Transition satisfaction and family well being among parents of young adults with severe intellectual disability

Educational inclusion and satisfaction of families of students with intellectual disabilities: a bibliometric study

This bibliometric study scrutinizes the corpus of scientific output within the Web of Science pertaining to familial satisfaction among parents raising children with intellectual disabilities, focusing specifically on the milieu of educational inclusion. The analysis discerns a discernible ascension in scholarly interest in this domain, encapsulating 77 papers emanating from 75 journals, incorporating an aggregate of 3,497 cited references. Our investigation delineated 354 researchers across 39 nations, underscoring the transnational purview of this scholarly endeavor. The United States emerged as the pre-eminent contributor, with Canada and the United Kingdom following suit. Collaboration on an international scale was notably led by the US, with the UK and Australia trailing in tandem. Prominent institutions were identified for their scholarly output; the University of Kansas led with four papers, followed closely by Monash University, University of California Los Angeles, and University of California Riverside, each contributing three papers. Of particular note, the University of Kansas accrued 250 global citations (TGCS). A total of 75 journals were encompassed in this study. The Journal of Intellectual Disability Research emerged as the vanguard with four published papers, closely trailed by Child Care Health and Development and Exceptional Children. Notably, the latter boasted the highest impact factor (JCR = 4.09; Q1). In summation, this review proffers a meticulous and expansive overview of extant scholarship concerning the experiences of families rearing children with disabilities within the inclusive education framework.

Family Caregiver Adaptation during the Transition to Adulthood of Individuals with Intellectual Disabilities: A Scoping Review

During the transition to adulthood, individuals diagnosed with intellectual disability (ID) and their family caregivers have unique experiences. This scoping review studies the sources of the family caregiver's objective burden, support, coping mechanisms, positive caregiving, and quality of life to understand the caregiver's adaptation process when the individual with ID transits to adulthood, according to Joanna Briggs Institute (JBI) Scoping Review methodology guidelines. The inclusion criteria included studies of family caregivers of any age who provide unpaid care and live with individuals diagnosed with ID who are transitioning to adulthood. Of 2875 articles identified, 12 published studies were included. The main themes included caregivers reporting dissatisfaction with the available adult services and exhaustion from being a caregiver. Overall, a vicious cycle of likely increased demands during the transition, with caregivers not being prepared to cope with these demands while concurrently being dissatisfied with the adult services system, leads the caregivers to develop a pervasive sense of helplessness. Future studies would benefit from recruiting caregivers from sources other than adult-only service centres and using qualitative (to identify the broad aspects of the key factors) and quantitative (to identify the significant differences between the key factors) methodologies.

High-Tech Classroom Management: Effects of the Use of an App on Disruptive and On-Task Classroom Behaviours for Students with Emotional and Behavioural Disorder

Students with emotional behavioural disorders may exhibit extremely challenging behaviour that interferes with their academic achievement and social relationships. Failure at school frequently leads to a succession of poor life outcomes including increased rates of unemployment or underemployment. Increasing on-task behaviours and decreasing disruptive classroom behaviours is of crucial importance. If successful, this may promote positive experiences and outcomes in terms of effective learning, and, ultimately, greater opportunities in life. This study evaluated a high-tech approach to classroom management using an App* that offers elements of choice and predictability to students. Teachers were provided with two hours of training on how to upload lesson plans to their smartphone and how to broadcast onto screens in classrooms. A multiple-baseline design across four participants was used and the data suggested that the use of the App resulted in both increases in on-task behaviour and a reduction in disruptive classroom behaviour for all participants.

Parents perception and experience of transitioning to adulthood for their child diagnosed with an intellectual disability

Definitions of adulthood for people with intellectual disability are often complicated, with milestones being markedly different for this population. This is then associated with difficulties for both the people with intellectual disability and their parents, who are closely involved in this transitional period. This paper aims to report on parents' perception and experience of adulthood for their son or daughter with an Intellectual Disability (ID). Qualitative data were collected through 30 - 60-minute phone interviews with eight parents of a person with an intellectual disability aged 15 or older (mean parent age = 60; mean child age = 23). Thematic analysis found that Perception of Adulthood encompassed themes of Independence and Normality. Experiences of Adulthood were categorised under Government Services, Responsibility and Social Supports. Findings of this research provide information for the growing literature around adulthood for people with intellectual disability, as well as how to amend policies and procedures for services that cater to people with intellectual disability and their parents during this transition.

What Every Internist-Endocrinologist Should Know about Rare Genetic Syndromes in Order to Prevent Needless Diagnostics, Missed Diagnoses and Medical Complications: Five Years of 'Internal Medicine for Rare Genetic Syndromes'

Patients with complex rare genetic syndromes (CRGS) have combined medical problems affecting multiple organ systems. Pediatric multidisciplinary (MD) care has improved life expectancy, however, transfer to internal medicine is hindered by the lack of adequate MD care for adults. We have launched an MD outpatient clinic providing syndrome-specific care for adults with CRGS, which, to our knowledge, is the first one worldwide in the field of internal medicine. Between 2015 and 2020, we have treated 720 adults with over 60 syndromes. Eighty-nine percent of the syndromes were associated with endocrine problems. We describe case series of missed diagnoses and patients who had undergone extensive diagnostic testing for symptoms that could actually be explained by their syndrome. Based on our experiences and review of the literature, we provide an algorithm for the clinical approach of health problems in CRGS adults. We conclude that missed diagnoses and needless invasive tests seem common in CRGS adults. Due to the increased life expectancy, an increasing number of patients with CRGS will transfer to adult endocrinology. Internist-endocrinologists (in training) should be aware of their special needs and medical pitfalls of CRGS will help prevent the burden of unnecessary diagnostics and under- and overtreatment.

Family Impact During the Time Between Autism Screening and Definitive Diagnosis

Over the past 10 years, identification of Autism Spectrum Disorder (ASD) risk has dramatically increased due to the wide-spread implementation of screening programs; yet, there is limited understanding about parent perceptions and experiences during the time period when risk is identified, but prior to receiving a formal diagnosis-a period that can last months to years given the long wait-lists for formal ASD evaluations. The current study aimed to examine parent perceptions of family impact (i.e., the impact their child's behaviors have on the family) between the time of risk-identification and formal diagnosis among 277 children identified as at-risk for ASD through screening positive in primary care. We aimed to compare family impact among those whose child met diagnostic criteria for ASD and those who did not. Parents of children who received a non-ASD diagnosis reported a higher baseline level of family impact (F[1, 274] = 5.82, p = .017); however, perceived difficult child behavior was a stronger predictor of family impact (t[6] = 13.11, p < .001) than later diagnostic group (t[6] = - 2.10, p = .037), and child functioning did not predict family impact (t[6] = -0.31, p = .76). These results suggest that in this population, perceived difficult child behavior is a stronger predictor of family impact than later diagnostic category and should be considered an important factor in family support.

The reporters' agreement in assessing the quality of life of young people with intellectual disabilities

A good evaluation of the quality of life (QoL) of young people with disability is essential to detect, monitor and report their support needs in research, and individual, institutional and policy planning. The aim of this study is to evaluate the reporters' agreement in the assessment of the QoL of young people with Intellectual Disabilities in transition to adulthood. Self and proxy-report version of INICO-FEAPS quality of life scale was used to assess 119 students of a post-compulsory educational program, being the proxy-report informed by one of their relatives. Results show poor intraclass correlations between informants. No discrepancies were found in the global QoL. However, small discrepancies were found for some dimensions. Young people's reports were higher for self-determination, personal development and interpersonal relationships. On the contrary, relatives' reports were higher for rights, material and physical wellbeing. The discrepancies in global QoL assessment were not related to student's severity, IQ, diagnosis or parent's gender. These findings underline the importance of young people's participation in the assessment of their QoL as well as the convenience of using both kind of informants when taking appropriate decisions in educational contexts during transition to adulthood.

Parent stress and coping trajectories in Hispanic and non-Hispanic families of children at risk of autism spectrum disorder

LAY ABSTRACT

Little is known about parent experiences throughout the diagnostic process for autism or how these parent experiences may help explain the disparities that exist between Hispanic and non-Hispanic families in time-to-diagnosis among children identified as at risk for autism. The current study examined trajectories of parenting stress, coping, and perceived family impact over time, throughout the autism diagnostic process among Hispanic and non-Hispanic families. Hispanic families reported lower levels of parenting stress, coping, and negative family impact across time. Further, there were differences in the change in use of coping and the amount of negative family impact reported between Hispanic and non-Hispanic parents over time. These differences shed light on the unique experiences and strengths of Hispanic families demonstrate. Interventions that leverage those strengths and focus on education, empowerment, and resilience might be particularly beneficial for Hispanic families and may also better inform work to increase resilience.

Caregiver resource utilization: Intellectual and development disability and dementia

BACKGROUND

Adults with intellectual and developmental disabilities and their families have high need for support services. This study assessed resource utilization among caregivers of intellectual and developmental disabilities and other conditions.

METHODS

We assessed 366 caregivers of adults with intellectual and developmental disabilities, dementia or other conditions Regressions assessed group differences in number of agency contacts and frequency of service use. A secondary analysis assessed reasons for underutilization of services.

RESULTS

Caregivers of individuals with dementia contacted twice as many agencies as other caregivers and were more likely to report using suggested services. Agency contact and service utilization were similar among caregivers of adults with intellectual and developmental disabilities compared to other caregivers. Caregivers of adults with intellectual and developmental indicated that suggested services were unavailable to them.

CONCLUSION

The findings of this study shed light on challenges with access to and utilization of support services.

The Experiences of Carers of Adults With Intellectual Disabilities During the First COVID-19 Lockdown Period

Background

The recent COVID‐19 pandemic led to widespread international restrictions, severely impacting on health and social care services. For many individuals with an intellectual disability (ID) this meant reduced access to services and support for them and their carers.

Aim

The aim of this study was to gain insight into the ways parents of adults with ID coped during the first 2020 lockdown period.

Methods

Eight parents of adults with ID were interviewed. The recordings of these interviews were subjected to a thematic analysis.

Results

Four main themes were identified: powerless and unappreciated; coping under lockdown; support; and the impact of lockdown on well‐being.

Conclusions

The parents of adults with ID who made up our sample reported that they received little support from services and experienced a sense of powerlessness. Nevertheless, they were open to accepting support from family and friends and showed remarkable resilience. These findings are discussed in the light of the Willner et al. (2020) survey results on parental mental health and coping, and suggestions for future service provision during pandemic conditions are proposed.

Phenomenological Study of the Transition Process for Adolescents With Intellectual and Developmental Disabilities

IMPORTANCE

Occupational therapy practitioners should understand the barriers faced by young adults with intellectual and developmental disabilities (IDD) who are attempting a successful transition to postsecondary work, higher education, community and social activities, and living opportunities so they can better advocate for them and tailor their involvement in the transition process.

OBJECTIVE

To explore the lived experience of parents of adolescents with IDD participating in the transition process.

DESIGN

Phenomenological design.

SETTING

Community-based setting with interviews occurring face-to-face in the participants' home or via telephone.

PARTICIPANTS

Eleven parents of adolescents and young adults (ages 16-22 yr) with IDD. Outcomes and Measures: Semistructured interviews focusing on parent and family experiences with the transition process.

RESULTS

Seven themes emerged from the data representing parent perceptions related to the use or lack of person-centered practices, needing more communication from the team, frustration with being the driving force of progress, feelings of defeat, gaps between programming options, positive team collaboration, and planning for the future.

CONCLUSIONS AND RELEVANCE

Parents identified person-centered planning, guidance from school staff, and resource sharing as desired practices in the transition planning process. The outcomes indicate that some aspects of the transition process have not changed in several decades. What This Article Adds: Occupational therapy practitioners are optimally positioned to remediate transition issues; therefore, it is essential that they assert their integral role in the transition planning process to increase self-determination and quality of life for all adolescents and young adults with IDD.

Development of the Fearless, Tearless Transition model of care for adolescents with an intellectual disability and/or autism spectrum disorder with mental health comorbidities

AIM

First, to understand the barriers to achieving effective transition and the supports required from the perspective of parents and carers, adolescents with intellectual disability and/or autism spectrum disorder and co-existing mental health disorders (often termed 'dual disability'), and those who provide services to this group. Second, to develop an informed model of shared care to improve the transition of adolescents with dual disabilities.

METHOD

Carers and a young adult with a dual disability were surveyed about their experience of transition care. Other key stakeholders including paediatricians, general practitioners, and policy makers were also interviewed. These data informed the model of care.

RESULTS

Paediatricians and general practitioners reported difficulties establishing working relationships to foster smooth transitions, and carers reported lacking a regular general practitioner with adequate expertise to care for people with dual disabilities. A process of shared care between paediatricians and general practitioners was developed and initiated by a dedicated transition manager, who assisted with care coordination and service linkages. Standardized clinical assessment tools were also introduced to determine patient and carer support needs.

INTERPRETATION

This study highlights the potential to improve transition outcomes for adolescents with dual disabilities and their carers through early transition planning, consistent methods of assessing patient and carer needs, and shared care.

WHAT THIS PAPER ADDS

Adolescents with co-occurring disabilities require a collaborative health and disability service interface. Fearless, Tearless Transition is a new approach to transitioning adolescents with dual disabilities from paediatric to adult care. Carers of adolescents with dual disabilities require support navigating and negotiating services. Engaging general practitioners and paediatricians in shared care early during the transition process is essential.

Parental stress and adjustment in the context of rare genetic syndromes: A scoping review

Chromosomal abnormalities are now considered a common cause of intellectual disability. With increased genetic testing, phenotyping and technological advancements, many new syndromes have been identified. This review sought to explore parental stress and adjustment in the context of rare genetic syndromes to evaluate their clinical impact. A systematic review of English peer-reviewed literature across three databases (PsycINFO, Medline, CINAHL) was completed and 69 articles were included. Parents of children with rare genetic syndromes experienced greater distress relative to other disabilities. Differences in parental wellbeing were syndrome-specific relative to ASD thus demonstrating the need to consider the contribution of syndrome-specific phenotypes. Child emotional and behavioural difficulties were the most consistent predictor of parental distress. Research reflecting other factors such as physical health, syndrome-specific behaviours, benefit finding and, parental appraisal in the context of a rare genetic aetiology is required in order to support parental adjustment in these conditions.

Caregiver Eligibility for Support Services: Correlates and Consequences for Resource Utilization

Policymakers and community organizations have implemented numerous programs and services to support the more than 40 million family caregivers in the United States. However, the existence of such services is not sufficient to ensure equitable and optimal access and utilization. Using data from the Caregiving in the US study (2015; n = 1,185), we estimated that nearly one in five family caregivers do not meet broad eligibility criteria for support services. This resource gap was particularly likely to affect high-priority populations such as those caring for someone with a mental health problem. Furthermore, ineligible caregivers had lower service utilization and increased financial strain. The findings highlight a pattern of vulnerability among caregivers who do not meet broad eligibility criteria for financial support resources. Careful policy consideration is needed to determine how support services should be allocated to maximize caregiver and care recipient outcomes at the population level.

Predicting the Outcomes of Parents of Transition-Age Youth or Young Adults with ASD

The transition outcomes for individuals with autism spectrum disorder (ASD) and their families are less than desirable. A survey of parent stressors, resources, coping/appraisals, and adaptation to transition was completed by 226 parents. The mediating mechanisms between stressors and parent outcomes were identified. At the indicator level, three stressors (i.e., autism severity, mental health crisis/challenging behaviors, and filial obligation), four resources (i.e., general social support, transition planning quality, parent-teacher alliance, and parenting efficacy), and three coping styles (i.e., problem-focused coping, avoidance-focused coping, and optimism) predicted parents' outcomes (i.e., burden, transition experience, subjective health, and quality of life). At the structural level, optimism, emotion-coping strategies, and resources mediated the relationships between stressors and parental outcomes. Research and practical applications are discussed.

Parents' psychological, social and financial outcomes as related to the transition of their offspring with ID from adolescence to adulthood

BACKGROUND

In general, there is extensive research on parents of young children with ID, particularly studies on stress and coping, social support as associated with quality of life. Unfortunately, there is scarce evidence -based knowledge on parental coping resources and well-being during the transition of their offspring from childhood to adulthood and thereafter.

AIMS

This research responds to the scarce knowledge on the effect of the transition of children with ID into adulthood and particularly within adulthood on families. It examined the social, psychological, and financial differences among caregivers of offspring with ID in three age groups: (1) under the age of 21; (2) 21-30; (3) 31 and above.

METHODS AND PROCEDURES

Three hundred and one caregivers completed an income and expenditure survey, including out-of-pocket expenditures, assets and liabilities index, services use survey, financial and other types of assistance from friends and family, a questionnaire regarding resources and stress levels, a social participation scale, and personal wellbeing index.

RESULTS

A statistically significant differences have been detected in the three caregivers' groups regarding the number of hours spent outside the house, social support, negative feelings such as frustration, sadness, and concern, life satisfaction and well-being. No significant differences have been identified in financial outcomes among caregivers' groups.

CONCLUSIONS AND IMPLICATIONS

Findings are discussed in respect to research and practice and highlight caregivers' concerns regarding the transition of their offspring from adolescence to adulthood and afterward and in parallel to their own aging process.

Exploring patterns between school perceptions, child behavior, and maternal well-being among Latina mothers of children with autism spectrum disorder (ASD)

Research suggests that child problem behavior and poor family-school partnerships contribute to maternal stress in families of children with autism spectrum disorder (ASD). However, most extant research focuses only on White families even though Latina mothers of children with ASD experience greater systemic barriers impacting parent well-being and access to school services. Using individual interviews, this study investigates the pattern between school perceptions, child behavior, and psychological well-being among 13 Latina mothers of school-aged children with ASD. This sample was selected based on their elevated scores on the Difficult Child subscale of the Parenting Stress Index. Findings indicate that all participants reported feeling fear, frustration, worry and stress due to their child's behavior. Specifically, participants worried about their child's safety and expressed frustration with their child's problem behavior. Notably, participants reported mixed responses regarding the schools' actions to address their children's behavior. Implications for research and practice are discussed with respect to family-school partnerships among Latina mothers.

What do stakeholders understand by self-determination? Consensus for its evaluation

BACKGROUND

Advances in international studies on self-determination point out the need for continuous efforts to deepen its understanding and implications. The aim of this study is to obtain a comprehensive pool of items to operationalize the self-determination construct that serves as a starting point towards a valid instrument based on the reports of others.

METHOD

We conducted a Delphi study of three rounds involving three panels of experts: ten professionals, five people with intellectual disability and six relatives of people with intellectual disability. Data analysis required both qualitative and quantitative methods.

RESULTS

The initial pool of 131 items was refined through the different rounds to a final set composed of 115-some were removed and new ones were added. Content-based evidence is provided. In this study, the present authors generated a potential valid pool of items to develop a new measurement tool based on the latest advances on the self-determination theoretical framework.

CONCLUSIONS

The implications for future research focus on strengthening the knowledge of self-determination.

Comparative Effects of Mindfulness and Support and Information Group Interventions for Parents of Adults with Autism Spectrum Disorder and Other Developmental Disabilities

This study evaluated two community based interventions for parents of adults with autism spectrum disorder and other developmental disabilities. Parents in the mindfulness group reported significant reductions in psychological distress, while parents in the support and information group did not. Reduced levels of distress in the mindfulness group were maintained at 20 weeks follow-up. Mindfulness scores and mindful parenting scores and related constructs (e.g., self-compassion) did not differ between the two groups. Results suggest the psychological components of the mindfulness based group intervention were effective over and above the non-specific effects of group processes and informal support.

The transition to adulthood of young adults with IDD: Parents' joint projects

INTRODUCTION

Parents have found the transition to adulthood for their sons or daughters with intellectual and/or developmental disabilities (IDD) particularly challenging. The literature has not examined how parents work together and with others in face of this transition nor has it highlighted parental goals in this process. This study used a perspective based on joint, goal-direct action to describe the projects that Canadian parents engaged in together and with others relative to this transition.

METHODS

Using the qualitative action-project method, joint projects between parents and with others were identified from their conversations and followed for 6 months.

FINDINGS

Three groups of projects were described: equipping the young adult for adult life, connecting for personal support and managing day-to-day while planning for the future.

CONCLUSIONS

Parents act together and with others relative to the transition to adulthood of their young adult children with IDD. These projects are complex and differ in goals, steps, resources and emotional regulation and motivation.

Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program

INTRODUCTION

Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury.

BACKGROUND

Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention.

METHODS

A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment.

RESULTS

Despite the limited number of participants (n = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period.

DISCUSSION

Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more participants in diverse geographic regions with longer lengths of participation and follow-up.

Out of School and Into Distress: Families of Young Adults with Intellectual and Developmental Disabilities in Transition

BACKGROUND

The transition period out of the educational system can be a source of stress for parents of young adults with intellectual and developmental disabilities, as families lose the support and respite offered by schools.

MATERIALS AND METHODS

Using a before and after design nested within a 24-month follow-up study of parents seeking adult developmental services for their children, parents' perception of distress was measured using the Brief Family Distress Scale (Journal of Child and Family Studies, 20, 2011, 521) and their perception of helpfulness of formal supports was assessed using the Family Support Scale (Journal of Individual, Family, and Community Wellness, 1, 1984, 45).

RESULTS

Parents reported significantly higher levels of distress after their child transitioned out of school. Employed parents and parents of a child with an autism spectrum disorder are at increased risk for distress.

CONCLUSIONS

Families fare worse once their adult children are no longer in school, although this is not associated with a reduction in the perception of the helpfulness of formal supports.

Family Quality of Life During the Transition to Adulthood for Individuals With Intellectual Disability and/or Autism Spectrum Disorders

Recognizing the prominent role of parents in supporting their children with intellectual and developmental disabilities (IDD), improving quality of life for these families is an essential endeavor. While much attention has focused on the experiences of families with younger children with IDD, little is known about the family quality of life (FQOL) among families with transition-age youth and young adults. We examined the FQOL ratings of 425 parents with a child between 13-21 years of age with intellectual disability or autism to understand FQOL and the factors that may shape it. Overall satisfaction with FQOL was somewhat high for this sample, with some variability across domains. Higher FQOL ratings were predicted by lower frequency of challenging behaviors, lower support needs, and higher strength of parental religious faith. We present recommendations for research and practice focused on promoting quality of life during the transition period.

Parental adaptation to out-of-home placement of a child with severe or profound developmental disabilities

Utilizing grounded theory qualitative research methods, a model was developed for describing parental adaptation after voluntary placement of a child with severe or profound developmental disabilities in out-of-home care. Interviews of parents from 20 families were analyzed. Parents' cognitive appraisals of placement outcomes were classified as either inducing emotional stress (i.e., guilt, sadness, fear and worry, anger and frustration, and uncertainty) or relief. Parental appraisals of responses to placement by children, extended family, and friends were identified as factors affecting the parents' adaptation to placement. The primary coping methods used by parents to decrease emotional stress and increase relief consisted of reappraisals regarding the necessity of placement, involvement in the child's life, psychotherapy, and the passage of time.

Family perspectives on a successful transition to adulthood for individuals with disabilities

When researchers evaluate adult outcomes for individuals with intellectual and/or developmental disabilities (IDD), the perspective of families is not always considered. Parents of individuals with IDD (N  =  198) answered an online survey about their definition of a successful transition to adulthood. Content analysis was used to describe themes and ideas present in the responses. Rather than focusing only on developmental tasks of adulthood, such as living independently, being competitively employed, and maintaining friendships, responses reflected a more varied and dynamic view of success in adulthood, taking into account the fit between the person with IDD and his or her environment. As services are developed and implemented for adults with IDD, it is important to consider the full range of goals that families have for their son or daughter's successful transition to adulthood.

Transferring young people with profound intellectual and multiple disabilities from pediatric to adult medical care: parents' experiences and recommendations

Many children with profound intellectual and multiple disabilities (PIMD) now reach adulthood. The aim of this study was to elicit parents' experiences with the transfer from pediatric to adult medical care. A convenience sample of 131 Dutch parents of young people with PIMD (16-26 years) completed a web-based questionnaire. Twenty-two percent of the young persons were still in pediatric care; 22% of the others had no care coordinator, although their health needs were the same. Parents valued the care provided by the pediatrician, and wished to see it continued. They were critical about how they had been prepared for transfer to adult care. Parents provided suggestions to improve transitional care, such as early start, information provision, and a joint consultation between pediatric and adult care.

The experiences of mothers of young adults with an intellectual disability transitioning from secondary school to adult life

BACKGROUND

The transition from school to adulthood for young adults with an intellectual disability involves movement from a generally secure and supported school environment to an emerging adult life that may be characterised by a wide variation in adoption of adult roles related to employment, independent living, friendships, and day activities.

METHOD

In this study, we investigated the perspectives of 18 mothers of young adults with either Down syndrome or Rett syndrome through qualitative semistructured interviews. The International Classification of Functioning, Disability and Health (ICF) framework was used as a conceptual basis.

RESULTS

Themes that emerged included adult roles assumed during the day, accommodation, quality of life, living a "good" life, and family impact.

CONCLUSIONS

In contrast with Rett syndrome, mothers of young adults with Down syndrome described more difficult pathways to attaining stability in adult roles. Environmental facilitators and barriers emerged in the area of support, relationships, services, systems, and policies.

What parents find important in the support of a child with profound intellectual and multiple disabilities

BACKGROUND

The importance of a partnership between parents and professionals in the support of children with disabilities is widely acknowledged and is one of the key elements of 'family-centred care'. To what extent family-centred principles are also applied to the support of persons with profound intellectual and multiple disabilities (PIMD) is not yet known.

AIM

The purpose of this exploratory study was to examine what parents with a child with PIMD find important in the support of their child. In addition, we examined which child or parent characteristics influence these parental opinions.

METHOD

In total, 100 parents completed an adapted version of the Measure of Processes of Care. Mean unweighted and weighted scale scores were computed. Non-parametric tests were used to examine differences in ratings due to child (gender, age, type and number of additional disabilities, type of services used and duration of service use) and parent characteristics (gender, involvement with support and educational level).

RESULTS

Parents rated situations related to 'Respectful and Supportive Care' and 'Enabling and Partnership' with averages of 7.07 and 6.87 respectively on a scale from 1 to 10. They were generally satisfied with the services provided, expressed in a mean score of 6.88 overall. The age of the child significantly affected the scores for 'Providing Specific Information about the Child'. Parents of children in the '6-12 years' age group gave significantly higher scores on this scale than did parents of children in the '≥17 years' age group (U = 288, r = -0.34).

CONCLUSION

This study shows that parents with children with PIMD find family-centred principles in the professional support of their children important. Although the majority of parents are satisfied with the support provided for their children, a substantial minority of the parents indicated that they did not receive the support they find important.

Transition planning for students with intellectual disability, autism, or other disabilities: data from the National Longitudinal Transition Study-2

To compare the status of transition planning for students with intellectual disability, autism, or other disabilities, we used data from the National Longitudinal Transition Study-2, a federally funded, national study of the secondary and postschool experiences of students with disabilities. Results show that although transition planning had been conducted for the majority of students, few of them took a leadership role in their transition planning. Students with autism or intellectual disability were significantly less likely than students with other disabilities to take a leadership role. The majority of the active participants in transition planning were school-based personnel. We also found limited participation from other agencies/support persons (e.g., vocational rehabilitation). Students with autism or intellectual disability had more identified needs for support after school than did students with other disabilities.