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Shaban S, Amin H. Childhood disabilities and the cost of developmental therapies: the serviceprovider perspective. Int J Qual Stud Health Well-being 2024; 19:2345816. [PMID: 38657277 PMCID: PMC11044749 DOI: 10.1080/17482631.2024.2345816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 04/17/2024] [Indexed: 04/26/2024] Open
Abstract
PURPOSE For children with neurodevelopmental disabilities (CWNDs), early diagnosis that leads to early intervention with regular targeted therapies is critical. In Qatar, private therapy centres that address this demand often have highly exclusive prices restricting families from availing them. This paper examines the challenges faced by families with CWNDs, as well as various financial and systemic obstacles, from the vantage point of these centres, all of which culminate in an extraordinarily high disability price tag for disability families in Qatar. METHODS This study is based on qualitative, semi-structured, and in-depth interviews with private therapy centres and developmental paediatricians. RESULTS Therapy centre representatives expressed common struggles in lengthy and cumbersome administration and licencing procedures, difficulty in hiring and retaining high quality staff, and expenses that need to be paid to the state. From their experience, families largely struggle with delayed diagnoses that significantly slow down intervention plans and therapies as well as staggeringly high financial costs with a dearth of funding options. CONCLUSIONS We recommend sincere engagement, dialogue, and cooperation between multiple stakeholders; a supportive ecosystem to balance and distribute the demand that includes schools and parents; as well more efficient administrative procedures and recruitment strategies.
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Affiliation(s)
- Sabika Shaban
- College of Islamic Studies, Hamad Bin Khalifa University, Doha, Qatar
| | - Hira Amin
- College of Public Policy, Hamad Bin Khalifa University, Doha, Qatar
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McManus M, White P, Beers N, Levey E, Coy N, Caulker J, Gaither T, Schmidt A, Ilango S. Value-Based Payment to Support Health Care Transition for Young Adults with Intellectual and Developmental Disabilities: A Feasibility Study. Matern Child Health J 2024; 28:789-797. [PMID: 37952212 DOI: 10.1007/s10995-023-03835-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Only 20% of youth with intellectual and developmental disability (ID/DD) receive health care transition (HCT) preparation from their health care providers (HCPs). To address HCT system gaps, the first-of-its-kind HCT value-based payment (VBP) pilot was conducted for young adults (YA) with ID/DD. METHODS This feasibility study examined the acceptability, implementation, and potential for expansion of the pilot, which was conducted within a specialty Medicaid managed care organization (HSCSN) in Washington, DC. With local pediatric and adult HCPs, the HCT intervention included a final pediatric visit, medical summary, joint HCT visit, and initial adult visit. The VBP was a mix of fee-for-service and pay-for-performance incentives. Feasibility was assessed via YA feedback surveys and interviews with HSCSN, participating HCPs, and selected state Medicaid officials. RESULTS Regarding acceptability, HSCSN and HCPs found the HCT intervention represented a more organized approach and addressed an unmet need. YA with ID/DD and caregivers reported high satisfaction. Regarding implementation, nine YA with ID/DD participated. Benefits were reported in patient engagement, exchange of health information, and care management and financial support. Challenges included care management support needs, previous patient gaps in care, and scheduling difficulties. Regarding expansion, HSCSN and HCPs agreed that having streamlined care management support, medical summary preparation, and payment for HCT services are critical. DISCUSSION This study examined the benefits and challenges of a HCT VBP approach and considerations for future expansion, including payer/HCP collaboration, HCT care management support, and updated system technology and interoperability.
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Affiliation(s)
- Margaret McManus
- The National Alliance to Advance Adolescent Health, 5335 Wisconsin Ave. NW, Suite 440, Washington, DC, 20015, USA
| | - Patience White
- The National Alliance to Advance Adolescent Health, 5335 Wisconsin Ave. NW, Suite 440, Washington, DC, 20015, USA
| | - Nathaniel Beers
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Eric Levey
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Nadine Coy
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Jalima Caulker
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Takisha Gaither
- Health Services for Children with Special Needs, 1101 Vermont Avenue NW, Suite 1200, Washington, DC, 20005, USA
| | - Annie Schmidt
- The National Alliance to Advance Adolescent Health, 5335 Wisconsin Ave. NW, Suite 440, Washington, DC, 20015, USA.
| | - Samhita Ilango
- The National Alliance to Advance Adolescent Health, 5335 Wisconsin Ave. NW, Suite 440, Washington, DC, 20015, USA
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Karimi M, Dhopeshwarkar R, Jiménez F, Ryan S, Plourde E. Improving Data Infrastructure for Person-Centered Outcomes Research on Intellectual and Developmental Disabilities. Am J Intellect Dev Disabil 2024; 129:231-241. [PMID: 38657962 DOI: 10.1352/1944-7558-129.3.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/28/2023] [Indexed: 04/26/2024]
Abstract
Individuals with intellectual and developmental disabilities (IDD) continue to experience disparities in health and well-being despite improved provisions of person-centered care. Patient-centered outcomes research (PCOR) translates evidence into practice for meaningful outcomes. This piece describes findings from an environmental scan and stakeholder outreach to identify and prioritize opportunities to enhance IDD PCOR data infrastructure. These opportunities include developing a standardized research definition; advancing data standards for service systems; improving capture of IDD at point of care; developing standardized outcome measures; and encouraging Medicaid data use for IDD research. Within this piece, we discuss the implications of addressing data gaps for enhanced research. While the identified activities provide a path towards advancing IDD PCOR data infrastructure, collaborative efforts between government, researchers, and others are paramount.
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Affiliation(s)
- Madjid Karimi
- Madjid Karimi, U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE)
| | - Rina Dhopeshwarkar
- Rina Dhopeshwarkar, Frances Jiménez, and Sofia Ryan, Health Sciences Department, NORC at the University of Chicago
| | - Frances Jiménez
- Rina Dhopeshwarkar, Frances Jiménez, and Sofia Ryan, Health Sciences Department, NORC at the University of Chicago
| | - Sofia Ryan
- Rina Dhopeshwarkar, Frances Jiménez, and Sofia Ryan, Health Sciences Department, NORC at the University of Chicago
| | - Emma Plourde
- Emma Plourde, Office of Behavioral Health, Disability, and Aging Policy, Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services
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Postma A, Ketelaar M, van Nispen Tot Sevenaer J, Downs Z, van Rappard D, Jongmans M, Zinkstok J. Exploring individual parent-to-parent support interventions for parents caring for children with brain-based developmental disabilities: A scoping review. Child Care Health Dev 2024; 50:e13255. [PMID: 38587275 DOI: 10.1111/cch.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/21/2024] [Accepted: 03/08/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Brain-based developmental disabilities (BBDDs) comprise a large and heterogeneous group of disorders including autism, intellectual disability, cerebral palsy or genetic and neurodevelopmental disorders. Parents caring for a child with BBDD face multiple challenges that cause increased stress and high risk of mental health problems. Peer-based support by fellow parents for a various range of patient groups has shown potential to provide emotional, psychological and practical support. Here, we aim to explore existing literature on individual peer-to-peer support (iP2PS) interventions for parents caring for children with BBDD with a view to (1) explore the impact of iP2PS interventions on parents and (2) identify challenges and facilitators of iP2PS. METHOD An extensive literature search (January 2023) was performed, and a thematic analysis was conducted to synthesize findings. RESULTS Fourteen relevant articles revealed three major themes regarding the impact of iP2PS on parents: (1) emotional and psychological well-being, (2) quality of life and (3) practical issues. Four themes were identified describing challenges and facilitators of iP2PS: (1) benefits and burden of giving support, (2) matching parent-pairs, (3) logistic challenges and solutions and (4) training and supervision of parents providing peer support. CONCLUSIONS This review revealed that iP2PS has a positive impact on the emotional and psychological well-being of parents, as well as the overall quality of life for families caring for a child with a BBDD. Individual P2PS offers peer-parents an opportunity to support others who are facing challenges similar to those they have experienced themselves. However, many questions still need to be addressed regarding benefits of different iP2PS styles, methods of tailoring support to individual needs and necessity of training and supervision for peer support providers. Future research should focus on defining these components and evaluating benefits to establish effective iP2PS that can be provided as standard care practice for parents.
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Affiliation(s)
- Amber Postma
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Department of Rehabilitation, Physical Therapy and Sports; Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- De Hoogstraat, Rehabilitation, Utrecht, The Netherlands
| | | | - Zahra Downs
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Diane van Rappard
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marian Jongmans
- Department of Pedagogical and Educational Sciences, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Janneke Zinkstok
- Department of Psychiatry and Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry Nijmegen, Nijmegen, The Netherlands
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Gosse G, Kumar S, Banwell H, Moran A. Exploring Allied Health Models of Care for Children with Developmental Health Concerns, Delays, and Disabilities in Rural and Remote Areas: A Systematic Scoping Review. Int J Environ Res Public Health 2024; 21:507. [PMID: 38673418 PMCID: PMC11050593 DOI: 10.3390/ijerph21040507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Access to appropriate healthcare is essential for children's healthy development. This is lacking in rural and remote areas, impacting health outcomes. Despite efforts to improve access for these communities, to date, no review has systematically mapped the literature on allied health models of care for children with developmental needs. This scoping review seeks to address this knowledge gap. METHODS Adhering to the PRISMA-ScR and Joanna Briggs Institute guidelines, a systematic search was conducted. A total of 8 databases (from inception to May 2023) and 106 grey literature sources were searched. Two reviewers independently undertook a two-stage screening process. Data were extracted using customised tools and narratively synthesised utilising the Institute of Medicine's quality domains. This review is registered a priori via Open Science Framework. RESULTS Twenty-five citations were identified within the literature. Varied models of care were reported from five mostly Western countries. Models of care identified in these areas were classified as screening services, role substitution, consultative services, or online-based services. Positive impacts on quality of healthcare were reported across all quality domains (apart from safety) with the domain of effectiveness being the most commonly reported. CONCLUSIONS Multiple models of care are currently in operation for children with developmental needs in rural and remote areas and appear to improve the quality of care. Due to complexities within, and limitations of, the evidence base, it is unclear if one model of care is superior to another. This review provides a basis for further research to explore why some models may be more effective than others.
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Affiliation(s)
- Georgia Gosse
- Innovation Implementation and Clinical Translation, Allied Health and Human Performance Unit, University of South Australia, North Tce, Adelaide, SA 5001, Australia
| | - Saravana Kumar
- Innovation Implementation and Clinical Translation, Allied Health and Human Performance Unit, University of South Australia, North Tce, Adelaide, SA 5001, Australia
| | - Helen Banwell
- Innovation Implementation and Clinical Translation, Allied Health and Human Performance Unit, University of South Australia, North Tce, Adelaide, SA 5001, Australia
| | - Anna Moran
- Department of Rural Health, Melbourne Medical School, The University of Melbourne, Graham St Shepparton, Melbourne, VIC 3630, Australia
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McKinnon I, Iranpour A, Charlton A, Green E, Groom F, Watts O, McKenna D, Hackett S. Models of care in secure services for people with intellectual and developmental disability: Implementing the Walkway to Wellness. Crim Behav Ment Health 2024; 34:144-162. [PMID: 38279962 DOI: 10.1002/cbm.2328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 01/04/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Changes to policy around inpatient services for people with intellectual and developmental disability (IDD) who offend, have led to a need for services to reconsider their models of care. This has led to calls for more tailored, patient-centred care models, with less reliance solely on offence-related treatment programmes which can be unsuitable for a growing proportion of patients with more complex cognitive and behavioural difficulties. In response, the Walkway to Wellness (W2W) was developed at one National Health Service Trust providing secure services to people with IDD, with the intention of delivering a more collaborative, co-produced and goal-oriented care model that was better understood by staff and patient stakeholders. AIMS To evaluate the implementation of the W2W using Normalisation Process Theory (NPT), an evidence-based theoretical approach is used across a number of health settings. METHODS Staff were invited to complete a short questionnaire, using the NPT informed Normalisation Measure Development questionnaire, at two time points along the implementation process. Patients were invited to complete a simplified questionnaire. Both groups were asked for their views on the W2W and the process of its implementation. RESULTS Although the W2W was more familiar to staff at the second time point, scores on the four NPT constructs showed a trend for it being less embedded in practice, with significant results concerning the ongoing appraisal of the new model. Patient views were mixed; some saw the benefit of more goal-oriented processes, but others considered it an additional chore hindering their own perceived goals. CONCLUSION Early involvement of all stakeholders is required to enhance the understanding of changes to models of care. Live feedback should be used to refine and revise the model to meet the needs of patients, carers and staff members.
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Affiliation(s)
- Iain McKinnon
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Morpeth, UK
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Arman Iranpour
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Morpeth, UK
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Anne Charlton
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Morpeth, UK
| | - Ellen Green
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Morpeth, UK
| | - Faye Groom
- School of Psychology, Newcastle University, Newcastle-upon-Tyne, UK
| | - Oliver Watts
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Morpeth, UK
| | - Dannielle McKenna
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Morpeth, UK
| | - Simon Hackett
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Morpeth, UK
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
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Carlson SR, Munandar V, Thompson JR. Outcomes for Adults With Intellectual and Developmental Disabilities Receiving Long-Term Services and Supports: A Systematic Review of the Literature. Intellect Dev Disabil 2024; 62:137-150. [PMID: 38545817 DOI: 10.1352/1934-9556-62.2.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/10/2023] [Indexed: 04/05/2024]
Abstract
The impact of long-term services and supports on the quality of life of adults with intellectual and developmental disabilities (IDD) is not well understood given the highly complex nature of researching this topic. To support future research addressing this topic, we conducted a systematic literature review of studies addressing outcomes of adults with IDD receiving long-term services and supports. Results of this review describe current outcomes for adults with IDD who receive long-term services and supports and can be used to inform program evaluation, policy development, and future research.
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Affiliation(s)
- Sarah R Carlson
- Sarah R. Carlson, University of New Mexico; Vidya Munandar, Kennesaw State University; and James R. Thompson, University of Kansas
| | - Vidya Munandar
- Sarah R. Carlson, University of New Mexico; Vidya Munandar, Kennesaw State University; and James R. Thompson, University of Kansas
| | - James R Thompson
- Sarah R. Carlson, University of New Mexico; Vidya Munandar, Kennesaw State University; and James R. Thompson, University of Kansas
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8
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Johnston KJ, Hendricks MA, Pollack HA. Closing Gaps in Public Services for US Residents With Intellectual and Developmental Disabilities. JAMA Pediatr 2024; 178:335-336. [PMID: 38372984 DOI: 10.1001/jamapediatrics.2023.6038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
This Viewpoint describes existing public health and social service systems for persons with intellectual and developmental disabilities as they transition to adult care, barriers and opportunities faced in service access, and potential actions to narrow these gaps and enhance equity.
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Affiliation(s)
- Kenton J Johnston
- Department of Medicine, General Medical Sciences Division, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Michelle A Hendricks
- Department of Medicine, General Medical Sciences Division, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Harold A Pollack
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, Illinois
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Kei N, Hassiotis A, Royston R. The effectiveness of parent-Child observation in parent-Mediated programmes for children with developmental disabilities and externalizing disorders: A systematic review and meta-analysis. Clin Child Psychol Psychiatry 2024; 29:713-736. [PMID: 37748447 DOI: 10.1177/13591045231203097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
This systematic review evaluated the treatment effects of communication-focused parent-mediated interventions (CF-PMT), a form of intervention that involves therapists observing parent-child interactions and giving feedback to parents on how they can practice positive parenting strategies to prevent or reduce externalizing behaviours in children with developmental disabilities. A literature search was conducted on three electronic databases. To be included in the review, studies had to: evaluate CF-PMT where therapists give feedback after observing parent-child interactions; examine changes in externalizing behaviours amongst children with any forms of developmental disability; and adopt a randomised controlled trial study design. Fifteen studies met eligible criteria for the literature review, of those, 13 studies had available data on changes in the primary (child externalizing behaviours) and secondary outcomes (parental stress, child linguistic abilities and child social responsiveness). We found significant treatment effects for CF-PMT in reducing child externalizing behaviours (d = -.60) but not for any of the secondary outcomes. A sensitivity analysis showed a small but significant treatment effect for parental stress (d = -.18). Considerable bias was observed due to the lack of available information reported by studies on aspects measured by the Mixed Methods Appraisal Tool. Overall, we found evidence to support the benefits of complex interventions which incorporate direct parent-child observations and feedback to improve behavioural outcomes amongst children with developmental disabilities.
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Affiliation(s)
- Noel Kei
- University College London, London, UK
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10
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Moore TR, Lee S, Freeman R, Mahmoundi M, Dimian A, Riegelman A, Simacek JJ. A Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities. Behav Modif 2024; 48:216-256. [PMID: 38197303 DOI: 10.1177/01454455231218742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Self-injurious behavior (SIB) among children and youth with developmental disabilities has not diminished in prevalence despite the availability of effective interventions, and the impact on quality of life for people and their families is devastating. The current meta-analysis reviews SIB intervention research between 2011 and 2021 using single-case experimental designs with children and youth up to 21 years old and provides a quantitative synthesis of data from high-quality studies including moderator analyses to determine effects of participant and study characteristics on intervention outcomes. Encouraging findings include a high level of effectiveness across studies in the decrease of SIB (Tau-U = -0.90) and increase of positive behavior (Tau-U = 0.73), as well as an increase in studies (relative to prior reviews) reporting intervention fidelity, generalization, maintenance, and social validity. However, our findings shed limited light on potential moderating variables in the development of interventions for children and youth who exhibit SIB. Of the potential moderators of intervention effects, only implementer (researcher/therapist vs. parent/caregiver) and setting (clinic vs. home) were significantly associated with improved outcomes. We discuss the need for more robust involvement of natural communities of implementers in SIB intervention research to better equip them to effectively and sustainably meet the needs of people they care for. We also discuss the importance of creating systems enabling broad access for children with SIB to effective interventions in service of reducing burden for people, families, and society over time.
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Affiliation(s)
- Timothy R Moore
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, USA
| | - Seunghee Lee
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
| | - Rachel Freeman
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
| | - Maryam Mahmoundi
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
| | - Adele Dimian
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
| | - Amy Riegelman
- Social Sciences Libraries, University of Minnesota, Minneapolis, USA
| | - Jessica J Simacek
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
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11
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Bihani NR, Klisz-Hulbert R. A Paradigm for Improving Transition Planning for Adolescents With Intellectual Developmental Disorder. J Am Acad Child Adolesc Psychiatry 2024; 63:301-303. [PMID: 37778725 DOI: 10.1016/j.jaac.2023.09.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 06/06/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
Families of children with intellectual and developmental disorder (IDD) face unique challenges while navigating the transition into adulthood, such as finding suitable housing, optimizing independence, fostering meaningful relationships, and identifying a vocation.1-3 Often, the daily struggles of managing the individual's needs overshadow essential long-term preparation. Individuals with IDD and their families need guidance to transition from an entitlement-driven system (special education) to multiple eligibility-driven systems (adult care, postsecondary education services, housing supports, etc). The majority of those currently involved in transition planning are school personnel, followed closely by family members. Few of these planning meetings include the individuals themselves or personnel from outside agencies, such as social services and mental health.2 The complexity of these systems marginalizes this population by creating barriers to accessing necessary support. This is where psychiatrists, especially child and adolescent psychiatrists, can create a bridge.
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Affiliation(s)
- Nina Rajesh Bihani
- Wayne State University, Detroit, Michigan; Detroit Medical Center, Detroit, Michigan; University of California San Diego, San Diego, California; Rady Children's Hospital, San Diego, California.
| | - Rebecca Klisz-Hulbert
- Wayne State University, Detroit, Michigan; Detroit Medical Center, Detroit, Michigan
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Ke JC, Hayati Rezvan P, Vanderbilt D, Mirzaian CB, Deavenport-Saman A, Smith BA. Similar early intervention referral rates following in-person administration of the Bayley Scales of Infant and Toddler Development, 4th Edition versus Telehealth Administration of the Developmental Assessment in Young Children, 2nd Edition in the high-risk infant population. Early Hum Dev 2024; 190:105971. [PMID: 38367589 DOI: 10.1016/j.earlhumdev.2024.105971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Infants with prematurity, low birthweight, and medical comorbidities are at high risk for developmental delays and neurodevelopmental disabilities and require close monitoring. Due to the COVID-19 pandemic, high-risk infant follow-up (HRIF) programs have adapted to perform developmental assessments via telehealth. OBJECTIVES Describe the referral rates to initiate, continue, or increase/add early intervention (EI) therapies based on in-person use of the Bayley Scales of Infant and Toddler Development, 4th Edition (BSID-IV) or telehealth use of the Developmental Assessment in Young Children, 2nd Edition (DAYC-2). METHODS A retrospective chart review was conducted on 203 patients seen in the HRIF program at an academic medical center in Southern California. Patients were divided into in-person (BSID-IV) and telehealth (DAYC-2) assessment groups. Statistical analyses were performed to describe demographic characteristics, medical information, and referral rates for EI therapies by the types of visits. RESULTS The in-person and telehealth groups demonstrated similar demographic and clinical characteristics and comparable referral rates for initiating EI therapies. Telehealth patients already receiving therapies were recommended to increase/add EI therapies at a higher rate compared to in-person patients. CONCLUSIONS The BSID-IV is widely used to assess for developmental delays in the high-risk infant population, but in-person administration of this tool poses limitations on its accessibility. Telehealth administration of an alternative tool, such as the DAYC-2, can lead to similar EI referral rates as in-person administration of the BSID-IV. Increased use of telehealth developmental assessments can promote timely detection of developmental delays and minimize gaps in healthcare access.
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Affiliation(s)
- Jasmine C Ke
- Division of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA.
| | - Panteha Hayati Rezvan
- Biostatistics and Data Management Core, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Douglas Vanderbilt
- Division of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Christine B Mirzaian
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; Division of General Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Alexis Deavenport-Saman
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; Division of General Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Beth A Smith
- Division of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
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Kim J, Gray JA. Measuring palliative care self-efficacy of intellectual and developmental disability staff using Rasch models. Palliat Support Care 2024; 22:146-154. [PMID: 36683394 DOI: 10.1017/s1478951522001833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The objectives of this study were to evaluate the psychometric properties of a palliative care self-efficacy instrument developed for intellectual and developmental disability (IDD) staff using Rasch analysis and assess the change in palliative care self-efficacy between 2 time points using Rasch analysis of stacked data. METHODS Staff from 4 nonprofit IDD services organizations in a US Midwestern state (n = 98) answered 11 questions with Likert-style responses at baseline and 1-month follow-up post training. Rasch analysis was performed to examine rating scale structure, unidimensionality, local independence, overall model fit, person and item reliability and separation, targeting, individual item and personal fit, differential item functioning (DIF), and change in palliative care self-efficacy between 2 time points. RESULTS The rating scale structure improved when 5 response categories were collapsed to 3. With the revised 3 response categories, the instrument demonstrated good psychometric properties. Principal components analysis of Rasch residuals supported the assumption of unidimensionality. Model fit statistics indicated an excellent fit of the data to the Rasch model. The instrument demonstrated good person and item reliability and separation. Gender-related DIF was found in 1 item, and work tenure-related DIF in 3 items. Overall palliative care self-efficacy improved between 2 time points. SIGNIFICANCE OF RESULTS Rasch analysis allowed for a more thorough examination of this palliative care self-efficacy instrument than classical test theory and provided information on rating scale structure, targeting, DIF, and individual persons and items. These recommendations can improve this instrument for research and practical contexts.
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Affiliation(s)
- Jinsook Kim
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
| | - Jennifer A Gray
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
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Razaq S, Anwar F. Response to Referral Profile of Developmental Disabilities at a Tertiary Care Hospital in a Resource-limited Country. J Coll Physicians Surg Pak 2024; 34:251-252. [PMID: 38342886 DOI: 10.29271/jcpsp.2024.02.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/04/2023] [Indexed: 02/13/2024]
Affiliation(s)
- Sarah Razaq
- Deparment of Physical Medicine and Rehabilitation, Combined Military Hospital, Mangla Cantt, Punjab, Pakistan
| | - Fahim Anwar
- Department of Rehabilitation Medicine, Addenbrooke's Hospital, University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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15
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James TG, Argenyi MS, Gravino A, Benevides TW. Human immunodeficiency virus diagnosis and care among adults with intellectual and developmental disabilities who are publicly insured. J Intellect Disabil Res 2024; 68:150-163. [PMID: 37859301 DOI: 10.1111/jir.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/18/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND This study aimed to assess the prevalence of human immunodeficiency virus (HIV) testing, HIV diagnosis and receipt of HIV care among adults with intellectual and developmental disabilities (IDDs) who are publicly insured in the USA. DESIGN This study is a cross-sectional analysis of Medicare-Medicaid linked data of adults with IDD who were publicly insured in 2012 (n = 878 186). METHODS We estimated adjusted prevalence ratios of HIV testing, diagnosis and receipt of antiretroviral therapy (ART). We also identified the relationship between predisposing (age, gender, race and ethnicity), enabling (Medicare, Medicaid or both; rural status; geographical location; and county income) and need-related characteristics (IDD diagnosis and other co-occurring conditions) associated with these outcomes. RESULTS Only 0.12% of adults with IDD who had no known HIV diagnosis had received an HIV test in the past year. The prevalence of HIV diagnosis among adults with IDD was 0.38%, although differences by type of IDD diagnosis were observed. Prevalence of HIV diagnosis differed by type of IDD. Among adults with IDD who were living with HIV, approximately 71% had received ART during 2012. The adjusted analyses indicate significant racial disparities, with Black adults with IDD making up the majority (59.11%) of the HIV-positive IDD adult population. CONCLUSIONS Adults with IDD are a unique priority population at risk for HIV-related disparities, and the level of risk is differential among subtypes of IDD. People with IDD, like other people with disabilities, should be considered in prevention programming and treatment guidelines to address disparities across the HIV care continuum.
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Affiliation(s)
- T G James
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - M S Argenyi
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - A Gravino
- Rutgers Center for Adult Autism Services, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - T W Benevides
- Institute of Public and Preventive Health & Department of Occupational Therapy, Augusta University, Augusta, GA, USA
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Schall C, Avellone L, Wehman P. Employment Interventions for People With Intellectual and Developmental Disabilities: A Delphi Study of Stakeholder Perspectives. Intellect Dev Disabil 2024; 62:27-43. [PMID: 38281515 DOI: 10.1352/1934-9556-62.1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/10/2023] [Indexed: 01/30/2024]
Abstract
The purpose of this study was to examine the social validity of five different evidence-based and emerging pathways to employment (i.e., supported employment, customized employment, internships, apprenticeships, and postsecondary education) from the perspective of multiple stakeholders. A Delphi method was used to determine whether stakeholders are in consensus regarding the accessibility, affordability, acceptability, efficacy, and the cost-benefit ratio of these interventions. Findings indicated that all pathways were deemed socially valid via stakeholder consensus except for apprenticeships, which could not be determined as a result of limited stakeholder knowledge and experience with the pathway. Future efforts to improve employment outcomes for people with intellectual and developmental disabilities (IDD) should focus on better training for service providers and increased access to services.
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Affiliation(s)
- Carol Schall
- Carol Schall, Lauren Avellone, and Paul Wehman, Virginia Commonwealth University
| | - Lauren Avellone
- Carol Schall, Lauren Avellone, and Paul Wehman, Virginia Commonwealth University
| | - Paul Wehman
- Carol Schall, Lauren Avellone, and Paul Wehman, Virginia Commonwealth University
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17
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Fawzi WW, Partap U. Optimizing Interventions for Early Childhood Development. JAMA 2024; 331:25-27. [PMID: 38165411 DOI: 10.1001/jama.2023.23652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Uttara Partap
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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18
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Atmar K, Defrancq A, Hermans M, van Vliet C, Kasius M. [Catatonia in youth with developmental disabilities: challenges in recognition and management]. Tijdschr Psychiatr 2024; 66:46-50. [PMID: 38380488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Catatonia in children and adolescents is not rare and, as in adults, has a favorable outcome, provided it is recognized and treated promptly. Nevertheless, in clinical practice we encounter several obstacles in terms of diagnosis and treatment in this population of patients. We describe a 14-year-old boy with an intellectually disability and autism spectrum disorder (ASD) in which clinicians did not diagnose catatonia until 1 year after the development of symptoms. Moreover, hesitations surrounding the correct treatment led to its delayed initiation. With this case report we aim to contribute to reduced reluctance and increased alertness in the treatment of catatonia in adolescents with developmental disorders.
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Northrup RA, Jacobson LA, Pritchard AE. "It starts with a knock on the door": Caregiver and provider perspectives on healthcare communication for youth with intellectual and developmental disabilities. Patient Educ Couns 2024; 118:108020. [PMID: 37871354 DOI: 10.1016/j.pec.2023.108020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES Effective healthcare communication (HCC) is critical for youth with intellectual and developmental disabilities (IDD) who may have complex healthcare needs. The goal of this study was to gain family caregiver and provider perspectives on facilitators and challenges to effective HCC for youth with IDD. METHODS Caregivers of, and providers for youth with IDD were recruited from the community to participate in virtual focus group (FG) sessions. FGs were 60-90 min long and were facilitated by a research team consisting of caregivers and providers. The FGs were recorded, transcribed, and coded inductively for HCC themes. RESULTS Nineteen stakeholders participated in the FGs (caregivers: n = 14; providers: n = 5). Twenty-three themes were coded from the transcripts and were categorized by whether they focused on providers, caregivers, or healthcare systems. CONCLUSIONS Provider behaviors such as active listening and demonstrating humility were found to be critical for effective HCC. Fewer caregiver factors, such as advocacy, and systems factors such as visit format, emerged from the FG data. FG themes represent challenges that future interventions must address. PRACTICE IMPLICATIONS Efforts to improve HCC, and thus healthcare outcomes for youth with IDD, should address challenges identified by caregivers and providers.
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Affiliation(s)
- Rachel A Northrup
- Kennedy Krieger Institute, Department of Neuropsychology, Baltimore, MD, USA.
| | - Lisa A Jacobson
- Kennedy Krieger Institute, Department of Neuropsychology, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Psychiatry and Behavioral Sciences, Baltimore, MD, USA
| | - Alison E Pritchard
- Kennedy Krieger Institute, Department of Neuropsychology, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Psychiatry and Behavioral Sciences, Baltimore, MD, USA
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20
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Affiliation(s)
- Martin T Stein
- University of California San Diego, Rady Children's Hospital, San Diego, CA
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21
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Pazol K, Tian LH, DiGuiseppi C, Durkin MS, Fallin MD, Moody EJ, Nadler C, Powell PS, Reyes N, Robinson B, Ryerson AB, Thierry JM, Tinker SC, Wiggins LD, Yeargin-Allsopp M. Health and Education Services During the COVID-19 Pandemic Among Young Children with Autism Spectrum Disorder and Other Developmental Disabilities. J Dev Behav Pediatr 2024; 45:e31-e38. [PMID: 38364085 PMCID: PMC10963045 DOI: 10.1097/dbp.0000000000001227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/29/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Understanding how the COVID-19 pandemic affected children with disabilities is essential for future public health emergencies. We compared children with autism spectrum disorder (ASD) with those with another developmental disability (DD) and from the general population (POP) regarding (1) missed or delayed appointments for regular health/dental services, immunizations, and specialty services; (2) reasons for difficulty accessing care; and (3) use of remote learning and school supports. METHOD Caregivers of children previously enrolled in the Study to Explore Early Development, a case-control study of children with ASD implemented during 2017 to 2020, were recontacted during January-June 2021 to learn about services during March-December 2020. Children were classified as ASD, DD, or POP during the initial study and were aged 3.4 to 7.5 years when their caregivers were recontacted during the pandemic. RESULTS Over half of all children missed or delayed regular health/dental appointments (58.4%-65.2%). More children in the ASD versus DD and POP groups missed or delayed specialty services (75.7%, 58.3%, and 22.8%, respectively) and reported difficulties obtaining care of any type because of issues using telehealth and difficulty wearing a mask. During school closures, a smaller proportion of children with ASD versus another DD were offered live online classes (84.3% vs 91.1%), while a larger proportion had disrupted individualized education programs (50.0% vs 36.2%). CONCLUSION Minimizing service disruptions for all children and ensuring continuity of specialty care for children with ASD is essential for future public health emergencies. Children may need additional services to compensate for disruptions during the pandemic.
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Affiliation(s)
- Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lin H. Tian
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | | | - Eric J. Moody
- University of Wyoming Institute for Disabilities, Laramie, WY
| | - Cy Nadler
- Children’s Mercy Kansas City, Kansas City, MO
| | - Patrick S. Powell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Nuri Reyes
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Britney Robinson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - JoAnn M. Thierry
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sarah C. Tinker
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
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Mazzucchelli TG, Tonge BJ, Brereton AV, Wade C, Baird-Bate K, Dawe S. The national disability insurance scheme and parenting support for families of children with developmental disability: A need for policy reform. Aust N Z J Psychiatry 2023; 57:1508-1510. [PMID: 37596953 PMCID: PMC10666470 DOI: 10.1177/00048674231192369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Affiliation(s)
- Trevor G Mazzucchelli
- School of Population Health, Curtin University, Perth, WA, Australia
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, QLD, Australia
| | - Bruce J Tonge
- Centre for Developmental Psychiatry and Psychology, Monash University, Clayton, VIC, Australia
| | - Avril V Brereton
- Centre for Developmental Psychiatry and Psychology, Monash University, Clayton, VIC, Australia
| | - Catherine Wade
- Parenting Research Centre, East Melbourne, VIC, Australia
| | - Kirsten Baird-Bate
- School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sharon Dawe
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
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23
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Nicholas DB, Mitchell W, Ciesielski J. Examining the Impacts of the COVID-19 Pandemic on Service Providers Working with Children and Youth with Neuro-developmental Disabilities and their Families: Results of a Focus Group Study. J Intellect Disabil 2023; 27:871-884. [PMID: 35652791 PMCID: PMC9163652 DOI: 10.1177/17446295221104623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has imposed unprecedented service interruptions in many sectors including services for children and youth with neuro-developmental disabilities (NDD). We examined the experiences of service providers as they supported this population during the pandemic. Five focus groups were convened with 24 service providers offering support to children/youth with NDD and their families. Results highlight substantial service changes and challenges, as observed by service providers. Service closures and program delivery modification resulted in the rapid adoption of virtual services and reduced program delivery. Service providers have faced heightened workloads, personal weariness and 'burn out', and new levels of conflict at work, yet with little opportunity and support for self-care. Beyond challenges, new learning and growth have emerged, with heightened collaboration amongst organizations. Strains in service delivery during the pandemic have exposed programming and systems gaps, for which proactive capacity building is warranted and recommended.
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Affiliation(s)
- David B. Nicholas
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
| | - Wendy Mitchell
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
| | - Jill Ciesielski
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
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24
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İsvan N, Bonardi A, Hiersteiner D. Effects of person-centred planning and practices on the health and well-being of adults with intellectual and developmental disabilities: a multilevel analysis of linked administrative and survey data. J Intellect Disabil Res 2023; 67:1249-1269. [PMID: 36808669 DOI: 10.1111/jir.13015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 12/20/2022] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND A person-centred service planning and practice approach (PCP) is one that is driven by service users' individual preferences, needs and priorities. The approach has been identified as a best practice and is codified in US policies that encourage and, in some contexts, require state systems of home and community-based services to adopt and demonstrate person-centred practice. However, there is insufficient research on PCP's direct impact on outcomes for service users. This study aims to contribute to the evidence base in this area by investigating the association between service experiences and outcomes of adults with intellectual and developmental disabilities (IDD) receiving state-funded services. METHODS The data for the study come from the 2018-2019 National Core Indicators® In-Person Survey that links survey responses with administrative records for a sample of 22 000 adults with IDD receiving services from 37 state developmental disabilities (DD) systems. Associations among service experiences and outcomes of survey participants are examined through multilevel regression techniques that include participant-level responses and state-level measures of PCP. The state-level measures are constructed by combining administrative records describing participants' service plans with the priorities and goals they expressed in response to the survey. RESULTS Case managers' (CM) accessibility and attentiveness to individual preferences, as reported by survey participants, are significantly associated with self-reported outcomes such as perceived control over life decisions and sense of health and well-being. Controlling for participants' experiences with their CMs, their reports of the person-centred content of their service plans have net positive associations with outcomes. After accounting for experiences with the service system as reported by participants, the state system's person-centred orientation, measured by the extent to which service plans across the state reflect participants' wishes for improving their social connections, remains a significant predictor of participants' sense of control over their daily lives. CONCLUSIONS This study contributes to the evidence base supporting PCP as a service model by identifying pathways that link person-centred service planning and delivery and person-centred orientation of state systems to positive outcomes reported by adults with IDD and by demonstrating the value of linking survey and administrative data. The key implication of the findings for policy and practice is that an overall person-centred orientation of state DD systems as well as PCP training for people who support planning for and delivery of direct supports will substantially improve the lives of adults with IDD.
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Affiliation(s)
- N İsvan
- Human Services Research Institute, Cambridge, MA, USA
| | - A Bonardi
- Human Services Research Institute, Cambridge, MA, USA
| | - D Hiersteiner
- Human Services Research Institute, Cambridge, MA, USA
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25
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Siegel J, McGrath K, Muniz E, Siasoco V, Chandan P, Noonan E, Bonuck K. Infusing intellectual and Developmental disability training into Medical School curriculum: a Pilot intervention. Med Educ Online 2023; 28:2271224. [PMID: 37859424 PMCID: PMC10591531 DOI: 10.1080/10872981.2023.2271224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Despite the rising prevalence of developmental disabilities (DD) in the US, there remains insufficient training for healthcare professionals to care for this medically underserved population - particularly adults. The National Inclusive Curriculum for Health Education (NICHE) aims to improve attitudes and knowledge towards people with intellectual and developmental disabilities (PWIDD); herein we describe one such intervention. METHOD The intervention integrated didactic, panel presentation and clinical skills components into a 2nd year medical school curriculum. The didactic session, covering health and assessment of PWIDDs, history of IDD, stigma, etc., was co-taught by a developmental pediatrician, family medicine physician and social worker. A panel of 3 adult self-advocates (SAs) with DD and a parent of a child with DD spoke about their lived experiences. One week later, students practiced taking clinical histories of SAs within small group settings with adult PWIDDs, facilitated by medical school faculty. Students completed the NICHE Knowledge(49 items) and Attitudes (60 items) surveys. The evaluation analyzed pre/post intervention differences in a) knowledge and attitude scores overall and b) by student age, gender, intended medical specialty, and prior experiences with PWIDDs. Open-ended comments were analyzed with content analysis. RESULTS Overall Knowledge scores increased from pre-to posttest (n = 85; 65[19] vs. 73[17], p = 0.00), while Attitudes score improved (i.e., decreased) (n = 88; 0.55 [.06] vs. 0.53 [0.06]); p = 0.00). Higher pretest knowledge was found among female identified students (vs. others; p = 0.01) and those knowing > = 5 PWIDD (vs < 5; p = 0.02). Students characterize their IDD training and experience prior to intervention as 'lacking' and described the sessions as effective. CONCLUSIONS A brief (4 hours total) intervention was associated with modest but significant improved knowledge and attitudes towards PWIDDs. Replication and sustainability of this and other NICHE interventions are needed to fill gaps in PWIDDs' health care.
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Affiliation(s)
- Joanne Siegel
- Department of Pediatrics, Co-director, Rose F. Kennedy Univeristy Center of Excellence (UCEDD) at Chidlren’s Evaluation and Rehabilitation Center (CERC), Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Kathleen McGrath
- Department of Pediatrics, CERC/Rose F. Kennedy Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elisa Muniz
- Developmental-Behavioral Pediatrics Fellowship Program, Department of Pediatrics (Developmental Medicine), CERC/Rose F. Kennedy Center, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Vincent Siasoco
- Department of Pediatrics (Developmental Medicine), Department of Family & Social Medicine, CERC/Rose F. KennedyCenter, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
| | - Priya Chandan
- Healthcare Quality and Analytics, Kramer DavisHealth, Clinical Associate, Professor, Division of Physical Medicine & Rehabilitation, University of Louisville School of Medicine, Louisville, KY, USA
| | - Emily Noonan
- Department of Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA
| | - Karen Bonuck
- Department of Pediatrics, Co-director, Rose F. Kennedy Univeristy Center of Excellence (UCEDD) at Chidlren’s Evaluation and Rehabilitation Center (CERC), Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA
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26
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Mac Giolla Phadraig C, Asimakopoulou K, Faulks D, Van Harten M, Ledger L, Spencer A, Roux S, Cleary C, Daly B, Waldron C. Using realist methods for intervention development to fill a methodological gap: A case study showing the development of an oral hygiene intervention for people with intellectual developmental disabilities. Community Dent Oral Epidemiol 2023; 51:1130-1140. [PMID: 36759914 DOI: 10.1111/cdoe.12844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 12/03/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Realist methods offer a novel approach to intervention design. Such novelty is needed for effective oral health promotion interventions with people with intellectual developmental disabilities (IDD) and their carers because existing interventions are poorly described and lack theoretical underpinning. In this study, the steps between inception and final intervention development are presented, with an aim to expand understanding of how realist theorizing can be used to develop interventions, and to demonstrate theory-driven intervention development in the field of oral health promotion. METHODS In this intervention development study, the use of realist methods to develop an intervention aiming to improve the oral hygiene of people with IDD is presented. Realist theories (RTs) arising from a mixed synthesis were used to develop the Keep My Teeth intervention. The use of realist theory in intervention development was mapped across seven domains and 18 actions with emphasis on how theory informed key actions. RESULTS Realist theories informed many but not all actions in the development process. Where gaps arose, this was augmented with other systems of intervention development, such as the Behaviour Change Wheel (BCW) and Behaviour Change Technique (BCT) systems. The resulting intervention and underlying theory are presented using TiDieR criteria. CONCLUSIONS It is demonstrated how realist methods could be integrated with substantive theory when developing an intervention. RTs enhanced the contextualization of the intervention that was developed but were insufficient in their own right to guide the development process from conception to intervention. This was overcome by augmenting with substantive theory, in this case, using the BCW and BCT behaviour change systems, to select and specify the behaviours that needed to change. In essence, the BCTs guided which techniques to select, while the RTs guided how to develop and intervene. Robust intervention development in the field of oral health promotion is also presented in this study.
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Affiliation(s)
| | - Koula Asimakopoulou
- Faculty of Dentistry Oral & Craniofacial Sciences, King's College London, London, UK
| | - Denise Faulks
- Universite Clermont Auvergne, CROC, Clermont-Ferrand, France
- CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
| | - Maria Van Harten
- School of Dental Science, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | | | | | - Sarah Roux
- Health Service Executive, Dublin, Ireland
| | | | - Blanaid Daly
- School of Dental Science, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - Catherine Waldron
- School of Dental Science, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
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Houseworth J, Pettingell SL, Bershadsky J, Tichá R, Lemanowicz J, Feinstein C, Zhang A. Examining Choice and Control for People With IDD Over Time. Am J Intellect Dev Disabil 2023; 128:449-461. [PMID: 37875272 DOI: 10.1352/1944-7558-128.6.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/14/2023] [Indexed: 10/26/2023]
Abstract
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.
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Affiliation(s)
- James Houseworth
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - Sandra L Pettingell
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - Julie Bershadsky
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - Renáta Tichá
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - James Lemanowicz
- James Lemanowicz and Celia Feinstein, Institute on Disabilities, Temple University
| | - Celia Feinstein
- James Houseworth, Sandra L. Pettingell, Julie Bershadsky, and Renáta Tichá, Institute on Community Integration, University of Minnesota
| | - Alicia Zhang
- Alicia Zhang, Institute on Community Integration, University of Minnesota
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Novak-Pavlic M, Rosenbaum P, Di Rezze B. Changing Directions and Expanding Horizons: Moving towards More Inclusive Healthcare for Parents of Children with Developmental Disabilities. Int J Environ Res Public Health 2023; 20:6983. [PMID: 37947541 PMCID: PMC10649410 DOI: 10.3390/ijerph20216983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Family-centred service (FCS) acknowledges the importance of family engagement in therapeutic processes and focuses on the needs of all family members. This way of thinking and practicing is becoming increasingly recognized as an optimal care delivery model for families of children with developmental disabilities (DDs). However, in most places, disability services are oftentimes 'child-centric', wherein family members are seen only as partners in therapy or care delivery, while their own needs are not addressed. This arises from the lack of awareness of complex and highly individual family needs by professionals with whom they interact, but also from a significant lack of service infrastructure oriented towards parent-specific needs in existing service delivery models. This concept paper highlights the known challenges associated with parenting a child with a DD and discusses the intersectionality of factors impacting parental health and well-being, with a goal of promoting more equitable, holistic, and inclusive healthcare for all family members of children with DDs.
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Affiliation(s)
- Monika Novak-Pavlic
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada;
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada;
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada;
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada;
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada;
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Nekar DM, Kang HY, Lee JW, Oh SY, Yu JH. Effects of Cooperative, Competitive, and Solitary Exergames on Cognition and Anxiety Levels in Children with Developmental Disabilities. Games Health J 2023; 12:405-413. [PMID: 37279027 DOI: 10.1089/g4h.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Objective: Exergames are playing an important role in person-centered therapy, health care services, and in the rehabilitation field. This study aimed to compare the effects of cooperative, competitive, and solitary exergames on cognition and anxiety levels in children with developmental disabilities (DD). Materials and Methods: This study was a randomized controlled trial pretest-posttest including 36 children with DD who were allocated to the cooperative exergame group (CGG), competitive exergame group (CmGG), and solitary exergame group (SGG). The exergame program was performed two times a week for 8 weeks and the outcome measurements were conducted before and after the program. A paired sample t-test and one-way analysis of variance (ANOVA) were used to analyze the changes within and between the groups. Results: The result indicated a significant improvement in memory, attention, and visual perception in all groups; the CGG and CmGG showed a high increase in attention compared with the SGG. However, only the CGG presented a significant improvement in the language subscale. In terms of anxiety, only the CGG presented substantial improvements in all anxiety subscales. The CmGG showed improvement in social phobia and the SGG in physical injury fears, social phobia, and general anxiety fears. Conclusion: The findings suggest that cooperative and competitive exergames may be used to effectively improve cognitive functions; cooperative exergames can be applied as the most effective method to reduce anxiety compared with the other game types for children with DD.
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Affiliation(s)
- Daekook M Nekar
- Department of Physical Therapy, Sun Moon University, Asan, Republic of Korea
| | - Hye-Yun Kang
- Department of Physical Therapy, Sun Moon University, Asan, Republic of Korea
| | - Jae-Won Lee
- Department of Physical Therapy, Sun Moon University, Asan, Republic of Korea
| | - Sung-Yeon Oh
- Department of Physical Therapy, Sun Moon University, Asan, Republic of Korea
| | - Jae-Ho Yu
- Department of Physical Therapy, Sun Moon University, Asan, Republic of Korea
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Bobbette NJ, Lysaght R, Ouellette-Kuntz H, Tranmer J, Donnelly C. Stakeholder Perspectives on Interprofessional Primary Care for Adults With Intellectual and Developmental Disabilities in Ontario, Canada. Intellect Dev Disabil 2023; 61:349-367. [PMID: 37770051 DOI: 10.1352/1934-9556-61.5.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/13/2023] [Indexed: 10/03/2023]
Abstract
Access to high-quality primary care has been identified as a pressing need for adults with intellectual and developmental disabilities (IDD). Interprofessional primary care teams offer comprehensive and coordinated approaches to primary care delivery and are well-positioned to address the needs of adults with IDD. The overall aim of this article is to describe the current provision of interprofessional primary care for adults with IDD from the perspectives of patients, caregivers, and health providers. Results provide important insights into the current state of practice and highlight a critical need for further work in the field to develop processes to engage in team-based care and demonstrate the value of the approach for this population.
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Affiliation(s)
- Nicole J Bobbette
- Nicole J. Bobbette, Rosemary Lysaght, Hélène Ouellette-Kuntz, Joan Tranmer, and Catherine Donnelly, Queen's University, Ontario, Canada
| | - Rosemary Lysaght
- Nicole J. Bobbette, Rosemary Lysaght, Hélène Ouellette-Kuntz, Joan Tranmer, and Catherine Donnelly, Queen's University, Ontario, Canada
| | - Hélène Ouellette-Kuntz
- Nicole J. Bobbette, Rosemary Lysaght, Hélène Ouellette-Kuntz, Joan Tranmer, and Catherine Donnelly, Queen's University, Ontario, Canada
| | - Joan Tranmer
- Nicole J. Bobbette, Rosemary Lysaght, Hélène Ouellette-Kuntz, Joan Tranmer, and Catherine Donnelly, Queen's University, Ontario, Canada
| | - Catherine Donnelly
- Nicole J. Bobbette, Rosemary Lysaght, Hélène Ouellette-Kuntz, Joan Tranmer, and Catherine Donnelly, Queen's University, Ontario, Canada
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Iniesta J, Verdugo MA, Schalock RL. Organizational change and evidence-based practices in support services for people with intellectual and developmental disabilities. Eval Program Plann 2023; 100:102337. [PMID: 37451034 DOI: 10.1016/j.evalprogplan.2023.102337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/22/2023] [Accepted: 06/18/2023] [Indexed: 07/18/2023]
Abstract
The impact on support services for persons with intellectual and developmental disabilities of the socioeconomic movements and theoretical reformulations of the last decades has generated the necessity, in order to guarantee their sustainability, to carry out processes of profound change in their organizational culture, intervening in the elements that compose it. Among them are professional practices as the best way to intervene in culture, with the use of comparative analysis between an organization's current practices and those expected with culture change. In this line, the organizational self-assessment tool "Organizational Effectiveness and Efficiency Scale" (OEES) is applied in a study with 24 organizations, which uses a collaborative assessment approach in the service of a set of evidence-based practices identified as standards in key aspects that guide culture change, specifically, a person-centered approach, participative structures, use of information systems and data management, implementation of quality systems and participative and transformational leadership. The results obtained show that a large majority of organizations have significant discrepancies between their current practices and evidence-based practices. The descriptive analysis allows affirming the usefulness of the scale for an organizational diagnosis and identification of strategies to guide transformational change.
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Gonzalez FF, Voldal E, Comstock BA, Mayock DE, Goodman AM, Cornet MC, Wu TW, Redline RW, Heagerty P, Juul SE, Wu YW. Placental Histologic Abnormalities and 2-Year Outcomes in Neonatal Hypoxic-Ischemic Encephalopathy. Neonatology 2023; 120:760-767. [PMID: 37742617 PMCID: PMC10711751 DOI: 10.1159/000533652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/12/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE We aimed to examine the association between placental abnormalities and neurodevelopmental outcomes in a multicenter cohort of newborn infants with hypoxic-ischemic encephalopathy (HIE) that underwent therapeutic hypothermia. We hypothesized that subjects with acute placental abnormalities would have reduced risk of death or neurodevelopmental impairment (NDI) at 2 years of age after undergoing therapeutic hypothermia compared to subjects without acute placental changes. STUDY DESIGN Among 500 subjects born at ≥36 weeks gestation with moderate or severe HIE enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) Trial, a placental pathologist blinded to clinical information reviewed clinical pathology reports to determine the presence of acute only, chronic only, or both acute and chronic histologic abnormalities. We calculated adjusted relative risks (aRRs) for associations between placental pathologic abnormalities and death or NDI at age 2 years, adjusting for HIE severity, treatment assignment, and site. RESULT 321/500 subjects (64%) had available placental pathology reports. Placental abnormalities were characterized as acute only (20%), chronic only (21%), both acute and chronic (43%), and none (15%). The risk of death or NDI was not statistically different between subjects with and without an acute placental abnormality (46 vs. 53%, aRR 1.1, 95% confidence interval (CI): 0.9, 1.4). Subjects with two or more chronic lesions were more likely to have an adverse outcome than subjects with no chronic abnormalities, though this did not reach statistical significance (55 vs. 45%, aRR 1.24, 95% CI: 0.99, 1.56). CONCLUSION Placental pathologic findings were not independently associated with risk of death or NDI in subjects with HIE. The relationship between multiple chronic placental lesions and HIE outcomes deserves further study.
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Affiliation(s)
- Fernando F. Gonzalez
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California San Francisco, San Francisco, CA, USA
| | - Emily Voldal
- Department Biostatistics, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Bryan A. Comstock
- Department Biostatistics, University of Washington, Seattle, WA, USA
| | - Dennis E. Mayock
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Amy M. Goodman
- Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA, USA
| | - Marie-Coralie Cornet
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California San Francisco, San Francisco, CA, USA
| | - Tai-Wei Wu
- Division of Neonatology, Fetal and Neonatal Institute, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Raymond W. Redline
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Patrick Heagerty
- Department Biostatistics, University of Washington, Seattle, WA, USA
| | - Sandra E. Juul
- Division of Neonatology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Yvonne W. Wu
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology and Weill Institute for Neuroscience, University of California San Francisco, San Francisco, CA, USA
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Wilson NJ, Lin Z, Pithouse M, Morrison B, Sumar B, George A. Qualitative Insights from A Novel Staff-Led Oral Health Champions Program Within a Residential Service For People With Intellectual and Developmental Disability. J Intellect Disabil 2023; 27:728-745. [PMID: 35549753 DOI: 10.1177/17446295221095654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The oral health of people with intellectual and developmental disability is poorer than that of the general community. Any solution for people with intellectual and developmental disability living in residential services needs to include disability support workers (DSWs). Previous studies have used either didactic or train-the-trainer approaches to enhance DSW knowledge and skills. Taking a different approach, a novel program used DSWs as embedded oral health champions. This model provided educational opportunities for DSWs to learn about good oral health and then share with peers and provide benefits to people with intellectual and developmental disability that they support. Interviews with a sample of these champions were conducted and analysed using content analysis. Findings suggest that DSWs are capable of affecting change with the right type and depth of training, management and organisational support. A DSW-led champions model has merit, however requires ongoing expert support to help maintain and sustain benefits over time.
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Affiliation(s)
- Nathan J Wilson
- Associate Professor, Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia
| | - Zhen Lin
- Research Assistant, School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia
| | | | - Bonnie Morrison
- Health Promotion Officer, Dental Health Services Victoria, Carlton, VIC, Australia
| | - Bashir Sumar
- Lecturer, School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia
| | - Ajesh George
- Professor, Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University. Ingham Institute for Applied Medical Research. Sydney Dental School, University of Sydney, Liverpool, NSW, Australia
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Kover ST, Abbeduto L. The Work Ahead for Intellectual and Developmental Disabilities Research. Am J Intellect Dev Disabil 2023; 128:388-392. [PMID: 37644864 PMCID: PMC10773982 DOI: 10.1352/1944-7558-128.5.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
In "Toward Equity in Research on Intellectual and Developmental Disabilities," we sought to make entrenched assumptions and practices of intellectual and developmental disabilities research visible by explicitly describing the status quo in terms of models of disability, participant and researcher identities, research priorities, and biases in measurement and treatment approaches. We then curated individual- and systems-level actions drawn from disability justice and broader social justice lenses to offer a way forward. We focused on three major areas (i.e., intersectionality and person-centered approaches, participatory research, and interprofessional collaboration), depicting influences, methods, and actions in a framework of disability, identity, and culture. In this Author Response, we address five commentaries that critique and extend that synthesis.
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Lineberry S, Bogenschutz M, Broda M, Dinora P, Prohn S, West A. Co-Occurring Mental Illness and Behavioral Support Needs in Adults with Intellectual and Developmental Disabilities. Community Ment Health J 2023; 59:1119-1128. [PMID: 36739327 PMCID: PMC9899157 DOI: 10.1007/s10597-023-01091-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/22/2023] [Indexed: 02/06/2023]
Abstract
People with intellectual and developmental disabilities (IDD) have higher incidences of mental health conditions and behavioral support needs than people without IDD but may not receive needed care from community providers. We examined rates of co-occurring conditions in a representative sample of adults with IDD who use state funded services in Virginia. Using data from two datasets, we identified four categories of mental health and behavioral conditions. We used these categories to examine differences in individual- and system-level factors in people with and without co-occurring conditions. We found high rates of co-occurring conditions in our sample. We found important disability factors and system-level characteristics that were associated with having a diagnosed mental health condition or behavioral support needs. Differing patterns of diagnosis and treatment for co-occurring conditions suggests more work needs to be done to support people with IDD and co-occurring mental health conditions living in the community.
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Affiliation(s)
- Sarah Lineberry
- School of Social Work, Virginia Commonwealth University, P. O. Box 842027, Richmond, VA 23284 USA
| | - Matthew Bogenschutz
- Partnership for People with Disabilities, 700 E Franklin St, 1st Floor, Suite 140, Richmond, VA 23219 USA
| | - Michael Broda
- Partnership for People with Disabilities, 700 E Franklin St, 1st Floor, Suite 140, Richmond, VA 23219 USA
| | - Parthenia Dinora
- Partnership for People with Disabilities, 700 E Franklin St, 1st Floor, Suite 140, Richmond, VA 23219 USA
| | - Seb Prohn
- Partnership for People with Disabilities, 700 E Franklin St, 1st Floor, Suite 140, Richmond, VA 23219 USA
| | - Angela West
- Partnership for People with Disabilities, 700 E Franklin St, 1st Floor, Suite 140, Richmond, VA 23219 USA
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Kalb LG, Kramer JM, Goode TD, Black SJ, Klick S, Caoili A, Klipsch S, Klein A, Urquilla MP, Beasley JB. Evaluation of telemental health services for people with intellectual and developmental disabilities: protocol for a randomized non-inferiority trial. BMC Health Serv Res 2023; 23:795. [PMID: 37491216 PMCID: PMC10369796 DOI: 10.1186/s12913-023-09663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/07/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Roughly 40% of those with intellectual/developmental disabilities (IDD) have mental health needs, twice the national average. Unfortunately, outpatient mental health services are often inaccessible, increasing reliance on hospital-based services. While telemental health services hold potential to address this gap, little is known about the effectiveness of telemental health for the diversity of persons with IDD, especially as it relates to crisis prevention and intervention services. Accordingly, the aims of this study are to: (1) compare telemental health versus in-person crisis prevention and intervention services among people with IDD; and (2) understand if outcomes vary across subpopulations, in order to identify potential disparities. METHODS This study will take place within START (Systemic, Therapeutic, Assessment, Resources, and Treatment), a national evidence-based model of mental health crisis prevention and intervention for people with IDD. A total of 500 youth and adults, located across nine states, will be randomized 1:1 to telemental health vs. in-person. Participant inclusion criteria are ages 12-45 years, living in a family setting, and newly enrolled (within 90 days) to START. Outcomes will be assessed, using a non-inferiority design, for up to 1 year or until discharge. The intervention is comprised of four components: (1) outreach; (2) consultation/coping skills; (3) intake/assessment; and, (4) 24-hour crisis response. The in-person condition will deliver all components in-person. The telemental health condition will deliver components 1 & 2, via telephonic or other communication technology, and components 3 & 4 in-person. Outcomes include mental health crisis contacts, mental health symptoms, emergency psychiatric service use, perceived quality of mental healthcare, and time to discharge. DISCUSSION To our knowledge, this will be the first trial of a telemental health crisis program for the IDD population. The study will be executed by an interdisciplinary team of experts that includes persons with lived experience of disability. Understanding the benefits of specific telemental health methods has important implications to the design of interventions. This telemental health study offers promise to address disparities in access to mental health care for people with IDD across diverse racial, ethnic, linguistic, and cultural groups. TRIAL REGISTRATION Clinicaltrials.gov ( #NCT05336955 ; Registration Date: 4/20/2022).
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Affiliation(s)
- Luther G Kalb
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, USA.
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 N. Broadway, 8th Floor, Baltimore, MD, 21205, USA.
| | | | - Tawara D Goode
- Georgetown National Center for Cultural Competence, Washington, USA
- Department of Pediatrics, Georgetown University Medical Center, Washington, USA
| | - Sandra J Black
- Department of Social Work, University of New Hampshire, Durham, USA
| | - Susan Klick
- Institute on Disability/UCEDD, University of New Hampshire, Durham, USA
| | - Andrea Caoili
- Institute on Disability/UCEDD, University of New Hampshire, Durham, USA
| | - Samantha Klipsch
- Institute on Disability/UCEDD, University of New Hampshire, Durham, USA
| | - Ann Klein
- Institute on Disability/UCEDD, University of New Hampshire, Durham, USA
| | - Micah P Urquilla
- Institute on Disability/UCEDD, University of New Hampshire, Durham, USA
| | - Joan B Beasley
- Institute on Disability/UCEDD, University of New Hampshire, Durham, USA
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Marquis S, McGrail KM, Lunsky Y, Baumbusch J. The Use of Medically Required Dental Services by Youth with Intellectual/Developmental Disabilities in British Columbia, Canada. J Can Dent Assoc 2023; 89:n7. [PMID: 37562040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
INTRODUCTION The literature indicates that youth with intellectual/developmental disabilities (IDD), such as Down syndrome or autism, have poor oral health. A number of factors influence their oral health, including the use of medically required dental treatments. METHODS This paper describes the first use of population-level administrative health data to examine the use of medically required dental services by youth with IDD compared with youth without IDD in Canada. RESULTS Youth with IDD had 4-9 times the odds of a medically required dental treatment compared with youth without IDD. Odds varied with age and type of IDD. CONCLUSIONS Youth with IDD used medically required dental services to a greater extent than youth without IDD. Use of medically required dental treatments by youth with IDD declined with age; this may indicate greater difficulty accessing services when youth transition from pediatric to adult services. These findings provide baseline information on the use of medically required dental treatments and can contribute to future assessments of dental services for youth with IDD.
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Biggs EE, Arserio AP, Robison SE, Ross ME. Home Literacy Environment and Interventions for Children With Intellectual and Developmental Disabilities: A Scoping Review. J Speech Lang Hear Res 2023; 66:2118-2140. [PMID: 37267447 PMCID: PMC10465154 DOI: 10.1044/2023_jslhr-22-00334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/29/2022] [Accepted: 02/17/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of this scoping review was to map the research literature published in English and in peer-reviewed journals related to the home literacy environment of children and youth aged 3-21 years with intellectual and developmental disabilities (IDD) who have significant support needs, including children with complex communication needs. METHOD A systematic search was conducted in four databases, along with forward and backward searching. The search yielded 60 studies, which included intervention and nonintervention studies. Data were charted related to participant characteristics, study focus, intervention components, study design and methodological rigor, and study results. RESULTS Findings provided insight into multiple dimensions of the home literacy environment for children with IDD, including the nature of parent views, practices, and interaction styles during shared reading. Findings also revealed gaps in the literature, specifically related to (a) limited representation of subgroups of children and youth with IDD, (b) limited representation of diverse families and caregivers, and (c) concerns about methodological quality. CONCLUSION This review identifies important directions for future research and suggests ways to improve the design and delivery of home literacy interventions for children and youth with IDD and their families, including through family-centered and culturally responsive models. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.22704817.
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Affiliation(s)
| | | | - Sarah E. Robison
- Disability and Psychoeducational Studies, The University of Arizona, Tucson
| | - Madison E. Ross
- Department of Special Education, Vanderbilt University, Nashville, TN
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Reynolds E, Blanchard S, Jalazo E, Chakraborty P, Bailey DB. Newborn Screening Conditions: Early Intervention and Probability of Developmental Delay. J Dev Behav Pediatr 2023; 44:e379-e387. [PMID: 37084319 DOI: 10.1097/dbp.0000000000001179] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/21/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES The purpose of this study is to explore which newborn screening (NBS) conditions are automatically eligible for early intervention (EI) across states and to determine the extent to which each disorder should automatically qualify for EI because of a high probability of developmental delay. METHODS We examined each state's EI eligibility policy and reviewed the literature documenting developmental outcomes for each NBS condition. Using a novel matrix, we assessed the risk of developmental delay, medical complexity, and risk of episodic decompensation, revising the matrix iteratively until reaching consensus. Three NBS conditions (biotinidase deficiency, severe combined immunodeficiency, and propionic acidemia) are presented in detail as examples. RESULTS Most states (88%) had Established Conditions lists to autoqualify children to EI. The average number of NBS conditions listed was 7.8 (range 0-34). Each condition appeared on average in 11.7 Established Conditions lists (range 2-29). After the literature review and consensus process, 29 conditions were likely to meet national criteria for an Established Condition. CONCLUSION Despite benefiting from NBS and timely treatment, many children diagnosed with NBS conditions are at risk for developmental delays and significant medical complexity. The results demonstrate a need for more clarity and guidance regarding which children should qualify for EI. We suggest that most NBS conditions should automatically qualify based on the probability of resulting in a developmental delay. These findings suggest a future opportunity for collaboration between NBS and EI programs to create a consistent set of Established Conditions, potentially expediate referrals of eligible children, and streamline children's access to EI services.
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Affiliation(s)
| | - Sheresa Blanchard
- Department of Human Development and Family Science, College of Education, East Carolina University, Greenville, NC
| | - Elizabeth Jalazo
- UNC Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC
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Marsack-Topolewski C, Milberger S, Janks E, Anderson N, Bray M, Samuel PS. Evaluation of peer-mediated systems navigation for ageing families of individuals with developmental disabilities. J Intellect Disabil Res 2023; 67:462-474. [PMID: 36866717 DOI: 10.1111/jir.13024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND As individuals with intellectual and developmental disabilities (I/DD) age, services often diminish, with many family caregivers experiencing challenges finding and navigating services. The purpose of this study was to examine the benefits of a state-wide family support project for ageing caregivers (50+) of adults with I/DD in accessing and using services. METHOD A one-group pre-test-post-test design was used to determine if participation in the MI-OCEAN intervention grounded in the Family Quality of Life (FQOL) theory reduced ageing caregivers' (n = 82) perceptions of barriers to accessing, using and needing formal services. RESULTS After participating in the study, there was a reduction in reported barriers to accessing services. There was also greater use and reduced need for 10 of the 23 listed formal services. CONCLUSIONS Findings indicate that a peer-mediated intervention grounded in FQOL theory can be beneficial in empowering ageing caregivers by reducing perceived barriers to accessing services and increasing their use of advocacy and support services.
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Affiliation(s)
- C Marsack-Topolewski
- School of Social Work, Eastern Michigan University, Ypsilanti, MI, USA
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - S Milberger
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - E Janks
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - N Anderson
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - M Bray
- Michigan Developmenal Disabilities Institute, Wayne State University, Detroit, MI, USA
| | - P S Samuel
- Department of Health Care Sciences, Wayne State University, Detroit, MI, USA
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Hotez E, Rava J, Russ S, Ware A, Halfon N. Using a life course health development framework to combat stigma-related health disparities for individuals with intellectual and/or developmental disability (I/DD). Curr Probl Pediatr Adolesc Health Care 2023; 53:101433. [PMID: 37867057 DOI: 10.1016/j.cppeds.2023.101433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
In the U.S., 1 in 6 children has an intellectual and/or developmental disability (I/DD). This population experiences a multitude of negative health outcomes across the life course, relative to the general population. Stigma-the social devaluation of individuals with certain characteristics, identities, or statuses within interpersonal, educational, healthcare, and policy contexts-is a potentially preventable contributor to health disparities. To date, existing approaches for addressing and preventing stigma are limited to discrete and siloed interventions that often fail to address the lifelong, cumulative impacts of the specific types of stigma experienced by the I/DD population. In the current paper, we describe three elements of Life Course Health Development (LCHD)-a novel translational framework that draws on evidence from biology, sociology, epidemiology, and psychology-that healthcare providers can use to prevent stigma-related health disparities and improve outcomes for individuals with I//DDs. We discuss the utility of targeting prevention to sensitive periods; prioritizing interventions for the most damaging types of stigmas; and leveraging supports from multiple service systems and sectors. By incorporating evidence from life course science into efforts to address stigma-related health disparities, providers can more effectively and strategically prevent and combat stigma-related health disparities for the I/DD population in childhood and across the life course.
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Affiliation(s)
- Emily Hotez
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States.
| | - Julianna Rava
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States
| | - Shirley Russ
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of General Internal Medicine / Health Services Research, 911 Broxton Ave, Los Angeles, CA, 90095, United States; University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States
| | - Allysa Ware
- Family Voices, 110 Hartwell Avenue, Lexington, MA, 02421, United States
| | - Neal Halfon
- University of California, Los Angeles (UCLA), David Geffen School of Medicine, Department of Pediatrics, Center for Healthier Children, Families, & Communities, 10960 Wilshire Blvd., Suite 960, Los Angeles, CA 90024-3913, United States; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, United States; Department of Public Policy, UCLA Luskin School of Public Affairs, Los Angeles, CA, United States
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Dinora P, Prohn SM, Bogenschutz M, Broda MD, Lineberry S, West A. An Examination of Support Needs, Supports, and Outcomes for People With Intellectual and Developmental Disabilities. Intellect Dev Disabil 2023; 61:65-78. [PMID: 36706006 DOI: 10.1352/1934-9556-61.1.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/17/2022] [Indexed: 05/16/2023]
Abstract
Researchers used a merged dataset to examine if more resources were expended on those with greater support needs and if support needs impacted personal outcomes when controlling for relevant personal and contextual factors. Results indicated that the amount of support a person receives had a direct relationship to their needs. However, we also found that people with the greatest needs had weaker personal outcomes suggesting that distribution of resources based on need may not result in equivalent outcomes. The authors suggest strategies at an individual and systems level to address the outcomes gap for people with the greatest support needs.
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Affiliation(s)
- Parthenia Dinora
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Seb M Prohn
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Matthew Bogenschutz
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Michael D Broda
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Sarah Lineberry
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
| | - Angela West
- Parthenia Dinora, Seb M. Prohn, Matthew Bogenschutz, Michael D. Broda, Sarah Lineberry, and Angela West, Virginia Commonwealth University
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Maccora I, Ramanan AV, Wiseman D, Marrani E, Mastrolia MV, Simonini G. Clinical and Therapeutic Aspects of Sideroblastic Anaemia with B-Cell Immunodeficiency, Periodic Fever and Developmental Delay (SIFD) Syndrome: a Systematic Review. J Clin Immunol 2023; 43:1-30. [PMID: 35984545 PMCID: PMC9840570 DOI: 10.1007/s10875-022-01343-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/01/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE Sideroblastic anaemia with B-cell immunodeficiency, periodic fever and developmental delay (SIFD) syndrome is a novel rare autoinflammatory multisystem disorder. We performed a systematic review of the available clinical and therapeutics aspects of the SIFD syndrome. METHODS A systematic review according to PRISMA approach, including all articles published before the 30th of July 2021 in Pubmed and EMBASE database, was performed. RESULTS The search identified 29 publications describing 58 unique patients. To date, 41 unique mutations have been reported. Onset of disease is very early with a median age of 4 months (range 0-252 months). The most frequent manifestations are haematologic such as microcytic anaemia or sideroblastic anaemia (55/58), recurrent fever (52/58), neurologic abnormalities (48/58), immunologic abnormalities in particular a humoral immunodeficiency (48/58), gastrointestinal signs and symptoms (38/58), eye diseases as cataract and retinitis pigmentosa (27/58), failure to thrive (26/58), mucocutaneous involvement (29/58), sensorineural deafness (19/58) and others. To date, 19 patients (35.85%) died because of disease course (16) and complications of hematopoietic cell stems transplantation (3). The use of anti-TNFα and hematopoietic cell stems transplantation (HCST) is dramatically changing the natural history of this disease. CONCLUSIONS SIFD syndrome is a novel entity to consider in a child presenting with recurrent fever, anaemia, B-cell immunodeficiency and neurodevelopmental delay. To date, therapeutic guidelines are lacking but anti-TNFα treatment and/or HCST are attractive and might modify the clinical course of this syndrome.
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Affiliation(s)
- Ilaria Maccora
- Rheumatology Unit, Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy.
- NeuroFARBA Department, University of Florence, Viale Pieraccini 24, 50139, Florence, Italy.
| | - Athimalaipet V Ramanan
- Bristol Royal Hospital for Children and Translational Health Sciences, University of Bristol, Bristol, UK
| | - Daniel Wiseman
- Department of Haematology, Royal Manchester Children's Hospital, Manchester, UK
| | - Edoardo Marrani
- Rheumatology Unit, Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Maria V Mastrolia
- Rheumatology Unit, Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Gabriele Simonini
- Rheumatology Unit, Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
- NeuroFARBA Department, University of Florence, Viale Pieraccini 24, 50139, Florence, Italy
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Berens JC, Tsami L, Lerman DC, Matteucci M, Fray DF, Warner BF, Keehan LA, Staggers KA, Peacock C. Preliminary Results of an Interdisciplinary Behavioral Program to Improve Access to Preventative Dental Care for Adults With Intellectual and Developmental Disabilities. Intellect Dev Disabil 2022; 60:504-519. [PMID: 36454615 DOI: 10.1352/1934-9556-60.6.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 02/16/2022] [Indexed: 06/17/2023]
Abstract
Adults with intellectual and developmental disabilities (AIDD) experience significant oral health disparities, partially due to perceived behavioral issues. This article describes the preliminary outcomes of a developing interdisciplinary (dental, medical, behavioral) program involving a behavioral intervention for AIDD previously receiving preventative dental care with sedation, general anesthesia, or protective stabilization (SAS). After a baseline assessment, a board-certified behavior analyst implemented increasingly complex behavioral interventions during simulated dental visits. Prior to COVID-19 pandemic-related restrictions, there were 32 active participants; 15 (46.9%) successfully completed a focused, real dental exam with simple behavioral interventions and 17 (53.1%) remain in treatment. These preliminary results suggest that many AIDD previously receiving SAS may participate in a preventative dental exam with minimal behavioral supports, if given the opportunity.
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Affiliation(s)
| | - Loukia Tsami
- Loukia Tsami, Dorothea C. Lerman, and Marissa Matteucci, University of Houston-Clear Lake
| | - Dorothea C Lerman
- Loukia Tsami, Dorothea C. Lerman, and Marissa Matteucci, University of Houston-Clear Lake
| | - Marissa Matteucci
- Loukia Tsami, Dorothea C. Lerman, and Marissa Matteucci, University of Houston-Clear Lake
| | - David F Fray
- David F. Fray and Ben F. Warner, The University of Texas Health Science Center at Houston School of Dentistry
| | - Ben F Warner
- David F. Fray and Ben F. Warner, The University of Texas Health Science Center at Houston School of Dentistry
| | - Laura A Keehan
- Laura A. Keehan, Kristen A. Staggers, and Cynthia Peacock, Baylor College of Medicine
| | - Kristen A Staggers
- Laura A. Keehan, Kristen A. Staggers, and Cynthia Peacock, Baylor College of Medicine
| | - Cynthia Peacock
- Laura A. Keehan, Kristen A. Staggers, and Cynthia Peacock, Baylor College of Medicine
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Havercamp SM, Bonardi A. Special Issue Introduction: Addressing Healthcare Inequities in Intellectual Disability and Developmental Disabilities. Intellect Dev Disabil 2022; 60:449-452. [PMID: 36454611 DOI: 10.1352/1934-9556-60.6.449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
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Johnston KJ, Chin MH, Pollack HA. Health Equity for Individuals With Intellectual and Developmental Disabilities. JAMA 2022; 328:1587-1588. [PMID: 36206010 DOI: 10.1001/jama.2022.18500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This Viewpoint discusses 3 types of systemic health inequity experienced by individuals with intellectual and developmental disabilities—stigma, exclusion, and devaluation of worth; underrepresentation in population epidemiology and research; and inadequate access to care and social services—and suggests potential approaches to ameliorating inequities in each of these areas.
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Affiliation(s)
- Kenton J Johnston
- General Medical Sciences Division, Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Marshall H Chin
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Harold A Pollack
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, Illinois
- Urban Health Lab, University of Chicago, Chicago, Illinois
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Elliott T, Floyd James K, Coleman KJ, Skrine Jeffers K, Nau CL, Choi K. Cross-sectional Comparison of Disparities by Race Using White vs Hispanic as Reference Among Children and Youths With Developmental Disabilities Referred for Speech Therapy. JAMA Netw Open 2022; 5:e2234453. [PMID: 36194413 PMCID: PMC9533182 DOI: 10.1001/jamanetworkopen.2022.34453] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
IMPORTANCE Health care research on racial disparities among children and youths has historically used the White race as a reference category with which other racial and ethnic groups are compared, which may inadvertently set up Whiteness as a standard for health. OBJECTIVE To compare 2 interpretations of an analysis of racial disparities in speech therapy receipt among children and youths with developmental disabilities: a traditional, White-referenced analysis and a Hispanic majority-referenced analysis. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used multiple logistic regression to analyze speech therapy referrals for children, adolescents, and transition age youths in an integrated health care system in Southern California from 2017 to 2020. Eligible participants were children and youths up to age 26 years with 1 or more diagnosed intellectual or developmental disability (eg, autism spectrum disorder, speech or language delay, developmental delay, Down syndrome, and others). EXPOSURES Child or youth race and ethnicity as reported by parents or caregivers (Asian, Black and African American, Hispanic and Latinx, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, White, multiple, and other). MAIN OUTCOMES AND MEASURES Receipt of speech therapy within 1 year of referral. RESULTS A total 66 402 referrals were included; 65 833 referrals (99.1%) were for children under age 17 years, 47 323 (71.3%) were for boys, and 39 959 (60.2%) were commercially insured. A majority of participants were identified as Hispanic (36 705 [55.3%]); 6167 (9.3%) were identified as Asian, 4810 (7.2%) as Black, and 14 951 (22.5%) as White. In the traditional racial disparities model where the reference category was White, referrals of children and youths who identified as Hispanic, Black, Pacific Islander, and other had lower odds of actual receipt of speech therapy compared with referrals for White children and youths (Hispanic: OR, 0.79; 95% CI, 0.75-0.83; Black: OR, 0.72; 95% CI, 0.66-0.78; Pacific Islander: OR, 0.74; 95% CI, 0.57-0.98). When using the majority race group (Hispanic) as the reference category, referrals for children and youths who identified as White (OR, 1.26; 95% CI, 1.20-1.30), Asian (OR, 1.21; 95% CI, 1.12-1.30), and multiracial (OR, 1.35; 95% CI, 1.08-1.71) had higher odds of resulting in actual service receipt in comparison with referrals for Hispanic children and youths. CONCLUSIONS AND RELEVANCE The cross-sectional study demonstrates the value of decentering Whiteness in interpreting racial disparities research and considering racial differences against multiple referents. Racial disparities researchers should consider investigating multiple between-group differences instead of exclusively using White as the default reference category.
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Affiliation(s)
- Thomas Elliott
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Kortney Floyd James
- Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Karen J. Coleman
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
- Southern California Permanente Medical Group, Kaiser Permanente Southern California, Pasadena
| | | | - Claudia L. Nau
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Kristen Choi
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
- School of Nursing, University of California, Los Angeles
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles
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Kim JH, Hughes OE, Demissie SA, Kunzier TJ, Cheung WC, Monarrez EC, Burke MM, Rossetti Z. Lessons Learned From Research Collaboration Among People With and Without Developmental Disabilities. Intellect Dev Disabil 2022; 60:405-415. [PMID: 36162045 DOI: 10.1352/1934-9556-60.5.405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/11/2022] [Indexed: 06/16/2023]
Abstract
Research related to the developmental disability (DD) community should include collaboration with individuals with DD. Unfortunately, people with DD are infrequently involved in research projects in meaningful ways, and there is little guidance about how to collaborate equitably with researchers with DD. The purpose of this article is to share lessons learned from a collaborative research study among researchers with and without DD using both qualitative and quantitative methods to develop and examine the effectiveness of a civic engagement intervention for transition-aged youth with disabilities. It includes how our research team compensated researchers with DD, clarified team member roles, leveraged the expertise of researchers with DD in using both qualitative and quantitative methods, and integrated technology throughout the research process.
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Affiliation(s)
| | | | | | | | - W Catherine Cheung
- W. Catherine Cheung, Edwin C., Monarrez, and Meghan M. Burke, University of Illinois
| | - Edwin C Monarrez
- W. Catherine Cheung, Edwin C., Monarrez, and Meghan M. Burke, University of Illinois
| | - Meghan M Burke
- W. Catherine Cheung, Edwin C., Monarrez, and Meghan M. Burke, University of Illinois
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Xu Y, Zeng W, Wang Y, Magaña S. Barriers to Service Access for Immigrant Families of Children With Developmental Disabilities: A Scoping Review. Intellect Dev Disabil 2022; 60:382-404. [PMID: 36162050 DOI: 10.1352/1934-9556-60.5.382] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/16/2022] [Indexed: 06/16/2023]
Abstract
This scoping review explores (a) barriers faced by immigrant families of children with intellectual and developmental disabilities (IDD) when accessing healthcare-related services in the United States, (b) where research stands based on the health disparity research framework, and (c) implications for future health disparities research with this population. Our scoping review found 26 empirical studies published between 2000 and 2020 that met our inclusion criteria. Data were extracted and synthesized based on the stages of research outlined in the health disparity research framework. Overall, immigrant families experienced barriers on multiple levels including patient, provider, and healthcare system levels. Studies focusing on detecting and reducing disparities are emerging. We conclude with recommendations for future research and practice with immigrant families of children with IDD.
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Affiliation(s)
- Yue Xu
- Yue Xu, University of Illinois College of Medicine at Rockford
| | | | - Yao Wang
- Yao Wang, University of Maryland, Baltimore
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Schalock RL, Luckasson R, Tassé MJ, Shogren KA. The IDD Paradigm of Shared Citizenship: Its Operationalization, Application, Evaluation, and Shaping for the Future. Intellect Dev Disabil 2022; 60:426-443. [PMID: 36162049 DOI: 10.1352/1934-9556-60.5.426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/06/2022] [Indexed: 06/16/2023]
Abstract
Changes in the field of intellectual and developmental disabilities (IDD) over the last 5 decades has resulted in the emergence of the shared citizenship paradigm. This paradigm is currently guiding the development of IDD-related policies and practices, and providing a framework for application, research-based inquiry, and evaluation. A shared citizenship paradigm is one that envisions, supports, and requires the engagement and full participation of people with IDD as equal, respected, valued, participatory, and contributing members of every aspect of society. The overall goals of the paradigm are to (a) further advance and focus on people with IDD as active agents in the change process, and (b) improve outcomes for people with IDD, including their access to and opportunity for shared citizenship. This article describes the paradigm's operationalization, application, evaluation, shaping for the future, and specific strategies to overcome implementation challenges.
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