COVID ‐19: Evolving challenges and opportunities for residential and vocational intellectual disability service providers

Trauma-informed climate scale-10 and attitudes related to trauma-informed care-10: An examination of scale psychometrics using data from disability service providers

BACKGROUND

Assessment is fundamental to the implementation of trauma-informed care. As trauma-informed care advances among organizations supporting people with intellectual and developmental disabilities (IDD), it is critical that they have access to validated assessment tools.

OBJECTIVE

This is the first study to examine the psychometric properties of two brief measures associated with trauma-informed care, Trauma-Informed Climate Scale (TICS-10) and Attitudes Related to Trauma-Informed Care (ARTIC-10), using data from the IDD service industry.

METHODS

We employed structural equation modeling to examine the factor structure, reliability of TICS-10 and ARTIC-10, and construct validity with the ProQOL using secondary data from 374 service providers.

RESULTS

We confirmed the factorial validity of TICS-10 and ARTIC-10 with single factor solutions; however, modifications were necessary to achieve adequate model fit.

CONCLUSIONS

The current study provides initial evidence of the validity and reliability of TICS-10 and ARTIC-10 when used within organizations supporting people with IDD. Recommendations for subsequent improvements and future research of the scales are provided.

Quality of life, satisfaction with care, and the experiences of adults with intellectual and developmental disabilities before and during COVID-19

BACKGROUND

Adults with intellectual and developmental disabilities (IDD) experienced significant disruptions in their access to health care, support services, and essential daily activities such as work, leisure, and routine daily care during COVID-19.

OBJECTIVE

The purpose of this study was to describe overall experiences related to COVID-19 among adults with IDD, including the vaccination process, quality of life (QoL), and service satisfaction before and during the pandemic.

METHODS

A longitudinal statewide survey of adults with IDD receiving long-term care support using a combination of self- and care partner report was completed prior to (2017; n = 331) and during (2021; n = 206) the pandemic.

RESULTS

Qualitative results identified specific vaccine barriers, vaccine decision influencers, and general experiences during COVID-19 for adults with IDD. The importance of support staff, vaccine availability, disruption in daily activities, social context, and mental health implications were noted in responses to all three topics. Quantitative results showed lower QoL during COVID-19 (M = 2.99 vs. 3.14, p = .028); however, when reporter (self vs. care partner) and age were added to the model, differences between pre-vs. during-COVID were no longer significant. No significant differences in satisfaction of services were noted pre-vs. during-COVID-19. Ninety-six percent of respondents reported access to the vaccine, and 16 % experienced barriers getting the vaccine. QoL was associated with receiving the COVID-19 vaccine (r = 0.15, p = .036), level of agreement that the vaccine is safe (r = 0.17, p = .024), and level of agreement that getting the vaccine will help protect other vulnerable people in the community (r = .25, p = .001). Level of satisfaction with quality of services was also associated with level of agreement that the vaccine is safe (r = 0.15, p = .048).

CONCLUSIONS

Overall, a better understanding of service continuation, support practices, and experiences related to COVID-19 will prepare us for future environmental and health crises by identifying areas for improvement, intervention, and policy change to meet the ongoing needs of adults with IDD.

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.

Incoming professionals' perspectives on the application of new knowledge in care organisations for people with intellectual disabilities: a concept mapping study

Objectives

Within care organisations for people with intellectual disabilities, numerous strategies are employed to stimulate the application of new knowledge, and professionals play a key role in this process. Consequently, gaining insight into professionals' perspectives on how to encourage the application of new knowledge is vital, especially in the case of incoming professionals. They have a stronger need for new knowledge due to having acquired only a limited knowledge base about intellectual disabilities in their education. Therefore, this study focused on the incoming professionals' perspectives on factors stimulating application of new knowledge within the care and support for people with intellectual disabilities.

Methods

A concept mapping study was conducted with incoming support staff, psychologists, and intellectual disabilities physicians. Data collection included brainstorming, pile sorting and rating to create three concept maps, which were interpreted by experts.

Results

Overall, the participants generated 234 statements. Incoming support staff primarily expressed their preference for experiential and work-based learning and described their role as being knowledge receivers. Incoming psychologists and physicians expressed their ownership of knowledge in requesting opportunities to develop themselves.

Conclusion

To enhance incoming professionals' application of new knowledge, care organisations for people with intellectual disabilities can encourage professionals in manifold ways, ranging from providing (in)formal learning opportunities and accessible sites to creating a learning culture.

Advancing trauma-informed care in intellectual and developmental disability services: A pilot study of a digital training with direct service providers

BACKGROUND

As trauma-informed care advances in the service delivery system for people with intellectual and developmental disabilities, additional resources are needed to foster staff development. This article describes the development and pilot evaluation of a digital training on trauma-informed care among direct service providers (DSPs) in the disability service industry.

METHOD

Following an AB design, a mixed methods approach was used to analyse the responses of 24 DSPs to an online survey at baseline and at follow-up.

RESULTS

The training was associated with increased staff knowledge in some domains and greater alignment with trauma-informed care. Staff expressed a strong likelihood of using trauma-informed care in practice and identified organisational assets and barriers to implementation.

CONCLUSIONS

Digital trainings can facilitate staff development and the advancement of trauma-informed care. Although additional efforts are warranted, this study fills a gap in the literature regarding staff training and trauma-informed care.

Resilience, and positive parenting in parents of children with syndromic autism and intellectual disability. Evidence from the impact of the COVID-19 pandemic on family's quality of life and parent-child relationships

Family quality of life (FQoL) outcomes collected during the first year of COVID-19 has been combined with 2018 data to estimate the outbreak's impact on parental outcomes on a sample of 230 families with syndromic autistic children and those with intellectual disabilities (IDs). Despite challenges imposed by the COVID-19 outbreak, our study found that FQoL outcomes reported by participating parents during the first year of COVID-19 appears to be similar to ratings from a prepandemic study of families with the same conditions. Parents of children in our sample generally displayed a stable functioning trajectory as measured by the validated FQoL instrument. Across syndromic autistic groups considered, families reported that their relationships with their children were positive. Our findings provide evidence of families' resilience which might explain the presence of positive parent-child interactions during COVID-19. Exploring mechanisms which would explain how families with autistic and ID children confront, manage disruptive experiences, and buffer COVID-19 induced stress is a fruitful direction for future research.

The challenges of mental health of staff working with people with intellectual disabilities during COVID-19--A systematic review

BACKGROUND

The COVID-19 pandemic has posed a great risk to the mental health of health workers (HWs). There are likely to be particular concerns for staff working with adults with an intellectual disability, where infection control may be more challenging.

METHOD

We conducted a systematic review of original research examining the mental health of HWs working with people with intellectual disability, published between March 2020 and July 2021.

RESULTS

Five original research studies were included. A high proportion of HWs working with people with intellectual disability reported having had poor mental health including stress, anxiety, and depression. This manifested in similar patterns as for other HWs and also some specific patterns seen as the need to manage increased rates of mental health issues of the people they support. Sources of support and resilience were also identified.

CONCLUSION

The support system should target risk factors, answer unmet needs, and build resilience. More research is also required on the ongoing and long-term effects.