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Marshall GS, McCormick ZL, Johns JS, Verduzco-Gutierrez M, Herrera-Restrepo O, Harrison LH. Understanding the Sequelae of Invasive Meningococcal Disease in the United States. Infect Dis Ther 2024:10.1007/s40121-024-01026-w. [PMID: 39269567 DOI: 10.1007/s40121-024-01026-w] [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: 05/30/2024] [Accepted: 07/26/2024] [Indexed: 09/15/2024] Open
Abstract
Invasive meningococcal disease (IMD) is an uncommon but serious and potentially fatal condition that can result in reduced life expectancy and a broad spectrum of sequelae, many of which may be lifelong and devastating for those who survive the acute disease period. In the United States of America (USA), vaccination is available against the five meningococcal serogroups (A, B, C, W, and Y), but meningococcal vaccination rates among healthy USA adolescents and individuals at high risk because of medical conditions are low, rendering them vulnerable to IMD and its sequelae. Despite the severity of the disease, the clinical impact and rates of IMD sequelae in the USA are poorly understood, as USA-specific data are limited, and the methodology of existing research is heterogenous. This commentary presents clinical experts' perspectives on IMD sequelae based on the available published evidence and direct clinical experience. Among sequelae previously identified in a global systematic literature review, 16 conditions were considered as related to IMD by the present authors. These sequelae include short- and long-term physical, neurological, and emotional consequences that impose a substantial humanistic burden on survivors and their caregivers and result in considerable healthcare and societal costs. This commentary highlights existing knowledge gaps concerning IMD sequelae, including the unclear relationship between IMD and mental health disorders, the contribution of sequelae to the disease burden, prevalence of late-onset sequelae among survivors, and timing of the development of sequelae in different age groups. Addressing these knowledge gaps can inform decisions regarding clinical management in the post-acute period and help quantify the impact of prevention through meningococcal vaccination.
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Affiliation(s)
- Gary S Marshall
- Norton Children's and the University of Louisville School of Medicine, Louisville, KY, USA
| | | | | | | | | | - Lee H Harrison
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Rubenstein E, Tewolde S, Levine AA, Droscha L, Meyer RM, Michals A, Skotko B. Medicare, Medicaid, and dual enrollment for adults with intellectual and developmental disabilities. Health Serv Res 2024; 59:e14287. [PMID: 38264862 PMCID: PMC11063084 DOI: 10.1111/1475-6773.14287] [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] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE Given high rates of un- and underemployment among disabled people, adults with intellectual and developmental disabilities rely on Medicaid, Medicare, or both to pay for healthcare. Many disabled adults are Medicare eligible before the age of 65 but little is known as to why some receive Medicare services while others do not. We described the duration of Medicare enrollment for adults with intellectual and developmental disabilities in 2019 and then compared demographics by enrollment type (Medicare-only, Medicaid-only, dual-enrolled). Additionally, we examined the percent in each enrollment type by state, and differences in enrollment type for those with Down syndrome. DATA SOURCES AND STUDY SETTING 2019 Medicare and Medicaid claims data for all adults (≥18 years) in the US with claim codes for intellectual disability, Down syndrome, or autism at any time between 2011 and 2019. STUDY DESIGN Administrative claims cohort. DATA COLLECTION AND ABSTRACTION METHODS Data were from the Transformed Medicaid Statistical Information System Analytic Files and Medicare Beneficiary Summary files. PRINCIPLE FINDINGS In 2019, Medicare insured 582,868 adults with identified intellectual disability, autism, or Down syndrome. Of 582,868 Medicare beneficiaries, 149,172 were Medicare only and 433,396 were dual-enrolled. Most Medicare enrollees were enrolled as child dependents (61.5%) Medicaid-only enrollees (N = 819,256) were less likely to be white non-Hispanic (58.5% white non-Hispanic vs. 72.9% white non-Hispanic in dual-enrolled), more likely to be Hispanic (19.6% Hispanic vs. 9.2% Hispanic in dual-enrolled) and were younger (mean 34.2 years vs. 50.5 years dual-enrolled). CONCLUSION There is heterogeneity in public insurance enrollment which is associated with state and disability type. Action is needed to ensure all are insured in the program that works for their healthcare needs.
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Affiliation(s)
- Eric Rubenstein
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Salina Tewolde
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - A. Alex Levine
- Department of Health Policy Law and ManagementBoston University School of Public HealthBostonMassachusettsUSA
| | - Lillian Droscha
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Rachel Midori Meyer
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Amy Michals
- Biostatistics and Epidemiology Data Analytics CenterBoston University School of Public HealthBostonMassachusettsUSA
| | - Brian Skotko
- Massachusetts General HospitalBostonMassachusettsUSA
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Pedersen ER, Anke A, Langøy EE, Olsen MI, Søndenaa E. Mental health, challenging behaviour, diagnosis, and access to employment for people with intellectual disabilities in Norway. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13217. [PMID: 38459896 DOI: 10.1111/jar.13217] [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: 05/31/2023] [Revised: 11/09/2023] [Accepted: 02/10/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Studies have found that presence of challenging behaviours and mental health problems limits employment for people with intellectual disabilities. This study investigates the associations between age, gender, living condition, level of intellectual disability, diagnoses, behaviour, mental health, and employment in adults with intellectual disabilities in Norway. METHOD A cross-sectional community-based survey including 214 adult participants (56% men) with intellectual disabilities. RESULTS In our sample, 25% had no organised day activity, 27% attended non-work day care, 19% attended sheltered employment, or day care with production, without pay and 29% worked in paid sheltered employment. One participant attended mainstream employment. Moderate and severe/profound level of intellectual disability, possible organic condition and irritability significantly reduced the odds of employment (paid and unpaid). CONCLUSION Findings suggest unequal access to the sheltered employment that was meant to be inclusive. More individualised evaluation of prerequisites is suggested to further facilitate employment for this group.
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Affiliation(s)
- Erlend Refseth Pedersen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emmy Elizabeth Langøy
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Høgskolen i Molde, Molde, Norway
| | - Monica Isabel Olsen
- Faculty of Humanities, Social Sciences and Teacher Education, Department of Teacher Education and Pedagogy, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Erik Søndenaa
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olavs Hospital, Centre for Research and Education in Forensic Psychiatry, Trondheim, Norway
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DuBois LA, Bradley V, Isvan N. An observational investigation of unemployment, underemployment, and competitive integrated employment of people with intellectual and developmental disabilities in 2021-2022. Disabil Health J 2024:101620. [PMID: 38584036 DOI: 10.1016/j.dhjo.2024.101620] [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: 10/31/2023] [Revised: 02/14/2024] [Accepted: 03/26/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Employment is an important component of community living, and a precursor to economic stability and independence. Despite this, research consistently demonstrates people with intellectual and developmental disabilities (IDD) have low rates of community-based employment. However, little research has been conducted to quantify competitive integrated employment, and which individuals have better employment outcomes as it relates to competitive integrated employment. OBJECTIVE This study aims to explore the ways in which key service-related and demographic characteristics of individuals with IDD are associated with participation in competitive integrated employment. METHODS We used the 2021-2022 National Core Indicators Intellectual and Developmental Disabilities In-Person Survey dataset. We conducted bivariate and multivariate analyses, using chi-square and generalized linear models, to examine the cross-sectional relationship between employment and demographic and service-related characteristics for 4629 individuals with IDD. RESULTS Overall, 42% of the sample was unemployed but wanted a job, while 39% were underemployed and just 21% have competitive integrated employment. Several demographic and service-related characteristics were significantly associated with employment. After controlling for demographic and service-related correlates of employment, having an employment-related goal in one's service plan was associated with 4.5 (95% CI: 3.6-5.5) times higher odds of competitive integrated employment relative to unemployment. CONCLUSIONS This study underscores the value of person-centered planning for improved employment outcomes. Further research is needed to fully understand potential inequities in employment and system-level factors that are associated with competitive, integrated employment, as well as solutions to improve access to customized individual employment supports for all people with IDD.
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Affiliation(s)
- Lindsay A DuBois
- Human Services Research Institute, 2336 Massachusetts Avenue, Cambridge, MA, 02140, United States.
| | - Valerie Bradley
- Human Services Research Institute, 2336 Massachusetts Avenue, Cambridge, MA, 02140, United States
| | - Nilüfer Isvan
- Human Services Research Institute, 2336 Massachusetts Avenue, Cambridge, MA, 02140, United States
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John A, Evans S, Dow E. Parenthood and Glee: An online study to examine differences between viewers and non-viewers of television shows featuring a character with a developmental disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241239103. [PMID: 38482837 DOI: 10.1177/17446295241239103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
We present findings from our study, which examined whether ability to identify Down syndrome and autism was linked to participants' willingness to maintain social contact with individuals with the respective conditions. Additionally, we explored whether viewers and non-viewers of Parenthood and Glee, television shows featuring a character with autism and Down syndrome respectively, differed in their awareness, beliefs regarding causes and interventions, and desire to maintain social proximity with individuals with these conditions. Participants completed an online survey, which included vignettes based on Max, the character with autism from Parenthood and Becky, the character with Down syndrome from Glee as well as the adapted Intellectual Disabilities Literacy Scale. Based on 300 responses, key differences were noted in the hypothesized direction on the assessed variables (symptom recognition, causal beliefs, and treatment beliefs) between Parenthood and Glee viewers and non-viewers. Findings are discussed in the context of practical implications and methodological limitations.
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Affiliation(s)
- Aesha John
- Department of Social Work, Texas Christian University, Fort Worth, TX, USA
| | - Spencer Evans
- Department of Social Work, Texas Christian University, Fort Worth, TX, USA
| | - Emily Dow
- Department of Social Work, Texas Christian University, Fort Worth, TX, USA
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MacKenzie KT, Beck KB, Eack SM, Zeglen KN, Conner CM, Mazefsky CA. Developing a Measure of Key Adult Outcomes in Adults with Developmental Disabilities: Conceptual Model and Item Generation of the REALS (Relationships, Employment, Autonomy, and Life Satisfaction). J Autism Dev Disord 2024:10.1007/s10803-023-06219-9. [PMID: 38291244 DOI: 10.1007/s10803-023-06219-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 02/01/2024]
Abstract
Employment, social relationships, and autonomy are priorities to people with intellectual and developmental disabilities (IDDs). However, few validated measures exist to systematically assess these key adult outcomes in this population. This research includes first steps to develop self- and proxy report measures of life outcomes for adults with IDDs-the Relationships, Employment, Autonomy, and Life Satisfaction (REALS). A literature search identified existing adult outcome measures, and comparison of their domains informed initial conceptual model development. External consultants revised the model, and items were generated. Autistic adults (n = 15), adults with other IDDs (n = 7), caregivers of autistic adults (n = 13), and caregivers of adults with other IDDs (n = 10) completed in-depth cognitive interviews to assess comprehension of items and response categories, factors influencing how participants respond to items, and the inclusiveness of the item pool. A final conceptual model was generated with three subdomains (social relationships, employment, and autonomy), including assessment of life satisfaction within each domain. Cognitive interviews revealed that response set restructuring and item-level revisions were needed to capture the complexity of adult life and make the measure more accessible across a range of abilities. This study developed a conceptual model of relationships, work, and autonomy specific to adults with IDDs. Future work will involve collecting data from 800 + self-reporters with IDDs and 800 + caregivers of adults with IDDs to conduct psychometric analyses. Improving measurement in this area is critical to better understanding the needs of adults with IDDs and improving services available to them.
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Affiliation(s)
| | - Kelly B Beck
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shaun M Eack
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- University of Pittsburgh, School of Social Work, Pittsburgh, PA, USA
| | | | - Caitlin M Conner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carla A Mazefsky
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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Houseworth J, Pettingell SL, Bershadsky J, Tichá R, Lemanowicz J, Feinstein C, Zhang A. Examining Choice and Control for People With IDD Over Time. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:449-461. [PMID: 37875272 DOI: 10.1352/1944-7558-128.6.449] [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: 02/04/2022] [Accepted: 02/14/2023] [Indexed: 10/26/2023]
Abstract
Choice making is an important aspect of everyone's life in terms of fully becoming an adult within a democratic society. People with intellectual and developmental disabilities (IDD) are at risk for diminished choice making due to various factors, including guardianships; dependence on supports that are not person-centered; and, in some cases, limited capacity to express one's desires effectively. Independent Monitoring for Quality (IM4Q) data for 9,195 and 9,817 for adult services users with IDD were analyzed across two types of choice. Repeated measures mixed regression examined choice over time after controlling for age, support needs, residence type, and community type. We found significant increases in everyday choice making among IDD service users in Pennsylvania, but not in support-related choice. This study is the first to our knowledge to consider change in choice making, an important indicator of rights and inclusion for persons with IDD. By comparing three waves of data from the state of Pennsylvania (2013, 2016, and 2019), we were able to detect changes in choice making over time among home and community-based service (HCBS) users with IDD.
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Affiliation(s)
- James Houseworth
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - Sandra L Pettingell
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - Julie Bershadsky
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - Renáta Tichá
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - James Lemanowicz
- James Lemanowicz and Celia Feinstein, Institute on Disabilities, Temple University
| | - Celia Feinstein
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - Alicia Zhang
- Alicia Zhang, Institute on Community Integration, University of Minnesota
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Belisle J, Burke R, Janota T, Dennis L, Taylor S. Promoting the Emergence of Vocational Knowledge through Equivalence-Based Instruction with a Young Adult with Autism. Behav Anal Pract 2023:1-6. [PMID: 37363647 PMCID: PMC10228887 DOI: 10.1007/s40617-023-00814-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/28/2023] Open
Abstract
We sought to evaluate the efficacy of an equivalence-based instructional program to teach vocational information to a young adult. This work has the potential to aid in workplace or vocational programming to teach declarative information about employment settings. We directly reinforced a subset of relations [Employee names (A) to job titles (B) (A-B) and a job titles (B) to a job responsibilities (C) (B-C)] and tested for the untrained emergence of other relations [Employee names (A) to job responsibilities (C) (A-C) and job responsibilities (C) to employee names (A) (C-A)]. In a multiple baseline across employment settings, mastery was observed across trained and derived relations with implications for vocational training. Supplementary Information The online version contains supplementary material available at 10.1007/s40617-023-00814-z.
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Affiliation(s)
- Jordan Belisle
- Missouri State University, 901 South National Avenue, Springfield, MO USA
| | - Ray Burke
- Apex Regional Program, Glenwood, IA USA
| | - Taylor Janota
- Missouri State University, 901 South National Avenue, Springfield, MO USA
| | - Lindsey Dennis
- Missouri State University, 901 South National Avenue, Springfield, MO USA
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Berástegui A, Suárez G, Gonzalez MD. Competencies and employment after a university program in young people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231178107. [PMID: 37217439 DOI: 10.1177/17446295231178107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study analyzes the relationship between the employability competencies acquired after completing an employment training program at university and the subsequent access to employment of young people with intellectual disabilities. To do this, the employability competencies of 145 students were analyzed at the end of the program (T1) and information was gathered on their career path at the time of the study (T2) (n = 72). Sixty-two per cent of the participants have had at least one job since graduation. Job competencies increase the probability of accessing and retaining employment in students who graduated at least 2 years before (X2 = 17.598; p < .001; r2 = .583). These results compel us to complement employment training programs with new opportunities and greater job accessibility.
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Affiliation(s)
- Ana Berástegui
- Cátedra de Familia y Discapacidad: Fundación Repsol-Down Madrid, Instituto Universitario de la Familia, Universidad Pontificia Comillas, Madrid, Spain
| | - Graciela Suárez
- Cátedra de Familia y Discapacidad: Fundación Repsol-Down Madrid, Instituto Universitario de la Familia, Universidad Pontificia Comillas, Madrid, Spain
| | - María Dolores Gonzalez
- Cátedra de Familia y Discapacidad: Fundación Repsol-Down Madrid, Instituto Universitario de la Familia, Universidad Pontificia Comillas, Madrid, Spain
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Lewańczyk AM, Langham-Walsh E, Edwards L, Branney P, Walters ER, Mitchell P, Vaportzis E. Back Onside protocol: A physical activity intervention to improve health outcomes in people who are unemployed or at risk of unemployment. EVALUATION AND PROGRAM PLANNING 2023; 97:102204. [PMID: 36529025 DOI: 10.1016/j.evalprogplan.2022.102204] [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: 10/14/2021] [Revised: 11/24/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Given the effects of physical activity on people's mental and physical health, a better understanding is needed of how physical activity interventions may impact the health of people who are unemployed or at risk of unemployment. This has added urgency in the context of rising rates of poverty-related unemployment in the UK in 2022. The current paper details the protocol used in the evaluation of the Back Onside Programme; a community-based programme delivered by the Bradford Bulls Foundation in the Bradford District. The Programme supports people from low socio-economic backgrounds who are unemployed or at risk of unemployment to maintain regular physical activity through a ten-week physical activity intervention. This pilot study evaluates how a physical activity intervention may impact the mental and physical health of people who are unemployed or at risk of unemployment in an uncontrolled pragmatic pilot study. Four cohorts run back-to-back between May 2021 and May 2022, with separate groups for men (N = 100) and women (N = 60). Physical and wellbeing assessment at baseline and post-intervention is conducted. If the intervention works in this context for these individuals, it will be a promising low-cost community-based intervention for people who are unemployed or at risk of unemployment.
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Affiliation(s)
| | | | - Lisa Edwards
- University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford, UK
| | - Peter Branney
- University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford, UK
| | - Elizabeth R Walters
- University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford, UK
| | | | - Eleftheria Vaportzis
- University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford, UK.
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Galán-Olleros M, Ramírez-Barragán A, Rodríguez-Zamorano P, Egea-Gámez RM, Serrano JI, Martínez-Caballero I. Long-term Impact of Planovalgus Foot on Activities of Daily Living in Patients With Down Syndrome. J Pediatr Orthop 2023; 43:259-267. [PMID: 36728006 DOI: 10.1097/bpo.0000000000002354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Planovalgus foot (PVF) is the most common orthopaedic abnormality in children with Down syndrome (DS), and as a result these patients rarely develop an adequate plantar arch in adulthood. The present study aims to evaluate the impact of PVF on activities of daily living and participation in sports among young adults with DS and determine whether this impact is related to the degree of foot deformity based on clinical and imaging studies. METHODS Observational analytical study examining a database of 649 patients with DS from a pediatric referral center, identifying those individuals over age 20 years at the time of the study with a childhood diagnosis of PVF. Finally, 51 patients (102 feet) were evaluated based on clinical and imaging studies, and function was assessed using the The Foot and Ankle Outcome Score (FAOS) and the Visual Analogue Scale (VAS) pain scale. A correlation analysis was performed to determine the clinical and radiographic variables associated with functional outcomes. Linear regression models were obtained to quantify the impact of these variables on function. RESULTS Patients had a mean age of 26.14±3.88 years and body mass index of 24.51±4.57. Clinically, 63.65% presented grade 3 or 4 PVF, and most were flexible. Radiographically, midfoot flattening was mild-moderate in 92.16%, 58.82% had medial talo-navicular uncoverage, and 30.39% had an increased hallux valgus (HV) angle. Mean scores for all FAOS subscales were between 65 and 71% and the mean VAS score was 1.45±1.96. An association analysis revealed a tendency toward lower scores on all FAOS subscales and greater pain according to the VAS scale in more severe PVF and in cases of moderate HV with asymmetry between feet. Linear regression models showed that major contributors to functional scores were radiographic evidence of hindfoot valgus, midfoot abduction, and flattening, and HV. CONCLUSIONS Young adults with DS who are diagnosed with PVF in childhood have acceptable functional scores and low pain. Alteration of radiographic parameters toward flatter, more valgus and abducted feet and greater and asymmetric HV tend to be associated with worse long-term functional scores in activities of daily living and sports participation and increased pain. Therefore, non-operative management of these patients is justified, although individualized treatment is recommended. LEVEL OF EVIDENCE Level IV, Case series.
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Affiliation(s)
| | | | | | - Rosa M Egea-Gámez
- Neural and Cognitive Engineering group, Center for Automation and Robotics, CAR CSIC-UPM, Arganda del Rey, Madrid, Spain
| | - J Ignacio Serrano
- Neural and Cognitive Engineering group, Center for Automation and Robotics, CAR CSIC-UPM, Arganda del Rey, Madrid, Spain
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Ra YA. Factors Affecting Disability Disclosure in Employment Setting for Individuals with Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3054. [PMID: 36833769 PMCID: PMC9959408 DOI: 10.3390/ijerph20043054] [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: 12/29/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to increase the understanding of this disability disclosure of people with intellectual disability by examining the determinants of their disclosure at work. For this aim, six individuals with intellectual disability were interviewed, and consensual qualitative research (CQR) was used to identify factors related to their disability disclosure. As results, the factors that affect the disability disclosure were largely divided into personal variables and environmental variables, and various factors including confidence, disability severity, employment type, employers, co-workers, and organizational culture were mentioned. The results of this study can help people have better understanding about disability disclosure in employment settings. We also discuss how vocational education for individuals with intellectual disability should be offered.
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Affiliation(s)
- Young-An Ra
- School of Counseling Psychology and Social Welfare, Handong Global University, Pohang-si 37554, Republic of Korea
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13
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Schwartz AE, Corey J, Duff J, Herer A, Rogers ES. Anticipating the outcomes: how young adults with developmental disabilities and co-occurring mental health conditions make decisions about disclosure of their mental health conditions at work. Disabil Rehabil 2023; 45:602-612. [PMID: 35152805 DOI: 10.1080/09638288.2022.2037749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE Little is known about how young adults (YA) with developmental disabilities (DD) and co-occurring mental health conditions navigate workplace disclosure of their mental health condition(s). We sought to understand the guidance professionals provide regarding disclosure and the decisions YA makes about disclosure of mental health conditions. METHODS We conducted focus groups with professionals who support YA with DD to attain and maintain employment (n = 17) and individual interviews with YA with DD and co-occurring mental health conditions (n = 12; DD diagnoses: autism, n = 9, other DD, n = 3). We conducted content analysis to identify why, when, what, and to whom YA disclose their mental health condition and guidance provided regarding disclosure. RESULTS YA and professionals described disclosure decisions as largely influenced by perceived needs (i.e., need for accommodations) and anticipated positive (e.g., support) and negative (e.g., stigma, not being hired) outcomes. They largely constrained disclosure to work-relevant content. Many YA disclosed to coworkers with whom they were comfortable, though both YA and professionals agreed that initial disclosure should be limited to supervisors and/or human resources. CONCLUSIONS Workplaces may support disclosure-a necessity for the provision of accommodations-by cultivating an inclusive environment and openly demonstrating familiarity and comfort with employees with disabilities.IMPLICATIONS FOR REHABILITATIONProfessionals who support young adults with developmental disabilities and co-occurring mental health conditions should be well-versed in current laws and regulations on disclosure and reasonable workplace accommodations.Workplace culture is one major factor impacting how disclosure is handled, including whether the disclosure is required at all.Individuals with disabilities and professionals should recognize that timing, content, and decisions to disclose may vary by individuals' needs and workplace supports, and that change may occur over time.
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Affiliation(s)
- Ariel E Schwartz
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | | | | | | | - E Sally Rogers
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
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14
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Ijezie OA, Healy J, Davies P, Balaguer-Ballester E, Heaslip V. Quality of life in adults with Down syndrome: A mixed methods systematic review. PLoS One 2023; 18:e0280014. [PMID: 37126503 PMCID: PMC10150991 DOI: 10.1371/journal.pone.0280014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/30/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND As the life expectancy of adults (aged ≥ 18 years) with Down syndrome increases for a plethora of reasons including recognition of rights, access, and technological and medical advances, there is a need to collate evidence about their quality of life. OBJECTIVE Using Schalock and Verdugo's multidimensional quality of life assessment model, this systematic review aimed to identify, synthesise and integrate the quantitative and qualitative evidence on quality of life in adults with Down syndrome via self-and proxy-reporting. METHODS Five databases were systematically searched: MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science to identify relevant articles published between 1980 and 2022 along with grey literature and reference lists from relevant studies. A mixed methods systematic review was performed according to the Joanna Briggs Institute methodology using the convergent integrated approach. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Thirty-nine studies were included: 20 quantitative, 17 qualitative, and 2 mixed methods studies. The synthesised findings were grouped into the 8 core domains of quality of life: personal development, self-determination, interpersonal relations, social inclusion, rights, emotional, physical and material well-being. Of the 39 studies, 30 (76.92%) reported on emotional well-being and 10 (25.64%) on rights. Only 7 (17.94%) studies reported that adults with Down syndrome have a good quality of life centred around self-determination and interpersonal relations. Most adults with Down syndrome wanted to become more independent, have relationships, participate in the community, and exercise their human rights. Self-reported quality of life from adults with Down syndrome was rated higher than proxy reported quality of life. Discrepancies in quality of life instruments were discovered. CONCLUSION This review highlighted the need for a better systematic approach to improving the quality of life in adults with Down syndrome in targeted areas. Future research is required to evaluate self-and proxy-reporting methods and culture-specific quality of life instruments that are more appropriate for adults with Down syndrome. In addition, further studies should consider including digital assistive technologies to obtain self-reported quality of life data in adults with Down syndrome. INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER CRD42019140056.
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Affiliation(s)
- Ogochukwu Ann Ijezie
- Department of Computing and Informatics, Bournemouth University, Poole, United Kingdom
| | - Jane Healy
- Department of Social Science and Social Work, Bournemouth University, Lansdowne, United Kingdom
| | - Philip Davies
- Department of Computing and Informatics, Bournemouth University, Poole, United Kingdom
| | - Emili Balaguer-Ballester
- Department of Computing and Informatics, Bournemouth University, Poole, United Kingdom
- Bernstein Centre for Computational Neuroscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Vanessa Heaslip
- School of Health and Society, University of Salford, Manchester, United Kingdom
- Department of Social Studies, University of Stavanger, Stavanger, Norway
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Broda MD, Bogenschutz M, Lineberry S, Dinora P, Prohn S, West A. Comparing employment, employment services, and employment goals in propensity-matched samples of people with intellectual and developmental disabilities with and without autism. JOURNAL OF VOCATIONAL REHABILITATION 2023; 58:10.3233/jvr-230019. [PMID: 38528971 PMCID: PMC10961952 DOI: 10.3233/jvr-230019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background People with intellectual and developmental disabilities (IDD) tend to have poor employment outcomes relative to the general population, as do people with autism. Research is unclear, however, about how people with IDD with and without autism compare on a variety of employment-related indicators, including desire to work, having work as a goal in their service plans, and being employed. Objectives To understand how people with IDD with and without autism compare on important employment related outcomes, based on a matched random sample. Methods Using merged administrative datasets, we used propensity score matching to construct statistically proximate samples of Medicaid waiver users in a single state with IDD both with and without autism, and then tested differences between the two groups on important employment-related indicators. Results People with IDD and autism were less likely than people with IDD alone to have a goal for employment in their individualized service plans and to hold employment in group community settings. There was no statistical difference between the two groups in terms of desire to have a job or employment in individual community settings. Conclusions Results reinforce the importance of planning for employment if holding employment is a person's aim, regardless of the presence of autism.
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Affiliation(s)
- Michael D Broda
- Virginia Commonwealth University, Department of Foundations of Education, 1015 W. Main Street, Richmond, VA, USA 23284-2020
| | | | - Sarah Lineberry
- School of Social Work, Virginia Commonwealth University, Virginia, USA
| | - Parthenia Dinora
- Partnership for People with Disabilities, Virginia Commonwealth University, Virginia, USA
| | - Seb Prohn
- Partnership for People with Disabilities, Virginia Commonwealth University, Virginia, USA
| | - Angela West
- Partnership for People with Disabilities, Virginia Commonwealth University, Virginia, USA
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Schutz MA, Schwartzman B, Awsumb JM, Burgess L, Carter EW, Taylor JL. Pathways to paid work for youth with severe disabilities: Perspectives on strategies for success. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND: Paid work during high school serves as a steppingstone to postsecondary employment for young adults with severe disabilities. Yet youth with significant cognitive impairments rarely have the opportunity to experience paid work during high school. OBJECTIVE: The purpose of this study was to identify the range of facilitators that promote paid employment for youth with severe disabilities during high school. METHODS: We conducted individual and focus group interviews with 74 special educators, adult agency providers, school district leaders, family members of youth with severe disabilities, and local employers. RESULTS: Participants discussed 36 facilitators spanning nine major categories: collaboration, training and information, attitudes and mindsets, supports for youth, youth work experiences, knowledge and skill instruction, staffing, individualization, and transportation. We identified similarities and differences in the factors emphasized by each of the five stakeholder groups. CONCLUSION: Renewed attention should be focused on key practices and partnerships needed to facilitate community-based work experiences for youth with severe disabilities prior to graduation.
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Affiliation(s)
| | - Ben Schwartzman
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Jessica M. Awsumb
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Leah Burgess
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Erik W. Carter
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
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17
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Schwartz A, Hwang IT. Supporting young adults with intellectual/developmental disabilities to deliver a peer mentoring intervention: Evaluating fidelity and resources required. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1336-1347. [PMID: 35730690 DOI: 10.1111/jar.13022] [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: 10/29/2021] [Revised: 05/20/2022] [Accepted: 05/27/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Peer-delivered interventions are a best practice in mental health, yet no such intervention exists for young adults (YA) with intellectual/developmental disabilities with co-occurring mental health conditions. We evaluated YA with intellectual/developmental disabilities' ability to deliver a novel peer mentoring intervention with fidelity and the supports received. METHODS We coded audio-recorded mentoring sessions to evaluate if 4 mentors adhered to 'content' (e.g., psychoeducation) and 'quality' (e.g., validation) fidelity criteria (codes: yes/no). We conducted content analysis of mentor support logs and interviews with mentors', mentors' parents and teachers to describe the supports mentors received. RESULTS Average fidelity for content criteria (M = 73.3%) was higher than quality criteria (M = 60.0%). Weekly support addressed logistics, delivering content, interpersonal interactions, emotional support, professionalism, and organisation. Family members and teachers rarely provided additional support. CONCLUSIONS With support, YA can deliver a peer mentoring intervention addressing mental health. Additional training activities will be developed to improve fidelity.
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Affiliation(s)
- Ariel Schwartz
- Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA
| | - I-Ting Hwang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
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18
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Houseworth J, Pettingell SL, Stancliffe RJ, Bershadsky J, Tichá R, Zhang A. Community employment, facility-based work, and day activities for working age people with intellectual and developmental disability. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Individuals with Intellectual and Developmental Disability (IDD) participate in a variety of day/employment activities including community-based activities and work and facility-based activities and work. These different activities have important implications for community inclusion and economic independence. OBJECTIVE: The purpose of this study is to use the National Core Indicators-In person Survey (NCI-IPS) to explore the prevalence of day/employment activities for adult service users with IDD and to determine what personal and environmental factors are related to each type of activity. METHODS: The data analyzed in this study come from the 2018-19 National Core Indicators (NCI), a survey of adult services users with IDD in the U.S. We used descriptive statistics and multinominal logistic regression to explore how the various covariates differentially relate to the four day/employment activity types. RESULTS: A variety of personal and environmental characteristics were associated with each type of activity. Characteristics related to equity (e.g., race and gender) and support needs (e.g., mental health) were associated with less community-based work. CONCLUSIONS: This study was the first, to our knowledge, to describe the complexity of day/employment activities individuals with IDD experience in terms of prevalence and overlap. Further, this study provides evidence that certain profiles are leading to different experiences and that services do impact service users employment opportunities.
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Affiliation(s)
- James Houseworth
- Institute on Community Integration, University ofMinnesota, Minneapolis, MN, USA
| | - Sandra L. Pettingell
- Institute on Community Integration, University ofMinnesota, Minneapolis, MN, USA
| | - Roger J. Stancliffe
- Institute on Community Integration, University ofMinnesota, Minneapolis, MN, USA
| | - Julie Bershadsky
- Institute on Community Integration, University ofMinnesota, Minneapolis, MN, USA
| | - Renáta Tichá
- Institute on Community Integration, University ofMinnesota, Minneapolis, MN, USA
| | - Alicia Zhang
- Institute on Community Integration, University ofMinnesota, Minneapolis, MN, USA
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19
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Hennessey RE, Goreczny AJ. Employment preferences of individuals with intellectual and developmental disabilities: An evaluation of gender and age differences. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:878-888. [PMID: 35318779 DOI: 10.1111/jar.12992] [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: 07/16/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Employment is often central to individuals' lives. However, individuals with intellectual or developmental disabilities are often absent from the workplace, and little research has examined their interest in working. AIMS This study examined whether people with intellectual and/or developmental disabilities want jobs; why they do or do not want jobs; and, if they want to work, what types of jobs they would like to have. MATERIALS AND METHODS Our analyses consisted of 629 participants (379 male, 248 female, 2 unspecified) who participated in an interview. RESULTS Results suggested that many individuals with intellectual or developmental disabilities want jobs. Our study identified gender differences in vocational interests and motivation for employment. There were no significant differences between age groups. DISCUSSION AND CONCLUSION In the future, research could expand upon these findings by exploring how various factors, such as other social identities, affect vocational interests of individuals with intellectual or developmental disabilities.
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Affiliation(s)
- Robin E Hennessey
- Department of Graduate Psychology, Chatham University, Pittsburgh, Pennsylvania, USA
| | - Anthony J Goreczny
- Department of Graduate Psychology, Chatham University, Pittsburgh, Pennsylvania, USA
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20
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Wendelborg C, Garrels V, Sigstad HMH, Dean EE. Recruitment and work arrangements for employees with intellectual disability in competitive employment. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Veerle Garrels
- Department of Vocational Teacher Education Oslo Metropolitan University Oslo Norway
| | | | - Evan E. Dean
- Center on Developmental Disabilities Kansas University Lawrence Kansas USA
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21
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Prohn SM, Dinora P, Broda MD, Bogenschutz M, Lineberry S. Measuring Four Personal Opportunities for Adults With Intellectual and Developmental Disabilities. INCLUSION (WASHINGTON, D.C.) 2022; 10:19-34. [PMID: 35721258 PMCID: PMC9201575 DOI: 10.1352/2326-6988-10.1.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study tests an empirically derived model for measuring personal opportunities for people with intellectual and developmental disabilities (IDD) using National Core Indicators In-Person Survey (NCI-IPS) state and national datasets. The four personal opportunities measured, (a) privacy rights, (b) everyday choice, (c) community participation, and (d) expanded friendships, were informed by existing conceptualizations of service as well as NCI-IPS measures. Analyses confirmed the fit of a four-factor model and demonstrated that factors were significantly and positively correlated. To demonstrate the relationships between personal opportunities and personal and environmental characteristics, we estimated a structural equation model that regressed personal opportunities on age, gender, place of residence, and level of intellectual disability. Implications for using personal opportunities for evaluating service quality of IDD systems are discussed.
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Affiliation(s)
- Seb M Prohn
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| | - Parthenia Dinora
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| | - Michael D Broda
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| | - Matthew Bogenschutz
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| | - Sarah Lineberry
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
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22
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Broda MD, Bogenschutz M, Dinora P, Prohn SM, Lineberry S, Ross E. Using Machine Learning to Predict Patterns of Employment and Day Program Participation. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:477-491. [PMID: 34700349 DOI: 10.1352/1944-7558-126.6.477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/16/2021] [Indexed: 06/13/2023]
Abstract
In this article, we demonstrate the potential of machine learning approaches as inductive analytic tools for expanding our current evidence base for policy making and practice that affects people with intellectual and developmental disabilities (IDD). Using data from the National Core Indicators In-Person Survey (NCI-IPS), a nationally validated annual survey of more than 20,000 nationally representative people with IDD, we fit a series of classification tree and random forest models to predict individuals' employment status and day activity participation as a function of their responses to all other items on the 2017-2018 NCI-IPS. The most accurate model, a random forest classifier, predicted employment outcomes of adults with IDD with an accuracy of 89 percent on the testing sample, and 80 percent on the holdout sample. The most important variable in this prediction was whether or not community employment was a goal in this person's service plan. These results suggest the potential machine learning tools to examine other valued outcomes used in evidence-based policy making to support people with IDD.
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Affiliation(s)
- Michael D Broda
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Matthew Bogenschutz
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Parthenia Dinora
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Seb M Prohn
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Sarah Lineberry
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
| | - Erica Ross
- Michael D. Broda, Matthew Bogenschutz, Parthenia Dinora, Seb M. Prohn, Sarah Lineberry, and Erica Ross, Virginia Commonwealth University
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23
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Fong CJ, Taylor J, Berdyyeva A, McClelland AM, Murphy KM, Westbrook JD. Interventions for improving employment outcomes for persons with autism spectrum disorders: A systematic review update. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1185. [PMID: 37052419 PMCID: PMC8354554 DOI: 10.1002/cl2.1185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The incidence of autism spectrum disorders (ASD) is on the rise. Currently, 1 in 59 children are identified with ASD in the United States. ASD refers to a range of neurological disorders that involve some degree of difficulty with communication and interpersonal relationships. The range of the spectrum for autism disorders is wide with those at the higher functioning end often able to lead relatively independent lives and complete academic programs even while demonstrating social awkwardness. Those at the lower functioning end of the autism spectrum often demonstrate physical limitations, may lack speech, and have the inability to relate socially with others. As persons with ASD age, options such as employment become increasingly important as a consideration for long-term personal planning and quality of life. While many challenges exist for persons with ASD in obtaining and maintaining employment, some research shows that, with effective behavioral and social interventions, employment can occur. About 37% of individuals with ASD report having been employed for 12 months or more, 4 years after exiting high school. However, several studies show that individuals with ASD are more likely to lose their employment for behavioral and social interaction problems rather than their inability to perform assigned work tasks. Although Westbrook et al. (2012a, 2013, 2015) have reviewed the literature on interventions targeting employment for individuals with ASD, this review is outdated and does not account for recent developments in the field. OBJECTIVES The objective of this review is to determine the effectiveness of employment interventions in securing and maintaining employment for adults and transition-age youth with ASD, updating two reviews by Westbrook et al. (2012a, 2013). SEARCH METHODS The comprehensive search strategy used to identify relevant studies included a review of 28 relevant electronic databases. Search terminology for each of the electronic databases was developed from available database thesauri. Appropriate synonyms were used to maximize the database search output. Several international databases were included among the 28 databases searched. In addition, the authors identified and reviewed gray literature through analysis of reference lists of relevant studies. Unpublished dissertations and theses were also identified through database searches. The programs of conferences held by associations and organizations relevant to ASD and employment were also searched. In sum, the search strategy replicated and expanded the prior search methods used by Westbrook et al. (2012a, 2013). SELECTION CRITERIA Selection criteria consisted of an intervention evaluation using a randomized controlled trial or quasi-experimental design, an employment outcome, and a population of individuals with ASD. DATA COLLECTION AND ANALYSIS We updated the search from Westbrook et al., replicating and broadening the information retrieval processes. Our wide array of sources included electronic databases, gray literature, and conference and organization websites. Once all potentially relevant studies were located, pairs of coders evaluated the relevance of each title and abstract. Among the studies deemed potentially relevant, 278 were subjected to full-text retrieval and screening by pairs of coders. Because many intervention studies did not include employment outcomes, only three studies met our inclusion criteria. Given the small number of included studies, meta-analytic procedures were not used; rather, we opted to use more narrative and descriptive analysis to summarize the available evidence, including an assessment of risk of bias. RESULTS The systematic review update identified three studies that evaluated employment outcomes for interventions for individuals with ASD. All three studies identified in the review suggest that vocation-focused programs may have positive impacts on the employment outcomes for individuals with ASD. Wehman et al. indicated that participants in Project SEARCH had higher employment rates than control participants at both 9-month and 1-year follow-up time points. Adding autism spectrum disorder supports, Project SEARCH in Wehman et al.'s study also demonstrated higher employment rates for treatment participants than control participants at postgraduation, 3-month follow-up, and 12-month follow-up. Smith et al. found that virtual reality job interview training was able to increase the number of job offers treatment participants received compared to control participants. AUTHORS' CONCLUSIONS Given that prior reviews did not identify interventions with actual employment outcomes, the more recent emergence of evaluations of such programs is encouraging. This suggests that there is a growing body of evidence regarding interventions to enhance the employment outcomes for individuals with ASD but also greater need to conduct rigorous trials of vocation-based interventions for individuals with ASD that measure employment outcomes.
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Michalski SC, Ellison C, Szpak A, Loetscher T. Vocational Training in Virtual Environments for People With Neurodevelopmental Disorders: A Systematic Review. Front Psychol 2021; 12:627301. [PMID: 34305704 PMCID: PMC8292897 DOI: 10.3389/fpsyg.2021.627301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 06/08/2021] [Indexed: 11/16/2022] Open
Abstract
People with neurodevelopmental disorders are often considered unsuitable or incapable of working in open employment. When employment is available, tasks are often limited, and opportunities for career development are restricted. Policy and funding constraints leave people with disabilities without an opportunity to develop skills due to the additional time and costs for employers. To overcome these barriers, virtual environments have been proposed as a safe and reliable solution for training. An important prerequisite for a wider uptake of training in virtual environments are demonstrations that the training leads to improved performance in the real world. This is particularly true for people with neurodevelopmental disorders, as transferring learnings from one context to another can be challenging. A systematic review was conducted to assess whether training in virtual environments can be used to improve real-world vocational skills in people with neurodevelopmental disorders. After a systematic search in six databases, eight out of the initially identified 1,806 articles met the inclusion criteria. The findings from these eight studies demonstrate that people with neurodevelopmental disorders can transfer vocational skills from virtual environments to real-world settings. With substantial technological improvements, a surge in accessibility, and improved affordability, there is a need to build upon the promising results identified in this review.
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Affiliation(s)
- Stefan C Michalski
- UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Caroline Ellison
- UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Ancret Szpak
- UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Tobias Loetscher
- UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
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Schwartz AE, Rogers ES, Russinova Z. Predictors of community-based employment for young adults with intellectual disability and co-occurring mental health conditions. Disabil Rehabil 2021; 44:1609-1618. [PMID: 34011223 DOI: 10.1080/09638288.2021.1907457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To identify predictors of community-based employment and employment quality for young adults ages 23-30 with intellectual disability and co-occurring mental health conditions (YA-ID-MH). METHODS We conducted secondary analysis of the 2017-2018 National Core Indicators® (NCI®) In-Person Survey. The NCI® survey was conducted in 35 states and Washington DC. Participants: YA with ID, ages 23-30 who had complete data. We conducted multiple regression analyses to examine demographic and environmental predictors of community-based employment, in addition to employment quality indicators: hourly wages, hours worked, and job duration. We also descriptively examined job satisfaction. RESULTS YA-ID-MH were somewhat less likely to be employed per record review and self-report than YA with ID only, but these findings did not reach statistical significance. On average, YA with ID only had higher hourly wages and worked more hours than those with ID-MH, but there were no significant differences in job duration. For YA-ID-MH, predictors of employment included gender, race, level of ID, and residential setting. Multiple demographic and environmental factors predicted employment quality. CONCLUSIONS YA-ID-MH experience employment disparities compared to YA with ID only. Service providers should specifically attend to those at the highest risk of unemployment/low quality employment.IMPLICATIONS FOR REHABILITATIONYoung adults with intellectual/developmental disabilities and co-occurring mental health conditions (ID-MH) experience employment disparities.Young adults with ID-MH who are non-white and female may have particularly low employment rates and employment quality.Societal-level interventions to address racial and gender-based bias may support individuals with ID-MH to acquire and maintain jobs by addressing disparities in social networks/social capital and ensuring equitable service provision and supports for those at the highest risk for unemployment.Policy makers should consider additional funding for employment services for transition-age youth with ID-MH, particularly those from marginalized populations.
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Affiliation(s)
- Ariel E Schwartz
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | - E Sally Rogers
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
| | - Zlatka Russinova
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA
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A Scoping Review of the Contextual Factors Impacting Employment in Neurodevelopmental Disorders. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00229-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lee A, Knafl G, Knafl K, Van Riper M. Quality of life in individuals with Down syndrome aged 4 to 21 years. Child Care Health Dev 2021; 47:85-93. [PMID: 32997835 DOI: 10.1111/cch.12815] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/11/2020] [Accepted: 09/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND To date, investigations of quality of life (QoL) in children with Down syndrome (DS) are rather limited. The purpose of this study was twofold: to examine QoL in children with DS and to explore possible differences in the QoL by age and gender. METHODS A cross-sectional study of 211 parents of children with DS was conducted using an online survey that included a consent form, a demographic questionnaire and the English version of KidsLife, which is a measure of children's QoL. RESULTS Our results demonstrated moderate or favourable levels of QoL except for the emotional well-being domain among children with DS. The children's QoL showed no variance by gender. However, emotional and material well-being, interpersonal relations and social inclusion varied by age. CONCLUSIONS The current findings provide important evidence that will help healthcare, educational and social services professionals to understand the multiple aspects of QoL in children with DS and support parents in their efforts to ensure the child's QoL. The results also point to the need to develop interventions aimed at improving QoL in those areas where children with DS are at increased risk for poorer QoL.
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Affiliation(s)
- Anna Lee
- Department of Nursing, College of Health and Welfare, Gangneung-Wonju National University, Wonju, South Korea
| | - George Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marcia Van Riper
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Romualdez AM. Autistic adults' experiences of diagnostic disclosure in the workplace: Decision-making and factors associated with outcomes. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2021; 6:23969415211022955. [PMID: 36381532 PMCID: PMC9620671 DOI: 10.1177/23969415211022955] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Autistic individuals often struggle to find and maintain employment. This may be because many workplaces are not suited to autistic individuals' needs. Among other difficulties, many autistic employees experience distracting or disruptive sensory environments, lack of flexibility in work hours, and unclear communication from colleagues. One possible way of mitigating these difficulties is for employees to disclose their diagnosis at work. While disclosure may increase understanding and acceptance from colleagues, it can also lead to discrimination and stigma in the workplace. Research has shown that disclosure outcomes are often mixed, but it is unclear what factors are associated with either positive or negative outcomes of disclosure for autistic people. This study aimed to identify these factors and explore the reasons why autistic employees choose to disclose or to keep their diagnosis private. Semi-structured interviews were conducted with 24 clinically-diagnosed autistic adults (12 male and 12 female) who were currently, or had been, employed in the UK (mean age = 45.7 years). Through thematic analysis, we identified three main themes under experiences of disclosure: 1) A preference for keeping my diagnosis private; 2) The importance of disclosure in the workplace; and 3) Disclosure has mixed outcomes. We also identified three factors associated with disclosure outcomes: understanding of autism, adaptations, and organisational culture. These results have implications for improving inclusive practices on both the individual and organisational level to ensure more positive disclosure experiences for autistic employees.
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Affiliation(s)
- Anna Melissa Romualdez
- Centre for Research in Autism and Education
(CRAE), UCL Institute of Education, University College London, London,
UK
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Matching Vocational Aptitude and Employment Choice for Adolescents and Adults with ASD. Behav Anal Pract 2020; 13:618-630. [PMID: 32953390 DOI: 10.1007/s40617-019-00398-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
As individuals age out of the public school system, they encounter what is colloquially referred to as the "services cliff." Although supports and services are readily available during school-age years, the lack of available resources for adults with autism spectrum disorder (ASD) is striking. Although schools are charged with preparing students for life after graduation, individuals with ASD are often woefully unprepared for integration into the workforce. Employment rates for adults with autism are lower than those reported for any other population of adults with disabilities (Burke, Andersen, Bowen, Howard, & Allen, 2010; Bush & Tassé, 2017; Newman, Wagner, Cameto, Knokey, & Shaver, 2010). In the present investigation, a skill-based vocational assessment was developed and implemented with 6 individuals diagnosed with ASD. The results of the assessment were used to design matched and unmatched jobs to determine if performance varied as a function of the assessment's results. The assessment resulted in varied job profiles across the participants. All the participants performed better (i.e., more on-task, less disruptive behavior) while completing jobs matched to their assessment results. In addition, when participants were allowed to choose between matched and unmatched jobs, they consistently chose to complete jobs that matched their profile results. Results from the current investigation suggest that a brief, skill-based vocational assessment may be a viable tool for improving employment outcomes for adolescents and adults with ASD.
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Nord D, Grossi T, Andresen J. Employment Equity for People With IDD Across the Lifespan: The Effects of State Funding. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:288-300. [PMID: 32750715 DOI: 10.1352/1934-9556-58.4.288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
In the last decade, major strides have been made to elevate the importance of employment for people with intellectual and developmental disabilities (IDD). Despite progress, improvement in employment outcomes remain modest. Using extant data, a sample of 9,871 adults with IDD accessing Medicaid Home and Community-Based Services waiver services across 33 states were studied using hierarchical modeling to understand the effects of age on employment as well as assess how state fiscal effort toward integrated employment services affects employment equity across the lifespan. Key findings showed young and older adults experienced the lowest employment outcomes. The effects of age, however, were moderated in states with higher fiscal effort to integrated employment services. Implications for research, policy, and practice are discussed.
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Affiliation(s)
- Derek Nord
- Derek Nord, Teresa Grossi, and John Andresen, Indiana Institute on Disability and Community at Indiana University
| | - Teresa Grossi
- Derek Nord, Teresa Grossi, and John Andresen, Indiana Institute on Disability and Community at Indiana University
| | - John Andresen
- Derek Nord, Teresa Grossi, and John Andresen, Indiana Institute on Disability and Community at Indiana University
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31
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Thompson T, Talapatra D, Hazel CE, Coleman J, Cutforth N. Thriving with Down syndrome: A qualitative multiple case study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1390-1404. [PMID: 32538538 DOI: 10.1111/jar.12767] [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: 02/08/2020] [Revised: 05/05/2020] [Accepted: 05/17/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Down syndrome (DS) is the most common genetic cause of intellectual disability. Prior research has primarily focused on associated medical problems and skill deficits. This study takes a novel positive psychology approach by examining critical individual characteristics and environmental factors that facilitate exceptional quality of life for people with DS. METHOD A qualitative multiple case study design was used to document the lives of four adults thriving with DS. Thriving was defined as high subjective well-being coupled with continued personal development. RESULTS Descriptive contexts were provided for each case along with four overarching themes: a supportive social ecology, high expectations for independence, advocacy, and strengths facilitating happiness. A new conceptual framework for understanding thriving with DS was proposed. CONCLUSIONS These findings provide insight as to what is possible for people with DS, including ideas for future research and practice to promote thriving in the DS population.
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Affiliation(s)
- Talia Thompson
- Department of Teaching and Learning Sciences, Morgridge College of Education, University of Denver, Denver, CO, USA.,Developmental Pediatrics, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Devadrita Talapatra
- Department of Teaching and Learning Sciences, Morgridge College of Education, University of Denver, Denver, CO, USA
| | - Cynthia E Hazel
- Department of Teaching and Learning Sciences, Morgridge College of Education, University of Denver, Denver, CO, USA
| | - Jeanine Coleman
- Department of Teaching and Learning Sciences, Morgridge College of Education, University of Denver, Denver, CO, USA
| | - Nicholas Cutforth
- Department of Research Methods and Information Science, Morgridge College of Education, University of Denver, Denver, CO, USA
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Khayatzadeh-Mahani A, Wittevrongel K, Petermann L, Graham ID, Zwicker JD. Stakeholders' engagement in co-producing policy-relevant knowledge to facilitate employment for persons with developmental disabilities. Health Res Policy Syst 2020; 18:39. [PMID: 32303228 PMCID: PMC7164207 DOI: 10.1186/s12961-020-00548-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 03/17/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Persons with developmental disabilities (PWDD) face a number of individual, environmental and societal barriers when seeking employment. Integrated knowledge translation (IKT) involves ongoing and dynamic interactions between researchers and stakeholders for the purpose of engaging in mutually beneficial research to address these types of multi-faceted barriers. There is a knowledge gap in the IKT literature on effective stakeholder engagement strategies outside of the dissemination stage to inform policy. In this paper, we report on a number of engagement strategies employed over a 2-year period to engage a wide range of stakeholders in different stages of an IKT project that aimed to investigate the 'wicked' problem of employment for PWDD. METHOD Our engagement plan included multiple linked strategies and was designed to ensure the meaningful engagement of, and knowledge co-production with, stakeholders. We held two participatory consensus-building stakeholder policy dialogue events to co-produce knowledge utilising the nominal group technique and the modified Delphi technique. A total of 31 and 49 stakeholders engaged in the first and second events, respectively, from six key stakeholder groups. Focused engagement strategies were employed to build on the stakeholder dialogues for knowledge mobilisation and included a focus group attended only by PWDD, a stakeholder workshop attended only by policy/decision-makers, a webinar attended by human resources professionals and employers, and a current affairs panel attended by the general public. RESULTS Our findings suggest that the level of engagement for each stakeholder group varies depending on the goal and need of the project. Our stakeholder dialogue findings highlight the inherent challenges in co-framing and knowledge co-production through the meaningful engagement of multiple stakeholders who hold different ideas and interests. Focused outreach is needed to foster relationships and trust for meaningful engagement. CONCLUSIONS In addition to providing guidance on how to implement adaptable meaningful engagement strategies, these findings contribute to discussions on how IKT projects are planned and funded. More studies to explore effective mechanisms for engaging a wide range of stakeholders in IKT research are needed. More evidence of successful engagement strategies employed by researchers to achieve meaningful knowledge co-production is also key to advancing the discipline.
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Affiliation(s)
- Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta T2P 1H9 Canada
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Krystle Wittevrongel
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta T2P 1H9 Canada
| | - Lisa Petermann
- Libin Cardiovascular Institute of Alberta, Calgary, Canada
| | - Ian D. Graham
- Ottawa Hospital Research Institute, Ottawa, Ontario Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario Canada
| | - Jennifer D. Zwicker
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta T2P 1H9 Canada
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Cheng SL, Prohn SM, Dinora P, Broda MD, Bogenschutz M. Measuring and Tracking Personal Opportunity Outcome Measures Over 3 Years to Guide Policy and Services That Promote Inclusive Community Living. INCLUSION (WASHINGTON, D.C.) 2020; 8:335-350. [PMID: 34423065 PMCID: PMC8375515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
National policy and litigation have been a catalyst in many states for expanding personal outcomes for people with intellectual and developmental disabilities (IDD) and have served as an impetus for change in state IDD systems. Although several metrics are used to examine personal outcomes, the National Core Indicators (NCI) In-Person Survey (IPS) is one tool that provides an annual depiction of the lives of people who receive Medicaid Home and Community Based IDD waiver services (HCBS). This article examines whether a validated, three-factor (Privacy Rights, Everyday Choice, and Community Participation) measure of Personal Opportunity, derived from NCI items, functions as predicted across non-equivalent, NCI cohorts (N=2400) from Virginia in 2017, 2018, and 2019. Multiple-groups confirmatory factor analysis (CFA) was employed to examine the invariance and generalizability of the Personal Opportunity constructs. Results indicated that Privacy Rights, Everyday Choice, and Community Participation measured the same concepts even when time and group varied. Significant improvements in Privacy Rights and Community Participation were observed when comparing latent factor means across years. Findings provide stakeholders with a tool for interpreting personal outcomes in the contexts of policy and practice intended to improve inclusion and quality of life for adults with IDD.
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Reinholdson J, Olsson I, Edelvik Tranberg A, Malmgren K. Long-term employment outcomes after epilepsy surgery in childhood. Neurology 2019; 94:e205-e216. [PMID: 31796526 PMCID: PMC6988983 DOI: 10.1212/wnl.0000000000008681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/09/2019] [Indexed: 11/15/2022] Open
Abstract
Objective To analyze long-term employment outcomes in a population-based cohort of adults who underwent epilepsy surgery in childhood or adolescence and to compare the results to general population reference data. Methods Prospective data on epilepsy surgery procedures performed on patients <19 years of age between 1995 and 2012 were extracted from the Swedish National Epilepsy Surgery Register. Five-, 10-, 15- and 20-year follow-up data were analyzed. Patients aged ≥19 years at follow-up were eligible for inclusion. Educational attainment and employment status were analyzed in relation to seizure outcome. Education and employment outcomes of seizure-free patients with a preoperative IQ of ≥70 were compared to general population reference data. Results A total of 203 patients were included. The mean age at surgery was 13.6 years and 66% had IQ ≥70. Of these, a majority had attained at least high school education 5 years after surgery. Employment rates were 44%, 69%, 71%, and 77% at the 5-, 10-, 15-, and 20-year follow-ups, respectively. Seizure-free patients were significantly more likely to work full-time. Educational attainment and rates of full-time employment of seizure-free patients were similar to the general population. A majority of patients with IQ <70 had attended special education and were reliant on social benefits. Conclusion Long-term overall employment rates were higher compared to most previous studies on surgery in adults. Seizure-free patients with a preoperative IQ ≥70 showed rates of full-time employment similar to the general population. Further research is needed to determine whether this also applies for occupational complexity and wages.
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Affiliation(s)
- Jesper Reinholdson
- From the Department of Clinical Neuroscience, Institute of Neuroscience and Physiology (J.R., A.E.T., K.M.), and Department of Paediatrics, Institute of Clinical Sciences (I.O.), Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
| | - Ingrid Olsson
- From the Department of Clinical Neuroscience, Institute of Neuroscience and Physiology (J.R., A.E.T., K.M.), and Department of Paediatrics, Institute of Clinical Sciences (I.O.), Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Anna Edelvik Tranberg
- From the Department of Clinical Neuroscience, Institute of Neuroscience and Physiology (J.R., A.E.T., K.M.), and Department of Paediatrics, Institute of Clinical Sciences (I.O.), Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Kristina Malmgren
- From the Department of Clinical Neuroscience, Institute of Neuroscience and Physiology (J.R., A.E.T., K.M.), and Department of Paediatrics, Institute of Clinical Sciences (I.O.), Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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Houseworth J, Stancliffe RJ, Tichá R. Examining the National Core Indicators' Potential to Monitor Rights of People With Intellectual and Developmental Disabilities According to the CRPD. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2019. [DOI: 10.1111/jppi.12315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- James Houseworth
- Institute on Community IntegrationUniversity of Minnesota Minneapolis MN USA
| | - Roger J. Stancliffe
- Centre for Disability Research and PolicyUniversity of Sydney Sydney NSW Australia
| | - Renáta Tichá
- Institute on Community IntegrationUniversity of Minnesota Minneapolis MN USA
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36
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Park JY, Park EY. Factors affecting the acquisition and retention of employment among individuals with intellectual disabilities. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:188-201. [PMID: 34188899 PMCID: PMC8211137 DOI: 10.1080/20473869.2019.1633166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 05/17/2023]
Abstract
This study analyzed factors affecting the acquisition and retention of employment among individuals with intellectual disabilities (ID). These factors were verified according to job type and were classified into general characteristics, family-related factors, psychological factors, and abilities. Data from 398 individuals with ID were analyzed using chi-square tests, independent t-tests, and regression analyses using the second wave of the first year Panel Survey of Employment for the Disabled in Korea. We found significant differences in sex, education level, receipt of basic living security assistance, transportation use, household income level, and family support between employed and unemployed participants. Additionally, the employed (vs. unemployed) ID group had significantly higher scores for all variables related to psychological factors and abilities. Factors affecting employment among individuals with ID included age, education level, receipt of basic living security assistance, family support, and vocational ability. Older age, higher education level, absence of basic living security assistance, greater family support, and higher vocational ability were associated with a higher probability of current employment. Transportation use and parents' education were associated with a high probability of non-manufacturing-type jobs. Being married, absence of basic living security assistance, greater householder income level, family support, and manufacturing industry work were associated with increased job retention. Consequently, modifying the benefit system and developing family support systems may promote employment acquisition and retention among people with ID. Efforts are also needed to expand the job types available to individuals with ID.
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Affiliation(s)
- Ju-Young Park
- Department of Rehabilitation, College of Medical Sciences, Jeonju University, Jeonbuk, Republic of Korea
| | - Eun-Young Park
- Department of Secondary Special Education, College of Education, Jeonju University, Jeonbuk, Republic of Korea
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Khayatzadeh-Mahani A, Wittevrongel K, Nicholas DB, Zwicker JD. Prioritizing barriers and solutions to improve employment for persons with developmental disabilities. Disabil Rehabil 2019; 42:2696-2706. [PMID: 30856355 DOI: 10.1080/09638288.2019.1570356] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Persons with a developmental disability have the lowest rate of labour force participation relative to other disabilities. The widening gap between the labour force participation of persons with versus without disability has been an enduring concern for many governments across the globe, which has led to policy initiatives such as labour market activation programs, welfare reforms, and equality laws. Despite these policies, persistently poor labour force participation rates for persons with developmental disabilities suggest that this population experiences pervasive barriers to participating in the labour force.Materials and methods: In this study, a two-phase qualitative research design was used to systematically identify, explore and prioritize barriers to employment for persons with developmental disabilities, potential policy solutions and criteria for evaluating future policy initiatives. Incorporating diverse stakeholder perspectives, a Nominal Group Technique and a modified Delphi technique were used to collect and analyze data.Results: Findings indicate that barriers to employment for persons with developmental disabilities are multi-factorial and policy solutions to address these barriers require stakeholder engagement and collaboration from multiple sectors.Conclusions: Individual, environmental and societal factors all impact employment outcomes for persons with developmental disabilities. Policy and decision makers need to address barriers to employment for persons with developmental disabilities more holistically by designing policies considering employers and the workplace, persons with developmental disabilities and the broader society. Findings call for cross-sectoral collaboration using a Whole of Government approach.Implications for RehabilitationPersons with a developmental disability face lower levels of labour force participation than any other disability group.Individual, environmental and societal factors all impact employment outcomes for persons with developmental disabilities.Decision and policy makers need to address barriers to employment for persons with developmental disabilities holistically through policies guiding employers and broader societal behaviour in addition to those aimed at the individuals (such as skill development or training).Due to multi-factorial nature of barriers to employment for persons with developmental disabilities, policy solutions are wide-ranging and fall under the responsibility of multiple sectors for implementation. This calls for cross-sectoral collaboration using a "Whole of Government" approach, with shared goals and integrated responses.
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Affiliation(s)
- Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Calgary, AB, Canada.,Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Houseworth J, Stancliffe RJ, Tichá R. Association of state-level and individual-level factors with choice making of individuals with intellectual and developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:77-90. [PMID: 30144747 DOI: 10.1016/j.ridd.2018.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/12/2018] [Accepted: 08/13/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND State-level factors have not been examined in research on choice, despite findings of between-state differences. AIMS To examine both individual and state-level factors associated with choice. METHODS AND PROCEDURES We used multilevel modeling to explore two choice scales, support-related and everyday choice, based on the National Core Indicators (NCI) data from 2013-14. OUTCOMES AND RESULTS At the individual level, milder ID, greater mobility, fewer problem behaviors, answering questions independently, communicating verbally, and living in a non-agency setting, particularly independent settings, were associated with more choice for both scales. State-level factors overall explained variance for both scales, but were more strongly associated with support-related choice. A higher proportion of people with IDD living independently within the state predicted more support-related choice. High cost of living within a state predicted less everyday choice. Higher proportion of people living with family and lower proportion being served within a state predicted more everyday choice. CONCLUSIONS AND IMPLICATIONS These findings suggest further study of choice in relation to policies that: (1) increase independent living for individuals with IDD, and (2) assist individuals/families living in high cost states. State differences on important QOL outcomes are likely to be associated with economic and system-based factorsbeyond individual differences.
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Affiliation(s)
- James Houseworth
- University of Minnesota, Institute on Community Integration, Minneapolis, MN, 55455, United States.
| | - Roger J Stancliffe
- University of Sydney, Centre for Disability Research and Policy, Sydney, Australia.
| | - Renáta Tichá
- University of Minnesota, Institute on Community Integration, Minneapolis, MN, 55455, United States.
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Scott M, Milbourn B, Falkmer M, Black M, Bӧlte S, Halladay A, Lerner M, Taylor JL, Girdler S. Factors impacting employment for people with autism spectrum disorder: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:869-901. [DOI: 10.1177/1362361318787789] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study is to holistically synthesise the extent and range of literature relating to the employment of individuals with autism spectrum disorder. Database searches of Medline, CINAHL, PsychINFO, Scopus, ERIC, Web of Science and EMBASE were conducted. Studies describing adults with autism spectrum disorder employed in competitive, supported or sheltered employment were included. Content analysis was used to identify the strengths and abilities in the workplace of employees with autism spectrum disorder. Finally, meaningful concepts relating to employment interventions were extracted and linked to the International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder. The search identified 134 studies for inclusion with methodological quality ranging from limited to strong. Of these studies, only 36 evaluated employment interventions that were coded and linked to the International Classification of Functioning, Disability and Health, primarily focusing on modifying autism spectrum disorder characteristics for improved job performance, with little consideration of the impact of contextual factors on work participation. The International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder are a useful tool in holistically examining the employment literature for individuals with autism spectrum disorder. This review highlighted the key role that environmental factors play as barriers and facilitators in the employment of people with autism spectrum disorder and the critical need for interventions which target contextual factors if employment outcomes are to be improved.
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Affiliation(s)
- Melissa Scott
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | - Marita Falkmer
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Jönköping University, Sweden
| | - Melissa Black
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Sven Bӧlte
- Karolinska Institutet, Sweden
- Stockholm County Council, Sweden
| | | | | | - Julie Lounds Taylor
- Vanderbilt Kennedy Centre, USA
- Vanderbilt University, USA
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, USA
| | - Sonya Girdler
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Abstract
Close to 750,000 youth with special health care needs transition to adult health care in the United States every year; however, less than one-half receive transition-planning services. Using the "F-words" organizing framework, this article explores life course outcomes and disparities in transition-aged youth with disabilities, with a special focus on youth with autism, Down syndrome, and cerebral palsy. Despite the importance of transition, a review of the available literature revealed that (1) youth with disabilities continue to have poor outcomes in all six "F-words" domains (ie, function, family, fitness, fun, friends, and future) and (2) transition outcomes vary by race/ethnicity and disability. Professionals need to adopt a holistic framework to examine transition outcomes within a broader social-ecological context, as well as implement evidence-based transition practices to help improve postsecondary outcomes of youth with disabilities. [Pediatr Ann. 2017;46(10):e371-e376.].
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