Friendship and Adults With Profound Intellectual and Multiple Disabilities and English Disability Policy

Transition to adulthood of adolescents with profound intellectual and multiple disabilities: Content validation of the SGU-PIMD to support families

BACKGROUND

For families with adolescent children, the transition to adulthood is usually challenging. This period may be extra demanding for families with a child with profound intellectual and multiple disabilities due to the child's strong and persistent support needs. To support these families during this phase and to facilitate the transition process of these adolescents, we adapted the Canadian skills for growing up (SGU) into the skills for growing up-profound intellectual and multiple disabilities (SGU-PIMD). The aim of this study is to determine its content validity.

METHOD

A Delphi study with family members and healthcare professionals was conducted.

RESULTS

Results showed good content validity. However, the Delphi panel suggested minor adjustments to improve relevance, comprehensibility and comprehensiveness.

CONCLUSIONS

The current SGU-PIMD can be used in practice for supporting adolescents with profound intellectual and multiple disabilities. However, there are also recommendations for research into the feasibility and acceptability of the instrument.

Communication partners experiences of communicating with adults with severe/profound intellectual disability through augmentative and alternative communication: A mixed methods systematic review

People with severe/profound intellectual disability experience challenges in communicating and require their communication partners to adapt to their means of communication. Augmentative and Alternative Communication (AAC) is recognised as a potential means to meet their communication needs. Interventions need to be aimed at both the individual and their communication partners. We conducted a mixed methods systematic review of the literature to synthesise evidence on communication partners experience of communicating with adults with severe/profound intellectual disability through AAC. Eight publications met the inclusion criteria, they underwent thematic synthesis where four themes emerged. A shared commitment to communication partnership is fundamental for the effective and efficient use of AAC. However, there was a disconnect between communication partners perceptions of their roles and responsibilities. This review prompts further research to explore communication partners perceptions of their roles and responsibilities in the use of AAC with people with severe/profound intellectual disabilities.

Reconciling communication repertoires: navigating interactions involving persons with severe/profound intellectual disability, a classic grounded theory study

BACKGROUND

A rights-based agenda, informed by the UNCRPD, that advocates person-centredness, inclusion, empowerment and self-determination is shaping service provision to people with intellectual disability (ID). Listening to their perspectives is fundamental to meeting these goals. However, communication with people with severe/profound ID is challenging and difficult. Therefore, this study aims to generate a theory that explains how people communicate with and understand each other in these interactions.

METHODS

Classic grounded theory (CGT) methodology was used as it recognises that knowledge can be captured rather than interpreted. According to CGT, capturing rather than interpreting experiences strengthens findings, particularly in relation to participants with severe/profound ID. Concurrent theoretical sampling, data collection and analysis were undertaken. Twenty-two individuals participated in the study: 3 people with severe/profound ID and 19 people with whom they interact. Data were collected over a 9-month period and involved video recordings, field notes, individual and group interviews. Data were analysed using CGT methods of coding, constant comparison and memoing.

RESULTS

The Theory of Reconciling Communication Repertoires was generated. Nurturing a sense of belonging emerged as the main concern and core category that is resolved by reconciling communication repertoires. A communication repertoire refers to the cache of communication skills a person has available to them. To reconcile repertoires is to harmonise or make them compatible with each other in order to communicate. Interactions are navigated through five stages: motivation to interact, connection establishment, reciprocally engaging, navigating understanding and confusion resolution.

CONCLUSIONS

The Theory of Reconciling Communication Repertoires explains how interactions involving people with severe/profound ID are navigated. While this is a substantive rather than formal theory, it has the potential to inform practice, policy, management, education and research as it outlines how communication with people with severe/profound ID can take place to design, inform and plan person-centred care.

The antecedents of loneliness in older people with an intellectual disability

INTRODUCTION

The cognitive discrepancy approach to loneliness is often used to describe loneliness in ageing populations, but to date, it has never been used to explore loneliness in older people with an intellectual disability. An analysis is needed utilising a refined list of causes of loneliness in this population.

METHOD

Using data from a nationally representative dataset of people aged over 40 with an intellectual disability (N = 708), this analysis runs repeated regressions of variables grouped into conceptual blocks, organised from sociodemographic to network quality.

RESULTS

Variables selected predicted 23% of the loneliness variance. Functional limitations, education, working in the community, transport difficulties, pain, stress caused by service change, emotional health problems and confiding were all significant predictors of loneliness.

CONCLUSION

That for those with fewer functional limitations only transport difficulties precipitated loneliness, suggests living a more independent life protects from loneliness, in this group. Those with functional limitations and who lead a more service dependent life appear more exposed to loneliness precipitating variables.

Strategies used by older women with intellectual disability to create and maintain their social networks: An exploratory qualitative study

Introduction

Social networks are important to health and wellbeing, and enhancing social networks are key occupations for older people. This is relevant for older people with intellectual disability, particularly older women, who face challenges in building social networks, and their social networks are vulnerable to loss as they age. This study aimed to investigate how older women with intellectual disability create and maintain their social networks.

Method

This exploratory qualitative study involved conducting in-depth interviews with five women with mild to moderate intellectual disability (as defined by their service organisation) aged over 50 years and living in the community, using the Support Interview Guide, that has previously been used with younger adults with intellectual disability. Participants could communicate in spoken English. Data were coded line by line and analysed using a thematic analysis.

Results

Participants created social networks independently and through others. Strategies used included communicating, sharing activities, celebrating special occasions, organising activities, supporting each other, having a routine, being out and about and using formal assistance. Barriers and facilitators were also identified.

Conclusion

As older women with intellectual disability age, occupational therapists and support organisations need to focus on assisting this group to build and maintain their social networks.