Deinstitutionalization and community inclusion of individuals with intellectual disabilities in Ontario : a case analysis

In the last few decades, there have been significant changes in the way people with intellectual disabilities (ID) live in many countries around the world. Large isolated institutions have been replaced by community-based housing. This study examined the deinstitutionalization process in Ontario and it's effects on the lives of three individuals with ID. A case analysis approach was used allowing for in depth evaluation of the quality of life of these participants following their discharge with a focus on family involvement, community engagement, and choice making. A discrepancy analysis between the Essential Elements Plan (EEP), constructed when they were entering the community placement, and the current living arrangements was also done. The results of this study suggested that with community living comes improvements in family interactions, community engagement, and decision-making. However, these improvements were found to be minimal. Also, little discrepancy was found between the EEPs and their actual placements.

Youth with intellectual disabilities and the right to make choices : investigating the family context to inform a training program

People with intellectual disabilities (ID) are more likely to be victims of abuse and human rights violations than people without ID. The 3Rs: Rights, Respect, and Responsibility project has developed and is testing a human rights training program for adults with ID. The current project was conducted to make recommendations to adapt the 3Rs rights training program to be used with youth with ID and their families. An interpretive phenomenological framework was employed to investigate youth with ID, parents', and siblings' perceptions of the i r experiences with choice making, an enactment of rights, in the family context. Thematic analysis of interviews revealed that, consistent with previous research, family members consider family values, conventions, and family members' well being when making decisions. A training program should promote a consideration of expanded opportunities for youth with ID to make choices and should be flexible to address individual families' cultures, needs, and desires.

Teaching persons with intellectual disabilities and limited receptive and expressive communication how to recognize and assert their human rights

Persons with intellectual disabilities (ID) are far more likely to be abused than the general population, but there is little research on teaching people with ID about their rights. The goal of this study was to teach four participants with ID and limited communication abilities about their human rights by training them on specific rights topics. The training program included icebreaker activities, instruction on rights concepts, watching and answering questions about videotaped scenarios of rights restrictions, watching and answering questions about role pl ay scenarios of rights restrictions, and responding to brief, low risk in situ rights restrictions imposed by the researchers. Participant performance did not improve significantly or consistently from baseline to training on the questions asked about the videotaped or the role play scenarios, but two of three participants demonstrated defmite improvements in responding to in situ rights restrictions.

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.

Community Recreation and Leisure Activities in Adults with Developmental Disabilities who have Recently Relocated to Community-based Residences in Ontario

In 2009, the Ontario Government closed the last three remaining large-scale institutions for people with Developmental Disabilities (DD). The purpose of this study is to examine the community-based recreation and leisure activities of 87 adults with DD who have recently moved into the community. Study 1 provided a descriptive insight into the community recreation and leisure activities, and revealed that people with DD engage in low levels of community activities, however are reported to have the desire to engage more often. Staff reported that people with DD do not have the opportunities to engage in their preferable activities. Study 2 investigated the prbspective predictors of the number and frequency of community, recreation and leisure activities and found that a higher level of functioning predicted a greater number of community activities ([beta] = .26, P < .05), while both a higher level of functioning ([beta] = .38,p < .001) and greater preference ([beta] = .23. p < .05) predicted more frequent access to community activities. Future research and the implications of the findings for clinical practice and policy development were discussed.

The impact of sexual esteem, body esteem, and sexual satisfaction on psychological well-being in people with physical disability

The current study investigated the association between sexuality and psychological well-being in people with physical disabilities. A total of 1,196 participants completed the study. There were 748 participants who had a physical disability and 448 participants who were able-bodied. The results demonstrated that sexual esteem, body esteem, and sexual satisfaction were strong predictors of self-esteem and depression among people with physical disability, and that this relationship was stronger among people with physical disability than able-bodied participants. It was also found that body esteem was more closely associated with self-esteem in disabled women, while sexual esteem was more closely associated with self-esteem in disabled men. The results of the study suggest that researchers and clinicians who are concerned with the psychological health of people with physical disability should consider strategies to improve the body esteem and sexual well-being of people with physical disabilities.

Sexual esteem, sexual satisfaction, and sexual behavior among people with physical disability

This study investigated the association between the severity and duration of physical disability and sexual esteem, sexual depression, sexual satisfaction, and the frequency of sexual behavior. A total of 1,196 participants completed the study. There were 748 participants (367 males, 381 females) who had a physical disability and 448 participants (171 males, 277 females) who were able-bodied. The age range of participants was 18–69 years, with a mean age of 36.39 years (SD = 10.41). The results demonstrated that people with more severe physical impairments experienced significantly lower levels of sexual esteem and sexual satisfaction and significantly higher levels of sexual depression than people who had mild impairments or who did not report having a physical impairment. The study also found that people with more severe physical disabilities engaged in mutual sexual activity significantly less frequently. Women with physical disabilities had significantly more positive feelings about their sexuality and significantly more frequent mutual sexual experiences than their male counterparts. For people with physical disabilities, the frequency of oral sex and nude cuddling were significant predictors of sexual satisfaction in men, while the frequency of deep kissing predicted sexual satisfaction in women. Furthermore, the viewing of erotica was significantly related to sexual dissatisfaction in men. Finally, it was found that people who had experienced their physical impairment for a longer period of time reported significantly more positive feelings about their sexuality. Implications of these findings are discussed and suggestions are made for future research.

Relationships, sexuality and adjustment among people with physical disability.

The current study investigated the association between relationship status and the psychological adjustment, sexual esteem and sexual behaviour of people with and without physical disability. A total of 1196 participants completed the study, 748 participants (367 men, 381 women) had a physical disability and 448 participants (171 men, 277 women) were able-bodied. The age range of participants was 18 to 69 years, with a mean age of 36.39 years (SD=10.41). The results demonstrated that physical disability and its severity were related to an increased likelihood of being single. Men with physical disabilities were more likely than women to be single. In terms of psychological adjustment, single people with physical disabilities were more depressed than those who had a partner they did not live with. However, they were not significantly disadvantaged in this area when compared to married people and those in de facto relationships. Relationship status was strongly related to sexual wellbeing in people with and without physical disability, with single people reporting lower levels of sexual satisfaction and sexual esteem as well as less frequent mutual sexual activity. However, married people with physical disabilities reported lower levels of sexual wellbeing than the people who had partners they did not live with. This suggests that among couples where a partner has a physical disability, marriage and live-in relationships may add burdens that do not exist in more casual relationships.

Accessible telecommunications information for people with communication impairment

Study investigating the telecommunication information needs of people with communication disabilities in Australia. Participants were informed about the project through flyers, letters, e-mail, disability agency contacts, and Web sites. A survey with multiple choice and closed and open-ended items was developed. People with communication disabilities used a hard-copy survey format to facilitate completion. Sixty-five participants age eighteen and over from Victoria, Tasmania, South Australia, and Queensland completed the survey. Preliminary results of the study indicated that the participants requested six text-based adaptations: (1) make information clear and easy to read and understand, (2) use larger print, (3) highlight the key points, (4) use dot points, (5) use visual information, such as photos and communication symbols, and (6) provide a range of oral/audio and visual formats for information. The accessibility characteristics requested by the participants called for the development of text and Web-based formats, and for the development of inclusive design guidelines. The authors concluded that further investigation was required to determine the best possible method of making the information accessible.

Attitudes towards people with intellectual disability : an Australian perspective

Attitudes in Australia toward people with intellectual disabilities were investigated among students, disability services professionals, and the general population. Three previously validated questionnaires and a measure of respondent self-reported "social desirability" were used. Students and disability services professionals exhibited similar attitudes, with both groups reporting significantly more positive attitudes than members of the general population. More positive attitudes were evident among younger people, people with higher educational attainment, and individuals with a prior knowledge of or regular contact with people with intellectual disabilities. These respondents were less likely to support the principles of eugenics and more likely to support the paradigm of community inclusion. The authors make recommendations concerning the development of policies and strategies to foster the acceptance and inclusion of adults with intellectual disabilities in the wider community. Further studies that include the use of qualitative techniques and target people in the general population are recommended.

The measurement of subjective wellbeing in people with intellectual disability in Australia

The importance of measuring quality of life, and most particularly the personal wellbeing of people with intellectual disabilities (ID), is now recognized. The measurement of wellbeing is an important component of program evaluation and can assist in the identification and planning of individualized support needs. There remains, however, a need for further research in this area. This paper describes a new scale, the Personal Wellbeing Index Intellectual Disability Scales (PWI-ID), which has been shown to be valid and reliable. Data is presented regarding its use in the measurement of wellbeing in people with ID and the focus of discussion is on its advantages and limitations.

Factors influencing obesity in people with an intellectual disability

These studies indicate that obesity levels, best measured by weight not the Body Mass Index, are high among people with an intellectual disability. Poor knowledge of nutrition and exercise, together with a body image that says "I'm OK", and carers' tolerance for overweight, are indicators of obesity in this population.

Perceptions of stress among people with an intellectual disability

A new stress scale was devised based on issues raised by people with an intellectual disability and entitled the Lifestress Inventory. The Inventory was used in a number of studies in order to assess the impact of daily hassles and life events on their perceived stress levels and quality of life. Data suggests that they experience general worries, negative interpersonal relations with others, and frustration with their restricted coping skills as their principal areas of stress.

Review of the literature on the use of social media by people with traumatic brain injury (TBI)

Purpose: To review the literature relating to use of social media by people with a traumatic brain injury (TBI), specifically its use for social engagement, information exchange or rehabilitation.

Method: A systematic review with a qualitative meta-synthesis of content themes was conducted. In June 2014, 10 databases were searched for relevant, peer-reviewed research studies in English that related to both TBI and social media.

Results: Sixteen studies met the inclusion criteria, with Facebook™ and Twitter™ being the most common social media represented in the included studies. Content analysis identified three major categories of meaning in relation to social media and TBI: (1) risks and benefits; (2) barriers and facilitators; and (3) purposes of use of social media. A greater emphasis was evident regarding potential risks and apparent barriers to social media use, with little focus on facilitators of successful use by people with TBI.

Conclusions: Research to date reveals a range of benefits to the use of social media by people with TBI however there is little empirical research investigating its use. Further research focusing on ways to remove the barriers and increase facilitators for the use of social media by people with TBI is needed. Implications for Rehabilitation: Communication disabilities following traumatic brain injury (TBI) can be wide-ranging in scope and social isolation with loss of friendships after TBI is common. For many people, social media is rapidly becoming a usual part of everyday communication and its use has the potential to increase communication and social participation for people with TBI.There is emerging evidence and commentary regarding the perceived benefits and risks, barriers and facilitators and purposes of use of social media within the TBI population.Risks associated with using social media, and low accessibility of social media sites, form barriers to its use. Facilitators for social media use in people with TBI include training the person with TBI and their communication partners in ways to enjoy and use social media safely.There is minimal rigorous evaluation of social media use by people with TBI and scant information regarding social media use by people with communication disabilities after TBI. Further investigation is needed into the potential benefits of social media use on communication, social participation and social support with the aim of reducing social isolation in people with TBI.