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Alruwaili AN, Alruwaili MM, Ramadan OME, Ali SI, Shaban M. Nursing strategies for enhancing calm in older Arabs with dementia: integrating Snoezelen methods, aromatherapy, and personal items to reduce agitation. Geriatr Nurs 2024; 59:379-391. [PMID: 39128143 DOI: 10.1016/j.gerinurse.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/29/2024] [Accepted: 07/22/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Agitation significantly impacts Arab elders with dementia. Multisensory stimulation, such as Snoezelen, shows promise but lacks exploration in Arab contexts. OBJECTIVE Evaluate a culturally adapted multisensory intervention-combining Snoezelen, aromatherapy, and personal items-on agitation in Arab elders with dementia. METHODS A quasi-experimental design assessed 31 patients receiving the intervention against 31 controls. Agitation, quality of life, and neuropsychiatric symptoms were measured using the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory (NPI). RESULTS The intervention group exhibited notable reductions in CMAI scores for aggression and agitation behaviors (p < 0.001) and improvements in quality of life and NPI scores for agitation/aggression and depression/dysphoria (p < 0.001). CONCLUSION This culturally tailored multisensory approach effectively reduced agitation and improved well-being in Arab dementia patients. The findings advocate for further research and suggest such interventions can be beneficial in culturally diverse dementia care settings. TRIAL REGISTRATION ClinicalTrials.gov, ID NCT06216275.
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Affiliation(s)
- Abeer Nuwayfi Alruwaili
- Department of Nursing Administration and Education, College of Nursing, Jouf University, Sakaka 72388, Al Jouf, Saudi Arabia.
| | - Majed Mowanes Alruwaili
- Department of Nursing Administration and Education, College of Nursing, Jouf University, Sakaka 72388, Al Jouf, Saudi Arabia
| | - Osama Mohamed Elsayed Ramadan
- Maternity and Child health Nursing Department, College of Nursing, Jouf University, Sakaka 72388, Al Jouf, Saudi Arabia.
| | - Sayed Ibrahim Ali
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Hofuf 31982, Al-Ahsa, Saudi Arabia
| | - Mostafa Shaban
- Community health Nursing Department, College of Nursing, Jouf University, Sakaka 72388, Al Jouf, Saudi Arabia.
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Talley M, Brown C, Wingo N, Conway J, Maha J, Kong M. Neurodivergent patient experience in a tertiary children's hospital-a qualitative analysis. Front Pediatr 2024; 12:1427433. [PMID: 39081926 PMCID: PMC11286462 DOI: 10.3389/fped.2024.1427433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/03/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Sensory processing challenges are commonly encountered in pediatric patients, particularly in those who are neurodivergent. We previously developed a novel clinical pathway (named "Sensory Pathway") which aimed at improving patient care for those with sensory barriers via staff training, provision of sensory toolkits and early integration of families throughout the hospital stay. We hypothesized that utilization of this pathway will result in improved patient experience and provide valuable feedback to improve care. Methods A voluntary survey was made available to all patients who utilized this resource as part of our hospital wide patient satisfaction survey. Qualitative data was coded using open coding as part of the constant comparison method data using NVivo 12 for Windows software for analysis. Software was used to create word clouds and clusters for visualization, which confirmed the themes and patterns that were noted from initial open coding. Results Between 2021 and 2022, surveys were obtained from 160 patients who utilized the Sensory Pathway. More than 50% reported that the most helpful components of the pathway were the approach by the staff and sensory tools. The three major themes identified from the survey were (1) Tools and techniques that benefited their children; (2) Positive interactions and communication with the hospital staff, and (3) Suggestions for future improvement. Conclusion The survey results highlight the importance of having tools readily available to aid with sensory regulation and comfort of patients during healthcare encounters, the value of a positive patient and staff encounter, as well as opportunities for improvement.
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Affiliation(s)
- Michele Talley
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Chelsea Brown
- Children’s of Alabama, Birmingham, AL, United States
| | - Nancy Wingo
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | | | - Michele Kong
- Children’s of Alabama, Birmingham, AL, United States
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Helbling M, Grandjean ML, Srinivasan M. Effects of multisensory environment/stimulation therapy on adults with cognitive impairment and/or special needs: A systematic review and meta-analysis. SPECIAL CARE IN DENTISTRY 2024; 44:381-420. [PMID: 37515496 DOI: 10.1111/scd.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
AIM This review aimed to evaluate the effects of multisensory environments/stimulation (MSE/MSS) therapy, on the behavior and psychological symptoms in adults with cognitive impairment and/or special needs. METHODS Online database searches were performed to identify studies reporting on the effects of MSS/MSE therapy in adults (>18 years). Data were extracted for the following investigated outcomes including anxiety, depression, mood, behavioral attributes, biomedical parameters, cognition, motor skills, quality of life (QoL), pain, and end of life quality. Two reciprocally blinded investigators extracted the data. Inter-investigator reliability (𝝹) was calculated. A meta-analysis and a qualitative analysis were performed on the information extracted. RESULTS Thirty-six studies were included for data extraction and analysis. Meta-analysis of the included studies revealed a significant improvement with the MSE/MSS therapy, for agitation (p = .018), anxiety (p = .023), cognition (p < .001), and depression (p < .001). MSS/MSE therapy demonstrated a tendency for the improvement of the QoL in adults (p = .05). CONCLUSION MSE/MSS therapies are beneficial in cognitively impaired adults and improve their anxiety, depression, cognitive and other behavioral attributes such as agitative behaviors. Promoting these therapies in geriatric care may help to improve/reduce the challenging/care-resistant behaviors in adults and facilitate effective provision of the necessary care.
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Affiliation(s)
- Meret Helbling
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marie-Laure Grandjean
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Mills C, Tracey D, Nash S, Gorkin R. Perceptions of a virtual reality sensory room for adults with neurodevelopmental disabilities. Disabil Rehabil 2024; 46:565-574. [PMID: 36727413 DOI: 10.1080/09638288.2023.2169773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Mental ill health and sensory processing difficulties often limit participation in everyday life for adults with neurodevelopmental disabilities. Interventions using technology such as virtual reality (VR) are increasingly accessible and may mitigate these difficulties. Understanding what contributes to the successful implementation of novel interventions is important for future use and evaluation. This study aimed to explore the feasibility of implementing a VR sensory room for adults with neurodevelopmental disabilities, their carers and support staff and to explore future iterations of the product and process. MATERIALS AND METHODS Thirteen stakeholders who participated in a pilot trial of a VR sensory room were interviewed. Interviews were recorded and transcribed verbatim for thematic analysis. RESULTS Eleven themes were identified which indicated that adults with neurodevelopmental disabilities found the VR sensory room to be mostly acceptable and enjoyable with usage largely consistent. Individual variation and support requirements were highlighted for each user. Future use may require modifications to the headset, in-built customisation options as well as buy-in and training for support staff. CONCLUSIONS The VR Sensory room is a promising tool to support adults with neurodevelopmental disabilities and results warrant further scaled research into the impact of this tool on outcomes for adults with disabilities.Implications for RehabilitationWhilst adults with neurodevelopmental disabilities may experience sensory processing difficulties which impact their everyday life, there is a paucity of interventions to address these difficulties.Implementation studies offer the opportunity to explore how evidence-based interventions may be implemented to facilitate the best outcomes.A Virtual Reality Sensory Room may offer an innovative alternative to a traditional sensory room for adults with neurodevelopmental disabilities where implementation is well supported.
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Affiliation(s)
- Caroline Mills
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, NSW, Australia
| | - Danielle Tracey
- School of Education, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, NSW, Australia
| | - Simone Nash
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Robert Gorkin
- SMART Infrastructure Facility, University of Wollongong, NSW, Australia
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Wilkinson A, Calder A, Elliott B, Rodger R, Mulligan H, Hale L, Perry M. Disabled People or Their Support Persons' Perceptions of a Community Based Multi-Sensory Environment (MSE): A Mixed-Method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6805. [PMID: 37835075 PMCID: PMC10572127 DOI: 10.3390/ijerph20196805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/14/2023] [Accepted: 09/15/2023] [Indexed: 10/15/2023]
Abstract
Multi-sensory environments (MSEs) are specialised spaces purposely designed to stimulate the senses, whilst providing a calming and relaxing environment for leisure and enjoyment, predominantly intended for disabled people. Most MSEs are in institutions, hospitals, or educational settings, with a few in community-based settings. We explored disabled users' experiences of a community based MSE in a large metropolitan area in New Zealand, with a view to expanding access to MSE-type environments within the area. We used a convergent mixed method design with a web-based electronic survey (e-survey; n = 105), as well as semi-structured interviews (n = 14) with disabled MSE users (adults and children), who were supported, where necessary, by their support person/s. We collected the MSE users' demographics, frequency of use with respect to age, disability, and ethnicity, and experiences of the room, equipment, and accessibility. The participants and their support persons' perspectives about their experiences of using the MSE were represented by four themes: (i) Self-determination; (ii) Enhancing wellbeing opportunities; (iii) the MSE itself; (iv) Accessibility. While the MSE was considered positively, the MSE experience could be enhanced by addressing access challenges and broadening the scope of equipment to improve the usability and make it a more inclusive environment for all.
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Affiliation(s)
- Amanda Wilkinson
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Allyson Calder
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Beth Elliott
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Ryan Rodger
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Hilda Mulligan
- Canterbury Multi-Sensory Trust, Christchurch 8024, New Zealand;
| | - Leigh Hale
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Meredith Perry
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
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Tulliani N, Mills C, Collison L, Peel N, Fahey PP, Liu K. PROTOCOL: The effectiveness of sensory interventions targeted at improving occupational outcomes, quality of life, well-being and behavioural and psychological symptoms for older adults living with dementia: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1322. [PMID: 37131459 PMCID: PMC10084746 DOI: 10.1002/cl2.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: The primary objective is to systematically review the available evidence of the effects of sensory interventions on quality of life, well-being, occupational participation, and behavioural and psychological symptoms of older adults living with dementia.
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Affiliation(s)
- Nikki Tulliani
- School of Health SciencesWestern Sydney UniversityCampbelltownAustralia
| | - Caroline Mills
- School of Health SciencesWestern Sydney UniversityCampbelltownAustralia
- Translation Health Research InstituteWestern Sydney UniversityCampbelltownAustralia
| | - Lily Collison
- School of Health SciencesWestern Sydney UniversityCampbelltownAustralia
| | - Nicole Peel
- School of Health SciencesWestern Sydney UniversityCampbelltownAustralia
- Translation Health Research InstituteWestern Sydney UniversityCampbelltownAustralia
| | - Paul P. Fahey
- School of Health SciencesWestern Sydney UniversityCampbelltownAustralia
- Translation Health Research InstituteWestern Sydney UniversityCampbelltownAustralia
| | - Karen Liu
- School of Health SciencesWestern Sydney UniversityCampbelltownAustralia
- Translation Health Research InstituteWestern Sydney UniversityCampbelltownAustralia
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O’Connell A, Stephenson KAJ, Flitcroft I. Risk of Neurotoxicity with Multiple General Anaesthetics for Examination Under Anaesthesia in Paediatric Ophthalmology - A Cause for Concern? Clin Ophthalmol 2023; 17:291-302. [PMID: 36711257 PMCID: PMC9880563 DOI: 10.2147/opth.s387098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/20/2022] [Indexed: 01/20/2023] Open
Abstract
Purpose To evaluate the impact of clinical protocol change via active minimisation on the number of general anaesthetic (GA)/sedation episodes for diagnostic ophthalmic purposes at Children's Health Ireland at Temple Street (CHI-TS), Dublin, Ireland, from 2016 to 2019, inclusive. Change was implemented following published cautionary principles in 2016 by the FDA regarding the potential neurotoxic risk from multiple GA exposure in children. Methods Retrospective analysis of electronic operating theatre records was completed using procedure codes "Ophthalmological examination" and "Examination of fundi". Available records for patients undergoing multiple examination under anaesthesia (EUA) procedures were assessed for demographics, indication. Comparison was made regarding overall EUA numbers and breakdown for each year, before and after the new departmental approach. From 2018 onward, a patient-centred, departmental strategy of active minimisation of EUA was adopted, using strategies of "training, technology and patience". A literature review was conducted using online databases. Results A total of 450 EUAs were performed over the 4 years investigated. In the former 2 years of the study period, prior to departmental policy change, EUAs represented 32% (304 of 948 total theatre episodes) of the ophthalmic theatre caseload. In the latter 2 years of this study period, this proportion fell to 19% (146 EUAs of 783 theatre episodes). Total theatre case numbers were comparable in both time periods. Eighteen children had multiple EUAs (ie, ≥2 EUAs, mean 6.5, SD 2.9) for life/sight threatening indications, totalling 116 EUAs (25.7%). Conclusion A significant reduction in diagnostic EUA volume was accomplished resulting in reduced individual patient risk and increased capacity for surgical interventions. A detailed description of this methodology is included for the purposes of replication at comparable units. EUA will continue to play a crucial role in the management of life/sight threatening conditions but the application of a cautionary principle to reduce EUA, where possible, is appropriate to reduce potential for neurotoxicity.
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Affiliation(s)
- Ann O’Connell
- Ophthalmology Department, Children’s Health Ireland at Temple Street Hospital, Dublin, Ireland,Correspondence: Ann O’Connell, Children’s Health Ireland at Temple Street, Dublin, Ireland, Tel +353 1 8784200, Email
| | - Kirk A J Stephenson
- Ophthalmology Department, Children’s Health Ireland at Temple Street Hospital, Dublin, Ireland
| | - Ian Flitcroft
- Ophthalmology Department, Children’s Health Ireland at Temple Street Hospital, Dublin, Ireland
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Mills CJ, Tracey D, Kiddle R, Gorkin R. Evaluating a virtual reality sensory room for adults with disabilities. Sci Rep 2023; 13:495. [PMID: 36627351 PMCID: PMC9832154 DOI: 10.1038/s41598-022-26100-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Sensory processing difficulties can negatively impact wellbeing in adults with disabilities. A range of interventions to address sensory difficulties have been explored and virtual reality (VR) technology may offer a promising avenue for the provision of sensory interventions. In this study, preliminary evidence about the impact of Evenness, an immersive VR sensory room experience, for people with disabilities was investigated via a single intervention pre-post mixed methods design. Quantitative methodology included single intervention pre-post design (five month timeframe) with 31 adults with various developmental disabilities to determine the impact of use of aVR sensory room using a head mounted display (HMD) in relation to anxiety, depression, sensory processing, personal wellbeing and adaptive behaviour. Qualitative semi-structured interviews were also conducted with thirteen purposefully selected stakeholders following Evenness use. Results indicated significant improvements in anxiety, depression and sensory processing following Evenness use. Qualitative analysis corroborated the anxiety findings. No significant changes were observed in personal wellbeing or adaptive behaviour. Results are promising and indicate that a VR sensory room may have a positive impact on anxiety, depression and sensory processing for adults with disabilities. A longer study timeframe and a more rigorous experimental methodology is needed to confirm these findings.
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Affiliation(s)
- Caroline J. Mills
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Danielle Tracey
- grid.1029.a0000 0000 9939 5719School of Education, Western Sydney University, Bankstown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Ryan Kiddle
- grid.1007.60000 0004 0486 528XInnovation Campus, Bunji Solutions, University of Wollongong, iAccelerate, Building 239Squires Way, North Wollongong, NSW 2500 Australia
| | - Robert Gorkin
- grid.1007.60000 0004 0486 528XSMART Intrastructure Facility, University of Wollongong, Wollongong, NSW 2522 Australia
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Billé V, Gonsalvès C, Lamarche-Vadel A, Verdoux H. “It’s possible”: reducing the coercion in care for adults living with neurodevelopmental disorders: a mixed-methods study. Rech Soins Infirm 2023; 153:40-59. [PMID: 37709665 DOI: 10.3917/rsi.153.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Introduction Adults living with a neurodevelopmental disorder may present episodes of aggression, which may lead to the use of seclusion or restraint. The aim of the study was to assess the effect of an intervention aimed at reducing the use of coercive measures in a long-term care unit for adults suffering from a neurodevelopmental disorder with or without psychiatric co-morbidities. Method The single-center study used a sequential mixed-methods explanatory design. Retrospective data on periods of seclusion, with and without physical restraint, were collected for the ten-month pre-intervention and post-intervention periods. A qualitative survey was conducted at the end of the intervention period among the health professionals working in the unit to review the implementation and the efficiency of the approach. Results A significant decrease was observed between the pre- and post-intervention period in the number of seclusion and restraint sequences, the number of patients experiencing seclusion and restraint, and the duration of seclusion and restraint sequences. The efficiency of the approach was confirmed by the health care professionals and was attributed to leadership focused on limiting coercive measures, better adherence to legal obligations, team cohesion, and the implementation of alternative tools and methods. Discussion Reducing the use of coercive measures with adults with neurodevelopmental disorders is possible. Further studies are needed to confirm the effectiveness of alternative strategies to seclusion and restraint.
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Affiliation(s)
- Vincent Billé
- Infirmier en pratique avancée en santé mentale et psychiatrie, M.Sc, centre hospitalier Charles Perrens, Bordeaux, France ; Faculté des sciences infirmières, Université de Montréal, Canada
| | - Claire Gonsalvès
- Infirmière en pratique avancée en santé mentale et psychiatrie, M.Sc, centre hospitalier Charles Perrens, Bordeaux, France
| | | | - Hélène Verdoux
- Médecin, Ph.D, professeure, Université de Bordeaux, centre de recherche INSERM 1219 Bordeaux Population Health, Bordeaux, France
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Desideri L. A microswitch-aided program to enable people with extensive multiple disabilities to control environmental stimulation through different responses. Front Psychiatry 2022; 13:1073650. [PMID: 36569625 PMCID: PMC9780668 DOI: 10.3389/fpsyt.2022.1073650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives This study assessed whether a simple technology-aided program (i.e., a program involving the use of microswitches linked to a smartphone) could be set up to enable people with motor, sensory and intellectual disabilities to control preferred environmental stimulation through two different response movements. Methods Ten participants were involved in the study. Each of them was exposed to an ABAB design, in which A represented baseline phases without the program and B intervention phases with the use of the program. The study assessed whether the participants (a) had significant increases of each of the two response movements available and/or showed response variability across sessions and over time and (b) had signs of satisfaction/happiness during the study sessions, in connection with their stimulation access and control. Results The program was effective in increasing the participants' responding and consequently their self-regulated stimulation input. Half of the participants showed a significant increase of both responses available from the first intervention phase. Other participants seemed to focus more on one of the two responses. Even so, they tended to have occasionally high performance frequencies also with regard to their non-dominant (not significantly increased) response. Finally, all participants showed clear signs of satisfaction/happiness during the intervention sessions. Conclusions The program represents a potentially useful approach for enabling people with extensive multiple disabilities to self-regulate their access to preferred environmental stimulation and improve their mood.
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Affiliation(s)
- Giulio E. Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Nirbhay N. Singh
- Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States
| | - Mark F. O'Reilly
- College of Education, University of Texas at Austin, Austin, TX, United States
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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Lo Buono V, Torrisi M, Leonardi S, Pidalà A, Corallo F. Multisensory stimulation and rehabilitation for disability improvement: Lessons from a case report. Medicine (Baltimore) 2022; 101:e31404. [PMID: 36401482 PMCID: PMC9678634 DOI: 10.1097/md.0000000000031404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE Spastic quadriplegia is most severe form of Infantile Cerebral Palsy. Patients are unable to use their legs, arms and body and show language disorder and profound intellectual disability. The treatment of patients diagnosed with spastic quadriplegia is complex and multidisciplinary. In this case report we described the positive effect of multisensory environment (MSEs) rehabilitation, and the strategies and technologies used to provide child who have to severe spastic quadriplegia and intellectual disability, palsy with playful and fun activities designed according to his abilities. PATIENT CONCERN A 7-years-old boy diagnosed with spastic quadriplegia and severe intellectual disability began rehabilitation by MSEs. DIAGNOSES Spastic quadriplegia is most severe form of Infantile Cerebral Palsy. Patients are unable to use their legs, arms and body and show language disorder and profound intellectual disability. INTERVENTIONS Multisensory room is a large environment containing various elements where child can interact spontaneously and independently. OUTCOMES The comparison scores between T0-T1 showed a reduction in self-harm and motor stereotypies (hand flapping). Sustained attention was improved and we observed a better therapeutic compliance by means of greater involvement in gaming activities. CONCLUSION The stimuli within the MSEs provided the child opportunities to express himself with facilities more suited to his potential. Future research should project designed randomized controlled trials to examine the efficacy of multisensory on reduction disability.
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Affiliation(s)
| | - Michele Torrisi
- IRCCS Centro Neurolesi Bonino Pulejo Messina, Italy
- * Correspondence: Torrisi, Michele IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS113, C. da Casazza, Messina 98124, Italy (e-mail: )
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Totsika V, Liew A, Absoud M, Adnams C, Emerson E. Mental health problems in children with intellectual disability. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:432-444. [PMID: 35421380 DOI: 10.1016/s2352-4642(22)00067-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 12/16/2022]
Abstract
Intellectual disability ranks in the top ten causes of disease burden globally and is the top cause in children younger than 5 years. 2-3% of children have an intellectual disability, and about 15% of children present with differences consistent with an intellectual disability (ie, global developmental delay and borderline intellectual functioning). In this Review, we discuss the prevalence of mental health problems, interventions to address these, and issues of access to treatment and services. Where possible, we take a global perspective, given most children with intellectual disability live in low-income and middle-income countries. Approximately 40% of children with intellectual disability present with a diagnosable mental disorder, a rate that is at least double that in children without intellectual disability. Most risk factors for poor mental health and barriers to accessing support are not unique to people with intellectual disability. With proportionate universalism as the guiding principle for reducing poor mental health at scale, we discuss four directions for addressing the mental health inequity in intellectual disability.
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Affiliation(s)
- Vasiliki Totsika
- Division of Psychiatry, University College London, London, UK; Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, VIC, Australia; Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry, UK; Tavistock & Portman NHS Foundation Trust, London, UK.
| | - Ashley Liew
- Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry, UK; National & Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK; Department of Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK; Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK; Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Colleen Adnams
- Division of Intellectual Disability, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Eric Emerson
- Centre for Disability Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK; Centre for Disability Research & Policy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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Justice H, Haines D, Wright J. Occupational therapy for adults with intellectual disabilities and sensory processing challenges: a Delphi study exploring practice within acute assessment and treatment units. IRISH JOURNAL OF OCCUPATIONAL THERAPY 2021. [DOI: 10.1108/ijot-11-2020-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
Lack of research means guidance regarding the most effective sensory interventions for adults with intellectual disabilities is limited. Preliminary consensus evidence was created by gathering experienced occupational therapists’ views on practice. The purpose of this study was to establish important elements of practice when using sensory integration-informed approaches on assessment and treatment units.
Design/methodology/approach
A modified Delphi process was used to gather, explore and synthesise the views of 13 occupational therapists. Data was collected via online surveys and included quantitative importance ratings and qualitative comments.
Findings
An experienced panel was in strong agreement regarding many elements of practice they felt were important for use in this setting, and a list of important practice items was created. Two themes were identified: “Complexity” and “Pragmatism vs. Ideal World.” The themes highlight challenges to practice in this area and the complex clinical reasoning used to overcome these.
Research limitations/implications
Participants disagreed about the level of importance of a substantial number of items, therefore items that did not reach consensus may still be important.
Practical implications
This study indicates potentially helpful clinical tools, facilities and training and identifies support needed for occupational therapists working in these settings.
Originality/value
This study contributes to the body of knowledge regarding how occupational therapists do and could work with people with intellectual disabilities and sensory integration difficulties. Although this study takes a UK and Ireland perspective, similar agendas regarding care and support for those with intellectual disabilities internationally mean findings are relevant more widely.
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