Resources, staff beliefs and organizational culture: factors in the use of information and communication technology for adults with intellectual disabilities

Background  Access to, and the use of, information and communication technology (ICT) is increasingly becoming a vital component of mainstream life. First-order (e.g. time and money) and second-order factors (e.g. beliefs of staff members) affect the use of ICT in different contexts. It is timely to investigate what these factors may be in the context of service provision for adults with intellectual disabilities given the role ICT could play in facilitating communication and access to information and opportunities as suggested in Valuing People. Method  Taking a qualitative approach, nine day service sites within one organization were visited over a period of 6 months to observe ICT-related practice and seek the views of staff members working with adults with intellectual disabilities. All day services were equipped with modern ICT equipment including computers, digital cameras, Internet connections and related peripherals. Results  Staff members reported time, training and budget as significant first-order factors. Organizational culture and beliefs about the suitability of technology for older or less able service users were the striking second-order factors mentioned. Despite similar levels of equipment, support and training, ICT use had developed in very different ways across sites. Conclusion  The provision of ICT equipment and training is not sufficient to ensure their use; the beliefs of staff members and organizational culture of sites play a substantial role in how ICT is used with and by service users. Activity theory provides a useful framework for considering how first- and second-order factors are related. Staff members need to be given clear information about the broader purpose of activities in day services, especially in relation to the lifelong learning agenda, in order to see the relevance and usefulness of ICT resources for all service users.

Interpreting communication of people with profound and severe learning difficulties

The present paper highlights some of the issues involved in interpreting the communication behaviours of people with profound and multiple learning difficulties (PMLDs). Both inference and intention can play an important role in the communication process, and this raises a number of difficulties and dangers where one of the communication partners is not in a position to correct misunderstandings. The present authors discuss the importance of validating communication and pose a number of key questions to ask those who are most significant in the life of a person with PMLDs. A case study is provided that illustrates a number of these issues.

Accessible information for people with complex communication needs

Information can be empowering if it is accessible. While a number of known information access barriers have been reported for the broader group of people with disabilities, specific information issues for people with complex communication needs have not been previously reported. In this consumer-focused study, the accessibility of information design and dissemination practices were discussed by 17 people with complex communication needs; by eight parents, advocates, therapists, and agency representatives in focus groups; and by seven individuals in individual interviews. Participants explored issues and made recommendations for content, including language, visual and audio supports; print accessibility; physical access; and human support for information access. Consumer-generated accessibility guidelines were an outcome of this study.

The recovery journey : employment support for people with depression and other mental illnesses

This paper presents the qualitative findings of a larger mixed method study aimed to articulate factors that clients and staff of the Disability Employment Network (DEN) identify in relation to re-engagement into the workforce. The DEN is a supported job training and employment program funded by the Australian Federal Government, established to assist clients with health disabilities, including mental health diagnoses, to seek and retain employment. Two DEN sites participated in the study (one regional and one metropolitan). Semi structured interviews and focus groups were undertaken with seven employment counsellors and 16 clients until data saturation occurred. Analysis of the narrative data identified two overarching emergent concepts articulated by clients and employment counsellors: employment enablers and employment barriers. The notion of recovery and re-engagement in the workforce in the context of mental illness is complex. The qualitative results of this study highlight the essential nature of supporting clients’ mental health and vocational needs concurrently through such means as service collaboration, vocational peer support and, importantly, provision of employment support congruent with phase of recovery.

Defining and measuring the outcomes of inclusive community for people with disability, their families and the communities with whom they engage

This paper explores the meaning of ‘inclusive community’ as understood by a major disability service provider in Victoria, Australia. Scope is a major non government agency with 1300 staff, a $50M annual budget and over 4500 clients. The recent adoption of a new Strategic plan for the organisation has focused significant attention on the priority area of building welcoming and inclusive communities. Given this mandate, the organisation has begun research to define and measure outcomes for people with a disability, their families, and the communities with whom they engage, as a result of increased community inclusion. This paper reviews literature on outcomes definition relevant to this task and suggests that outcome measures to date, especially within the field of disability, have offered a set of outcomes that are too limited in their aspiration and breadth. It has been the experience within Scope that people with a disability, including people with intellectual, multiple and complex disabilities, aspire to and experience outcomes across a far broader range of life domains than is currently captured in either existing disability outcome measures or in government policies that frame service delivery. As a result, the paper introduces an emerging outcomes framework which seeks to define outcomes across a range of citizenship domains.

Investigations of access for people with disability and older people

The phenomenon of access was investigated in regard to people with disability and older people. Access is described as a journey which involves navigation of numerous access opportunities and barriers and achievement of an access goal. While differences existed, numerous access issues and solutions are relevant to the two groups.

Restrictive interventions for people with a disability exhibiting challenging behaviours : analysis of a population database

Background: People with an intellectual disability whose behaviours are perceived to be of serious harm to themselves or others are at risk of being subjected to restrictive interventions. Prevalence rates are difficult to determine, as most research is unable to draw on the results of population-level data.

Method: The current study reports on the use of chemical and mechanical restraint and seclusion in the State of Victoria, Australia, over a 12-month period.

Results: The majority of people included were subjected to chemical restraint. The use of restraint was found to be routine rather than a strategy of last resort. Consistent with findings in the UK and USA, those subjected to restrictive interventions were more likely to be young males with multiple disabilities, including autism.

Conclusions: Systemic policy and procedural developments are needed to address current use of restrictive interventions, together with a longitudinal study to evaluate the effectiveness, of alternative, non-restrictive strategies.

The impression that I get : educational inclusion explored through the voices of young people with vision impairment

Despite the notion of educational inclusion of students with disabilities increasing in popularity, the day-to-day reality of its effectiveness remains mostly unknown. This paper reports key findings of a small-scale qualitative study that was conducted with a group of young people with vision impairment who attended an inclusive secondary school. The aim of the research was to ascertain their voiced experiences of their inclusion. Relevant to the study was the researcher’s insider status, which allowed for his unique insight and shared experiences with participants to influence data collection and analysis. The students reported a constant trade off that occurred between their aspirations for access and autonomy and practices of other stakeholders in the school that both facilitated and inhibited their inclusion. In sum, the students’ inclusion was ineffective because of habitual inhibiting actions of others. Recommendations are made based on Slee’s (2001) call for altered teaching and learning realities to promote educational inclusion, and a model of social justice that could bring about increased student agency (Higgins, Macarthur & Kelly, 2009).

Community based rehabilitation for people with disability in Iraq

This thesis explores the role of government and non-government organisations and international agencies in community based rehabilitation in Iraq. It examines the possibility of initiating and running community-based rehabilitation programmes for people with disability by NGOs regardless of Iraqi government commitment or participation. The research results show that implementation of CBR in Iraq is vital but not widely- spread. Non-government organisations seem more active, committed and capable in the time being to initiate, run and manage CBR programmes compared to the government of Iraq. Despite the high numbers of people with disabilities and lack of capacity to respond to their needs, there is little evidence that the Iraqi government has made efforts in adopting CBR as a cost-effective response.

An accessible survey method: increasing the participation of people with a disability in large sample social research

The 1 in 4 Poll project seeks to increase understanding of the views and needs of people with a disability by developing an accessible survey method. It is being conducted by Deakin University in partnership with the Victorian disability service provider, Scope. To address this goal, the 1 in 4 Poll method has focused on three key strategies: an accessible Internet-based survey; use of an assisted and proxy report; and a ‘standard’ and Easy English version of the survey. A bespoke online survey design seeks to overcome the limitations in accessibility of available online survey tools. Positive evaluative comments, from respondents across a wide-range of disabilities, suggests that the combination of the three major strategies used in the 1 in 4 Poll has resulted in a valuable and accessible method of large scale surveying of people with a disability.

Teaching and learning in the crucible: Actors with disabilities as experts preparing pre-service teachers to be inclusive educators

Dorothy Heathcote understood teaching and learning to take place in a kind of ‘crucible’ in which participants, who are both teachers and learners, contribute to the mix sometimes resulting in a radical transformation. This paper reports the ways Heathcote’s ideas have influenced both research and practice in the Teaching for Diversity workshop - a drama workshop that brings together pre-service teachers, teacher educators and actors from Fusion Theatre, a community-based theatre company for people with intellectual disabilities.

Diabetes in people with an intellectual disability : a systematic review of prevalence, incidence and impact.

To establish the prevalence and incidence of Type 1 and Type 2 diabetes in people with an intellectual and developmental disability and determine their impact on health and well-being and to appraise the evidence available to inform good practice in diabetes management for people with intellectual and developmental disabilities.