Self-determination and future goals in a sample of adults with intellectual disability

Preparing adults with intellectual disabilities for their future: How do support services staff view their role?

BACKGROUND

Person-centred service delivery underpins current approaches to working with individuals with intellectual disabilities. We investigated views of staff from a service organisation regarding their roles in creating desired futures for adults with intellectual disabilities.

METHODS

Data were gathered from staff of a large organisation that provided a range of services to adults with intellectual disabilities. Respondents were asked to describe their role in assisting an individual with intellectual disability to meet their goals for the future. Responses were analysed using a text analysis programme.

RESULTS

Two major themes were identified: 'Support for self-determination' and 'Business-as-usual'. These themes were not entirely separate but had some overlap. There were indications that staff experienced competing demands in their role(s).

CONCLUSION

Although central to person-centred planning, staff who work with adults with intellectual disabilities may not see support of self-determination as a key factor in creating a desired future.

Perspectives of adolescents with disabilities and their parents regarding autonomous decision-making and self-determination

BACKGROUND

Parents' promotion of autonomous decision-making (PADM) is essential for adolescents with disabilities and constitutes the basis for maturation of self-determination (SD). SD develops based on adolescents' capacities and the opportunities offered to them at home and at school, to make personal decisions regarding their life.

AIM

Examine the associations between the PADM and SD of adolescents with disabilities from their own perspective and that of their parents.

METHOD

Sixty-nine adolescents with disabilities and one of their parents completed a self-report questionnaire including PADM and SD scales.

OUTCOMES

The findings showed associations between parents' and adolescents' reports of PADM, and opportunities for SD at home. PADM was associated with capacities for SD among adolescents. Gender differences were also apparent, with both adolescent girls and their parents reporting higher ratings of SD than adolescent boys.

CONCLUSIONS

Parents who promote autonomous decision-making among their adolescent children with disabilities start a virtuous circle by offering greater opportunities for SD within the home. In turn, these adolescents rate their SD as higher, and communicate this perspective to their parents. Consequently, their parents offer them more opportunities for autonomous decision-making at home, thus enhancing their SD.

Degree of autonomy in making independent choices by frail older people with intellectual disabilities in a care home: A descriptive ethnographic study

BACKGROUND

We aimed to gain more insight into autonomy of older people with intellectual disabilities in a residential care facility in making choices.

METHODS

We performed a descriptive ethnographic study in a residential facility in the Netherlands for 22 persons, aged 54-89 years, with mild to moderate intellectual disabilities (IQ <70) and low social-emotional development levels. We combined participant observations and qualitative interviews.

RESULTS

Based on the observations, the main themes for the interviews were established. Residents indicated to be free to make independent choices, and experienced less autonomy with regard to health issues and finances. Support staff stated that residents' level of autonomy depends on residents' characteristics, needs, preferences, the attitude of support staff and the rules of the care institution.

CONCLUSION

Residents had a clear view on their autonomy in making independent choices. Support staff is mindful of preserving residents' autonomy, which in practice is limited.

The influence of meaningful activities in the quality of life and functional autonomy of adults with intellectual disability: A prospective study during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic might negatively impact the quality of life and functional autonomy of Spanish adults with intellectual disability, and meaningful activities could prevent this negative progression.

METHODS

This is a prospective cohort study in Spanish adults with intellectual disability during the COVID-19 pandemic. Quality of life, functional autonomy and functional independence were measured. The meaningful activities studied were structured-leisure, community self-management, and occupational and physical activities.

RESULTS

Seventy-three participants were included in the study. Quality of life and functional autonomy significantly deteriorated during the COVID-19 pandemic (all p > .001). Greater participation in community self-management activities before COVID-19 was associated with less detriment to quality of life (ß = -.312; p = .008), while greater participation in occupational and physical activities was associated with less detriment to the performance of instrumental activities (ß = -.317; p = .016; and ß = -.285; p = .030, respectively).

CONCLUSION

People with intellectual disability living in residential homes experienced a decrease in their quality of life and functional autonomy during the COVID-19 pandemic. Their involvement in community self-management activities and physical and occupational activities before the pandemic had preventive effects on the detriment to the quality of life and functional autonomy.

Direct Speech-Language Intervention Effects on Augmentative and Alternative Communication System Use in Adults With Developmental Disabilities in a Naturalistic Environment

PURPOSE

Research involving the effects of augmentative and alternative communication (AAC) intervention in adults, especially in naturalistic settings, has been identified as a critical public health need. Despite rapid advances in high-tech AAC, many adults with developmental disabilities have experienced reduced access to assistive technology and AAC, which can function as a de facto environmental barrier to participation, for these individuals. As a means of decreasing barriers to participation, this study targeted skill increases in the operational, linguistic, social, and strategic use of AAC systems.

METHOD

This study used a preexperimental, single-case AB design to identify skill level changes in the operational, linguistic, social, and strategic use of their AAC system from baseline to the completion of intervention. The four adult participants with developmental disabilities and limited use of natural speech as a primary modality of communication were identified through a collaborative relationship between a communication sciences and disorder university program and a state-run adult day program for individuals who had aged out of the K-12 school system. Each participant received direct intervention in the four areas described across 7 weeks.

RESULTS

Visual analysis and percent of nonoverlap of all pairs were used to identify changes in performance occurring between baseline and the conclusion of the intervention period. Results revealed increases across the specific skills, with individuals' variation across participants and target area. Out of 22 total goals targeted, strong effect sizes were observed for 10 goals and moderate effect sizes were observed for seven.

CONCLUSIONS

Skill increases in the four areas of AAC system use can be achieved with direct intervention in adults with developmental disabilities and limited use of natural speech as a primary modality of communication. This approach also underscores the value of collaborations between university training programs, providers of adult services, and adult participants as a cost-effective strategy for service delivery.

The Role of Psychological Capital in Human Service Professionals' Work Experiences

The study was set up as a first exploration of the predictive role of human service professionals’ (i.e., teachers and healthcare professionals) psychological capital (PC) in their perception of work experiences and some core aspects of their own work, such as their efficacy to instill positive resources in their clients, the positive representation of their work and of the results that they can obtain, and positive beliefs about their career growth. Three hundred and eight Northern Italian human service professionals were involved, of which 163 were elementary school teachers of inclusive classrooms and 145 were healthcare professionals in day and residential centers. The regression analyses which were carried out—controlling for age, gender, years of work experience and the typology of the human service jobs—confirmed the predictive role of PC in the efficacy to instill positive resources in one’s clients, the positive representation of the work and of the results that can be obtained, and positive beliefs about career growth. These results have important implications for practice, and they emphasize that specific interventions aimed at promoting human service professionals’ PC may positively impact the effectiveness of their actions for the adaptation and psychosocial development of their clients.

The High School Competencies Scale (H-Comp Scale): A First Validation Study

Researchers widely explored non-intellective study factors because they play a central role in academic performance and are potentially more modifiable than intellective ones. The scientific literature suggests that the non-intellective factors can be classified into three main areas: self-concept, which refers to self-esteem and efficacy, motivation and emotional reactions; the area of study, related to study dedication and operative skills; and the area of relationships, comprising those with family, fellow students and teachers. Basing on these findings, the C-Comp Scale has been developed and tested in the past, addressed to college students. This study aimed to adapt and test a new version of this questionnaire on high school students. Methods. A pilot study was conducted on 364 Italian high school students to adapt and test the new version of the questionnaire, called the H-Comp Scale. The following study, conducted on 792 Italian high school students, provided further evidence of its reliability, structural validity, and concurrent validity with general self-efficacy, academic self-efficacy, social self-efficacy, and academic performance. Results. The H-Comp Scale showed to possess excellent reliability and structural and concurrent validity. The final version is composed of twelve subscales, aggregated in three areas, with just 48 items: Study (Intrinsic Motivation, Extrinsic Motivation, Time Management, Study Dedication), Self (Learning Assessment, General Self-Esteem, Self-Efficacy, Reaction to Failures, Emotional Control), and Relationships (Family Relationships, Fellow Student Relationships, Teacher Relationships). Conclusions. The H-Comp Scale would be a useful and easy-to-use instrument to support school counselors, tutors, teachers, and researchers in exploring different types of non-intellective variables, to better project educational intervention aimed to improve high school students’ academic performance and satisfaction.