Work-related self-efficacy among community residents with psychiatric disabilities

A new measure of work-related self-efficacy for people with psychiatric disabilities is reported. The 37-item scale measures self-efficacy in four relevant activity domains: 1) vocational service access and career planning, 2) job acquisition, 3) work-related social skills, and 4) general work skills. The scale was developed in a 12-month longitudinal survey of urban residents diagnosed with schizophrenia or schizoaffective disorder (n = 104). Results indicate validity of both a four-factor structure differentiating four core skill domains, and a single factor representing total work-related self-efficacy. The favorable psychometric properties support further research and trial applications in supported employment and psychiatric vocational rehabilitation.

Anticholinergic burden in older adults with intellectual disability; relationships with multimorbidity and adverse effects

Background: Anticholinergic medications may be associated with adverse clinical outcomes, including acute impairments in cognition and anticholinergic side effects, the risk of adverse outcomes increasing with increasing anticholinergic exposure. Older people with intellectual disability may be at increased risk of exposure to anticholinergic medicines due to their higher prevalence of comorbidities. We sought to determine anticholinergic burden in ageing people with intellectual disability. Methods: Medication data (self-report/proxy-report) was drawn from Wave 1 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA), a study on the ageing of 753nationally representative people with an IDC40 years randomly selected from the National Intellectual Disability Database. Each individual’s cumulative exposure to anticholinergic medications was calculated using the Anticholinergic Cognitive Burden Scale (ACB) amended by a multi-disciplinary group with independent advice to account for the range of medicines in use in this population. Results: Overall, 70.1 % (527) reported taking medications with possible or definite anticholinergic properties (ACBC1), with a mean (±SD) ACB score of 4.5 (±3.0) (maximum 16). Of those reporting anticholinergic exposure (n=527), 41.3 % (217) reported an ACB score o fC5. Antipsychotics accounted for 36.4 % of the total cumulative ACB score followed by anticholinergics (16 %) and antidepressants (10.8 %). The most frequently reported medicine with anticholinergic activity was carbamazepine 16.8 % (127). The most frequently reported medicine with high anticholinergic activity (ACB 3) was olanzapine13.4 % (101). There was a significant association between higher anti-cholinergic exposure and multimorbidity, particularly mental health morbidity, and some anticholinergic adverse effects such as constipation and day-time drowsiness but not self-rated health. Conclusion: Using simple cumulative measures proved an effective means to capture total burden and helped establish that anticholinergic exposure in the study population was high. The finding highlights the need for comprehensive reviews of medications.

Qualitat de vida i centres d'educació especial: una aproximació a la seva conceptualització i avaluació

La qualitat de vida s’està convertint en un concepte clau i unificador en l’atenció i educació de les persones amb discapacitat intel•lectual. Així mateix, la percepció actual sobre les persones amb discapacitat ha canviat substancialment. En el moment actual, cal plantejar-se quines són les aplicacions i les implicacions que tenen per l’atenció i educació de les persones amb discapacitat intel•lectual els principis derivats del nou concepte de discapacitat i de la qualitat de vida. Aquesta investigació pretén essencialment elaborar un conjunt d’instruments que permetin avaluar la qualitat de les pràctiques educatives dels centres d’educació especial. Amb aquest objectiu s’ha seguit un procediment estructurat i ordenat en l’elaboració dels instruments com en la seva valoració inicial. Per avaluar la qualitat dels centres d’educació especial es proposen una sèrie qüestionaris tant pels professionals, les famílies i els alumnes. Els resultats indiquen que el conjunt d’instruments d’avaluació permeten recollir informació àmplia i variada de les pràctiques d’un centre d’educació especial, determinar les seves fortaleses i debilitats i servir de base per establir plans de millora estretament relacionats amb el context particular del centre i amb el que es considera una bona pràctica educativa.

¿Continuidad o fragmentación? Percepción de los profesionales sobre la coordinación entre servicios en los procesos de tránsito a la vida adulta de los jóvenes con discapacidad intelectual

This article is part of a research focusing on the process of transition to adulthood of young people with intellectual disabilities. Specifically, this study analyses transition partnership programs, as the professionals involved in them see them. The information is obtained in two stages: in the first stage 45 interviews to professionals working in this field are conducted. In the second stage we develop a study applying the Delphi method in which two panels of experts, the first one with educational professionals and the second one with professionals working with afters chool services, were asked about several topics. The results show a lack of continuity underlying the actions taken in support of young people with ID during the transition process. Insufficient information and collaboration among services and professionals and a lack of leadership are the main problems perceived by professionals. The study helps to identify problems in the transition partnership programs and establishes actions in order to enhance the transition process

Apoyando proyectos de vida inclusivos: claves para transformar las prácticas socioeducativas de personas adultas con discapacidad intelectual

En el marco del modelo social de la discapacidad cobran importancia la autodeterminación y autogestión de las personas con discapacidad intelectual, replanteando la relación de poder entre profesionales y usuarios. Por ello, la transformación de las prácticas socioeducativas en la construcción y logro de proyectos de vida personalizados constituye un reto para los servicios dirigidos a personas adultas con discapacidad. El objetivo del presente artículo es mostrar, a partir de la revisión de literatura y el análisis de buenas prácticas, algunos elementos clave que facilitan esta transformación. En primerlugar, se presentan las líneas principales de la nueva conceptualización de las personas con discapacidad intelectual como protagonistas de sus proyectos de vida. Seguidamente, y después de contextualizar brevemente el escenario formado por los servicios de adultos en España, se presentan algunas estrategias e instrumentos básicos para la transformación de las prácticas educativas. En las conclusiones se incide en los retos que estas claves plantean en nuestro contexto

Effectiveness of personal planning for residents re-entering the community during the facility initiative in Ontario

This paper reports on the relocation of people with intellectual disabilities (ID) from large-scale provincially run institutions that took place in Ontario as part of the Facility Initiative. Three case studies were examined in order to report on this process as experienced by those who lived and worked through it. Specifically, the planning process conducted by the Ministry of Community and Social Services (MCSS) to assist each person with hislher transition to community living was examined using the current standard of practice in person- centered planning approaches. Effectiveness was evaluated as the ability to apply a person-centered approach across settings and people, as well as what factors facilitated or hindered its application. Results show that, in general, the personal plans do not appear to reflect the pre-transition experience of the person. Also, the transitional planning process did not appear person-centered nor facilitate further person-centered planning in the community.

A Description of Psychotropic Medication Use in Institution and Community Settings in Ontario.

This study examined patterns of psychotropic medication use among 120 participants with intellectual disabilities (ID) who used to live in facilities and now reside in community-based settings in Ontario. There were significantly more participants taking psychotropic medication in the community (83.30/0) than in the facility (74.2%). Of those who showed change, 4.2% were taking medication in the facility but not in the community, and 13.3% were taking medications in the community but not in the facility. While significantly more participants in the community were taking antipsychotic and antidepressant medications, there was no significant increase in psychiatric diagnoses after relocation. Additionally, PRN use was significantly reduced in the comlnunity while daily medication use was significantly higher. The most common PRN in both settings was lorazepam and the most common antipsychotics were risperidone, quetiapine and olanzapine.

Actitudes hacia la discapacidad : la influencia de variables individuales y contextuales

Este trabajo constituye una revisión de la influencia de las variables individuales y contextuales sobre las actitudes hacia la discapacidad. Para alcanzar este objetivo, se describió el concepto de discapacidad desde una perspectiva social, en donde se concibió la discapacidad como un aspecto relacional en vez de una característica individual. Por otra parte se describieron las actitudes hacia la discapacidad, los tipos y sus consecuencias, teniendo en cuenta las percepciones, creencias, emociones, información sobre discapacidad y variables sociodemográficas las cuales tienen un papel significativo en la formación y mantenimiento de las actitudes hacia la discapacidad. Adicionalmente se presentaron algunas de las estrategias de intervención que tiene como propósito mejorar las actitudes, aspecto que puede ayudar o contribuir a la aceptación de las personas con discapacidad. Finalmente, el presente trabajo muestra la necesidad de continuar el estudio de las actitudes hacia la discapacidad, y el mejorar las intervenciones basadas en los hallazgos presentados.

Apoyando proyectos de vida inclusivos: claves para transformar las prácticas socioeducativas de personas adultas con discapacidad intelectual

En el marco del modelo social de la discapacidad cobran importancia la autodeterminación y autogestión de las personas con discapacidad intelectual, replanteando la relación de poder entre profesionales y usuarios. Por ello, la transformación de las prácticas socioeducativas en la construcción y logro de proyectos de vida personalizados constituye un reto para los servicios dirigidos a personas adultas con discapacidad. El objetivo del presente artículo es mostrar, a partir de la revisión de literatura y el análisis de buenas prácticas, algunos elementos clave que facilitan esta transformación. En primer lugar, se presentan las líneas principales de la nueva conceptualización de las personas con discapacidad intelectual como protagonistas de sus proyectos de vida. Seguidamente, y después de contextualizar brevemente el escenario formado por los servicios de adultos en España, se presentan algunas estrategias e instrumentos básicos para la transformación de las prácticas educativas. En las conclusiones se incide en los retos que estas claves plantean en nuestro contexto

¿Contribuye a la inclusión laboral la formación que recibe el alumnado con discapacidad intelectual en la ESO?: análisis y propuestas

Las investigaciones centradas en el análisis de buenas prácticas de inclusión laboral de personas con discapacidad demuestran la importancia de la formación previa, y específicamente la recibida en la etapa de secundaria. El objetivo de este artículo es presentar los resultados de una investigación sobre las características básicas de la formación laboral que reciben los jóvenes con discapacidad intelectual en la ESO. En el primer apartado se realiza una aproximación al papel de la educación secundaria en el desarrollo del rol laboral desde una óptica inclusiva. A continuación, se presenta la investigación realizada con el objeto de obtener datos sobre la adecuación de la formación socio-laboral que se realiza en la ESO (objetivos, método y resultados). Por último se plantean las orientaciones dirigidas a mejorar las oportunidades futuras de inclusión laboral desde el sistema educativo

De sociala konstruktionerna av hög ålder och funktionsförmåga : exemplet intellektuellt funktionshinder

The social constructions of old age and ability – the example of intellectual disability The aim of this article is to analyse and discuss constructions of old age as they are reflected in disability research with the focus on ageing and what it means to be elderly. The results of this study show three tendencies. First, the consequences of the impairment tend to be at forefront in studies of experiences of ageing among persons with intellectual disabilities. This obscures the fact that people with intellectual disabilities partake in a common idealisation of youthfulness that often contains ambivalence towards old age. Second, the concept of old age in disability research embraces significantly wider chronological age groups than those considered in ageing studies. Third, both disability and ageing research tend to use a late modern perspective of individualization as a way to illustrate new options and strategies, including resistance against stigmatisation. This article illustrates that social constructions of disability and old age are tightly interwoven, and constitute negations of normatively defined ideals of normality in a society where ability are highly regarded.

Inserção de pessoas com deficiência intelectual: um estudo em empresas situadas na região metropolitana de São Paulo

Esta dissertação teve origem no questionamento sobre as reais possibilidades de inclusão das pessoas com deficiência intelectual (PCDI), cada vez mais frequentemente inseridas nas organizações brasileiras. O objetivo principal é analisar a maneira como tem acontecido a inserção de PCDI em cinco grandes empresas situadas na região metropolitana de São Paulo, a partir das perspectivas das pessoas diretamente envolvidas. Isso implica, primeiramente, em uma contextualização das políticas de inserção adotadas pelas organizações participantes. Além disso, a partir da análise dos temas mais abordados pelas pessoas entrevistadas, pretende-se identificar os significados da inserção das pessoas com deficiência intelectual e suas implicações mais relevantes para as pessoas envolvidas: os sujeitos com deficiência intelectual, seus chefes, pares hierárquicos de convivência direta, profissionais de gestão de pessoas e pessoas vinculadas a organizações externas, mas que de alguma forma influenciam ou interferem nas atividades de inserção e inclusão no ambiente organizacional. Como arcabouço teórico foram abordados os conceitos de inclusão, inserção e diversidade nas organizações; preconceito, estigma e demais barreiras atitudinais à inclusão; questões familiares e educacionais; as concepções de deficiência ao longo da história, além de aspectos demográficos e regulatórios relacionados ao tema. A pesquisa foi realizada por meio de entrevistas com baixo grau de estruturação e as transcrições analisadas conforme a abordagem de análise de conteúdo proposta por Bardin (1977), a partir dos pressupostos do interacionismo simbólico estrutural (STRYKER, 2006). A partir da discussão dos temas que emergiram da análise de conteúdo e da contextualização e comparação das políticas de inserção adotadas pelas organizações, pôde-se concluir que é possível incluir as pessoas com deficiência intelectual, tendo em vista as fronteiras organizacionais em que elas se inserem.

Instabilidade postural em indivíduos obesos com deficiência intelectual

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A inclusão das diferenças e as diferenças na inclusão: impasses na inclusão de alunos com necessidades especiais

Pós-graduação em Psicologia - FCLAS

O ensino da escrita e o desenvolvimento das pessoas com deficiência intelectual

This article proposes a theoretical reflection on the development of children with intellectual disabilities, regarding the importance and necessity of the process of learning the written language, from a historical-cultural point of view. For this approach, the course of development of a child disabled or not will occur according to cultural and social conditions experimented by him or her. Therefore, concerning the child with intellectual disabilities, his cultural condition, in dynamic relationship with the obstacles placed in its special condition, will be the source of his development. If the development of higher psychological functions is realized through the use of tools and if the people with intellectual disabilities present an inability to use these tools, there will be the need for aids so they can learn to use them in order to train and develop their psychic functions. In this process, education and written language acquisitions are fundamental ways of accessibility to the cultural world, a wider significance of communication in the world and to oneself. In short, the educators' comprehension about the importance of intentional teaching of written language and the historical process that envolves its development represents a fundamental contribution to the process of humanization of children with disabilities.