Two separate meta-analyses were conducted to examine (1) the effects of training programs on the behaviour of direct care staff working with clients with ID who present challenging behaviour problems ...(predominantly aggressive and violent behaviour), and (2) the effects of staff training on the challenging behaviour of their clients with ID. A 3-level random effects model was used for both meta-analyses to account for both within and between study variance. Results showed that staff training was moderately effective in changing staff behaviour, but no convincing evidence was found for an effect on the reduction of challenging behaviour of persons with ID. The type, content and goal of training did not moderate the effects of staff training, whereas sample and study characteristics (e.g., sex participant or year of publication) did. The way a training program is delivered to staff may be much more important than characteristics of a training.
•Staff training for challenging behaviour of clients with ID changes staff behaviour.•No evidence that staff training changes challenging behaviour of clients with ID.•Sample and study characteristics moderated the effects of staff training.
The aim of the literature review was to identify knowledge and knowledge gaps concerning risks of violence toward children, youth, adults and elderly with intellectual disabilities, and how risks can ...be identified and prevented. The research revealed that children, youths and adults labelled with intellectual disabilities are more exposed to violence than others and that the target group lack knowledge about risks of violence and what it means to be exposed to violence. It was also found that professionals who work with people with intellectual disabilities may lack knowledge about violence, and those who work with violence lack knowledge about intellectual disabilities. There is thus a need to further elaborate routines to identify exposure to violence, and to identify the target group and a need to create collaborative teams with professionals who have in-depth knowledge of violence, and those who have in-depth knowledge about the target group.
User involvement and participation in the supervision of the quality of care is an important topic for many healthcare inspectorates. It offers regulators an additional view on quality, increases the ...legitimacy and accountability of the inspectorate, empowers users and enhancing the public's trust in the inspectorate. To assess the accessibility of the local governmental social domain services the Joint Inspectorate Social Domain in the Netherlands worked together with people with intellectual disabilities performing as 'mystery guests' in an innovative project. This paper describes the findings of the evaluation of this project.
People with intellectual disabilities living at home on their own may need some help with daily activities such as administrative tasks, raising children, household tasks, managing debts or finding work. In the Netherlands they have to arrange this help at their municipality. The goal of this project was to find out how easily people with intellectual disabilities could get help from their municipality. The participants were equal partners with the JISD inspectors from the beginning: in constructing an inspection framework, in acting as mystery guest with a fictive support request, reported back the results by storytelling.
The evaluation of the project showed that the JISD succeeded in their key aspect of the project: the goal to involve people with intellectual disabilities in a leading role from the beginning until the end. Their perspectives and preferences were the starting point of supervision. Pain points in accessibility became clear straight away and gave important insights for both inspectors as municipality professionals. Municipalities started to improve their services and evaluated the improvements with the clients. Furthermore, the impact on the participants themselves was also huge: they felt being taken seriously, valued and empowered.
Involving people with intellectual disabilities as participants in all phases of supervision processes contributes to more relevant and useful outcomes, creates mutual understanding of perspectives, as affirmed by both municipalities and inspectors, and creates empowerment of the participants. Furthermore, it fits perfectly within the United Nation Convention on the rights of persons with disabilities and the current development of 'value driven regulation'.
The COVID-19 pandemic has disproportionately affected persons in long-term care, who often experience health disparities. To delineate the COVID-19 disease burden among persons with intellectual ...disabilities, we prospectively collected data from 36 care facilities for 3 pandemic waves during March 2020-May 2021. We included outcomes for 2,586 clients with PCR-confirmed SARS-CoV-2 infection, among whom 161 had severe illness and 99 died. During the first 2 pandemic waves, infection among persons with intellectual disabilities reflected patterns observed in the general population, but case-fatality rates for persons with intellectual disabilities were 3.5 times higher and were elevated among those >40 years of age. Severe outcomes were associated with older age, having Down syndrome, and having >1 concurrent condition. Our study highlights the disproportionate COVID-19 disease burden among persons with intellectual disabilities and the need for disability-inclusive research and policymaking to inform disease surveillance and public health policies for this population.
Decision making is the basis for individual autonomy and societal participation. To support persons' human right to make life decisions, the model of supported decision making (SDM) has evolved and ...complies with Article 12 of the United Nations Convention on the Human Rights of Persons with Disabilities. Models for implementing SDM and outcomes achieved by applying SDM in community settings remain insufficiently explored. This study used a human rights perspective with participatory, qualitative research methods to investigate environmental conditions and social support measures that enabled persons with intellectual disabilities (ID) to make and implement their own decisions. Data gathered were 6 months of field notes about implementing SDM in a L'Arche day activity program with 26 adults with ID, with opinions and drawings illustrating persons' decision making. All data were analyzed thematically. As a result of using the SDM intervention, persons with ID became more expressive, able to discuss and debate options, participated in organizational and municipal decision making, and expressed "joy" and feeling "more like a human." Staff supporters found SDM fulfilling and noticed it increased the sense of ownership persons with ID experienced in individual and group meetings. An organizational environment that respects human dignity, supports sustained relationships between persons with ID and decision supporters, individualizes SDM depending on how persons can communicate, and encourages staff self-reflection about prejudices and positionality is essential for implementing SDM with persons with ID. SDM processes shift oppressive social narratives and policies in the direction of a social, relational model of the decision-making capacities and competencies of persons with ID.
Public Policy Relevance Statement
The United Nations Convention on the Human Rights of Persons with Disabilities mandates supported decision making (SDM) to actualize social participation of persons with intellectual disabilities (ID). Legislation needs to replace substitute decision making with SDM. Social service organizations need to implement SDM with persons with ID and their families. Research with persons with ID needs to include priorities of persons with ID and SDM processes and outcomes.
The objective of this work is to study the quality of working life associated to psychosocial factors and risks,
syndrome and emotional intelligence, as well as being able to detect predictors of the ...said syndrome. The sample consisted of 311 professionals working in direct contact with an intellectual disability from 15 associations of Extremadura (Spain). The Spanish version of the CESQT questionnaire was administered to evaluate burnout syndrome, the Wong & Law Emotional Intelligence Scale (WLEIS) was used to evaluate emotional intelligence, while the UNIPSICO Battery was used to evaluate the psychosocial factors of demands (work-family conflict and psychosomatic problems) and resources, such as social support and work satisfaction. The results indicate average values of burnout, revealing that work satisfaction, emotional intelligence, and social support are related to burnout syndrome. In addition, there are also positive correlations between psychosomatic symptoms and work-family conflict. Satisfaction at work, social support, and emotional intelligence (intrapersonal and interpersonal perception, use and regulation of emotions) predict burnout syndrome. What is more, the psychosomatic symptoms and work-family conflict explain, respectively, 17% and 17.9% of their variance. Thus, there is a need to develop intervention programs that encourage social support and the conciliation of family life, as well as training skills related to emotional intelligence, such as communication and conflict resolution.
This article analyzes sexual and reproductive health policies in the intellectual sphere. To this end, sexuality is first considered as a historical and social construction, as well as a modern ...device of classification, hierarchization, normalization and control of bodies. Next, a historical overview of the discussions on sexuality and sexual and reproductive rights in Ecuador is made in order to understand the way in which the issue of sexual and reproductive health of persons with disabilities enters the public agenda. Finally, an analysis of the "“Manual de atención integral en salud sexual y reproductiva para personas con discapacidad” is conducted, concluding that it falls short of proposing a comprehensive approach, as it constructs the sexuality of people with intellectual disabilities as a space for social control and regulation.
En el presente artículo se realiza un análisis de las políticas sobre salud sexual y reproductiva en Ecuador y su relación con la construcción de la sexualidad de las personas con discapacidad intelectual. Para tal efecto, se considera en primer lugar a la sexualidad como una construcción histórica y social, además como un dispositivo moderno de clasificación, jerarquización, normalización y control de los cuerpos. A continuación, se realiza un panorama histórico de las discusiones en torno a la sexualidad y los derechos sexuales y reproductivos en el Ecuador con el propósito de entender la forma en la que la temática de la salud sexual y reproductiva de las personas con discapacidad entra en la agenda pública. Finalmente se analiza el “Manual de atención integral en salud sexual y reproductiva para personas con discapacidad” del Ministerio de Salud Pública del Ecuador, concluyéndose que éste dista de plantear un enfoque integral, pues construye una sexualidad de las personas con discapacidad intelectual como un espacio para el control y regulación social.
Background: Priority given to supported decision-making has increased internationally since the United Nations General Assembly adopted the Convention on the Rights of Persons with Disabilities ...(CRPDs). Nations worldwide have moved to ratify and enact the CRPD. Methods: A questionnaire survey on the supported decision-making status was conducted in Japan and Taiwan (60 and 73 people, respectively; N = 133, 82 women and 51 men). Survey items were objective indicators based on the CRPD. Results: In both countries, people who are older (vs younger) or those having more (vs less) experience supporting persons with intellectual disabilities were more likely to practice supported decision-making. Relationships between persons with intellectual disabilities and family members are vital. Conclusions: It is necessary to establish appropriate supported decision-making methods, that do not depend on aspects such as support experience, for persons with intellectual disabilities in Japan and Taiwan. Additionally, it is necessary to clarify the relationship with the family in supported decision-making for persons with intellectual disabilities and to work together appropriately.
Background
Persons with intellectual disabilities have the right to pursue and acquire gainful employment and thereby obtain the psychological, social and economic benefits derived from employment.
...Aims
This study aimed to examine workers' attitudes towards and perspectives with respect to the challenges of employing persons with intellectual disabilities.
Method
The sample was composed of 168 persons (60% male). Participants responded to a questionnaire that assessed their attitudes towards working with persons with intellectual disabilities (ATWQ) and a challenges questionnaire (CHQ).
Results and Conclusion
This study found that familiarity (frequency of contact) and having a previous work experience with someone with an intellectual disability were positively associated with workers' attitudes towards employing persons with intellectual disabilities. Furthermore, owners and supervisors were more reluctant to accept the practice of employing persons with intellectual disabilities than were employees. No differences were found by gender. Implications based on the findings are discussed herein.
Medical care for people with intellectual and developmental disabilities (IDD) is organized differently across the globe and interpretation of the concept of medical care for people with IDD may vary ...across countries. Existing models of medical care are not tailored to the specific medical care needs of people with IDD. This study aims to provide an improved understanding of which aspects constitute medical care for people with IDD by exploring how international researchers and practitioners describe this care, using concept mapping. Twenty-five experts (researchers and practitioners) on medical care for people with IDD from 17 countries submitted statements on medical care in their country in a brainstorming session, using an online concept mapping tool. Next, they sorted all collected statements and rated them on importance. The themes, clusters and statements identified through this explorative study provide additional content and context for the specific patient group of people with IDD to the dimensions of previous models of medical care.
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