Discovering an Untapped Resource: Recruiting, Hiring, and Promoting People with Cognitive Disabilities.

Sections to the Paper include the following: America's Shrinking Labor Force, People with Cognitive Disabilities: an Untapped Labor Source, Focus, Initiative, Understand, Enhance.

Making sense of a trial maths intervention program for teachers of students with disability in Australia: Interim report

The Disability Standards for Education (2005) and the Australian Curriculum, Assessment and Reporting Authority relevant standards underscore the right of students with disability to access the curriculum on the same basis as students without disability. Students with disability are entitled to rigorous, relevant and engaging learning opportunities drawn from the Australian curriculum content. Taking this context into account, this paper provides a work-in-progress report on a two-year mathematics intervention project conducted in 12 special schools (Preparatory-Year 12) in Queensland, Australia. The project aims to build the capacity of teachers to teach mathematics to their students and to identify and make sense of the intervention program’s impact. It combines two approaches—appreciative inquiry and action research to monitor schools’ change processes. The interim findings demonstrated that teachers were concerned about their students’ underachievement in mathematics and that the multi-sensory forms of teaching advocated in the program increased student engagement and performance.

Obesity in People with Learning Disabilities: the impact of nurse led health screenings and health promotion activities

Background. Obesity appears to be more common among people with intellectual disabilities, with few studies focusing on achieving weight reduction. Aim. Firstly, to follow up people identified as overweight and obese following special health screening clinics and to determine the actions taken. Secondly, to evaluate the impact of health promotion classes on participants' weight loss. Methods. A clinic led by two learning disbaility nurses was held for all people aged 10 years and over (n=464) who attended special services within the area of one Health and Social Services Trust in Northern Ireland. In a second study, the nurses organised health promotion classes for 20 people over a 6 - 8 week period. Findings. The health screen identified 64% of adults and 26% of 10 - 19 year olds as being overweight or obese. Moreover, those aged 40 - 49 years who were obese had significantly higher levels of blood pressure. However, information obtained from a follow up questionnaire sent after 3 months suggested that of the 122 people identified for wiehgt reduciton, action had been taken for only 34% of them and only three were reported to have lost weight. The health promotion classes, however, led to a significant reduction in weight and body mass index scores. Conclusion. Health screening per se has limited impact on reducing obesity levels in this client group. Rather, health personnel such as general practitioners, nurses and health promotion staff need to work in partnership with service staff, carers and people with intellectual disabiltieis to create more active lifestyles.

People with intellectual disabilities: promoting quality end of life care

Background: Internationally concerns have been highlighted about the quality of palliative care that people with intellectual disability receive. It has also been evidenced that people with intellectual disabilities are seldom referred to hospice and palliative care services. 

Aims: This study aimed to explore the experience of health and social care professionals in providing palliative care to people with intellectual disabilities. 

Methods An exploratory, qualitative design was used. A purposive sample of thirty health and social care professionals, working in intellectual disability and palliative care services, who had provided end-of-life care to adults with intellectual disabilities, were recruited to the study following informed consent. They were asked to reflect on a case scenario of a person with intellectual disability to whom they had provided end of life care. A semi-structured interview technique, with open questions and prompts, was used to explore their experiences and insights. The narrative from the case scenarios were content analysed using a recognised framework. 

Results: Three themes emerged from the data within the case scenarios: Identifying end of life care needs, meeting support needs and empowerment in partnership. Examples of good practice and issues in practice were apparent. 

Conclusion/ Discussion: This study contributes to the developing international evidence base to enhance end of life care for people with intellectual disabilities and provides further insights into this area of practice. Funder: HSC Research and Development Doctoral Fellowship Scheme

The dual role of students with behavioural problems: an analysis of their experiences as bullies and victims /

The present study examined the bullying experiences of a group of students, age 10-14 years, identified as having behaviour problems. A total often students participated in a series of mixed methodology activities, including self-report questionnaires, story telling exercises, and interview style joumaling. The main research questions were related to the prevalence of bully/victims and the type of bullying experiences in this population. Questionnaires gathered information about their involvement in bullying, as well as about psychological risk factors including normative beliefs about antisocial acts, impulsivity, problem solving, and coping strategies. Journal questions expanded on these themes and allowed students to explain their personal experiences as bullies and victims as well as provide suggestions for intervention. The overall results indicated that all of the ten students in this sample have participated in bullying as both a bully and a victim. This high prevalence of bully/victim involvement in students from behavioural classrooms is in sharp contrast with the general population where the prevalence is about 33%. In addition, a common thread was found that indicated that these students who participated in this study demonstrate characteristics of emotionally dysregulated reactive bullies. Theoretical implication and educational practices are discussed.

Wrap around analysis of the affordances and constraints for girls with physical disabilities participating in physical activities /

This is a qualitative study exploring the physical activity patterns of a group of women with physical disabilities through their lifespan. In-depth interviews were done with a group of 6 women aged 1 9 to 3 1 . The data were analyzed via content and demographic strategies. Participants in this study reported that their physical activity patterns and their experiences related to their physical activity participation changed over their lives. They were most physically active in their youth (under 14 years of age) and as they reached high school age (over 14 years of age) and to the present time, they have become less physically active. They also reported both affordances and constraints to their physical activity participation through their lifespan. In their youth, they reported affordances such as their parents' assistance, an abundance of available physical activity opportunities, and independent unassisted mobility, as all playing an important factor in their increased youth physical activity. In adulthood, the participants' reported less time, fewer opportunities for physical activity, and reliance on power mobility as significant constraints to their physical activity. The participants reported fewer constraints to being physically active in their youth when compared to adulthood. Their reasons for participation in physical activity changed from fun and socialization in their youth instead of for maintenance of health, weight, and function in adulthood. These affordances, constraints and reasons for physical activity participation were supported in the literature.

Making the transition from secondary to post-secondary education : a retrospective study of students with learning disabilities

The purpose of this study was to investigate what students with Learning Disabilities perceive are the personal characteristics they possess and services they require to assist them to complete secondary school and to continue their education in a postsecondary setting. Twenty-one students (12 female and 9 male) participated in the study which consisted of an interview and completion of a questionnaire. The central findings were as follows: 1) the participants perceived that personal characteristics were important in secondary school and still remain of importance at th~ postsecondary level; 2) Many of the typical accommodations and services supposed to be provided in secondary schools were not provided to the participants in this study; 3) the participants believed that they had more academic than social problems. Recommendations for future research in this field are based on findings related to the transition of LD students from secondary school to postsecondary education.

Supporting and maximizing communication between individuals with intellectual disabilities and health care providers

The goal of the present study was to examine the barriers to access in health services faced by individuals with intellectual disabilities (ID), as well as the nature of communication between people with ID and those who are directly involved in supporting their health and well being. The study included in-depth interviews with five adults who have been identified as having ID and are supported by a community agency, five community agency support staff and four physicians who are specialists in supporting people who have ID. A qualitative content analysis approach facilitated the comparative exploration of key themes that each participant group saw as positive or negative influences on health care access and on effective health care communication. Themes drawn from the findings emphasize the unique roles each of these groups plays within the dialogical framework of the health care encounter. Of particular importance to informants was the issue of people with ID being seen as full participants in their own health care who, like all people, are unique individuals and not simply members of an identified or marginalized group. Participants across groups emphasized the need for the health care recipient to be known as an individual who is an expert in her/his own health and well being and, therefore, entitled to full participation with the support of but not control by others.

Experiences and meaning of the aquatic environment for individuals with physical disabilities

This study examines the experiences and meaning of physical activity in the aquatic environment to enhance social, cultural and political understanding of its impact in the lives of individuals with physical disabilities. Interviews, lived experience descriptions and artifacts present an explanation of the felt sense oftheir bodies as they engage in swimming or scuba diving. 11 Combining written, verbal and visual descriptions generated by informants provides a detailed account of the unique qualities of physical activity in the water for those with physical disabilities. Participants' descriptions highlight that context is an important aspect of physical activity among individuals with physical disabilities through discussion of motility and the role of the lived body. Aspects of the aquatic environment create a setting that facilitates forgetfulness of the lived body's presence. Instructors and participants alike will benefit from learning the difference between the object body and the lived body, listening to the body's voice as they participate in physical activity .

Psychotropic medication use by adults with intellectual disabilities living in community settings

This study examined the variables related to psychotropic medication use among 73 adults with intellectual disabilities living in community residential settings in Ontario, Canada over a one-year period based on staff reports. Despite only 16% percent having a documented psychiatric diagnosis, 84% of these individuals were receiving psychotropic medications, and 74% were receiving two or more psychotropic medications (polypharmacy). Anti-psychotics, anti-anxiety medications, and anti-convulsant medications were the most frequently reported drug classes. While problem behaviour was reported for 60% of the participants, only 33% had a formal behaviour plan. There was a significant relationship between the reported number of problem behaviours and the reported number of prescribed psychotropic medications. Reported medication reviews did not adhere to the Canadian 'Consensus Guidelines for the Primary Care of Adults with Developmental Disabilities' (Sullivan et aI., 2006). Results, based on staff reports, suggested incongruence with recommended best practices, and raised concern about over-reliance on psychotropic medication with these individuals. Keywords: intellectual disabilities, psychotropic medication, problem behaviour

Sport Commitment in Wheelchair Basketball: An Interpretive Look into the Lives of Individuals with Physical Disabilities

It is estimated that over 4.4 million people are living in Canada with a reported disability. Due to a number of risk factors associated with potential health concerns and sedentary lifestyles, it is important for people with physical disabilities to lead an active lifestyle. Recreation and leisure pursuits are a great outlet for this to take place. However, in order to gain the long terms benefits of these pursuits one must be committed to an activity. With the use of a collaborative interview method, with the Sport Commitment Model serving as the guiding framework, this study sought to find the underlying factors for continued participation for people with physical disabilities in wheelchair basketball. Through utilizing an interpretive approach it was found that enjoyment, social support, perceived ability and to some extent involvement opportunities, were the main contributors to overall commitment. Criticisms and suggestions for future research are also provided.

Retombées du cirque social (Cirque du Soleil) en contexte de réadaptation sur la participation sociale de jeunes adultes avec déficiences physiques en transition vers la vie active : étude qualitative

Introduction : Les adolescents avec déficiences physiques en transition vers la vie adulte éprouvent des difficultés à établir une participation sociale optimale. Cette étude explore les retombées d'un programme de cirque social sur la participation sociale de ces jeunes selon leur point de vue et celui de leurs parents. Méthode : Étude qualitative exploratoire d’orientation phénoménologique. Neuf personnes avec déficiences physiques, âgées de 18 et 25 ans, ont participé au programme pendant neuf mois. Données recueillies : perceptions de leur qualité de participation sociale à partir d’entrevues semi-structurées en pré, mi-temps et post-intervention avec les participants et un de leurs parents. Le guide d’entrevue validé est ancré sur le Modèle du développement humain- Processus de production du handicap - 2 (HDM-PPH2). L’enregistrement audio des entretiens a été transcrit en verbatim. Le contenu a été analysé avec le logiciel Nvivo 9 à travers une grille de codage préalablement validée (co-codage, codage-inverse). Résultats : Corpus de 54 entrevues. L’âge moyen des jeunes était de 20,0 ± 1,4 années et de 51 ± 3,6 années pour les parents. Selon tous, la participation sociale des jeunes adultes a été optimisée, surtout sur le plan de la communication, des déplacements, des relations interpersonnelles, des responsabilités et de la vie communautaire. La perception de soi et les habiletés sociales, également améliorées, ont favorisé une plus grande auto-efficacité. Conclusion : Cette étude soutient donc le potentiel du cirque social comme approche novatrice et probante en réadaptation physique pour cette population, et appuie la pertinence d’autres études rigoureuses mesurant les diverses retombées possibles et identifiées.

The use of ICT by adults with learning disabilities in day and residential services

The use of Information and Communication Technology (ICT) by adults with learning disabilities has been positively promoted over the past decade. More recently, policy statements and guidance from the UK government have underlined the importance of ICT for adults with learning disabilities specifically, as well as for the population in general, through the potential it offers for social inclusion. The aim of the present study was to provide a picture of how ICT is currently being used within one organisation providing specialist services for adults with learning disabilities and more specifically to provide a picture of its use in promoting community participation. Nine day and 14 residential services were visited as part of a qualitative study to answer three main questions: What kinds of computer programs are being used? What are they being used for? Does this differ between day and residential services? Computers and digital cameras were used for a wide range of activities and ‘mainstream’ programs were used more widely than those developed for specific user groups. In day services, ICT was often embedded in wider projects and activities, whilst use in houses was based around leisure interests. In both contexts, ICT was being used to facilitate communication, although this was more linked to within-service activities, rather than those external to service provision.

Interviewing children and young people with learning disabilities: guidelines for researchers and multi-professional practice

We argue that it is important for researchers and service providers to not only recognize the rights of children and young people with learning disabilities to have a ‘voice’, but also to work actively towards eliciting views from all. A set of guidelines for critical self-evaluation by those engaged in systematically collecting the views of children and young people with learning disabilities is proposed. The guidelines are based on a series of questions concerning: research aims and ethics (encompassing access/gatekeepers; consent/assent; confidentiality/anonymity/secrecy, recognition, feedback and ownership; and social responsibility) sampling, design and communication

Autonomy Markers in Brazilian Adults With Intellectual Disabilities

The objective of the study was to investigate the relationship between autonomy markers in adult people with intellectual disabilities (ID) and variables such as intelligence quotient (IQ), early aging, and literacy. Participants were 47 adults with ID (33 men; aged 28-58 years with nonspecific etiology, 34 literate). All participants were trainees at the Center for Training of Capacity and Orientation for Employment at Associação de Pais e Amigos dos Excepcionais de São Paulo, São Paulo State, Brazil. They were divided into two age groups: younger (n = 27, mean age 31.85; +/- 2.23), and older (n = 38, mean age 41.84; +/- 5.54). They were administered intelligence scales twice, and answered questions related to social participation, community integration, and choice-making; the percentage of item responses leaning toward self-determination and freedom in choice-making was considered in defining the autonomy score. For both groups, IQ declined from the first to the second assessment. Autonomy scores were more determined by IQ classification than by literacy. Authors concluded that autonomy in people with ID is a multifactorial phenomenon associated with cognitive decline.