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Modified Ride-on Car Intervention for Children With Profound Intellectual and Multiple Disabilities: A Case Series. Pediatr Phys Ther 2023; 35:277-283. [PMID: 36854116 DOI: 10.1097/pep.0000000000001002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PURPOSE To describe a pilot clinical case series of a modified ride-on car (MROC) intervention on mobility and alertness for young children with profound intellectual and multiple disabilities (PIMD). METHODS Four young children with PIMD participated in 4 baseline observations and 5 intervention sessions (A-B design). Data collection occurred via video. Assessment of mobility and alertness duration used structured visual analysis. RESULTS Three of the 4 children increased their independent mobility during the intervention sessions. One of the 4 children increased their active alertness during the intervention sessions. CONCLUSIONS This pilot study demonstrates the initial feasibility of an MROC intervention in a clinical setting and outcome measures of mobility and alertness for children with PIMD. This provides support that this population should be considered for power mobility in early childhood. Further, this study used a novel, caregiver-implemented prompting protocol to teach children how to use the MROC.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Desideri L. A microswitch-aided program to enable people with extensive multiple disabilities to control environmental stimulation through different responses. Front Psychiatry 2022; 13:1073650. [PMID: 36569625 PMCID: PMC9780668 DOI: 10.3389/fpsyt.2022.1073650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives This study assessed whether a simple technology-aided program (i.e., a program involving the use of microswitches linked to a smartphone) could be set up to enable people with motor, sensory and intellectual disabilities to control preferred environmental stimulation through two different response movements. Methods Ten participants were involved in the study. Each of them was exposed to an ABAB design, in which A represented baseline phases without the program and B intervention phases with the use of the program. The study assessed whether the participants (a) had significant increases of each of the two response movements available and/or showed response variability across sessions and over time and (b) had signs of satisfaction/happiness during the study sessions, in connection with their stimulation access and control. Results The program was effective in increasing the participants' responding and consequently their self-regulated stimulation input. Half of the participants showed a significant increase of both responses available from the first intervention phase. Other participants seemed to focus more on one of the two responses. Even so, they tended to have occasionally high performance frequencies also with regard to their non-dominant (not significantly increased) response. Finally, all participants showed clear signs of satisfaction/happiness during the intervention sessions. Conclusions The program represents a potentially useful approach for enabling people with extensive multiple disabilities to self-regulate their access to preferred environmental stimulation and improve their mood.
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Affiliation(s)
- Giulio E. Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Nirbhay N. Singh
- Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States
| | - Mark F. O'Reilly
- College of Education, University of Texas at Austin, Austin, TX, United States
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Campodonico F, Chiariello V, Desideri L, Buono S. Everyday Technology to Help People with Intellectual and Other Disabilities Access Stimulation via Functional Motor Responses and Improved Body Posture. Dev Neurorehabil 2022; 25:59-67. [PMID: 34629013 DOI: 10.1080/17518423.2021.1989513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This study assessed everyday technology to help eight participants with intellectual and sensory-motor disabilities access stimulation via functional arm/hand responses and improved body posture. METHODS An ABABB1BB1 design was used for each participant, with A representing baseline phases, B intervention phases in which arm/hand responses led to a 12-s stimulation, and B1 intervention phases in which the stimulation for arm/hand responses was conditional on an improved/correct torso and head posture. The technology involved a Samsung Galaxy A10 smartphone fitted with Google Assistant and MacroDroid, a mini voice-recording device, and a portable mini voice amplifier. RESULTS All participants had a large increase in arm/hand responses from the baseline periods to the B and B1 phases. They also had a large increase in correct posture from the B phases to the B1 phases. CONCLUSION This technology-aided approach may be a helpful resource for people similar to the participants of this study.
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Affiliation(s)
| | | | | | - Jeff Sigafoos
- Victoria University of Wellington, Wellington, New Zealand
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Dhondt A, Van Keer I, Nijs S, van der Putten A, Maes B. In search of a novel way to analyze early communicative behavior. Augment Altern Commun 2021; 37:87-101. [PMID: 34096819 DOI: 10.1080/07434618.2021.1928283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The aim of this study was to develop a coding scheme that enables researchers and practitioners to conduct a detailed analysis of the communicative behavior of young children with significant cognitive and motor developmental delays. Currently, there is a paucity of methods to do conduct such an analysis. For the study, video observations of three different scenarios from 38 children with significant cognitive and motor developmental delays aged between 12 and 54 months, were used. Findings from the video observations served as the primary means for development of the coding scheme, which comprises three main categories - context, partner behavior, and individual behavior - and several subcategories. The coding scheme was used to document the early expressive communicative behavior of persons with significant cognitive and motor developmental delays in a detailed manner. This fine-grained information is necessary to differentiate children based on their communicative abilities, to monitor their communicative development longitudinally, and to inform person-centered communicative interventions.
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Affiliation(s)
- Ann Dhondt
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Leuven, Belgium
| | - Ines Van Keer
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Leuven, Belgium
| | - Sara Nijs
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Leuven, Belgium
| | - Annette van der Putten
- Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Bea Maes
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Leuven, Belgium
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Maes B, Nijs S, Vandesande S, Van Keer I, Arthur-Kelly M, Dind J, Goldbart J, Petitpierre G, Van der Putten A. Looking back, looking forward: Methodological challenges and future directions in research on persons with profound intellectual and multiple disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:250-262. [PMID: 33073444 DOI: 10.1111/jar.12803] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/29/2020] [Accepted: 07/29/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Within the context of the Special Interest Research Group (SIRG) on Persons with Profound Intellectual and Multiple Disabilities (PIMD), researchers often discuss the methodological problems and challenges they are confronted with. The aim of the current article was to give an overview of these challenges. METHODS The challenges are centred on six topics. These reflect the main components of a study's design: (a) participant demarcation, (b) participant recruitment, (c) data collection and instruments, (d) data analysis, (e) ethics/including the "voice" of persons with PIMD and (f) theoretical models. RESULTS Next, to describing the specific challenges, possible solutions and pathways to address them are discussed. These are illustrated by recent studies by the authors and other researchers in the field. CONCLUSIONS The current contribution wants to stimulate further discussion and exchange of ideas, and the development of creative research techniques.
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Affiliation(s)
- Bea Maes
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Catholic University of Leuven, Leuven, Belgium
| | - Sara Nijs
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Catholic University of Leuven, Leuven, Belgium
| | - Sien Vandesande
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Catholic University of Leuven, Leuven, Belgium
| | - Ines Van Keer
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Catholic University of Leuven, Leuven, Belgium
| | | | - Juliane Dind
- Département de Pédagogie spécialisée, Université de Fribourg, Fribourg, Switzerland
| | - Juliet Goldbart
- Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Manchester, UK
| | | | - Annette Van der Putten
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Alberti G, Campodonico F, Acquaviva G, Chiariello V, Desideri L. Persons with intellectual and multiple disabilities activate via non-verbal responses a smartphone's Google Assistant to access preferred stimulation. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:518-527. [PMID: 35937160 PMCID: PMC9351553 DOI: 10.1080/20473869.2020.1827213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/18/2020] [Accepted: 09/13/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The present study evaluated a new smartphone-based program to help 12 participants with intellectual disability plus visual and motor impairments to self-regulate their stimulation input (thus avoiding their dependence on staff) through simple non-verbal responses. METHOD Nonconcurrent multiple baseline designs across participants were used to assess the effects of the program. The technology used for the program involved a Samsung J4 Plus smartphone with Android 9.0 operating system, two voice recording devices, smart-plugs, and a mini speaker. The smartphone was provided with a Google account and Internet connection, which allowed the participants to access Google Assistant and Google Play Music. The participants could make requests for two different types of stimulation (e.g. songs and familiar voices or noises) by activating via hand pressure the two voice recording devices. The verbal request messages emitted by the devices were recognized by the Google Assistant, which led the smartphone to deliver the related stimulation. RESULTS During the baseline sessions (without the support of the voice recording devices), the participants failed to access any stimulation. During the intervention and post-intervention phases (with the support of the voice recording devices), all participants managed to access the types of stimulation available independently. The mean frequency of responses (i.e. activations of both voice recording devices) per session ranged between about 8 and 14. CONCLUSION The new smartphone-based program can be viewed as a useful resource to enable individuals like the participants of this study to access preferred stimulation independently.
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Affiliation(s)
- Giulio E. Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Nirbhay N. Singh
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Mark F. O’Reilly
- Department of Special Education, University of Texas at Austin, Austin, TX, USA
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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Roemer M, Verheul E, Velthausz F. Identifying perception behaviours in people with profound intellectual and multiple disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:820-832. [PMID: 29266636 DOI: 10.1111/jar.12436] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND To support people with profound intellectual and multiple disabilities (PIMD), it is essential to understand how they experience their environment. Insight into perception behaviour may provide an entry point for improved understanding. MATERIALS AND METHODS A random sample of a 30-min video registration of five participants with PIMD was used to code behaviours per second based on an ethogram containing 157 different perception behaviours in nine categories. RESULTS Eighty-nine different perception behaviours were observed, of which movements with eyes, head and arms were most common. The senses used most were seeing, hearing and touching. Finally, the function of five perception patterns was established in relation to their function:awareness, focusing attention and tension regulation. CONCLUSIONS Close observation using an observation ethogram provides insight into how people with PIMD perceive their environment.
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Affiliation(s)
- Miriam Roemer
- Esdégé-Reigersdaal, Broek op Langedijk, The Netherlands
| | - Ellen Verheul
- Esdégé-Reigersdaal, Broek op Langedijk, The Netherlands
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Chan JSL, Chien WT. A randomised controlled trial on evaluation of the clinical efficacy of massage therapy in a multisensory environment for residents with severe and profound intellectual disabilities: a pilot study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:532-548. [PMID: 28387017 DOI: 10.1111/jir.12377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/19/2017] [Accepted: 03/14/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Recent literature has suggested that relaxation activities can reduce the challenging behaviours of people with intellectual disabilities, particularly in severe and profound grades, due to the counteractive effect of muscle relaxation on emotional frustration or psychological distress. Despite having inconclusive evidence, multisensory environment (MSE) and massage therapy (MT) are the commonly used approaches to relaxation among these people. However, these two approaches have not yet practised or tested in combination for reducing these people's challenging behaviours. METHODS A preliminary clinical efficacy trial was conducted to evaluate the effects of MT, MSE and their combined use for residents with intellectual disabilities in a long-term care facility on reducing their challenging behaviours. Eligible residents were recruited and randomly assigned to one of the four study groups (n = 11-12 per group), that is, MT in MSE, MSE alone, MT alone or usual care, for a 10-week intervention after a 1-month washout period. Outcome measures, including the Behaviour Problem Inventory, pulse and respiration rates, Behaviour Checklist and Alertness Observation Checklist, were assessed at recruitment and immediately following the interventions. RESULTS A total of 42 participants (17 men and 25 women) completed the study. There were no significant differences in frequency and severity of challenging behaviours and most of the outcome measures between the four groups at post-test. Nevertheless, there were statistical significant differences on the active and inactive state (Alertness Observation Checklist) between the three treatment and control groups. Many participants in the three treatment groups changed from an active to inactive state (i.e. reduced activity levels) throughout the interventions, especially the MT in MSE. Such inactivity might suggest the participants' brief exhaustion followed by a period of alertness during the treatment activities. But their attention span and social contact to the immediate environment could still be maintained. CONCLUSIONS Participants of MT in multisensory environment acquired more inactive state than the other study groups. This inactive state indicates a state of 'passive alertness', which is more likely in a relaxing manner.
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Affiliation(s)
- J S L Chan
- Siu Lam Hospital, Hospital Authority of Hong Kong, Hong Kong
| | - W T Chien
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
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Jonker D, Sterkenburg PS, Van Rensburg E. Caregiver-mediated therapy for an adult with visual and intellectual impairment suffering from separation anxiety. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:1-13. [PMID: 26321690 DOI: 10.1016/j.ridd.2015.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 07/27/2015] [Accepted: 08/05/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Separation anxiety among intellectually disabled (ID) persons with comorbid visual impairment could be rooted in a weak sense of person permanence. Technology-assisted Therapy for Separation Anxiety (TTSA) was used to address this problem. AIMS The primary aim was to determine whether technology alone or including caregivers was the best option, and whether TTSA decreased separation anxiety and challenging behaviour. Also, how the caregivers and the client experienced TTSA. METHODS AND PROCEDURES A pre-experimental, quantitative approach (AB1C1B2C2D) was used for this single-subject study. The frequency of the client's text messages was recorded daily. The variables were monitored with standardised instruments and caregivers rated the intensity and frequency of the client's anxious and challenging behaviour. The social validity was evaluated by means of questionnaires. OUTCOMES AND RESULTS There was a significant decrease in the anxious and angry messages sent, and in anxious and challenging behaviour, in the phase in which the caregivers were included, compared with the phase in which technology alone was used. The client and the caregivers were positive about TTSA. CONCLUSION AND IMPLICATION Technology and the caregivers reactions reduces the anxiety and challenging behaviour. It might also aid the acquisition of the concept of person permanence.
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Affiliation(s)
- D Jonker
- School of Psychosocial Behavioural Sciences: Psychology, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa
| | - P S Sterkenburg
- VU University Amsterdam, FPP, Department of Clinical Child and Family Studies and EMGO+, Institute for Health and Care Research, Van der Boechorststraat 1, Amsterdam 1081 BT, the Netherlands; Bartiméus, P.O. Box 87, Doorn 3940 AB, the Netherlands.
| | - E Van Rensburg
- School of Psychosocial Behavioural Sciences: Psychology, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa
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Neerinckx H, Maes B. Joint attention behaviours in people with profound intellectual and multiple disabilities: the influence of the context. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:574-584. [PMID: 26427610 DOI: 10.1111/jar.12217] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND In spite of the profound cognitive and physical problems, people with profound intellectual and multiple disabilities (PIMD) are able to develop joint attention behaviours (JAB) and benefit from positive interactions. AIMS To investigate which context factors influence the JAB of people with PIMD. METHOD Based on video recordings of 45 participants, JAB and context factors were analysed. RESULTS An unstructured interaction situation produced the most responses of a person with PIMD, whereas a structured interaction situation produced the most initiatives. Furthermore, the familiarity of the partner and the familiarity of objects used in the interaction had no influence on the JAB. The sensitivity of the interaction partner was positively related to the presence of JAB. CONCLUSIONS Interaction partners of people with PIMD should be aware of both the ability of people with PIMD to use JAB and the influence of different context factors on these JAB.
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Affiliation(s)
- Heleen Neerinckx
- KU Leuven, Faculty of Psychology and Educational Sciences, Leuven, Belgium.
| | - Bea Maes
- Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
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Munde V, Vlaskamp C. Initiation of activities and alertness in individuals with profound intellectual and multiple disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:284-292. [PMID: 24806398 DOI: 10.1111/jir.12138] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND When providing activities to individuals with profound intellectual and multiple disabilities (PIMD), direct support persons (DSPs) often face questions that are, among other things, related to the alertness of the person with PIMD. While previous studies have revealed that stimulation might have a greater impact on levels of alertness than the internal conditions of the individual, they have also emphasized the importance of interaction in order to influence the level of alertness. Because the initiation of this interaction has been described as one of its core components, the present study has focused on the relationship between the stimuli presented, the initiation of the activity (by the person with PIMD or the DSP), and the level of alertness of the person with PIMD. METHOD Videotapes of the one-to-one interactions of 24 individuals with PIMD and their DSPs in multisensory environments have been scored using the Alertness Observation List. In a sequential analysis, the percentages of stimuli presented were related to the percentages of initiation. Furthermore, two other analyses focused on the relationship between the level of alertness and the preceding and subsequent percentages of initiation respectively. RESULTS The results show that high percentages of the activities are initiated by the DSPs. In addition, activities that were initiated by the individual with PIMD were preceded and followed by higher percentages of alert behaviour than those initiated by the DSP. Outcomes differed for the different types of stimuli. CONCLUSIONS These results have striking implications for the lives of individuals with PIMD. It is quite possible that DSPs often act too quickly, whereas they would be better off waiting for a reaction on the part of their client. In general, DSPs need to find a balance between being passive themselves and promoting in the individual with PIMD a state of being as active and alert as possible.
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Affiliation(s)
- V Munde
- University of Groningen, Groningen, The Netherlands; Rijksuniversiteit Groningen, Orthopedagogiek, Groningen, The Netherlands
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Wilderjans TF, Lambrechts G, Maes B, Ceulemans E. Revealing interdyad differences in naturally occurring staff reactions to challenging behaviour of clients with severe or profound intellectual disabilities by means of Clusterwise Hierarchical Classes Analysis (HICLAS). JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:1045-1059. [PMID: 23957686 DOI: 10.1111/jir.12076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/29/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Investigating interdyad (i.e. couples of a client and their usual caregiver) differences in naturally occurring patterns of staff reactions to challenging behaviour (e.g. self-injurious, stereotyped and aggressive/destructive behaviour) of clients with severe or profound intellectual disabilities is important to optimise client-staff interactions. Most studies, however, fail to combine a naturalistic setup with a person-level analysis, in that they do not involve a careful inspection of the interdyad differences and similarities. METHOD In this study, the recently proposed Clusterwise Hierarchical Classes Analysis (HICLAS) method is adopted and applied to data of in which video fragments (recorded in a naturalistic setting) of a client showing challenging behaviour and the staff reacting to it were analysed. In a Clusterwise HICLAS analysis, the staff-client dyads are grouped into a number of clusters and the prototypical behaviour-reaction patterns that are specific for each cluster (i.e. interdyad differences and similarities) are revealed. RESULTS Clusterwise HICLAS discloses clear interdyad differences (and similarities) in the prototypical patterns of clients' challenging behaviour and the associated staff reactions, complementing and qualifying the results of earlier studies in which only general patterns were disclosed. CONCLUSIONS The usefulness and clinical relevance of Clusterwise HICLAS is demonstrated. In particular, Clusterwise HICLAS may capture idiosyncratic aspects of staff-client interactions, which may stimulate direct support workers to adopt person-centred support practices that take the specific abilities of the client into account.
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Affiliation(s)
- T F Wilderjans
- Methodology of Educational Sciences Research Group, Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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