1
|
Bruun A, Jordan L, Giles J, Hughes R, Anderson-Kittow R, Tuffrey-Wijne I. Don't assume, ask! A focus group study on end-of-life care planning with people with intellectual disabilities from minoritised ethnic groups. BMC Palliat Care 2025; 24:13. [PMID: 39810093 PMCID: PMC11731549 DOI: 10.1186/s12904-025-01646-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/06/2025] [Indexed: 01/16/2025] Open
Abstract
BACKGROUND People with intellectual disabilities are less likely to have access to palliative care, and the evidence shows that their deaths are often unanticipated, unplanned for, and poorly managed. Within the general population, people from minoritised ethnic groups are under-represented within palliative care services. End-of-life care planning with people with intellectual disabilities from minoritised ethnic groups may be a way to address these issues. There is a huge gap in the evidence regarding intersectionality of intellectual disability and ethnicity within end-of-life care planning. This study explored the characteristics of effective and preferred end-of-life care planning approaches and resources for people with intellectual disabilities from minoritised ethnic groups. METHODS Nine focus groups and three semi-structured individual interviews were held with 41 participants from minoritised ethnic groups (11 family carers; 25 support staff; and five people with intellectual disabilities). Session recordings were transcribed verbatim and analysed using the framework analytical approach. RESULTS Participants thought that end-of-life care planning practices were dependent on the person's culture, ethnicity, and religion, and that it was important to follow these at the end-of-life. They deemed it important to discover and respect (and not assume) the individual's perspectives, values, needs, and wishes through a person-centred approach. Cultural attitudes to talking about death could hinder end-of-life care planning as participants perceived it as taboo. Disagreement was described as hindering end-of-life care planning, particularly when strong feelings about cultural and religious practices were involved. Staff highlighted the need for cultural and religious awareness, which could involve seeking information and receiving training. Opening the conversation about death and dying was seen as a potential facilitator for exploring end-of-life care planning. CONCLUSIONS The study was committed to addressing issues of equity, diversity, and inclusion. It is the first study to explore perspectives on end-of-life care planning with people with intellectual disabilities from minoritised ethnic groups. It was deemed important that staff did not assume but discovered and respected the views and preferences of people with intellectual disabilities regarding culture and religion. There is an urgent need for more research into end-of-life care planning with people with intellectual disabilities from minoritised ethnic groups.
Collapse
Affiliation(s)
- Andrea Bruun
- Kingston University London, London, United Kingdom.
- Kenry House, Kingston Hill Campus, Kingston upon Thames, London, KT2 7LB, United Kingdom.
| | - Leon Jordan
- Kingston University London, London, United Kingdom
| | - Jo Giles
- Kingston University London, London, United Kingdom
| | - Rhidian Hughes
- Voluntary Organisations Disability Group, London, United Kingdom
| | | | | |
Collapse
|
2
|
Navas P, Arias VB, Vicente E, Esteban L, Guillén VM, Alvarado N, Heras I, Rumoroso P, García-Domínguez L, Verdugo MÁ. Empowering lives: How deinstitutionalization and community living improve the quality of life of individuals with intellectual and developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2025; 157:104909. [PMID: 39799901 DOI: 10.1016/j.ridd.2024.104909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 12/18/2024] [Accepted: 12/28/2024] [Indexed: 01/15/2025]
Abstract
BACKGROUND The number of people with intellectual and developmental disabilities (IDD) living in residential settings has not changed substantially in recent years in Spain. To change this situation the project "My House: A Life in the Community" aims to promote the transition of individuals with IDD and high support needs into community settings. AIMS This paper deepens the understanding of the underlying mechanisms responsible for the changes observed in the process of deinstitutionalization. METHODS A longitudinal study was designed to evaluate the quality of life of individuals with IDD (n = 90) across different environments at two distinct time points: when they were living in an institution and nine months after transitioning to a community-based setting. A comparison group (n = 72) consisting of individuals who remained institutionalized was included to carry out intergroup comparisons. T-tests were used to estimate mean differences both between and within groups. Longitudinal path models were used to investigate the processes underlying the relationships between variables. RESULTS After transition, movers obtained significantly higher mean scores on all variables with large or very large effect sizes. However, simply moving to a different place was not the factor responsible for the observed improvements: positive changes in quality of life require the constant availability of opportunities to support decision making. IMPLICATIONS deinstitutionalization will only lead to improvements in quality of life if it favors people's control over their lives. Community living should therefore be understood not as an autonomous life but as a chosen one.
Collapse
Affiliation(s)
- Patricia Navas
- Institute for Community Inclusion (INICO), Spain; University of Salamanca, Spain
| | - Víctor B Arias
- Institute for Community Inclusion (INICO), Spain; University of Salamanca, Spain.
| | - Eva Vicente
- Institute for Community Inclusion (INICO), Spain; University of Zaragoza, Spain
| | - Laura Esteban
- Institute for Community Inclusion (INICO), Spain; University of Salamanca, Spain
| | - Verónica M Guillén
- Institute for Community Inclusion (INICO), Spain; University of Cantabria, Spain
| | - Natalia Alvarado
- Institute for Community Inclusion (INICO), Spain; University of Salamanca, Spain
| | - Inés Heras
- Institute for Community Inclusion (INICO), Spain; University of Salamanca, Spain
| | - Paula Rumoroso
- Institute for Community Inclusion (INICO), Spain; University of Salamanca, Spain
| | | | - Miguel Ángel Verdugo
- Institute for Community Inclusion (INICO), Spain; University of Salamanca, Spain
| |
Collapse
|
3
|
Bradshaw J, Maguire R, Gillooly A, Hatton C, Caton S, Jahoda A, Oloidi E, Taggart L, Todd S, Hastings R. What Would Have Helped People With Profound Intellectual and Multiple Disabilities in the UK During COVID-19? JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2024; 21:e70000. [PMID: 39582792 PMCID: PMC11582349 DOI: 10.1111/jppi.70000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/22/2024] [Accepted: 11/08/2024] [Indexed: 11/26/2024]
Abstract
People with profound intellectual and multiple disabilities can be excluded from research and relatively little is known about the experiences of people with profound intellectual and multiple disabilities and their carers during COVID-19. This paper aims to further explore the impact on this group via information provided by paid and family carers. It focuses on key areas such as access to social and health services in addition to questions about health and well-being. In contextualising these results, some comparisons are made to impacts on other groups. This paper also explores what we might do better in future to support this population. Carers were invited to complete an online survey about their experiences and the experiences of people they supported during COVID-19 and to suggest what might have made life better. They were invited to complete this survey at four time points (waves) between December 2020 and December 2022. This paper reports on Waves 1-3, that is to August 2022. Services for people with profound intellectual and multiple disabilities reduced during COVID-19 and have yet to return to pre-pandemic levels. People with profound intellectual and multiple disabilities were reported to experience increased social isolation, deteriorating mental and physical health, increased behavioural signs of distress and reduced life skills. Three areas were identified regarding what would have made life better: opportunities for social contact and activities; improved access to health and social care services, and; consistent and responsive staff. Results are explored in the context of current challenges in service provision, including staff retention and shifts in staff culture during the pandemic.
Collapse
Affiliation(s)
| | - Roseann Maguire
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Amanda Gillooly
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Christopher Hatton
- Department of Social Care and Social WorkManchester Metropolitan UniversityManchesterUK
| | - Sue Caton
- Department of Social Care and Social WorkManchester Metropolitan UniversityManchesterUK
| | - Andrew Jahoda
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Edward Oloidi
- Unit for Development in Intellectual and Developmental DisabilitiesUniversity of South WalesCardiffUK
| | - Laurence Taggart
- Institute of Nursing and Health ResearchUniversity of UlsterBelfastUK
| | - Stuart Todd
- Unit for Development in Intellectual and Developmental DisabilitiesUniversity of South WalesCardiffUK
| | - Richard Hastings
- Centre for Research in Intellectual and Developmental DisabilitiesUniversity of WarwickCoventryUK
| |
Collapse
|
4
|
Bakkum L. Pushing the boundaries of digital social contact: Experiences of people with disabilities and their social networks during the COVID-19 pandemic. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:940-961. [PMID: 37878741 PMCID: PMC11585181 DOI: 10.1177/17446295231210021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/27/2023]
Abstract
During the COVID-19 pandemic, many people with intellectual disabilities living in care facilities could not receive visitors. Health authorities suggested the use of digital social contact as an alternative for in-person visits. We examined how people with intellectual disabilities living in care facilities experienced the use of digital social contact with their informal social network throughout 2020. Residents, their relatives, volunteer visitors, direct support staff, and care facility managers (N = 283) completed an online questionnaire, of whom 35 participated in an interview. Video calling and in-person visits were among the most common forms of staying in touch. Experiences with digital social contact depended on residents' abilities and support needs, and on preconditions, such as staff availability. The first phases of the pandemic led to experiences of possibilities and benefits of using digital social contact as complementary to in-person contact for people with different levels of intellectual disability, also after the pandemic.
Collapse
Affiliation(s)
- Lianne Bakkum
- Lianne Bakkum, Department of Educational and Family Sciences, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands.
| |
Collapse
|
5
|
Van Keer I, Maes B. Our path together: Development of the inclusive parenting goals questionnaire. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241304463. [PMID: 39607010 DOI: 10.1177/17446295241304463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
Background: Instruments on parenting goals are often outdated and don't consider goals related to capabilities and needs of children with (severe) disabilities. This study aimed to develop an inclusive questionnaire on parenting goals applicable to parents of all children (0-21 years). Method: The iterative development process relied on academic and experiential expertise of parents and professionals; and included consultation of relevant literature, interviews with 6 parents of a child with severe to profound intellectual disabilities, a feedback round with diverse stakeholders, and a pilot study. Results: The Inclusive Parenting Goals Questionnaire (IPGQ) is a 99-item summated rating scale demonstrating high face and content validity. A renewed and inclusive definition of parenting goals was formulated, alongside extensive reflection on theoretically robust and practically relevant categorization. Discussion: The IPGQ is suitable for gaining insight into parents goal patterns and differentiating between (various groups of) parents. It also provides a basis for further discussion and elaboration.
Collapse
Affiliation(s)
- Ines Van Keer
- Catholic University of Leuven, Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Belgium
| | - Bea Maes
- Catholic University of Leuven, Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Belgium
| |
Collapse
|
6
|
Dahlerbruch K, Helfrich C, Gill SV. Participation as Co-Occupation Between Parents and Adult Children With Profound Intellectual and Multiple Disabilities. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241292267. [PMID: 39498857 DOI: 10.1177/15394492241292267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2024]
Abstract
Adults with profound intellectual and multiple disabilities (PIMD) require high levels of assistance to participate in occupations. Otherwise, they experience low occupational engagement. This study aimed to explore how parents describe participation in occupations for their adult children with PIMD. Semi-structured interviews (n = 9) were conducted to understand how parents described their adult children's participation in occupations. Data were analyzed using the theory of co-occupation to identify themes and triangulate findings with the literature. Parents described participation as co-occupation in "essential" versus "non-essential" occupations. Participation in essential co-occupations emphasized shared physicality, while non-essential co-occupations focused on joint meaning (shared intentionality) and emotional responses (shared emotionality). Findings illustrate a way to conceptualize participation in essential versus non-essential co-occupations for adults with PIMD, highlight the importance of recognizing and illuminating subjective experiences of adults with PIMD, and provide a foundation for occupational therapists to increase occupational engagement within this population.
Collapse
|
7
|
Goodall M, Irving K, Nevin M. Discovering the Current 'State of Play' in Pain Recognition and Assessment for People With Profound Intellectual Disabilities by Nurses: An Appreciative Inquiry Approach. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13305. [PMID: 39370136 DOI: 10.1111/jar.13305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 07/23/2024] [Accepted: 09/16/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND Pain recognition and assessment in individuals with profound intellectual disabilities are challenging. Exploring effective methods of addressing this is essential. This study aims to discover current nursing practice in this area of care as the first of a four-phased appreciative inquiry study, to inform further research and practice. METHODS Data from individual and focus group interviews with co-researching nurses were collated and developed into themes. RESULTS Six themes were identified: unconditional positive regard, honouring of relationship, creative best practice, pain through a competing lens, accurate assessment-an impossible task? Medicating pain-oversimplified and undervalued? CONCLUSION Relationship is essential, in recognising pain and distress. There is an understanding of the multifaceted nature of pain in the care of this population; however, physical pain recognition and assessment are prioritised, to prevent serious ill health and death. Formal methods of assessment and communication between professionals are needed.
Collapse
Affiliation(s)
- Maeve Goodall
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Ireland
| | - Kate Irving
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Ireland
| | - Mary Nevin
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Ireland
| |
Collapse
|
8
|
Testerink G, Ten Brug A, Douma G, van der Putten A. The Use of Snoezelen to Support People With Profound Intellectual and Multiple Disabilities: An International Survey Describing the Perspectives of Support Persons. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13295. [PMID: 39210528 DOI: 10.1111/jar.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 07/17/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Snoezelen is often used for people with profound intellectual and multiple disabilities, but scarcely evaluated. This study aimed to provide insight into the application and perceived effects of snoezelen from the perspective of support persons. METHOD We conducted an international survey with professionals (n = 130) and relatives (n = 8) supporting people with profound intellectual and multiple disabilities. Information regarding the application and perceived effects was gathered. Content and descriptive analysis were used. RESULTS Despite variation, common characteristics were identified regarding purpose, approach and context. Perceived positive effects mostly concerned improved mental health of the person receiving snoezelen (n = 88). A person-centred approach was reported as important element for positive effects. CONCLUSIONS This study describes the use of snoezelen for people with profound intellectual and multiple disabilities. These insights can be used for future research into working elements and effects of snoezelen and facilitate evidence-based support.
Collapse
Affiliation(s)
- Gemma Testerink
- Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- 's Heeren Loo, Amersfoort, The Netherlands
| | - Annet Ten Brug
- Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Gerdine Douma
- Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Annette van der Putten
- Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
9
|
Rousseau MC, Hamouda I, Aim MA, Anzola AB, Maincent K, Lind K, Felce A, Auquier P, De Villemeur TB, Baumstarck K. Health status of individuals with polyhandicap across a 5-year follow-up period. Sci Rep 2024; 14:23197. [PMID: 39369038 PMCID: PMC11455907 DOI: 10.1038/s41598-024-74102-3] [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: 11/06/2023] [Accepted: 09/23/2024] [Indexed: 10/07/2024] Open
Abstract
The present longitudinal study examined a large sample of individuals with PIMD/Polyhandicap to: (i) describe the evolution over time of the health status in terms of severity, (ii) identify the potential predictors of health status change. This study used the data of the French national EVAL-PLH cohort. Inclusion criteria were: individuals with PIMD/Polyhandicap; age > 3 years at the time of inclusion; age at onset of cerebral lesion younger than 3 years old. The definition of the change in health status over the 5-year period was derived from the Polyhandicap Severity Scale. Among the 875 individuals included in 2015-2016, 492 (56.2%) individuals were assessed in 2020-2021. According to the definition, 68.8% (n = 309), 64.7% (n = 310), and 80.2% (n = 368) of the individuals presented with a worsened or stable severity status based on the global score, the abilities score, and the comorbidities score, respectively. Compared with the individuals with a non-worsened health status (global score), the individuals with a stable or worsened health status were more likely to receive care in specialized rehabilitation centres, more likely to have an antenatal or progressive aetiology, and more likely to have a higher dependency level. The current study provides a robust perspective of the worsened health among persons with PIMD/Polyhandicap over time.
Collapse
Affiliation(s)
- Marie-Christine Rousseau
- Fédération des Hôpitaux de Polyhandicap et Multihandicap, San Salvadour Hospital, University Hospital of Paris, 4312 Rte de l'Almanarre, Hyères, France
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
| | - Ilyes Hamouda
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
- Epidemiology and Health Economy Department, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
| | - Marie-Anastasie Aim
- UR 849, LPS - Social Psychology Laboratory, Aix-Marseille University, 29 Av. Robert Schuman, Aix-en-Provence, France
| | - Any Beltran Anzola
- Epidemiology and Health Economy Department, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
| | - Kim Maincent
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées, CESAP, 62 Rue de La Glacière, Paris, France
| | - Katia Lind
- Union Générale Caisse Assurance Maladie (UGECAM), 26-50 Avenue du Professeur-André-Lemierre, Paris, Ile de France, France
| | - Agnès Felce
- Hôpital Marin d'Hendaye, route Corniche, Hendaye, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pascal Auquier
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
- Epidemiology and Health Economy Department, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
| | - Thierry Billette De Villemeur
- Clinical Research Group GRC ConCer-LD, Sorbonne University & Pierre-et-Marie-Curie University, 4, Place Jussieu, Paris, France
- Department of Neuropediatrics Armand-Trousseau Hospital, 26 Av. du Dr Arnold Netter, Paris, France
| | - Karine Baumstarck
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France.
- Epidemiology and Health Economy Department, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France.
| |
Collapse
|
10
|
Brittlebank S, Light JC, Pope L. A scoping review of AAC interventions for children and young adults with simultaneous visual and motor impairments: Clinical and research Implications. Augment Altern Commun 2024; 40:219-237. [PMID: 38578299 DOI: 10.1080/07434618.2024.2327044] [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: 04/05/2023] [Revised: 01/23/2024] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
Individuals with multiple disabilities are among the most challenging to serve and AAC teams often lack direction in determining effective interventions. The purpose of this scoping review was to summarize the research evidence on AAC interventions for individuals with complex communication needs and simultaneous motor, and visual impairments as part of their multiple disabilities; to consider implications for practice; and to determine gaps and directions for future research. A total of 27 studies were identified and reviewed, involving 55 unique participants with multiple disabilities. Most studies focused on direct intervention to increase requesting or choice-making, with little focus on social communication. Only two studies focused on training communication partners. Results indicated that AAC interventions can be highly effective to increase communication for individuals with multiple disabilities. However, there is an urgent need for increased rigor and more detailed participant information in future AAC intervention research with this population. Future research should investigate AAC intervention to improve social communication and increase language development, not just expression of needs and wants. Future research should focus on the needs of individuals with multiple disabilities from culturally and linguistically diverse backgrounds and on implementation of AAC within natural environments.
Collapse
Affiliation(s)
- Savanna Brittlebank
- Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Janice C Light
- Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Lauramarie Pope
- Speech, Language and Hearing Sciences, Auburn University, Auburn, Alabama, USA
| |
Collapse
|
11
|
de Kuijper G, Jonker J, Kouwer K, Hoekstra PJ, de Bildt A. Integrative Care for Challenging Behaviors in People with Intellectual Disabilities to Reduce Challenging Behaviors and Inappropriate Psychotropic Drug Prescribing Compared with Care as Usual: A Cluster-Randomized Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:950. [PMID: 39063526 PMCID: PMC11277020 DOI: 10.3390/ijerph21070950] [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] [Received: 04/27/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
People with intellectual disabilities (IDs) often present with challenging behaviors (CBs) mostly due to inappropriate environments and mental and physical disorders. Integrative care is recommended to address CBs. However, in clinical practice, psychotropic drugs are often prescribed off-label for CBs, although the effectiveness is unclear, and side effects frequently occur. We conducted a cluster-randomized controlled study to investigate the effect of integrative care provided by a collaboration of an ID specialized mental healthcare team and participants' own ID service providers' care team on reducing CBs and inappropriate off-label psychotropic drug prescriptions compared with care as usual. Participants (N = 33, aged 19-81 years) had a moderate, severe, or profound intellectual disability and used off-label psychotropic drugs. The primary outcome measures were the Aberrant Behavior Checklist and the total dose of psychotropic drug prescriptions. At the study endpoint of 40 weeks, we found no effect of the intervention on the total ABC score and on the total dose of psychotropic drug prescriptions. In the intervention group, however, the psychotropic drug dose decreased significantly, while CBs did not change. The small sample size and not-completed interventions due to organizational problems may have affected our findings. This study illustrates the difficulties in the implementation of integrative care.
Collapse
Affiliation(s)
- Gerda de Kuijper
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (J.J.); (P.J.H.)
- Mental Healthcare Drenthe, Department Centre for intellectual Disability and Mental Health, Middenweg 19, 9404 LL Assen, The Netherlands
| | - Josien Jonker
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (J.J.); (P.J.H.)
- Mental Healthcare Drenthe, Department Centre for intellectual Disability and Mental Health, Middenweg 19, 9404 LL Assen, The Netherlands
| | - Karlijn Kouwer
- Mental Healthcare Drenthe, Department Centre for intellectual Disability and Mental Health, Middenweg 19, 9404 LL Assen, The Netherlands
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies Vei 91, 5009 Bergen, Norway
| | - Pieter J. Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (J.J.); (P.J.H.)
- Accare Child Study Center, Lübeckweg 2, 9723 HE Groningen, The Netherlands
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (J.J.); (P.J.H.)
- Accare Child Study Center, Lübeckweg 2, 9723 HE Groningen, The Netherlands
| |
Collapse
|
12
|
Kúld PB, Frielink N, Schuengel C, Embregts PJCM. Supporting self-determination of individuals with severe or profound intellectual and multiple disabilities according to relatives and healthcare professionals: A concept mapping study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13267. [PMID: 38863165 DOI: 10.1111/jar.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 05/16/2024] [Accepted: 06/03/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND This study aimed to identify perspectives of relatives and healthcare professionals regarding self-determination support for people with severe or profound intellectual and multiple disabilities, highlighting agreements and differences in their viewpoints. METHOD Following a concept mapping study, online focus group meetings yielded statements on self-determination support from relatives (residential facilities: n = 6, family homes: n = 7) and healthcare professionals (residential facilities: n = 9, family home: n = 5). Participants clustered and rated statements, resulting in four concept maps interpreted by experts (N = 6). RESULTS The 285 statements were categorised into 5-7 clusters per map, revealing key strategies for self-determination support: communication and choice making (facilitated by aids), sensitivity, familiarity, and collaboration among involved parties. CONCLUSION Each group placed different emphasis on these strategies, highlighting importance of continuous support in their implementation. Future research should prioritise practical implementations of these strategies to enhance self-determination.
Collapse
Affiliation(s)
- P B Kúld
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - N Frielink
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - C Schuengel
- Department of Clinical Child and Family Studies, Vrije Universiteit, Amsterdam, The Netherlands
| | - P J C M Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
13
|
van der Weele S, Bredewold F. What's Good About Inclusion? An Ethical Analysis of the Ideal of Social Inclusion for People with Profound Intellectual and Multiple Disabilities. HEALTH CARE ANALYSIS 2024; 32:106-123. [PMID: 38082208 PMCID: PMC11133059 DOI: 10.1007/s10728-023-00470-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2023] [Indexed: 02/03/2024]
Abstract
'Social inclusion' is the leading ideal in services and care for people with intellectual disabilities in most countries in the Global North. 'Social inclusion' can refer simply to full equal rights, but more often it is taken to mean something like 'community participation'. This narrow version of social inclusion has become so ingrained that it virtually goes unchallenged. The presumption appears to be that there is a clear moral consensus that this narrow understanding of social inclusion is good. However, that moral consensus is not clear in the case of people with profound intellectual and/or multiple disabilities (PIMD), who are not able to express their needs and preferences verbally. Moreover, social inclusion has proven to be difficult to conceptualize and implement for people with PIMD. Therefore, it becomes imperative to ask about the ethical rationale of the narrow understanding of social inclusion. For what reasons do we think social inclusion is good? And do those reasons also apply for people with PIMD? This article addresses these questions by providing an ethical analysis of the ideal of social inclusion for people with PIMD. It discusses four ethical arguments for social inclusion and probes their relevance for people with PIMD. The article argues that none of these arguments fully convince of the value of the narrow understanding of social inclusion for people with PIMD. It ends with advocating for an ethical space for imagining a good life for people with PIMD otherwise.
Collapse
Affiliation(s)
- Simon van der Weele
- Department Citizenship and Humanisation of the Public Sector, University of Humanistic Studies, Utrecht, The Netherlands.
| | - Femmianne Bredewold
- Department Citizenship and Humanisation of the Public Sector, University of Humanistic Studies, Utrecht, The Netherlands
| |
Collapse
|
14
|
van Tuyll van Serooskerken JM, Willemen AM, Embregts PJ, Schuengel C. Parent-perceived autonomy-supportive experiences and basic psychological needs of people with complex support needs: Development and preliminary psychometric evaluation of two questionnaires. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241237553. [PMID: 38488090 DOI: 10.1177/17446295241237553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Background: Understanding and supporting basic psychological needs of persons with complex support needs is important but difficult because of communicative challenges . We developed and tested questionnaires to obtain parents' perspectives on autonomy support and basic psychological needs of autonomy, competence, and relatedness. Method: Two parent-informant questionnaires were developed, administered, and subjected to psychometric property analyses. Participants were 63 Dutch parents of persons diagnosed with severe or profound intellectual and multiple disabilities. Results: Principal component analyses revealed a one-factor structure for the Parental Perceptions on Autonomy-Supportive Experiences questionnaire, while the Parental Perceptions on Basic Psychological Need Signals questionnaire yielded two-factors interpreted as Noticing Signals of Autonomy and Noticing Signals of Competence/Relatedness. Evidence for construct validity was found for both instruments. Conclusions: Preliminary evaluation of the new questionnaires is encouraging, but further validation with a larger sample size is warranted.
Collapse
Affiliation(s)
| | - Agnes M Willemen
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, The Netherlands
| | - Petri Jcm Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies, LEARN! Research Institute for Learning and Education, Vrije Universiteit Amsterdam, The Netherlands
| |
Collapse
|
15
|
Bessaguet H, Rousseau MC, Gautheron V, Ojardias E, Dohin B. Impact of spinal fusion on severity health status in scoliotic adolescents with polyhandicap. PLoS One 2024; 19:e0300065. [PMID: 38451892 PMCID: PMC10919586 DOI: 10.1371/journal.pone.0300065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/19/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Scoliosis constitutes a prevalent comorbidity in adolescents with polyhandicap and frequently leads to other severe impairments, impacting abilities and requiring complex caregiving strategies. Therefore, spinal fusion surgeries are commonly performed to alleviate pain and provide more comfort. However, spine stabilization has not previously been proven to improve the severity health status of adolescents with polyhandicap according to specific clinical scales. OBJECTIVE This study describes and compares the severity health status of adolescents with polyhandicap before and after they underwent spinal fusion. METHODS A monocentric retrospective observational study was conducted in the university hospital centre of Saint-Etienne, France. We included between 2009 to 2020, 30 scoliotic adolescents with polyhandicap who underwent spinal fusion performed with the same surgical technique and the same surgeon. The main outcome was the variation in the Polyhandicap Severity Scale (PSS) score after surgery. Secondary outcomes were variations in PSS subscores, quality of life scores, fronto-sagittal X-ray parameters, and measures of surgical complication rates and lengths of stay. RESULTS Among 30 adolescents, 27 PSS analyses were performed. We found a significant improvement between pre- and postoperative PSS scores, mainly for pain and respiratory, digestive, and skin disabilities. These improvements were accompanied by significant reductions in pelvic obliquity, in frontal and sagittal curves. The mean hospital length of stay was 45 days. During postoperative period, patients received a personalized postoperative rehabilitation procedure with spasticity and pain treatments, physiotherapy, and verticalization (wheelchair sitting and positioning devices such as contoured seat intended to increase postural stability). The mortality rate was estimated at 7%. At least 1 complication per patient occurred. CONCLUSIONS We show that spinal fusion surgeries confer a significant improvement in the severity health status in scoliotic adolescents with polyhandicap.
Collapse
Affiliation(s)
- Hugo Bessaguet
- Department of Physical and Rehabilitation Medicine, University Hospital of Saint-Etienne, Saint-Etienne, France
- Saint-Etienne University Jean Monnet, Lyon 1, Savoie Mont-Blanc University, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint Etienne, France
| | - Marie-Christine Rousseau
- EA 3279, CEReSS, Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
- Fédération des Hôpitaux de Polyhandicap et Multihandicap, San Salvadour Hospital, University Hospital of Paris, Hyères, France
| | - Vincent Gautheron
- Department of Physical and Rehabilitation Medicine, University Hospital of Saint-Etienne, Saint-Etienne, France
- Saint-Etienne University Jean Monnet, Lyon 1, Savoie Mont-Blanc University, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint Etienne, France
| | - Etienne Ojardias
- Department of Physical and Rehabilitation Medicine, University Hospital of Saint-Etienne, Saint-Etienne, France
- Lyon Neuroscience Research Center, Trajectoires Team, Inserm UMR-S 1028, CNRS UMR 5292, Lyon1 & Saint-Etienne Universities, Saint-Étienne, France
| | - Bruno Dohin
- Saint-Etienne University Jean Monnet, Lyon 1, Savoie Mont-Blanc University, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint Etienne, France
- Department of Pediatric Orthopedic Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| |
Collapse
|
16
|
Mol-Bakker A, Van der Putten AAJ, Krijnen WP, Waninge A. Physical health conditions in young children with profound intellectual and multiple disabilities: The prevalence and associations between these conditions. Child Care Health Dev 2024; 50:e13252. [PMID: 38520205 DOI: 10.1111/cch.13252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 01/24/2024] [Accepted: 02/09/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND It is thought that physical health conditions start at a young age in people with profound intellectual and multiple disabilities (PIMD). Knowledge regarding the prevalence, associations and development of these physical health conditions could be used for purposes of prevention as well as appropriate care and support but is currently lacking. OBJECTIVE The aim of this study is to gain insight into the prevalence of physical health conditions and associations between these conditions in young children with PIMD. METHODS The study used cross-sectional data related to the physical health conditions of children with PIMD (n = 51, aged between 12 and 61 months). Data were collected in Belgium and in the Netherlands through a checklist filled in by primary caregiver(s). Physical health conditions were classified into categories by the 10th revision of the International Classification of Diseases and Related Health Problems (ICD-10) system. The number of physical health conditions and associations between them were analysed. The analysis focused on prevalence rates and associations represented by odds ratios (p < 0.05). A graphical model was estimated to represent dependencies and conditional dependencies between physical health conditions. RESULTS We found a mean of 3.8 (range 1-8, SD 1.9) physical health conditions per child. Most of the physical health conditions were found in the ICD-10 chapter 'Nervous System', with hypotonia as the most frequent at 70.6%. Five significant large associations were found between spasticity-contractures (OR 9.54); circulatory system-contractures (OR 7.50); scoliosis-contractures (OR 10.25); hearing impairments-skin problems (OR 58.20) and obstipation-hypotonia (OR 19.98). CONCLUSION This study shows that at a young age, multiple physical health conditions are present in children with PIMD. In addition, we found five associations between physical health conditions.
Collapse
Affiliation(s)
- Anouk Mol-Bakker
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Health Psychology Research, University of Groningen, Groningen, The Netherlands
| | - Annette A J Van der Putten
- Department of Inclusive and Specials Needs Education, University of Groningen, Groningen, The Netherlands
| | - Wim P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Health Psychology Research, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
17
|
Ware J, Buell S, Chadwick DD, Bradshaw J, Goldbart J. A systematic review of research on staff training as an intervention to develop communication in children and adults with profound intellectual and multiple disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13201. [PMID: 38332474 DOI: 10.1111/jar.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 02/10/2024]
Abstract
INTRODUCTION This paper aims to identify to what extent staff training interventions are successful in enhancing the development of communication skills in people with profound intellectual and multiple disabilities. METHODS A systematic review was undertaken, conforming to PRISMA guidelines. English language, peer reviewed, empirical studies of staff training interventions to enhance the communication of people with profound intellectual and multiple disabilities were included. Databases Scopus, Web of Science, Proquest, Linguistics and Language Behaviour Abstracts (LLBA) and Medline were searched in July 2015 and updated in December 2022. Quality appraisal was conducted on 13 studies using Crowe's Critical Appraisal Tool (CCAT). RESULTS Few good quality evaluations of interventions were found. Challenges to research rigour included the diversity of people with profound intellectual and multiple disabilities, small sample sizes, intervention intensity and the management of fidelity. CONCLUSIONS Manualised and bespoke interventions showed promise in improving staff communication and responsiveness.
Collapse
Affiliation(s)
- Jean Ware
- School of Educational Sciences, Bangor University, Bangor, Wales
| | - Susan Buell
- School of Health Sciences, University of Dundee, Dundee, Scotland
| | - Darren D Chadwick
- School of Psychology, Liverpool John Moores University, Liverpool, England
| | - Jill Bradshaw
- Tizard Centre, University of Kent, Canterbury, England
| | - Juliet Goldbart
- Department of Psychology, Manchester Metropolitan University, Manchester, England
| |
Collapse
|
18
|
Luitwieler N, Luijkx J, van der Stege HA, Grootoonk A, van der Schans CP, van der Putten AAJ, Waninge A. Transition to adulthood of adolescents with profound intellectual and multiple disabilities: Content validation of the SGU-PIMD to support families. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13161. [PMID: 37793995 DOI: 10.1111/jar.13161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 09/11/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
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.
Collapse
Affiliation(s)
- Nicole Luitwieler
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Jorien Luijkx
- Faculty of Behavioural and Social Sciences, Basic Unit Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Heleen A van der Stege
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Anneke Grootoonk
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette A J van der Putten
- Faculty of Behavioural and Social Sciences, Basic Unit Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
19
|
Zalmstra TAL, Reinders-Messelink HA, Elema A, van Gils W, van der Sluis CK, van der Putten AAJ. Assessing the reliability and validity of a health-related quality of life instrument, CPADULT, in a Dutch sample of adults with severe disabilities who are non-ambulatory. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13160. [PMID: 37737053 DOI: 10.1111/jar.13160] [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: 05/30/2022] [Revised: 09/10/2023] [Accepted: 09/10/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND A measure to provide insight regarding health-related quality of life of adults with severe motor and intellectual disabilities was lacking. For this reason, the CPADULT was developed. This measure includes domains relating to an individual's physical, mental, and social functioning. The purpose of this study was to assess the psychometric characteristics of the CPADULT. METHOD Caregivers (n = 47; 77% female, 23% male) of individuals with severe disabilities who are non-ambulatory completed the questionnaire. Internal consistency, test-retest reliability and construct validity were analysed. RESULTS Internal consistency was adequate with Cronbach's alpha values from 0.75 to 0.95. Test-retest reliability was good, as intraclass correlation coefficient of the total score was 0.84 (domains: 0.61-0.89). Construct validity was confirmed with significant differences between subgroups of motor or intellectual abilities. CONCLUSION The CPADULT has sufficient reliability and validity as a proxy measure of health-related quality of life for adults with severe disabilities who are non-ambulatory.
Collapse
Affiliation(s)
- Trees A L Zalmstra
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
- Stichting Omega, Amsterdam, The Netherlands
| | - Heleen A Reinders-Messelink
- Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Agnes Elema
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- 's Heeren Loo, De Noorderbrug, Groningen, The Netherlands
| | - Willemijn van Gils
- Rehabilitation Center 'Revalidatie Friesland', Heerenveen, The Netherlands
| | - Corry K van der Sluis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette A J van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
20
|
Wessels MD, Van Assen AAG, Post WJ, Van der Putten AAJ. The construct validity and reliability of the Motor Development List for the assessment of motor skills in children with profound intellectual and multiple disabilities: The next step? JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2023; 48:370-383. [PMID: 39815879 DOI: 10.3109/13668250.2023.2188877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/26/2023] [Indexed: 01/18/2025]
Abstract
BACKGROUND There are no psychometrically validated instruments available to measure motor skills of children with profound intellectual and multiple disabilities (PIMD). In this study, the construct validity and reliability (Rho) of the Motor Development List for children with PIMD (MDL-PIMD), a proxy-reported measure, was investigated. METHODS The MDL-PIMD was filled in by parents of 52 children with PIMD every six months over a period of two years. The items of the original MDL were categorised into subscales. A Mokken scale analysis for polytomous items was conducted for five subscales (Posture, Locomotion, Reaching, Grabbing and Facial Actions). RESULTS Several items were deleted to improve scalability. All scales showed good scalability (range scale H .66-.78) and reliability (range Rho .92-.98). CONCLUSIONS The MDL-PIMD seems to be a valid and reliable instrument for assessing the motor skills of children with PIMD, although more research is needed to confirm the factorial structure.
Collapse
Affiliation(s)
- Marleen D Wessels
- Department of Inclusive and Special Needs Education, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Academic Collaborative Centre for Profound Intellectual and Multiple Disabilities, Groningen, The Netherlands
| | - Arjen A G Van Assen
- Academic Collaborative Centre for Profound Intellectual and Multiple Disabilities, Groningen, The Netherlands
- Department of Child and Family Welfare, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Wendy J Post
- Department of Child and Family Welfare, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Annette A J Van der Putten
- Department of Inclusive and Special Needs Education, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
- Academic Collaborative Centre for Profound Intellectual and Multiple Disabilities, Groningen, The Netherlands
| |
Collapse
|
21
|
Petitpierre G, Dind J, De Blasio C. Olfactive short-term habituation in children and young people with profound intellectual and multiple disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 140:104569. [PMID: 37473626 DOI: 10.1016/j.ridd.2023.104569] [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: 08/09/2022] [Revised: 06/21/2023] [Accepted: 07/04/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Despite its importance for learning, the existence of the habituation process and its characteristics in people with profound intellectual and multiple disabilities (PIMD) remains understudied. Habituation is, however, considered the simplest form of learning, and a significant neuroadaptive mechanism. Even though habituation occurs in all sensory modalities, the olfactory system is where it manifests itself very visibly. AIM This study explores the olfactory short-term habituation abilities of children and young people with PIMD. METHOD Twenty children and young people with PIMD (7-18 years) were presented six times successively with a 30-second habituating olfactory stimulus. The interstimulus interval was 15 s. A new odour was presented on the seventh trial. The scenario was carried out two times with two pairs of stimuli. The participants' head alignment duration on the odour was measured. RESULTS Seventeen participants out of 20 manifested a decline in response, which reached about 50 % between the first and sixth presentation of the habituation odour. All habituators also showed a distinctive response when exposed to a novel odour. The participants who did not habituate showed a strong, non-fluctuating response to the stimulus throughout the presentations. Three participants only habituated to one of the two habituation stimuli. CONCLUSION AND IMPLICATIONS The results raise theoretical, scientific, and practical issues. They question the factors explaining olfactory habituation mechanisms, namely the stimulus properties and the severity of impairment, reveal the need for points of comparison for interpreting this population's responses, and point to the consequences of stimuli repetition and or variety in therapeutic or educational settings for these individuals' learning and cognitive functioning.
Collapse
Affiliation(s)
- Geneviève Petitpierre
- Université de Fribourg, Département de Pédagogie spécialisée, R. St Pierre Canisius 21, Fribourg CH-1700, Switzerland.
| | - Juliane Dind
- Université de Fribourg, Département de Pédagogie spécialisée, R. St Pierre Canisius 21, Fribourg CH-1700, Switzerland
| | - Catherine De Blasio
- Université de Fribourg, Département de Pédagogie spécialisée, R. St Pierre Canisius 21, Fribourg CH-1700, Switzerland
| |
Collapse
|
22
|
De Blasio C, Dind J, Petitpierre G. Odor hedonic responses in children and young people with profound intellectual and multiple disabilities. Front Psychiatry 2023; 14:1066286. [PMID: 37692315 PMCID: PMC10484511 DOI: 10.3389/fpsyt.2023.1066286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 07/21/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Odors are closely linked to emotions, play an important role in the well-being of individuals and can influence mood. Despite these crucial properties, the hedonic responses to odors of people with profound intellectual and multiple disabilities (PIMD) remain little explored. Aim This within-subjects study aims to examine whether children and young people with PIMD react in a differentiated way to odors evaluated as pleasant or unpleasant by neurotypical adults and, if so, with which behaviors. The influence of their global mood on their emotional responses to odors is also examined. Method Twenty children and young people (7-18 years old) with PIMD were exposed to four pairs of hedonically contrasted odors. A control stimulus was presented before each odorant. Five emotional responses, one physiological reaction (nausea reactions), and three responses reflecting approach toward or avoidance of the stimulus were recorded throughout the duration of the stimulus exposure. The participants' global mood status was measured before the start of the research with the French version of the Mood, Interest and Pleasure Questionnaire (Ross and Oliver, 2003). Results The results show that when exposed to pleasant odorants, participants kept their heads aligned with the odorant source longer, smiled longer, and produced more positive vocalizations. In contrast, unpleasant odorants elicit more pouts and grimaces. Nausea reactions occurred in the presence of unpleasant odorants. The hedonic responses were more marked during the second presentation of the stimuli. Participants with a higher MIPQ score showed significantly more emotional reactions to odors. Conclusion The results confirm the presence of olfactory preferences in participants with PIMD and the existence of a link between their mood, emotions and olfactory hedonic processing. They prompt the use of odors to support not only the cognitive development of this population, but also their mood and their emotional regulation abilities.
Collapse
|
23
|
Esteban L, Navas P, Verdugo MÁ, Iriarte EG, Arias VB. A community living experience: Views of people with intellectual disability with extensive support needs, families, and professionals. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 137:104503. [PMID: 37058934 DOI: 10.1016/j.ridd.2023.104503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Despite the benefits of community living for people with intellectual disabilities (ID) and extensive support needs, they remain highly institutionalized. AIMS To qualitatively analyze the perceptions of people with ID, including those with extensive support needs, professionals, and family members six months after the implementation of 11 community homes for 47 people in different regions of Spain METHODS: Thematic analysis of 77 individual interviews conducted with 13 people with ID, 30 professionals and 34 family members was performed using Nvivo12. RESULTS Seven themes were found: (1) "the room as I like it", (2) "sometimes I don't obey", (3) "here I do a bit of everything", (4) "lots of people love me here", (5) "all thanks to them, who have helped me" (6) "I miss my mom", and (7) "I'm happy here". IMPLICATIONS Transitioning into the community has shown a clear positive change in emotional well-being, opportunities to participate in activities or exercise control over one's life. Nevertheless, certain restrictions were still present in people's lives, which significantly limit their right to independent living. While many of these restrictions may disappear, professional practices typical of a medical model can be recreated in services located in the community.
Collapse
Affiliation(s)
- Laura Esteban
- Institute for Community Inclusion (INICO). University of Salamanca, Spain
| | - Patricia Navas
- Institute for Community Inclusion (INICO). University of Salamanca, Spain.
| | | | | | - Víctor B Arias
- Institute for Community Inclusion (INICO). University of Salamanca, Spain
| |
Collapse
|
24
|
Vandesande S, Bosmans G, Sterkenburg P, Schuengel C, Maes B. Piloting attachment psychoeducation provided to parents of children with severe disabilities: Testing the feasibility of a digital micro-intervention. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:433-450. [PMID: 35465752 DOI: 10.1177/17446295221087564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BackgroundA digital micro-intervention offering attachment psychoeducational videos was explored regarding its feasibility in parents of children with severe disabilities. Method: A mixed-methods study (including daily diaries and one-time questionnaires) with 16 parents (75.0% female) of children with severe disabilities (up to 10 years of age) was done during a three-week intervention. Results: Parents were positive about the video series and almost no drop-out occurred. The videos stimulated their learning and thinking and offered parents some personal meaning. Preliminary efficacy tests showed no major changes in parents' parenting self-efficacy (PSE) or perceptions of statements on parent-child attachment. Conclusions: The study showed promising results regarding the micro-interventions' acceptability and implementation. The limited efficacy testing did not show major changes in parents' PSE. Further research is needed to investigate the differential relevance of the micro-intervention, based on parents' needs, as well as its optimal embeddedness in a broader intervention trajectory.
Collapse
Affiliation(s)
- Sien Vandesande
- Department of Special Education and Parenting, KU Leuven, Belgium
| | - Guy Bosmans
- Department of Clinical Psychology, KU Leuven, Belgium
| | - Paula Sterkenburg
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, The Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, The Netherlands
| | - Bea Maes
- Department of Special Education and Parenting, KU Leuven, Belgium
| |
Collapse
|
25
|
Dhondt A, Van Keer I, van der Putten A, Maes B. Changes in the early communicative behaviors of young children with significant cognitive and motor developmental delays in a two-year span. JOURNAL OF COMMUNICATION DISORDERS 2023; 104:106337. [PMID: 37253298 DOI: 10.1016/j.jcomdis.2023.106337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 06/01/2023]
Abstract
INTRODUCTION This study examines longitudinal changes in communicative behavior of young children with significant cognitive and motor developmental delays (SDD) and determines their individual communicative trajectories. A second focus of this study is the relation of changes in communicative behavior with motor skills. METHODS Data consists of codes resulting from a self-developed coding scheme used on observations of 23 children in three different settings and responses on a questionnaire. First, group trends were determined to find out whether communication-related variables tend to significantly change over the course of two years. Furthermore, these findings were contrasted with the individual trajectories of the children. Next, the association of initial communicative skills and (the acquisition of) specific motor skills with the change in their communicative functioning was studied. Wilcoxon Signed Ranks and correlational analyses were used to answer the research questions. RESULTS Out of sixteen different variables related to communicative behavior, ten changed significantly over the course of two years. Children with more focus on prompt on the first datapoint showed a significantly larger increase of signs of functionality. Still, all children showed highly individual trajectories. Children with better motor skills on the first datapoint showed a significantly larger increase in communication rate. CONCLUSIONS Results show that if a myriad of detailed variables are taken into account children with significant cognitive and motor developmental disabilities do change regarding their communicative functioning, but that they tend to all show unique developmental trajectories. Children with stronger skills in some aspects of communication and motor functioning, can be considered advantaged regarding their communicative development.
Collapse
Affiliation(s)
- Ann Dhondt
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Belgium.
| | - Ines Van Keer
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Belgium
| | | | - Bea Maes
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Belgium
| |
Collapse
|
26
|
Enninga A, Waninge A, Post WJ, van der Putten AAJ. Reliable assessment of pain behaviour in adults with profound intellectual and multiple disabilities: The development of an instruction protocol. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:653-663. [PMID: 36915941 DOI: 10.1111/jar.13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/22/2023] [Accepted: 02/20/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Persons with profound intellectual and multiple disabilities (PIMD) are vulnerable when it comes to experiencing pain. Reliable assessment of pain-related behaviour in these persons is difficult. Aim To determine how pain items can be reliably scored in adults with PIMD. METHODS We developed an instruction protocol for the assessment of pain-related behaviour in four phases. We used videos of 57 adults with PIMD during potentially painful situations. The items were assessed for inter-rater reliability (Cohen's kappa or percentage of agreement). RESULTS The developed instruction protocol appeared to be adequate. Twelve items had satisfactory inter-rater reliability (n = 9: .30-1.00; n = 3: 85%-100%). DISCUSSION Calibrating and adjustments to the instructions and item set appeared to be crucial to reliably score 12 items in adults with PIMD. Further research should focus on creating an assessment instrument based on these reliably scored items.
Collapse
Affiliation(s)
- Annemieke Enninga
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Wendy J Post
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Annette A J van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
27
|
Hewitt OM, Langdon PE, Hales SA, Larkin M. The phenomenology of mental imagery in people with intellectual disabilities. Psychol Psychother 2023; 96:25-39. [PMID: 36018277 PMCID: PMC10087696 DOI: 10.1111/papt.12424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Mental imagery is important in the development and maintenance of psychological disorders and well-being but has been neglected in people with intellectual disabilities. A detailed idiographic analysis of the lived experience of mental imagery in this population is presented. DESIGN This qualitative study uses interpretative phenomenological analysis (IPA). It involved inclusive research methods with people with intellectual disabilities and other stakeholders (including family members, advocates, support workers and intellectual disability service managers). METHODS Ten individual semi-structured interviews were conducted with people with mild-moderate intellectual disabilities. Participants were opportunistically sampled through organisations providing community services to people with intellectual disabilities in the UK. Two men and eight women (mean age 43 years) participated. Interviews were audio-recorded and analysed using IPA. RESULTS People with intellectual disabilities are able to experience a range of rich and detailed mental images across all sensory modalities. Participants reported changes in affect based on mental imagery, and an ability to experience both spontaneous and deliberate mental images. The emotional saliency of the object of mental imagery appeared to influence participants' ability to engage with imagery. A number of adaptations make mental imagery more accessible and easier to report. The ability of people with intellectual disabilities to experience vivid mental imagery has important clinical implications for the use of a range of mental imagery interventions with this population. CONCLUSIONS The need to consider mental imagery interventions for this population, and how these can be adapted to ensure accessibility is a priority for people with intellectual disabilities and psychological disorders.
Collapse
Affiliation(s)
- Olivia Mary Hewitt
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK.,Learning Disability Services, Berkshire Healthcare NHS Foundation Trust, Reading, UK
| | - Peter E Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK.,Coventry and Warwickshire Partnership NHS Trust, Rainbow Unit, Brooklands Hospital, Birmingham
| | - Susie A Hales
- Emotion and Mental Imagery Lab (EMIL), Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Michael Larkin
- Department of Psychology, Institute for Health and Neurodevelopment, Aston University, Birmingham, UK
| |
Collapse
|
28
|
Gjermestad A, Skarsaune SN. Advancing inclusive research with people with profound and multiple learning disabilities through a sensory-dialogical approach. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:40-53. [PMID: 35015585 PMCID: PMC9941796 DOI: 10.1177/17446295211062390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
People with profound and multiple learning disabilities are often excluded from the processes of knowledge production and face barriers to inclusion in research due to cognitive and communicative challenges. Inclusive research-even when intending to be inclusive-tends to operate within criteria that exclude people with profound and multiple learning disabilities. The aim of this article is to provide a state-of-the-art review of the topic of inclusive research involving people with profound disabilities and thereby challenge traditional assumptions of inclusive research. The review presents themes that will inform a discussion on how to challenge the criteria in ways that make it possible to understand inclusive research for people who communicate in unconventional ways. We argue that a fruitful way of rethinking inclusive research is by applying a sensory-dialogical approach that privileges the dialogical and sensory foundations of the research. We suggest this might be a way to understand inclusive research that regards the person's communicative and cognitive distinctiveness.
Collapse
Affiliation(s)
- Anita Gjermestad
- Faculty of Health, Sandnes. VID Specialized
University, Sandnes, Norway
| | - Synne N Skarsaune
- Faculty of Health, Sandnes. VID Specialized
University, Sandnes, Norway
| |
Collapse
|
29
|
Skarsaune SN. Self-determination of people with profound intellectual and multiple disabilities. Dev Med Child Neurol 2023; 65:16-23. [PMID: 35869593 PMCID: PMC10084087 DOI: 10.1111/dmcn.15363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 12/01/2022]
Abstract
Self-determination is a human right that people with profound intellectual and multiple disabilities (PIMD) risk not being granted. Exploration of such topics and research in general has traditionally not included people with PIMD as sources of knowledge; rather, the perspective of others has been sought. Ethnographic methods highlighting descriptions of lived experience have been argued as a way of including such individuals, producing knowledge building on the person's perspective. Exploring the human right to be self-determined through ethnographic approaches can bring novel ways of understanding the concept, both about how to listen and learn from such experiences, and about implications for understanding self-determination. All people have the potential for self-determination, by being understood through embodied communication in caring relationships. By fostering relations with people with PIMD in sensitive, ethical ways, and addressing their profound dependency, their self-determination can be realized. WHAT THIS PAPER ADDS: Attentive engagement with people with lived experience of profound intellectual and multiple disabilities can inform both researchers and clinicians on self-determination. Through real-life descriptions, self-determination is demonstrated to move beyond independence and choice-making.
Collapse
Affiliation(s)
- Synne Nese Skarsaune
- VID Specialized University, Centre for Diaconia and Professional Practice, Norway
| |
Collapse
|
30
|
Dins T, Keeley C. Recognising Basic Health Literacy Capabilities: An Explorative Study on the Relevance of Health-Related Information in the Support of People with Profound Intellectual and Multiple Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16874. [PMID: 36554754 PMCID: PMC9779809 DOI: 10.3390/ijerph192416874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/04/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Background: People with profound intellectual disabilities represent a vulnerable and heterogeneous population whose health-related needs and questions often remain unheard. One reason for this is that they are usually unable to participate in verbal communication. However, there is also a lack of suitable approaches to communicate health-related information to them according to their capabilities. The research presented in this paper addresses this gap. Methods: Following grounded theory methodology, we used a multimethod approach. Based on a theoretical analysis, a Delphi study (n = 14) was conducted as a starting point to map the research field. In a second step, these findings were incorporated into an online survey targeting disability care professionals (n = 111). Three field studies supplemented the data, encompassing a variety of ethnographic methods. Results: People with PIMD have basic health-related capabilities that can improve their health literacy. Nevertheless, their support environments have to take over many health literacy-related requirements by proxy or substitution. One of the most important tasks is to engage health information in an individualised way. Conclusions: The findings underline the importance of focusing on more basic capabilities and intersubjective approaches in health literacy research and practice, especially regarding new perspectives on the inclusion of previously marginalised populations (such as people with PIMD).
Collapse
|
31
|
Dhondt A, Van keer I, Ceulemans E, van der Putten A, Maes B. Describing the communicative profiles of young children with a significant cognitive and motor developmental delay. Augment Altern Commun 2022:1-12. [DOI: 10.1080/07434618.2022.2138780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ann Dhondt
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Ines Van keer
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Eva Ceulemans
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Annette van der Putten
- Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Bea Maes
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| |
Collapse
|
32
|
Penninga W, Nijs SLP, van Bakel HJA, Embregts PJCM. Meaningful moments of interaction with people with profound intellectual disabilities: Reflections from direct support staff. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1307-1316. [PMID: 35726014 PMCID: PMC9796127 DOI: 10.1111/jar.13019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 04/28/2022] [Accepted: 05/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND High-quality, affective relationships are built on meaningful moments of interaction, which are challenging for support staff to establish with people with profound intellectual disabilities. Therefore, we explored what makes a moment of interaction meaningful to support staff and what circumstances facilitate meaningful moments of interaction taking place. METHOD Five direct support staff took part in unstructured, in-depth interviews. The interviews were analysed using interpretative phenomenological analysis (IPA). Member checks were also conducted. RESULTS Support staff experienced moments of interaction as meaningful because they felt a connection with a person with profound intellectual disabilities and/or they had the feeling of being meaningful for this person. Staff-related and contextual circumstances facilitating meaningful moments of interaction to take place were described. CONCLUSIONS Meaningful moments of interaction are highly valued by support staff, who believe these moments are valued by persons with profound intellectual disabilities as well. Implications for daily practice are described.
Collapse
Affiliation(s)
- Wieneke Penninga
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands,AmerpoortBaarnThe Netherlands
| | - Sara L. P. Nijs
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Hedwig J. A. van Bakel
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Petri J. C. M. Embregts
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| |
Collapse
|
33
|
Vandesande S, Bosmans G, Sterkenburg P, Schuengel C, Maes B. The Attachment Strengths and Needs Interview for parents of children with severe or profound intellectual disabilities: An acceptability and feasibility study. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2022; 47:118-130. [PMID: 39818584 DOI: 10.3109/13668250.2021.1925528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2025]
Abstract
BACKGROUND The feasibility and acceptability was explored of the newly-constructed Attachment Strengths and Needs Interview for parents of children with severe or profound intellectual disabilities. METHOD A partially mixed methods approach (with focus on the quantitative data) was used to clarify parents' and professionals' viewpoints regarding the acceptability of the interview through websurvey-ratings. RESULTS Parents generally felt appreciated during or after the interview, were motivated to work on the proposed goals and felt the interview covered their actual needs, but were, however, more neutral on the aspects of reflection and learning. Professionals indicated that the interview gathered sufficient information on most elements of interest at the start of an intervention trajectory, but generally missed information on the origins of parents' questions and the families' expectations towards taking part in an intervention. CONCLUSIONS The current study showed preliminary support for the feasibility and acceptability of the Attachment Strengths and Needs Interview, as part of a broader intake procedure, to inform attachment-focused interventions for parents of children with disabilities by identifying their strengths and needs.
Collapse
Affiliation(s)
- Sien Vandesande
- Parenting and Special Education and Parenting, KU Leuven, Leuven, Belgium
| | - Guy Bosmans
- Clinical Psychology, KU Leuven, Leuven, Belgium
| | - Paula Sterkenburg
- Department of Clinical Child and Family Studies, Vrije Universiteit, Amsterdam, the Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies, Vrije Universiteit, Amsterdam, the Netherlands
| | - Bea Maes
- Parenting and Special Education and Parenting, KU Leuven, Leuven, Belgium
| |
Collapse
|
34
|
Lundqvist LO, Frank A, Duberg A. Effects of the Structured Water Dance Intervention (SWAN) on muscular hypertonia in adults with profound intellectual and multiple disabilities. Sci Rep 2022; 12:8746. [PMID: 35610353 PMCID: PMC9130208 DOI: 10.1038/s41598-022-12716-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/06/2022] [Indexed: 11/09/2022] Open
Abstract
This study aimed to evaluate the effect of Structured Water Dance Intervention (SWAN) on muscular hypertonia in individuals with profound intellectual and multiple disability (PIMD). Muscular hypertonia has a multitude of negative consequences for people with PIMD because it can lead to contractures, pain, mobility impairment, pressure ulcers that limits functional behavior as well as gross and fine motor function. Thirty-six individuals with PIMD in four Swedish regions were randomized to two groups in a multicenter, crossover design. Two withdrew participation, thus 34 individuals completed the intervention. The intervention was administered for 40 min once a week during a 12-week period. Outcomes related to muscular hypertonia were examined using the Modified Ashworth Scale (MAS), and based on accompanying assistants' assessments. Hypertonia decreased from baseline to the end of the intervention period, as demonstrated by a decrease in MAS score. Hypertonia also decreased during the sessions, as shown by the assistants' ratings. In conclusion, this study demonstrates that SWAN holds potential to reduce muscular hypertonia in people with PIMD and points out the importance of customized physical treatment alternatives. The study provides useful information for the design of future non-invasive, non-pharmacological interventions to reduce muscular hypertonia in PIMD.
Collapse
Affiliation(s)
- Lars-Olov Lundqvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden.
| | - André Frank
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden
| |
Collapse
|
35
|
Dind J, Petitpierre G. Development and preliminary validation of the Self-Awareness Situation-Based Observation Lists for children with Profound Intellectual and Multiple Disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 121:104153. [PMID: 34942442 DOI: 10.1016/j.ridd.2021.104153] [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: 08/26/2021] [Revised: 11/26/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND A primary, pre-reflective form of self-awareness develops during the first two years of life, through sensory perceptions and bodily and social experiences. Although this is a central dimension in the development of children with PIMD, no tools are available to guide caregivers' observations. AIMS To present the development procedure and the results of the first validation step of a battery aimed at direct observation of primary self-awareness behaviors in children with PIMD. METHODS AND PROCEDURE We built a criterion-referenced tool composed of five scales proposed in two complementary lists. The first list comprises inducing standardized tasks; the second natural observation situations. The battery was administered three times to 18 children with PIMD. OUTCOMES AND RESULTS The inducing tasks list was shown to be reliable, with good internal consistency, inter- and intra-rater reliability, high procedural reliability and high test-retest reliability. The natural observation situations list has a lower internal consistency, but high test-retest reliability. The social validity of both lists is deemed to be excellent. CONCLUSION AND IMPLICATIONS The tool looks promising. Even if these first results need to be confirmed by further research, it opens up perspectives for assessment and intervention on a key dimension of human functioning.
Collapse
Affiliation(s)
- Juliane Dind
- Department of Special Needs Education, University of Fribourg, Rue St-Pierre Canisius 21, 1700, Fribourg, Switzerland.
| | - Geneviève Petitpierre
- Department of Special Needs Education, University of Fribourg, Rue St-Pierre Canisius 21, 1700, Fribourg, Switzerland.
| |
Collapse
|
36
|
Variation in differential reactions to comfort by parents versus strangers in children with severe or profound intellectual disabilities: the role of parental sensitivity and motor competence. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02501-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
37
|
Van Keer I, Dhondt A, Van der Putten A, Maes B. Lessons learned: A critical reflection on child- and contextual variables related to the development of children with a significant cognitive and motor developmental delay. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 120:104142. [PMID: 34875547 DOI: 10.1016/j.ridd.2021.104142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The scientific study of young children with a significant cognitive and motor developmental delay is challenging due to the children's complex disabilities and high demands on family life and professional support. We aim to critically reflect on the measurement and analysis of child- and contextual variables within an ongoing research project on these children's developmental trajectories. METHOD The OJKO-project tracked the development of a sample of children (n = 45) between the age of 6 months and 4 years with a significant cognitive and motor developmental delay, in Belgium and the Netherlands. RESULTS The complexity of the children's disabilities and daily life context, and subsequent challenges in measurement and analysis of variables, were confirmed and reflected upon. CONCLUSIONS Due to the uniqueness and complexity of this target group, research should be characterized by creativity, perseverance and substantial modesty in the immediate generalization of results.
Collapse
Affiliation(s)
- Ines Van Keer
- University of Leuven, Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Leopold Vanderkelenstraat 32, box 3765, 3000 Leuven, Belgium.
| | - Ann Dhondt
- University of Leuven, Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Leopold Vanderkelenstraat 32, box 3765, 3000 Leuven, Belgium
| | - Annette Van der Putten
- University of Groningen, Faculty of Behavioural and Social Sciences, Grote Rozenstraat 38, 9712 TJ Groningen, The Netherlands
| | - Bea Maes
- University of Leuven, Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Leopold Vanderkelenstraat 32, box 3765, 3000 Leuven, Belgium
| |
Collapse
|
38
|
Petitpierre G, Dind J, De Blasio C, Gremaud G. Odour detection in children and young people with profound intellectual and multiple disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:519-530. [PMID: 34859541 PMCID: PMC9299868 DOI: 10.1111/jar.12963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Olfaction provides information on very important dimensions of the environment; however the olfactory abilities of children and young people with profound intellectual and multiple disabilities (PIMD) remain largely unknown. This within-subjects study explores olfactory detection abilities in children with PIMD. METHOD Twenty-two children and young people with PIMD (7-18 years) were presented with 18 medium intensity odours and an odourless control stimulus. Odorants were presented one by one in a randomised order. The neutral stimulus was presented prior to each odorant. Participants' responses were measured using 21 behavioural indicators. RESULTS Results show that participants make a clear distinction between odorous and neutral conditions, between food and non-food, and between pleasant and unpleasant odours. The detection abilities are manifested by several behaviours, in particular by the duration of the head alignment on the odorant. CONCLUSIONS This study shows that participants detect the stimuli and act differently depending on the category.
Collapse
Affiliation(s)
| | - Juliane Dind
- Department of Special Education, University of Fribourg, Fribourg, Switzerland
| | - Catherine De Blasio
- Department of Special Education, University of Fribourg, Fribourg, Switzerland
| | - Germaine Gremaud
- Department of Special Education, University of Fribourg, Fribourg, Switzerland
| |
Collapse
|
39
|
Rensfeldt Flink A, Boström P, Gillberg C, Lichtenstein P, Lundström S, Åsberg Johnels J. Exploring co-occurrence of sensory, motor and neurodevelopmental problems and epilepsy in children with severe-profound intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104114. [PMID: 34689027 DOI: 10.1016/j.ridd.2021.104114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Severe to profound intellectual disability (SPID) is associated with multiple neurodevelopmental disorders and problems. In the most severe cases, the term profound intellectual and multiple disabilities (PIMD) is used. This study aimed to explore the co-occurring disorders and neurodevelopmental problems in a sample of twins where the proband had SPID. METHOD Within a population-based sample of (30 312) twins, 20 individuals with a national patient register SPID diagnosis were identified. Parent telephone interview data (screening of neurodevelopmental disorders) and register data (APGAR, birth weight, intellectual disabilities, epilepsy, motor and sensory disorders) were gathered for probands and co-twins. RESULTS The 20 individuals with SPID all had between one and five additional disorders or problems, with autistic traits, motor problems and epilepsy being the most common. Clear discordance was found for ID and all additional disorders and problems between probands with SPID and their non-SPID co-twins. CONCLUSION Children with SPID almost never present without neurodevelopmental and/or sensory and/or motor comorbidities. This heterogeneity should be reflected in clinical routine and in research targeting individuals with SPID. The results support a previously suggested conceptualization of a S/PIMD "spectrum". Autism may be considered for inclusion in future elaborations of such a S/PIMD spectrum.
Collapse
Affiliation(s)
- Anna Rensfeldt Flink
- Department of Health and Rehabilitation, University of Gothenburg, Gothenburg, Sweden; Habilitation and Health, Region Västra Götaland, Gothenburg, Sweden.
| | - Petra Boström
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | | | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Jakob Åsberg Johnels
- Department of Health and Rehabilitation, University of Gothenburg, Gothenburg, Sweden; Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
40
|
Thurm A, Halladay A, Mandell D, Maye M, Ethridge S, Farmer C. Making Research Possible: Barriers and Solutions For Those With ASD and ID. J Autism Dev Disord 2021; 52:4646-4650. [PMID: 34716842 DOI: 10.1007/s10803-021-05320-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
Participation in research can provide direct and indirect benefit to individuals with autism spectrum disorder (ASD), their caregivers, families, and society at large. Unfortunately, individuals with high support needs, including those with intellectual disability, cognitive disability or minimal verbal ability, are often systematically excluded from research on ASD. This limits the ability to generalize discoveries to all people with ASD, and results in a disparity in who benefits from research. This piece outlines the importance and extent of the problem, which is part of a broader lack of inclusivity in ASD research. It also provides examples of studies that have directly addressed issues that arise when conducting inclusive research and makes recommendations for researchers to reduce disparities in research participation.
Collapse
Affiliation(s)
- Audrey Thurm
- National Institute of Mental Health, Bethesda, MD, USA.
| | - Alycia Halladay
- Autism Science Foundation, New York, NY, USA
- Rutgers University, Piscataway, NJ, USA
| | | | | | | | | |
Collapse
|
41
|
Johnels L, Vehmas S, Wilder J. Musical interaction with children and young people with severe or profound intellectual and multiple disabilities: a scoping review. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:487-504. [PMID: 37346263 PMCID: PMC10281396 DOI: 10.1080/20473869.2021.1959875] [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: 02/18/2021] [Revised: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 06/23/2023]
Abstract
This scoping review addresses peer-reviewed research on musical interaction with children and young people with severe/profound intellectual and multiple disabilities (S/PIMD). Twenty-five articles published between the years 2000 and 2020 met the inclusion criteria. A narrative synthesis was used to summarise and evaluate different features, including participant characteristics, study design and methods, type of musical interaction, the abilities and behaviours in focus, reported benefits, promising components of musical interaction, and quality appraisal of the studies. The results revealed a variation in participant characteristics and study designs, where small-sample descriptive case studies were most common. In terms of the type of musical interaction, active music therapy was the most commonly used approach, followed by technology-mediated and multisensory musical activities. In terms of abilities and behaviours, a large majority of the studies focused on social interaction and communication, followed by engagement, attention and affect. Six categories were identified as promising components of musical interaction: the responsivity of the interaction partner, singing songs, structure and predictability in the activities, long-term interventions, technology-mediated and multisensory musical activities, and a therapeutic alliance between interaction partners. Based on this review, we discuss future research and practical implications for musical interaction and music therapy for children and young people with S/PIMD.
Collapse
Affiliation(s)
- Linn Johnels
- Department of Special Education, Stockholm University, Stockholm, Sweden
| | - Simo Vehmas
- Department of Special Education, Stockholm University, Stockholm, Sweden
| | - Jenny Wilder
- Department of Special Education, Stockholm University, Stockholm, Sweden
| |
Collapse
|
42
|
Wessels MD, van der Putten AAJ, Paap MCS. Inventory of assessment practices in people with profound intellectual and multiple disabilities in three European countries. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1521-1537. [PMID: 34137122 PMCID: PMC8596661 DOI: 10.1111/jar.12896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/15/2021] [Accepted: 04/23/2021] [Indexed: 11/27/2022]
Abstract
Background Knowledge about the quality of assessment methods used in the support of people with profound intellectual and multiple disabilities (PIMD) is scarce. This study aimed to provide an overview of the assessment methods used in practice and to examine whether these instruments were studied for their psychometric properties for people with PIMD. Method Professionals (N = 148) from three European countries completed a survey on assessment practices. We performed a literature search to find information about the psychometric properties of the instruments that were identified in the survey. Results Of the participants, 78.1% used assessments that were not developed for people with PIMD. Documentation on psychometric properties was found for 8 out of 116 instruments. Conclusions Most of the instruments in use were not designed for people with PIMD, and information about their quality is lacking. Guidelines are needed regarding the use and development of assessment methods for people with PIMD.
Collapse
Affiliation(s)
- Marleen D Wessels
- Department of Inclusive and Special Needs Education, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Annette A J van der Putten
- Department of Inclusive and Special Needs Education, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Muirne C S Paap
- Department of Inclusive and Special Needs Education, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands.,Department of Child and Family Welfare, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
43
|
Hsieh YH, Borgestig M, Gopalarao D, McGowan J, Granlund M, Hwang AW, Hemmingsson H. Communicative Interaction with and without Eye-Gaze Technology between Children and Youths with Complex Needs and Their Communication Partners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105134. [PMID: 34066169 PMCID: PMC8151590 DOI: 10.3390/ijerph18105134] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022]
Abstract
Use of eye-gaze assistive technology (EGAT) provides children/youths with severe motor and speech impairments communication opportunities by using eyes to control a communication interface on a computer. However, knowledge about how using EGAT contributes to communication and influences dyadic interaction remains limited. Aim: By video-coding dyadic interaction sequences, this study investigates the impacts of employing EGAT, compared to the Non-EGAT condition on the dyadic communicative interaction. Method: Participants were six dyads with children/youths aged 4–19 years having severe physical disabilities and complex communication needs. A total of 12 film clips of dyadic communication activities with and without EGAT in natural contexts were included. Based on a systematic coding scheme, dyadic communication behaviors were coded to determine the interactional structure and communicative functions. Data were analyzed using a three-tiered method combining group and individual analysis. Results: When using EGAT, children/youths increased initiations in communicative interactions and tended to provide more information, while communication partners made fewer communicative turns, initiations, and requests compared to the Non-EGAT condition. Communication activities, eye-control skills, and communication abilities could influence dyadic interaction. Conclusion: Use of EGAT shows potential to support communicative interaction by increasing children’s initiations and intelligibility, and facilitating symmetrical communication between dyads.
Collapse
Affiliation(s)
- Yu-Hsin Hsieh
- Department of Special Education, Stockholm University, Se-106 91 Stockholm, Sweden;
- Correspondence:
| | - Maria Borgestig
- Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden;
| | - Deepika Gopalarao
- Al Noor Training Centre for Persons with Disabilities, Building No. 01, Street No. 21 Al Barsha 1, Dubai PO 8397, United Arab Emirates;
| | - Joy McGowan
- Easterseals of Southeastern Pennsylvania, 3975 Conshohocken Ave., Philadelphia, PA 19131, USA;
| | - Mats Granlund
- CHILD, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, 553 18 Jönköping, Sweden;
| | - Ai-Wen Hwang
- Graduate Institute of Early Intervention, College of Medicine, Chang-Gung University, Tao-Yuan City 33301, Taiwan;
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 5 Fu-Xing St., Kwei-Shan, Tao-Yuan City 33301, Taiwan
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Se-106 91 Stockholm, Sweden;
| |
Collapse
|
44
|
Van keer I, Vandesande S, Dhondt A, Maes B. Changes in the social-emotional functioning of young children with a significant cognitive and motor developmental delay across a two-year period. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:867-879. [PMID: 36568628 PMCID: PMC9788725 DOI: 10.1080/20473869.2021.1904772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/25/2021] [Accepted: 03/12/2021] [Indexed: 06/17/2023]
Abstract
Children with a significant cognitive and motor developmental delay (SDD) are vulnerable for the development of (future) behavioral and mental health problems. To support children within this target group, knowledge on their social-emotional development is necessary. Therefore, in this paper, an explorative assessment of the changes in the social-emotional functioning of children with SDD over a two-year period was done. Yearly semi-structured interviews with one or more primary caregiver(s) of 25 children were conducted and analyzed on 13 domains of social-emotional functioning, according to an adapted version of the Scale for Emotional Development - Revised (SED-R). This study showed a lot of variation in individual and group patterns of change across the two-year period. Charting the social-emotional development in this target group is challenging and requires further in-depth analysis of individual trajectories as well as more fine-grained and long-term data collection.
Collapse
Affiliation(s)
- Ines Van keer
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, University of Leuven, Leuven, Belgium
| | - Sien Vandesande
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, University of Leuven, Leuven, Belgium
| | - Ann Dhondt
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, University of Leuven, Leuven, Belgium
| | - Bea Maes
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, University of Leuven, Leuven, Belgium
| |
Collapse
|
45
|
Zalmstra TAL, Elema A, van Gils W, Reinders-Messelink HA, van der Sluis CK, van der Putten AAJ. Development and sensibility assessment of a health-related quality of life instrument for adults with severe disabilities who are non-ambulatory. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1127-1135. [PMID: 33675148 PMCID: PMC8359413 DOI: 10.1111/jar.12873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 01/20/2021] [Accepted: 02/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Insight in health-related quality of life (HRQoL) of adults with severe disabilities who are non-ambulatory is important, but a measure is lacking. The aim was to develop a HRQoL measure for this group. METHOD The developmental process consisted of the adaptation process of a proxy HRQoL measure for children with severe disabilities who are non-ambulatory and the assessment of the sensibility of the developed instrument. A three-step process was used: focus groups, e-survey and interviews. RESULTS In total, 72% of the items remained unchanged. Three new items and one element to an existing item were added. In ten items, the formulation of the items was adapted to the target group. Concerning the sensibility, respondents suggested minor changes to the instruction and the output scales. CONCLUSIONS This study has yielded a proxy HRQoL measure for adults with severe disabilities who are non-ambulatory, the CPADULT, with good sensibility.
Collapse
Affiliation(s)
- Trees A L Zalmstra
- Stichting Omega, Amsterdam, The Netherlands.,Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Agnes Elema
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Willemijn van Gils
- Rehabilitation Center 'Revalidatie Friesland', Heerenveen, The Netherlands
| | - Heleen A Reinders-Messelink
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands
| | - Corry K van der Sluis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette A J van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| |
Collapse
|