A Systematic Review of the Assessment of Support Needs in People with Intellectual and Developmental Disabilities

Subjective well-being and social inclusion at school for students with a disability, according to their parents, in France

BACKGROUND

Providing inclusive, quality education for all children is one of the United Nations' sustainable development goals for 2030.

AIMS

The aim of this study, carried out in France among 491 parents of children with a disability aged 3 to 18 and enrolled in ordinary schools, is to measure the well-being and social inclusion of children and to identify the factors that promote well-being and social inclusion at school.

METHODS AND PROCEDURES

The parents fill in various questionnaires relating to the well-being and social inclusion of their child, the quality of their relationship with the teacher and their satisfaction with the accommodations offered at school. They also provide information about their child and their socio-economic situation.

OUTCOMES AND RESULTS

Regression analyses show that well-being and social inclusion depend on the nature of the child's disability and decrease with age but do not significantly depend on child's gender and academic level or social background. Furthermore, well-being and social inclusion can be significantly improved when the quality of the parent-teacher relationship and school accommodations are satisfying.

CONCLUSIONS AND IMPLICATIONS

The results of this study encourage the development of quality parent-teacher relationships to promote well-being at school.

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.].

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.

Examining Choice and Control for People With IDD Over Time

Choice making is an important aspect of everyone's life in terms of fully becoming an adult within a democratic society. People with intellectual and developmental disabilities (IDD) are at risk for diminished choice making due to various factors, including guardianships; dependence on supports that are not person-centered; and, in some cases, limited capacity to express one's desires effectively. Independent Monitoring for Quality (IM4Q) data for 9,195 and 9,817 for adult services users with IDD were analyzed across two types of choice. Repeated measures mixed regression examined choice over time after controlling for age, support needs, residence type, and community type. We found significant increases in everyday choice making among IDD service users in Pennsylvania, but not in support-related choice. This study is the first to our knowledge to consider change in choice making, an important indicator of rights and inclusion for persons with IDD. By comparing three waves of data from the state of Pennsylvania (2013, 2016, and 2019), we were able to detect changes in choice making over time among home and community-based service (HCBS) users with IDD.

Support Needs of Children with Autism Spectrum Disorders: Implications for Their Assessment

The construct of support needs has become a key aspect for the diagnostics, classification, and interventional management of autism spectrum disorders (ASDs). However, instruments specifically designed to assess support needs in this population are not available. Currently, the Supports Intensity Scale for Children (SIS-C), which could be administered to assess students with any type of intellectual disability (ID), is the only valid tool able to assess support needs in Spain. Our aim was to verify whether the SIS-C is useful for assessing the support needs of students with ASD, regardless of whether or not they present ID. The participants were subdivided into two groups. One group included students with ASD and ID (n = 248), and the other comprised participants with ASD without an ID (n = 44). The results of the two groups were compared with those reported in the original validation sample of the SIS-C, which involved participants with ID without ASD (n = 566). The results showed that this scale could be useful for assessing support needs in the three subgroups, but it appeared that different standardized norms based on the characteristics of each specific population would be appropriate.

Are They the Same for All People? Nurses' Knowledge about the Basic Human Needs of People with Disabilities

Nursing care involves a continuous interaction between nurses and people with disabilities. This has created a need for assessment tools that measure nurses' knowledge about the basic human needs of people with disabilities. The aim of this cross-sectional study was to develop a Knowledge of Basic Human Needs Scale and investigate nurses' levels of knowledge about the basic human needs of people with disabilities and their association with nurses' education. Data were analyzed using principal component analysis to test the construct validity and to identify factors using principal varimax rotation. The reliability estimate was based on Cronbach's alpha coefficient. Linear regression models were used to assess the association between knowledge about basic human needs and predictors. Factor analysis extracted eight factors, explaining 66.3% of the total variance. The sampling adequacy, criterion validity, and internal consistency were satisfactory. The nurses' levels of education was associated with their knowledge about the basic human needs of people with disabilities. The questionnaire constitutes a valuable contribution to improving nurses' knowledge and practice, as well as the quality of healthcare, and it provides a contribution to improving the quality of life for people with disabilities.

Workplace accommodation in return to work after mild traumatic brain injury

BACKGROUND: While a vast amount of research focuses on unmodifiable and individual factors that may impact return to work (RTW) for patients with traumatic brain injury (TBI), less knowledge exists of the relationship between specific workplace factors and work retention. OBJECTIVE: Identify types of accommodation in the workplace that influence the RTW process for employees with TBI and the challenges associated with them. METHODS: A multiple case study consisting of 38 cases and 109 interviews of employees with TBI and their managers conducted between 2017 and 2020 at two time points. RESULTS: Accommodation of both the organizational and psychosocial work environment influences RTW for employees with TBI. Social support and supportive management may have positive and negative effects. RTW is often not a linear process. Over time, maintaining and developing customized accommodation in the work organization is challenging. CONCLUSIONS: Uncertainty about accommodation in RTW for employees with TBI is closely linked to lack of knowledge in the workplace of how to handle complex and nonlinear RTW processes. Work-oriented rehabilitation should to a greater extent provide managers with relevant information and support to develop the person-environment fit over time.

Perceived Support Needs of School-Aged Young People on the Autism Spectrum and Their Caregivers

With increasing demands for health, disability and education services, innovative approaches can help distribute limited resources according to need. Despite an increased focus on support needs within the clinical pathway and policy landscape, the body of research knowledge on this topic is at a relatively early stage. However, there appears to be a sense of unmet support needs and dissatisfaction with the provision of required support following an autism diagnosis amongst caregivers of young people on the spectrum. The primary aim of this study was to explore the perceived support needs of Australian school-aged young people on the spectrum and their caregiver(s). This was achieved using a phenomenographic Support Needs Interview conducted by occupational therapists during home-visits with caregivers of 68 young people on the spectrum (5-17 years). Qualitative data analysis resulted in two hierarchical outcome spaces, one each for young people and their caregivers, indicating interacting levels of support need areas that could be addressed through a combination of suggested supports. These support needs and suggested supports align with almost all chapters within the Body Functions, Activities and Participation and Environmental Factors domains of the International Classification of Functioning, Disability and Health. The overall goals of meeting these complex and interacting support needs were for the young people to optimize their functioning to reach their potential and for caregivers to ensure the sustainability of their caregiving capacity. A series of recommendations for support services, researchers and policy makers have been made to position support needs as central during the assessment, support and evaluation phases.

Operationalisation of quality of life for students with intellectual and developmental disabilities to improve their inclusion

BACKGROUND

Quality of life (QoL) is regarded as a framework to enhance inclusive education outcomes in different domains for all students, especially for those with intellectual and developmental disabilities (IDD). Assessment tools are needed to implement this framework. Although there is a long trajectory of QoL assessment in people with IDD, we identify a lack of instruments for students with IDD who attend to general education contexts.

AIMS

The goal of this study is to produce a pool of items in order to develop a field-test version of a QoL instrument for this target group.

METHODS

14 educational professionals participated in a four-round Delphi study, assessing the content of the items proposed according to four criteria (suitability, importance, observability and sensitivity).

RESULTS

The results of this study provided evidence of content validity regarding the pool of items that will be included in a field-test version.

CONCLUSIONS

The results obtained are important for the development of a QoL assessment tool to improve the inclusion of students with IDD in general education settings.

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.

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.