The use of proxy measurement of internal states in people with intellectual disability: A scoping review

BACKGROUND

The measurement of internal states of people with an intellectual disability is challenging. Given these difficulties, proxy respondents are sometimes used. However, the literature provides some caution about the validity of the use of proxy respondents.

AIMS

This review aims to identify the available evidence regarding the use of proxy respondents in the measurement of internal states of people with intellectual disabilities.

METHOD

The Arksey and O'Malley scoping review framework was used for this review, refined with the Joanna Briggs Institute Methodology.

RESULTS

Results indicate there are some differences in the findings reported with respect to the efficacy of the use of proxy respondents. These may be due to a number of inconsistencies and weaknesses in examinations of their utility.

CONCLUSIONS

If proxy-reports are to be useful in understanding the internal states of people with intellectual disability, researchers need to address the shortcomings revealed by this review.

An Equity-Based Research Agenda to Promote Social Inclusion and Belonging for People With IDD

Having a sense of social inclusion and belonging, typically characterized by our personal relationships and community participation, is the central essence of life for most people, yet it remains elusive for many people with intellectual and developmental disabilities (IDD). This article summarizes the work of a diverse group of researchers and advocates to propose 6 big-picture, equity-based goals to drive future research in the field: (1) understanding the role of intersectionality, (2) understanding intimate relationships, (3) promoting formation of communities of care to support social inclusion, (4) understanding life course trajectories of social inclusion, (5) understanding social inclusion in virtual spaces, and (6) understanding how to promote social inclusion in the entire research process.

A longitudinal study of loneliness in autism and other neurodevelopmental disabilities: Coping with loneliness from childhood through adulthood

LAY ABSTRACT

We know that many autistic people feel lonely, but we don't know whether their loneliness changes over time. Our research study followed autistic people and people with other non-spectrum neurodevelopmental disabilities from childhood through young adulthood and asked them about their loneliness. While many people told us they felt lonely or very lonely, a sizable group also told us that they do not feel lonely. We found that people who reported feeling lonely earlier in life were likely to also report feeling lonely later in life. Overall, autistic people and people with other neurodevelopmental disabilities in our study became lonelier from adolescence to adulthood. People described multiple ways they cope with feeling lonely, such as distracting themselves or reaching out to connect with another person. People who used distraction tended to be lonelier than those who did not. Our findings tell us that there is a need for greater support of social connections for many autistic people as they become adults.

Understanding experiences of 'Gig Buddies': A befriending scheme for people with intellectual disabilities

BACKGROUND

Research into befriending for people with intellectual disabilities is limited. This study aimed to explore the impact, mechanisms of change, and limitations of a befriending scheme for adults with intellectual disabilities and/or autism.

METHODS

Participants were recruited using convenience sampling. Thirteen individuals with intellectual disabilities and/or autism were interviewed and data thematically analysed.

RESULTS

Four themes were generated: 'Something fun for me'; 'A good connection'; 'Increasing independence'; and 'A life less quiet'. Befriending had direct benefits through the activities undertaken and the befriending relationships themselves being fun and reducing isolation. Befriending facilitated belonging, improved access to mainstream activities, and fostered independence by providing safety and support. The importance of shared interests and external support for the relationship was highlighted.

CONCLUSIONS

Positive outcomes of befriending were found, supporting existing literature and revealing new information from the voices of participants with intellectual disabilities themselves.

Personal support networks of young people with and without intellectual disability. A comparative study

BACKGROUND

Previous studies show that the personal support networks of people with intellectual disability are smaller and less diverse than those of people without intellectual disability. This article aims to compare the characteristics of the personal networks of young people with and without intellectual disability.

METHOD

The Personal Network Analysis (McCarty, Revista Hispana Para El Análisis de Redes Sociales, 2010, 19, 242-271) was applied. The participants comprised 51 young people aged between 13 and 19, of whom 27 had an intellectual disability. The Egonet programme was used to compile information, and SPSS v.27 for the statistical analysis.

RESULTS

Young people with intellectual disabilities have smaller personal networks than people without disability, while they also comprise more people with disability and fewer 'friends' and support people.

CONCLUSIONS

The full social inclusion of people with intellectual disability requires schools, families, the community and the individual to work together to develop activities that help them initiate and maintain relationships, prioritising mainstream contexts.

Mental Health Problems Among Adolescents With Mild Intellectual Disability and Relation to Sleep Quality and Perceived Social Support: A Comparative Study

The current cross-sectional study sought to determine the mental health problems of adolescents with mild intellectual disability (ID) and influencing factors. This study, which used a comparison group, was performed with 188 adolescents (91 with mild ID and 97 without ID) between January 2019 and June 2019 in Turkey. Data were collected using a Personal Information Form, the Strengths and Difficulties Questionnaire, Pittsburgh Sleep Quality Index, and Perceived Social Support Scale. Adolescents with mild ID were at higher risk for mental health problems compared to those without ID. According to linear regression analysis, sex, age, birth order, maternal age, parents' educational level, sleep quality, and perceived social support were statistically significant predictive factors of mental health problems in adolescents with mild ID. Results of this study indicate that adolescents with mild ID are at greater risk for mental health problems and that effective prevention/intervention strategies are needed. [Journal of Psychosocial Nursing and Mental Health Services, 62(3), 39-50.].

Developing a Measure of Key Adult Outcomes in Adults with Developmental Disabilities: Conceptual Model and Item Generation of the REALS (Relationships, Employment, Autonomy, and Life Satisfaction)

Employment, social relationships, and autonomy are priorities to people with intellectual and developmental disabilities (IDDs). However, few validated measures exist to systematically assess these key adult outcomes in this population. This research includes first steps to develop self- and proxy report measures of life outcomes for adults with IDDs-the Relationships, Employment, Autonomy, and Life Satisfaction (REALS). A literature search identified existing adult outcome measures, and comparison of their domains informed initial conceptual model development. External consultants revised the model, and items were generated. Autistic adults (n = 15), adults with other IDDs (n = 7), caregivers of autistic adults (n = 13), and caregivers of adults with other IDDs (n = 10) completed in-depth cognitive interviews to assess comprehension of items and response categories, factors influencing how participants respond to items, and the inclusiveness of the item pool. A final conceptual model was generated with three subdomains (social relationships, employment, and autonomy), including assessment of life satisfaction within each domain. Cognitive interviews revealed that response set restructuring and item-level revisions were needed to capture the complexity of adult life and make the measure more accessible across a range of abilities. This study developed a conceptual model of relationships, work, and autonomy specific to adults with IDDs. Future work will involve collecting data from 800 + self-reporters with IDDs and 800 + caregivers of adults with IDDs to conduct psychometric analyses. Improving measurement in this area is critical to better understanding the needs of adults with IDDs and improving services available to them.

Social cognition, emotion regulation and social competence in classical galactosemia patients without intellectual disability

OBJECTIVE

Classical galactosemia (CG) is an inborn error of galactose metabolism. Many CG patients suffer from long-term complications including poor cognitive functioning. There are indications of social dysfunction but limited evidence in the literature. Therefore, this study aims to improve our understanding of social competence in CG by investigating social cognition, neurocognition and emotion regulation.

METHODS

A comprehensive (neuro)psychological test battery, including self and proxy questionnaires, was administered to CG patients without intellectual disability. Social cognition was assessed by facial emotion recognition, Theory of Mind and self-reported empathy. Standardised results were compared to normative data of the general population.

RESULTS

Data from 23 patients (aged 8-52) were included in the study. On a group level, CG patients reported satisfaction with social roles and no social dysfunction despite the self-report of lower social skills. They showed deficits in all aspects of social cognition on both performance tests (emotion recognition and Theory of Mind) and self-report questionnaires (empathy). Adults had a lower social participation than the general population. Parents reported lower social functioning, less adaptive emotion regulation and communication difficulties in their children. Individual differences in scores were present.

CONCLUSION

This study shows that CG patients without intellectual disability are satisfied with their social competence, especially social functioning. Nevertheless, deficits in social cognition are present in a large proportion of CG patients. Due to the large variability in scores and discrepancies between self- and proxy-report, an individually tailored, comprehensive neuropsychological assessment including social cognition is advised in all CG patients. Treatment plans need to be customised to the individual patient.

Psychological and social outcomes of befriending interventions for adults with intellectual disabilities: A systematic review

BACKGROUND

Befriending is an intervention intended to provide companionship and support to socially isolated populations. This review aimed to understand the key characteristics and psychological and social outcomes of befriending interventions for adults with intellectual disabilities.

METHODS

Systematic searches of electronic databases (PsycINFO, MedLine and Web of Science) identified 11 studies for inclusion. A narrative synthesis of the findings was completed, along with critical appraisal of study quality.

RESULTS

Increased community participation, positive changes to social networks and mood were frequently reported outcomes for befriendees. Increased knowledge, new experiences and opportunities to 'give back' were most reported for befrienders.

CONCLUSIONS

The review highlighted that existing research in this field is limited in scope and methodologically diverse. Future research should focus upon the effectiveness and long-term impact of befriending interventions, understanding the mechanisms of change, and eliciting the views of people with intellectual disabilities on their experiences.

The role of metaverse on sexual health of people with disabilities: narrative review

Metaverse is the implementation of an Internet-based hypothetical meta-universe, which should facilitate an immersive experience in meeting people, working, shopping and other leisure activities. Immersive reality makes it possible to feel involved in a virtual environment using the mechanism of the "embodied simulations", i.e., the capacity to evoke a sense of presence in a specific reality, whether real or imagined. The growing interest in the metaverse suggests exploring how this new kind of communicative space could be used to provide and guarantee sexual entertainment and/or education for people with disabilities. Through a thematic analysis, we aimed to define the theoretical framework and analyze scientific literature on this subject. Our purpose is to provide a comprehensive picture of the use of metaverse as a tool for sexuality, and of the possible benefits of such technologies for people with disabilities. To this end, we have also discussed a major topic, related to the Sexual Assistants, examining how their possible application can be implemented within the context of augmented reality. Our study further explores the importance of the metaverse in sexual education. Finally, we addressed the issue of cyber security as well as possible threats and negative consequences linked to metaverse misuse.

Pre- and Post-COVID-19 Outcomes for Israelis With Intellectual and Developmental Disabilities in the Community

This study is among the first pre-post examinations to explore differences in subjective well-being, adaptive and maladaptive behavior, close relationships, community integration, family members' satisfaction with residential and community living settings, and family contact before and after the COVID-19 outbreak. Participants demonstrated better life satisfaction and adaptive behavior before COVID-19 than after COVID-19. Participants reported closer relationships with family members and peers before COVID-19 and closer relationships with staff members after COVID-19. The findings reveal mixed, although mostly negative, effects of the pandemic on people with intellectual and developmental disabilities in the community in Israel, in accord with extant comparative research.

No ordinary adult life: Living conditions from the perspective of adults with intellectual disabilities

This study focuses on the subjective experience of the living conditions of adults with intellectual disabilities as related to the Uppsala Quality of Life model (UQoL2). Eleven semi-structured interviews were conducted to study issues raised by people with intellectual disabilities. Study participants had their own home, either in an ordinary dwelling or group home. The findings show that the dependence on support in daily life infringes on the sense of adult social status and control of life. Staff and family had a mandate to define Quality of Life, which countered the possibilities of a life based on the preferences of those with intellectual disabilities. Knowledge about factors that affect living conditions, one of the social determinants of health, has implications for public health in general and the development of society's efforts for people who are in lifelong dependence on support and service from others.

Long-term social restrictions and lack of work activities during the COVID-19 pandemic: impact on the daily lives of people with intellectual disabilities

PURPOSE

Lockdowns due to the Covid-19 pandemic may have had a disproportionate impact on the daily lives of people with intellectual disabilities. Many of them had to deal with limited social contacts for an extended period. This study explores in depth how people with intellectual disabilities in the Netherlands experienced their daily lives, in particular due to lack of access to regular work activities.

MATERIALS AND METHODS

Eight participants with intellectual disabilities were interviewed. Interpretative Phenomenological Analysis (IPA) was employed in conducting and analysing interviews.

RESULTS AND CONCLUSIONS

Analysis yielded three overarching themes that are conceptually linked. Participants experienced a prolonged lack of social connections that resulted in experiences of social isolation and feelings of loneliness. This led to different kinds of struggles: either internal struggles involving negative thoughts or depressive feelings, or a perceived threat to their autonomous position in society. Meanwhile participants had to sustain their sense of self-worth in the absence of work activities. The findings emphasise the importance of social opportunities through the access to work activities for people with intellectual disabilities. Interventions are suggested to help reverse the increased social inequalities and enhance rehabilitation via work activities for people with intellectual disabilities.IMPLICATIONS FOR REHABLITATIONMore awareness may be raised among authorities, employers and the general public about the significant value people with intellectual disabilities attribute to meaningful social connections, in particular through work activities.Also, more awareness may be raised about the potential adverse effects of the loss of work activities and social connections on the quality of life of people with intellectual disabilities.Providing social support to others may help people with intellectual disabilities to construct social valued roles, either in or outside the work situation.Professionals and employers can support people with intellectual disabilities to find opportunities to provide social support to others.It is important to invest in sustainable and innovative post-pandemic community participation initiatives and particularly in accessible post-pandemic employment support, for example by organising paid in-company training placements.It is essential that professionals support people with intellectual disabilities to enhance their sources of resilience and coping strategies, that may have diminished as a result of the pandemic.

Personal Factors, Living Environments, and Specialized Supports: Their Role in the Self-Determination of People with Intellectual Disability

The self-determination of people with disabilities, and specifically people with intellectual disabilities (ID), is a growing issue due to its relevance in the field of inclusion and human rights. Although research has shown a significant relationship between self-determination and intelligence, other factors also contribute to its development. The purpose of this study was to understand what other variables may be influencing self-determination. Using the scores from 483 adolescents and adults with ID who completed the AUTODDIS scale, we performed inferential and regression analyses to determine the relationships between levels of self-determination, personal variables (sex, age, severity of ID), and contextual variables (living environment, specialized supports). We found that self-determination is affected by the severity of ID, and when this variable is controlled for, greater self-determination is mainly related to receiving occupational support and support for autonomy and independent living. Results also showed that, together with ID severity, occupational and psychoeducational support, as well as support for autonomy and independent living, were also predictors of the level of self-determination. In conclusion, this study confirms the importance of contextual variables in the development of self-determination in people with ID, placing the focus of intervention on social opportunities.

Facilitators of Sense of Belonging Among People With Intellectual and Developmental Disabilities: A Systematic Review

Background: This review synthesizes the available literature regarding factors which facilitate a sense of belonging in people with intellectual and developmental disabilities, and provide a comprehensive integrative view of the subject. Methods: Four electronic databases were searched, and 13 studies met inclusion criteria for review. The "standard quality assessment criteria for evaluating primary research papers from a variety of fields" indicated satisfactory quality. Factors which facilitate a sense of belonging in people with intellectual and developmental disabilities were analyzed into themes. Results: Sense of belonging is enhanced by feeling respected, accepted, and valued (Subjectivity). These experiences are more likely to be achieved in a familiar and safe environment (Dynamism), and with access to platforms for social interactions (Groundedness), where a sense of relatedness and connectedness achieved by shared experiences with others (Reciprocity). Sense of belonging is associated with committed action of people with disability, taking assertive action or being agentic (Self-determination). Conclusion: Sense of belonging is a unique concept that should be addressed in disability research and practice.

The Relationship Between Acceptance, Biopsychosocial Factors, and Quality of Life: A Structural Equation Model

Disability acceptance is one of the most significant constructs in the psychosocial adaptation process. Although prior research has examined the relationship among different biopsychosocial factors, disability acceptance, and quality of life (QoL), limited study focused on entering a series of biopsychosocial factors simultaneously into analysis to reflect live experience of individuals with disabilities. This study aimed to examine the role of acceptance regarding the relationship between a series of biopsychosocial factors (i.e., general health, physical functioning, pain, anxiety, depression, stress, loneliness, stigma, sense of community, and neighborhood problems) and QoL based on Livneh’s psychosocial adaptation model to inform psychosocial interventions. A total of 430 participants with disabilities completed an online survey consisting of instruments measuring target variables. Exploratory and confirmatory factor analyses indicated a three-factor structure for selected biopsychosocial factors (i.e., psychological difficulties, physical status, and community issues). Structural equation modeling results showed that the proposed model indicated a fair model fit after respecification. Effect analyses showed that disability acceptance directly affected QoL and partially mediated the relationship between physical status and QoL and psychological difficulties and QoL. In addition, loneliness has been found to significantly and directly predict QoL in the respecified model. The model demonstrated that disability acceptance and loneliness have a significant impact on QoL.

Outcome measures for economic evaluations and cost-effectiveness analyses of interventions for people with intellectual disabilities: A methodological systematic review

BACKGROUND

Mainstream economic evaluations methods may not be appropriate to capture the range of effects triggered by interventions for people with intellectual disabilities. In this systematic review, we aimed to identify, assess and synthesise the arguments in the literature on how the effects of interventions for people with intellectual disabilities could be measured in economic evaluations.

METHOD

We searched for studies providing relevant arguments by running multi-database, backward, forward citation and grey literature searches. Following title/abstract and full-text screening, the arguments extracted from the included studies were summarised and qualitatively assessed in a narrative synthesis.

RESULTS

Our final analysis included three studies, with their arguments summarised in different methodological areas.

CONCLUSIONS

Based on the evidence, we suggest the use of techniques more attuned to the population with intellectual disabilities, such sensitive preference-based instruments to collect health states data, and mapping algorithms to obtain utility values.

The (radical) role of belonging in shifting and expanding understandings of social inclusion for people labelled with intellectual and developmental disabilities

There is a gap between the desired outcomes of social inclusion policy and the everyday experiences of people labelled with intellectual and developmental disabilities. Despite belonging rhetorically named in social inclusion policy and practice, belonging is often absent in the lives of people labelled with intellectual and developmental disabilities and remains undertheorised in its relationship to social inclusion. In this paper, we explore the role belonging might play in narrowing the gap between how social inclusion is theorised and how it is experienced. Drawing on critical disability and feminist relational theories, we outline a relational conceptualisation of belonging and use it to 'crip' the construct of social inclusion. Exploring the synergies and tensions that surface when social inclusion and belonging are held together as discrete but interconnected constructs, we name four conceptual shifts and expansions that allow us to see social inclusion differently. Through the centring of the experiences of people labelled with intellectual and developmental disabilities, we explore the ways belonging can help to reimagine inclusion from assimilationist, static, objective and formal towards inclusion as fluid, negotiated, (inter)subjective, (in)formal and intimate.

Determining Factors of Psychosocial Wellbeing Among People With Disabilities During the COVID-19 Pandemic: Mediating Role of Social Support

This study aimed to understand how the COVID-19 pandemic impacted the stress levels and life satisfaction of individuals with disabilities and what role social support plays in mitigating these impacts. Data from individuals with disabilities (n= 600) were extracted from a larger international cross-sectional survey study. Regression analyses were conducted to examine how personal and environmental factors contributed to stress levels and life satisfaction changes during the pandemic. Mediation analyses were used to test whether social support mediated the association between stress level and life satisfaction. The negative impact of the pandemic, having a psychiatric disability, being a female, and being younger significantly predicted stress levels. Moreover, the negative impact of the pandemic and stress levels significantly predicted life satisfaction. The relationship between stress levels and life satisfaction was mediated by social support from significant others and friends. There is an urgent need to provide training and education for healthcare professionals, families, and caregivers on the basic aspects of mental health care, developing time-limited and culturally-sensitive mental health interventions, and strategies for expanding the social support system for the population. Broad dissemination of effective therapeutic strategies is crucial in mitigating the negative psychosocial impact of the pandemic.

An exploration of the consequences of, and coping with loneliness in an ageing intellectual disability population

Background: Loneliness has been associated with increased hypervigilance and sad passivity. The physiological and psychological reactions of people with an intellectual disability to loneliness have never been investigated. Therefore, this research aims to explore the outcomes of loneliness for an ageing intellectual disability population. Methods: In Ireland, data from a nationally representative data set of people aged over 40 years with an intellectual disability (N=317) was applied to a social environment model that describes the effects of loneliness in five pre-disease pathways which are: health behaviours, exposure to stressful life events, coping, health and recuperation. The data was tested through chi-squared, ANCOVA and binary logistic regression. Results: Being lonely predicted raised systolic blood pressure (A.O.R=2.051, p=0.039), sleeping difficulties (AOR=2.526, p=0.002) and confiding in staff (AOR=0.464 p=0.008). Additionally, participants who did 10 to 20 minutes of exercise daily (moderate activity) had significantly higher loneliness scores than those who did not (F=4.171, p<0.05). Conclusions: The analysis supports the concept of hypervigilance in older people with an intellectual disability but finds that the health behaviours of the lonely do not differ from the not lonely. Future research needs to investigate the longitudinal relationships between loneliness and health

Dutch forensic patients with and without intellectual disabilities: A comparison of demographic, offence, and diagnostic characteristics

BACKGROUND

Patients with an intellectual disability (ID) and offending histories constitute a challenging clinical group. The present study examined commonalities and differences in demographic, diagnostic and offence characteristics in patients with and without intellectual disabilities who were either convicted for violent or sexual offences and who resided in mandated care in the Netherlands.

METHOD

We compared 165 offenders with an ID to 249 offenders without an ID. We compared both groups by type of offence (i.e., sexual versus violent offence) using Mann-Whitney U-test or independent samples t-tests for continuous variables and Chi-square tests for categorical variables.

RESULTS

In general, forensic patients with an ID were younger at admission (U=357, z = -12.668, p < .001), had more prior convictions for violent offences (χ²(1)= 6.175, p = .013) and more prevalent diagnoses of substance abuse disorders (χ²(1)= 9.266, p = .002) than those without an ID. Similar results were found for patients with IDs with sexual offence histories.

CONCLUSION

A clear understanding of distinct characteristics of forensic patients with intellectual disabilities is crucial in understanding (sexual) violent behavior in this population as it mayassistclinicians in prioritizing interventionstrategies.

A Distance-Delivered Social Skills Program for Young Adults with Williams Syndrome: Evaluating Feasibility and Preliminary Efficacy

Adults with Williams syndrome (WS) display hypersocial behaviors and experience social skills deficits. To improve social outcomes, we evaluated the feasibility, acceptability, and preliminary efficacy of an 8-week distance-delivered social skills program for adults with WS. Sessions were offered twice a week for 90 min. Twenty-four adults with WS were assigned to an intervention or waitlist control group. Outcomes were assessed through interviews and surveys with adults with WS, parents, and facilitators. The intervention was rated as acceptable and feasible by all. Parents rated adults with WS as displaying significant improvements in social skills; yet ratings by adults with WS did not change. Adults also displayed increased social skills knowledge following participation. Implications for practice and future research are discussed.

Relationships of People with Intellectual Disabilities in Times of Pandemic: An Inclusive Study

(1) Background: Since 2012, our Inclusive Research Team has developed several studies on various topics that interest the co-researchers with intellectual disabilities. In 2021, throughout the COVID-19 pandemic, the co-researchers decided to investigate the impact of the pandemic on the relationships of people with intellectual disabilities. The aim of this article is to disseminate how this inclusive study was developed and to explain its results; (2) Methods: Co-researchers and academic researchers met six times to make different decisions: decide on the research topic; discuss the topic; prepare an interview script for people with intellectual disabilities; analyse the data obtained; and decide how to disseminate the results of the research. The co-researchers interviewed 10 people with intellectual disabilities and participated as facilitators in 3 focus groups; (3) Results: During the pandemic, digital devices have enabled people with intellectual disabilities to maintain their social relationships. However, the lack of access or support in using them, as well as the restrictions imposed on people with intellectual disabilities living in institutions, have presented significant barriers to maintaining their social relationships; (4) Conclusions: This article shows the difficulties people with intellectual disabilities face in maintaining successful social relationships in times of pandemic, and how we undertook research in an inclusive, virtual manner.

The contribution of distress factors and Coping Resources to the motivation to use ICT among adults with intellectual disability during COVID-19

The current study focused on people with intellectual disability (ID), who have unique disadvantages that place them at greater risk for negative outcomes due to COVID-19. The study goals are three-fold: (a) To examine whether differences in distress factors (loneliness and stress) would be found between adults with ID who used the Zoom application, and those who did not use Zoom during the pandemic; (b) To examine whether differences in psychological and coping resources (psychological capital), and practical-technological resources (attitudes and motivation to use information communication technology) would be found between the groups; (c) To examine the contribution of background variables (gender, type of residence, Zoom use), distress factors and psychological and practical technological coping resources on the motivation to use technology. The sample included 35 adults with ID (MCA = 40.06, SD = 11.02). Of these, 57% learned to use the Zoom application during the COVID-19 pandemic (N = 20), and 47% did not (N = 15). Participants answered seven questionnaires examining distress factors and psychological and technological resources. Both groups exhibited distress factors. However, the Zoom users demonstrated higher scores in hope and motivation to use technology. Regression analysis indicated that the resilience and attitudes toward technology among the Zoom users contributed to the explained variance of motivation to use technology. In light of the higher coping resources among Zoom users, we may carefully say that using Zoom might increase the independence of individuals with ID in learning, develop their communications possibilities, and help them to cope better in distress situations.

Personality traits predict attitudes toward individuals with intellectual disability

Background: Explaining individual differences in people's attitudes toward individuals with intellectual disability (ID) is important for increasing social inclusion of people with ID. The aim of the current study was to replicate and extend past research by formulating a single model of attitudes toward individuals with ID with several predictors: personality traits, quality and quantity of contact, perceived knowledge of ID, social desirability, and demographics. Methods: A sample of 221 undergraduate students in the United States completed several surveys in a lab setting: the Mental Retardation Attitude Inventory-Revised, the Big Five Inventory, McManus et al.'s measures of contact with and perceived knowledge of ID, and the Marlowe-Crowne Social Desirability Scale. Results: Results replicated previous findings by showing quality of contact was the strongest predictor of attitudes. Additionally, we found openness to experience and agreeableness remained significant predictors after holding all other variables constant. A follow-up mediation analysis demonstrated that quality of contact mediated the relations from openness and agreeableness to attitudes. Conclusions: Findings suggest personality factors can influence attitudes toward individuals with ID, and further emphasize the importance of quality of contact. Implications for the social inclusion of individuals with ID are discussed.

An exploration of the consequences of, and coping with loneliness in an ageing intellectual disability population

Background: Loneliness has been associated with hypervigilance and sad passivity. The physiological and psychological reactions of people with an intellectual disability to loneliness have never been investigated. This research aims to explore the outcomes of loneliness for an ageing intellectual disability population. Methods: In Ireland, data from a nationally representative data set of people aged over 40 years with an intellectual disability (N=317) was applied to a social environment model that describes the effects of loneliness in five pre-disease pathways health behaviours, exposure to stressful life events, coping, health and recuperation. The data was tested through chi-squared, ANCOVA and binary logistic regression. Results: Being lonely predicted raised systolic blood pressure (A.O.R=2.051, p=0.039), sleeping difficulties (AOR=2.526, p=0.002) and confiding in staff (AOR=0.464 p=0.008). Additionally, participants who did moderate activity had significantly higher loneliness scores (F=4.171, p<0.05). Conclusions: The analysis supports the concept of hypervigilance in older people with an intellectual disability and limited support for the use of coping mechanisms that differ from those found in the wider population. Future research needs to investigate the longitudinal relationships between loneliness and health.

Social Adventure

Social environments can be challenging for people with intellectual disability. These challenges impact a person’s social inclusion and participation in their communities. Social skills development requires training and practice, but training is often time-limited, costly, and hard to access. However, games on smart speakers provide interesting opportunities to improve training access, motivate self-directed learning, and focus on speech. The authors developed an interactive narrative-based social skills training game for smart-speakers. The game facilitates exploration of the social consequences of making various choices in different social situations and uses natural language inputs. Having tested the game with ten adults with intellectual disability, the authors offer designers insights into participant engagement and the game’s audio-only, natural language interface usability. The authors also propose four design considerations to help designers design applications that help people with intellectual disability participate in social activities.

The Feasibility and Effectiveness of a Novel, On-Line Social Skills Intervention for Individuals With Prader-Willi Syndrome

INTRODUCTION

People with neurodevelopmental disabilities, including Prader-Willi syndrome (PWS), are at heightened risk for the negative sequalae of loneliness, including depression and anxiety. While societal factors such as stigma or limited social opportunities contribute to loneliness, so too do deficits in social cognition and social skills. People with PWS have specific difficulties recognizing affect in others, accurately interpreting social interactions, and taking the perspectives of others. These features, combined with hyperphagia, rigidity, and insistence on sameness conspire to impede the abilities of people with PWS to make and sustain friendships and reduce feelings of loneliness.

METHODS

We developed and administered an intervention, Building Our Social Skills (BOSS), that aimed to improve social skill deficits in PWS. The 10-week intervention was administered on-line via Zoom to 51 young people with PWS in the U.S. (M age = 20.8, SD = 6.42). Two clinicians co-led groups of 6-8 participants in 30-min sessions, 3 times per week, and also trained 4 graduate students to co-lead groups with high fidelity. We used a pre-post intervention and 3-month follow-up design, with no control group, and mitigated this design limitation by triangulating across informants and methodologies. Specifically, parents completed the widely used Social Responsiveness Scale (SRS) and Child Behavior Checklist (CBCL), and participants were individually interviewed about their friendships and loneliness. Interview responses were reliably coded by independent raters.

RESULTS

Repeated measure multivariate analyses, with baseline values entered as covariates, revealed significant pre-to post-test improvements in the SRS's social cognition, motivation and communication subscales (p's < 0.001), with large effect sizes ( n p 2 = 0.920, 0.270, and 0.204, respectively). Participant and parental reports of loneliness were correlated with the CBCL's Internalizing domain, specifically the Anxiety/Depressed subdomain. Over time, parents reported getting along better with peers, increased contact with friends, more friends and less loneliness. Participants also reported significantly less loneliness and more friends.

CONCLUSIONS

This mixed method, proof-of-concept study demonstrated the feasibility of delivering an on-line social skills intervention to young people with PWS. As no differences were found between clinician vs. graduate student outcomes, the BOSS curriculum holds considerable promise for wider dissemination and implementation in the PWS community.

Empirically supported psychological treatments: The challenges of comorbid psychiatric and behavioral disorders in people with intellectual disability

This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability (ID) at all stages of their life. We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population, along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems. We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID. The review is structured around the three generations of therapies: Applied behavior analysis (e.g., positive behavior support), cognitive behavioral therapies (e.g., mindfulness-based cognitive therapy), and contextual therapies (e.g., dialectical behavior therapy). We conclude with some recommendations for professional practice in the fields of ID and psychiatry.

Exploring social networks, employment and self-determination outcomes of graduates from a postsecondary program for young adults with an intellectual disability

BACKGROUND: Data on graduates’ development and employment outcomes from postsecondary programs for young adults with an Intellectual Disability (ID) continue to increase and provide information on program efficacy and areas for growth. OBJECTIVE: This study explored the development of graduates’ social networks, employment outcomes, and self-determination a year after graduating from an inclusive postsecondary program. METHODS: The social networks, employment outcomes, and evidence of self-determination in a combined cohort of graduates (n = 6) were analyzed using social network analysis. RESULTS: All graduates except one were employed a year later. Half displayed smaller networks consisting of family members and new work ties. Only two graduates displayed large networks because of opportunities for socialization. In the absence of employment, students also fall back on familiar supports. Most parents were involved in graduates’ employment decisions, thereby curbing graduates’ expression of self-determination. CONCLUSIONS: Family supports are prominent in graduates’ networks and play a crucial role in employment choices. They act as constant protective and social-emotional supports ensuring graduates’ access to benefits and maintenance of well-being. Employment skills valued by employers and further opportunities to develop students’ social networks while in the PSE program needs to be a focus going forward.

Personal Support Networks of Young People with Mild Intellectual Disabilities during the Transition to Adult Life

Social support networks occupy a priority position requiring attention in the processes of social inclusion of people with intellectual disabilities, during their transition to adult life. The objective of the study was to analyze social support from a relational approach through Personal Network Analysis. A total of 41 young people with mild intellectual disabilities participated in the study, in two groups differentiated according to their educational stage, either compulsory secondary education or post-compulsory training. Descriptive and comparative results are presented based on the variables of structure, composition, and functional content in the social support of their personal networks. The results show that both groups have restricted personal networks, made up of members of the family and the educational environment who constitute the main providers of support. When moving towards adult life, the change in social contacts in other educational, geographical, and relational settings may mean a change in the provision of support received in previous life stages. Developing social and educational actions to support these people in the development and maintenance of social relationships is essential to their access to support resources that will affect their social inclusion.

Supporting Remote Survey Data Analysis by Co-researchers with Learning Disabilities through Inclusive and Creative Practices and Data Science Approaches

Through a process of robust co-design, we created a bespoke accessible survey platform to explore the role of co-researchers with learning disabilities (LDs) in research design and analysis. A team of co-researchers used this system to create an online survey to challenge public understanding of LDs [3]. Here, we describe and evaluate the process of remotely co-analyzing the survey data across 30 meetings in a research team consisting of academics and non-academics with diverse abilities amid new COVID-19 lockdown challenges. Based on survey data with >1,500 responses, we first co-analyzed demographics using graphs and art & design approaches. Next, co-researchers co-analyzed the output of machine learning-based structural topic modelling (STM) applied to open-ended text responses. We derived an efficient five-steps STM co-analysis process for creative, inclusive, and critical engagement of data by co-researchers. Co-researchers observed that by trying to understand and impact public opinion, their own perspectives also changed.

Affordability, Feasibility, and Accessibility: Companion Animal Guardians with (Dis)Abilities' Access to Veterinary Medical and Behavioral Services during COVID-19

The research aims to explore COVID-19 health and safety protocol impacts on companion animal guardians living with (dis)abilities relating to veterinary medical and behavioral service access. The COVID-19 global public health crisis has impacted almost all international communities; however, vulnerable and marginalized groups have been disproportionately affected. Within the human-companion animal domain, COVID-19-driven societal impacts (e.g., social, health, and economic) not only boomed with new companion animal guardians, but also negatively influenced guardians' access to veterinary services. Although studies have examined guardian-related COVID-19-specific challenges, there is a paucity of concentration on vulnerable populations, such as persons with disabilities (PWDs). Responding to this research deficit, this study recruited twelve companion animal guardians to participate in semi-structured in-depth interviews, and eight (67%) of the twelve participants self-identified as PWDs. From a PWD perspective, this research reveals three pandemic-triggered primary barriers, preventing PWDs from pursuing veterinary services: (1) service affordability, (2) assistance program feasibility, and (3) veterinary service accessibility. This article argues that PWD-driven approaches could improve existing assistance and support programs to address PWDs' unique requirements, promoting a healthy human-animal bond.

A qualitative study on parents' concerns about adult children with intellectual disabilities amid the COVID-19 pandemic in South Korea

BACKGROUND

This study aimed to understand parents' concerns about their adult child with intellectual disabilities due to the restriction of community-based services amid the COVID-19 pandemic in South Korea.

METHODS

In-depth interviews were conducted face-to-face or by telephone with 19 parents of adult children with intellectual disabilities who had to stop using community-based services.

RESULTS

Participants worried that their adult child was not aware of the seriousness of COVID-19, was more susceptible to the COVID-19 virus, could not recognize self-infection and could have fatal consequences of getting infected with COVID-19. They expected challenges in their adult child's life (losing a daily routine, being isolated, regression in skills, becoming bored, lacking physical activities and increased behavioural challenges) but also experienced adjustments and hopes.

CONCLUSION

The study demonstrated parents' worry about their adult child becoming infected with COVID-19, highlighting the urgent need for community-based services to address psychosocial challenges during the pandemic.

Remote Support for Adults with Intellectual Disability During COVID-19: From a Caregiver's Perspective

The reality of people with ID changed during the pandemic COVID‐19. Most institutions supporting people with ID switched to remote work. This required some major adaptation to these individuals' new realities, their immediate families, and facility staff. Supporting and monitoring the quality of life of individuals with disabilities and their family members during a crisis is an essential topic of current research. This research project aimed to explore the experiences of parents of adults with ID in relation to remote support provided by public support agencies. In a qualitative study, the authors used semistructured individual interviews with caregivers of people with ID. Data analysis distinguished the following categories: parents as therapists, organization difficulties, material problems, lack of social contacts, positive solutions, and difficult behavior. The results show the difficulties of parents in balancing professional, domestic, and supporting tasks. The study was the first in Poland to report on the qualitative assessment of remote support for people with ID during COVID‐19. Further, more extensive research is needed to search for solutions that respect the rights of people with disabilities to professional support.

A qualitative exploration of stigma experience and inclusion among adults with mild to moderate intellectual disability in an Indonesian context

BACKGROUND

People with intellectual disability are among the most stigmatised groups in society. There is a paucity of studies reporting on how stigma is experienced in low- and middle-income countries. This study aims to explore the experience of stigma among adults with mild/moderate intellectual disability and the extent of their inclusion in Indonesian society.

METHOD

Fifteen adults with mild/moderate intellectual disability were purposively recruited from three service providers and were interviewed using a semi-structured interview schedule. The data were analysed using thematic analysis.

RESULTS

The findings suggest that adults with intellectual disability experience stigma in multiple settings (family, school, community), have limited access to social activities, and internalised the experienced stigma.

CONCLUSION

This study adds to the international understanding of stigma experienced by adults with mild/moderate intellectual disability in daily life and their inclusion in society in a middle-income country.

Assessing the quality of support and discovering sources of resilience during COVID-19 measures in people with intellectual disabilities by professional carers

BACKGROUND

During COVID-19 measures face-to-face contact is limited and professional carers have to find other ways to support people with intellectual disabilities. COVID-19 measures can increase stress in people with intellectual disabilities, although some people may adapt to or grow from these uncertain situations. Resilience is the process of effectively negotiating, adapting to, or managing significant sources of stress and trauma. The current study aims to provide professional carers with new insights into how they can support people with intellectual disabilities.

METHOD

An online survey was shared through the social media and organizational newsletters of MEE ZHN (a non-governmental organization for people with disabilities). The resilience framework by Ungar (2019) was adapted to fit to people with intellectual disabilities during COVID-19 measures. Statistical analyses were performed in SPSS statistics version 26.

RESULTS

Results show that professional carers applied diverse and distal methods to maintain contact with people with intellectual disabilities during the COVID-19 measures. Professional carers reported a significant decrease in the quality of contact with clients with intellectual disabilities, but overall high levels of resilience in the same clients.

IMPLICATIONS

Online methods of communication are possibly insufficient for professionals to cover all needs of people with intellectual disabilities. During this pandemic professionals should be aware of stress but also of resilience in people with intellectual disabilities.

Worry about debt is related to social loneliness in older adults in the Netherlands

The amount of financial debt held by older adults has grown substantially over the past two decades in Europe. This study examines the association of objective and subjective debt burden with social and emotional loneliness among 1,606 older adults in the Netherlands. Objective debt burden is based on financial terms, such as debt-to-income ratio; whereas subjective debt burden measures the psychological distress caused by financial debt. Data are from the 2015/2016 wave of the Longitudinal Aging Study Amsterdam. First, we use means-comparison tests to examine whether older adults who experience social and emotional loneliness differ from older adults who do not experience loneliness regarding their subjective and objective debt burdens. Subsequently, using linear regression models we address two questions: whether social loneliness and emotional loneliness are associated with objective and subjective debt burden; and whether social participation, social network size, anxiety and depression mediate these relationships. We find that subjective debt burden (i.e. the worry related to debt) is a significant predictor of social loneliness, above and beyond the role of social and psychological measures. Objective debt burden, in contrast, is unrelated to social and emotional loneliness. Social participation, social network size, anxiety and depression do not mediate the debt-burden-to-loneliness relationships. The results point to the importance of subjective debt burden in understanding social loneliness and designing interventions.

The intellectual ableism of leisure research: Original considerations towards understanding well-being with and for people with intellectual disabilities

People with intellectual disabilities (IDs) are considered to be one of the most marginalized, isolated and disenfranchised groups in society. However, recent social prescription intervention programmes are being introduced to enhance the physical and mental well-being of these individuals through participation in leisure activities, thus increasing academic interest in research within the area. This article introduces the theoretical and methodological tensions in applying mainstream scholarly thinking of leisure and well-being to people with IDs and argues that by failing to acknowledge and address such tensions scholars are at risk of demonstrating intellectual ableism. Layering Kleiber's components of leisure over Seligman's Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment concept of well-being, this article poses critical questions of how each contributing element of well-being could be reconceptualized for people with neurological diversities. The intersection of leisure, well-being and ID is ripe for research development; however, many studies in the domain are falling short of suitable theoretical discussion and methodological rigour. This article concludes with suggestions on how scholars can reduce intellectual ableism through inclusive design, methodological reporting, acknowledging bias and grappling theoretical dissonance.

'I was scared at first, but not anymore': interpersonal contact and attitudes toward people with intellectual and developmental disabilities among Korean American adolescents and young adults

The purpose of this qualitative study is to explore experiences of naturalistic interpersonal contact with persons with intellectual and developmental disabilities (IDD) and attitudes toward persons with IDD among Korean American adolescents and young adults. In interviews with 12 Korean American high school and college students, Korean American participants reported six common themes regarding their experiences of interpersonal contact with persons with IDD: 1) affective attitude, 2) behavioral attitude, 3) cognitive attitude, 4) communication with persons with IDD, 5) moments of having a positive attitude, and 6) comparisons of attitudes in the United States and Korea. Recommendations for research and practical implications are discussed.

'I feel valued': the experience of social networking site engagement among people with intellectual and developmental disabilities in South Korea

Previous studies have shown that participation in social networking sites (SNSs) enhances users' knowledge, social capital, and quality of life. However, people with intellectual developmental disabilities (PIDD) do not use SNSs to the same extent as the general population does. This study aimed to explore the experiences of those PIDD in South Korea who use social media. Data were collected through face-to-face interviews with 20 PIDD. The study participants reported benefits associated with the use of SNSs, which included enhanced social capital, self-confidence, and positive self-image. Participants also used SNSs to maintain friendships, initiate new relationships, and engage in self and community advocacy. Safety concerns were also reported by the participants. The study concluded that SNSs can be used as tools for promoting community inclusion and developing social capital for PIDD. However, the outcomes of using SNSs depend on the availability of support provided by one's network. The absence of support may result in frustration and even exploitation. With effective support, SNSs become powerful tools that can be used by PIDD to combat social isolation through creating ample opportunities for social inclusion.

Building a research team and selecting a research topic within the process of an inclusive research project in Spain

BACKGROUND

In this paper, we illustrate the extent to which building an inclusive research team and the selection of a research topic, based on a collaborative group approach, constitute key elements of inclusive research.

METHOD

The selection and analysis of activities and methodological strategies, extracted from the recordings of the research meetings, offer clues about the creation of collaborative and deliberative research spaces.

RESULTS

Some of the elements that reaffirm the inclusive nature of this research are as follows: contributions by all members of the research team receive equal recognition, the particular interests of all of those involved are taken into account and research strategies that are supported in different languages encourage the participation of all researchers.

CONCLUSIONS

We need to review our practices in order to identify the added value of this type of work and move towards research training proposals that promote the research ownership of people with intellectual disabilities.

Communication Support Needs in Adults with Intellectual Disabilities and Its Relation to Quality of Life

Research suggests that individuals with intellectual disabilities (ID) experience difficulties in communication, ranging from intelligibility issues to more severe problems in the use and comprehension of spoken, written or sign language. Despite the negative effects that the inability to communicate have on quality of life (QoL), not much research has explored the relationship between communicative competence and QoL in the adult population with ID. The aim of this study was to describe the global communication profile of a sample of 281 adults with ID recruited from Grupo AMÁS Social Foundation, who differed in their level of communication support needs (CSN). The relationships between communicative competence and CSN with QoL were further examined. The results showed lower QoL indices for those participants characterized by their limited use of discourse and inability to exhibit certain communicative purposes, with the largest differences in the dimensions of self-determination, social inclusion, interpersonal relationships, emotional wellbeing and personal development. Overall, low levels of QoL were found for all participants, with even lower scores for the group identified as having CSN. A multiple regression model revealed that having speech/discourse competence is a powerful predictor of QoL, along with the level of disability and having the communicative competences to express likes and preferences or to establish new relationships. This clear relationship between communication and QoL is an important argument for disability support services when it comes to setting communication supports as a priority and as an important preventive step towards the protection of those at risk of exclusion.

"We have been magnified for years - Now you are under the microscope!": Co-researchers with Learning Disabilities Created an Online Survey to Challenge Public Understanding of Learning Disabilities

Public attitudes towards learning disabilities (LDs) are generally reported as positive, inclusive and empathetic. However, these findings do not reflect the lived experiences of people with LDs. To shed light on this disparity, a team of co-researchers with LDs created the first online survey to challenge public understanding of LDs, asking questions in ways that are important to them and represent how they see themselves. Here, we describe and evaluate the process of creating an accessible survey platform and an online survey in a research team consisting of academic and non-academic professionals with and without LDs or autism. Through this inclusive research process, the co-designed survey met the expectations of the co-researchers and was well-received by the initial survey respondents. We reflect on the co-researchers' perspectives following the study completion, and consider the difficulties and advantages we encountered deploying such approaches and their potential implications on future survey data analysis.

Loneliness in young adults with a visual impairment: Links with perceived social support in a twenty-year longitudinal study

BACKGROUND

Young people with disabilities are more at risk of experiencing loneliness in later life than their typically developing peers.

AIM

To identify those who become lonely in later life, trajectories of perceived parent and peer support from adolescence to adulthood of young people with a visual impairment were studied.

METHODS

A total of 316 adolescents (M = 18 years; SD = 6.5) enrolled in a cohort study in 1996; 205 of them participated in 2005, 178 in 2010, and 161 in 2016. Latent growth curve models were fitted to the data.

RESULTS

Perceived parent support followed a linear decreasing course. No association was found between perceived parent support and loneliness in later life. For perceived peer support a quadratic growth pattern was found, with an increase in peer support up to age 27, and thereafter a decrease. Both the initial level and the rate of change in perceived peer support significantly predicted loneliness in adulthood.

CONCLUSIONS

The course of peer support is a better indicator for the risk of loneliness in later life than support from parents. Normative life transitions may affect the already vulnerable social support for young people with a visual impairment. This study highlights the importance of establishing and maintaining peer relationships throughout life.

Resilience in the face of adversity in adults with an intellectual disability: A literature review

Background

Persons with an intellectual disability are at a higher risk of experiencing adversities. The concept of resilience offers promising insights into facilitating personal growth after adversity. The current study aims at providing an overview of the current research on resilience and the way this can contribute to quality of life in people with intellectual disability.

Method

A literature review was conducted in the databases PsycINFO and Web of Science. To evaluate the quality of the studies, the Mixed Method Appraisal Tool (MMAT) was used.

Results

The themes, autonomy, self‐acceptance and physical health, were identified as internal sources of resilience. External sources of resilience can be found within the social network and daily activities.

Conclusion

The current overview shows promising results to address resilience in adults with intellectual disability. More research is needed to identify the full range of resiliency factors.

An Examination of Social Skills, Friendship Quality, and Loneliness for Adults with Williams Syndrome

Individuals with Williams Syndrome (WS) are hypersocial, overfriendly, and experience social skills deficits that may adversely impact their social outcomes. This study examined the relation between social skills, friendship quality, and feelings of loneliness for adults with WS as reported by 114 parent-adult with WS dyads. Results indicate that although most friends do not live close-by, adults with WS have good quality friendships and do not report high feelings of loneliness. Positive friendship qualities were found to partially mediate the relationship between social skills impairments and social feelings of loneliness. Findings indicate that although adults with WS experience social skills deficits and struggle to maintain friendships in their immediate community, they still report positive friendship qualities and low feelings of loneliness.