Parents' perception of the quality of life of preschool children at risk or having developmental disabilities.

Despite increased concern for the health related quality of life (HRQOL) of people with disabilities, little is known about the HRQOL of children with developmental disabilities. The present study aimed to explore the HRQOL of children who were at risk or having developmental disabilities in Hong Kong. Using the parent-reported Chinese Pediatric Quality of Life Inventory (PedsQL), the HRQOL of 173 children (2–4 years) with signs of delays in development was contrasted with that of 132 children with typical development. We found that those who exhibited high risk of developing a developmental disability had significantly lower overall well-being (76.3 ± 13.7 vs. 84.2 ± 11.3; p<0.001) and psychosocial health (71.3 ± 15.6 vs. 82.5 ± 12.9; p<0.001) but not necessarily physical health. The findings are consistent with previous findings in children with different disabilities and chronic illnesses. They suggest children at risk or having DDs need help in restoring their quality of life up to the standard experienced by their healthy peers, particular in psychosocial aspects such as social functioning, emotion functioning, and school functioning.

The perceived employability of ex-prisoners and offenders

A large-scale study was conducted to examine the perceived employability of ex-prisoners and offenders. Four participant groups comprising 596 (50.4%) employers, 234 (19.8%) employment service workers, 176 (14.9%) corrections workers, and 175 (14.8%) prisoners and offenders completed a questionnaire assessing the likelihood of a hypothetical job seeker's both obtaining and maintaining employment; the importance of specific skills and characteristics to employability; and the likelihood that ex-prisoners, offenders, and the general workforce exhibit these skills and characteristics. Apart from people with an intellectual or psychiatric disability, those with a criminal background were rated as being less likely than other disadvantaged groups to obtain and maintain employment. In addition, ex-prisoners were rated as being less likely than offenders and the general workforce to exhibit the skills and characteristics relevant to employability. Implications for the preparation and support of ex-prisoners and offenders into employment are discussed, together with broader community-wide initiatives to promote reintegration.

Introducing active support in the United States : staff training developments and research directions

Aim: Active Support, an evidence-based intervention developed in the UK and tested in Australia, enables direct support professionals to engage people with high support needs in meaningful and rewarding every day activities. This paper outlines the practical details of adapting the Active Support curriculum for service providers in the US and outlines an evaluation methodology that will inform both service delivery and future developments of Active Support.

Method: Active Support curricula developed in the UK and Australia were adapted for implementation the US.Train-the-trainer activities were conducted in early 2008 in three group homes serving 12 people with intellectual or developmental disabilities. A formative evaluation process was used to identify changes in the materials and training design needed to support a randomized controlled trial of the intervention in 20 small group homes.

Results: Modifications in the delivery of training are needed to account for differences in scheduling patterns and high turnover rates in US group homes, and to adjust British/Australian terminology to the U.S. context.

Conclusions: The translation of active support into the U.S. context requires modifications to support successful implementation. Research is planned to document the success of the modified curriculum in improving outcomes for persons with disabilities.

Double disability : lived experience of Australian tertiary students with ME/CFS

This research is the exploration of the lived experience of tertiary students in Australia with the medical condition usually known as ME/CFS (Myalgic Encephalomyelitis /Chronic Fatigue Syndrome) seeking to explore issues of equity and human rights from the perspective of the Disability Discrimination Act 1992. Students feel that their difficulties are not caused just by the illness itself but by the failure of the tertiary institutions to understand the effects of this illness on them, the student, especially within the areas of accommodations and assessments. Their lived experiences are studied to ascertain if their experiences differ from those of other tertiary students. Forty participants came from every state and territory of Australia and twenty -four of Australia's universities as well as eight Technical and Further Education/Open Training Education Network (TAFE/OTEN) colleges are represented. The selection of the chosen methodology, Critical Ethnography from a Habermasian perspective, has been circumscribed by the medical condition which placed limitations on methodology and also data gathering methods. Non-structured stories, in which the participants wrote of their lived experience as students, were considered the most appropriate source of data. These were transmitted by electronic mail (with some by postal mail) to the researcher. A short questionnaire provided a participant background to the stories and was also collated for a composite overview of the participants. The stories are analysed in a number of ways: six selected stories are retold and the issues arising from these stories have been weighed against the remainder of the stories. Four intertwined themes were constructed from the issues raised in each story. Apparent infringements of the Disability Discrimination Act (1992) which impact on quality of life, human rights and equity are found. No accommodations are being made by the academic institutions for the cognitive dysfunctions and learning difficulties. Students are stigmatised and lack credibility to negotiate appropriate academic accommodations. A possible means of improving the ability of students to negotiate appropriate accommodations is explored. Finally the researcher reflects on her own involvement in the research as an 'insider' researcher.

Why has the rising economic tide failed to float the disability employment boat? A call to action : business,community, government and people power

It is well established that people with disabilities are under-represented in the workforce. Disability labour market scholars agree that there is a significant gap between labour market participation of people with disabilities and people without disabilities, with on-going labour market disadvantage widely reported. All indicate that notwithstanding the recent economic growth of Western economies, the employment rate for people with disabilities has not improved. This paper draws on the findings of three recent research projects on disability employment in Australia and on data from contemporary literature on workplace discrimination and proposes that a combination of more robust social inclusion policies and legislation, revitalised supported employment models, intensive social marketing, and radical disability advocacy is required.

Interacting with adults with congenital deafblindness : the experiences of disability support workers

Background This study aimed to gain greater insight into the perspectives of staff on their interactions with adults with congenital deafblindness in light of the research literature reporting these interactions to be lacking in quality and quantity.

Method Data from interviews with 8 disability support workers were analysed using the approach described by Charmaz (2006).

Results Three key themes emerged from the interview data, which support and elaborate on fi ndings of previous studies. These were (1) the construction of client happiness, (2) the rationalisation of client disengagement, and (3) imperatives of the staff role. These fi ndings elucidate the reasons for staff behaviour in their interactions with adults with congenital deafblindness.

Conclusion The fi ndings suggest the need for staff policy and procedural documents to be explicit about the importance of social interaction between staff and clients.

Disability and disability services

This chapter provides a profile of people who are at various points on this disability continuum, but with an emphasis on those facing more severe limitations. Information is presented on both mainstream and sector-specific service use, and the outcomes associated with the use of these services. The focus in this chapter is on people aged under 65 years.

Impact of the Learn to Play program on play, social competence and language for children aged 5 - 8 years who attend a specialist school

Introduction
The aim of this study was to investigate the change in the relationship between play, language and social skills of children aged 5–8 years pre and post participation in the ‘Learn to Play’ program. The Learn to Play program is a child led play based intervention aimed at developing self-initiated pretend play skills in children.

Methods
All 19 participants attended a specialist school, with 10 of the 19 children having a diagnosis of autism. The play, language and social skills of the children were assessed at baseline and at follow up. Children were assessed using the Child-Initiated Pretend Play Assessment, the Preschool Language Scale and the Penn Interactive Peer Play Scale. Follow up data collection occurred after the children had been participating in the Learn to Play program for 1 hour twice a week for 6 months.

Results
After 6 months in the program, typical indicators of play accounted for an increase of 47.3% in shared variance with social interaction and an increase of 36% in shared variance for social connection. For language, object substitution ability accounted for 50% of the shared variance, which was an increase of 27% from baseline.

Conclusion
The ‘Learn to Play’ program was associated with increases in children's language and social skills over a 6-month period within a special school setting, indicating the Learn to Play program is an effective intervention for children with developmental disabilities. This paper presents an example of how the Learn to Play program can be adapted into a classroom setting.

Development of play profiles : influence of disability on children's play

Occupational therapists value play as a significant occupation in a child’s life and use play both as a means and as an end in itself to support development. This thesis explores the nature of play in children with developmental disabilities, seeking to determine whether there are consistent patterns of play specific to different disability categories. An extensive literature review of play and disability was completed, and Cooper’s (2000) model of play is used to organize the literature findings. This study investigated differences in play behaviour in 50 children diagnosed with Autistic Spectrum Disorder, Down syndrome, Developmental Delay and Physical impairments, aged 4 to 6 years 6 months who attended educational facilities in a regional centre in South East Queensland. Quantitative and qualitative play behaviour was assessed using two measures, Revised Knox Preschool Play Scale (Knox, 2008) and the Child Initiated Pretend Play Assessment (Stagnitti, 2007) with the Australian Developmental Screening Test (Burdon, 1993) used to determine developmental age to eliminate this as a potential confounding variable when statistically analyzing the results.
Cognitive, language and fine motor abilities were found to have a statistically significant impact on play ability rather than the different disability groupings. Children with Down syndrome had significantly more imitative play actions than any other disability grouping. Cooper’s (2000) model was found to be a useful tool to analyze differing play characteristics according to different disability groupings. Modifications to Cooper’s original model of play to more accurately depict play characteristics are proposed.

A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research

Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.

Does disability status modify the association between psychosocial job quality and mental health? A longitudinal fixed-effects analysis

BACKGROUND: People with disabilities have difficulties in obtaining work. However, evidence suggests that those with disabilities derive substantial mental health benefits from employment. This paper assesses how the relationship between work and mental health is influenced by psychosocial job quality for people working with a disability. METHODS: The study design was a longitudinal cohort with 13 annual waves of data collection, yielding a sample of 122,883 observations from 21,848 people. Fixed-effects within-person regression was used to control for time invariant confounding. The Mental Component Summary (MCS) of the Short Form 36 (SF-36) measure was used as the primary outcome measure. The main exposure was a six-category measure of psychosocial job quality and employment status (including 'not in the labour force' [NILF] and unemployment). Disability status ('no waves of disability reported' and 'all contributed waves with reported disability') was assessed as an effect modifier. We also conducted a secondary analysis on respondents contributing both disability and non-disability waves. RESULTS: For those with no disability, the greatest difference in mental health (compared to optimal employment) occurs when people have the poorest quality jobs (-2.12, 95% CI -2.48, -1.75, p < 0.001). The relative difference in mental health was less in relation to NILF and unemployment (-0.39 and -0.66 respectively). For those with consistent disability, the difference in mental health when employed in an optimal job was similar between the poorest quality jobs (-2.25, 95% CI -3.84, -0.65, p = 0.006), NILF (-2.84, 95% CI -4.49, -1.20, p = 0.001) or unemployment (-2.56, 95% CI -4.32, -0.80, p = 0.004). These results were confirmed by the secondary analysis. CONCLUSIONS: Efforts to improve psychosocial job quality may have significant mental health benefits for people with disabilities. This will contribute to the economic viability of disability employment insurance schemes in Australia and other high-income countries.

The differential effects of Autism and Down's Syndrome on sexual behavior.

Although sexuality plays a major role in the socialization of people, few studies have examined the sexual behaviors of individuals with developmental disabilities. Because of this, we decided to investigate sexuality in adolescents with autism spectrum disorder (ASD) and Down's syndrome (Ds) and to compare them with typically developing adolescents, by surveying their parents. Specifically, it was hypothesized that young people with ASD would display lower levels over five domains: social behavior, privacy, sex education, sexual behavior, and parental concerns, than peers with Ds and typically developing young people. In addition, we sought to verify developmental trends in five domains with age for each group. Overall, 269 parents participated; 94 parents of typically developing adolescents, 93 parents of adolescents diagnosed with Ds, and 82 parents of adolescents diagnosed with ASD. Participants were surveyed with a Sexual Behavior Scale developed by Stokes and Kaur [] that assesses parents' reports of their child's: social behavior, privacy awareness, sex education, sexual behavior and parental concerns about the child's behaviors. It was found that three groups were significantly different on all five domains, adolescents with ASD reportedly displaying lower levels than other groups. Moreover, there was a significant improvement in knowledge of privacy and parental concerns with age for adolescents with ASD and a decline in sex education for adolescents with Ds. The results obtained emphasize the need to train adolescents with developmental disability, and especially for adolescents with ASD through sex education programs. Autism Res 2015.