1
|
Prohn SM, Dinora P, Broda MD, Bogenschutz M, Lineberry S. Measuring Four Personal Opportunities for Adults With Intellectual and Developmental Disabilities. INCLUSION (WASHINGTON, D.C.) 2022; 10:19-34. [PMID: 35721258 PMCID: PMC9201575 DOI: 10.1352/2326-6988-10.1.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study tests an empirically derived model for measuring personal opportunities for people with intellectual and developmental disabilities (IDD) using National Core Indicators In-Person Survey (NCI-IPS) state and national datasets. The four personal opportunities measured, (a) privacy rights, (b) everyday choice, (c) community participation, and (d) expanded friendships, were informed by existing conceptualizations of service as well as NCI-IPS measures. Analyses confirmed the fit of a four-factor model and demonstrated that factors were significantly and positively correlated. To demonstrate the relationships between personal opportunities and personal and environmental characteristics, we estimated a structural equation model that regressed personal opportunities on age, gender, place of residence, and level of intellectual disability. Implications for using personal opportunities for evaluating service quality of IDD systems are discussed.
Collapse
Affiliation(s)
- Seb M Prohn
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| | - Parthenia Dinora
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| | - Michael D Broda
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| | - Matthew Bogenschutz
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| | - Sarah Lineberry
- Seb M. Prohn, Parthenia Dinora, Michael Broda, Matthew Bogenschutz, and Sarah Lineberry, Virginia Commonwealth University
| |
Collapse
|
2
|
Talman L, Stier J, Wilder J, Gustafsson C. Participation in daily life for adults with profound intellectual (and multiple) disabilities: How high do they climb on Shier's ladder of participation? JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 25:98-113. [PMID: 31319749 DOI: 10.1177/1744629519863959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Participation is the goal of Swedish disability policy, but it is difficult to achieve for adults with profound intellectual (and multiple) disabilities (PI(M)D). Since these adults are dependent on others in every aspect of their lives, others control their ability to participate in everyday life decisions. This study used observations, analyzed with Shier's ladder of participation, to elucidate and describe participation in daily life for adults with PI(M)D living in a group home. The results showed that the adults often reached the first three levels of Shier's ladder, one adult reached the fourth level once, and no one reached the fifth level. Participation on a higher level, therefore, seems hard to reach for adults. Staff members' attitudes toward the adults' capability can also be a barrier to participation. Applying Shier's ladder of participation can provide valuable information that might lead to increased participation in daily life for adults with PI(M)D.
Collapse
Affiliation(s)
| | - Jonas Stier
- 8177Mälardalen University, Sweden; Dalarna University, Sweden
| | - Jenny Wilder
- 8177Mälardalen University, Sweden; Stockholm University, Sweden
| | | |
Collapse
|
3
|
Lin J, Manokara V, Ng JS, Penchaliah S. Implementing Active Support in disability day services: A 6-month prospective study on engagement and behaviours of concern among adults with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1307-1317. [PMID: 32413250 DOI: 10.1111/jar.12750] [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: 02/04/2020] [Revised: 04/14/2020] [Accepted: 04/19/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adults with intellectual disability are often disengaged in disability services. While Active Support has found efficacy in residential settings, less is known in day services. This study examines the impact of Active Support in day services for adults with intellectual disability in Singapore, particularly on engagement and behaviours of concern. METHOD An experimental design was used, with a group of 32 participants receiving an Active Support programme over 6 months, compared to a control group of 16 participants with treatment as usual. Time sampling of behaviours was conducted every 4 weeks. RESULTS The Active Support group saw increases in activity engagement and social engagement with staff, and decreases in disengagement and stereotypical behaviours, compared to the control group over time. CONCLUSION Results support the implementation of Active Support across other day services for adults with intellectual disability. Active Support principles should be considered in planning policies and service outcome measures.
Collapse
|
4
|
Bigby C, Bould E, Iacono T, Kavanagh S, Beadle‐Brown J. Factors that predict good Active Support in services for people with intellectual disabilities: A multilevel model. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:334-344. [PMID: 31612579 PMCID: PMC7187299 DOI: 10.1111/jar.12675] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/01/2019] [Accepted: 09/20/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Active Support, now widely adopted by disability support organizations, is difficult to implement. The study aim was to identify the factors associated with good Active Support. METHODS Data on service user and staff characteristics, quality of Active Support and practice leadership were collected from a sample of services from 14 organizations annually for between 2 and 7 years, using questionnaires, structured observations and interviews. Data were analysed using multilevel modelling (MLM). RESULTS Predictors of good Active Support were adaptive behaviour, practice leadership, Active Support training, and time since its implementation. Heterogeneity, having more than six people in a service and larger organizations were associated with lower quality of Active Support. CONCLUSIONS In order to ensure that Active Support is consistently implemented, and thus, quality of life outcomes improved, organizations need to pay attention to both service design and support for staff through training and practice leadership.
Collapse
Affiliation(s)
- Christine Bigby
- Living with Disability Research CentreLa Trobe UniversityMelbourneVicAustralia
| | - Emma Bould
- Living with Disability Research CentreLa Trobe UniversityMelbourneVicAustralia
- Department of Occupational TherapyMonash UniversityMelbourneVicAustralia
| | - Teresa Iacono
- Living with Disability Research CentreLa Trobe UniversityMelbourneVicAustralia
| | - Shane Kavanagh
- Department of Public HealthSchool of Psychology and Public HealthLa Trobe UniversityBundooraVictoriaAustralia
| | - Julie Beadle‐Brown
- Living with Disability Research CentreLa Trobe UniversityMelbourneVicAustralia
- Tizard CentreUniversity of KentCanterburyUK
| |
Collapse
|
5
|
Olsson S, Gustafsson C. Employees' experiences of education and knowledge in intellectual disability practice. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sylvia Olsson
- Department of School of Health Care and Social WelfareMälardalen University Eskilstuna Sweden
| | - Christine Gustafsson
- Department of School of Health Care and Social WelfareMälardalen University Eskilstuna Sweden
| |
Collapse
|
6
|
Bossink LWM, van der Putten AAJ, Paap MCS, Vlaskamp C. Factors associated with direct support professionals' behaviour in the physical activity support provided to people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:981-991. [PMID: 30945358 PMCID: PMC6850131 DOI: 10.1111/jir.12616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 01/04/2019] [Accepted: 02/20/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Direct support professionals play an important role in facilitating physical activity support for people with intellectual disabilities (ID). This study examined how the characteristics of people with ID and the characteristics of direct support professionals are related to the professionals' behaviour when supporting people with ID in physical activity. METHODS A cross-sectional approach was used. Direct support professionals (n = 217) who support people with ID completed a self-report questionnaire, which aimed to measure the components that produced behaviour when providing physical activity support for people with ID. Associations with the characteristics of people with ID and the characteristics of the professionals were analysed using multivariate linear regression models. RESULTS The results demonstrate that the professionals' characteristics - such as age, workplace and training - were related to the variance in the components that theoretically produced the direct support professionals' behaviour. The characteristics of the people with ID did not contribute to the variance in the direct support professionals' behaviour. CONCLUSIONS The findings suggest that professional characteristics are the dominant reasons for the differences observed in the capability, opportunity and motivation of direct support professionals to provide physical activity support. This study also underscores the need for integrated training programmes to help direct support professionals promote physical activity in people with ID.
Collapse
Affiliation(s)
- L. W. M. Bossink
- Department of Special Needs, Education, and Youth CareUniversity of GroningenGroningenThe Netherlands
| | - A. A. J. van der Putten
- Department of Special Needs, Education, and Youth CareUniversity of GroningenGroningenThe Netherlands
| | - M. C. S. Paap
- Department of Special Needs, Education, and Youth CareUniversity of GroningenGroningenThe Netherlands
| | - C. Vlaskamp
- Department of Special Needs, Education, and Youth CareUniversity of GroningenGroningenThe Netherlands
| |
Collapse
|
7
|
Qian X, Larson SA, Tichá R, Stancliffe R, Pettingell SL. Active Support Training, Staff Assistance, and Engagement of Individuals With Intellectual and Developmental Disabilities in the United States: Randomized Controlled Trial. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 124:157-173. [PMID: 30835526 DOI: 10.1352/1944-7558-124.2.157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Two non-U.S. quasi-experimental studies reported Active Support training was associated with increased engagement in individuals with IDD, but no randomized controlled trials (RCTs) exist. We evaluated effects of Active Support training on staff assistance, and social and nonsocial engagement in 75 individuals with intellectual and developmental disabilities (IDD) in U.S. group homes. We detected no significant effects of active support training. Individuals with more skills and less challenging behavior engaged more in nonsocial activities. Younger individuals with more skills living in homes with fewer staff changes were more socially engaged. Factors associated with nonsocial engagement mirrored those reported in Qian, Tichá, Larson, Stancliffe, & Wuorio, (2015) . Staffing-related implementation challenges and statistical power limited our ability to detect differences.
Collapse
Affiliation(s)
- Xueqin Qian
- Xueqin Qian, Sheryl A. Larson, and Renáta Tichá, Institute on Community Integration, University of Minnesota, Minneapolis; Roger Stancliffe, University of Sydney, Lidcombe, NSW, 1825, Australia; and Sandra L Pettingell, Institute on Community Integration, University of Minnesota, Minneapolis
| | - Sheryl A Larson
- Xueqin Qian, Sheryl A. Larson, and Renáta Tichá, Institute on Community Integration, University of Minnesota, Minneapolis; Roger Stancliffe, University of Sydney, Lidcombe, NSW, 1825, Australia; and Sandra L Pettingell, Institute on Community Integration, University of Minnesota, Minneapolis
| | - Renáta Tichá
- Xueqin Qian, Sheryl A. Larson, and Renáta Tichá, Institute on Community Integration, University of Minnesota, Minneapolis; Roger Stancliffe, University of Sydney, Lidcombe, NSW, 1825, Australia; and Sandra L Pettingell, Institute on Community Integration, University of Minnesota, Minneapolis
| | - Roger Stancliffe
- Xueqin Qian, Sheryl A. Larson, and Renáta Tichá, Institute on Community Integration, University of Minnesota, Minneapolis; Roger Stancliffe, University of Sydney, Lidcombe, NSW, 1825, Australia; and Sandra L Pettingell, Institute on Community Integration, University of Minnesota, Minneapolis
| | - Sandra L Pettingell
- Xueqin Qian, Sheryl A. Larson, and Renáta Tichá, Institute on Community Integration, University of Minnesota, Minneapolis; Roger Stancliffe, University of Sydney, Lidcombe, NSW, 1825, Australia; and Sandra L Pettingell, Institute on Community Integration, University of Minnesota, Minneapolis
| |
Collapse
|
8
|
Vagenas D, Totsika V. Modelling correlated data: Multilevel models and generalized estimating equations and their use with data from research in developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 81:1-11. [PMID: 29786528 DOI: 10.1016/j.ridd.2018.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/19/2018] [Accepted: 04/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The use of Multilevel Models (MLM) and Generalized Estimating Equations (GEE) for analysing clustered data in the field of intellectual and developmental disability (IDD) research is still limited. METHOD We present some important features of MLMs and GEEs: main function, assumptions, model specification and estimators, sample size and power. We provide an overview of the ways MLMs and GEEs have been used in IDD research. RESULTS While MLMs and GEEs are both appropriate for longitudinal and/or clustered data, they differ in the assumptions they impose on the data, and the inferences made. Estimators in MLMs require appropriate model specification, while GEEs are more resilient to misspecification at the expense of model complexity. Studies on sample size seem to suggest that Level 1 coefficients are robust to small samples/clusters, with any higher-level coefficients less so. MLMs have been used more frequently than GEEs in IDD research, especially for fitting developmental trajectories. CONCLUSIONS Clustered data from research in the IDD field can be analysed flexibly using MLMs and GEEs. These models would be more widely used if journals required the inclusion of technical specification detail, simulation studies examined power for IDD study characteristics, and researchers developed core skills during basic studies.
Collapse
Affiliation(s)
- Dimitrios Vagenas
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal, and Research (CEDAR) and Centre for Education Studies (CES), University of Warwick, UK; Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, Monash University, Australia
| |
Collapse
|
9
|
Flynn S, Totsika V, Hastings RP, Hood K, Toogood S, Felce D. Effectiveness of Active Support for adults with intellectual disability in residential settings: Systematic review and meta-analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:983-998. [PMID: 29947444 DOI: 10.1111/jar.12491] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 04/30/2018] [Accepted: 05/23/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND The review examined the effectiveness of Active Support (RQ1) and stakeholders' experiences of the model (RQ2). METHOD Data were meta-analysed (RQ1; studies = 14) and synthesized narratively (RQ2; studies = 10). RESULTS By follow-up (6 months post-training), effect sizes (RQ1) for resident total activity engagement were significant and ranged from small (d = 0.33, 95% CIs: 0.10-0.50) to large (Tau-U = 0.95, 95% CIs: 0.64-1.25) depending on study design. Follow-up changes in staff assistance were moderate (d = 0.56, 95% CIs: 0.23-0.89; Tau-U 0.63, 95% CIs: 0.32-0.93) and large for quality of support (d = 1.03, 95% CIs: 0.61-1.44). Other outcomes did not change. CONCLUSIONS Active Support was more effective following complete staff training, in larger settings, at lower staff-to-resident ratios and with less experienced staff. Active Support training and outcomes were valued by staff and residents (RQ2), and staff experienced increased job satisfaction. Lower staff turnover and organizational readiness appear crucial for maintaining implementation.
Collapse
Affiliation(s)
- Samantha Flynn
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - Vasiliki Totsika
- CEDAR and Centre for Education Studies (CES), University of Warwick, Coventry, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Vic., Australia
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Vic., Australia
| | - Kerry Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | |
Collapse
|
10
|
Qian X, Tichá R, Stancliffe R. Contextual Factors Associated with Implementing Active Support in Community Group Homes in the United States: A Qualitative Investigation. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2017. [DOI: 10.1111/jppi.12204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Xueqin Qian
- Institute on Community Integration; University of Minnesota; Minneapolis MN USA
| | - Renáta Tichá
- Institute on Community Integration; University of Minnesota; Minneapolis MN USA
| | - Roger Stancliffe
- Centre for Disability Research and Policy; Sydney University; Licombe NSW Australia
| |
Collapse
|
11
|
King E, Okodogbe T, Burke E, McCarron M, McCallion P, O'Donovan MA. Activities of daily living and transition to community living for adults with intellectual disabilities. Scand J Occup Ther 2016; 24:357-365. [PMID: 27707082 DOI: 10.1080/11038128.2016.1227369] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND As adults with intellectual disability (ID) in Ireland move to the community from residential settings, the changed environment is intended to increase opportunities for occupational engagement, autonomy and social relationships. It is important to consider how increased resources and opportunities available within the community can be optimized to promote engagement and quality of life. AIMS This paper investigates if and how ADL and IADL performance of people ageing with ID is related to place of residence. METHODS ADL and IADL performance of adults with ID in Ireland across different living situations was analyzed using descriptive and bivariate analysis of data collected from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS TILDA). RESULTS Greater ability to perform ADL and IADL was noted in those living in independent or community group home settings when compared to traditional residential settings. Place of residence was strongly related to ADL and IADL performance. CONCLUSION AND SIGNIFICANCE Given that people with ID will likely require physical and social supports to complete ADL and IADL when transitioning to community living from residential settings, an occupational justice perspective can inform occupational therapists working with people with ID, facilitating successful transitions to community living.
Collapse
Affiliation(s)
- Eilish King
- a School of Nursing and Midwifery , Trinity College Dublin , Ireland
| | - Theresa Okodogbe
- b School of Social Work and Social Policy , Trinity College Dublin , Ireland
| | - Eilish Burke
- c School of Nursing and Midwifery , Trinity College Dublin , Ireland
| | - Mary McCarron
- d Faculty of Health Sciences , Trinity College Dublin , Ireland
| | - Philip McCallion
- e Centre for Excellence in Aging and Wellness, University of Albany , NY , USA
| | | |
Collapse
|