Deinstitutionalization and its Effects on Social Inclusion, Choice-Making, Adaptive and Maladaptive Behavior for Individuals with Intellectual Disabilities: Case Studies Analysis

In the past three decades institutions for persons with intellectual disabilities (ID) have been downsizing and closing in Ontario, Canada. This trend is reflective of the changes that have occurred in society. As of March 2009 the last institution operated by the Ontario government for persons with ID closed, placing the remaining approximately 1000 persons into the community. The current study was an analysis of part of one study in a four-study research project, called the Facilities Initiative Study, to explore the impact of the closures on the lives of individuals who have been reintegrated into community settings. The goal of the current case study analysis was to describe the impact of changes in social inclusion, choice-making/autonomy, and adaptive/maladaptive functioning of four individuals prior to and following transition to the community. The results suggested that, in most cases, community integration was related to more social inclusion opportunities and autonomy in choice-making, a wider range of adaptive behaviors and fewer maladaptive behaviors. In some cases, the evidence suggested that some of these indices of quality of life were not improving. Overall, the study found that the differences observed were unique to each of the individuals who participated in the case study analysis. Some generalized themes were generated that can be applied to future deinstitutionalization endeavors.

Social Economy and Developmental Disabilities: An Employment Option that Promotes a Form of Authentic Work and Fosters Social Inclusion

Typical employment options for people with developmental disabilities are insufficient. Most employment opportunities that are community-based provide typical workplace and geographical inclusion but tend not to support social inclusion and "belonging". This study explored the innovative employment alternative of social businesses and considered this form of employment for persons with a developmental disability as a viable avenue for meaningful work and social inclusion. A total of six business partners with a developmental disability were interviewed; two partners from three separate worker owned businesses. The partners' descriptions of their job and their workplace composed the interpretative findings. The social businesses provided an avenue for this group of people who tend to be segregated in isolated workshops or marginalized in mainstream work environments and who feel a sense of being "outsiders" to participate in meaningful work in community settings. This group of partners described their job as authentic "work" and discussed the many skills and the work ethic learned from their employment opportunity. In addition to the instrumental aspects of the job, the partners also discussed the group autonomy and self-determination of being their own "bosses". The partners confidently expressed feeling valued, understood in the context of others with similar life experiences, attached to the workplace and connected to a larger community as important outcomes of their businesses. These criteria of social inclusion (Hall, 2010) were complemented by teamwork, friendship and ultimately, with a feeling of being genuine "insiders". Replication of this innovative employment model would be recommended for groups of marginalized people with DD in other geographic areas.

Creating and Enabling a Sustainable Livelihood for Persons with Intellectual Disabilities: A Comparative Case Study of Ghana and Canada.

Abstract Despite the plethora of published studies on rights, including employment rights, for persons with intellectual disabilities (Hatton, 2002; Tarulli, et al., 2004; Ward & Stewart, 2008), relatively few have discussed their applicability to individuals with intellectual disabilities to facilitate their full involvement in socio-economic development. This study explored the mechanisms facilitating and inhibiting the full participation of persons with intellectual disabilities in the area of employment through a comparative case analysis of policies and practices in Ontario, Canada (a developed country) and in Ghana (a developing country) both of which are signatories to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). The study employed targeted recruitment based on the nature of the research which is a combination of policy and practice investigation.

Strategies and Techniques for Teaching Children with Learning Disabilities: A Case Study of the Spring Reading Program

This case study explored strategies and techniques in order to assist individuals with learning disabilities in their academic achievement. Of particular focus was how a literacy-based program, titled The Spring Reading Program, utilizes effective tactics and approaches that result in academic growth. The Spring Reading Program, offered by the Learning Disabilities Association of Niagara Region (LDANR) and partnered with John McNamara from Brock University, supports children with reading disabilities academically. In addition, the program helps children increase their confidence and motivation towards literacy. I began this study by outlining the importance of reading followed by and exploration of what educators and researchers have demonstrated regarding effective literacy instruction for children with learning disabilities. I studied effective strategies and techniques in the Spring Reading Program by conducting a qualitative case study of the program. This case study subsequently presents in depth, 4 specific strategies: Hands-on activities, motivation, engagement, and one-on-one instruction. Each strategy demonstrates its effectiveness through literature and examples from the Spring Reading Program.

Nutrient Mobility in Chalakudy River,Typified With Riparian Buffer Zone and Its Adjoining Estuary:Spatiotemporal Manifestation

This study was aimed at to characterize the spatio-temporal trends in the distributional characteristics of various species of nitrogen and phosphorus as well as to elucidate the factors and processes aflecting these nutrients in the dissolved, particulate and sedimentary phases of a river estuarine system. The main area of study is Chalakudy river in Kerala, which is a fresh water system originating from Anamalai hills and ending at Arabian Sea. Its basin is between I00 05 ’ to I00 35’ North latitude and 76” 15 ’ to 760 55’ East longitude. Being a riparian bufler zone, the dynamics of nutrient mobility tend to be more complex and variable in this river-estuarine system.The diflerent species of nitrogen estimated from the filtrate were nitrite-N, nitrateN, ammonia-N, urea-N, total nitrogen and residual nitrogen. The diflerent forms of phosphorus estimated from the filtrate were phosphate-P, total-P and residualP. Pre weighed sediments as well as particulate matter were analysed for quantijying nitrite-N, nitrate-N, ammonia-N and urea-N. Total nitrogen was estimated after digestion with potassium persulfate. Fractionation of phosphorus in sediment/particulate matter was performed by applying sequential extraction procedure. The dijferent forms of phosphorus thus estimated were loosely bound (exchangeable) P, Fe/Al bound P, polyphosphates, Ca bound P and refractory P. Sedimental total P was also measured directly by applying digestion method.The analyses carried out in this bimonthly annual survey have revealed specific information on the latent factors influencing the water quality pattern ofthe river. There was dependence among the chemical components of the river sediment and suspended matter, reflecting the water quality. A period of profound environmental change occurred and changes in various species had been noted in association with seasonal variations in the waterway, especially following enhanced river runoff during the monsoon. The results also successfully represented the distribution trend of nutrients during the rainy as well as dry season. Thus, the information gathered in this work will also be beneficial for those interested or involved in river management, conservation, regulation and policy making in regional and national levels.

Most comfortable listening levels of hearing impaired people: effects of everyday auditory and visual environments

This paper discusses a study to evaluate the changes that may occur in most comfortable listening levels when hearing aid users encounter a realistic auditory and visual environment.

Isotopes and individuals: diet and mobility among the medieval Bishops of Whithorn

Stable isotopes get personal in this analysis of burials at a medieval cathedral. Compared with the local meat-eating rank and file, those people identified as bishops consumed significantly more fish and were incomers from the east. These results, while not so surprising historically, lend much increased confidence that isotope analysis can successfully read the status and mobility of individuals in a cemetery.

Idiom comprehension in French-speaking children and adolescents with Williams syndrome

This study looks at idiom comprehension by French-speaking people with Williams’ syndrome (WS) and metapragmatic knowledge is examined. Idiomatic expressions are a nonliteral form of language where there is a considerable difference between what is said (literal interpretation) and what is meant (idiomatic interpretation). WS is characterized by a relatively preserved formal language, social interest and poor conversational skills. Using this framework, the present study aims to explore the comprehension of idiomatic expressions by 20 participants with WS. Participants performed a story completion task (comprehension task), and a task of metapragmatic knowledge to justify their chosen answers. WS performances were compared to typically developing children with the same verbal mental age. The main results can be summarized as follows: (1) People with WS have difficulties to understand idioms; (3) WS group seems to perform partly as typically developing children for the acquisition of metapragmatic knowledge of linguistic convention: there is a progressive increase in metapragmatic knowledge of linguistic convention as age increased. Our results indicate a delay of acquisition in idiom comprehension in Williams’ syndrome.

Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomised controlled trial

Objectives To evaluate the effectiveness of integrated motivational interviewing and cognitive behaviour therapy in addition to standard care for patients with psychosis and a co-morbid substance use problem. Design Two-centre, open, rater-blind randomised controlled trial Setting UK Secondary Care Participants 327 patients with clinical diagnoses of schizophrenia, schizophreniform or schizoaffective disorder and DSM-IV diagnoses of drug and/or alcohol dependence or abuse Interventions Participants were randomly allocated to integrated motivational interviewing and cognitive behaviour therapy or standard care. Therapy has two phases. Phase one – “motivation building” – concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. Phase two –“Action” – supports and facilitates change using cognitive behavioural approaches. Up to 26 therapy sessions were delivered over one year. Main outcomes The primary outcome was death from any cause or admission to hospital in the 12 months after therapy. Secondary outcomes were frequency and amount of substance use (Timeline Followback), readiness to change, perceived negative consequences of use, psychotic symptom ratings, number and duration of relapses, global assessment of functioning and deliberate self harm, at 12 and 24 months, with additional Timeline Followback assessments at 6 and 18 months. Analysis was by intention-to-treat with robust treatment effect estimates. Results 327 participants were randomised. 326 (99.7%) were assessed on the primary outcome, 246 (75.2%) on main secondary outcomes at 24 months. Regarding the primary outcome, there was no beneficial treatment effect on hospital admissions/ death during follow-up, with 20.2% (33/163) of controls and 23.3% (38/163) of the therapy group deceased or admitted (adjusted odds-ratio 1.16; P= 0.579; 95% confidence interval 0.68 to 1.99). For secondary outcomes there was no treatment effect on frequency of substance use or perceived negative consequences, but a statistically significant effect of therapy on amount used per substance-using day (adjusted odds-ratios: (a) for main substance 1.50; P=0.016; 1.08 to 2.09, (b) all substances 1.48; P=0.017; 1.07 to 2.05). There was a statistically significant treatment effect on readiness to change use at 12 months (adjusted odds-ratio 2.05; P=0.004; 1.26 to 3.31), not maintained at 24 months. There were no treatment effects on assessed clinical outcomes. Conclusions Integrated motivational interviewing and cognitive behaviour therapy for people with psychosis and substance misuse does not improve outcome in terms of hospitalisation, symptom outcomes or functioning. It does result in a reduction in amount of substance use which is maintained over the year’s follow up. Trial registration Current Controlled Trials: ISRCTN14404480