Active Support Training, Staff Assistance, and Engagement of Individuals With Intellectual and Developmental Disabilities in the United States: Randomized Controlled Trial

Active Support Measure: a multilevel exploratory factor analysis

BACKGROUND

Active Support is a person-centred practice that enables people with intellectual disabilities (IDs) to engage in meaningful activities and social interactions. The Active Support Measure (ASM) is an observational tool designed to measure the quality of support that people with IDs living in supported accommodation services receive from staff. The aim of the study was to explore the underlying constructs of the ASM.

METHODS

Multilevel exploratory factor analysis was conducted on ASM data (n = 884 people with IDs across 236 accommodation services) collected during a longitudinal study of Active Support in Australian accommodation services.

RESULTS

Multilevel exploratory factor analysis indicated that 12 of the ASM's 15 items loaded on two factors, named Supporting Engagement in Activities and Interacting with the Person.

CONCLUSIONS

The 12-item ASM measures two dimensions of the quality of staff support. Both technical and interpersonal skills comprise good Active Support.

Leadership in intellectual disability practice: design, development, and evaluation of a programme to support practice

BACKGROUND

Intellectual disability services have and continue to experience changes in service provision. This has an implication for leadership in practice as the quality of leadership has a direct influence on staff practice and care provided.

AIM

To design, deliver, and evaluate a leadership programme for nurse and social care managers in Ireland.

DESIGN

An accredited programme was designed based on evidence from literature, practice, and national expertise. A cross-sectional survey was used to collect information on the attitudes and behaviour of participants before commencing and after completing the programme. Data from the questionnaires were analysed using SPSS and open-ended questions were analysed using content analysis.

SETTING

Intellectual disability services.

PARTICIPANTS

102 participants completed the programme and survey.

METHODS

Pre-post survey and reported using the CROSS guidelines.

RESULTS

Participants' expectations were rated highly, and all items scored higher in the post-survey. Qualitative data was overall positive regarding opportunities for more time to work through each aspect of the programme. The key learning was through the forum day where participants shared their group projects.

CONCLUSIONS

Overall, the programme was positively evaluated and through engaging with the programme participants' perceptions moved from seeing leadership as mostly task-oriented to realising that qualities such as good communication, person-centredness, advocacy, supporting, role modelling, and empowering are key to leadership.

A model for fostering community capacity to support adults with intellectual disabilities who engage in challenging behaviour: A scoping review

Developmental support agencies support many adults with intellectual disabilities in the community. Unfortunately, these adults often exhibit high rates of challenging behaviour, which present significant pressures on these service providers. Agencies need to develop effective means of increasing their capacity to provide quality support. Previous systematic reviews found that training staff in positive behaviour supports can improve outcomes; however, the factors facilitating training's effects, long-term effectiveness, and outcomes for service users have yet to be determined. We conducted a scoping review of 98 journal articles and book chapters to develop a model for fostering capacity development drawing from Organizational Behaviour Management and Knowledge Translation theories. Some relevant factors include features of the inner and outer organizational contexts, training approaches (e.g., behavioural skills training & in-situ coaching), ongoing support and feedback. This model may lead to more effective and enduring treatment programs and improved support for adults with intellectual disabilities.

The Quality of Life Supports Model as a Vehicle for Implementing Rights

The Quality of Life Supports Model (QOLSM) is emerging as a new framework that is applicable to people with disabilities in general, but specially to people with intellectual and developmental disabilities (IDD). The aim of this conceptual paper is twofold. Firstly, it aims to show the overlap between the QOLSM and the Convention on the Rights of People with Disabilities (CRPD), highlighting how the former can be used to address many of the goals and rights embedded in the latter. Secondly, the article seeks to illustrate the connection between these two frameworks and highlight the importance of acknowledging and measuring the rights of people with IDD. Therefore, we posit that the new #Rights4MeToo scale is ideal for: (a) providing accessible means and opportunities for people with IDD to identify and communicate their needs regarding their rights; (b) enhancing the supports and services that families and professionals provide to them; and (c) guiding organizations and policies to identify strengths and needs in relation to rights and quality of life. We also discuss future research needs and summarize the main findings of this article, highlighting its implications for practice and research.

Measuring Four Personal Opportunities for Adults With Intellectual and Developmental Disabilities

This study tests an empirically derived model for measuring personal opportunities for people with intellectual and developmental disabilities (IDD) using National Core Indicators In-Person Survey (NCI-IPS) state and national datasets. The four personal opportunities measured, (a) privacy rights, (b) everyday choice, (c) community participation, and (d) expanded friendships, were informed by existing conceptualizations of service as well as NCI-IPS measures. Analyses confirmed the fit of a four-factor model and demonstrated that factors were significantly and positively correlated. To demonstrate the relationships between personal opportunities and personal and environmental characteristics, we estimated a structural equation model that regressed personal opportunities on age, gender, place of residence, and level of intellectual disability. Implications for using personal opportunities for evaluating service quality of IDD systems are discussed.

A quality of life supports model: Six research-focused steps to evaluate the model and enhance research practices in the field of IDD

In the field of intellectual and developmental disabilities (IDD) the constructs of quality of life and supports have been combined into a Quality of Life Supports Model (QOLSM) that is currently used internationally for supports provision, organization transformation, and systems change. With the model's increasing and widespan use in research and practice, there is a need to evaluate the model's impact at the individual, organization, and systems levels. The purpose of this article is to outline six specific research-focused evaluation steps that allow researchers to evaluate the model and thereby enhance research practices is the field of IDD. These steps involve: (1) operationalizing components of the QOLSM; (2) relating QOLSM components to the type of research planned and intended outcome indicators; (3) gathering evidence and establishing its credibility; (4) interpreting and communicating the results; (5) implementing research outcomes at the level of the microsystem, mesosystem and macrosystem; and (6) judging the impact of the model. These steps delineate a research framework that is based on a systematic approach to evidence-based practices and enhanced research practices in the field of IDD.

Ongoing Transformation in the Field of Intellectual and Developmental Disabilities: Taking Action for Future Progress

There has been a significant transformation in the field of intellectual and developmental disabilities (IDD) over the last 5 decades. Although this transformation has profoundly influenced multiple stakeholders, the field is currently at a critical juncture and facing a number of social and political challenges. Given the relevance of the question, "where is the field of IDD and where do we go," the present article describes the field's transformation, and suggests future action steps to facilitate and sustain the transformation. The seven action steps discussed in the article relate to using precise terminology, incorporating a functional and holistic approach to IDD, embracing the supports model and evidence-based practices, implementing outcome evaluation, empowering individuals and families, understanding better the multidimensional properties of context, and incorporating an explicit notion of professional responsibility.

El modelo de calidad de vida y apoyos: la unión tras veinticinco años de caminos paralelos

El artículo presenta la integración operativa de los paradigmas de calidad de vida y apoyos en un modelo conjunto denominado Modelo de Calidad de Vida y Apoyos (MOCA) que integra características significativas de la transformación actual en el campo de las discapacidades intelectuales y del desarrollo. Estas características abarcan un enfoque holístico e integrado, centrado en los derechos humanos y legales, que sirve de base para tomar las decisiones sobre servicios y apoyos en las limitaciones significativas de las principales áreas de actividad de la vida, con un énfasis en los apoyos individualizados proporcionados dentro de ambientes inclusivos de la comunidad y que promueva la evaluación de resultados. Los contenidos de este artículo incluyen: (a) los cuatro elementos del MOCA: valores fundamentales, dimensiones de calidad de vida individual y familiar, sistemas de apoyo y condiciones facilitadoras; (b) cómo se puede utilizar el MOCA como marco para la provisión de apoyos, la evaluación de resultados centrada en la persona, la transformación de la organización y el cambio de sistemas; y (c) cómo el MOCA es esencial para el cambio de paradigma actual en el campo de las discapacidades intelectuales y del desarrollo.