1
|
Whitelaw S. Fostering resilience in young people with intellectual disabilities using a 'settings' approach. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:549-566. [PMID: 36977495 PMCID: PMC11059839 DOI: 10.1177/17446295231168186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The need to foster resilience amongst young people with intellectual disabilities is increasingly recognised within policy. Critically, understanding of the actual means by which this aspiration might be most sensitively and effectively met is considered weak. This paper reports on an exploratory case-study of a social enterprise community café - The Usual Place - that through the promotion of employability, seeks to promote resilience amongst its young 'trainees' with intellectual disabilities. Two research questions were set: "how is 'resilience' conceptualized within the organisation" and "what features within the organisation are significant in fostering resilience"? We identify a range of significant features associated with being able to successfully foster resilience - the need for a foundational 'whole organisation'(settings) approach based on high levels of participation and choice; the negotiation of a constructive dynamic tension between 'support' and 'exposure'; and the embedding of these actions in embodied actions and day-to-day organisational activities.
Collapse
Affiliation(s)
- Sandy Whitelaw
- School of Interdisciplinary Studies, University of Glasgow, Dumfries, UK
| |
Collapse
|
2
|
Hamdani Y, Bonder R, McPherson AC. Wellness in children's rehabilitation - what does it mean? Disabil Rehabil 2023; 45:4236-4244. [PMID: 36437808 DOI: 10.1080/09638288.2022.2148295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Rehabilitation research on wellness promotion for children and youth with disabilities is limited and tends to narrowly focus on physical aspects of health. An overarching sense of wellness includes multiple, overlapping dimensions (e.g., physical, social, emotional, occupational). This study's main objectives were to explore what wellness means for young people with disabilities, and what contributes to their sense of wellness. METHODS A qualitative design involving World Café-style focus groups was used to explore the perspectives of youth with disabilities (14-25 years old, n = 3), parents (n = 6) and healthcare providers (n = 10) on how wellness is understood and addressed at a Canadian children's rehabilitation hospital. Themes were identified through an inductive analysis of focus group transcripts and notes written by participants and research team members. RESULTS Having a variety of relationships and social connections, meaningful activity opportunities, becoming as independent as possible, and having stable medical health contributed to wellness for young people with disabilities. CONCLUSIONS Rehabilitation care can promote wellness by co-creating personalized care pathways across multiple wellness dimensions with young people with disabilities and their families, focusing on strengths rather than deficits, and improving access to a variety of activities and communities.IMPLICATIONS FOR REHABILITATIONRehabilitation professionals in children's rehabilitation have unique, ongoing opportunities to promote and support wellness with young people with disabilities and their families.Rehabilitation professionals can embed personalized, strengths-focused wellness pathways across multiple dimensions into the care of children with disabilities.Helping children and families address barriers to meaningful activities and promoting social connections can foster an overarching sense of wellness.
Collapse
Affiliation(s)
- Yani Hamdani
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Revi Bonder
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
3
|
Hilberdink CE, van Zuiden M, Olff M, Roseboom TJ, de Rooij SR. The impact of adversities across the lifespan on psychological symptom profiles in late adulthood: a latent profile analysis. J Dev Orig Health Dis 2023; 14:508-522. [PMID: 37477375 DOI: 10.1017/s2040174423000181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
People commonly face adverse circumstances throughout life, which increases risk for psychiatric disorders, such as anxiety, depression, psychosis, and posttraumatic stress disorder (PTSD). Adversities may occur during different periods in life. Especially adversity during early periods has been suggested to put individuals at risk for adverse mental health outcomes. Here, we investigated whether timing of adversity during the prenatal period, childhood, or mid-to-late adulthood differentially impacted classification into late adulthood symptom profiles. We performed sex-stratified Latent Profile Analysis to identify latent profiles regarding anxious, depressive, psychotic, and PTSD symptoms in n = 568 Dutch famine birth cohort members (n = 294 women, n = 274 men, mean age(SD) = 72.9(0.8)). Cross-sectional late adulthood symptomatology, childhood traumatic maltreatment, and adulthood trauma were based on self-report questionnaires. Prenatal adversity was considered present when individuals were prenatally exposed to the 1944-45 Dutch famine. In both men and women we identified one anxious/depressive profile and three profiles with approximately equal severity of all symptom types within each profile, yet differentiating in overall severity (low, mild, high) between profiles. We additionally found a PTSD symptom profile in women. In men, logistic regression models showed significant associations between prenatal, childhood and adulthood adversity, and profile classification, with differential effects depending on timing and most profound effects of child maltreatment. In women, childhood and adulthood adversity significantly increased classification probability into almost all profiles, with no significant effect of prenatal adversity. These findings support a time-dependent and sex-specific impact of adversity during different periods across the lifespan on psychological health, with consequences into late adulthood.
Collapse
Affiliation(s)
- C E Hilberdink
- Amsterdam UMC Location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Mood, Anxiety, Psychosis, Stress and Sleep, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, University of Amsterdam, Amsterdam, The Netherlands
| | - M van Zuiden
- Amsterdam UMC Location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Mood, Anxiety, Psychosis, Stress and Sleep, Amsterdam, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - M Olff
- Amsterdam UMC Location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Mood, Anxiety, Psychosis, Stress and Sleep, Amsterdam, The Netherlands
- ARQ, National Psychotrauma Centre, Diemen, The Netherlands
| | - T J Roseboom
- Department of Epidemiology and Data Science, University of Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - S R de Rooij
- Department of Epidemiology and Data Science, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam, The Netherlands
| |
Collapse
|
4
|
Hewitt O, Langdon PE, Tapp K, Larkin M. A systematic review and narrative synthesis of inclusive health and social care research with people with intellectual disabilities: How are co‐researchers involved and what are their experiences? JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023. [DOI: 10.1111/jar.13100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Olivia Hewitt
- Centre for Educational Development, Appraisal and Research (CEDAR) University of Warwick Coventry CV4 7AL UK
- Learning Disability Services Berkshire Healthcare NHS Foundation Trust 3 Floor, Fitzwilliam House, Skimped Hill Lane Bracknell RG12 1BQ UK
| | - Peter E. Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR) University of Warwick Coventry CV4 7AL UK
- Coventry and Warwickshire Partnership NHS Trust, Rainbow Unit Brooklands Hospital Marston Green Birmingham B37 5RY UK
| | - Katherine Tapp
- Centre for Educational Development, Appraisal and Research (CEDAR) University of Warwick Coventry CV4 7AL UK
| | | |
Collapse
|
5
|
Moonen X, Festen D, Bakker-van Gijsel E, Vervoort-Schel J. A Dutch Perspective on Two Health Related Issues Regarding Children and Adolescents with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11698. [PMID: 36141966 PMCID: PMC9517279 DOI: 10.3390/ijerph191811698] [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: 07/13/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
In this opinion article, we want to inspire readers by highlighting recent Dutch developments about two important health related issues regarding the quality of life of children and adolescents with intellectual disabilities. Firstly we focus on the prevention, treatment and reduction of (disability-related) somatic and psychological problems by specialized physicians for people with intellectual disabilities. Secondly, we emphasize the importance of the prevention of adverse childhood experiences and the promotion of protective and compensatory experiences. Subsequently, we stress the need for trauma informed care to support children and adolescents with intellectual disabilities who encounter adverse events. A specialized and multidisciplinary approach is advised as is the need for promoting healthy (family) relations with a focus on (co)regulation and connection as a basis for recovery.
Collapse
Affiliation(s)
- Xavier Moonen
- Ben Sajet Center, Zwanenburgwal 206, 1011 JH Amsterdam, The Netherlands
- Department of Child Development and Education, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, The Netherlands
| | - Dederieke Festen
- Erasmus MC, University Medical Center Rotterdam, Postbus 2040, 3000 CA Rotterdam, The Netherlands
| | | | - Jessica Vervoort-Schel
- Ben Sajet Center, Zwanenburgwal 206, 1011 JH Amsterdam, The Netherlands
- Department of Child Development and Education, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, The Netherlands
| |
Collapse
|
6
|
Ali A, McKenzie E, Hassiotis A, Priebe S, Lloyd‐Evans B, Jones R, Panca M, Omar R, Finning S, Moore S, Roe C, King M. A pilot randomised controlled trial of befriending by volunteers in people with intellectual disability and depressive symptoms. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:1010-1019. [PMID: 34570405 PMCID: PMC9291894 DOI: 10.1111/jir.12886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/13/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND People with intellectual disability (ID) are more likely to experience chronic depression compared with the general population, which may be compounded by loneliness and lower levels of social support. Befriending aims to provide social support and promote engagement in community activities. No randomised controlled trials have examined whether befriending improves symptoms of depression and social outcomes in people with ID. The aim of this pilot trial was to assess the feasibility and acceptability of a future larger trial of one-to-one befriending by volunteers in people with ID and depressive symptoms. METHODS Participants were adults with mild or moderate ID with a score of 5 or more on the Glasgow Depression Scale for People with Learning Disabilities (GDS-LD). They were randomised to the intervention arm (matched to a volunteer befriender for 6 months) or the control arm (usual care). Volunteers received training and supervision provided by two community befriending schemes. The main outcomes were feasibility of recruitment (minimum target n = 35), retention rate of participants, adherence (minimum 10 meetings), acceptability of the intervention, changes in depressive symptoms (assessed at baseline and 6 months) and feasibility of collecting data for a health economic analysis. RESULTS Recruitment was challenging, and only 16 participants with ID and 10 volunteers were recruited. Six participants were matched with a volunteer and no participants dropped out (except for two volunteers). Four participants completed 10 meetings (mean 11.8). Befriending was thought to be acceptable, but modifications were suggested. An exploratory analysis suggested that GDS-LD score was lower in the intervention group compared with the control group after adjusting for baseline scores, but not significant (adjusted mean difference: -4.0; 95% confidence interval: -11.2 to 3.2). CONCLUSIONS A large trial would not be feasible based on the recruitment strategies employed in this study. A further feasibility study addressing these challenges or the use of other study designs should be considered.
Collapse
Affiliation(s)
- A. Ali
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - E. McKenzie
- Research and Development OfficeGoodmayes Hospital, North East London NHS Foundation TrustLondonUK
| | - A. Hassiotis
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - S. Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services DevelopmentQueen Mary University of LondonLondonUK
| | - B. Lloyd‐Evans
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - R. Jones
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| | - M. Panca
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| | - R. Omar
- Department of Statistical ScienceUniversity College LondonLondonUK
| | - S. Finning
- Outward HousingOutward, Newlon HouseLondonUK
| | - S. Moore
- The Befriending SchemeSudburySuffolkUK
| | - C. Roe
- The Befriending SchemeSudburySuffolkUK
| | - M. King
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| |
Collapse
|
7
|
Ali A, Mckenzie E, Rasoul Z, Hassiotis A, Priebe S, Lloyd-Evans B, Jones R, Panca M, Omar R, Finning S, Moore S, Roe C, King M. One-to-one volunteer befriending to reduce symptoms of depression in people with intellectual disability: a feasibility RCT. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Little is known about the effectiveness of befriending for people with intellectual disability and whether or not befriending improves depressive symptoms and social outcomes.
Objective
This pilot trial aimed to assess the feasibility and acceptability of conducting a future full-scale randomised controlled trial of one-to-one befriending for people with intellectual disability who had depressive symptoms.
Design
This was a parallel-group, two-armed randomised controlled trial incorporating an exploratory economic analysis and a mixed-methods process evaluation. Outcome assessments were conducted at baseline and at 6 months post randomisation by a research assistant who was blind to allocation. We aimed to approach 50 participants, with a view to recruiting 40.
Setting
Participants with intellectual disability were recruited from one NHS trust and from referrals to two community befriending services. The intervention was delivered by community befriending services.
Participants
Adults with mild or moderate intellectual disability with a score on the Glasgow Depression Scale for people with a Learning Disability of ≥ 5 were included. Those attending a day service/college for ≥ 3 days a week were excluded. Volunteers were aged ≥ 18 years and had no history of prior convictions.
Intervention
Participants in the intervention group were matched with a volunteer befriender and were expected to meet once per week for 1 hour, over 6 months. Volunteers recorded activities in a logbook. Volunteers received training and regular supervision. Both groups received usual care and a resource booklet of local activities.
Main outcome measures
The feasibility outcomes and progression criteria were recruitment of at least 70% of participants approached; matching of at least 70% of participants in the intervention group to a volunteer; a dropout rate of < 30% of participants and volunteers; adherence to the intervention (10 meetings between pairs); acceptability of the intervention; and feasibility of collecting data on costs and resource use for an economic evaluation. Changes in depressive symptoms (primary clinical outcome: Glasgow Depression Scale) and self-esteem, quality of life, social participation, social support, health-related quality of life and service use were recorded at 6 months. Outcomes in volunteers were also assessed.
Results
We recruited only 16 participants with intellectual disability (40% of target) and 10 volunteers. Six of the eight (75%) participants in the intervention group were matched with a befriender and there was good adherence (mean number of meetings attended 11.8; range 1–21 meetings). Going to a cafe/restaurant and having a conversation were the most frequent activities. All participants were retained at follow-up, but two volunteers dropped out. Trial procedures and the intervention might be acceptable, but modifications were suggested. Data on costs and resource use were obtained, but there were discrepancies in the health-related quality-of-life data.
Limitations
Delays to the study prevented the use of alternative recruitment strategies and the planned 12-month follow-up could not be completed.
Conclusions
Recruitment was not feasible, but other feasibility outcomes were more positive.
Future work
Evaluating befriending for people with intellectual disability could be explored through alternative study designs, such as observational studies.
Trial registration
Current Controlled Trials ISRCTN63779614.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 10. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Afia Ali
- Division of Psychiatry, University College London, London, UK
| | - Emma Mckenzie
- Research and Development Office, Goodmayes Hospital, North East London NHS Foundation Trust, London, UK
| | - Zara Rasoul
- Division of Psychiatry, University College London, London, UK
| | | | - Stefan Priebe
- Unit for Social and Community Psychiatry (World Health Organization Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | | | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
- Priment Clinical Trials Unit, University College London, London, UK
| | - Monica Panca
- Priment Clinical Trials Unit, University College London, London, UK
| | - Rumana Omar
- UK Department of Statistical Science, University College London, London, UK
| | | | | | | | - Michael King
- Division of Psychiatry, University College London, London, UK
- Priment Clinical Trials Unit, University College London, London, UK
| |
Collapse
|
8
|
Santiago AM, Berg KA, Leroux J. Assessing the Impact of Neighborhood Conditions on Neurodevelopmental Disorders during Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179041. [PMID: 34501630 PMCID: PMC8430861 DOI: 10.3390/ijerph18179041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
Nearly three out of ten neurodevelopmental disabilities in the United States have been linked to environmental conditions, prompting emerging lines of research examining the role of the neighborhood on children’s developmental outcomes. Utilizing data from a natural experiment in Denver, this study quantifies the impact of exposure to varied neighborhood contexts on the diagnosis of neurodevelopmental disorders over the course of childhood. Our analysis is based upon retrospective child, caregiver, household and neighborhood data derived from the Denver Child Study for a sample of approximately 590 Latino and African American children and youth whose families were quasi-randomly assigned to subsidized housing operated by the Denver (CO) Housing Authority during part of their childhood. We employed binary response models with endogenous explanatory variables, estimated using instrumental variables (IV) probit and average marginal effects to identify predictors of a neurodevelopmental disorder diagnosis during childhood. We found that multiple dimensions of neighborhood context—especially neighborhood socioeconomic status, older housing stock, residential instability and prevalence of neurological hazards in the ambient air—strongly and robustly predicted the diagnosis of a neurodevelopmental disorder during childhood.
Collapse
Affiliation(s)
- Anna Maria Santiago
- School of Social Work, College of Social Science, Michigan State University, East Lansing, MI 48824, USA
- Correspondence:
| | - Kristen A. Berg
- Center for Health Care Research and Policy, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Joffré Leroux
- Department of Economics, Michigan State University, East Lansing, MI 48824, USA;
| |
Collapse
|
9
|
Vervoort-Schel J, Mercera G, Wissink I, Van der Helm P, Lindauer R, Moonen X. Prevalence of and relationship between adverse childhood experiences and family context risk factors among children with intellectual disabilities and borderline intellectual functioning. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103935. [PMID: 33756254 DOI: 10.1016/j.ridd.2021.103935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/12/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are an overlooked risk factor for behavioural, mental and physical health disparities in children with intellectual disabilities (ID) and borderline intellectual functioning (BIF). AIMS To gain insight into the presence of the 10 original Wave II ACEs and family context risk variables in a convenience sample of children with ID and BIF in Dutch residential care. METHODS AND PROCEDURES 134 case-files of children with ID (n = 82) and BIF (n = 52) were analysed quantitatively. OUTCOMES AND RESULTS 81.7 % of the children with ID experienced at least 1 ACE, as did 92.3 % of the children with BIF. The average number of ACEs in children with ID was 2.02 (range 0-8) and in children with BIF 2.88 (range 0-7). About 20 % of the children with moderate and mild ID experienced 4 ACEs or more. Many of their families faced multiple and complex problems (ID: 69.5 %; BIF 86.5 %). Multiple regression analysis indicated an association between family context risk variables and the number of ACEs in children. CONCLUSIONS AND IMPLICATIONS The prevalence of ACEs in children with ID and BIF appears to be considerably high. ACEs awareness in clinical practice is vital to help mitigate negative outcomes.
Collapse
Affiliation(s)
- Jessica Vervoort-Schel
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands.
| | - Gabriëlle Mercera
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Vijverdalseweg 1, 6226 NB Maastricht, the Netherlands
| | - Inge Wissink
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands
| | - Peer Van der Helm
- Expert Centre Social Work and Applied Psychology, Professional University of Applied Sciences Leiden, Zernikedreef 11, 2333 CK Leiden, the Netherlands; Fier, National Expertise and Treatment Centre, Holstmeerweg 1, 8936 AS Leeuwarden, the Netherlands; Amsterdam UMC, University of Amsterdam, Department Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Ramón Lindauer
- Amsterdam UMC, University of Amsterdam, Department Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Levvel, Academic Centre for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - Xavier Moonen
- Koraal Centre of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, the Netherlands; Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, the Netherlands
| |
Collapse
|
10
|
McNally P, Taggart L, Shevlin M. Trauma experiences of people with an intellectual disability and their implications: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:927-949. [PMID: 33772975 DOI: 10.1111/jar.12872] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/14/2021] [Accepted: 02/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with an intellectual disability are more vulnerable to psychological trauma compared with the general population. The aim of this scoping review was to identify the current status of the literature on trauma that is specific to the experiences of adults with an intellectual disability, living in community settings. METHODS A scoping review was conducted using the Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) framework. Forty-one international papers were reviewed spanning 2000-2020, and their quality assessed using the MMAT. FINDINGS (1) Aggressive behaviours can be symptoms of trauma, (2) there are appropriate assessment tools for the impact of trauma, (3) evidence-based interventions for trauma may be effective, and (4) factors associated with disability can be experienced as traumatic. CONCLUSION There is a growing body of literature highlighting assessment needs and potential interventions for people with an intellectual disability who have experienced psychological trauma. Further research is needed to develop trauma-informed pathways.
Collapse
Affiliation(s)
- Paddy McNally
- Institute of Nursing and Health Science, Ulster University, Newtownabbey, UK
| | | | | |
Collapse
|
11
|
Goad E. Working alongside people with intellectual disabilities who have had difficult experiences: Reflections on trauma-informed care within a service context. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 26:1744629520987717. [PMID: 33615861 DOI: 10.1177/1744629520987717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
People with intellectual disabilities are more likely to experience adverse childhood experiences than those in the general population. Additionally, the conceptualization of 'trauma' is far broader than traditionally understood in order to encompass the far reaching relational nature of people with intellectual disabilities traumatic experiences. This reflective account details the first steps one service took to embrace trauma-informed care as a whole systems approach. The paper is a response to calls following conference presentations about our work, to share the process of the beginning of this journey, it also aims to provide key learning points, practical considerations and questions for reflection in order to support other services to begin their own relationships with trauma-informed care.
Collapse
Affiliation(s)
- Elisabeth Goad
- 9490Surrey and Borders Partnership NHS Foundation Trust, UK
| |
Collapse
|
12
|
Resilience in Autism and Intellectual Disability: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00239-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
13
|
Mental Health of Parents of Special Needs Children in China during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249519. [PMID: 33353165 PMCID: PMC7765938 DOI: 10.3390/ijerph17249519] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 12/21/2022]
Abstract
We assessed the mental health of parents (N = 1450, Mage = 40.76) of special needs children during the COVID-19 pandemic. We conducted an online survey comprising items on demographic data; two self-designed questionnaires (children’s behavioral problems/psychological demand of parents during COVID-19); and four standardized questionnaires, including the General Health Questionnaire, Perceived Social Support, Parenting Stress Index, and Neuroticism Extraversion Openness Five Factor Inventory. The results showed that there were significant differences among parents of children with different challenges. Parents of children with autism spectrum disorder were more likely to have mental health problems compared to parents whose children had an intellectual disability or a visual or hearing impairment. Behavioral problems of children and psychological demands of parents were common factors predicting the mental health of all parents. Parent–child dysfunctional interactions and parenting distress were associated with parents of children with autism spectrum disorder. Family support, having a difficult child, and parenting distress were associated with having children with an intellectual disability. It is necessary to pay attention to the parents’ mental health, provide more social and family support, and reduce parenting pressures.
Collapse
|
14
|
Nouwens PJG, Smulders NBM, Embregts PJCM, van Nieuwenhuizen C. Differentiating care for persons with mild intellectual disability or borderline intellectual functioning: a Delphi study on the opinions of primary and professional caregivers and scientists. BMC Psychiatry 2020; 20:57. [PMID: 32039715 PMCID: PMC7008567 DOI: 10.1186/s12888-020-2437-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/10/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The demand for support for persons with mild intellectual disability or borderline intellectual functioning is growing rapidly. These persons often encounter individual and familial limitations that influence their human functioning, and often have difficulty coping with the demands of modern society. Although in the areas of policy, research and practice, people with mild intellectual disability or borderline intellectual functioning are generally approached as one group, important differences between them have been reported. Current support seems to be both suboptimal and insufficiently differentiated. METHODS In this Delphi study we aimed to explore the need for appropriate and differentiated support for individuals with mild intellectual disability or borderline intellectual functioning. The study was based on five unique profiles of persons with mild intellectual disability or borderline intellectual functioning that are associated with individual and environmental variables. The opinions of expert primary caregivers, professional caregivers and scientists were analysed for potentially appropriate types of support for each of the five profiles. RESULTS A total of 174 statements, divided over the five profiles, were presented to the participants. For 74 statements, consensus was reached between the expert groups. For each profile, these consensual statements represented specific items (e.g. concrete personal goals) and non-specific items (e.g. the attitude towards persons with mild intellectual disability or borderline intellectual functioning, and the coordination of health care) related to the support needs. CONCLUSION This Delphi-based study generated consensual opinions contributing to a more differentiated system of support for individuals with mild intellectual disability or borderline intellectual functioning. Although these findings need additional investigation, they address actions that might enhance the support programmes for these individuals into more personalized support.
Collapse
Affiliation(s)
- Peter J. G. Nouwens
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | | | - Petri J. C. M. Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Chijs van Nieuwenhuizen
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
- GGzE Centre for Child & Adolescent Psychiatry, Eindhoven, the Netherlands
| |
Collapse
|
15
|
Dean EE, Shogren KA, Hagiwara M, Wehmeyer ML. How does employment influence health outcomes? A systematic review of the intellectual disability literature. JOURNAL OF VOCATIONAL REHABILITATION 2018. [DOI: 10.3233/jvr-180950] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Evan E. Dean
- Beach Center on Disability/Kansas University Center on Developmental Disabilities, Lawrence, KS, USA
- Department of Occupational Therapy Education, University of Kansas, Kansas City, KS, USA
| | - Karrie A. Shogren
- Beach Center on Disability/Kansas University Center on Developmental Disabilities, Lawrence, KS, USA
| | - Mayumi Hagiwara
- Beach Center on Disability/Kansas University Center on Developmental Disabilities, Lawrence, KS, USA
| | - Michael L. Wehmeyer
- Beach Center on Disability/Kansas University Center on Developmental Disabilities, Lawrence, KS, USA
| |
Collapse
|
16
|
Szatmari P. Risk and resilience in autism spectrum disorder: a missed translational opportunity? Dev Med Child Neurol 2018; 60:225-229. [PMID: 28976014 DOI: 10.1111/dmcn.13588] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 01/09/2023]
Abstract
UNLABELLED The objective of this review is to provide a narrative summary of risk and resiliency in autism spectrum disorder (ASD) over the lifespan. In recent years, much has been learned about risk factors for ASD which include both genetic and environmental mechanisms. Resiliency in ASD is much less studied but examples can be gleaned by exploring studies that allow for heterogeneity in causation and outcome. Possible examples come from the literature on sex difference, infant siblings, and natural history. Exciting translational opportunities can be achieved through a greater focus on understanding protective factors and resiliency in ASD than the field's almost exclusive focus on risk factors and the ability to predict poor outcomes. Although the exact nature of processes that protect in ASD are not yet known, putting a resiliency lens on research and clinical practice may prove illuminating. WHAT THIS PAPER ADDS Resiliency in autism spectrum disorder is a function of the vast variation seen in etiology and outcome. A focus on strengthening protective factors may improve long-term outcome.
Collapse
Affiliation(s)
- Peter Szatmari
- Child and Youth Mental Health Collaborative, Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, Canada
| |
Collapse
|
17
|
Clegg J, Bigby C. Debates about dedifferentiation: twenty-first century thinking about people with intellectual disabilities as distinct members of the disability group. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23297018.2017.1309987] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Jennifer Clegg
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Christine Bigby
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
18
|
Kayrouz N, Milne SL, McDonald JL. Social disadvantage and developmental diagnosis in pre-schoolers. J Paediatr Child Health 2017; 53:563-568. [PMID: 28398695 DOI: 10.1111/jpc.13505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 11/07/2016] [Accepted: 11/21/2016] [Indexed: 11/28/2022]
Abstract
AIM To explore the association between social disadvantage and developmental diagnoses in pre-school children. METHODS Between 2012 and 2015, 845 pre-school children were assessed by the Child Assessment Team at Campbelltown Hospital. A social worker interviewed 469 families and these children were eligible for inclusion in the study. Autism spectrum disorder (ASD) was confirmed in 290 children. Of those without ASD, 72 did not have global developmental delay (GDD) and were excluded from the study. The remaining 107 children with GDD were used as the comparison group. Social risk factors in the two groups were compared using χ 2 tests. Variables with statistical significance were then entered into a logistic regression. RESULTS After logistic regression, children with ASD were more likely to be male (odds ratio (OR) 3.1, 95% CI 0.195-0.529; P < 0.001) and their parents were more likely to have a clinically significant stress score (OR 1.3, 95% CI 0.334-0.992; P = 0.047). Children with GDD were more likely to live in a disadvantaged suburb (OR 1.7, 95% CI 1.042-2.940; P = 0.034), more likely to have a sole parent (OR 1.8, 95% CI 1.062-3.082; P = 0.029) and much more likely to have had involvement with child protection services (OR 3.9, 95% CI 2.044-7.416; P < 0.001). CONCLUSIONS Children with GDD without autism were more likely to be disadvantaged and to have had contact with child protection services than children with ASD. This has implications for the assessment, early intervention and support services for children with disabilities and their families.
Collapse
Affiliation(s)
- Norma Kayrouz
- The Child Assessment Team, Department of Community Paediatrics, Campbelltown Hospital, Sydney, New South Wales, Australia
| | - Susan L Milne
- The Child Assessment Team, Department of Community Paediatrics, Campbelltown Hospital, Sydney, New South Wales, Australia
| | - Jenny L McDonald
- The Child Assessment Team, Department of Community Paediatrics, Campbelltown Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
19
|
Lovell A, Bailey J. Nurses' perceptions of personal attributes required when working with people with a learning disability and an offending background: a qualitative study. J Psychiatr Ment Health Nurs 2017; 24:4-14. [PMID: 27439391 DOI: 10.1111/jpm.12326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 11/28/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Learning disability nursing in the area of people with a learning disability and an offending background has developed considerably over recent years, particularly since the publication of the Bradley (). There has been limited work into the competencies nurses require to work in this area, and even less about the personal attributes of learning disability nurses. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Learning disability nursing's specific contribution to the care of this population lies in their knowledge of the interaction between the learning disability, an individual's, sometimes abusive, personal history and an understanding of the subsequent offending behaviour. The knowledge base of nurses working with people with learning disabilities and an offending background needs to reflect the changing service user group. This is particularly in relation to substance misuse, borderline personality disorder, and mental health and the way such factors inter-relate with the learning disability. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further research is required into the relationship among decision making, risk taking or reluctance to do this, and the personal attributes required by nurses to work in secure learning disability care. Learning disability secure services are likely to continue to undergo change as circumstances alter and the offending population demonstrate greater complexity; nursing competencies and personal attributes need similarly to adapt to such changes. Mental health nursing has a great deal to contribute to effective working with this population, specifically with regard to developing strong relationships when concerns around borderline personality disorder or substance misuse are particularly in evidence. ABSTRACT Aim To identify and discuss the personal attributes required by learning disability nurses to work effectively with people with an offending background in secure and community settings. Background This study was part of a larger research investigation into the nursing competencies required to work with people with an offending background. There are few existing studies examining the personal attributes necessary for working with this group. Design A qualitative study addressing the perceptions of nurses around the personal attributes required to work with people with learning disabilities and an offending background. Methods A semi-structured interview schedule was devised and constructed, and 39 individual interviews were subsequently undertaken with learning disability nurses working in high, medium, low secure and community settings. Data were collected over 1 year in 2010/11 and analysed using a structured thematic analysis supported by the software package MAXqda. Findings The thematic analysis produced three categories of personal attributes, named as looking deeper, achieving balance and connecting, each of which contained a further three sub-categories. Conclusion Nursing of those with a learning disability and an offending background continues to develop. The interplay among personal history, additional background factors, nurses' personal attributes and learning disability is critical for effective relationship building.
Collapse
Affiliation(s)
- A Lovell
- Department of Mental Health & Learning Disabilities, Faculty of Health & Social Care, University of Chester, Chester, UK
| | - J Bailey
- Faculty of Health & Social Care, University of Chester, Chester, UK
| |
Collapse
|
20
|
Pownall J, Wilson S, Jahoda A. Health knowledge and the impact of social exclusion on young people with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 33:29-38. [DOI: 10.1111/jar.12331] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/30/2022]
Affiliation(s)
| | - Sarah Wilson
- Institute of Health and Wellbeing University of Glasgow Glasgow UK
| | - Andrew Jahoda
- Institute of Health and Wellbeing University of Glasgow Glasgow UK
| |
Collapse
|
21
|
Patton KA, Ware R, McPherson L, Emerson E, Lennox N. Parent-Related Stress of Male and Female Carers of Adolescents with Intellectual Disabilities and Carers of Children within the General Population: A Cross-Sectional Comparison. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 31:51-61. [DOI: 10.1111/jar.12292] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Kiri A. Patton
- School of Psychology; The University of Queensland; St Lucia Brisbane Qld Australia
| | - Robert Ware
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
- School of Population Health; The University of Queensland; Herston Qld Australia
| | - Lyn McPherson
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
| | - Eric Emerson
- Centre for Disability Research & Policy; University of Sydney; Sydney NSW Australia
- Centre for Disability Research; Lancaster University; UK
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability; The University of Queensland; Mater Hospital; Raymond Terrace; South Brisbane Qld Australia
| |
Collapse
|
22
|
Gilroy J, Emerson E. Australian indigenous children with low cognitive ability: Family and cultural participation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 56:117-127. [PMID: 27286466 DOI: 10.1016/j.ridd.2016.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/20/2016] [Accepted: 05/11/2016] [Indexed: 06/06/2023]
Abstract
Family and cultural inclusion are essential for the healthy development of young Australian Indigenous peoples with low cognitive ability. To date, this issue has received limited research attention. A secondary analysis of data collected in Wave 4 of Footprints in Time, Australia's Longitudinal Study of Indigenous Children, was conducted to help address this research gap. The study results indicated that in some areas, Indigenous children with low cognitive ability are at a higher risk of social exclusion than their peers. We discuss the policy implications of these findings with regards to addressing Indigenous disadvantage.
Collapse
Affiliation(s)
- John Gilroy
- Centre for Disability Research and Policy, University of Sydney, Sydney, Australia.
| | - Eric Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, Australia.
| |
Collapse
|
23
|
Berghs M, Atkin K, Graham H, Hatton C, Thomas C. Implications for public health research of models and theories of disability: a scoping study and evidence synthesis. PUBLIC HEALTH RESEARCH 2016. [DOI: 10.3310/phr04080] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BackgroundPublic health interventions that are effective in the general population are often assumed to apply to people with impairments. However, the evidence to support this is limited and hence there is a need for public health research to take a more explicit account of disability and the perspectives of people with impairments.Objectives(1) To examine the literature on theories and models of disability; (2) to assess whether or not, and how, intervention studies of effectiveness could incorporate more inclusive approaches that are consistent with these theories and models; and (3) to use the findings to draw out implications for improving evaluative study designs and evidence-based practice.Review methodsThe project is a scoping review of the literature. The first stage examines theories and models of disability and reflects on possible connections between theories of disability and public health paradigms. This discussion is used to develop an ethical–empirical decision aid/checklist, informed by a human rights approach to disability and ecological approaches to public health. We apply this decision aid in the second stage of the review to evaluate the extent to which the 30 generic public health reviews of interventions and the 30 disability-specific public health interventions include the diverse experiences of disability. Five deliberation panels were also organised to further refine the decision aid: one with health-care professionals and four with politically and socially active disabled people.ResultsThe evidence from the review indicated that there has been limited public health engagement with theories and models of disability. Outcome measures were often insensitive to the experiences of disability. Even when disabled people were included, studies rarely engaged with their experiences in any meaningful way. More inclusive research should reflect how people live and ‘flourish’ with disability.LimitationsThe scoping review provides a broad appraisal of a particular field. It generates ideas for future practice rather than a definite framework for action.ConclusionsOur ethical–empirical decision aid offers a critical framework with which to evaluate current research practice. It also offers a resource for promoting more ethical and evidence-based public health research that is methodologically robust while being sensitive to the experiences of disability.Future workDeveloping more inclusive research and interventions that avoid conceptualising disability as either a ‘burden’ or ‘problem’ is an important starting point. This includes exploring ways of refining and validating current common outcome measures to ensure that they capture a diverse range of disabling experiences, as well as generating evidence on meaningful ways of engaging a broad range of disabled children and adults in the research process.FundingThe National Institute for Health Research Public Health Research programme.
Collapse
Affiliation(s)
- Maria Berghs
- Department of Health Sciences, University of York, York, UK
| | - Karl Atkin
- Department of Health Sciences, University of York, York, UK
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Chris Hatton
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, UK
| | - Carol Thomas
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, UK
| |
Collapse
|
24
|
Hall AM, Theron LC. Resilience Processes Supporting Adolescents With Intellectual Disability: A Multiple Case Study. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 54:45-62. [PMID: 26824133 DOI: 10.1352/1934-9556-54.1.45] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Resilience, or the process of adjusting well to risk, relies on constructive collaboration between youths and their social ecologies. Although the literature details the risks of an intellectual disability (ID), there is little explanation of why some young people cope well despite these risks. Accordingly, we report a multiple case study that affords insight into the resilience of 24 adolescents with ID. Using a draw-and-talk methodology, these young people explained their resilience as enabled primarily by supportive social ecologies (which facilitated behavioral and emotional regulation, encouraged mastery, treated them as agentic beings, and offered safe spaces). Adolescents' positive orientation to their life-worlds co-facilitated their resilience. These insights advance effective ways to champion the resilience of young people with ID.
Collapse
Affiliation(s)
- Anna-Marié Hall
- Anna-Marié Hall, North-West University, Optentia Research Focus Area, Gauteng, South Africa; and
| | - Linda C Theron
- Linda Theron, North-West University, Optentia Research Focus Area, Gauteng, South Africa
| |
Collapse
|
25
|
Lakhan R, Ekúndayò OT, Shahbazi M. An estimation of the prevalence of intellectual disabilities and its association with age in rural and urban populations in India. J Neurosci Rural Pract 2016; 6:523-8. [PMID: 26752897 PMCID: PMC4692010 DOI: 10.4103/0976-3147.165392] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Intellectual disability (ID) is a global public health concern. Prevalence of ID and its association with age and other demographic factors is required for planning purposes in India. Objective: This study analyzed the age-adjusted prevalence of ID in rural and urban populations and its correlation with age in children and adults. Materials and Methods: Disability data published in the report (2002) of National Sample Survey Organization were analyzed, using Z-test to measure differences in age-adjusted prevalence. Spearman rho was calculated to determine strength and direction of the association, and regression analysis was used to predict prevalence rate, based on age in rural and urban population settings. Results: Overall, India has a prevalence of 10.5/1000 in ID. Urban population has slightly higher rate (11/1000) than rural (10.08/1000; P = 0.044). Age was found to be highly correlated with prevalence of ID in rural children (ϱ =0.981, P = 0.019) as well as in children (ϱ = −0.954, P = 0.000) and adults (ϱ = −0.957, P = 0.000) in urban population. The possibility of confounding or the existence of covariates for children in urban settings was noted. Conclusion: Results of this study match findings in other epidemiological studies. However, multistage, large-scale studies are recommended for investigating prevalence rates with different severity levels of ID.
Collapse
Affiliation(s)
- Ram Lakhan
- Department of Epidemiology, School of Health Sciences, College of Public Service, Jackson State University, Jackson, USA
| | | | - Mohammad Shahbazi
- Department of Behavioral Health and Education, School of Health Sciences, College of Public Service, Jackson State University, Jackson, Mississippi, USA
| |
Collapse
|
26
|
Schalock RL, Verdugo MA, Gomez LE, Reinders HS. Moving Us Toward a Theory of Individual Quality of Life. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:1-12. [PMID: 26701070 DOI: 10.1352/1944-7558-121.1.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
This article discusses three steps involved in moving us toward a theory of individual quality of life: developing a conceptual model, integrating theory components, and applying and evaluating the theory. Each of the proposed steps is guided by established standards regarding theory development and use. The article concludes with a discussion of criteria that can be used to evaluate the theory and the contribution that a theory of individual quality of life would make to the field of disability.
Collapse
Affiliation(s)
| | - Miguel A Verdugo
- Miguel A. Verdugo, Professor of Psychology and Director of the Institute on Community Inclusion (INICO), University of Salamanca, Spain
| | - Laura E Gomez
- Laura E. Gomez, Department of Psychology, University of Oviedo, Spain; and
| | - Hans S Reinders
- Hans S. Reinders, Faculty of Theology, University of Amsterdam, Netherlands
| |
Collapse
|
27
|
Hatton C, Emerson E, Robertson J, Baines S. The Mental Health of British Adults with Intellectual Impairments Living in General Households. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 30:188-197. [PMID: 26647916 DOI: 10.1111/jar.12232] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND People with intellectual disability or borderline intellectual functioning may have poorer mental health than their peers. The present authors sought to (i) estimate the risk of poorer mental health among British adults with and without intellectual impairments and (ii) estimate the extent to which any between-group differences in mental health may reflect between-group differences in rates of exposure to common social determinants of poorer health. MATERIALS AND METHODS The present authors undertook secondary analysis of confidentialized unit records collected in Wave 3 of Understanding Society. RESULTS British adults with intellectual impairments living in general households are at significantly increased risk of potential mental health problems than their non-disabled peers (e.g. GHQ Caseness OR = 1.77, 95% CI (1.25-2.52), P < 0.001). Adjusting for between-group differences in age, gender and indicators of socio-economic position eliminated this increased risk [GHQ Caseness adjusted OR = 1.06, 95% CI (0.73-1.52), n.s]. CONCLUSIONS Our analyses are consistent with the hypothesis that the increased risk of poor mental health among people with intellectual impairments may be attributable to their poorer living conditions rather than their intellectual impairments per se. Greater attention should be given to understanding and addressing the impact of exposure to common social determinants of mental health among marginalized or vulnerable groups.
Collapse
Affiliation(s)
- Chris Hatton
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - Eric Emerson
- Centre for Disability Research, Lancaster University, Lancaster, UK.,Centre for Disability Research and Policy, University of Sydney, Sydney, NSW, Australia
| | - Janet Robertson
- Centre for Disability Research, Lancaster University, Lancaster, UK
| | - Susannah Baines
- Centre for Disability Research, Lancaster University, Lancaster, UK
| |
Collapse
|
28
|
Families supporting a child with intellectual or developmental disabilities: the current state of knowledge. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 27:420-30. [PMID: 25254268 DOI: 10.1111/jar.12078] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This IASSIDD Position Paper provides a concise authoritative summary of (i) existing scientific knowledge regarding the situation, challenges and wellbeing of families that include a child with intellectual and/or developmental disabilities, and (ii) priorities for future research. IASSIDD (www.iassidd.org) is the leading global organisation for researchers and research centres that seek to improve the understanding of and improve the lives of people with intellectual or developmental disabilities, their families and those who support them. The paper and the recommendations it contains have been developed through an iterative process led by IASSIDD’s Families Special Interest Research Group (SIRG). During this process, all members of the Families SIRG and all members of IASSIDD’s ruling council have had the opportunity to comment on drafts of this paper. The final Position Paper was adopted by the Council of IASSIDD on 9 July 2012.
Collapse
|
29
|
Gore N, Emerson E, Brady S. Rates of breastfeeding and exposure to socio-economic adversity amongst children with intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 39:12-19. [PMID: 25613368 DOI: 10.1016/j.ridd.2014.12.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/19/2014] [Accepted: 12/19/2014] [Indexed: 06/04/2023]
Abstract
Children with intellectual disability are at increased risk of experiencing poor health relative to their typically developing peers. Previous research indicates that exposure to socio-economic disadvantage contributes towards this disparity but that additional factors (including parenting practices) may be involved in mediating/moderating pathways. This study examined duration of breastfeeding amongst children with and without intellectual disability by a secondary analysis of data from the UK Millennium Cohort Study. Children with intellectual disability were significantly less likely to have been ever breastfed; breastfed exclusively or at all at 3 months or breastfed at all at 6 months relative to children without intellectual disability. None of these differences remained significant when other psycho-social risk factors for reduced breastfeeding were controlled for. The study adds to both the sparse literature on breastfeeding practices amongst families of children with intellectual disability and research demonstrating relationships between socio-economic disadvantage and wellbeing for children with intellectual disability.
Collapse
Affiliation(s)
- Nick Gore
- Tizard Centre, University of Kent, United Kingdom.
| | - Eric Emerson
- University of Sydney, Australia; University of Lancaster, United Kingdom
| | - Serena Brady
- Tizard Centre, University of Kent, United Kingdom
| |
Collapse
|
30
|
Emerson E, Brigham P. Exposure of children with developmental delay to social determinants of poor health: cross-sectional case record review study. Child Care Health Dev 2015; 41:249-57. [PMID: 24797435 DOI: 10.1111/cch.12144] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research on child development in general has highlighted the importance that the family environment plays in mediating the pathway between exposure to low socio-economic position (SEP) and child well-being. While child developmental models in intellectual disability have highlighted the interplay between social context, family environment and child development, little empirical work has attempted to formally evaluate the evidence in support of specific mediating pathways between low SEP and child outcomes. METHODS Secondary analysis of cross-sectional confidentialized needs analysis data collected in three Primary Care Trusts in England covering a total population of 1.25 million people. Case record reviews were undertaken for 46 023 households, 2236 (4.9%) of which contained a child in the target age range with developmental delay. RESULTS Children with developmental delay, when compared with their non-disabled peers, were at significantly increased risk of poorer health outcomes and of being exposed to a wide range of social determinants of poor health. Controlling for between-group differences in exposure to social determinants of poor health reduced the risk of developmental delay being associated with poorer health outcomes by 45% for behaviour problems and 89% for risk of significant harm. For children with developmental delay, parenting difficulties appears to play a particularly significant role in partially mediating the effects of low SEP. CONCLUSIONS The findings of the present study point to the potential effectiveness of family-focused early intervention to prevent the emergence and escalation of behavioural difficulties and health problems in children with developmental delay.
Collapse
Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, NSW, Australia
| | | |
Collapse
|
31
|
|
32
|
Emerson E, Blacher J, Einfeld S, Hatton C, Robertson J, Stancliffe RJ. Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3508-3517. [PMID: 25238636 DOI: 10.1016/j.ridd.2014.08.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/28/2014] [Accepted: 08/28/2014] [Indexed: 06/03/2023]
Abstract
We investigated the association between exposure to environmental risks in early childhood and the prevalence and persistence of conduct difficulties (CD) in children with intellectual disability (ID) who did not have autistic spectrum disorder (ASD), children with ASD and typically developing (TD) children. Results indicated that: (1) exposure to risk was associated with elevated prevalence of CD at age three and, for TD children and children with ID, increased risk of CD persisting to ages five and seven; (2) at all levels of risk, children with ASD were more likely to show persistent CD than other children; (3) children with ID were no more likely to show persistent CD than TD children at low levels of exposure to environmental risk.
Collapse
Affiliation(s)
- Eric Emerson
- University of Sydney, Australia; Lancaster University, UK.
| | | | | | | | | | | |
Collapse
|
33
|
Dowse L, Cumming TM, Strnadová I, Lee JS, Trofimovs J. Young People with Complex Needs in the Criminal Justice System. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/23297018.2014.953671] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
34
|
Emerson E, Giallo R. The wellbeing of siblings of children with disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2085-2092. [PMID: 24878630 DOI: 10.1016/j.ridd.2014.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/01/2014] [Accepted: 05/05/2014] [Indexed: 06/03/2023]
Abstract
(1) to estimate the extent of differences in wellbeing between siblings of children with disabilities or long-term health conditions and siblings of 'typically developing' children in a nationally representative cohort of Australian children (the Longitudinal Study of Australian Children); (2) to determine whether any between-group differences in wellbeing may be potentially attributable to between-group differences in exposure to socio-economic disadvantage. The results of our analyses were consistent with the existing literature in indicating that, in unadjusted comparisons, the siblings of children with long-term health conditions or disabilities: (1) had lower wellbeing than their peers on some, but not all, indicators of wellbeing; and (2) that where differences did exist the effect sizes were small. Our results add to the existing literature in: (1) indicating that adjusting for between-group differences in exposure to low SEP and associated adversities eliminated the statistical significance of unadjusted comparisons in the majority of instances; and (2) failing to find any evidence of deterioration over time in the wellbeing of siblings with long-term health conditions or disabilities over a two-year period from age 4/5 to age 6/7.
Collapse
Affiliation(s)
- Eric Emerson
- Centre for Disability Research & Policy, The University of Sydney, Sydney, New South Wales 2006, Australia.
| | - Rebecca Giallo
- Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia; RMIT University, GPO Box 2476, Melbourne, Victoria 3001, Australia
| |
Collapse
|
35
|
Emerson E, Robertson J, Baines S, Hatton C. The self-rated health of British adults with intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:591-596. [PMID: 24480610 DOI: 10.1016/j.ridd.2014.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 01/03/2014] [Indexed: 06/03/2023]
Abstract
People with intellectual disability have significantly higher age-adjusted rates of mortality and morbidity than their non-disabled peers. While self-rated health status is commonly used as an indicator of the health status of populations of interest, few studies have explored the self-rated health of adults with intellectual disability. We undertook secondary analysis of de-identified cross-sectional data from the first waves of two contemporary UK surveys: the Life Opportunities Survey (n=37,513) and Understanding Society (n=50,976). In the Life Opportunities Survey we identified 316 participants age 16-49 (1.7% of the age-restricted sample) as having intellectual disability. In Understanding Society we identified 415 participants age 16-49 (1.5% of the age-restricted sample) as having intellectual disability. Participants with intellectual disability were significantly more likely to report having fair or worse health than their peers (Life Opportunities Survey OR=8.86 (6.54-12.01), p<0.001; Understanding Society OR=13.14 (10.65-16.21), p<0.001). However the strength of this association was significantly attenuated when risk estimates were adjusted to take account of the increased rates of exposure of participants with intellectual disability to socio-economic disadvantage and (in the Life Opportunities Survey) exposure to discrimination and violence.
Collapse
Affiliation(s)
- Eric Emerson
- Centre for Disability Research, Lancaster University, UK; Centre for Disability Research and Policy, University of Sydney, Australia.
| | | | | | - Chris Hatton
- Centre for Disability Research, Lancaster University, UK.
| |
Collapse
|
36
|
Emerson E, Halpin S. Anti-social behaviour and police contact among 13- to 15-year-old English adolescents with and without mild/moderate intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2014; 26:362-9. [PMID: 23925959 DOI: 10.1111/jar.12041] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe the rates of anti-social behaviour (ASB) among adolescents with/without mild/moderate intellectual disability (MMID). To estimate whether any differences could be attributable to differences in exposure to extraneous risk factors. DESIGN Secondary analysis of the Longitudinal Study of Young People in England. METHODS Participants with MMID were identified through data linkage with educational records. RESULTS Parents of children with MMID were more likely to report police contact, children with MMID were more likely to self-report fighting/public disturbance, shoplifting and graffiti. When controlling for differences in exposure to extraneous risk factors, MMID was associated with increased rates of police contact and self-reported graffiti, no difference in self-reported shoplifting, reduced rates of self-reported fighting/public disturbance and vandalism. CONCLUSIONS Differences in the rates of exposure to extraneous risk factors play an important role in accounting for the differences in the prevalence of self-reported ASB among adolescents with and without MMID.
Collapse
Affiliation(s)
- Eric Emerson
- Centre for Disability Research, Lancaster University, Lancaster, UK.
| | | |
Collapse
|