1
|
Parents' Perspectives on Adaptive Sports in Children with Profound Intellectual and Multiple Disabilities. CHILDREN-BASEL 2021; 8:children8090815. [PMID: 34572247 PMCID: PMC8471413 DOI: 10.3390/children8090815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/06/2021] [Accepted: 09/15/2021] [Indexed: 11/18/2022]
Abstract
Children with profound intellectual and multiple disabilities (PIMD) need adaptations to participate in sports and it is more difficult for them to access these activities. We investigated the effects of adaptive sports in children with PIMD as perceived by their parents. The parents answered a postal questionnaire exploring the effects of adaptive sports during the 3 days following an activity. The questionnaire explored twelve domains of children’s daily lives, such as sleep and appetite. We calculated a composite score, including all of these domains, to assess whether the children globally benefited from adaptive sports. Of the families, 27/63 responded (participation 42.9%). Four domains improved after the sports activity in an important proportion of children (improvement in 64.0% of children for wellbeing, 57.6% for mood, 56.0% for comfort and 48.1% for sleep). Among the majority of children, the other eight domains remained mostly stable. Three quarters of parents reported a globally positive effect of adapted physical activities on their child. These findings support the further development and provision of adaptive sports for children with severe neurological impairments.
Collapse
|
2
|
Paediatricians' Views on Pain in Children with Profound Intellectual and Multiple Disabilities. Brain Sci 2021; 11:brainsci11030408. [PMID: 33807064 PMCID: PMC8004709 DOI: 10.3390/brainsci11030408] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/11/2021] [Accepted: 03/23/2021] [Indexed: 02/06/2023] Open
Abstract
Pain is a frequent issue in children with profound intellectual and multiple disabilities (PIMD). Its identification and treatment can prove highly challenging for primary care physicians, mainly because of the children’s limited communication abilities. We used an online survey to explore paediatricians’ views regarding the experience and management of pain in children with PIMD and invited 480 professionals working in the canton of Vaud, Switzerland, to take part. We received 121 responses (participation rate 25.5%). A large majority of respondents provided care to children with PIMD. All paediatricians considered that these children feel pain at least as much as typically developing children. However, paediatricians had mixed views on their tolerance to pain. More than 90% held the view that their pain is under-assessed and undertreated. The principal barriers they reported to appropriate management were communication limitations with the child, difficulties in pain assessment, lack of knowledge about children with disabilities and lack of experience. Paediatricians have complex opinions regarding how children with PIMD experience pain and how to manage this problem. Professional education and training on the specificities of children with PIMD, including how to address their pain, seem necessary to foster paediatricians’ ability and confidence in approaching this complex issue.
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Health issues in polyhandicapped patients according to age: Results of a large French cross-sectional study. Rev Neurol (Paris) 2020; 176:370-379. [DOI: 10.1016/j.neurol.2019.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/24/2019] [Indexed: 11/20/2022]
|
5
|
Rousseau MC, Baumstarck K, Auquier P, Billette de Villemeur T. Health characteristics and health care trajectory of polyhandicaped person before and after 1990. Rev Neurol (Paris) 2019; 176:92-99. [PMID: 31255322 DOI: 10.1016/j.neurol.2019.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/11/2019] [Accepted: 04/16/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Polyhandicap is defined as the combination of severe mental impairment and severe motor deficit resulting in reduced mobility and an extreme reduction in autonomy. Over the last 20years, care management for these patients has become more structured, however, their care pathway is not always optimal. OBJECTIVE To describe/compare the health characteristics, treatment and history of the care pathways of subjects who received care before and after 1990. METHOD Multicentre cross-sectional study, population studied: patients with polyhandicap: (i) causal brain damage<3years, (ii) severe mental impairment, (iii) motor disability, (iv) reduced mobility, (v) extreme restriction of autonomy. DATA COLLECTED clinical and medical, care procedures, treatments, history of care pathways. RESULTS Patients are divided into 2 groups: 545 patients who received care after 1990 and 330 before 1990. Older patients present more recurrent urinary infections, slow transit, behavioural disorders and pain, and are prescribed a greater number of drugs. For those who received care before 1990, the age of admission to an establishment is lower, with one-third receiving a consultation dedicated to the transition from paediatric to adult teams. DISCUSSION/CONCLUSION The care sector for patients with polyhandicap makes it possible to meet their needs throughout their lives, however, there is still progress to be made in terms of formalisation and of coordinating the care pathway in order to facilitate the transition from paediatric to adult services/establishments.
Collapse
Affiliation(s)
- M-C Rousseau
- Fédération des Hôpitaux de Polyhandicap et Multihandicap, Hôpital San Salvadour, Assistance publique-Hôpitaux de Paris, Hyères, France; EA 3279 CEReSS, Santé publique et qualité de vie, Aix-Marseille Université, 13005 Marseille, France.
| | - K Baumstarck
- EA 3279 CEReSS, Santé publique et qualité de vie, Aix-Marseille Université, 13005 Marseille, France
| | - P Auquier
- EA 3279 CEReSS, Santé publique et qualité de vie, Aix-Marseille Université, 13005 Marseille, France
| | - T Billette de Villemeur
- Fédération des Hôpitaux de Polyhandicap et Multihandicap, Hôpital San Salvadour, Assistance publique-Hôpitaux de Paris, Hyères, France; Sorbonne Université, UPMC, GRC ConCer-LD, AP-HP, Hôpital Trousseau, Service de Neuropédiatrie, Pathologie du développement, Paris, France; Centre de référence des déficits intellectuels de causes rares, Inserm U 1141, 75000 Paris, France
| |
Collapse
|
6
|
Dunwoodie Stirton F, Heslop P. Medical Certificates of Cause of Death for people with intellectual disabilities: A systematic literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:659-668. [DOI: 10.1111/jar.12448] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Fred Dunwoodie Stirton
- The Learning Disabilities Mortality Review (LeDeR) Programme; School for Policy Studies; University of Bristol; Bristol UK
| | - Pauline Heslop
- The Learning Disabilities Mortality Review (LeDeR) Programme; School for Policy Studies; University of Bristol; Bristol UK
| |
Collapse
|
7
|
Bourke J, Nembhard WN, Wong K, Leonard H. Twenty-Five Year Survival of Children with Intellectual Disability in Western Australia. J Pediatr 2017; 188:232-239.e2. [PMID: 28705655 DOI: 10.1016/j.jpeds.2017.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/04/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To investigate survival up to early adulthood for children with intellectual disability and compare their risk of mortality with that of children without intellectual disability. STUDY DESIGN This was a retrospective cohort study of all live births in Western Australia between January 1, 1983 and December 31, 2010. Children with an intellectual disability (n = 10 593) were identified from the Western Australian Intellectual Disability Exploring Answers Database. Vital status was determined from linkage to the Western Australian Mortality database. Kaplan-Meier product limit estimates and 95% CIs were computed by level of intellectual disability. Hazard ratios (HRs) and 95% CIs were calculated from Cox proportional hazard regression models adjusting for potential confounders. RESULTS After adjusting for potential confounders, compared with those without intellectual disability, children with intellectual disability had a 6-fold increased risk of mortality at 1-5 years of age (adjusted HR [aHR] = 6.0, 95%CI: 4.8, 7.6), a 12-fold increased risk at 6-10 years of age (aHR = 12.6, 95% CI: 9.0, 17.7) and a 5-fold increased risk at 11-25 years of age (aHR = 4.9, 95% CI: 3.9, 6.1). Children with severe intellectual disability were at even greater risk. No difference in survival was observed for Aboriginal children with intellectual disability compared with non-Aboriginal children with intellectual disability. CONCLUSIONS Although children with intellectual disability experience higher mortality at all ages compared with those without intellectual disability, the greatest burden is for those with severe intellectual disability. However, even children with mild to moderate intellectual disability have increased risk of death compared with unaffected children.
Collapse
Affiliation(s)
- Jenny Bourke
- Telethon Kids Institute, University of Western Australia, Subiaco, Western Australia, Australia.
| | - Wendy N Nembhard
- Telethon Kids Institute, University of Western Australia, Subiaco, Western Australia, Australia; Division of Birth Defects Research, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Research Institute, Little Rock, AR
| | - Kingsley Wong
- Telethon Kids Institute, University of Western Australia, Subiaco, Western Australia, Australia
| | - Helen Leonard
- Telethon Kids Institute, University of Western Australia, Subiaco, Western Australia, Australia
| |
Collapse
|
8
|
van Timmeren EA, van der Putten AAJ, van Schrojenstein Lantman-de Valk HMJ, van der Schans CP, Waninge A. Prevalence of reported physical health problems in people with severe or profound intellectual and motor disabilities: a cross-sectional study of medical records and care plans. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:1109-1118. [PMID: 27197564 DOI: 10.1111/jir.12298] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 03/16/2016] [Accepted: 04/13/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND People with severe or profound intellectual and motor disabilities (SPIMD) experience numerous serious physical health problems and comorbidities. Knowledge regarding the prevalence of these problems is needed in order to detect and treat them at an early stage. Data concerning these problems in individuals with SPIMD are limited. Therefore, the aim of this study was to determine the prevalence of reported physical health problems in adults with SPIMD through a review of medical records and care plans. METHOD We conducted a cross-sectional study employing data obtained from medical and support records. A sample of adults with SPIMD was recruited in eight residential care settings. Physical health problems that had occurred during the previous 12 months or were chronic were recorded. RESULTS The records of 99 participants were included. A wide range of physical health problems were found with a mean of 12 problems per person. Very high prevalence rates (>50%) were found for constipation, visual impairment, epilepsy, spasticity, deformations, incontinence and reflux. CONCLUSIONS The results suggest that people with SPIMD simultaneously experience numerous, serious physical health problems. The reliance on reported problems may cause an underestimation of the prevalence of health problems with less visible signs and symptoms such as osteoporosis and thyroid dysfunction.
Collapse
Affiliation(s)
- E A van Timmeren
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
| | - A A J van der Putten
- Faculty of Behavioural and Social Sciences, Department of Special Needs Education and Youth Care, University of Groningen, Groningen, The Netherlands
| | | | - C P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| |
Collapse
|
9
|
Rousseau MC, Mathieu S, Brisse C, Motawaj M, Grimont E, Auquier P, Billette de Villemeur T. Aetiologies, comorbidities and causes of death in a population of 133 patients with polyhandicaps cared for at specialist rehabilitation centres. Brain Inj 2015; 29:837-42. [DOI: 10.3109/02699052.2015.1004757] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
10
|
Savage TA, Moro TT, Boyden JY, Brown AA, Kavanaugh KL. Implementation challenges in end-of-life research with adults with intellectual and developmental disabilities. Appl Nurs Res 2014; 28:202-5. [PMID: 25457272 DOI: 10.1016/j.apnr.2014.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 10/04/2014] [Indexed: 11/24/2022]
Abstract
Although the 4 million+people in the U.S. with an intellectual or developmental disability (I/DD) experience the same life expectancy as those in the general population, end-of-life research including these individuals is lacking and can be difficult to implement. As will be described in this paper, it is possible to overcome barriers to successfully include people with I/DD in end-of-life research. In this paper, the implementation challenges, feasibility, and implications for successful end-of-life research with individuals with I/DD using focus groups are described. Individuals with I/DD were able to discuss their experiences and views about end-of-life care. However, while people with I/DD made valuable contributions to the focus groups, there were several modifications needed in order to execute this study. In order to gain a complete picture of end-of-life care for people with I/DD, it is imperative to include them in research to the best of their ability. By anticipating issues related to recruitment, the consent process, setting, and support needs of participants, focus groups can be successfully implemented.
Collapse
Affiliation(s)
- Teresa A Savage
- University of Illinois at Chicago College of Nursing, Department of Women, Children and Family Health Sciences, 845S. Damen, Room 858, Chicago, IL 60612, USA.
| | - Teresa Thalia Moro
- University of Chicago, School of Social Service Administration, 969 E. 60th Street, Chicago, IL 60637, USA.
| | - Jackelyn Y Boyden
- Capital Caring, Education Research, 2900 Telestar Court, Falls Church, VA 22042, USA.
| | - Allison A Brown
- Department of Psychology, University of Illinois Urbana-Champaign, 603 E. Daniel St. (M/C 716), Champaign, IL 61820, USA.
| | - Karen L Kavanaugh
- Wayne State University College of Nursing, Family, Community, and Mental Health, 5557 Cass Avenue, Detroit, MI 48202, USA.
| |
Collapse
|
11
|
Lunsky Y, Tint A, Robinson S, Gordeyko M, Ouellette-Kuntz H. System-Wide Information About Family Carers of Adults With Intellectual/Developmental Disabilities-A Scoping Review of the Literature. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12068] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yona Lunsky
- Centre for Addiction and Mental Health; Toronto Ontario Canada
| | - Ami Tint
- Department of Psychology; York University; Toronto Ontario Canada
| | - Suzanne Robinson
- Department of Psychology; York University; Toronto Ontario Canada
| | - Marcia Gordeyko
- School and Child Clinical Psychology; Ontario Institute for Studies in Education; University of Toronto; Toronto Ontario Canada
| | - Hélène Ouellette-Kuntz
- Departments of Community Health & Epidemiology and Psychiatry; Queen's University; Kingston Ontario Canada
| |
Collapse
|
12
|
Caring for older people with an intellectual disability: A systematic review. Maturitas 2012; 72:286-95. [DOI: 10.1016/j.maturitas.2012.05.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 05/17/2012] [Indexed: 11/18/2022]
|
13
|
Chou YC, Chiao C, Fu LY. Health status, social support, and quality of life among family carers of adults with profound intellectual and multiple disabilities (PIMD) in Taiwan. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2011; 36:73-79. [PMID: 21314595 DOI: 10.3109/13668250.2010.529803] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Primary family carers of adults with profound intellectual and multiple disabilities (PIMD) experience a range of considerable demands. METHOD A census survey was conducted in a city of Taiwan; 796 family carers of adults (aged 18 or older) diagnosed with intellectual disability and/or with multiple disabilities living with the family completed interviews. RESULTS Adults with PIMD made up 9.5% of this group (n = 76). Nonparametric analyses showed that health status, formal social support, and quality of life (QoL; physical domain score) of carers of adults with PIMD were significantly lower than their counterparts (i.e., carers of adults with less severe disability), and that these variables were significantly associated with carer educational level, employment status, family income, and social networks. CONCLUSIONS Interventions need to include the creation of a supportive environment for adults with PIMD and their lifelong family carers, particularly those who are more socially disadvantaged.
Collapse
Affiliation(s)
- Yueh-Ching Chou
- Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan.
| | | | | |
Collapse
|
14
|
Kerins GJ, Price LC, Broadhurst A, Gaynor CM. A Pilot Study Analyzing Mortality of Adults With Developmental Disabilities Residing in Nursing Homes in Connecticut. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2010. [DOI: 10.1111/j.1741-1130.2010.00262.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Gale L, Naqvi H, Russ L. Asthma, smoking and BMI in adults with intellectual disabilities: a community-based survey. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2009; 53:787-796. [PMID: 19627422 DOI: 10.1111/j.1365-2788.2009.01192.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Recent research evidence from the general population has shown that tobacco smoking and raised body mass index (BMI) are associated with worse asthma outcomes. There are indications that asthma morbidity and mortality may be higher among people with intellectual disabilities (ID) than the general population, but the reason for this is not known. This is the first study to investigate the extent of smoking and higher than recommended BMI among adults with ID and a diagnosis of asthma. METHOD Health-related data for 1097 adults with ID were collected from 28 primary care practices in Bristol, UK. RESULTS Prevalence of asthma in this sample of adults with ID was 12% which was much higher than among the general population living in the region. The 132 patients with asthma were found to be nearly twice as likely to be current smokers as patients with ID who did not have asthma (29.5% vs. 15.6%). Smoking rates were higher among men than women with asthma (35.7% vs. 22.6%). Patients diagnosed with asthma were also more likely to be obese (BMI >or= 30) than patients with ID but no asthma (42.7% vs. 31.6%). Obesity was particularly a problem among women with asthma as more than half (52.1%) had a BMI >or= 30. CONCLUSIONS A very high proportion of patients with ID and asthma were found to be current smokers and/or obese. There is now strong research evidence that both smoking and obesity are implicated in the development of asthma and associated with worse disease outcomes. This study highlights the urgent need for programmes aimed at providing support for people with ID and asthma to stop smoking and to achieve a healthy body weight.
Collapse
Affiliation(s)
- L Gale
- Mental Health Research Network, Academic Unit of Psychiatry, Bristol, UK.
| | | | | |
Collapse
|
16
|
Hirono K, Konishi T, Origasa H, Ichida F, Miyawaki T. Echocardiographic and electrocardiographic analyses of patients with severe motor and intellectual disabilities. Heart Vessels 2009; 24:46-53. [DOI: 10.1007/s00380-008-1070-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2008] [Accepted: 05/16/2008] [Indexed: 10/21/2022]
|