Chapter 2 The Transition to Adulthood for Individuals with Intellectual Disability

Family Caregiver Adaptation during the Transition to Adulthood of Individuals with Intellectual Disabilities: A Scoping Review

During the transition to adulthood, individuals diagnosed with intellectual disability (ID) and their family caregivers have unique experiences. This scoping review studies the sources of the family caregiver's objective burden, support, coping mechanisms, positive caregiving, and quality of life to understand the caregiver's adaptation process when the individual with ID transits to adulthood, according to Joanna Briggs Institute (JBI) Scoping Review methodology guidelines. The inclusion criteria included studies of family caregivers of any age who provide unpaid care and live with individuals diagnosed with ID who are transitioning to adulthood. Of 2875 articles identified, 12 published studies were included. The main themes included caregivers reporting dissatisfaction with the available adult services and exhaustion from being a caregiver. Overall, a vicious cycle of likely increased demands during the transition, with caregivers not being prepared to cope with these demands while concurrently being dissatisfied with the adult services system, leads the caregivers to develop a pervasive sense of helplessness. Future studies would benefit from recruiting caregivers from sources other than adult-only service centres and using qualitative (to identify the broad aspects of the key factors) and quantitative (to identify the significant differences between the key factors) methodologies.

The reporters' agreement in assessing the quality of life of young people with intellectual disabilities

A good evaluation of the quality of life (QoL) of young people with disability is essential to detect, monitor and report their support needs in research, and individual, institutional and policy planning. The aim of this study is to evaluate the reporters' agreement in the assessment of the QoL of young people with Intellectual Disabilities in transition to adulthood. Self and proxy-report version of INICO-FEAPS quality of life scale was used to assess 119 students of a post-compulsory educational program, being the proxy-report informed by one of their relatives. Results show poor intraclass correlations between informants. No discrepancies were found in the global QoL. However, small discrepancies were found for some dimensions. Young people's reports were higher for self-determination, personal development and interpersonal relationships. On the contrary, relatives' reports were higher for rights, material and physical wellbeing. The discrepancies in global QoL assessment were not related to student's severity, IQ, diagnosis or parent's gender. These findings underline the importance of young people's participation in the assessment of their QoL as well as the convenience of using both kind of informants when taking appropriate decisions in educational contexts during transition to adulthood.

Belonging through sport participation for young adults with intellectual and developmental disabilities: A scoping review

BACKGROUND

Research suggests that sport facilitates belonging for diverse athletes. This scoping review characterizes literature on sport participation and belonging for young adults with intellectual and developmental disabilities.

MATERIALS AND METHODS

A search of five databases identified 17,497 articles. Selected articles (N = 39) underwent data extraction and analysis guided by a theoretical framework of belonging, outlining four processes through which belonging is experienced by individuals with intellectual and developmental disabilities.

RESULTS

Articles originated from developed countries and in the context of Special Olympics (N = 17). Studies commonly used qualitative interviews with proxy respondents. While all studies described at least one belonging process, only 11 studies applied the term "belonging," and no study defined the construct.

CONCLUSION

Belonging is not well-conceptualized in sports literature for athletes with intellectual and developmental disabilities. Understanding belonging through sport participation for this population may inform sport-based policies and programming.

Depression and anxiety symptoms during the transition to early adulthood for people with intellectual disabilities

BACKGROUND

The transition to adulthood is a major developmental milestone; a time of self-discovery and increased independence. For young adults (YA) with intellectual disabilities (ID), however, this period is especially challenging. The increased incidence of mental health disorders in this population, such as depression and anxiety, make this transition even more difficult, increasing caregiver burden at a time when the young adult would traditionally be gaining independence. It is not clear, however, why YA with ID are more susceptible and what factors may predict mental health symptoms.

METHOD

Potential risk and protective factors (demographic variables, coping styles, sense of hopelessness, unmet achievement of adulthood milestones, self-reflection and insight) of anxiety and depression symptoms were assessed in 55 YA with ID and a sample of age-matched controls.

RESULTS

Insight was the strongest predictor of anxiety (with gender in the controls) for YA with and without ID, with increased insight predicting fewer anxiety symptoms. However, YA with ID had significantly less insight than their aged-matched counterparts and significantly higher levels of anxiety. They were also less likely to have achieved traditional adulthood milestones. Maladaptive coping was the strongest predictor of depression for YA with ID. In comparison, both maladaptive coping and insight predicted depression in controls. More maladaptive coping predicted increased depressive symptoms in both populations, whilst increased insight predicted fewer depressive symptoms in controls.

CONCLUSIONS

Insight and maladaptive coping are potential targets in the treatment of anxiety and depression among YA with ID. Longitudinal intervention studies exploring the efficacy of such targeted programmes in reducing mental health symptoms and improving the transition to adulthood for these young people are recommended.