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Grandits J, Davis A, Rikard B, Vatrano A, Martin H, Taylor MA. Disability terminology: the use of "disability," "disorder," and "illness" in academic writing. Disabil Rehabil 2024; 46:4664-4674. [PMID: 37970845 DOI: 10.1080/09638288.2023.2280780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE The ways in which words are used to describe and discuss people with disabilities has long been an area of social concern. Previous research has demonstrated that language can overtly and subtly influence cognitions and perceptions of individuals, but there is less research on how language relates to perceptions of individuals with disabilities. MATERIALS AND METHODS A content analysis of 236 peer-reviewed articles was performed to explore differences in the frequency of the use of "disability," "disorder," and "illness" in academic articles related to eight common conditions: deafness, blindness, multiple sclerosis, quadriplegia, anxiety, depression, schizophrenia, and addiction. RESULTS Results indicated that there were differences in how disability language was used by academic writers. Specifically, "disability" appeared in the writing more frequently in articles related to physical disabilities, "disorder" appeared most frequently in articles related to anxiety and depression, and "illness" appeared most frequently in articles related to schizophrenia. CONCLUSIONS This observed difference in frequency use could reflect differences in the context and meaning of the use of these conditions. Suggestions for future research are discussed.
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Affiliation(s)
| | - Alyssa Davis
- Department of Psychology, Clemson University, Clemson, SC, USA
| | - Bradley Rikard
- Department of Psychology, Clemson University, Clemson, SC, USA
| | - Angela Vatrano
- Department of Psychology, Clemson University, Clemson, SC, USA
| | - Hannah Martin
- Department of Psychology, Clemson University, Clemson, SC, USA
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McFeely A, O'Connor A, Kennelly SP. Use of biomarkers in the diagnosis of Alzheimer's disease in adults with intellectual disability. THE LANCET. HEALTHY LONGEVITY 2024:100639. [PMID: 39369728 DOI: 10.1016/j.lanhl.2024.100639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 08/25/2024] [Accepted: 08/27/2024] [Indexed: 10/08/2024] Open
Abstract
People with intellectual disability are a vulnerable cohort who face challenges accessing health care. Compared with the general population, people with intellectual disability have an elevated risk of developing dementia, which often presents at a younger age and with atypical symptoms. The lifelong cognitive and functional difficulties faced by people with intellectual disability further complicate the diagnostic process. Specialised intellectual disability memory services and evaluation using reliable biomarkers of neurodegeneration are needed to improve diagnostic and prognostic certainty in this group. Inadequate specialist services and paucity of research on biomarkers in this population hinders progress and impedes the delivery of adequate health care. Although cerebrospinal fluid-based biomarkers and radiological biomarkers are used routinely in the evaluation of Alzheimer's disease in the general population, biological variation within the clinically heterogenous group of people with intellectual disability could affect the clinical utility of existing biomarkers. As disease-modifying therapies become available for the treatment of early Alzheimer's disease, and hopefully other neurodegenerative conditions in the future, biomarkers will serve as gatekeepers to establish the eligibility for such therapies. Inadequate representation of adults with intellectual disability in biomarker research will result in their exclusion from treatment with disease-modifying therapies, thus perpetuating the inequity in health care that is already faced by this group. The aim of this Series paper is to summarise current evidence on the application of biomarkers for Alzheimer's disease in a population with intellectual disability (that is not attributable to Down syndrome) and suspected cognitive decline.
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Affiliation(s)
- Aoife McFeely
- National Intellectual Disability Memory Service, Institute of Memory and Cognition, Tallaght University Hospital, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Antoinette O'Connor
- National Intellectual Disability Memory Service, Institute of Memory and Cognition, Tallaght University Hospital, Dublin, Ireland; Department of Neurology, Tallaght University Hospital, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sean P Kennelly
- National Intellectual Disability Memory Service, Institute of Memory and Cognition, Tallaght University Hospital, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Lin J, Xu X, Li C, Kendrick T, He WQ. Multiple developmental disabilities among American children: prevalence and secular trends 2016-2022. Public Health 2024; 237:22-29. [PMID: 39321659 DOI: 10.1016/j.puhe.2024.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/09/2024] [Accepted: 08/28/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVES We aimed to estimate the prevalence of multiple developmental disabilities, identify associated characteristics, and examine trends among American children from 2016 to 2022. STUDY DESIGN This was a cross-sectional study. METHODS Using the National Survey of Children's Health data from 2016 to 2022, we estimated the prevalence of multiple developmental disabilities among children aged 3-17 years. Multiple developmental disabilities were defined as two or more concurrent disabilities from 12 common disabilities. Trends were investigated using log-linear regression. Multivariate log-binominal regression was used to compare the prevalence prior to the COVID-19 pandemic (2016-2019) with prevalence during the COVID-19 pandemic (2020-2022). RESULTS From 239,534 eligible children (mean age = 10.1 years; male = 51.7%), we found the overall prevalence of multiple developmental disabilities was 10.6%. The most predominant phenotype was attention-deficit/hyperactivity disorder concurrent with behavioural problems (2.1%). Higher prevalence was found among boys, non-Hispanic black children, those from low-household-income families and from families with lower education levels. Prevalence of multiple developmental disabilities increased from 9.8% in 2016 to 11.5% in 2022 (P = 0.014) with significantly higher prevalence during COVID-19 pandemic than before (11.2% vs 10.1%). These increases were found consistently across most sociodemographic groups. CONCLUSIONS Children from certain socio-disadvantaged groups were disproportionally affected by multiple developmental disabilities, highlighting the need for targeted strategies to improve health. The increasing prevalence during the pandemic suggests the need for ongoing monitoring of the trend and the impact of these conditions.
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Affiliation(s)
- J Lin
- Centre for Future Health Systems, University of New South Wales, Sydney, Australia
| | - X Xu
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia; The George Institute for Global Health, Sydney, Australia
| | - C Li
- Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia
| | - T Kendrick
- Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia; New South Wales Newborn & Paediatric Emergency Transport Service, Sydney, Australia
| | - W-Q He
- Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia.
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Burke M, Li C, Cheung WC, Terol AK, Johnston A, Schueller SM. Leveraging Feedback From Families of Children With Autism to Create Digital Support for Service Navigation: Descriptive Study. JMIR Form Res 2024; 8:e56043. [PMID: 39141412 PMCID: PMC11358655 DOI: 10.2196/56043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/16/2024] [Accepted: 06/15/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND It is difficult for families to navigate and access services for their children with autism. Barriers to service access are compounded among families from low-resourced backgrounds. OBJECTIVE The purpose of our study was to explore the development of an app to facilitate access to services among families of children with autism from low-resourced backgrounds. Our specific aims were to explore feedback from an advisory board about the app and to explore feedback from navigators about the app. METHODS Via a multistage codevelopment process, we elicited feedback from 5 key parties: the research team, a community organization, the app development team, the advisory board, and family navigators. Collectively, 36 individuals provided feedback about the development of the app via individual interviews, focus groups, observations, and surveys. The key features of the app included a dashboard showing the service needs of the family and related resources, a messaging feature between the family, the navigator, and the supervisor, and a fidelity checklist and evaluation feature. RESULTS The advisory board provided feedback about the app to increase its user-friendliness, include the ability to develop an action plan, improve the identification of needed services, and add information about service providers. Navigators suggested that the app should connect navigators to one another, have a clearer purpose for the notes section, and reflect an easier log-in process. Navigators also wanted training to role-play using the app. After participating in a role play using the app, navigators reported significantly more satisfaction with the app and greater usefulness (P<.001). CONCLUSIONS Our work sheds light on the importance of eliciting feedback from end users, especially users who are often overlooked by the research community and app developers. Further, it is important to elicit feedback in multiple ways to improve the app.
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Affiliation(s)
- Meghan Burke
- Department of Special Education, Vanderbilt University, Nashville, TN, United States
| | - Chak Li
- Department of Special Education, Vanderbilt University, Nashville, TN, United States
| | | | | | - Amanda Johnston
- Department of Special Education, Vanderbilt University, Nashville, TN, United States
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Callahan PA, Jeglic EL, Calkins C. Sexual Offenders With Intellectual Disabilities: An Exploratory Comparison Study in an Incarcerated U.S. Sample. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024; 68:1052-1073. [PMID: 34963349 DOI: 10.1177/0306624x211066825] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research indicates that individuals with intellectual disabilities (ID) are overrepresented among sexual offenders, and that those with ID might differ from those without ID in terms of the etiology of offending behavior. Despite this, few studies have explored ID using incarcerated U.S. samples. The present study sought to identify relevant characteristics of this population by comparing individuals with and without ID who are incarcerated in the U.S. for sexual offenses. Archival records for 3,066 participants were used to determine demographic, historical, and offense-related characteristics. Participants with ID, including those with borderline ID, comprised 19.1% of the sample and displayed elevated rates of adverse childhood experiences and psychopathology. Contrary to previous research, participants with ID were no more likely to offend against children than those without ID. These findings help to elucidate the etiology of offending behavior among those with ID and inform on potential targets for intervention.
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Miner DC, Ailey SH, Thompson RA, Squires A, Adarlo A, Brown H. "We have met the enemy and it is us": Healthcare professionals as the barrier to health equity for people with intellectual and developmental disability. Res Nurs Health 2024; 47:269-273. [PMID: 38415432 DOI: 10.1002/nur.22376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Dianne C Miner
- Golisano Institute for Developmental Disability Nursing, Rochester, New York, USA
- Wegmans School of Nursing, St John Fisher University, Pittsford, New York, USA
| | - Sarah H Ailey
- Rush University College of Nursing, Chicago, Illinois, USA
| | - Roy A Thompson
- Preparing Future Faculty for Inclusive Excellence Postdoctoral Fellow, Sinclair School of Nursing, University of Missouri, Kansas City, Missouri, USA
| | - Allison Squires
- NYU Rory Meyers College of Nursing, New York, New York, USA
- Department of General Internal Medicine, Grossman School of Medicine, New York City, New York, USA
- National Academy of Medicine, Washington, District of Columbia, USA
| | - Amyela Adarlo
- Loma Linda University, School of Nursing, Loma Linda, California, USA
- Gamma Alpha Chapter of Sigma Theta Tau International, Indianapolis, Indiana, USA
| | - Holly Brown
- Golisano Institute for Developmental Disability Nursing, Rochester, New York, USA
- Wegmans School of Nursing, St John Fisher University, Pittsford, New York, USA
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Tan SHX, Lee GKY, Goh CE, Tong HJ, Chuang JCP, Ang KY, Lim DGX, Gao X. Impact of income and financial subsidies on oral health care utilization among persons with disabilities in Singapore. Community Dent Oral Epidemiol 2024; 52:336-343. [PMID: 38644526 DOI: 10.1111/cdoe.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND/AIM(S) Globally, studies have shown that the dental disease burden among persons with intellectual and/or developmental disabilities (IDD) is high and can be attributed to lower utilization levels of dental services. The aim of the study was to assess the influence of income and financial subsidies on the utilization of dental care services among persons with IDD in Singapore. METHODS Between August 2020 and August 2021, a cross-sectional study was conducted via centres offering Early Intervention Programme for Infants and Children, special education schools and adult associations in Singapore serving persons with IDD. A sample of 591 caregivers of children and adults with IDD completed the survey. Data on sociodemographic information, oral health behaviours and dental utilization were collected. Financial subsidy status was assessed by the uptake of a government-funded, opt-in Community Health Assist Scheme (CHAS) for low-income families that provided a fixed subsidy amount for dental services in the primary care setting. Statistical analysis was carried out using univariable, multiple logistic regression and modified Poisson regression. Propensity score matching was carried out in R version 4.0.2 to assess the impact of financial subsidies on oral health care utilization among persons with IDD. RESULTS Compared to those with lower gross monthly household incomes, the adjusted prevalence ratios of having at least one dental visit in the past year, having at least one preventive dental visit in the past year, and visiting the dentist at least once a year for persons with IDD with gross monthly household incomes of above SGD$4000 were 1.28 (95% CI 1.08-1.52), 1.48 (95% CI 1.14-1.92) and 1.36 (95% CI 1.09-1.70), respectively. Among those who were eligible for CHAS Blue subsidies (247 participants), 160 (62.0%) took up the CHAS Blue scheme and 96 (35.4%) visited the dentist at least yearly. There was no statistically significant difference in the utilization of dental services among individuals enrolled in the CHAS Blue subsidy scheme among those eligible for CHAS Blue subsidies. CONCLUSION Higher household income was associated with a higher prevalence of dental visits in the past year, preventive dental visits in the past year, and at least yearly dental visits. CHAS Blue subsidies alone had limited impact on dental utilization among persons with IDD who were eligible for subsidies.
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Affiliation(s)
- Sharon Hui Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Charlene Enhui Goh
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Huei Jinn Tong
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | | | | | - David Guang Xu Lim
- Tzu Chi Singapore Free Clinic, Buddhist Compassion Relief Tzu Chi Foundation, Singapore, Singapore
- National Dental Centre Singapore, Singapore, Singapore
| | - Xiaoli Gao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Wang DS, Chung CH, Hsu WF, Chen SJ, Chu DM, Chien WC, Tzeng NS, Fan HC. Higher Risk of Psychiatric Disorders in Children With Febrile Seizures: A Nationwide Cohort Study in Taiwan. Pediatr Neurol 2024; 154:26-35. [PMID: 38458101 DOI: 10.1016/j.pediatrneurol.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 01/05/2024] [Accepted: 02/12/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Febrile seizures occur commonly in children aged between six months and six years. A previous Danish study found a positive correlation between febrile seizures and the overall incidence of psychiatric disorders. This population-based nationwide observational study was conducted to investigate the association between febrile seizures and different psychiatric disorders in Taiwan and the associated risk factors. METHODS This cohort study used data from the National Health Insurance Research Database in Taiwan-a nationwide claims database covering >99% of the Taiwanese population. The study period was from January 2000 to December 2015; the overall median follow-up time was 11.04 ± 10.95 years. Overall, 2464 children with febrile seizures diagnosed between 2000 and 2015 met the inclusion criteria, and 7392 children without febrile seizures matched by index year, age, and sex were included in the control cohorts. Febrile seizures and psychiatric disorders were measured as the exposure and main outcomes, respectively. RESULTS Children with febrile seizures (n = 2463) were at a high risk of psychiatric disorders (adjusted hazard ratio, 4.70; 95% confidence interval [CI], 2.44 to 7.30; P < 0.001). The risk for anxiety was the highest (adjusted hazard ratio, 21.92; 95% CI, 11.40 to 34.05; P < 0.001). CONCLUSIONS When treating children with febrile seizures, particular attention should be paid to the symptoms of psychiatric disorders, as early referral may be beneficial for these children.
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Affiliation(s)
- Der-Shiun Wang
- Department of Pediatrics, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Pediatrics, Tri-Service General Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Wan-Fu Hsu
- Department of Pediatrics, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Shyi-Jou Chen
- Department of Pediatrics, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Pediatrics, Tri-Service General Hospital, Taipei, Taiwan
| | - Der-Ming Chu
- Department of Pediatrics, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan; Student Counselling Center, National Defense Medical Center, Taipei, Taiwan
| | - Hueng-Chuen Fan
- Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan; Department of Pediatrics, Tung's Taichung Metro Harbor Hospital, Taichung, Taiwan; Department of Medical Research, Tung's Taichung Metro Harbor Hospital, Taichung, Taiwan; Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
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Zorrilla M, Ao J, Terhorst L, Cohen SK, Goldberg M, Pearlman J. Using the lens of assistive technology to develop a technology translation readiness assessment tool (TTRAT)™ to evaluate market readiness. Disabil Rehabil Assist Technol 2024; 19:1145-1160. [PMID: 36538509 DOI: 10.1080/17483107.2022.2153936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/15/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Assistive Technologies encompass a wide array of products, services, healthcare standards, and the systems that support them. Product/market fit is necessary for a technology to be transferred successfully. Current tools lack variables that are key to technology transfer, and current trainings do not have a validated tool to assess the effectiveness of a training, increasing innovators' readiness for technology transfer. The goal was to develop a tool to evaluate the readiness of a technology by incorporating other models and focusing beyond just commercialization. MATERIALS AND METHODS The development involved five stages: 1. Review of current tools used in technology transfer in academic, government, and industry settings; 2. Development of the draft version of the tool with internal review; 3. Alpha version review and refinement, 4. Content validation of the tool's beta version; 5. Assessment of the readiness tool for reliability and preparedness for wide-use dissemination. RESULTS The tool was revised and validated to 6 subscales and 25 items. The assistive technology subscale was removed from the final version to eliminate repetitive questions and taking into consideration that the tool could be used across technologies. CONCLUSIONS We developed a flexible assessment tool that looked beyond just commercial success and considered the problem being solved, implications on or input from stakeholders, and sustainability of a technology. The resulting product, the Technology Translation Readiness Assessment Tool (TTRAT)TM, has the potential to be used to evaluate a broad range of technologies and assess the success of training programs.IMPLICATIONS FOR REHABILIATIONQuality of life can be substantially impacted when an assistive technology does not meet the needs of an end-user. Thus, effective Assistive Technology Tech Transfer (ATTT) is needed.The use of the TTRAT may help to inform NIDILRR and other funding agencies that invest in rehabilitation technology development on the overall readiness of a technology, but also the impact of the funding on technology readiness.The TTRAT may help to educate novice rehabilitation technology innovators on appropriate considerations for not only technology readiness, but also general translation best practices like assembling a diverse team with appropriate skillsets, understanding of the market and its size, and sustainability strategies.
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Affiliation(s)
- Michelle Zorrilla
- Department of Rehabilitation Science and Technology, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, PA, USA
| | - Jingning Ao
- Department of Business Administration, University of Pittsburgh, Katz Graduate School of Business, Pittsburgh, PA, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, PA, USA
| | - Susan K Cohen
- Department of Business Administration, University of Pittsburgh, Katz Graduate School of Business, Pittsburgh, PA, USA
| | - Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, PA, USA
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, School of Health and Rehabilitation Science, Pittsburgh, PA, USA
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10
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Brown HK, Mitra M. Perinatal health framework for people with intellectual disability. Disabil Health J 2024; 17:101576. [PMID: 38216418 DOI: 10.1016/j.dhjo.2023.101576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/14/2024]
Abstract
We propose a framework for guiding research on perinatal health in people with intellectual disability (ID). We developed this framework based on the perinatal health framework for people with physical disabilities, American Association on Intellectual and Developmental Disabilities conceptual framework of human functioning, disability reproductive justice framework, trauma-informed care, and socio-ecological model. The framework reflects health outcomes of birthing people with ID and their infants that result from interactions of factors across the life course at policy (health, social, and disability policies), community (attitudes, social and physical environment), institutional (health care delivery-related factors, access to information/resources), interpersonal (social determinants of health/histories of trauma, social support, interactions with service-providers), and individual levels (demographics, intellectual functioning, adaptive behavior, health conditions, genetic factors, psychosocial factors, health behaviors). This framework will facilitate research to identify factors leading to perinatal health disparities in people with ID and development and evaluation of resources to address them.
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Affiliation(s)
- Hilary K Brown
- Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
| | - Monika Mitra
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
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Furnier SM, Gangnon R, Daniels JL, Ellis Weismer S, Nadler C, Pazol K, Reyes NM, Rosenberg S, Rubenstein E, Wiggins LD, Yeargin-Allsopp M, Durkin MS. Racial and ethnic disparities in the co-occurrence of intellectual disability and autism: Impact of incorporating measures of adaptive functioning. Autism Res 2024; 17:650-667. [PMID: 38415400 PMCID: PMC11151777 DOI: 10.1002/aur.3107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
Intellectual disability (ID) commonly co-occurs in children with autism. Although diagnostic criteria for ID require impairments in both cognitive and adaptive functioning, most population-based estimates of the frequency of co-occurring ID in children with autism-including studies of racial and ethnic disparities in co-occurring autism and ID-base the definition of ID solely on cognitive scores. The goal of this analysis was to examine the effect of including both cognitive and adaptive behavior criteria on estimates of co-occurring ID in a well-characterized sample of 2- to 5-year-old children with autism. Participants included 3264 children with research or community diagnoses of autism enrolled in the population-based Study to Explore Early Development (SEED) phases 1-3. Based only on Mullen Scales of Early Learning (MSEL) composite cognitive scores, 62.9% (95% confidence interval [CI]: 61.1, 64.7%) of children with autism were estimated to have co-occurring ID. After incorporating Vineland Adaptive Behavior Scales, Second Edition (VABS-II) composite or domains criteria, co-occurring ID estimates were reduced to 38.0% (95% CI: 36.2, 39.8%) and 45.0% (95% CI: 43.1, 46.9%), respectively. The increased odds of meeting ID criteria observed for non-Hispanic (NH) Black and Hispanic children relative to NH White children when only MSEL criteria were used were substantially reduced, though not eliminated, after incorporating VABS-II criteria and adjusting for selected socioeconomic variables. This study provides evidence for the importance of considering adaptive behavior as well as socioeconomic disadvantage when describing racial and ethnic disparities in co-occurring ID in epidemiologic studies of autism.
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Affiliation(s)
- Sarah M. Furnier
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ronald Gangnon
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Julie L. Daniels
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Susan Ellis Weismer
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Cy Nadler
- Division of Developmental and Behavioral Health, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nuri M. Reyes
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Steven Rosenberg
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Eric Rubenstein
- Department of Epidemiology, Boston University, Boston, Massachusetts, USA
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maureen S. Durkin
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Brennan D, D’eath M. Irish social policy to family carers of adults with an intellectual disability: A critical analysis. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:1013-1031. [PMID: 35835719 PMCID: PMC10647897 DOI: 10.1177/17446295221115296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This paper explores contemporary Irish social policy for family caregivers with specific focus on the dynamic between the individual, the family and the state in terms of the social contract for care provision for people with intellectual disability. Drawing from Bacchi's analytical framework (Bacchi, 2009), the Irish National Carers' Strategy is interrogated specifically with regards to how it frames and assumes the social contract for family care provision for adults with an intellectual disability. We suggest that Irish social policy constructs family caregiving as the assumed natural and neutral point of departure for providing care within society, and this constructed identify is subsequently reinforced through the provisions contained with the policies themselves that seek to support such caregivers. A fundamental reconsideration of the social contract for such care provision and support with society would appear warranted.
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Affiliation(s)
- Damien Brennan
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Maureen D’eath
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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13
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Vaitsiakhovich N, Landes SD. The association between the Patient Protection and Affordable Care Act and healthcare affordability among US adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1270-1290. [PMID: 37129079 DOI: 10.1111/jir.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/28/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Historically, US adults with intellectual disability (ID) experience worse healthcare access than the general population. However, the implementation of the Patient Protection and Affordable Care Act (ACA) may have reduced disparities in healthcare access. METHODS Using a pre-ACA 2011-2013 sample and a post-ACA implementation 2014-2016 sample from the National Health Interview Survey data, we examined the association between the ACA's introduction and healthcare access among adults with ID (N = 623). Negative binomial regression models were used to test the association between the ACA and the total number of foregone healthcare services. Binary logistic regression was used to explore whether the ACA's implementation was associated with the increased likelihood of possessing health insurance as well as the decreased likelihood of any and particular measures of foregone healthcare services due to cost. RESULTS The study provides evidence that the ACA's implementation was associated with the decreased likelihood of the total number and any foregone care services owing to cost. Findings also revealed that the ACA's implementation was associated with expansion of health insurance coverage and decreasing instances of foregone care services for medical care, dental care, specialist visit and mental care among adults with ID. However, persons with ID were still at a higher risk of foregone prescription medicines, follow-up medical care and eyeglasses due to cost in the post-ACA years. CONCLUSIONS The study provides evidence that healthcare access among Americans with ID improved after the ACA's implementation. However, challenges in access to follow-up care, eyeglasses and prescription medicines persist and require policy solutions, which extend beyond the ACA's provisions.
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Affiliation(s)
- N Vaitsiakhovich
- Department of Sociology and Lerner Center for Public Health Promotion and Population Health, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA
| | - S D Landes
- Department of Sociology and Aging Studies Institute, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA
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14
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Bahador RS, Farokhzadian J, Rafiee Sarbijan Nasab F, Abbasi M. Experiences of family caregivers of people with intellectual disabilities from rural areas in southeastern Iran: a qualitative study. BMC Psychiatry 2023; 23:613. [PMID: 37608274 PMCID: PMC10463806 DOI: 10.1186/s12888-023-05077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Caring for people with intellectual disabilities can be a challenging task, but it can also bring about positive experiences for family caregivers. The present study aimed to explore these positive experiences and shed light on the ways in which family caregivers of people with intellectual disabilities can find meaning and fulfillment in their roles. METHODS This qualitative study used conventional content analysis to explore the positive experiences of family caregivers of people with intellectual disabilities. Sixteen family caregivers from rural areas in southeastern Iran were purposively selected to participate in the study. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using the method proposed by Graneheim and Lundman. RESULTS The data analysis resulted in the emergence of a single theme, which was achievements of providing care for people with intellectual disabilities. This theme was comprised of four main categories: a new outlook on life, family caregivers' peace of mind, strengthening of family ties, and improvement of social status. The provision of care for people with intellectual disabilities created positive changes, affecting family functioning and care provision for people with intellectual disabilities. CONCLUSION It is recommended that families of people with intellectual disabilities focus on these positive experiences and share them with other families who may be struggling with a recent diagnosis of intellectual disability in their child.
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Affiliation(s)
- Raziyeh Sadat Bahador
- Department of Nursing, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
| | | | | | - Mohsen Abbasi
- Department of Nursing, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
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15
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Gabrielsson A, Tromans S, Newman H, Triantafyllopoulou P, Hassiotis A, Bassett P, Watkins L, Sawhney I, Cooper M, Griffiths L, Pullen A, Roy A, Angus-Leppan H, Rh T, Kinney M, Tittensor P, Shankar R. Awareness of social care needs in people with epilepsy and intellectual disability. Epilepsy Behav 2023; 145:109296. [PMID: 37336133 DOI: 10.1016/j.yebeh.2023.109296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Nearly a quarter of people with intellectual disability (ID) have epilepsy with large numbers experiencing drug-resistant epilepsy, and premature mortality. To mitigate epilepsy risks the environment and social care needs, particularly in professional care settings, need to be met. PURPOSE To compare professional care groups as regards their subjective confidence and perceived responsibility when managing the need of people with ID and epilepsy. METHOD A multi-agency expert panel developed a questionnaire with embedded case vignettes with quantitative and qualitative elements to understand training and confidence in the health and social determinants of people with ID and epilepsy. The cross-sectional survey was disseminated amongst health and social care professionals working with people with ID in the UK using an exponential non-discriminative snow-balling methodology. Group comparisons were undertaken using suitable statistical tests including Fisher's exact, Kruskal-Wallis, and Mann-Whitney. Bonferroni correction was applied to significant (p < 0.05) results. Content analysis was conducted and relevant categories and themes were identified. RESULTS Social and health professionals (n = 54) rated their confidence to manage the needs of people with ID and epilepsy equally. Health professionals showed better awareness (p < 0.001) of the findings/recommendations of the latest evidence on premature deaths and identifying and managing epilepsy-related risks, including the relevance of nocturnal monitoring. The content analysis highlighted the need for clearer roles, improved care pathways, better epilepsy-specific knowledge, increased resources, and better multi-disciplinary work. CONCLUSIONS A gap exists between health and social care professionals in awareness of epilepsy needs for people with ID, requiring essential training and national pathways.
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Affiliation(s)
- A Gabrielsson
- Hertfordshire Partnership University NHS Trust, Hatfield, UK
| | - S Tromans
- University of Leicester, Leicester, UK; Leicestershire Partnership NHS Trust, Leicester, UK
| | - H Newman
- University of Plymouth Peninsula School of Medicine, Plymouth, UK
| | | | | | | | - L Watkins
- University of South Wales, Pontypridd, UK; Swansea Bay University Health Board, Port Talbot, UK
| | - I Sawhney
- Hertfordshire Partnership University NHS Trust, Hatfield, UK
| | - M Cooper
- National Development Team for Inclusion Bath, UK
| | - L Griffiths
- National Development Team for Inclusion Bath, UK
| | | | - A Roy
- Coventry and Warwickshire Partnership Trust, Birmingham, UK
| | | | | | - M Kinney
- Belfast Health and Social Trust, Belfast, UK
| | - P Tittensor
- Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - R Shankar
- University of Plymouth Peninsula School of Medicine, Plymouth, UK; Cornwall Partnership NHS Foundation Trust, Truro, UK.
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16
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Anderson LL, Hall S, Kramme JED, Stancliffe R. Transition to retirement: The lived experiences of adults with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:547-557. [PMID: 36738096 PMCID: PMC10245290 DOI: 10.1111/jar.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Adults with intellectual disabilities are living longer and experiencing retirement. However, research about retirement experiences is limited. METHOD This qualitative study used semi-structured interviews with 10 retired/retiring U.S. adults with intellectual disabilities and an ally of their choice. RESULTS Participants described factors that pushed or pulled them into retirement, such as health issues or wanting to spend more time with family. Individuals in community work settings described greater self-determination in their decision to retire. Regardless of reasons for retiring, all participants described initial difficulties with adjusting to retirement but over time people's situation, including their mental and physical health, reportedly improved. CONCLUSION Retirement is a significant life transition. More attention is needed about planning and developing age-appropriate and person-cantered inclusive retirement options for older adults with intellectual disabilities, similar to the transition into adulthood and work life.
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Affiliation(s)
| | - Sarah Hall
- University of Minnesota, Minneapolis, Minnesota, USA
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17
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Goscicki BL, Goldman SE, Burke MM, Hodapp RM. Applicants to a Special Education Advocacy Training Program: "Insiders" in the Disability Advocacy World. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:110-123. [PMID: 36996281 DOI: 10.1352/1934-9556-61.2.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/17/2022] [Indexed: 05/16/2023]
Abstract
Although social groups have "insiders," this construct has not been measured within the disability advocacy community. Examining 405 individuals who applied for an advocacy training program, this study examined the nature of insiderness within the disability advocacy community and ties to individual roles. Participants showed differences in mean ratings across 10 insider items. A principal components analysis revealed two distinct factors: Organizational Involvement and Social Connectedness. Non-school providers scored highest on Organizational Involvement; family members/self-advocates highest on Social Connectedness. Themes from open-ended responses supported the factors and showed differences in motivation and information sources across insiderness levels and roles. Qualitative analysis revealed two additional aspects of insiderness not addressed in the scale. Implications are discussed for future practice and research.
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Affiliation(s)
| | | | - Meghan M Burke
- Meghan M. Burke, University of Illinois, Urbana-Champaign
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18
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Sugiyama Y, Mutai R, Matsushima M. Association between patient complexity and healthcare costs in primary care on a Japanese island: a cross-sectional study. BMJ Open 2023; 13:e068497. [PMID: 36963794 PMCID: PMC10040045 DOI: 10.1136/bmjopen-2022-068497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2023] Open
Abstract
OBJECTIVES This study aimed to elucidate the relationship between patient complexity and healthcare costs in a primary care setting on a Japanese island. DESIGN Cross-sectional study. SETTING Tarama Clinic, Okinawa Miyako Hospital, on Tarama Island, Okinawa Prefecture, Japan. PARTICIPANTS Patients who visited Tarama Clinic from 1 April 2018 to 30 June 2018, were aged 20 years or above, were resident in Tarama Village and had decision-making capacity. OUTCOME MEASURES Patient complexity scored using Patient Centred Assessment Method (PCAM), healthcare costs per person per year/visit and participant characteristics. RESULTS We included 355 study participants. The means (SD) of the total PCAM scores and healthcare costs per person per year/visit were 21.4 (5.7) and 1056.4 (952.7)/125.7 (86.7) in US dollars, respectively. Spearman's rank correlation coefficients between the total PCAM scores and healthcare costs per person per year/visit were 0.33 and 0.28 (p values <0.0001 and <0.0001), respectively. The healthcare costs per person tended to be relatively low in the patient groups with the highest complexity. In the groups, the proportion of those with psychological conditions tended to be higher and those with cardiovascular diseases tended to be lower than in the other groups. Multiple regression analysis showed that total PCAM scores were associated with healthcare costs per person per year/visit, which were log-transformed: the regression coefficients were 3.87×10-2 and 2.34×10-2, respectively; the p values were <0.001 and <0.001, respectively. CONCLUSIONS This study clarified the association between patient complexity and healthcare costs in a primary care setting on a Japanese island. We found that such costs tended to be relatively low in patient groups with the highest complexity. In primary care, healthcare costs probably do not accurately reflect the value of services provided by medical institutions; it may be essential to introduce a system that provides incentives for problem-solving approaches to social issues.
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Affiliation(s)
- Yoshifumi Sugiyama
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
- Tarama Clinic, Okinawa Miyako Hospital, Miyakojima, Okinawa, Japan
- Division of Community Health and Primary Care, Center for Medical Education, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Rieko Mutai
- Department of Adult Nursing, The Jikei University School of Nursing, Chofu, Tokyo, Japan
| | - Masato Matsushima
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
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Banda DR, Carter SL, Nguyen T. A qualitative study of financial concerns of mothers' of adults with intellectual and developmental disabilities. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:857-864. [PMID: 39131759 PMCID: PMC11308951 DOI: 10.1080/20473869.2022.2152967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/18/2022] [Accepted: 11/24/2022] [Indexed: 08/13/2024]
Abstract
Parents have long been concerned with the transition to adulthood of their children with intellectual and developmental disability (IDD) particularly with financial issues. The purpose of this study was to explore the financial concerns of mothers of adults with IDD. Five mothers of adults with IDD participated in a focus group to share their experiences, opinions, concerns, and challenges related to finances. Five themes emerged from the qualitative data analysis: (a) job-related difficulties, (b) living expenses, (c) access to essential services, (d), skills deficits and/or challenging behavior, and (e) long-term care. Mothers in general indicated tremendous financial burdens, loss of income, and expressed concerns about long-term care of their children with IDD. These themes are discussed and implications for practice and research are provided.
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Affiliation(s)
- Devender R. Banda
- Department of Special Education, Texas Tech University, Lubbock, TX, USA
| | - Stacy L. Carter
- Department of Special Education, Texas Tech University, Lubbock, TX, USA
| | - The Nguyen
- Department of Curriculum and Instruction, Texas Tech University, Lubbock, TX, USA
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20
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Tsang W, Oliver D, Triantafyllopoulou P. Quality of life measurement tools for people with dementia and intellectual disabilities: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 36:28-38. [PMID: 36380473 PMCID: PMC10099806 DOI: 10.1111/jar.13050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/15/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Adults with intellectual disabilities are an at-risk group of developing dementia. In the absence of a cure for dementia, emphasis on treatment is the promotion of Quality of life (QoL). The aim of this review is to identify and describe QoL tools for people with intellectual disabilities and dementia. METHOD A systematic review was carried out using 10 databases and papers from up to March year 2021. RESULTS Two instruments were identified and examined. The QoL in late-stage dementia, which showed evidence of good levels of internal consistency, intra-rater reliability, test-retest reliability, and convergent validity. The Dementia Quality of Life - proxy was also used; however, its psychometric properties have yet to be studied within the intellectual disabilities population. CONCLUSION It is recommended instruments should be developed and psychometrically tested specifically for adults with intellectual disabilities and dementia to help inform policy makers, measure outcomes of interventions and personal outcomes.
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Affiliation(s)
- Winnie Tsang
- School of Social Policy, Sociology and Social Research, Tizard Centre University of Kent Canterbury UK
| | - David Oliver
- School of Social Policy, Sociology and Social Research, Tizard Centre University of Kent Canterbury UK
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21
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McMahon M, Hatton C, Hardy C, Preston NJ. The relationship between subjective socioeconomic status and health in adults with and without intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1390-1402. [PMID: 36054256 PMCID: PMC9804692 DOI: 10.1111/jar.13028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 07/04/2022] [Accepted: 07/20/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND This study investigated if subjective socioeconomic status (SSS) is related to self-rated health (SRH) and objective indicators of health in people with and without intellectual disability. METHODS Participants were 217 adults with, and 2350 adults without intellectual disability in Jersey. In the intellectual disability sample, 85 (39.2%) participants consented independently, while 132 (60.8%) participants consented through proxy procedures. The MacArthur Scale of Subjective Social Status was used to measure SSS. The Euro-Qol EQ-5D-5L and a five-point scale ranging from poor to excellent health were used to measure SRH. RESULTS Higher SSS and younger age were predictors of better SRH for the proxy-report intellectual disability group. Being employed was associated with higher EQ-5D-5L index values for all intellectual disability groups. CONCLUSION As SSS was only related to SRH in the proxy intellectual disability group, further research with a larger intellectual disability sample is needed to explore its utility further.
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Affiliation(s)
- Martin McMahon
- Division of Health ResearchLancaster UniversityLancasterUK
- Health and Community Services Government of JerseyJerseyUK
| | - Chris Hatton
- Division of Health ResearchLancaster UniversityLancasterUK
- Faculty of Health, Psychology & Social CareManchester Metropolitan UniversityManchesterUK
| | - Claire Hardy
- Division of Health ResearchLancaster UniversityLancasterUK
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22
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Gilligan HT. A Foundation For Health And Well-Being: Meaningful Employment. Health Aff (Millwood) 2022; 41:1366-1370. [DOI: 10.1377/hlthaff.2022.01069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Heather Tirado Gilligan
- Heather Tirado Gilligan is a freelance journalist based in Oakland, California. The names Sean Jefferson and Shannon James are pseudonyms created to protect the individuals’ privacy. This article is part of a series on transforming health systems published with support from The Robert Wood Johnson Foundation. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon
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23
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Khanna A, Smith LD, Parish SL, Mitra M. Pregnancy recommendations from women with intellectual and developmental disabilities to their peers. Disabil Health J 2022; 15:101343. [PMID: 35739053 DOI: 10.1016/j.dhjo.2022.101343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND As recent as the mid-twentieth century, eugenics practices on women with intellectual and developmental disabilities were commonplace. Deinstitutionalization has led to an increasing proportion of women with intellectual and developmental disabilities living in the community and becoming pregnant. Previous research has reported barriers to maternal health care (i.e., perceived provider stigma, inadequate communication, stress surrounding child protective services involvement, and financial strain). Research shows that this population is at increased risk of adverse outcomes including preterm delivery, low birth weight babies, and maternal mortality. OBJECTIVE/HYPOTHESIS This study aimed to explore recommendations from mothers with intellectual and developmental disabilities for other women to potentially improve pregnancy experiences for this population. METHODS We conducted semi-structured individual interviews among 16 women with intellectual and developmental disabilities. Data were coded using a content analysis process and iteratively analyzed using inductive and deductive techniques to determine emergent themes. RESULTS Participants offered recommendations for navigating pregnancy to their peers who are pregnant, or thinking about becoming pregnant. Themes included: (1) planning for birth; (2) advocating at the point-of-care; (3) seeking supports and services; (4) interacting with child protective services; (5) communicating with providers; and (6) exhibiting resilience. CONCLUSION Our study highlights recommendations for improving pregnancy experiences of women with intellectual and developmental disabilities. Informed by the lived pregnancy experiences of our participants, these recommendations can inform clinician training, new guidelines, and services to support and improve pregnancy experiences for women with intellectual and developmental disabilities.
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Affiliation(s)
- Aishwarya Khanna
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA; Center for Healthcare Organization and Implementation Research (CHOIR), Bedford VA Healthcare System, 200 Spring Rd, Bedford, MA, 01730, USA
| | - Lauren D Smith
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA.
| | - Susan L Parish
- College of Health Professions, Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA, 23284, USA
| | - Monika Mitra
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA
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24
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Riches VC, O'Brien P, Manokara V, Mueller A. A study of caregiver support services: Perspectives of family caregivers of persons with intellectual disabilities in
Singapore. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Vivienne C. Riches
- Centre for Disability Studies, an Affiliate of the Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
| | - Patricia O'Brien
- Centre for Disability Studies, an Affiliate of the Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
| | - Vimallan Manokara
- Movement for the Intellectually Disabled of Singapore (MINDS) Singapore Singapore
| | - Arne Mueller
- Centre for Disability Studies, an Affiliate of the Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
- Manchester Metropolitan University Manchester UK
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25
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Hall KAE, Deusdad B, D’Hers Del Pozo M, Martínez-Hernáez Á. How Did People with Functional Disability Experience the First COVID-19 Lockdown? A Thematic Analysis of YouTube Comments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10550. [PMID: 36078263 PMCID: PMC9518368 DOI: 10.3390/ijerph191710550] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
People with functional disability endure barriers to health and other services and to full participation in social life. In the context of COVID-19, this discrimination has been intensified worldwide. We examine how the experience of COVID-19 lockdown was depicted in comments to a video about functional disability and COVID published on VICE's YouTube channel. We analysed the first 100 comments on the video, which was posted in spring 2020, during the first COVID-19 lockdown (roughly from March to June 2020, with some variations around the world). We identified four themes: lack of access to care and services, isolation and lifestyle changes, mental health consequences, and peer support. Legal regulations regarding COVID-19 and people with functional disability have not been sufficient in most countries. The COVID-19 pandemic has exposed inadequate care systems, even in Western countries with advanced social protection policies.
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Affiliation(s)
| | - Blanca Deusdad
- Correspondence: (K.A.E.H.); (B.D.); Tel.: +34-686724851 (B.D.)
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26
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Brown HK, Tint A, Heifetz M, Chacra MA, Bluestein D, Vigod S, Lunsky Y. Barriers and requirements for parenting supports and mental health care among mothers with intellectual disabilities: Health and social service-provider perspectives. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104237. [PMID: 35487050 DOI: 10.1016/j.ridd.2022.104237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/30/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Mothers with intellectual disability (ID) experience high rates of mental illness, but these needs are not adequately addressed. AIMS We examined health and social service-provider perceptions of barriers to parenting and mental health care among mothers with ID and strategies for building good practice capacity. METHODS AND PROCEDURES In this qualitative study in Ontario, Canada, we interviewed 13 service-providers working with mothers with ID about their experiences supporting parenting and mental health in mothers with ID, including barriers to services and strategies for building good practice capacity. Data were analyzed via inductive, semantic-level thematic analysis. OUTCOMES AND RESULTS Perceived barriers to care provision were the vulnerable social context of women with ID, distrust of "the system" by women with ID, and siloed services. Increased training of service-providers, making accommodations in existing services, and building a community of support for women with ID were offered as strategies for good practice capacity. CONCLUSIONS AND IMPLICATIONS Efforts to improve mental health among mothers with ID should focus on improving service-provider capacity and accommodations in existing services, and enhancing coordination of care. WHAT THIS PAPER ADDS?: Mothers with intellectual disability (ID) experience high rates of mental illness, but supports for mothers with ID typically focus on parenting skills, and women's mental health care services do not consider the unique needs of those with ID. Health and social service-providers have reported inadequate training, fragmented services, high caseloads, and lack of practical supports as barriers to providing quality care to mothers with ID. However, no studies have examined service-providers' perceptions of needs related specifically to parenting and mental health among mothers with ID. This study provides new information on barriers to parenting and mental health care among mothers with ID and strategies for good practice capacity, from the perspectives of service-providers. Perceived barriers to care provision include social determinants of health, a distrust of "the system" by women with ID, and siloed services. Providers recommended that providing better training, including accommodations in existing services, and building a community of support could be beneficial to improving practice capacity in the context of mental health care and parenting supports. These factors need to be addressed to improve mental health among mothers with ID.
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Affiliation(s)
- Hilary K Brown
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada; Dalla Lana School of Public Health, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Ami Tint
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Marina Heifetz
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | | | - Simone Vigod
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yona Lunsky
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Sajewicz-Radtke U, Jurek P, Olech M, Łada-Maśko AB, Jankowska AM, Radtke BM. Heterogeneity of Cognitive Profiles in Children and Adolescents with Mild Intellectual Disability (MID). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127230. [PMID: 35742482 PMCID: PMC9223773 DOI: 10.3390/ijerph19127230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 12/04/2022]
Abstract
Mild Intellectual Disability (MID) is a neurodevelopmental disorder that begins in childhood and is characterized by limitations in intellectual functioning (IQ = 55-69) and adaptive behavior that manifests in everyday living. In addition to these specific criteria, clinical practice shows that the population of children with MID has heterogeneous deficits in cognitive functioning. Thus, the aim of this study was to identify groups of homogenous cognitive profiles within a heterogeneous population of students with MID. The cognitive profiles of 16,411 participants with Mild Intellectual Disability were assessed based on their performance on the Stanford-Binet Intelligence Scales-Fifth Edition. Prior to the assessment, participants were divided into three age groups corresponding to the levels of the Polish education system: (1) 7;00-9;11, (2) 10;00-14;11, and (3) 15;00-18;11 years old. Using cluster analysis, we identified three distinct cognitive profiles (clusters) in each age group. These clusters differed from each other within and between each age group. Distinguishing cognitive profiles among children and adolescents with MID is important both in the context of diagnosis as well as the development of research-based interventions for these students.
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Affiliation(s)
| | - Paweł Jurek
- Institute of Psychology, University of Gdansk, Bażyńskiego 4, 80-952 Gdańsk, Poland; (P.J.); (M.O.); (A.B.Ł.-M.); (A.M.J.)
| | - Michał Olech
- Institute of Psychology, University of Gdansk, Bażyńskiego 4, 80-952 Gdańsk, Poland; (P.J.); (M.O.); (A.B.Ł.-M.); (A.M.J.)
- Department of Psychology, Medical University of Gdańsk, M. Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland
| | - Ariadna B. Łada-Maśko
- Institute of Psychology, University of Gdansk, Bażyńskiego 4, 80-952 Gdańsk, Poland; (P.J.); (M.O.); (A.B.Ł.-M.); (A.M.J.)
| | - Anna M. Jankowska
- Institute of Psychology, University of Gdansk, Bażyńskiego 4, 80-952 Gdańsk, Poland; (P.J.); (M.O.); (A.B.Ł.-M.); (A.M.J.)
| | - Bartosz M. Radtke
- Laboratory of Psychological and Pedagogical Tests, Czarnieckiego 5A, 80-239 Gdańsk, Poland;
- Correspondence:
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Chicas VE, Steinway C, Chen J, Schwartz MC, Wright C, Cornacchia M, Davis TW, Berens JC, Riddle I, Woodward JF, Jan S. Identifying key components of a web‐based long term care planning intervention for family caregivers of individuals with intellectual/developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:867-877. [PMID: 35277898 PMCID: PMC9313859 DOI: 10.1111/jar.12991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Vanessa E. Chicas
- Alan and Marlene Norton College of Medicine at Upstate Medical University Syracuse New York USA
| | - Caren Steinway
- Division of General Pediatrics Steven & Alexandra Cohen Children's Medical Center of Northwell Health New Hyde Park New York USA
- Department of Pediatrics Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead New York USA
| | - Jack Chen
- Division of General Pediatrics Steven & Alexandra Cohen Children's Medical Center of Northwell Health New Hyde Park New York USA
| | - Matthew C. Schwartz
- Lewis Katz School of Medicine of Temple University Philadelphia Pennsylvania USA
| | - Charmaine Wright
- Departments of Pediatrics and Medicine ChristianaCare Health System Newark Delaware USA
| | | | - Thomas W. Davis
- Department of Medicine Geisinger Health System Danville Pennsylvania USA
| | - John C. Berens
- Department of Medicine Baylor College of Medicine Houston Texas USA
| | - Ilka Riddle
- Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA
| | - Jason F. Woodward
- Department of Pediatrics Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA
| | - Sophia Jan
- Division of General Pediatrics Steven & Alexandra Cohen Children's Medical Center of Northwell Health New Hyde Park New York USA
- Department of Pediatrics Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead New York USA
- Feinstein Institutes for Medical Research Northwell Health Manhasset New York USA
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Lee CE, Burke MM, Perkins EA. Compound Caregiving: Toward a Research Agenda. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:66-79. [PMID: 35104349 DOI: 10.1352/1934-9556-60.1.66] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/10/2021] [Indexed: 05/17/2023]
Abstract
Aging family caregivers of adults with intellectual and developmental disabilities (IDD) have unique circumstances setting them apart from the general caregiving population. Such differences include the extensive duration of the caregiving, and health concerns that manifest in the caregiver and individuals with IDD over time. Because of increasing longevity, family caregivers are likely to become compound caregivers (i.e., individuals caregiving for multiple people). Almost 70% of family caregivers of individuals with IDD experience compound caregiving, yet we know very little about compound caregiving. In this article, we highlight the importance of supporting compound caregivers by identifying research issues that address current challenges and future directions. Implications for research are noted, including the need for multidimensional outcome measures and longitudinal studies.
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Affiliation(s)
- Chung Eun Lee
- Chung Eun Lee, Chonnam National University, Republic of Korea; Meghan M. Burke, University of Illinois at Urbana-Champaign; and Elizabeth A. Perkins, University of South Florida
| | - Meghan M Burke
- Chung Eun Lee, Chonnam National University, Republic of Korea; Meghan M. Burke, University of Illinois at Urbana-Champaign; and Elizabeth A. Perkins, University of South Florida
| | - Elizabeth A Perkins
- Chung Eun Lee, Chonnam National University, Republic of Korea; Meghan M. Burke, University of Illinois at Urbana-Champaign; and Elizabeth A. Perkins, University of South Florida
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Lemos CD, Kranios A, Beauchamp-Whitworth R, Chandwani A, Gilbert N, Holmes A, Pender A, Whitehouse C, Botting N. Awareness of developmental language disorder amongst workplace managers. JOURNAL OF COMMUNICATION DISORDERS 2022; 95:106165. [PMID: 34800812 DOI: 10.1016/j.jcomdis.2021.106165] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/07/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Developmental Language Disorder (DLD) is one of the most prevalent developmental disorders and affects expressive and receptive language with no clear cause (Bishop et al., 2017). Awareness of DLD is currently much lower than other (sometimes less prevalent) disorders such as Autism or Attention Deficit Hyperactivity Disorder (ADHD) (Bishop, 2010). Despite this, it has now been established that the implications of DLD reach well into adulthood (Botting, 2020; Botting et al., 2016; Clegg et al., 2005; Johnson et al., 2010). Thus, DLD may affect not only school progress but also employment. Whilst recent research indicates that the rate of employment in this group was similar to peers (Conti-Ramsden et al., 2018), it also reported lower levels of employment in terms of hours, contracts and employment type. However, there is virtually no research examining why this might be the case. In contrast there is already a growing evidence base surrounding Autism Spectrum Disorder (ASD) and Dyslexia in the workplace. Systematic reviews of factors affecting employment in ASD and Dyslexia (de Beer et al., 2014; Scott et al., 2019) have revealed barriers including the job application process itself. AIMS & METHODS In this study we aimed to explore managers' awareness of DLD and their views on training, adjustments and feasibility when considering employing an individual with DLD. Specifically, we asked: 1) What awareness do managers have of DLD and how does this compare to awareness of ASD and other developmental disorders? 2) What is the extent of training on DLD and other developmental disorders in the workplace? 3) What barriers to employment are perceived to be most significant by managers? 4) What strategies do managers report as currently in place to help support people with DLD? 5) What are perceived strengths of people with DLD according to managers? RESULTS In total, 77 managers completed an anonymous online survey which was accessed via a social media link. Managers came from a wide variety of backgrounds with an equal split between public and private organisations, and across gender. The number of managers who had heard of DLD was lower than for the other disorders (ADHD, ASD, Dyslexia). This pattern was partly mirrored in the proportion of managers who felt they had received adequate training on communication difficulties. However, training on developmental disorders generally was reported as very scarce. A qualitative examination of barriers identified by managers included interviewing and CV submission, reading and following instructions, lack of clear guidelines around support needed, and financial restrictions in providing support. CONCLUSIONS These findings support existing literature and have implications for policy and practice - namely that young people with DLD may need to be proactive about disclosing their language needs, and that workplaces need increased basic training in DLD.
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Affiliation(s)
- Carmen de Lemos
- Language and Communication Science, City University of London United Kingdom
| | - Ariadne Kranios
- Language and Communication Science, City University of London United Kingdom
| | | | - Anna Chandwani
- Language and Communication Science, City University of London United Kingdom
| | - Nick Gilbert
- Language and Communication Science, City University of London United Kingdom
| | - Amy Holmes
- Language and Communication Science, City University of London United Kingdom
| | - Abby Pender
- Language and Communication Science, City University of London United Kingdom
| | - Ciara Whitehouse
- Language and Communication Science, City University of London United Kingdom
| | - Nicola Botting
- Language and Communication Science, City University of London United Kingdom.
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Chemerynska N, Marczak M, Kucharska J. What are the experiences of clinical psychologists working with people with intellectual disabilities during the COVID-19 pandemic? JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:587-595. [PMID: 34913546 DOI: 10.1111/jar.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/08/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with intellectual disabilities are a particularly vulnerable group, at an increased risk of mortality from COVID-19 and of poor mental health. Psychologists providing mental health support to people with intellectual disabilities report poorer mental wellbeing and higher occupational stress. Moreover, they raise concerns about the ability of people with intellectual disabilities to engage with digital technologies for mental health support in the context of reduced face-to-face psychological provision. AIMS The study aimed to understand psychologists' experiences of working with people with intellectual disabilities during the pandemic. MATERIALS & METHODS Semi-structured interviews were conducted with 11 psychologists from community intellectual disabilities services. Data were analysed using interpretative phenomenological analysis. RESULTS Two superordinate themes emerged. Survive or Thrive highlighted the challenges and successes clinical psychologists experienced while working during the pandemic. 'Left to Their Own Devices' described psychologists' experiences of their clients as forgotten within society. CONCLUSION The current study demonstrates psychologists' ability to adapt to extremely challenging circumstances, exposes the vulnerabilities of people with intellectual disabilities and highlights the gaps in service provision.
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Affiliation(s)
- Nataliya Chemerynska
- Department of Psychology and Behavioural Sciences, Coventry University, Coventry, UK.,Department of Psychology, University of Warwick, Coventry, UK
| | - Magda Marczak
- Department of Psychology and Behavioural Sciences, Coventry University, Coventry, UK
| | - Jo Kucharska
- Department of Psychology and Behavioural Sciences, Coventry University, Coventry, UK
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Carollo A, Bonassi A, Lim M, Gabrieli G, Setoh P, Dimitriou D, Aryadoust V, Esposito G. Developmental disabilities across the world: A scientometric review from 1936 to 2020. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104031. [PMID: 34333315 DOI: 10.1016/j.ridd.2021.104031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/07/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Developmental disabilities have been largely studied in the past years. Their etiological mechanisms have been underpinned to the interactions between genetic and environmental factors. These factors show variability across the world. Thus, it is important to understand where the set of knowledge obtained on developmental disabilities originates from and whether it is generalizable to low- and middle-income countries. AIMS This study aims to understand the origins of the available literature on developmental disabilities, keeping a focus on parenting, and identify the main trend of research. METHODS AND PROCEDURE A sample of 11,315 publications from 1936 to 2020 were collected from Scopus and a graphical country analysis was conducted. Furthermore, a qualitative approach enabled the clustering of references by keywords into four main areas: "Expression of the disorder", "Physiological Factors", "How it is studied" and "Environmental factors". For each area, a document co-citation analysis (DCA) on CiteSpace software was performed. OUTCOMES AND RESULTS Results highlight the leading role of North America in the study of developmental disabilities. Trends in the literature and the documents' scientific relevance are discussed in details. CONCLUSIONS AND IMPLICATIONS Results demand for investigation in different socio-economical settings to generalize our knowledge. What this paper adds? The current paper tries to provide insight into the origins of the literature on developmental disabilities with a focus on parenting, together with an analysis of the trends of research in the field. The paper consisted of a multi-disciplinary and multi-method review. In fact, the review tried to integrate the analysis of the relation between developmental disabilities with a closer look at the scientific contributions to the field across the world. Specifically, the paper integrates a total of 11,315 papers published on almost a century of research (from 1936 to 2020). An initial qualitative analysis on keywords was combined to a subsequent quantitative approach in order to maximize the comprehension of the impact of almost a century of scientific contributions. Specifically, documents were studied with temporal and structural metrics on a scientometric approach. This allowed the exploration of patterns within the literature available on Scopus in a quantitative way. This method not only assessed the importance of single documents within the network. As a matter of fact, the document co-citation analysis used on CiteSpace software provided insight into the relations existing between multiple documents in the field of research. As a result, the leading role of North America in the literature of developmental disabilities and parenting emerged. This was accompanied by the review of the main trends of research within the existing literature.
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Affiliation(s)
- Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Andrea Bonassi
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Mobile and Social Computing Lab, Bruno Kessler Foundation, Trento, Italy
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Giulio Gabrieli
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Peipei Setoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Dagmara Dimitriou
- Sleep Research and Education Laboratory, UCL Institute of Education, London, United Kingdom
| | - Vahid Aryadoust
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
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Inositol monophosphatase 1 (IMPA1) mutation in intellectual disability patients impairs neurogenesis but not gliogenesis. Mol Psychiatry 2021; 26:3558-3571. [PMID: 32839513 DOI: 10.1038/s41380-020-00862-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 11/09/2022]
Abstract
A homozygous mutation in the inositol monophosphatase 1 (IMPA1) gene was recently identified in nine individuals with severe intellectual disability (ID) and disruptive behavior. These individuals belong to the same family from Northeastern Brazil, which has 28 consanguineous marriages and 59 genotyped family members. IMPA1 is responsible for the generation of free inositol from de novo biosynthesis and recycling from inositol polyphosphates and participates in the phosphatidylinositol signaling pathway. To understand the role of IMPA1 deficiency in ID, we generated induced pluripotent stem cells (iPSCs) from patients and neurotypical controls and differentiated these into hippocampal dentate gyrus-like neurons and astrocytes. IMPA1-deficient neuronal progenitor cells (NPCs) revealed substantial deficits in proliferation and neurogenic potential. At low passage NPCs (P1 to P3), we observed cell cycle arrest, apoptosis, progressive change to a glial morphology and reduction in neuronal differentiation. These observations were validated by rescuing the phenotype with myo-inositol supplemented media during differentiation of patient-derived iPSCs into neurons and by the reduction of neurogenic potential in control NPCs-expressing shIMPA1. Transcriptome analysis showed that NPCs and neurons derived from ID patients have extensive deregulation of gene expression affecting pathways necessary for neurogenesis and upregulation of gliogenic genes. IMPA1 deficiency did not affect cell cycle progression or survival in iPSCs and glial progenitor cells or astrocyte differentiation. Therefore, this study shows that the IMPA1 mutation specifically affects NPC survival and neuronal differentiation.
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Vlot-van Anrooij K, Naaldenberg J, Hilgenkamp TIM, Vaandrager L, van der Velden K, Leusink GL. Towards healthy settings for people with intellectual disabilities. Health Promot Int 2021; 35:661-670. [PMID: 31243433 PMCID: PMC7414853 DOI: 10.1093/heapro/daz054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
People with intellectual disabilities (ID) depend on their environment for support to live healthily. The characteristics of healthy settings for people with ID are unknown. This study aims to conceptualize healthy settings for people with ID by conducting an international and multidisciplinary concept mapping study. As theoretical framework the settings approach, an ecological model with a whole system focus toward health promotion, was used. The integrative mixed-methods approach of this study involved concept mapping with researchers specialized in healthcare for people with ID and researchers specialized in healthy settings. The 41 participants generated statements that were later sorted and rated. Findings encompass 13 clusters relating to the social environment, the physical environment and societal preconditions. Specific factors of healthy settings for people with ID include: (i) universal design of the physical environment, (ii) the role of care professionals in the social environment to empower people with ID, (iii) possibilities for care providers to contribute to a health-promoting setting and (iv) preconditions that allow people to engage in society. These factors can be used in strategies to apply the approach in practice and give directions to put in place policies on developing enabling environments and decreasing health inequities.
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Affiliation(s)
- Kristel Vlot-van Anrooij
- Department of Primary and Community Care, Research group Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
- Corresponding author. E-mail:
| | - J Naaldenberg
- Department of Primary and Community Care, Research group Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - T I M Hilgenkamp
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000CA Rotterdam, The Netherlands
| | - L Vaandrager
- Department of Social Sciences, Health and Society, Wageningen University, PO Box 8130, 6706 KN Wageningen, The Netherlands
| | - K van der Velden
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - G L Leusink
- Department of Primary and Community Care, Research group Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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Wos K, Baczała D. Parenting by mothers with intellectual disabilities in Poland: A photovoice study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1452-1462. [PMID: 33823563 DOI: 10.1111/jar.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND The diverse nature of parenting among people with intellectual disabilities can be affected by many factors, including stereotypes, experiencing social isolation, living in poverty, suffering from chronic diseases and limited access to health care. Because of these factors, people with intellectual disabilities are not readily viewed as potential parents by society. METHOD The research was conducted using the photovoice method, which analyses photographs taken by participants-seven mothers with intellectual disabilities (aged 22-43). RESULTS Thematic analysis yielded six main areas: pregnancy and childbirth, household duties-everyday life, caring for children, the importance of motherhood for a woman, parenting problems and difficulties, and types and forms of assistance. CONCLUSION Raising a child has become a life goal for the interviewed women. However, there were also difficulties in their lives, which have not been solved by formal and informal support. Individual support for mothers should include tailor-made sexual education, access to gynaecological care or long-term family support.
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Affiliation(s)
- Klaudia Wos
- Interdisciplinary Doctoral School of Social Sciences, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Ditta Baczała
- Faculty of Philosophy and Social Sciences, Nicolaus Copernicus University in Toruń, Toruń, Poland
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Mehari K, Iyengar S, Schneider M, Berg K, Bennett A. Adverse Childhood Experiences Among Children with Neurodevelopmental Delays: Relations to Diagnoses, Behavioral Health, and Clinical Severity. J Clin Psychol Med Settings 2021; 28:808-814. [PMID: 33761107 DOI: 10.1007/s10880-021-09769-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 11/28/2022]
Abstract
Limited research has examined adverse childhood experiences (ACEs) among children at risk for neurodevelopmental delays. The purpose of this study was to (1) identify the prevalence of ACEs among children at risk for neurodevelopmental delays; (2) explore differences in rates of ACEs across neurodevelopmental diagnoses; and (3) examine relations between ACEs and indicators of behavioral health functioning (e.g., enuresis, feeding problems, sleeping problems, and functional impairment). Participants were 193 children ages 2 to 11 who received a developmental and behavioral pediatrics evaluation at a subspecialty clinic. Caregivers completed a survey about their child's ACEs, and researchers conducted an electronic health record review. Overall, 47% experienced at least one ACE. ACEs were not related to neurodevelopmental diagnosis or to externalizing symptoms. ACEs were related to difficulty sleeping, lower hyperactivity, and greater functional impairment at home. The relations between early adversity and poor behavioral health functioning may develop over time, creating an excellent window of opportunity for prevention work.
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Affiliation(s)
- Krista Mehari
- Department of Psychology, University of South Alabama, 307 N University Blvd, UCOM 1000, Mobile, AL, 36606, USA.
| | - Sandhyaa Iyengar
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Mallory Schneider
- Department of Psychology, University of South Alabama, Mobile, AL, USA.,Department of Pediatrics, Aflac Cancer and Blood Disorders Center, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Kristin Berg
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL, USA
| | - Amanda Bennett
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Kim ET, Franz L, Fannin DK, Howard J, Maslow G. Educational classifications of autism spectrum disorder and intellectual disability among school‐aged children in North Carolina: Associations with race, rurality, and resource availability. Autism Res 2021; 14:1046-1060. [PMID: 33644951 DOI: 10.1002/aur.2492] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 02/10/2021] [Indexed: 12/11/2022]
Abstract
Disparities exist in the recognition of autism spectrum disorder (ASD) and intellectual disability (ID) in racial/ethnic minorities in the United States. This study examined whether rurality, race/ethnicity, and low resource availability are associated with disparities in primary educational classifications of ASD and ID in North Carolina (NC). Descriptive maps were created. Multilevel logistic regression models examined two separate outcomes (mild ID vs. ASD; moderate/severe ID vs. ASD). For the interaction term included in the model (race/ethnicity and residence), predicted probabilities were estimated and plotted. The effects of other covariates were also estimated. Rural counties had fewer students with ASD and a greater number of students with ID compared to urban counties. The majority of students with ASD were non-Hispanic Whites, while the majority of students with ID were non-Hispanic Blacks. Compared to non-Hispanic White students, non-Hispanic Black students were overrepresented in the ID classification and underrepresented in the ASD classification across urban and rural areas. Indicators of low resource availability were also associated with higher probabilities of ID vs. ASD classification. Differences in primary educational classification based on urban-rural divide, race/ethnicity, and resource availability are important to understand as they may point to disparities that could have significant policy and service implications. Because disparities manifest through complex interactions between environmental, socioeconomic and system-level factors, reduction in these disparities will require broader approaches that address structural determinants. Future research should utilize disparity frameworks to understand differences in primary educational classifications of ASD and ID in the context of race/ethnicity and rurality. LAY SUMMARY: Rural counties in North Carolina had fewer students with ASD and a greater number of students with ID compared to urban counties. Compared to non-Hispanic White students, non-Hispanic Black students were over-represented in the ID educational classification and underrepresented in the ASD classification. Differences in classification of ASD and ID based on urban-rural divide, race/ethnicity, and resource availability may point to disparities that could have significant policy and service implications. Autism Res 2021, 14: 1046-1060. © 2021 International Society for Autism Research, Wiley Periodicals LLC.
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Affiliation(s)
| | - Lauren Franz
- Duke Global Health Institute Duke University Durham North Carolina USA
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development Duke University School of Medicine Durham North Carolina USA
- Division of Child and Adolescent Psychiatry, Center for Autism Research in Africa University of Cape Town Cape Town South Africa
| | - Danai Kasambira Fannin
- Department of Communication Sciences and Disorders, College of Health and Sciences North Carolina Central University Durham North Carolina USA
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
| | - Gary Maslow
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
- Department of Pediatrics Duke University School of Medicine Durham North Carolina USA
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O'Donovan M. The Elusive Inclusive University: What Does This Look Like for Students With Intellectual Disability? An Irish Perspective. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mary‐Ann O'Donovan
- Trinity Centre for People with Intellectual Disabilities School of Education, Trinity College Dublin Dublin 2 Ireland
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Abstract
This article is an attempt to determine the level of poverty in rural areas in Poland. The author reviewed the most important publications on poverty and the indicators that determine its scale. Relative, objective and subjective poverty lines were used to present the range of rural poverty against the background of total poverty. Analyses showed that the at-risk-of-poverty rate for rural areas in Poland amounted to 21.2%. This means that almost every fifth rural resident is at risk of poverty, whereas every tenth resident is at risk of extreme poverty. The article also presents the rural areas in Poland which are at the highest risk of social exclusion. These areas were distinguished on the basis of the number of registered families receiving social benefits. Both Eurostat (EU-SILC) and Local Data Bank of the Statistics Poland (BDL GUS) were used. (original abstract)
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Serra P, Costa R, Almeida N, Baptista A. Visual Status in a Portuguese Population with Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217715. [PMID: 33105693 PMCID: PMC7672629 DOI: 10.3390/ijerph17217715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Neurosensory deprivation associated with vision is a well-known fact in people with intellectual disability (ID). This work aims to report the visual status of a population with ID in Portugal. METHODS A vision screening protocol was conducted during two Special Olympics events. The vision protocol included personal medical history, ocular health evaluation, and clinical measures, such as visual acuity (VA), binocular vision, colour vision, refractive error, and intraocular pressure. This protocol was administered to 134 subjects. RESULTS Half of the subjects reported that they had never attended or they did not remember having attended a previous eye exam. Additionally, 10% of them had not attended an eye exam in the immediate past three years. Half the subjects failed the VA test and 13% presented moderate Visual Impairment (VI) (VA worse than 0.5 logMAR in the best eye). Manifest ocular deviation was found in 25% of the subjects and the most common ocular health dysfunction conditions were conjunctiva hyperaemia, meibomian gland dysfunction, and lens anomalies. Refractive error correction allowed a reduction in the level of moderate VI to 3.7%. CONCLUSIONS The population analysed showed a poor eye care attendance rate and vision-related conditions are in agreement with previous reports. The development of national strategies to promote the awareness for routine eye care in people with ID and improving accessibility to eye care services may mitigate many of the most prevalent conditions encountered.
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Affiliation(s)
- Pedro Serra
- Instituto Superior de Educação e Ciências, Alameda das Linhas de Torres, 1750-142 Lisboa, Portugal
| | - Regina Costa
- Novas Olimpiadas Especiais—Special Olympics Portugal, Rua Sítio do Casalinho da Ajuda, 1300-536 Lisboa, Portugal;
| | - Nuno Almeida
- Opening Eyes Portugal—Special Olympics Portugal, Rua Sítio do Casalinho da Ajuda, 1300-536 Lisboa, Portugal;
| | - António Baptista
- Centre of Physics, Campus Gualtar, School of Sciences, University of Minho, 4710-057 Braga, Portugal;
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Willner P, Rose J, Stenfert Kroese B, Murphy GH, Langdon PE, Clifford C, Hutchings H, Watkins A, Hiles S, Cooper V. Effect of the COVID-19 pandemic on the mental health of carers of people with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1523-1533. [PMID: 32885897 DOI: 10.1111/jar.12811] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The measures implemented to manage the COVID-19 pandemic have been shown to impair mental health. This problem is likely to be exacerbated for carers. METHOD Informal carers (mainly parents) of children and adults with intellectual disabilities, and a comparison group of parents of children without disabilities, completed an online questionnaire. Almost all the data were collected while strict lockdown conditions were in place. RESULTS Relative to carers of children without intellectual disability, carers of both children and adults with intellectual disability had significantly greater levels of a wish fulfilment coping style, defeat/entrapment, anxiety, and depression. Differences were 2-3 times greater than reported in earlier pre-pandemic studies. Positive correlations were found between objective stress scores and all mental health outcomes. Despite their greater mental health needs, carers of those with intellectual disability received less social support from a variety of sources. CONCLUSIONS The greater mental health needs of carers in the context of lesser social support raises serious concerns. We consider the policy implications of these findings.
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Affiliation(s)
- Paul Willner
- Department of Psychology, Swansea University, Swansea, UK
| | - John Rose
- School of Psychology, University of Birmingham, Birmingham, UK
| | | | | | - Peter E Langdon
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK.,Coventry and Warwichshire Partnership NHS Trust, Coventry, UK
| | | | | | | | - Steve Hiles
- Swansea University Medical School, Swansea, UK
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Facilitators and Barriers to Positive Special Education Experiences and Health Among Latino Families of Children with Disabilities: Two Systematic Literature Reviews. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00220-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Umb Carlsson Õ. Changes in Living Conditions of People with ID: A Follow‐Up after 16 Years. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Õie Umb Carlsson
- Department of Public Health and Caring Sciences, Disability and Habilitation Uppsala University Box 564 Uppsala SE‐751 22 Sweden
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Van Patten R, Vella L, Mahmood Z, Clark JMR, Maye JE, Twamley EW. Accuracy of case managers in estimating intelligence quotients and functional status of people experiencing homelessness. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2020; 90:586-589. [PMID: 32406707 PMCID: PMC9213068 DOI: 10.1037/ort0000463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Adults who are homeless experience high rates of health conditions and psychological distress, including low IQ and functional status. Resources are available to help these individuals, but provision of support is often contingent upon the identification of a known disability. In this context, we examined case managers' (CMs') subjective estimates of IQ and functional status in 77 adult residents of an urban homeless shelter. Participants completed objective measures of IQ and functional capacity. CMs overestimated IQs of lower IQ (IQ < 90) participants, correctly estimated IQs of average IQ (IQ = 90-110) participants, and underestimated IQs of higher IQ (IQ > 110) participants. CMs correctly identified 2 out of 8 participants meeting criteria for intellectual disability and 4 out of 16 participants with impaired functional status. These findings suggest that subjective evaluations of IQ and functional status are prone to a central tendency bias, leading CMs to overlook clients who are in need of assistance. Consequently, the objective measurement of IQ and functional status in homeless shelters is highly recommended. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Ryan Van Patten
- Department of Psychiatry, University of California, San Diego
| | - Lea Vella
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology
| | - Zanjbeel Mahmood
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology
| | | | - Jacqueline E Maye
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
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Dunn K, Rydzewska E, Fleming M, Cooper SA. Prevalence of mental health conditions, sensory impairments and physical disability in people with co-occurring intellectual disabilities and autism compared with other people: a cross-sectional total population study in Scotland. BMJ Open 2020; 10:e035280. [PMID: 32341043 PMCID: PMC7204861 DOI: 10.1136/bmjopen-2019-035280] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To investigate prevalence of mental health conditions, sensory impairments and physical disability in children, adults and older adults with co-occurring intellectual disabilities and autism, given its frequent co-occurrence, compared with the general population. DESIGN Whole country cohort study. SETTING General community. PARTICIPANTS 5709 people with co-occurring intellectual disabilities and autism, compared with 5 289 694 other people. OUTCOME MEASURES Rates and ORs with 95% CIs for mental health conditions, visual impairment, hearing impairment and physical disability in people with co-occurring intellectual disabilities and autism compared with other people, adjusted for age, sex and interaction between age and co-occurring intellectual disabilities and autism. RESULTS All four long-term conditions were markedly more common in children, adults and older adults with co-occurring intellectual disabilities and autism compared with other people. For mental health, OR=130.8 (95% CI 117.1 to 146.1); visual impairment OR=65.9 (95% CI 58.7 to 73.9); hearing impairment OR=22.0 (95% CI 19.2 to 25.2); and physical disability OR=157.5 (95% CI 144.6 to 171.7). These ratios are also greater than previously reported for people with either intellectual disabilities or autism rather than co-occurring intellectual disabilities and autism. CONCLUSIONS We have quantified the more than double disadvantage for people with co-occurring intellectual disabilities and autism, in terms of additional long-term health conditions. This may well impact on quality of life. It raises challenges for staff working with these people in view of additional complexity in assessments, diagnoses and interventions of additional health conditions, as sensory impairments and mental health conditions in particular, compound with the persons pre-existing communication and cognitive problems in this context. Planning is important, with staff being trained, equipped, resourced and prepared to address the challenge of working for people with these conditions.
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Affiliation(s)
- Kirsty Dunn
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Ewelina Rydzewska
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | - Michael Fleming
- Department of Public Health, University of Glasgow, Glasgow, Scotland, UK
| | - Sally-Ann Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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Rocheleau JN, Cobigo V, Chalghoumi H, Jahan A, Jutai J, Lake J, Farrell S, Lachapelle Y. Factors affecting information technology use from the perspective of aging persons with cognitive disabilities: A scoping review of qualitative research. ACTA ACUST UNITED AC 2020. [DOI: 10.3233/tad-190242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
| | - Virginie Cobigo
- School of Psychology and Centre for Research on Educational and Community Services, University of Ottawa, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | | | - Alhadi Jahan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jeffrey Jutai
- Interdisciplinary School of Health Sciences and LIFE Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Johanna Lake
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | - Yves Lachapelle
- Psychoéducation Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Rossetti Z, Burke MM, Rios K, Rivera JI, Schraml-Block K, Hughes O, Lee JD, Aleman-Tovar J. Parent Leadership and Civic Engagement: Suggestions for the Next Individuals With Disabilities Education Act Reauthorization. JOURNAL OF DISABILITY POLICY STUDIES 2020. [DOI: 10.1177/1044207319901260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although parent involvement is a cornerstone of the Individuals with Disabilities Education Act (IDEA), few individual parents of children with disabilities participate in civic engagement to voice their suggestions for the next IDEA reauthorization. To address this gap, a civic engagement training was conducted with 95 parents of children with disabilities across four states. At the end of the training, participants completed videotaped testimonials voicing their suggestions for the next IDEA reauthorization. Participant suggestions clustered around three themes: expanding IDEA to address specific concerns; adding text to provide specificity and clarity in IDEA; and implementing the current version of IDEA. Implications for research and policy are discussed.
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Schofield D, Zeppel MJB, Tanton R, Veerman JL, Kelly SJ, Passey ME, Shrestha RN. Intellectual disability and autism: socioeconomic impacts of informal caring, projected to 2030. Br J Psychiatry 2019; 215:654-660. [PMID: 31524109 DOI: 10.1192/bjp.2019.204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Intellectual disability and autism spectrum disorder (ASD) influence the interactions of a person with their environment and generate economic and socioeconomic costs for the person, their family and society. AIMS To estimate costs of lost workforce participation due to informal caring for people with intellectual disability or autism spectrum disorders by estimating lost income to individuals, lost taxation payments to federal government and increased welfare payments. METHOD We used a microsimulation model based on the Australian Bureau of Statistics' Surveys of Disability, Ageing and Carers (population surveys of people aged 15-64), and projected costs of caring from 2015 in 5-year intervals to 2030. RESULTS The model estimated that informal carers of people with intellectual disability and/or ASD in Australia had aggregated lost income of AU$310 million, lost taxation of AU$100 million and increased welfare payments of AU$204 million in 2015. These are projected to increase to AU$432 million, AU$129 million and AU$254 million for income, taxation, and welfare respectively by 2030. The income gap of carers for people with intellectual disability and/or ASD is estimated to increase by 2030, meaning more financial stress for carers. CONCLUSIONS Informal carers of people with intellectual disability and/or ASD experience significant loss of income, leading to increased welfare payments and reduced taxation revenue for governments; these are all projected to increase. Strategic policies supporting informal carers wishing to return to work could improve the financial and psychological impact of having a family member with intellectual disability and/or ASD. DECLARATION OF INTEREST None.
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Affiliation(s)
- Deborah Schofield
- Professor of Health Economics, Centre for Economic Impacts of Genomic Medicine, Department of Economics, Faculty of Business and Economics, Macquarie University, Australia
| | - Melanie J B Zeppel
- Senior Research Fellow, Centre for Economic Impacts of Genomic Medicine, Department of Economics, Faculty of Business and Economics, Macquarie University, Australia
| | - Robert Tanton
- Professor, National Centre for Social and Economic Modelling, University of Canberra, Australia
| | | | - Simon J Kelly
- Professor, National Centre for Social and Economic Modelling, University of Canberra, Australia
| | - Megan E Passey
- Associate Professor, University Centre for Rural Health, University of Sydney, Australia
| | - Rupendra N Shrestha
- Senior Research Fellow, Centre for Economic Impacts of Genomic Medicine, Department of Economics, Faculty of Business and Economics, Macquarie University, Australia
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Brown HK, Ray JG, Liu N, Lunsky Y, Vigod SN. Rapid repeat pregnancy among women with intellectual and developmental disabilities: a population-based cohort study. CMAJ 2019; 190:E949-E956. [PMID: 30104188 DOI: 10.1503/cmaj.170932] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2018] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Rapid repeat pregnancy within 12 months of a live birth is associated with adverse perinatal outcomes. We evaluated the risk for rapid repeat pregnancy among women with intellectual and developmental disabilities, with whom sharing of information about pregnancy planning and contraception may be inadequate. METHODS We accessed population-based health administrative data for all women with an index live birth in Ontario, Canada, for the period 2002-2013. We used modified Poisson regression to compare relative risks (RRs) for a rapid repeat pregnancy within 12 months of the index live birth in women with and without intellectual and developmental disabilities, first adjusting for demographic factors and then additionally adjusting for social, health and health care disparities. RESULTS We compared 2855 women with intellectual and developmental disabilities and 923 367 women without such disabilities. At the index live birth, women with intellectual and developmental disabilities were more likely to be younger than 25 years of age (46.8% v. 18.2%) and to be disadvantaged on each measure of social, health and health care disparities. These women had a higher rate of rapid repeat pregnancy than those without such disabilities (7.6% v. 3.9%; adjusted RR 1.34, 95% confidence interval [CI] 1.18-1.54, after controlling for demographic factors). This risk was attenuated upon further adjustment for social, health and health care disparities (adjusted RR 1.00, 95% CI 0.87-1.14). INTERPRETATION Rapid repeat pregnancy, which was more common among women with intellectual and developmental disabilities, may be explained by social, health and health care disparities. To optimize reproductive health, multifactorial approaches to address the marginalization experienced by this population are likely needed.
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Affiliation(s)
- Hilary K Brown
- Interdisciplinary Centre for Health and Society, University of Toronto Scarborough (Brown), Dalla Lana School of Public Health (Brown, Liu), Department of Medicine (Ray) and Department of Psychiatry (Lunsky, Vigod), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Institute for Clinical Evaluative Sciences (Brown, Ray, Liu, Lunsky, Vigod); Li Ka Shing Knowledge Institute (Ray), St. Michael's Hospital; Centre for Addiction and Mental Health (Lunsky), Toronto, Ont.
| | - Joel G Ray
- Interdisciplinary Centre for Health and Society, University of Toronto Scarborough (Brown), Dalla Lana School of Public Health (Brown, Liu), Department of Medicine (Ray) and Department of Psychiatry (Lunsky, Vigod), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Institute for Clinical Evaluative Sciences (Brown, Ray, Liu, Lunsky, Vigod); Li Ka Shing Knowledge Institute (Ray), St. Michael's Hospital; Centre for Addiction and Mental Health (Lunsky), Toronto, Ont
| | - Ning Liu
- Interdisciplinary Centre for Health and Society, University of Toronto Scarborough (Brown), Dalla Lana School of Public Health (Brown, Liu), Department of Medicine (Ray) and Department of Psychiatry (Lunsky, Vigod), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Institute for Clinical Evaluative Sciences (Brown, Ray, Liu, Lunsky, Vigod); Li Ka Shing Knowledge Institute (Ray), St. Michael's Hospital; Centre for Addiction and Mental Health (Lunsky), Toronto, Ont
| | - Yona Lunsky
- Interdisciplinary Centre for Health and Society, University of Toronto Scarborough (Brown), Dalla Lana School of Public Health (Brown, Liu), Department of Medicine (Ray) and Department of Psychiatry (Lunsky, Vigod), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Institute for Clinical Evaluative Sciences (Brown, Ray, Liu, Lunsky, Vigod); Li Ka Shing Knowledge Institute (Ray), St. Michael's Hospital; Centre for Addiction and Mental Health (Lunsky), Toronto, Ont
| | - Simone N Vigod
- Interdisciplinary Centre for Health and Society, University of Toronto Scarborough (Brown), Dalla Lana School of Public Health (Brown, Liu), Department of Medicine (Ray) and Department of Psychiatry (Lunsky, Vigod), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Institute for Clinical Evaluative Sciences (Brown, Ray, Liu, Lunsky, Vigod); Li Ka Shing Knowledge Institute (Ray), St. Michael's Hospital; Centre for Addiction and Mental Health (Lunsky), Toronto, Ont
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