Further examination of relationships between events and psychiatric symptoms in adults with intellectual disability

Background: It has been proposed that people with intellectual disability (ID) might be similar to the general population in the way they respond to significant life events. Some preliminary findings have demonstrated that adults with ID who have experienced recent life events have an increased probability of having psychiatric problems. The aims of the present study were to determine whether previous findings can be replicated, and to examine the influence of additional diagnoses associated with ID on the strength of relationships between life event frequency and psychiatric problems.

Methods: Adults with ID (n = 624), living either in staffed community accommodation or in family or foster homes, were assessed on the Developmental Behaviour Checklist for Adults (DBC-A) and a 37-item life events checklist. Carers who knew the person well acted as proxy informants.

Results: People living in staffed accommodation experienced more life events than people living with natural or foster families. Life event frequency predicted DBC-A total score, five of six sub-scale scores, and caseness status, after significant demographic factors were taken into account. However, the strength of correlations between life event frequency and DBC-A total score varied among sub-groups identified by type of developmental disability and level of ID.

Conclusions: Weak but significant associations between emotional and behavioural problems and life events experienced by adults with ID were demonstrated, but it was also shown that the strength of such associations varies among sub-groups of this heterogeneous population. Future research needs to take account of the circumstances surrounding the life changes, the period of time over which changes might have taken place, and the meaning that the person might attach to the changes. Research into the causal relationship between exposure to life events and the onset of psychiatric problems is also warranted.

Towards universal accessibility : including users with a disability in the design process

While increased awareness of disability issues has resulted in the development of guidelines for developing accessible software, such guidelines do not guarantee that the end product will be optimal for users with a disability. We present an overview of a user-centred approach to the needs analysis and ultimate design of a disability aware email client (Multimail). We discuss the process we used to work with participants in developing the software and reflect on the benefits and challenges of the process.

Young people with an intellectual disability: risk and resilience.

There is a large body of literature about personal risk and resilience among children and adolescents from a variety of subpopulations. However, in intellectual disability research, resilience has almost exclusively been investigated and reported at the level of family stress and coping rather than an individual child's capacity to function adaptively despite severe risk. In this study young people with an intellectual disability, family members and non-family members (carers, teachers and family friends) were interviewed and asked about the young people’s relationships, coping styles, behaviour patterns and resilience. The main features placing these young people at risk included having autism or inflexible patterns of behaviour, displaying some forms of challenging behaviour, difficulty with receptive and expressive communication, living in families with high competing demands for time and living in a relatively unaccommodating community environment. The main factors leading to resilience were an attractive appearance/disposition, ability to get one’s message across, ability to adapt behaviour to changing contexts, low family stress levels and high sense of competence, stable relationships with supportive others and an accommodating/accepting community environment (both school and social).

Towards ending the silence: working women as carers of children with chronic illness/disability

This research presents stories from Australian women who work and care for a child with a significant chronic illness or disability. The paper considers the theory of Silencing the Self (Jack, 1991) in relation to the reported experiences and behaviours of these women. We report three themes of Caring and Working: "Otherness", "Doing it All" - but "Wanting to Live a Normal Life". As in Jack's study, these women engaged in silencing of the self. However, we also observed other people contributing to their silence and, unlike the respondents in Jack's study, many of these women fought the silence and did not accept that their unhappy situations should continue. They sought a life where silencing may not have been necessary.

Hearing what older consumers say about participation in their care

A study exploring older people's participation in their care in acute hospital settings reveals both consumers' and nurses' views of participation. Using a critical ethnographic design, data were collected through participant observation and interviews from consumers in acute care settings who were over 70 years old and nurses who were caring from them. Thematic analysis identified that older people equated participation with being independent. Importantly, consumers highlighted the complexity of the notion of participation when describing situations where they were unable to participate in their own care. The difficulties in communicating with health professionals and an inability to administer their own medications in inpatient settings were identified as barriers to participation. Understanding what consumers believe participation means provides a starting point for developing meaningful partnerships between health professionals and people receiving care.

Early detection of depression and associated risk factors in adults with mild/moderate intellectual disability

The aim of this study was to determine the presentation and risk factors for depression in adults with mild/moderate intellectual disability (ID). A sample of 151 adults (83 males and 68 females) participated in a semi-structured interview. According to results on the Beck Depression Inventory II, 39.1% of participants evinced symptoms of depression (2 severe, 14 moderate, and 43 mild). Sadness, self-criticism, loss of energy, crying, and tiredness appeared to be the most frequent indicators of depression or risk for depression. A significant difference was found between individuals with and without symptoms of depression on levels of automatic negative thoughts, downward social comparison and self-esteem. Automatic negative thoughts, quality and frequency of social support, self-esteem, and disruptive life events significantly predicted depression scores in people with mild/moderate ID, accounting for 58.1% of the variance.

Sources of well-being and commitment of staff in the Australian Disability Employment Services

This study examined the role of working conditions in predicting the psychological health, job satisfaction and organisational commitment of personnel responsible for helping people with disabilities gain employment in the mainstream Australian labour market. The working conditions were assessed using two theories: the Job Strain Model (job demand, social support and job control) and Psychological Contract Theory (unwritten reciprocal obligations between employers and employees). In the case of the Job Strain Model, the generic dimensions had been augmented by industry-specific sources of stress. A cross-sectional survey was undertaken in June and July 2005 with 514 staff returning completed questionnaires (representing a response rate of 30%). Comparisons between respondents and non-respondents revealed that on the basis of age, gender and tenure, the sample was broadly representative of employees working in the Australian disability employment sector at that time. The results of regression analyses indicate that social support was predictive of all of the outcome measures. Job control and the honouring of psychological contracts were both predictive of job satisfaction and commitment, while the more situation-specific stressors - treatment and workload stressors - were inversely related to psychological health (i.e. as concern regarding the treatment and workload stressors increased, psychological health decreased). Collectively, these findings suggest that strategies aimed at combating the negative effects of large-scale organisational change could be enhanced by addressing several variables represented in the models - particularly social support, job control, psychological contracts and sector-specific stressors.

Temporal processing and reading disability

The present investigation examined thehypothesis that early auditory temporalprocessing deficits cause later specificreading disability by impairing phonologicalprocessing (Farmer & Klein 1995; Tallal1980, 1984). Temporal processing ability atschool entry was examined using Tallal'sRepetition Test in a large unselected sample ofover 500 children followed over subsequentyears. Although our data confirmed the presenceof certain non-speech auditory processingdeficits in children later classified asspecific reading-disabled, many findings wereclearly at odds with a causal interpretation ofthis relationship. (1) Reading-disabled (RD)children were impaired at school entry on thesubtest with long interstimulus intervals(ISIs) but not the critical short-ISIsubtest. (2) RD children were not inferior toreading-age (RA) controls. (3) A subgroup of RDchildren with evidence of temporal deficitswere no less proficient on later phonologicalor reading measures than RD children with noevidence of early temporal impairment. (4)Although there was a reliable concurrentcorrelation between temporal deficits andphonological awareness at school entry(suggesting a possible common causeexplanation), early temporal deficits did notpredict later phonological impairment,pseudoword processing difficulties, or specificreading disability. On the other hand, earlytemporal deficits did predict later oralreceptive vocabulary and reading comprehensionweaknesses. These findings suggest thatauditory temporal deficits in dyslexics may beassociated with the same dysphasic-typesymptoms observed by Tallal and her colleaguesin specific language-impaired populations, butdo not cause the core phonological deficitsthat characterize dyslexic groups.

Educational enrolment of students with a disability in New South Wales and Victoria

The extent to which legislation and special education policy have impacted on the nature of the educational enrolment of students with a disability in Australia has not been clearly addressed. Although there are no detailed and systematic national data on the enrolment of students with a disability in inclusive settings, special classes and special schools in Australia, some broad trends are apparent. The legislative background to these trends is discussed. As might be expected, there are variations in the nature of the educational enrolment of students with a disability across the states and territories of Australia. Enrolment trends in the two most populous states, New South Wales and Victoria, are examined and discussed within the context of their respective special education policies, disability discrimination legislation, and educational precedent.

Individual characteristics associated with community intergration of adults with intellectual disability

Background The purpose of this study was to identify individual characteristics associated with community integration of adults with an intellectual disability.

Method A group of 37 males with high support needs, and who had previously lived in a large institution, participated in the study. Using proxy respondents, data were collected on three measures of community integration, and on the participants' adaptive and maladaptive functioning. Chronological age and years of institutionalisation were also examined for their associations with community integration.

Results Level of daily living skills predicted life circumstances. There were no significant associations among the measures of community integration.

Conclusions The examination of the relationships between participant characteristics and community integration produced similar conclusions to previous research. Only daily living skills scores were uniquely associated with variations in life circumstances. Further research is required to determine whether these findings will be replicated with other cohorts of participants.