Mid-life social participation in people with intellectual disability: The 1958 British birth cohort study

BACKGROUND

Low social participation is a potentially modifiable risk factor for cognitive deterioration in the general population and related to lower quality of life (QoL). We aimed to find out whether social participation is linked to cognitive deterioration and QoL for people with borderline intellectual functioning and mild intellectual disability.

METHOD

We used data from the National Child Development Study, consisting of people born during one week in 1958, to compare midlife social participation in people with mild intellectual disability, borderline intellectual functioning, and without intellectual impairment. We defined social participation as 1. confiding/emotional support from the closest person and social network contact frequency at age 44, and 2. confiding relationships with anyone at age 50. We then assessed the extent to which social participation mediated the association between childhood intellectual functioning and cognition and QoL at age 50.

RESULTS

14,094 participants completed cognitive tests at age 11. People with borderline intellectual functioning and mild intellectual disability had more social contact with relatives and confiding/emotional support from their closest person, but fewer social contacts with friends and confiding relationships with anyone than those without intellectual disability. Having a confiding relationship partially mediated the association at age 50 between IQ and cognition (6.4%) and QoL (27.4%) for people with borderline intellectual functioning.

CONCLUSION

We found adults with intellectual disability have positive family relationships but fewer other relationships. Even at the age of 50, confiding relationships may protect cognition for people with borderline intellectual functioning and are important for QoL.

Units of Analysis of Social Interaction Outcomes in Supported Education

In spite of increased advocacy efforts, demonstrations, and consumer demand for supported education, there is a paucity of empirical research that investigates the predicted outcomes of this model. The rationale for supported education is based largely on increasing social participation, acceptance, and friendships between students with severe disabilities and nondisabled students. This article discusses several issues that underlie the development of measurement systems to evaluate the social effects of supported education. We believe that it is essential to measure the outcomes of supported education (i.e., increased acceptance, social participation, and levels of friendships) as well as the process variables (e.g., specific social interaction skills) that are pivotal in creating the outcomes. An assessment model for outcome and process variables is described. Within this model, social interaction skills, organizational support characteristics, and contextual features are viewed as pivotal events in attaining valued outcomes.

The Social Networks and Activity Patterns of Adults with Severe Disabilities: A Correlational Analysis

This article reports information on the interrelations among measures of lifestyle quality for 20 adults with severe disabilities living in the community. Using two interview-based measures, data were collected on the social networks and activity patterns of the participants. The results indicate that the overall size of the social networks and the number of family members were highly associated with a greater frequency and variety of activities across home and community settings. The results also indicate that neither the number of social network members paid to provide support, nor the number of friends were significantly related to activity patterns. Finally, implications for measuring lifestyle quality and the use of outcome-based measures for assisting people to build and maintain social relationships are presented.

Measuring the Activity Patterns of Adults with Severe Disabilities Using the Resident Lifestyle Inventory

Outcome measures that document activity patterns provide an empirical basis for improving the lifestyles of adults with severe disabilities. This report provides a psychometric assessment of an instrument, the Resident Lifestyle Inventory (RLI), that can be used to measure the activities performed by such persons. In a series of three assessments the congruent validity (Assessment 1), test-retest reliability (Assessment 2), and social validity (Assessment 3) of the RLI were analyzed to determine its acceptability as a measurement instrument for documenting activity patterns. Results from the three assessments demonstrated that the RLI is a psychometrically acceptable measure that is used accurately by residential programs. It is perceived by support staff to be a useful strategy for improving lifestyle quality. Implications of this report are provided for the role of outcome measures in community-based residential support, the individualized plan development process, and future research.

Some Effects of Regular Class Participation on the Social Contacts and Social Networks of High School Students with Severe Disabilities

We studied the effects of participating in regular education classes on the social life of three high school students with severe disabilities. Using a multiple baseline design across students (with an embedded ABAB withdrawal design), participants' social contacts and social networks were analyzed. Data were collected throughout the school day across 1 school year. Regular class participation, the independent variable, was introduced within a baseline focusing upon a community-based curriculum including access to peers without disabilities via peer tutoring and “friendship” programs. Our results indicate that regular class participation: (a) increased the frequency of social contacts students had with peers without disabilities, (b) was the locus for meeting half of the peers without disabilities contacted across the school year, and (c) was an important source for meeting peers without disabilities who subsequently became members of students' social networks. In addition, our results showed that: (a) durable and frequent social contacts also occurred with peers without disabilities met outside of regular education classes, (b) the amount of contact with peers extending outside of regular classes varied across students, and (c) the perceived quality of social contacts did not vary systematically with the locus of initial contact. The results are discussed in relation to possible outcomes relating to regular class participation at the secondary level and areas for future research.

Using a Social Guide to Improve Social Relationships of People with Severe Disabilities

Staff members of community-based residential programs serving individuals with intellectual disabilities often have difficulty helping participants develop social relationships with community members. A “social guide model” taught staff of an apartment-based residential program to use a set of “community network strategies” to improve the social relationships of three women with disabilities. Results demonstrated a functional relationship between staff members' use of the strategies under the supervision of the social guide model and increases in the size of participants' social networks and the frequency with which they experienced social integration. The intervention also was associated with a higher weekly rate of introduction of new network members and a higher rate of socially integrated activities per network member per week. Gains generally were maintained during a follow-up period, with a regular staff member assuming the role of social guide.

Placement along the Continuum of Services and its Impact on Students' Social Relationships

To better understand the conditions facilitating social relationships, we studied the impact of educational placement on the social life of students with severe disabilities. Several indicator variables were used to assess students' social relationships, including measures of social contacts, social support behaviors, and friendship networks. Placement at two points along the continuum of services—general education and self-contained classrooms—constituted the independent variables under study. Two matched groups of students with severe disabilities, one from each placement type, served as participants. The results from direct observation and interviews indicated that: (a) students placed in general education had higher levels of social contact with peers without disabilities; (b) students in general education received higher levels of social support from others, as well as provided higher levels of social support; and (c) those students had substantially larger friendship networks composed primarily of peers without disabilities. Implications regarding the impact of the continuum of services on students' social lives are discussed, along with general issues relating to the development and maintenance of social relationships.

Compatibility of person-centered planning and applied behavior analysis

In response to Osborne (1999), the aims and practices of person-centered planning (PCP) are compared to the basic principles of applied behavior analysis set forth by Baer, Wolf, and Risley (1968, 1987). The principal goal of PCP is social integration of people with disabilities; it qualifies as a socially important behavior, and its problems have been displayed sufficiently. However, social integration is a complex social problem whose solution requires access to system contingencies that influence lifestyles. Nearly all of the component goals of PCP proposed by O'Brien (1987b) have been reliably quantified, although concurrent measurement of outcomes such as friendship, autonomy, and respect presents a formidable challenge. Behavioral principles such as contingency and contextual control are operative within PCP, but problems in achieving reliable implementation appear to impede an experimental analysis.

Social support and intellectual disabilities: a comparison between social networks of adults with intellectual disability and those with physical disability

BACKGROUND

Social support has been identified as a major protective factor in preventing mental health problems and also as a major contributor to quality of life. People with intellectual disabilities (ID) have been identified as having limited social support structures. Interventions have been focused on promoting their social presence and integration. However, previous studies have shown that this does not always lead to the formation of social relationships. To date few studies have looked at how having an ID leads to impoverished social networks. This study aimed to do this by contrasting the social relationships of people with physical disabilities (PD) and people with ID.

METHODS

Two groups of participants were recruited; 30 people with mild ID and 17 people with PD. Social and functional support networks were assessed, in addition to life experiences. Between and within group differences were then explored statistically.

RESULTS

Adults with ID had more restricted social networks than PD, despite being involved in more activities. Social support for adults with ID was mainly provided by family and carers and few relationships with non-disabled people were identified. In contrast adults with PD had larger social networks than had been reported in the mainstream literature and had a balance of relationships with disabled and non-disabled people.

CONCLUSIONS

The results suggest that there are additional processes attached to having an ID, which lead to continued impoverished lifestyles. The findings also endorse other work that suggests being physically integrated and engaged in a wide range of activities does not guarantee good social and emotional support.

Community integration of young adults with mental retardation: a multivariate analysis of adjustment

The purpose of the present study was to determine whether differences in community adjustment existed for three groups of young adults with mental retardation using data organized on the basis of four empirically validated factors identified in prior research. A descriptive discriminant function analysis was used as a follow-up to a statistically significant multivariate analysis of variance F-ratio. Results obtained from the discriminant analysis indicated that five variables (number of limiting factors, earned income, number of support services, living arrangement, number of daytime activities) contributed substantively to separation of the three group centroids.