The authors also discuss uncertainties that inhere in available data concerning both the prevalence of these conditions and the related costs of treatment, as well as the complexity of drawing correlations among variables with respect to these costs and the difficulty of identifying a meaningful measure of the economic consequences that attend mental disabilities. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Little is known about the influence of practice schedules on motor learning and skills transfer in children with and without developmental coordination disorder (DCD). Understanding how practice schedules affect motor learning is necessary for motor skills development and rehabilitation.Aims: The study investigated whether active video games (exergames) training delivered under variable practice led to better learning and transfer than repetitive practice.Methods and Procedures: 111 children aged 6-10 years (M=8.0, SD=1.0) with no active exergaming experience were randomized to receive exergames training delivered under variable (Variable Game Group (VGG), n=56) or repetitive practice schedule (Repetitive Game Group (RGG), n=55). Half the participants were identified as DCD using the DSM-5 criteria, while the rest were typically developing (TD), age-matched children. Both groups participated in two 20min sessions per week for 5 weeks.Outcomes and Results: Both participant groups (TD and DCD) improved equally well on game performance. There was no significant difference in positive transfer to balance tasks between practice schedules (Repetitive and Variable) and participant groups (TD and DCD).Conclusions and Implications: Children with and without DCD learn balance skills quite well when exposed to exergames. Gains in learning and transfer are similar regardless of the form of practice schedule employed.What This Paper Adds: This is the first paper to compare the effect of practice schedules on learning in children with DCD and those with typical development. No differences in motor learning were found between repetitive and variable practice schedules. When children with and without DCD spend the same amount of time on exergames, they do not show any differences in acquisition of motor skills. Transfer of motor skills is similar in children with and without DCD regardless of differences in practice schedules. [ABSTRACT FROM AUTHOR]

Copyright of American Journal on Intellectual & Developmental Disabilities is the property of American Association on Intellectual & Developmental Disabilities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: There is a need for interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Implementation of physical activity (PA) within the rehabilitation of people with mental health problems (PMHP) could reduce the burden and facilitate recovery. The objective of the current review was to explore (1) the role of PA within mental health policies of SSA countries, and (2) the current research evidence for PA to improve mental health in SSA. Methods: We screened the Mental Health Atlas and MiNDbank for mental health policies in SSA countries and searched PubMed for relevant studies on PA in PMHP in SSA. Results: Sixty-nine percent (=33/48) of SSA countries have a dedicated mental health policy. Two of 22 screened mental health policies included broad physical activity recommendations. There is clear evidence for the role of PA in the prevention and rehabilitation of depression in SSA. Conclusion: Despite the existing evidence, PA is largely a neglected rehabilitation modality in the mental health care systems of SSA. Continued education of existing staff, training of specialized professionals and integration of PA for mental health in public health awareness programs are needed to initiate and improve PA programs within the mental health care systems of SSA. [ABSTRACT FROM AUTHOR]

This study assessed the effects of a cross-circuit training intervention program on the body composition, cardiorespiratory fitness, balance, and muscular strength endurance of overweight or obese students with intellectual disability. A total of 43 students with intellectual disability (aged 13-19 years) were enrolled in this program; 28 overweight/obese students were assigned to either an obesity-control group (n=14) or obesity-exercise group (n=14), and those with normal weight were assigned to a normal weight group (n=15). The experiment was divided into three periods: pretest (involving the three groups), exercise intervention (involving only the obesity-exercise group), and post-test (involving the obesity-exercise and obesity-control groups). The test involved measuring the body composition, 1-min sit-ups, dynamic and static balance, vertical jumps, and modified Bruce treadmill protocols for measuring cardiorespiratory fitness. The exercise program involving the cross-circuit training concept was conducted nonstop with different types of exercise activities. The training program lasted 12 weeks, and it was executed 5days a week, with each daily session lasting 50min. The results revealed that the obesity-exercise group demonstrated reduced weight, BMI, and fat mass after the intervention program. Moreover, the exercise tolerance test (including total exercise time and maximal heart rate), dynamic balance, sit-up, and vertical jump performance of the participants improved significantly. In conclusion, the cross-circuit training program effectively improved cardiorespiratory fitness, dynamic balance, muscular strength and endurance, and weight control in overweight or obese students with intellectual disability enrolled in a special education school. [ABSTRACT FROM AUTHOR]

Background/aims/methods: The Concrete-Representational-Abstract (CRA) instructional approach supports students with disabilities in mathematics. Yet, no research explores the use of the CRA approach to teach functional-based mathematics for this population and limited research explores the CRA approach for students who have a disability different from a learning disability, such as an intellectual disability. This study investigated the effects of using the CRA approach to teach middle school students in a self-contained mathematics class focused on functional-based mathematics to solve making change problems. Researchers used a multiple probe across participants design to determine if a functional relation existed between the CRA strategy and students' ability to solve making change problems.Procedures/outcomes: The study of consisted of five-to-eight baseline sessions, 9-11 intervention sessions, and two maintenance sessions for each student. Data were collected on percentage of making change problems students solved correctly.Results/conclusions: The CRA instructional strategy was effective in teaching all four participants to correctly solve the problems; a functional relation between the CRA approach and solving making change with coins problems across all participants was found.Implications: The CRA instructional approach can be used to support students with mild intellectual disability or severe learning disabilities in learning functional-based mathematics, such as purchasing skills (i.e., making change). [ABSTRACT FROM AUTHOR]

Background: People with intellectual disabilities (ID) experience more health problems and have different lifestyle change needs, compared with the general population.Aims: To improve lifestyle change interventions for people with ID, this review examined how behaviour change techniques (BCTs) were applied in interventions aimed at physical activity, nutrition or physical activity and nutrition, and described their quality.Methods and Procedures: After a broad search and detailed selection process, 45 studies were included in the review. For coding BCTs, the CALO-RE taxonomy was used. To assess the quality of the interventions, the Physiotherapy Evidence Database (PEDro) scale was used. Extracted data included general study characteristics and intervention characteristics.Outcomes and Results: All interventions used BCTs, although theory-driven BCTs were rarely used. The most frequently used BCTs were 'provide information on consequences of behaviour in general' and 'plan social support/social change'. Most studies were of low quality and a theoretical framework was often missing.Conclusion and Implications: This review shows that BCTs are frequently applied in lifestyle change interventions. To further improve effectiveness, these lifestyle change interventions could benefit from using a theoretical framework, a detailed intervention description and an appropriate and reliable intervention design which is tailored to people with ID. [ABSTRACT FROM AUTHOR]

Copyright of American Journal on Intellectual & Developmental Disabilities is the property of American Association on Intellectual & Developmental Disabilities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Children with intellectual and developmental disabilities (IDD) experience heightened attention difficulties which have been linked to poorer cognitive, academic and social outcomes. Although, increasing research has focused on the potential of computerised cognitive training in reducing attention problems, limited studies have assessed whether this intervention could be utilised for those with IDD. This study aimed to assess the efficacy of a computerised attention training programme in children with IDD. Methods: In a double-blind randomised controlled trial, children (n = 76; IQ < 75) aged 4–11 years were assigned to an adaptive attention training condition or a nonadaptive control condition. Both conditions were completed at home over a 5-week period and consisted of 25 sessions, each of 20-min duration. Outcome measures (baseline, posttraining and 3-month follow-up) assessed core attention skills (selective attention, sustained attention and attentional control) and inattentive/hyperactive behaviour. Results: Children in the attention training condition showed greater improvement in selective attention performance compared to children in the control condition (SMD = 0.24, 95% CI 0.02, 0.45). These improvements were maintained 3 months after training had ceased (SMD = 0.26, 95% CI 0.04, 0.48). The attention training programme was not effective in promoting improvements in sustained attention, attentional control or inattentive/ hyperactive behaviours. Conclusions: The findings suggest that attention training may enhance some aspects of attention (selective attention) in children with IDD, but the small to medium effect sizes indicate that further refinement of the training programme is needed to promote larger, more global improvements. [ABSTRACT FROM AUTHOR]