Brady, Nancy C.; Bruce, Susan; Goldman, Amy; Erickson, Karen; Mineo, Beth; Ogletree, Bill T.; Paul, Diane; Romski, Mary Ann; Sevcik, Rose; Siegel, Ellin; Schoonover, Judith; Snell, Marti; Sylvester, Lorraine; Wilkinson, Krista
The National Joint Committee for the Communication Needs of People with Severe Disabilities (NJC) reviewed literature regarding practices for people with severe disabilities in order to update guidance provided in documents originally published in 1992. Changes in laws, definitions, and policies that affect communication attainments by persons with severe disabilities are presented, along with guidance regarding assessment and intervention practices. A revised version of the Communication Bill of Rights, a powerful document that describes the communication rights of all individuals, including those with severe disabilities is included in this article. The information contained within this article is intended to be used by professionals, family members, and individuals with severe disabilities to inform and advocate for effective communication services and opportunities. PMID:26914467
Moghimi, Saba; Kushki, Azadeh; Guerguerian, Anne Marie; Chau, Tom
Electroencephalography (EEG) is a non-invasive method for measuring brain activity and is a strong candidate for brain-computer interface (BCI) development. While BCIs can be used as a means of communication for individuals with severe disabilities, the majority of existing studies have reported BCI evaluations by able-bodied individuals.…
Brown, Fredda; Gothelf, Carole R.; Guess, Doug; Lehr, Donna H.
This article explores implications of people's interpretations of communicative efforts by people with severe disabilities. Recent initiatives to support and promote self-determination are critically assessed as possibly functioning to limit self-determination. Use of preference assessments and behavior supports is discussed as a key to…
Full Text Available Communication barriers often result in exclusion of children and youth with disabilities from activities and social settings that are essential to their psychosocial development. In particular, difficulties in describing their experiences of activities and social settings hinder our understanding of the factors that promote inclusion and participation of this group of individuals. To address this specific communication challenge, we examined the feasibility of developing a language-free measure of experience in youth with severe physical disabilities. To do this, we used the activity of the peripheral nervous system to detect patterns of psychological arousal associated with activities requiring different patterns of cognitive/affective and interpersonal involvement (activity engagement. We demonstrated that these signals can differentiate among patterns of arousal associated with these activities with high accuracy (two levels: 81%, three levels: 74%. These results demonstrate the potential for development of a real-time, motor- and language-free measure for describing the experiences of children and youth with disabilities.
The iconicity of graphic symbols and the iconicity hypothesis are theoretical concepts that have had an impact on the use of augmentative and alternative communication strategies for people with severe intellectual disabilities. This article reviews some of the recent literature on the impact of iconicity on symbol recognition and use by typically developing children and relates those findings to people with severe disability. It seems that although iconicity may have some impact on symbol learning, there are other variables that are likely to be much more important. It is likely that iconicity is not helpful to those learning graphic symbols who have little or no comprehension of spoken language.
Cannella-Malone, Helen I.; Fleming, Courtney; Chung, Yi-Cheih; Wheeler, Geoffrey M.; Basbagill, Abby R.; Singh, Angella H.
We conducted a systematic replication of Cannella-Malone et al. by comparing the effects of video prompting to video modeling for teaching seven students with severe disabilities to do laundry and wash dishes. The video prompting and video modeling procedures were counterbalanced across tasks and participants and compared in an alternating…
Saito, Yoshiaki; Aoki, Yusuke; Takeshita, Eri; Saito, Takashi; Sugai, Kenji; Komaki, Hirofumi; Nakagawa, Eiji; Ishiyama, Akihiko; Takanoha, Satoko; Wada, Satoru; Sasaki, Masayuki
To describe the characteristics of hypophosphatemia in severely disabled individuals with neurological disorders and to identify its causative factors. We retrospectively reviewed clinical data from 82 individuals with motor skills classified as sitting, rollover or bedridden. Age, gender and body mass index were compared in individuals with (n=19) and without (n=63) a history of hypophosphatemia (serum phosphate levels refeeding syndrome (n=4) and Fanconi syndrome (n=3), but was unidentifiable in one episode. Significant elevations in C-reactive protein levels and reductions in sodium levels were observed during hypophosphatemia episodes. Hypophosphatemia is a common complication in severely disabled individuals with frequent bacterial infections, refeeding following malnutrition and valproate administration for epilepsy treatment. Because severe hypophosphatemia is life threatening, serum phosphate levels should be closely monitored in this population. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
Although some studies have analysed the disability phenomenon and its effect on, for example, labour force participation, wages, job satisfaction, or the use of disability pension, the empirical evidence on how disability steals time (e.g. hours of work) from individuals is very scarce. This article examines how disabled individuals allocate their time to daily activities as compared to their non-disabled counterparts. Using time diary information from the Spanish Time Use Survey (last quarter of 2002 and the first three quarters of 2003), we estimate the determinants of time (minutes per day) spent on four aggregate categories (market work, household production, tertiary activities and leisure) for a sample of 27,687 non-disabled and 5250 disabled individuals and decompose the observed time differential by using the Oaxaca-Blinder methodology. The results show that disabled individuals devote less time to market work (especially females), and more time to household production (e.g. cooking, cleaning, child care), tertiary activities (e.g., sleeping, personal care, medical treatment) and leisure activities. We also find a significant effect of age on the time spent on daily activities and important differences by gender and disability status. The results are consistent with the hypothesis that disability steals time, and reiterate the fact that more public policies are needed to balance working life and health concerns among disabled individuals. Copyright © 2013 Elsevier Ltd. All rights reserved.
Frick, Marty; And Others
Includes "Reviewing Commitment to Individuals with Disabilities" (Frick); "Modifying Laboratory Equipment" (Silletto); "Equine Facilitated Therapy" (Hoover et al.); "Horticultural Therapy" (Rees, Iverson); "How Accessible Is Your Agriculture Program? (Delks, Sillery); "Agricultural Education for…
Andreasen Struijk, Lotte N S; Bentsen, Bo; Gaihede, Michael; Lontis, Eugen R
For severely paralyzed individuals, alternative computer interfaces are becoming increasingly essential for everyday life as social and vocational activities are facilitated by information technology and as the environment becomes more automatic and remotely controllable. Tongue computer interfaces have proven to be desirable by the users partly due to their high degree of aesthetic acceptability, but so far the mature systems have shown a relatively low error-free text typing efficiency. This paper evaluated the intra-oral inductive tongue computer interface (ITCI) in its intended use: Error-free text typing in a generally available text editing system, Word. Individuals with tetraplegia and able bodied individuals used the ITCI for typing using a MATLAB interface and for Word typing for 4 to 5 experimental days, and the results showed an average error-free text typing rate in Word of 11.6 correct characters/min across all participants and of 15.5 correct characters/min for participants familiar with tongue piercings. Improvements in typing rates between the sessions suggest that typing ratescan be improved further through long-term use of the ITCI.
Wheaton, Joe E.; Hertzfeld, Jennifer
Examines effects of ancestry and severity of disability of vocational rehabilitation consumers. European Americans, individuals with higher costs, and persons who received assistive technology were more likely to be closed rehabilitated. Individuals from other ancestry groups, who were coded severely disabled, or who had been in the system for…
Madsen, Emily K.; Peck, Janelle A.; Valdovinos, Maria G.
In working with individuals with intellectual and developmental disabilities (IDDs), it is direct care staff who are often required to collect data on individuals' behavior which is used as the basis for implementation of empirically based approaches for intervention and treatment. Due to limited resources, indirect and descriptive measures of…
Kamstra, Aafke; van der Putten, Annette; Vlaskamp, Carla
Most people with profound intellectual and multiple disabilities (PIMD) have limited social contact and it is unclear what is done to maintain or increase these contacts. Individual support planning (ISP) can be used in the systematic enhancement of social contacts. This study analyses the content
Ngandu, Kathleen M.
This handbook contains advice for the teacher in diagnosing dyslexia and developing an individualized program for overcoming severe reading problems. Observable characteristics of dyslexia are listed as an aid to the teacher's diagnosis, but it is emphasized that cooperation between the teacher and a reading specialist is of great importance in…
van den Hazel, Teunis; Didden, Robert; Korzilius, Hubert
The diagnosis personality disorder is often found among samples of adults with mild intellectual disability and severe behavioral and mental health disorders. The number of studies on the adverse effects of this diagnosis are scarce. Using vignettes in the present study, we have explored the relationship between the diagnosis personality disorder…
Raviv, Dorit; Stone, C. Addison
This study found that 49 adolescents with learning disabilities (LD) scored lower than 49 normally achieving peers on a self-image questionnaire. Later-diagnosed adolescents with LD scored higher than early diagnosed adolescents. LD severity was not related to self-image. Moderate relationships were found between parents' perceptions and…
Hatice Yildirim Sari
Full Text Available Mentally disabled individuals are at risk of health problems. In fact, health problems are more frequent in mentally disabled individuals than in the general population and mentally disabled individuals less frequently use health care facilities. It has been shown that mentally disabled individuals frequently have nutritional problems. They may suffer from low weight, malnutrition, high weight, pica, iron and zinc deficiencies and absorption and eating disorders. Activities can be limited due to motor disability and restricted movements. Depending on insufficient liquid intake and dietary fiber, constipation can be frequent. Another problem is sleep disorders such as irregular sleep hours, short sleep, waking up at night and daytime sleepiness. Visual-hearing losses, epilepsy, motor disability, hepatitis A infection and poor oral hygiene are more frequent in mentally disabled children than in the general population. The mentally disabled have limited health care facilities, poorer health status than the general population and difficulties in demanding for health care and expressing health problems. Therefore, they should be provided with more health promotion services. [TAF Prev Med Bull 2010; 9(2.000: 145-150
Lustig, Daniel C.; Zanskas, Stephen
Purpose: The purpose of this pilot study was to compare the work value preferences of individuals with disabilities with the work value preferences for a sample of individuals without disabilities. Methods: The preferred work values of a sample of vocational rehabilitation consumers were compared to workers employed in a Southeastern university.…
Schleien, Stuart J.; And Others
The importance of leisure education for severely disabled students is emphasized as a means of enabling them to purposefully use leisure time and to expand social and motor skills that facilitate independent daily living. Sample activities for inclusion in physical education programs are included. (DG)
Full Text Available Self-reported disability in performing daily life activities was assessed in adults with severe obesity (BMI ≥ 35 kg/m2 using the Health Assessment Questionnaire (HAQ. 262 participants were recruited into three BMI groups: Group I: 35–39.99 kg/m2; Group II: 40–44.99 kg/m2; Group III: ≥45.0 kg/m2. Progressively increasing HAQ scores were documented with higher BMI; Group I HAQ score: 0.125 (median (range: 0–1.75; Group II HAQ score: 0.375 (0–2.5; Group III HAQ score: 0.75 (0–2.65 (Group III versus II P 0. The prevalence of this degree of disability increased with increasing BMI and age. It also correlated to type 2 diabetes, metabolic syndrome, and clinical depression, but not to gender. Our data suggest that severe obesity is associated with self-reported disability in performing common daily life activities, with increasing degree of disability as BMI increases over 35 kg/m2. Functional assessment is crucial in obesity management, and establishing the disability profiles of obese patients is integral to both meet the specific healthcare needs of individuals and develop evidence-based public health programs, interventions, and priorities.
Raver, Sharon A; Michalek, Anne P M; Gillespie, Amy M
Caregivers of individuals with disabilities can experience stress as they manage caregiving responsibilities while they attempt to balance family, work, and the satisfaction of their personal goals. In this pilot study, 31 caregivers of individuals with a variety of disabilities completed a quantitative-qualitative survey. A statistically significant relationship was found between the age and severity of disability of the family member receiving care, the length of time care had been provided, the educational level and the relationship of the caregiver to the family member and reported feelings of optimism, humbleness, quality of family relationships, financial concerns, loss of control, and hope. When life goals were probed, the most common reported were achieving financial stability, having a strong, healthy family, and experiencing happiness. The implications for supporting caregivers and their families are discussed.
Stodden, Robert A.
The paper reviews problems in the sheltered workshop concept and proposes a change of focus in the provision of occupational life preparatory services for individuals with severe disabilities. Among problems cited are a lack of efficient production and training technologies, a lack of trained community placement personnel, and a general lack of…
Full Text Available The review presents a study provided to t the Faculty of psychology and Department of Graduate College of the University of Nebraska (United States by the Supervisory Commission draft Ed. S. Field Project. The Commission examined this study to assess the conformity of the rules of procedures for the award of a master's degree in the field of school psychology. Publication may be of interest to readers because of the unrelenting relevance of psycho-pedagogical problems of safety and effectiveness of educational environment for students with developmental and behavioral limitations, as well as the need to expand the arsenal of tools and school preventive intervention strategies in alternative schools. The publication helps to estimate the difficulty of psycho-pedagogical work and educational process in relation to children with severe personality disorderss
Fitzcharles, Mary-Ann; Ste-Marie, Peter A; Rampakakis, Emmanouil; Sampalis, John S; Shir, Yoram
It is intuitive that disability caused by illness should be reflected in illness severity. Because disability rates for fibromyalgia (FM) are high in the developed world, we have examined disease and work characteristics for patients with FM who were working, unemployed, or receiving disability payments for disability as a result of FM. Of the 248 participants in a tertiary care cohort study of patients with FM, 90 were employed, 81 were not employed and not receiving disability payments, and 77 were not working and currently receiving disability payments awarded for disability caused by FM. Demographic, occupation, and disease characteristics were compared among the groups. The prevalence of disability caused by FM was 30.8%. There were no demographic differences among the working, unemployed, or disabled patients. With the exception of measures for anxiety and depression, all measurements for disease severity differed significantly among the groups, with greater severity reported for the disabled group, which used more medications and participated less in physical activity. Disabled patients were more likely previously employed in manual professions or the service industry, whereas employed patients were more commonly working in non-manual jobs that included clerical, managerial, or professional occupations (p = 0.005). The one-third rate of disability for this Canadian cohort of patients with FM is in line with other reports from the western world. Associations of disability compensation were observed for subjective report of symptom severity, increased use of medications, and previous employment in more physically demanding jobs.
Zhu, Huiping; Xiang, Huiyun; Xia, Xin; Yang, Xia; Li, Dan; Stallones, Lorann; Du, Yukai
Little research has been done in China to study injury in individuals with disability. We investigated the impact of type and severity of disability on injury among children with disability in Hubei Province of China. A sample of 1201 children with disability were matched with 1201 healthy children on gender, age, and neighborhood. Disability type and severity were determined using the Chinese national standards. Caregivers were interviewed face-to-face about nonfatal unintentional injuries suffered by the child in the past 12 months before the interview. Univariate χ(2) test and logistic regression models were used to investigate association between disability type/severity and nonfatal unintentional injuries. Injury rate among children with disability was significantly higher than that among children without disability (10.2% vs. 4.4%; P disability and injury varied by type and severity of disability. The magnitude of the association between the presence or absence of disability in children and their risk of injury was large and significant, regardless of the type or severity of the children's disabilities. Copyright © 2014 Elsevier Inc. All rights reserved.
Haydon-Laurelut, Mark Andrew
Knowledge about disabled people has and continues to be dominated by the medical and allied professions and inevitably this provides only one story of disabled life: a story of a problem seeking solutions (Grue, 2015). The rehabilitative professions write most of what is read and written about disability. As a family therapist I wondered how family therapy might be constructing disability? If, as Michalko (2012) has noted, medicine finds a home in all kinds of places to what extent has it mad...
McEachern, Adriana G.
Sexual abuse of individuals with disabilities occurs in alarming proportions, although the prevalence and incidence of such abuse is difficult to determine. Although all states maintain statistics on child sexual abuse, the rate of victimization for individuals with disabilities is not specific. This paper reviews several studies conducted on…
Asmus, Jennifer M.; Carter, Erik W.; Moss, Colleen K.; Biggs, Elizabeth E.; Bolt, Daniel M.; Born, Tiffany L.; Bottema-Beutel, Kristen; Brock, Matthew E.; Cattey, Gillian N.; Cooney, Molly; Fesperman, Ethan S.; Hochman, Julia M.; Huber, Heartley B.; Lequia, Jenna L.; Lyons, Gregory L.; Vincent, Lori B.; Weir, Katie
This randomized controlled trial examined the efficacy of peer network interventions to improve the social connections of 47 high school students with severe disabilities. School staff invited, trained, and supported 192 peers without disabilities to participate in individualized social groups that met throughout one semester. Compared to…
Despite the important role that leisure time plays in individuals' health, wellness and quality of life, the disability studies addressing leisure remain extremely limited. Examine how people with disabilities allocate their time to leisure activities as compared to their non-disabled counterparts. Using data at an individual level from the Time Use Survey for Spain in 2002-2003 and the social model of disability as a framework, we estimate the determinants of time (minutes per day) spent on three aggregate categories (active, passive and social activities) for non-disabled, non-limited disabled and limited disabled individuals. Individuals who are limited in their daily activities are more likely to allocate their time to passive leisure (e.g., reading, television, video, and radio) and less likely to spend their time in social entertainment (e.g., theater, culture, and social events) as compared to non-disabled individuals. In addition, we find significant differences in minutes per day spent on leisure activities by gender, age, marital status and number of children. Accessible facilities and leisure installations as well as actions aimed at combating barriers and discrimination practices are needed to encourage participation in physical activity and social entertainment of people with disabilities. It is necessary to define, adapt and implement specific leisure activities that allow people with disabilities to fully participate in these activities and increase their levels of social integration and life satisfaction. Copyright © 2014 Elsevier Inc. All rights reserved.
This study of 20 elementary-school children with severe disabilities examined differences in their interactions with friends without disabilities compared with interactions with acquaintances without disabilities. Friends and acquaintances did not differ in developmental level, language age, functional movement, or social competence. Group…
Patel, Meera; Rose, John
The aim of the study was to investigate attitudes held by a British student population towards individuals with an intellectual disability. Students participated in focus groups addressing their attitudes, behaviours and perceptions of individuals with an intellectual disability. Thematic analysis was the method used to identify emergent themes.…
Naruse, Takashi; Sakai, Mahiro; Matsumoto, Hiroshige; Nagata, Satoko
Understanding causes of disability among elderly individuals is an important public health issue, particularly because of the increasing rate of disabled elderly individuals and the social costs in a rapidly aging society. Accordingly, we aimed to describe the diseases that precede disability and investigate the types of diseases that are related to severe disability among Japanese elderly individuals aged over 75 years. Using claim data from the latter-stage elderly healthcare system and long-term care insurance system, we identified 76,265 elderly individuals over 75 years old who did not qualify as disabled on April 1, 2011. Among them, 3,715 elderly individuals who had been newly qualified as disabled between April 1, 2011 and March 31, 2012 were selected. Disease codes from the medical claim data in the 6 months prior to disability were collected. All descriptions were developed separately for six groups divided by gender and disability level (low, middle, and high). The results of the ordinal logistic analysis including sex and age revealed that men tended to have significantly higher levels of disability (β = 0.417, p disability level groups. In low-level disability groups, cancer in men (12.8%) and arthropathy and fracture in women (11.9% and 13.5%, respectively) were as common as cerebrovascular disorder (12.2% and 9.7%, in men and women, respectively). Stroke was the most common disease for all genders and disability levels. The diseases preceding low-level disability differed by gender. This study demonstrated the need to consider arthropathy and fracture as well as CVD in order to prevent disability.
Braam, Wiebe; Smits, Marcel G.; Didden, Robert; Korzilius, Hubert; van Geijlswijk, Ingeborg M.; Curfs, Leopold M. G.
Recent meta-analyses on melatonin has raised doubts as to whether melatonin is effective in treating sleep problems in people without intellectual disabilities. This is in contrast to results of several trials on melatonin in treating sleep problems in individuals with intellectual disabilities. To investigate the efficacy of melatonin in treating…
Aleman, Steven R.
The Individuals with Disabilities Education Act (IDEA) authorizes several programs to support and improve the education of children with disabilities. The grants to States, preschool, and infants and toddlers programs are formula grant programs that fund special education services. The discretionary grant programs fund research, demonstrations,…
Rossetti, Zach; Hall, Sarah
The purpose of this qualitative study was to examine perceptions of adult sibling relationships with a brother or sister with severe disabilities and the contexts affecting the relationships. Adult siblings without disabilities (N = 79) from 19 to 72 years of age completed an online survey with four open-ended questions about their relationship…
Music therapists regard music therapy as a valuable intervention for students with moderate to severe intellectual disability or multiple disabilities, but many special educators would regard it as a controversial practice, unsupported by empirical research. This paper reviews the goals and strategies used by music therapists working with students…
Test, D W; Spooner, F; Keul, P K; Grossi, T
Two adolescents with severe disabilities served as participants in a study conducted to train in the use of the public telephone to call home. Participants were trained to complete a 17-step task analysis using a training package which consisted of total task presentation in conjunction with a four-level prompting procedure (i.e., independent, verbal, verbal + gesture, verbal + guidance). All instruction took place in a public setting (e.g., a shopping mall) with generalization probes taken in two alternative settings (e.g., a movie theater and a convenience store). A multiple probe across individuals design demonstrated the training package was successful in teaching participants to use the telephone to call home. In addition, newly acquired skills generalized to the two untrained settings. Implications for community-based training are discussed.
Hutchins, Tiffany L; Prelock, Patricia A
This article describes the relationship between expressive communication impairments and common challenging behaviors in individuals with Autism Spectrum Disorder and Intellectual Disability. The communication challenges of individuals with Autism Spectrum Disorder/Intellectual Disability are described and several evidence-based intervention strategies are proposed to support communication so as to decrease challenging behaviors. Recommendations for practice are offered. Copyright © 2014 Elsevier Inc. All rights reserved.
... permitted by law, to ensure the retention of those who are injured on the job. Agencies shall work to... retention of these individuals. My Administration is committed to increasing the number of individuals with... statistics on the hiring of individuals with disabilities. Sec. 3. Increasing Agencies' Retention and Return...
Full Text Available In primary health care clinics nurses are faced with individuals of different ages with different problems, ranging from minor ailments to severe disabilities. ABSTRAK In primêre gesondheidsorgklinieke kom verpleegkundiges in aanraking met individue van verskillende ouderdomme met ‘n verskeidenheid probleme, wat strek vanaf geringe kwale tot erge gestremdhede.
Park, Jiyoon; Bouck, Emily
Although there are many secondary data analyses of the National Longitudinal Transition Study-2 (NLTS-2) to investigate post-school outcome for students with disabilities, there has been a lack of research with in-school service predictors and post-school outcome for students with specific disability categories. This study was a secondary data analysis of NLTS-2 to investigate the relationship between current employment status and in-school services for individuals with intellectual disability. Statistical methods such as descriptive statistics and logistic regression were used to analyze NLTS-2 data set. The main findings included that in-school services were correlated with current employment status, and that primary disability (i.e., mild intellectual disability and moderate/severe intellectual disability) was associated with current employment status. In-school services are critical in predicting current employment for individuals with intellectual disability. Also, data suggest additional research is needed to investigate various in-school services and variables that could predict employment differences between individuals with mild and moderate/severe intellectual disability. Copyright © 2018 Elsevier Ltd. All rights reserved.
Vashdi, E.; Hutzler, Y.; Roth, D.
Background: Individuals with Intellectual Disability (ID) exhibit reduced levels of compliance to exercise, including treadmill walking. The purpose of this study was to measure the effects of several training conditions on compliance to participation in treadmill walking of children with moderate to severe ID. Method: Criteria for compliance were…
Werner, Shirli; Araten-Bergman, Tal
Introduction: People with disabilities often identify professionals' stigmatic views as significant barriers to accessing mainstream services. This study aimed to examine differences in stigmatic attitudes held by social workers toward individuals with intellectual disabilities (ID), mental illness (MI), or dual diagnosis (DD) of ID and MI.…
Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi
The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…
Bindawas, Saad M; Vennu, Vishal
The prevalence of disability varies between countries ranging from less than 1% to up to 30% in some countries, thus, the estimated global disability prevalence is about 15%. However, it is unknown what the current estimate of disability and its types and severity are in Saudi Arabia. Thus, the objective of this study is to estimate national and regional prevalence rates of any disability, types of disability, and their severity among Saudi populations. Data on disability status were extracted from the national demographic survey conducted in 2016 as reported by the General Authority for Statistics, Saudi Arabia (N = 20,064,970). Prevalence rates per a population of 100,000 of any disability, type of disability, and its severity were calculated at the national level and in all 13 regions. Out of 20,064,970 Saudi citizens surveyed, 667,280 citizens reported disabilities, accounting for a prevalence rate of 3326 per a population of 100,000 (3.3%). Individuals aged 60 years and above (11,014) and males (3818) had a higher prevalence rate of disability compared with females (2813). The Tabuk region has the highest rate of reported disability, at 4.3%. The prevalence rates of extreme disabilities in mobility and sight were higher in Madinah (57,343) and Northern border (41,236) regions, respectively. In Saudi Arabia, more than half a million Saudi citizens (1 out of every 30 individuals) reported the presence of disability during the year 2016. A higher prevalence rate of disability was seen among those aged 60 years and above, and males. Targeted efforts are required at the national and regional levels to expand and improve rehabilitation and social services for all people with disabilities.
Arvio, Maria; Salokivi, Tommi; Bjelogrlic-Laakso, Nina
We aimed to ascertain the average age at death (AD) in the intellectual disability population for each gender and compare them to those of the general population during 1970-2012. By analysing medical records, we calculated the ADs of all deceased clients (N = 1236) of two district organizations responsible for intellectual disability services. Statistics Finland's database generated data regarding ADs of all inhabitants who had died after having resided in same district. During the follow-up, average ADs for the intellectual disability population and general population increased, and simultaneously the AD difference between these populations decreased. In the 2000s, the AD difference between the intellectual disability population and the whole population was 22 years for men (95% CI: -24 to -20) and 30 years for women (95% CI: -33 to -27). In 2000s, the mean AD of those with mild-to-moderate intellectual disability (IQ 50-69) for women and men was 56 (SD17) and 54 (SD18), and those with severe to profound intellectual disability (IQ<50), 44 (SD23) and 43 (SD21). Intellectual disability is still a considerable risk factor for early death. Among the intellectual disability population, unlike in general population, the lifespans of women and men are equal. © 2016 John Wiley & Sons Ltd.
Juan Bornman; Diane Nelson Bryen; Enid Moolman; John Morris
Background: Advancements in wireless technology (e.g. cell phones and tablets) have opened new communication opportunities and environments for individuals with severe communication disabilities. The advancement of these technologies poses challenges to ensuring that these individuals enjoy equal access to this increasingly essential technology. However, a paucity of research exists. Objectives: To describe the nature and frequency with which South African adults with severe communicatio...
Park, Yujeong; Seo, Dong Gi; Park, Jaekook; Bettini, Elizabeth; Smith, Jamie
This study aims to explore the influences of personal, vocational, and job environment related factors that are associated with job satisfaction of individuals with disabilities in South Korea. Data for wage-based working employees from a nationwide survey were obtained, which resulted in a total number of 417 participants. The six hypotheses and mediation effects of personal and work related environmental factors were tested using the structural equation modeling drawn from existing research evidence. Results revealed that (a) life satisfaction and job related environments directly influenced job satisfaction; (b) the relationship between personal experience and job satisfaction was mediated by life satisfaction for both mild/moderate and severe/profound disabilities group; and (c) the mediating role of job environment between vocational preparedness and job satisfaction was only observed for individuals with mild/moderate disabilities. Summary of findings and implications for future research and practices are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.
Copeland, Susan R.; Keefe, Elizabeth B.
For students with moderate or severe disabilities, developing literacy skills is a critical component of successful communication, employment, and community participation. Finally, educators have a practical, concise guidebook for helping these students meet NCLB's academic standards for literacy. Appropriate for use in all settings, including…
Ncube, B. L.; Perry, A.; Weiss, J. A.
Background: Research examining the quality of life (QoL) of children with severe developmental disabilities (SDD) is limited. The present study examines parent perceptions of child QoL in children with SDD compared with typically developing (TD) children and then examines predictors of QoL for the SDD group. Method: Parents of 246 children with…
Rusk, Howard A.; And Others
To help quadriplegics and other severely disabled achieve vocational placement and confront the catastrophic impact of quadriplegia on bodily function (as detailed in the report), a rehabilitation team provided medical, various special, and vocational rehabilitation services. The 100 clients (59% men, 79% less than 45 years and 62% between 20 and…
Wisniewski, Lech; Alper, Sandra
This paper presents five systematic phases for bringing about successful regular education inclusion of students with severe disabilities. Phases include develop networks within the community, assess school and community resources, review strategies for integration, install strategies that lead to integration, and develop a system of feedback and…
Bouck, Emily C; Flanagan, Sara M
This study sought to understand the extent to which students with severe disabilities receive assistive technology in school and out-of-school, and the relationship between receipt of assistive technology in school and post-school outcomes for these students. This study was a secondary analysis of the National Longitudinal Transition Study-2 (NLTS2) from the USA. To analyze the data in this correlational study, researchers conducted frequency distributions, Chi Square Tests of Associations, significance tests and logistic regressions. The main results suggest (a) receipt of assistive technology in school varied greatly by disability identification; (b) receipt of assistive technology post-school also varied by disability identification, but receipt was generally lower; and (c) few statistically significant post-school outcome differences existed between students who received assistive technology and those who did not. An under-utilization of assistive technology exists in practice in the USA for students with severe disabilities. Implications for Rehabilitation An under-utilization of assistive technology for secondary students and adults with severe disabilities likely exists. A need exists for improved collaboration between professionals in rehabilitation and professionals in schools to ensure continuation of needed services or aids, such as assistive technology. Additional research is needed to better understand the adult life (or post-school) outcomes of individuals with severe disabilities, factors from PK-12 schooling or post-school services that positively and negative impact those outcomes.
Thorin, Elizabeth J.; Irvin, Larry K.
Analysis of concerns expressed by 42 members of 19 families of young adults with severe developmental disabilities indicated concerns in such areas as self-care capabilities, sexuality, and quality of residential services. Concerns in the residential domain were most predictive of overall individual and family stress. Effects of questioning…
Shurr, Jordan; Hollingshead, Aleksandra
Understanding family challenges and perspectives are critical to effective programming and services for individuals with severe disabilities. Equally central, yet often overlooked, is the relationship between family challenges and diversity. This systematic review examined a set of peer reviewed literature published between 2002-2015 at the…
... DEPARTMENT OF TRANSPORTATION Office of the Secretary 49 CFR Parts 27, 37, and 38 [Docket No. OST-2006-23985] RIN 2105-AD54 Transportation for Individuals With Disabilities AGENCY: Office of the Secretary (OST), U.S. Department of Transportation (DOT). ACTION: Notice of Public Meeting and Extension of...
Haymes, Linda K; Storey, Keith; Maldonado, Ana; Post, Michal; Montgomery, Joyce
Individuals with intellectual disabilities often have special healthcare concerns such as diabetes, kidney disease, severe allergies, progressive illnesses, respiratory weaknesses, and obesity. Smart technology can be an asset for individuals with intellectual disabilities for better managing their healthcare needs. A critical review of the literature related to applied behavior analysis, smart technology, and health needs of individuals with intellectual disabilities was conducted. This discussion paper describes factors that contribute to the successful use of smart technology for the health issues of individuals with intellectual disabilities. We see key components in developing appropriate access and use of smart technology for the health of people with intellectual disabilities being: (a) systematic instructional methods for consistent and accurate use of the technology, (b) modifying the current technology for people with intellectual disabilities, (c) guidelines for implementation, and (d) resources for getting the technology.
... 42 Public Health 4 2010-10-01 2010-10-01 false Blind and disabled individuals eligible in December... Mandatory Coverage of the Aged, Blind, and Disabled § 435.133 Blind and disabled individuals eligible in... December 1973 as blind or disabled individuals, whether or not they were receiving cash assistance in...
In many cases, the provision of an automobile equipped with a special control system is a necessary part of the rehabilitation of the severely disabled. The car is so important to the disabled as it enables him to overcome daily the distance between home and place of work, hence increasing his mobility and life quality. The presented care control system was developed to meet the individual needs of a particular disability. It is, however, possible to use this system for, or adapt it to, similar types of disabilities. This problem complex has been overcome by following innovations: 1. The electronically controlled accelerator which can be operated with minimal finger pressure. 2. The LIDA shoulder device for tetraplegics, a connecting piece between the shoulder and the manually operated brake lever. 3. The removable armrest on the right hand side of the driver's seat to improve the sitting stability. The car can be easily be converted for "normal driving". The author received financial assistance.
Matson, J. L.; Gonzalez, M. L.; Terlonge, C.; Thorson, R. T.; Laud, R. B.
Background: While researchers have attempted to address the difficulties of diagnosing affective disorders in the intellectually disabled population, diagnosing bipolar disorder in an individual with severe intellectual disability (ID) remains a challenge. The aim of this study was to identify what symptoms can predict a diagnosis of mania in the…
Full Text Available The low level of physical fitness of intellectually disabled individuals is most often the result of a sedentary lifestyle and the lack of the possibility for these individuals to take part in various forms of physical activity, and as a consequence these individuals are often unable to take part in any form of planned physical activities, are unable to adequately perform everyday activities and have limited abilities for performing workrelated duties. Regular physical activity can have a preventive effect, can reduce health risks and prevent the onset of various illnesses, as well as to promote an active lifestyle and increase physical and work capacities among the members of this particular population. Sport can play an important role in the life of individuals with intellectual disability as it represents a good basis for the development of physical and cognitive abilities. Team sports, which include interaction among a large number of people, a decision-making processes in a variety of situations and the understanding of the game itself in its constituent parts can be used as an effective and practical treatment of individuals with intellectual disability.
Gómez, L E; Arias, B; Verdugo, M Á; Tassé, M J; Brown, I
The operationalisation of quality of life for people with more severe disabilities has been acknowledged in the published research for more than two decades. This study aims to contribute to our knowledge and understanding of the quality of life of adults with severe disabilities by developing a set of quality of life indicators appropriate to this population using a Delphi method and the eight-domain conceptual model proposed by Schalock & Verdugo (2002). The participating panel in the Delphi method included 12 experts who evaluated each proposed item according to four criteria: suitability, importance, observability and sensitivity. Descriptive analyses were used to select the best items in each of the four rounds of this Delphi study, as well as examining the coefficients of concordance that were calculated for the final pool of items. The four rounds of the Delphi study resulted in a final pool of 118 items (91 that were considered valid in the first round plus 27 items proposed, reformulated or discussed in the following rounds). Importance and sensitivity were the criteria that received the highest and lowest ratings, respectively, but also the ones that had the highest and lowest mean coefficients of concordance. Experts showed the strongest agreement for items related to material well-being, while the weakest was found for items related to personal development. This study further contributes to our understanding of how to operationalise and measure quality of life in adults with severe disabilities. The item pool generated may prove helpful in the development of instruments for the measurement of quality of life-related outcomes in this population. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Siegel, Ellin B; Maddox, Laura L; Ogletree, Billy T; Westling, David L
Speech-language pathologists in school settings were surveyed with an instrument created from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities' quality indicators self-assessment tool. Participants valued practice indicators of quality communication assessment and intervention to a higher degree than their actual practice. These findings appear to suggest that SLPs may not provide best practice services to individuals with severe disabilities. Suggestions for enhancing inservice training and intervention practices of SLPs and team members who work with individuals with severe disabilities are provided. The reader will be able to; (1) understand the value of using the NJC quality indicators to guide SLP practices with individuals with severe disabilities in schools; (2) recognize that research indicates that SLPs working with individuals with severe disabilities in schools may not provide best practice services to the extent that they value these practices; (3) discuss possible strategies to increase the quality of services provided to individuals with severe disabilities in schools.
Lash, M; Licenziato, V
This article describes a vocational training program entitled, 'Careers in Automation for Persons with Severe Physical Disabilities', that was developed by the Department of Physical Medicine and Rehabilitation at Tufts University School of Medicine in collaboration with the Massachusetts Rehabilitation Commission. Its goal is to secure employment for individuals with severe physical impairments by using computers and technology as job related accommodations. Psychosocial, educational, and vocational profiles are presented for 24 clients over 4 years. Three case studies involving persons with traumatic, chronic and developmental disabilities illustrate the importance of matching technological accommodations with employer needs and personal preferences. Discussion of employment outcomes illustrates that the effective use of computers and technology by persons with disabilities is best measured not by the degree of sophistication and engineering of systems and devices, but by employer and employee satisfaction with job performance and productivity.
Park, Jung Min; Oh, Ukchan; Roh, Beop-Rae; Moon, Yeongmin
This longitudinal study examines to what extent the risk of mortality-all-cause, natural death, suicide, and unintentional injury mortality-differs by types and severity of disabilities as well as disability status. Data were the National Sample Cohort of 1,025,340 individuals in South Korea followed from 2002 to 2013. Cox regression with time-variant variables was used to estimate the hazard ratio of mortality by disability. Individuals with disabilities had a higher risk of mortality compared to those without (HR 1.84, 95% CI 1.80-1.88 for natural death; HR 1.83, 95% CI 1.64-2.03 for suicide; HR 1.54, 95% CI 1.38-1.71 for unintentional injury). All types of disability were associated with an increased risk of natural death. Individuals with mental disability were the highest risk group for suicide (HR 7.14, 95% CI 5.31-9.60). People defined as having severe disability had an elevated risk for all categories of mortality. Disabilities are important markers of high risk of mortality. Findings call for actions to reduce mortality risk of people with disabilities, including preventing suicidal behaviors of those with mental disability.
Kreuger, Linda; van Exel, Job; Nieboer, Anna
Background: A demand-oriented approach is becoming increasingly important in care provision. The purpose of this study was to identify the primary needs of clients with Severe Behavioural Disorders and Severe Intellectual Disabilities. Materials and Methods: We used the theory of Social Production Function and Maslow's hierarchy of needs to…
... type of substantial gainful activity. (b) Childhood disability benefits. An individual who has attained... Nonpayments of Benefits § 404.467 Nonpayment of benefits; individual entitled to disability insurance benefits... definition of disability for disability insurance benefits purposes based on statutory blindness, as defined...
Borji , Rihab; Zghal , Firas; Zarrouk , Nidhal; Martin , Vincent; Sahli , Sonia; Rebai , Haithem
International audience; Purpose: This study aimed to explore neuromuscular fatigue and recovery profiles in individuals with intellectual disability (ID) after exhausting submaximal contraction.Methods: Ten men with ID were compared to 10 men without ID. The evaluation of neuromuscular function consisted in brief (3 s) isometric maximal voluntary contraction (IMVC) of the knee extension superimposed with electrical nerve stimulation before, immediately after, and during 33 min after an exhaus...
Werner, Shirli; Hochman, Yael
Despite policies advocating the social inclusion of persons with disabilities in all settings that are a part of everyday life within society, individuals with intellectual disabilities (ID) are usually excluded from service in the military. This study examined the meaning of service in the military for individuals with ID from the perspective of various stakeholder groups. Semi-structured qualitative interviews were conducted with 31 individuals with ID, 36 relatives, and 28 commanders. The recent model for social inclusion developed by Simplican et al. (2015) served as the basis for analyses. Findings suggest a successful social inclusion process for individuals with ID, which resulted in them feeling as an integral part and as contributing members of the military unit and of society at large. Social inclusion in the military was described with reference to two overlapping and interacting domains of interpersonal relationships and community participation. The interaction between interpersonal relationships within the military and community participation has led to positive outcomes for soldiers with ID. Recommendations are provided for the continued inclusion of individuals with ID in the military and in other everyday settings. Copyright © 2017 Elsevier Ltd. All rights reserved.
... seeking to employ individuals with disabilities. (5) In the case of any small business enterprise operated..., including enterprises established under the Randolph-Sheppard program, management services and supervision... and improve small business enterprises operated by individuals with significant disabilities...
London, P S
Existing services for the disabled do not cater for the needs of lame-brain survivors of severe head injury who may be capable of productive work though they may never become employable. A grant from the Nuffield Provincial Hospitals Trust made it possible to set up in 1967 a special workshop in premises provided by the regional hospital board. The hospital management committee assumed financial responsibility for the centre after three years, and after five years the Department of Health and Social Security purchased adjoining premises, which will double the present accommodation for about 35 persons. Though 45% of the 101 patients attending the workshop have returned to work, no financial support has yet been received from the Department of Employment. A suitably staffed hostel is needed for patients who live too far away to travel daily to and from the workshop. This undertaking has shown a need for special facilities for some of the victims of severe head injury, who differ in many important ways from other disabled persons.
Jacob E. Tulipan, MD
Conclusions:. Electrodiagnostic severity grades do not correlate with patient-reported disability, including the DASH and MCS–12 surveys. There is a counterintuitive correlation between more-severe electrodiagnostic findings and decreased physical disability. These findings indicate that disability may not correlate with electrodiagnostic severity of median neuropathy in CTS.
Stephens, Dawn L; Collins, Michael D; Dodder, Richard A
Recent legislation, especially the Americans with Disabilities Act in 1990, generated the closure of institutions for people with disabilities and inclusion into community residences and employment. It has been well documented that individuals with developmental disabilities often experience difficulties with employment including both obtaining and maintaining jobs, and many researchers have looked for ways to make employment more successful [McConkey, R. & Mezza F. (2001). Employment aspirations of people with learning disabilities attending day centers. Journal of Learning Disabilities, 5(4), 309-318; Stevens, G. (2002). Employers' perceptions and practice in the employability of disabled people: a survey of companies in south east UK. Disability and Society, 17(7), 779-796; Capella, M., Roessler, R., & Hemmeria, K. (2002). Work-related skills awareness in high-school students with disabilities. Journal of Applied Rehabilitation Counseling, 33(2), 17-23; Ingraham, K., Rahimi, M., Tsang, H., Chan, F., & Oulvey, E. (2001). Work support groups in state vocational rehabilitation agency settings: a case study. Psychiatric Rehabilitation Skills, 5(1), 6-21; Gosling, V. & Cotterill, L. (2000). An employment project as a route to social inclusion for people with learning difficulties? Disability and Society, 15(7), 1001-1018; Neitupski, J. & Hamre-Nietupski, S. (2000). A systematic process for carving supported employment positions for people with severe disabilities. Journal of Developmental and Physical Disabilities, 12(2), 103-119]. While research has accumulated that has examined predictors of successful employment, this research assessed longitudinal outcomes of employment. Data were obtained from an existing data set of all known persons receiving services from the Developmental Disabilities Division of the Oklahoma Department of Human Services (N=2760). Results indicated that as people moved to employment, scores on adaptive skills increased, that as people moved
... university affiliated programs or for projects of national significance grants must also contain an assurance... DISABILITIES, DEVELOPMENTAL DISABILITIES PROGRAM REQUIREMENTS APPLICABLE TO THE DEVELOPMENTAL DISABILITIES PROGRAM § 1385.4 Rights of individuals with developmental disabilities. (a) Section 110 of the Act, Rights...
Bengtsson, Steen; Gupta, Nabanita Datta
The literature on disability has suggested that an educated individual with a disability is more likely to better cope with her/his disability than those without education. However, few published studies explore whether the relationship between education and ability to cope with a disability...... is anything more than an association. Using data on disability and accommodation from a large Danish survey from 2012–13 and exploiting a major Danish schooling reform as a natural experiment, we identified a potential causal effect of education on both economic (holding a job) as well as social (cultural...... with a disability indeed had higher levels of both economic and social coping. To some extent, having more knowledge of public support systems and higher motivation explained the better coping among the group of individuals with disabilities who were educated. Our results indicated, however, that a large part...
Full Text Available Over the last 15 years, since introductionof the Disability Discrimination Act (DDA(Commonwealth Government of Australia,1992, there has been much discussionabout the extent and nature of buildingaccess for the disabled, particularly inresponse to proposed revisions to theBuilding Code of Australia (BCA and theintroduction of a Premises Standardcovering building access. Much of theargument which contributed to the twoyear delay in submitting a final version ofthese documents for government approvalrelated to the extent of access provisionsand the burden of cost. The final versionsubmitted to government by the AustralianBuilding Codes Board (ABCB (notreleased publicly appears to still containinconsistencies between the DDA and theBCA in several areas such as wayfindingand egress.In the debate preceding submission of thefinal version there appears to have beenlittle reference to access requirements forindividuals with intellectual disability (ID.This may be due to a general lack ofresearch on the topic. Consequently, thispaper uses a combination of theknowledge gained from a limited numberof previous wayfinding studies, literaturedescribing general problems faced bythose with ID and the author’s personalexperience observing others with ID tocreate a list of probable difficulties andsuggested solutions. The paperconcludes with a discussion about theassociated cost implications and benefitsin providing the required access.
Hearne, D; Stone, S
The field of learning disabilities, like education in the main, is undergoing calls for reform and restructuring, an upheaval brought on in great part by the forces of opposing paradigms--reductionism and constructivism. In reexamining our past, we must begin to address the failures of traditional deficit models and their abysmally low "cure" rate. Several new theories have arisen that challenge traditional practices in both general and special education classrooms. Particularly influential has been the work of Howard Gardner, whose theory of multiple intelligences calls for a restructuring of our schools to accommodate modes of learning and inquiry with something other than deficit approaches. At least some current research in the field of learning disabilities has begun to focus on creativity and nontraditional strengths and talents that have not been well understood or highly valued by the schools. In this article, we briefly summarize the findings in our search for the talents of students labeled learning disabled, evidence of their abilities, implications of these for the schools, and a beginning set of practical recommendations.
Lawler, James; Iturralde, Val; Goldstein, Allan; Joseph, Anthony
College curricula of engineering and information systems do not afford frequent engagement with individuals with disabilities. The authors of this research study analyzed the benefits of disability films for a community film festival of largely engineering and information systems students and individuals with developmental and intellectual…
Alexander C Phillips
Full Text Available To investigate, using accelerometers, the levels of physical activity being undertaken by individuals with intellectual disabilities with and without Down's syndrome.One hundred and fifty two individuals with intellectual disabilities aged 12-70 years from East and South-East England. Physical activity levels in counts per minute (counts/min, steps per day (steps/day, and minutes of sedentary, light, moderate, vigorous, and moderate to vigorous physical activity (MVPA measured with a uni-axial accelerometer (Actigraph GT1M for seven days.No individuals with intellectual disabilities met current physical activity recommendations. Males were more active than females. There was a trend for physical activity to decline and sedentary behaviour to increase with age, and for those with more severe levels of intellectual disability to be more sedentary and less physically active, however any relationship was not significant when adjusted for confounding variables. Participants with Down's syndrome engaged in significantly less physical activity than those with intellectual disabilities without Down's syndrome and levels of activity declined significantly with age.Individuals with intellectual disabilities, especially those with Down's syndrome may be at risk of developing diseases associated with physical inactivity. There is a need for well-designed, accessible, preventive health promotion strategies and interventions designed to raise the levels of physical activity for individuals with intellectual disabilities. We propose that there are physiological reasons why individuals with Down's syndrome have particularly low levels of physical activity that also decline markedly with age.
Walton, Catherine; Kerr, Mike
The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and profound intellectual disability. The review aimed to examine the methods used to assess for depression. The secondary aim was to explore the frequency and symptoms of depression. The PRISMA (2009) Checklist for systematic review was followed, and a search of electronic databases was undertaken. Nine studies were included in the qualitative synthesis from over 2000 records identified. The quality of the studies was assessed and scored, with a wide range of results. Individual studies scored between 2 and 7 of a maximum possible score of 8. The diagnostic tools utilized by each of the studies were assessed and compared. In terms of the methods used to assess for depression, results were varied. This was due to the heterogeneous nature of the individual study designs. The Aberrant Behaviour Checklist consistently showed promise, in particular when combined with other instruments or clinical examination. Qualitative analysis of the selected studies has shown a wide variation in the quality of primary research in this field, with more required to make firm conclusions regarding the diagnosis, frequency and presentation of depression in severe and profound intellectual disability. © 2015 John Wiley & Sons Ltd.
Bornman, Juan; Bryen, Diane Nelson; Moolman, Enid; Morris, John
Advancements in wireless technology (e.g. cell phones and tablets) have opened new communication opportunities and environments for individuals with severe communication disabilities. The advancement of these technologies poses challenges to ensuring that these individuals enjoy equal access to this increasingly essential technology. However, a paucity of research exists. To describe the nature and frequency with which South African adults with severe communication disabilities have access to and use wireless devices, as well as the types of activities for which wireless devices are used. Survey research was conducted with 30 individuals who use augmentative and alternative communication (AAC) technology using the Survey of User Needs Questionnaire developed in the United States, and localized to the South African context. All participants, despite their limited education, unemployment and low economic status, owned and/or used mainstream wireless devices. Slightly more than half of the participants (53.3%) needed adaptations to their wireless devices. Advantages of using wireless devices were highlighted, including connecting with others (through using text messaging, social networking, making plans with others, sharing photos and videos with friends), for leisure activities (e.g. listening to music, watching videos, playing games), and for safety purposes (e.g. to navigate when lost, using the device when in trouble and needing immediate assistance). These wireless devices offer substantial benefits and opportunities to individuals with disabilities who rely on AAC in terms of independence, social participation, education and safety/security. However, they still do not enjoy equal opportunity to access and use wireless devices relative to the non-disabled population.
Full Text Available Background: Advancements in wireless technology (e.g. cell phones and tablets have opened new communication opportunities and environments for individuals with severe communication disabilities. The advancement of these technologies poses challenges to ensuring that these individuals enjoy equal access to this increasingly essential technology. However, a paucity of research exists. Objectives: To describe the nature and frequency with which South African adults with severe communication disabilities have access to and use wireless devices, as well as the types of activities for which wireless devices are used. Method: Survey research was conducted with 30 individuals who use augmentative and alternative communication (AAC technology using the Survey of User Needs Questionnaire developed in the United States, and localized to the South African context. Results: All participants, despite their limited education, unemployment and low economic status, owned and/or used mainstream wireless devices. Slightly more than half of the participants (53.3% needed adaptations to their wireless devices. Advantages of using wireless devices were highlighted, including connecting with others (through using text messaging, social networking, making plans with others, sharing photos and videos with friends, for leisure activities (e.g. listening to music, watching videos, playing games, and for safety purposes (e.g. to navigate when lost, using the device when in trouble and needing immediate assistance. Conclusion: These wireless devices offer substantial benefits and opportunities to individuals with disabilities who rely on AAC in terms of independence, social participation, education and safety/security. However, they still do not enjoy equal opportunity to access and use wireless devices relative to the non-disabled population.
Aim of the study. To evaluate the benefits of recreational activities, their organisation and realization for individuals with physical disabilities. Objectives. 1. To determine the accessibility and organisation of health promotion through recreational activities for individuals with physical disabilities. 2. To evaluate how economical-financial, informational, physical and psychosocial factors influence physically disabled people’s health promotion through recreational activities....
Sigmon, Scott B.
This study describes the implications of the Individual Psychology of Alfred Adler and field theory associated with Kurt Lewin in understanding orthopedically disabled children and points out that orthopedically disabled youngsters have a remarkable range of individual differences both in type of disability as well as level of adjustment.…
Walton, Katherine M.; Ingersoll, Brooke R.
Social skills are important treatment targets for individuals with autism spectrum disorders (ASD) across the lifespan. However, few treatments are available for adolescents and adults with ASD who also have severe to profound intellectual disability (S/PID). Several social skill interventions have been described that may improve social skills in…
Pennington, Robert; Courtade, Ginevra; Jones Ault, Melinda; Delano, Monica
Despite encouraging changes in the expectations of programming for persons with moderate to severe intellectual disability (MSD), data suggest that programs for these individuals are still lacking in several critical areas. Building administrators play a key role in promoting high quality programs for students with MSD within local schools but may…
Full Text Available Objective: To identify the sociodemographic characteristics, degree and cause of visual disability among certified visually disabled individuals in a rural district of West Bengal, India and to identify possible lacunae, if any, in the existing certification system. Materials and Methods: A cross-sectional study by secondary data analysis of medical records of 155 visually disabled individuals and their 310 eyes. Demographical features, diagnosis, percentage of visual disability and work activity status of each individual were analyzed. Results: One hundred and thirty one (84.52% individuals had 100% disability. The number of males was significantly higher than that of females. Fifty eight (37.42% individuals were below 21 years of age. Phthisis bulbi was the most common cause followed by microphthalmos. Further, 81.29% patients had the same lesion bilaterally. Conclusion: Patients with higher grades of disability have attended certification boards. A large number of disabled individuals comprised children and young adults. Male gender bias demands concern.
Levy, J M; Jessop, D J; Rimmerman, A; Levy, P H
Executives (N = 341) responsible for hiring decisions in Fortune 500 industrial and service corporations returned a mail questionnaire measuring their attitudes toward persons with severe disabilities and their employability. Responses indicated that attitudes were favorable to persons with disabilities and to their employability, both in terms of advantages for the individual and lack of disadvantages for others in the work setting. Significant differences in attitudes existed among subgroups of executives. Executives who had contact with persons with disabilities in the corporate work world had more positive attitudes than did executives who did not have such experiences.
Smith, Matthew J.; Ginger, Emily J.; Wright, Michael; Wright, Katherine; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D.; Fleming, Michael F.
Services are available to help support existing employment for individual with psychiatric disabilities; however, there is a gap in services targeting job interview skills that can help obtain employment. We assessed the feasibility and efficacy of Virtual Reality Job Interview Training (VR-JIT) in a randomized controlled trial. Participants were randomized to VR-JIT (n=25) or treatment as usual (TAU) (n=12) groups. VR-JIT consisted of 10 hours of simulated job interviews with a virtual character and didactic online training. Participants attended 95% of lab-based training sessions and found VR-JIT easy-to-use and felt prepared for future interviews. The VR-JIT group improved their job interview role-play performance (pinterview skills and self-confidence. Future research may help clarify whether this intervention is efficacious in community-based settings. PMID:25099298
Burton, Cynthia Z; Vella, Lea; Twamley, Elizabeth W
Prospective memory (the ability to remember to do things) has clear implications for everyday functioning, including employment, in people with severe mental illnesses (SMI). This study aimed to evaluate prospective memory performance and its relationship to real-world functional variables in an employment-seeking sample of people with SMI (Clinical Trial registration number NCT00895258). 153 individuals with DSM-IV diagnosis of depression (n = 58), bipolar disorder (n = 37), or schizophrenia (n = 58) who were receiving outpatient psychiatric care at a university clinic enrolled in a trial of supported employment and completed a baseline assessment. Prospective memory was measured with the Memory for Intentions Test (MIST); real-world functional status included work history variables, clinical history variables, baseline functional capacity (UCSD Performance-based Skills Assessment-Brief), and work outcomes (weeks worked and wages earned during two years of supported employment). Participants with schizophrenia performed worse on the MIST than did those with affective disorders. Independent of diagnosis, education, and estimated intellectual functioning, prospective memory significantly predicted variance in measures of disability and illness burden (disability benefits, hospitalization history, current functional capacity), and work outcomes over two years of supported employment (weeks worked). Worse prospective memory appears to be associated with greater illness burden and functional disability in SMI. Mental health clinicians and employment specialists may counsel clients to use compensatory prospective memory strategies to improve work performance and decrease functional disability associated with SMI.
...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... appointment of people with mental retardation, severe physical disabilities, and psychiatric disabilities. As... a particular work environment. Persons with disabilities today, however, often have work...
de la Torre-Luque, Alejandro; Valero-Aguayo, Luis; de la Rubia-Cuestas, Ernesto J.
This study aims to test how an intervention based on virtual reality (VR) may enhance visuospatial skills amongst people with disability. A quasi-experimental intra-group study was therefore conducted. Participants were 20 people with severe disability (65% males; 34.35 years, on average, and 84.95% of disability rate according to the Andalusian…
van den Heuvel, Renée J F; Lexis, Monique A S; de Witte, Luc P
The aim of this study was to explore the potential of ZORA robot-based interventions in rehabilitation and special education for children with severe physical disabilities. A two-centre explorative pilot study was carried out over a 2.5-month period involving children with severe physical disabilities with a developmental age ranging from 2 to 8 years. Children participated in six sessions with the ZORA robot in individual or in group sessions. Qualitative and quantitative methods were used to collect data on aspects of feasibility, usability, barriers and facilitators for the child as well as for the therapist and to obtain an indication of the effects on playfulness and the achievement of goals. In total, 17 children and seven professionals participated in the study. The results of this study show a positive contribution of ZORA in achieving therapy and educational goals. Moreover, sessions with ZORA were indicated as playful. Three main domains were indicated to be the most promising for the application of ZORA: movement skills, communication skills and cognitive skills. Furthermore, ZORA can contribute towards eliciting motivation, concentration, taking initiative and improving attention span of the children. On the basis of the results of the study, it can be concluded that ZORA has potential in therapy and education for children with severe physical disabilities. More research is needed to gain insight into how ZORA can be applied best in rehabilitation and special education.
Savino, M. J.; Fernández, E. A.
During the last years several interfaces have been developed to allow communication to those patients suffering serious physical disabilities. In this work, a computer based communication interface is presented. It was designed to allow communication to those patients that cannot use neither their hands nor their voice but they can do it through their eyes. The system monitors the eyes movements by means of a webcam. Then, by means of an Artificial Neural Network, the system allows the identification of specified position on the screen through the identification of the eyes positions. This way the user can control a virtual keyboard on a screen that allows him to write and browse the system and enables him to send e-mails, SMS, activate video/music programs and control environmental devices. A patient was simulated to evaluate the versatility of the system. Its operation was satisfactory and it allowed the evaluation of the system potential. The development of this system requires low cost elements that are easily found in the market.
Savino, M J [Fac. de Ingenieria, Universidad Catolica de Cordoba, Camino a Alta Gracia km. 10 (5000) Cordoba, Cordoba (Argentina); Fernandez, E A [Fac. de Ingenieria, Universidad Catolica de Cordoba, Camino a Alta Gracia km. 10 (5000) Cordoba, Cordoba (Argentina)
During the last years several interfaces have been developed to allow communication to those patients suffering serious physical disabilities. In this work, a computer based communication interface is presented. It was designed to allow communication to those patients that cannot use neither their hands nor their voice but they can do it through their eyes. The system monitors the eyes movements by means of a webcam. Then, by means of an Artificial Neural Network, the system allows the identification of specified position on the screen through the identification of the eyes positions. This way the user can control a virtual keyboard on a screen that allows him to write and browse the system and enables him to send e-mails, SMS, activate video/music programs and control environmental devices. A patient was simulated to evaluate the versatility of the system. Its operation was satisfactory and it allowed the evaluation of the system potential. The development of this system requires low cost elements that are easily found in the market.
Savino, M J; Fernandez, E A
During the last years several interfaces have been developed to allow communication to those patients suffering serious physical disabilities. In this work, a computer based communication interface is presented. It was designed to allow communication to those patients that cannot use neither their hands nor their voice but they can do it through their eyes. The system monitors the eyes movements by means of a webcam. Then, by means of an Artificial Neural Network, the system allows the identification of specified position on the screen through the identification of the eyes positions. This way the user can control a virtual keyboard on a screen that allows him to write and browse the system and enables him to send e-mails, SMS, activate video/music programs and control environmental devices. A patient was simulated to evaluate the versatility of the system. Its operation was satisfactory and it allowed the evaluation of the system potential. The development of this system requires low cost elements that are easily found in the market
Forslund, Marit V; Roe, Cecilie; Perrin, Paul B; Sigurdardottir, Solrun; Lu, Juan; Berntsen, Svein; Andelic, Nada
To assess longitudinal trajectories of overall disability after moderate-to-severe traumatic brain injury (TBI) and to examine whether those trajectories could be predicted by socio-demographic and injury characteristics. Demographics and injury characteristics of 105 individuals with moderate-to-severe TBI were extracted from medical records. At the 1-, 2-, and 5-year follow-ups, TBI-related disability was assessed by the GOSE. A hierarchical linear model (HLM) was used to examine functional outcomes up to 5 years following injury and whether those outcomes could be predicted by: time, gender, age, relationship, education, employment pre-injury, occupation, GCS, cause of injury, length of post-traumatic amnesia (PTA), CT findings and injury severity score, as well as the interactions between each of these predictors and time. Higher GOSE trajectories (lower disability) were predicted by younger age at injury and shorter PTA, as well as by the interaction terms of time*PTA and time*employment. Those who had been employed at injury decreased in disability over time, while those who had been unemployed increased in disability. The study results support the view that individual factors generally outweigh injury-related factors as predictors of disability after TBI, except for PTA.
Darling, Joseph A; Circo, Deborah K
This quantitative study assessed whether presentation of preferred items and activities during multiple periods of the day (and over multiple days) increased indices of happiness (over time/sustained) in individuals with PMD. A multiple baseline design across participants was utilized to measure changes in indices of happiness of the participants. Participants were recruited from an adult day activity program specializing in providing assistance to individuals with disabilities. For Mary, baseline indices of happiness were 26.67% of intervals, increasing 6.76% during intervention to 33.43%. For Caleb, baseline indices of happiness were 20.84% of intervals, increasing 6.34% during intervention to 27.18%. For Mark, baseline indices of happiness were 40.00% of intervals, increasing 12.75% during intervention to 52.75%. Overall interobserver agreement was 82.8%, with interobserver agreement observations occurring during 63.04% of the observations. The results of the investigation demonstrated that presenting preferred items and activities increased the indices of happiness compared to baseline rates of indices of happiness. Results may have been more robust if the participants were assessed for overall responsiveness patterns prior to the initiation of measurement of indices of happiness. Copyright © 2015 Elsevier Ltd. All rights reserved.
Dammeyer, Jesper; Koppe, Simo
Research in social interaction and nonverbal communication among individuals with severe developmental disabilities also includes the study of body movements. Advances in analytical technology give new possibilities for measuring body movements more accurately and reliably. One such advance is the Qualisys Motion Capture System (QMCS), which…
Hilgenkamp, Thessa Irena Maria; Baynard, Tracy
Individuals with intellectual disability (ID) have very low physical activity and low peak oxygen uptake (VO 2peak ), potentially explained by physiologically lower peak heart rates (HR peak ). The present authors performed a retrospective analysis of a large data set of individuals with intellectual disability (n = 100), with Down syndrome (DS) (n = 48) and without intellectual disability (n = 224) using multiple linear regression analyses, to determine if individuals with intellectual disability exhibit lower HR peak and VO 2peak than individuals without intellectual disability, controlling for age, sex and body mass index (BMI). Individuals with intellectual disability on average have significantly lower HR peak and VO 2peak than individuals without intellectual disability, even when controlling VO 2peak for the lower HR peak . This study suggests potential physiological differences in individuals with intellectual disability and warrants further investigation to determine their relevance to physical activity promotion and exercise testing in individuals with intellectual disability. © 2017 John Wiley & Sons Ltd.
Lawson, Janelle E; Cruz, Rebecca A; Knollman, Gregory A
Providing equal-status contact between those with and without disabilities can improve attitudes and reduce discrimination toward individuals with disabilities. This study investigated community service learning as a means by which to provide college students with equal-status contact with individuals with disabilities and increase their positive attitudes toward those with disabilities. A total of 166 college students in one university in the United States enrolled in an Introduction to Disability course received content on disability in society and participated in community service involving 20h of direct contact with individuals with disabilities. Findings indicated that college students who had prior contact with individuals with disabilities had more positive attitudes toward individuals with disabilities than college students who did not have prior contact at the start of the course. For the college students who did not have any prior contact, their attitudes toward individuals with disabilities became significantly more positive at the end of the community service learning course. Implications and suggestions for future research are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Avhandling (doktorgrad) - Norges idrettshøgskole, 2017 There is increasing evidence for physical activity having a positive impact on physical and mental health, as well as on illness symptoms in individuals with severe mental illness (SMI). However, individuals with SMI experience several barriers related to physical activity that makes it difficult for them to take advantage of the benefits associated with physical activity. One barrier consistently reported to impede physical activity i...
Smith, Matthew J; Ginger, Emily J; Wright, Michael; Wright, Katherine; Boteler Humm, Laura; Olsen, Dale; Bell, Morris D; Fleming, Michael F
Services are available to help support existing employment for individuals with psychiatric disabilities; however, there is a gap in services targeting job interview skills that can help obtain employment. We assessed the feasibility and efficacy of Virtual Reality Job Interview Training (VR-JIT) in a randomized controlled trial. Participants were randomized to VR-JIT (n = 25) or treatment-as-usual (TAU) (n = 12) groups. VR-JIT consisted of 10 hours of simulated job interviews with a virtual character and didactic online training. The participants attended 95% of laboratory-based training sessions and found VR-JIT easy to use and felt prepared for future interviews. The VR-JIT group improved their job interview role-play performance (p ≤ 0.05) and self-confidence (p ≤ 0.05) between baseline and follow-up as compared with the TAU group. VR-JIT performance scores increased over time (R = 0.65). VR-JIT demonstrated initial feasibility and efficacy at improving job interview skills and self-confidence. Future research may help clarify whether this intervention is efficacious in community-based settings.
Kurth, Jennifer A.; Lyon, Kristin J.; Shogren, Karrie A.
The purpose of the present study was to investigate practices that support the inclusion of students with severe disabilities in the learning and social activities of inclusive K-8 schools to inform inclusive school reform research and practice. Eighteen K-8 students with severe disabilities in six schools recognized for their implementation of…
Ferreri, Summer J.; Plavnick, Joshua B.
Many children with severe developmental disabilities emit idiosyncratic gestures that may function as verbal operants (Sigafoos et al., 2000). This study examined the effectiveness of a functional analysis methodology to identify the variables responsible for gestures emitted by 2 young children with severe developmental disabilities. Potential…
Vall Castelló, Judit
Policymakers and organizations representing people with disabilities have highlighted the importance of promoting the employment prospects of disabled individuals as a determinant to ensure their broader integration into the society. Policy reforms that attempt to incentivise disabled individuals to work typically involve reduced financial punishments for earning above a predetermined threshold (substantial gainful activity). This paper exploits a Spanish reform that entirely eliminated any disincentives for disabled individuals to work. Partially disabled individuals in Spain are subject to income taxation in all regions except in the province of Bizkaia. Before 2007, partially disabled individuals in Bizkaia were exempt from income taxation if they did not work. In December 2006, a new law was passed in Bizkaia that distinguished between individuals aged 55 or younger, who were no longer tax-exempt, and those who were older than 55 years, who continued to be tax-exempt if they did not work. I exploit this change in the legislation and employ both a difference-in-difference strategy comparing the employment outcomes of disabled young men across provinces and time as well as a triple difference model with disabled men older than 55 years, who are unaffected by the policy. My results show that the reform increased the probability of working by 6.5 percentage points for disabled men aged 55 or younger. Copyright © 2017 John Wiley & Sons, Ltd.
... provide a written communication to the railroad setting forth the reasons for the delay and an estimate of... speculation, stereotypes, or generalizations about individuals with disabilities or their mobility devices..., not on mere speculation, stereotypes, or generalizations about individuals with disabilities or about...
James, Jessica S.
Depression is common in individuals with intellectual disabilities, but evidence regarding treatment for this population is lacking. Through a systematic literature review of cognitive-behavioral therapy (CBT) with individuals with intellectual disabilities, a total of six studies were identified that used pretest-post-test nonequivalent control…
The article presents results of a study on the correlation between value preferences and attitudes towards individuals with a disability. Five hundred and eighty respondents took part in the research, among them 300 special needs teachers (SNT) and 280 general teachers (GT). Attitudes towards Individuals with a Disability Scale and Brzozowski's…
Head, David W.; And Others
Presents dimensions that serve as a background for counselors to assist families in considering options related to disabled infants. Dimensions include the meaning of life, cost to benefit ratio, medical options, legal precedent, and a theological perspective. This issue is related to counseling practice through counselor ethics and values.…
Fox, Robert A.; Burke, Amie M.; Fung, Michael P.
We studied the effectiveness of an individually-tailored leisure program implemented by direct care staff in a residential program for 28 adults with severe to profound intellectual disability using a multiple baseline design across two homes over a 1.5 year baseline and treatment period followed by another nearly 1.5 year maintenance phase. The…
Line drawings are commonly used as communication symbols for individuals with severe intellectual disabilities. This study investigated the effect of color on the recognition and use of line drawings by young children with severe intellectual disabilities and poor verbal comprehension who were beginning picture users. Drawings where the color of the picture matched the object and where the color of the drawing did not match the object were used, as well as black and white line drawings. Tentative findings suggest that some students with intellectual disabilities may find it more difficult to recognize and line drawings where the color does not match the object compared to line drawings where the color of the drawing does match the color of the object.
... 42 Public Health 4 2010-10-01 2010-10-01 false Aged, blind, and disabled individuals in States... Coverage of the Aged, Blind, and Disabled § 435.230 Aged, blind, and disabled individuals in States that... for aged, blind, and disabled SSI recipients using more restrictive requirements than those used under...
Johnson, Hilary; Douglas, Jacinta; Bigby, Christine; Iacono, Teresa
Background: Social interaction is integral to social inclusion. Little is known about the nature of social interaction between adults with severe intellectual disability and those with whom they engage. Method: Participants were six adults with intellectual disability and people identified as those with whom they shared demonstrable pleasurable…
Luijkx, J.; Ten Brug, A.; Vlaskamp, C.
BACKGROUND: Researchers have shown that the characteristics of a person with an intellectual disability (ID), in particular the severity of the disability, are related to the outcomes of professional support. Hardly any studies have asked parents and/or legal guardians for their own opinion about
Kemp, Coral; Stephenson, Jennifer; Cooper, Megan; Hodge, Kerry
A single subject multiple treatment design was used to compare the engagement of 3 preschool children with severe and multiple disabilities, using 2 different stimuli: picture books and iPad apps matched for theme and content. Two of the 3 children had diagnoses of autism spectrum disorder in addition to their other disabilities. Sessions for each…
3 ABSTRACT Name: Conditions for sports activities in selected organisations for disabled individuals in the town of Teplice. Aim of the work: Monitoring sports activities as a socialisation factor for integration and socialisation of individuals with disabilities caused by poliomyelitis in the selected town of Teplice. Another objective was to describe conditions of sports activities and to determine opinions of handicapped individuals on attendance at sports groups in selected centres as wel...
Erickson, William A.; von Schrader, Sarah; Bruyère, M.; VanLooy, Sara A.; Matteson, S.
Purpose: To determine what disability-inclusive policies and practices employers have in place and examine the relationship between these practices and the actual recruitment and hiring of persons with disabilities. Method: A survey 675 of human resources professionals who were members of the Society for Human Resource Management. Results: After…
Broersen Jake PJ
Full Text Available Abstract Background Work disability is a major problem for both the worker and society. To explore the work opportunities in regular jobs of persons low in functional abilities, we tried to identify occupations low in task demands. Because of the variety of functional abilities and of the corresponding work demands, the disabled persons need to be classified by type of disability in a limited number of subgroups. Within each subgroup, occupations judged suitable for the most seriously disabled will be selected as having a very low level of the corresponding task demands. These occupations can be applied as reference occupations to assess the presence or absence of work capacity of sick-listed employees in regular jobs, and as job opportunities for people with a specific type of functional disability. Methods Registered data from 50,931 disability assessments within the Dutch social security system were used in a second order factor analysis to identify types of disabilities in claimants for a disability pension. Threshold values were chosen to classify claimants according to the severity of the disability. In the disability assessment procedure, a labour expert needs to select jobs with task demands not exceeding the functional abilities of the claimant. For each type of disability, the accessible jobs for the subgroup of the most severely disabled claimants were identified as lowest in the corresponding demand. Results The factor analysis resulted in four types of disabilities: general physical ability; autonomy; psychological ability; and manual skills. For each of these types of disablement, a set of four to six occupations low in task demands were selected for the subgroup of most severely disabled claimants. Because of an overlap of the sets of occupations, 13 occupations were selected in total. The percentage of claimants with at least one of the occupations of the corresponding set (the coverage, ranged from 84% to 93%. An alternative
Full Text Available Prior research has shown that people with intellectual disabilities (ID are more likely to experience child abuse as well as other forms of traumatic events later in life compared to the general population. Little is known however, about the association of these experiences with adult mental health in individuals with ID. The present study aimed to assess whether child abuse in families and institutions as well as other types of adverse life events, were associated with current Posttraumatic Stress Disorder (PTSD and depression symptoms in individuals with ID. We conducted clinical interviews which included standardized self-report measures for childhood abuse, PTSD, and depression in an unselected sample of 56 persons with a medical diagnosis of intellectual disability who were attending a specialized welfare center. The frequency of traumatic experiences was very high, with physical and emotional child abuse being the most common trauma types. 87% of the persons reported at least one aversive experience on the family violence spectrum, and 50% of the sample reported a violent physical attack later in adulthood. 25% were diagnosed with PTSD and almost 27% had a critical score on the depression scale. Physical and emotional child abuse was positively correlated with the amount of institutional violence and the number of general traumatic events, whereas childhood sexual abuse was related to the experience of intimate partner violence in adult life. A linear regression revealed child abuse in the family to be the only significant independent predictor of PTSD symptom severity. The current findings underscore the central role of child maltreatment in the increased risk of further victimization and in the development of mental health problems in adulthood in individuals with ID. Our data have important clinical implications and demonstrate the need for targeted prevention and intervention programs that are tailored to the specific needs of children
Full Text Available Alesia Sadosky,1 Vijaya Koduru,2 E Jay Bienen,3 Joseph C Cappelleri4 1Pfizer Inc, New York, NY, 2Eliassen Group, New London, CT, 3Outcomes Research Consultant, New York, NY, 4Pfizer Inc, Groton, CT, USA Background: painDETECT is a screening measure for neuropathic pain. The nine-item version consists of seven sensory items (burning, tingling/prickling, light touching, sudden pain attacks/electric shock-type pain, cold/heat, numbness, and slight pressure, a pain course pattern item, and a pain radiation item. The seven-item version consists only of the sensory items. Total scores of both versions discriminate average pain-severity levels (mild, moderate, and severe, but their ability to discriminate individual item severity has not been evaluated.Methods: Data were from a cross-sectional, observational study of six neuropathic pain conditions (N=624. Average pain severity was evaluated using the Brief Pain Inventory-Short Form, with severity levels defined using established cut points for distinguishing mild, moderate, and severe pain. The Wilcoxon rank sum test was followed by ridit analysis to represent the probability that a randomly selected subject from one average pain-severity level had a more favorable outcome on the specific painDETECT item relative to a randomly selected subject from a comparator severity level.Results: A probability >50% for a better outcome (less severe pain was significantly observed for each pain symptom item. The lowest probability was 56.3% (on numbness for mild vs moderate pain and highest probability was 76.4% (on cold/heat for mild vs severe pain. The pain radiation item was significant (P<0.05 and consistent with pain symptoms, as well as with total scores for both painDETECT versions; only the pain course item did not differ.Conclusion: painDETECT differentiates severity such that the ability to discriminate average pain also distinguishes individual pain item severity in an interpretable manner. Pain-severity
Chiba, Yoichi; Shimada, Atsuyoshi; Yoshida, Futoshi; Keino, Hiromi; Hasegawa, Mariko; Ikari, Hiroyuki; Miyake, Shikako; Hosokawa, Masanori
Our aim was to identify risk factors for falling and establish a method to assess risk for falls in adults with intellectual disabilities. In a cross-sectional survey of 144 Japanese adults, we found that age, presence of epilepsy, and presence of paretic conditions were independent risk factors. The Tinetti balance and gait instrument was…
Grimaldi, Caroline; Goette, Tanya
This study examined the role of the Internet and its usage on the level of perceived independence among people with physical disabilities. Discusses independence, perceived control, psychological self-reliance, adaptive technology, hypotheses tested, and future directions. A copy of one of the questionnaires used is appended. (Author/LRW)
Walker, Zachary; Vasquez, Eleazar; Wienke, Wilfred
The purpose of this research study was to explore the efficacy of role-playing and coaching in mixed-reality environments for the acquisition and generalization of social skills leading to successful job interview performance. Using a multiple baseline across participants design, five young adults with intellectual disability practiced…
Arvio, Maria; Salokivi, Tommi; Bjelogrlic-Laakso, Nina
Background: We aimed to ascertain the average age at death (AD) in the intellectual disability population for each gender and compare them to those of the general population during 1970-2012. Methods: By analysing medical records, we calculated the ADs of all deceased clients (N = 1236) of two district organizations responsible for intellectual…
Bonner, Vint K. H.
Employability skills are important for employment access, success, and excellence, regardless of disability status. Importantly, employability skills are essential to the employment success of individuals with intellectual disabilities. Unfortunately, there are differences between the employability skills valued by employers, and the employability…
Sullivan, Amanda L.; Bal, Aydin
We examined the risk of disability identification associated with individual and school variables. The sample included 18,000 students in 39 schools of an urban K-12 school system. Descriptive analysis showed racial minority risk varied across 7 disability categories, with males and students from low-income backgrounds at highest risk in most…
Tam, Gee May; Phillips, Katrina J.; Mudford, Oliver C.
We replicated and extended previous research on microswitch facilitated choice making by individuals with profound multiple disabilities. Following an assessment of stimulus preferences, we taught 6 adults with profound multiple disabilities to emit 2 different responses to activate highly preferred stimuli. All participants learnt to activate…
Full Text Available The article analyzes the relationship parameters of temperament with offence severity in mental health subjects. The results of a comparative study of males with violent, nonviolent civil disturbances and non-criminals were observed. The proposition of the study is to measure individual traits in two ways: as a quantitate factor, that includes assessment of gradual change from lower to higher crime severity, like State Anxiety and Behavior Inhibition, or as qualitative factor, that includes revealing of multilevel combinations of individual characteristics based on innate traits of nervous system. There are correlation of activation processes and physical aggression in group of subjects with violent crimes, and activation processes and characteristics of communication sphere in subjects with nonviolent crimes.
Tse, M My; Kwan, R Yc; Lau, J L
The increasing longevity of people with intellectual disability is testimony to the positive developments occurring in medical intervention. Nonetheless, early-onset age-related issues and concerns cause deterioration of their overall wellbeing. This paper aimed to explore the issues and concerns about individuals with intellectual disability as they age. Articles that discussed people older than 30 years with an intellectual disability and those that identified ageing health issues and concerns were included. Only studies reported in English from 1996 to 2016 were included. We searched PubMed, Google Scholar, and Science Direct using the terms 'intellectual disability', 'ageing', 'cognitive impairment', 'health', and 'screening'. Apart from the early onset of age-related health problems, dementia is more likely to develop by the age of 40 years in individuals with intellectual disability. Geriatric services to people with intellectual disability, however, are only available for those aged 60 years and older. Cognitive instruments used for the general population are not suitable for people with intellectual disability because of floor effects. In Hong Kong, the Chinese version of the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities is the only validated instrument for people with intellectual disability. The use of appropriate measurement tools to monitor the progression of age-related conditions in individuals with intellectual disability is of great value. Longitudinal assessment of cognition and function in people with intellectual disability is vital to enable early detection of significant deterioration. This allows for therapeutic intervention before substantial damage to the brain occurs such as dementia that hastens cognitive and functional decline.
Havinga-Top, Thamar; Waninge, Aly; van der Schans, Cees; Jager, Harriët
Background: Body composition measurements provide importanti nformation about physical fitness and nutritional status. People with severe intellectual and visual disabilities (SIVD) have an increased risk for altered body composition. Bioelectrical impedance analysis (BIA) has been evidenced as a
Havinga-Top, A. M.; Waninge, A.; van der Schans, C. P.; Jager-Wittenaar, H.
Background: Body composition measurements provide important information about physical fitness and nutritional status. People with severe intellectual and visual disabilities (SIVD) have an increased risk for altered body composition. Bioelectrical impedance analysis (BIA) has been evidenced as a
Rieken, Rob; van Goudoever, Johannes B.; Schierbeek, Henk; Willemsen, Sten P.; Calis, Elsbeth A. C.; Tibboel, Dick; Evenhuis, Heleen M.; Penning, Corine
Accurate prediction equations for estimating body composition and total energy expenditure (TEE) in children with severe neurologic impairment and intellectual disability are currently lacking. The objective was to develop group-specific equations to predict body composition by using
ACED LOPEZ, Sebastian; Corno, Fulvio; DE RUSSIS, Luigi
Being able to play games in early years is very important for the development of children. Even though, children with physical disabilities encounter several obstacles that exclude them from engaging in many popular games. In particular, children with severe motor disabilities that rely on one-switch interfaces for accessing electronic devices find dynamic video games completely unplayable. In this paper we present the development and evaluation of GNomon: a framework, based on the NOMON inte...
Werner, Shirli; Hochman, Yael
Identity development among individuals with disabilities may depend on their being included in central institutions in society. The centrality of the military in Israeli society makes it a highly important setting for inclusion and identity development. We examined the self-identity of young adults with intellectual disabilities who serve in the "Equal in Uniform" project. Forty-nine interviews were conducted with 31 individuals with intellectual disabilities. Findings showed that military service helped develop the identity of soldiers, which enhanced their self-efficacy. Participants described their participation in the military as an opportunity to take an active part in socially valued roles. Findings are discussed with reference to the effect of the project on the self-identity of individuals with intellectual disabilities. The meaning of successfully serving in socially valued roles for self-efficacy is discussed. Implications for rehabilitation Completing socially valued roles leads to greater self-efficacy, enhanced self-esteem and greater psychological well-being among individuals with intellectual disabilities. Inclusion of individuals with intellectual disabilities within a central community setting (specifically the military) allows them to deal with issues of identity development, as it does for other young people without intellectual disabilities. Receiving ongoing positive input from others for one's abilities and success is a conducive factor in positive identity formation.
N S Andreasen Struijk, Lotte; Lontis, Eugen R; Gaihede, Michael; Caltenco, Hector A; Lund, Morten Enemark; Schioeler, Henrik; Bentsen, Bo
Individuals with tetraplegia depend on alternative interfaces in order to control computers and other electronic equipment. Current interfaces are often limited in the number of available control commands, and may compromise the social identity of an individual due to their undesirable appearance. The purpose of this study was to implement an alternative computer interface, which was fully embedded into the oral cavity and which provided multiple control commands. The development of a wireless, intraoral, inductive tongue computer was described. The interface encompassed a 10-key keypad area and a mouse pad area. This system was embedded wirelessly into the oral cavity of the user. The functionality of the system was demonstrated in two tetraplegic individuals and two able-bodied individuals Results: The system was invisible during use and allowed the user to type on a computer using either the keypad area or the mouse pad. The maximal typing rate was 1.8 s for repetitively typing a correct character with the keypad area and 1.4 s for repetitively typing a correct character with the mouse pad area. The results suggest that this inductive tongue computer interface provides an esthetically acceptable and functionally efficient environmental control for a severely disabled user. Implications for Rehabilitation New Design, Implementation and detection methods for intra oral assistive devices. Demonstration of wireless, powering and encapsulation techniques suitable for intra oral embedment of assistive devices. Demonstration of the functionality of a rechargeable and fully embedded intra oral tongue controlled computer input device.
Marco Di Nardo
Full Text Available Background: Inclusion refers to the notion that all students, regardless of disability (mild or severe, will be taught in regular education classes even if special resources are needed. Attitudes about inclusion are extremely complex and vary from country to country and school to school. One of the factors influencing the effective implementation of inclusion is the teacher's attitudes. The latest results from literature show that attitudes toward people with disabilities are changing in a positive direction over the last few decades. Objective: The purpose of this study was to examine the effects of an undergraduate adapted physical education course on the attitudes of pre-service physical educators toward individuals with disabilities. Methods: The Attitudes Towards Individuals with Physical Disabilities in Physical Education (ATIPDPE instrument, based upon the Theory of Planned Behaviour (Ajzen, 1991 was used to measure the attitudes of pre-service teachers within three groups of students of the Department of Sport Science at the Università Degli Studi di Napoli "Parthenope" (Italy enrolled in the 1st and 3rd year of Bachelor's studies in the Department of Sport Science, and students enrolled in the last year of a Master degree in Motor Activities and Preventive for Health. The software package SPSS 19.0 was used to analyze results via a Mann-Whitney U test and multiple regression analysis. Results: Although no significant differences between the groups were found in relation to group year or subject major, results found positive attitudes of pre-service teachers towards inclusion (Physical Education (PE 1st year attitude (ATT mean = 58.93; PE 3rd year ATT mean = 61.11; Postgraduate 2nd year mean = 59.80, as well as very high intentions. Attitudes were found to account for 30% of variance of intentions (R2 = .30. Conclusion: This research concluded that it is necessary to further improve and develop attitudes and intentions
Burke, Meghan M; Taylor, Julie Lounds; Urbano, Richard; Hodapp, Robert M
With the growing life expectancy for individuals with intellectual and developmental disabilities, siblings will increasingly assume responsibility for the care of their brother or sister with intellectual and developmental disabilities. Using a 163-item survey completed by 757 siblings, the authors identified factors related to future caregiving expectations. Siblings expected to assume greater caregiving responsibility for their brother or sister with disabilities if they were female, had closer relationships with and lived closer to their brother or sister with intellectual and developmental disabilities, and were the lone sibling without a disability. Siblings who expected to assume higher levels of caregiving had parents who were currently more able to care for their brother or sister with disabilities. With a better understanding of who intends to fulfill future caregiving roles, support can be provided to these siblings.
Jones, Sara K.
This article explores trends in research since the 1975 passage of the Education for All Handicapped Children Act (now known as the Individuals with Disabilities Education Act), notes gaps in the literature, and offers suggestions for future directions music education researchers could take in exploring the needs and experiences of music teachers…
Carver, Jordan; Ganus, Ashley; Ivey, Jon Mark; Plummer, Teresa; Eubank, Ann
This study aims to address the gap in research and contribute to the body of knowledge on the perspectives assistive technology device users have toward their devices. Mixed methods were used to better understand the impact of mobility assistive technology devices (MATDs) on participation for individuals with disabilities. The Functional Mobility Assessment was administered in conjunction with two qualitative questions developed by the research team allowing participants to expound on the impact of their MATD experience. Participants were recruited online via the National Spinal Cord Injury Association website and in-person at Abilities Expo in Atlanta, Georgia, and the International Seating Symposium in Nashville, Tennessee. Results are consistent with findings from prior research regarding accessibility for individuals with disabilities. Corresponding findings were found in both the quantitative and qualitative data and are categorized into several major themes: environment (indoor and outdoor), surface heights, transportation, dependence, independence, quality of life and participation. Quantitative data from this study indicate that users of MATD are satisfied with the way in which their devices enable maneuvering indoors, while qualitative data suggest otherwise. Implications for healthcare practitioners are described and future recommendations are provided. Implications for Rehabilitation Healthcare professionals should advocate for proper mobility assistive technology devices (MATDs) for their patients in order to enable increased independence, safety and efficiency. Healthcare professionals must be cognizant of the impact of the environment and/or environmental barriers when prescribing MATD. Additional areas of interest for future research may include investigating the impact of MATD in association with date of onset of disability, according to diagnoses, or specific to length of time since acquiring the device.
Full Text Available Abstract Background Severely disabling chronic pain in the adult population is strongly associated with a range of negative health consequences for individuals and high health care costs, yet its prevalence in young adults is less clear. Methods All adults aged 18–25 years old registered with three general practices in North Staffordshire were invited to complete a postal questionnaire containing questions on pain within the last 6 months, pain location and duration. Severity of chronic pain was assessed by the Chronic Pain Grade. Severely disabling chronic pain was defined as pain within the last six months that had lasted for three months or more and was highly disabling-severely limiting (Grade IV. Results 858 responses from 2,389 were received (adjusted response = 37.0%. The prevalence of any pain within the previous six months was 66.9% (95%CI: 63.7%, 70.1%. Chronic pain was reported by 14.3% (95%CI: 12.0%, 16.8% of respondents with severely disabling chronic pain affecting 3.0% (95%CI: 2.0%, 4.4% of this population. Late responders were very similar to early responders in their prevalence of pain. Cross-checking the practice register against the electoral roll suggested register inaccuracies contributed to non-response. Conclusion Pain is a common phenomenon encountered by young adults, affecting 66.9% of this study population. Previously observed age-related trends in severely disabling chronic pain in older adults extend to younger adults. Although a small minority of younger adults are affected, they are likely to represent a group with particularly high health care needs. High levels of non-response in the present study means that these estimates should be interpreted cautiously although there was no evidence of non-response bias.
Devshi, Rajal; Shaw, Sarah; Elliott-King, Jordan; Hogervorst, Eef; Hiremath, Avinash; Velayudhan, Latha; Kumar, Satheesh; Baillon, Sarah; Bandelow, Stephan
A review of 23 studies investigating the prevalence of Behavioural and psychological symptoms of dementia (BPSD) in the general and learning disability population and measures used to assess BPSD was carried out. BPSD are non-cognitive symptoms, which constitute as a major component of dementia regardless of its subtype Research has indicated that there is a high prevalence of BPSD in the general dementia population. There are limited studies, which investigate the prevalence of BPSD within individuals who have learning disabilities and dementia. Findings suggest BPSDs are present within individuals with learning disabilities and dementia. Future research should use updated tools for investigating the prevalence of BPSD within individuals with learning disabilities and dementia.
Full Text Available Background: Literature recommends that refractory cases with lumbar disc herniation and appropriate indications are better to be treated surgically, but do all the patients throughout the world consent to the surgery with a same disability and pain threshold? We aim to elucidate the prevalence and severity of disabilities and pain in Iranian patients with lumbar disc herniation who have consented to the surgery. Methods: In this case series study, we clinically evaluated 194 (81 female and 113 male admitted patients with primary, simple, and stable L4-L5 or L5-S1 lumbar disc herniation who were undergoing surgical discectomy. The mean age of the patients was 38.3±11.2 (range: 18-76 years old. Disabilities were evaluated by the items of the Oswestry Disability Index (ODI questionnaire and severity of pain by the Visual Analogue Scale (VAS. Chi-square test was used to compare the qualitative variables. Results: Severe disability (39.2% and crippled (29.9% were the two most common types of disabilities. Mean ODI score was 56.7±21.1 (range: 16-92. Total mean VAS in all patients was 6.1±1.9 (range: 0-10. Sex and level of disc herniation had no statistical effect on preoperative ODI and VAS. The scale of six was the most frequent scale of preoperative VAS in our patients. Conclusion: Iranian patients with lumbar disc herniation who consented to surgery have relatively severe pain or disability. These severities in pain or disabilities have no correlation with sex or level of disc herniation and are not equal with developed countries.
Qian, X; Tichá, R; Larson, S A; Stancliffe, R J; Wuorio, A
Being engaged in daily activities is a strong indicator of quality of life for individuals with intellectual disability (ID) who live in small community group homes. This study aimed to identify individual and organisational factors that predict high levels of engagement. Individuals with ID (n = 78), direct support professionals (DSPs; n = 174) and supervisors (n = 21) from 21 US group homes participated in the study. For each individual with ID, we conducted 80 min of observation at the person's residence. Information was also gathered regarding demographic characteristics, DSP competence, supervisor years of experience and management practices. Data were analysed using multilevel modelling. On average, individuals were engaged in social activities 12% of observed time and non-social activities 35% of the time. Individuals with greater adaptive skills who were supported by more competent staff showed significantly higher levels of social engagement. Individuals with less severe deficits in adaptive behaviours and less challenging behaviour showed higher levels of non-social engagement. Although none of the factors related to group homes were significant, 24% of the variance in non-social engagement existed among group homes. These results suggested that engagement is a dynamic construct. The extent to which an individual with ID is engaged in daily life is a result of interplay between the individual's characteristics and the group home environment. Future research is needed to investigate the influence of variables specific to the group home on the engagement level of individuals with disabilities. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Jingree, Treena; Finlay, W M L
Over the last decade the UK Government has made proposals to empower individuals with learning disabilities. Strategies have been implemented to reduce institutionalisation and social segregation. Consequently, some learning disability services are being phased out and the focus of care has moved away from institutions and into the community and family domain. Focusing on discourse as a site for social action and identity construction, we used critical discursive psychology to examine focus group discussions between family carers about facilitating the independence of adult family members with learning disabilities. Unlike official UK Government and learning disability services' constructions of empowerment policy, we found that parents invoked empowerment talk: (1) as a resource to construct the facilitation of independence as an abstract, irresponsible, politically correct professional trend; (2) dilemmatically with meritocratic or practical arguments to undermine notions of facilitating choices; and (3) as a resource to construct new service developments as contrary to the preferences of people with learning disabilities. Parents also described individuals with learning disabilities as unable to cope, and drew stark contrasts between their practice and those of service-professionals when expressing concerns about empowerment. We discuss possible implications of such discourses and contrasts on opportunities for empowering individuals with learning disabilities. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.
Zimmerer, Vitor C; Cowell, Patricia E; Varley, Rosemary A
One factor in syntactic impairment in aphasia might be damage to general structure processing systems. In such a case, deficits would be evident in the processing of syntactically structured non-linguistic information. To explore this hypothesis, we examined performances on artificial grammar learning (AGL) tasks in which the grammar was expressed in non-linguistic visual forms. In the first experiment, AGL behavior of four aphasic participants with severe syntactic impairment, five aphasic participants without syntactic impairment, and healthy controls was examined. Participants were trained on sequences of nonsense stimuli with the structure A(n)B(n). Data were analyzed at an individual level to identify different behavioral profiles and account for heterogeneity in aphasic as well as healthy groups. Healthy controls and patients without syntactic impairment were more likely to learn configurational (item order) than quantitative (counting) regularities. Quantitative regularities were only detected by individuals who also detected the configurational properties of the stimulus sequences. By contrast, two individuals with syntactic impairment learned quantitative regularities, but showed no sensitivity towards configurational structure. They also failed to detect configurational structure in a second experiment in which sequences were structured by the grammar A(+)B(+). We discuss the potential relationship between AGL and processing of word order as well as the potential of AGL in clinical practice. © 2013 Published by Elsevier Ltd.
Ellis, Roger; Hogard, Elaine; Sines, David
This article describes a risk audit carried out on the support provided for 36 people with profound learning disabilities who had been resettled from hospital care to supported housing. The risks were those factors identified in the literature as associated with deleterious effects on quality of life. The audit was carried out with a specially designed tool that covered 24 possible risks and involved a support worker familiar with the service user choosing the most appropriate statement regarding each risk. Their judgements were verified by care managers and social needs assessors. Whilst one or more risks were identified for 32 of the 36 service users, the overall result showed relatively low risks for the group as a whole with 62 incidences (7%) from a possible 864, which nevertheless highlighted several areas that needed attention. The results of the audit have led to action plans for the provision and for the individual service users for whom risks were identified.
Rivera, Christopher J.; Jimenez, Bree A.; Baker, Joshua N.; Spies, Tracy; Mims, Pamela J.; Ginevra, Courtade
The needs of culturally and linguistically diverse (CLD) students with moderate or severe intellectual disability (ID) are quite unique and complex. CLD students with moderate or severe ID face many of the same issues as their non-disabled CLD peers; however, due to the nature of their disability this may lead to even less access to the general…
Sigurdardottir, Solrun; Andelic, Nada; Skandsen, Toril; Anke, Audny; Roe, Cecilie; Holthe, Oyvor Oistensen; Wehling, Eike
To explore the frequency of posttraumatic olfactory (dys)function 1 year after severe traumatic brain injury (TBI) and determine whether there is a relationship between olfactory identification and neuropsychological test performance, injury severity and TBI-related disability. A population-based multicenter study including 129 individuals with severe TBI (99 males; 16 to 85 years of age) that could accomplish neuropsychological examinations. Olfactory (dys)function (anosmia, hyposmia, normosmia) was assessed by the University of Pennsylvania Smell Identification Test (UPSIT) or the Brief Smell Identification Test (B-SIT). Three tests of the Delis-Kaplan Executive Function System (D-KEFS) were used to assess processing speed, verbal fluency, inhibition and set-shifting, and the California Verbal Learning Test-II was used to examine verbal memory. The Glasgow Outcome Scale-Extended (GOSE) was used to measure disability level. Employing 2 different smell tests in 2 equal-sized subsamples, the UPSIT sample (n = 65) classified 34% with anosmia and 52% with hyposmia, while the B-SIT sample (n = 64) classified 20% with anosmia and 9% with hyposmia. Individuals classified with anosmia by the B-SIT showed significantly lower scores for set-shifting, category switching fluency and delayed verbal memory compared to hyposmia and normosmia groups. Only the B-SIT scores were significantly correlated with neuropsychological performance and GOSE scores. Brain injury severity (Rotterdam CT score) and subarachnoid hemorrhage were related to anosmia. Individuals classified with anosmia demonstrated similar disability as those with hyposmia/normosmia. Different measures of olfaction may yield different estimates of anosmia. Nevertheless, around 1 third of individuals with severe TBI suffered from anosmia, which may also indicate poorer cognitive outcome. (c) 2015 APA, all rights reserved).
Norin, H; Krafft, M; Korner, J; Nygren, A; Tingvall, C
Injury classification and assessment is one of the most important fields of injury prevention. At present, injury assessment focuses primarily on the risk of fatalities, in spite of the fact that most people who are injured survive the trauma. The net result of a fatality-based approach is that safety and vehicle engineers must make decisions with an incomplete, and sometimes misleading, picture of the traffic safety problem. By applying disability scaling reflecting long-term consequences to injury data, the most significant disabling injuries can be identified. The priorities change with the level of disability used in the scaling. In this study, the risk of permanent medical disability due to different injuries was derived and linked to abbreviated injury scale (AIS) values for 24,087 different injured body regions. This material is based on insurance data. To study how the importance of different bodily injuries changes with different severity assessments in a realistic real-world injury distribution, Swedish insurance industry disability scaling was applied to 3066 cases of belted Volvo drivers involved in frontal collisions. Crash severity was included in the study by using equivalent barrier speed (EBS). When lower levels of disability are included, injuries to the neck and the extremities become the most important, while brain and skull injuries become the most prominent at higher levels of disability. The results presented in this article should be regarded as a contribution to the development of a suitable disability scaling method. The results can also be utilized to further injury research and vehicle design aimed at reducing injuries which have the most important long-term disability consequences.
Recently, the attendance rate for breast screening has been increasing in Japan. However, little is known about how to conduct effective breast cancer screening, especially for patients with mental disability. The purpose of this study was to clarify the present status of breast cancer screening for severely disabled patients. Breast screening was performed for 160 disabled patients by physical examination and ultrasound from 2002 to 2005. The patients included 158 women and two men, with an average age of 59 years old. Ten disabled patients (10/160; 6.3%) showed abnormal findings on physical examination and four (4/160; 2.5%) showed probably benign findings by ultrasound examination. Mammography (MMG) screening was performed for only 33 patients (33/160; 21%), one of whom needed further examination. One lesion was diagnosed as breast cancer (1/160; 0.63%). Breast ultrasound is useful for severely disabled patients because it is painless, easy and rapid to perform. On the other hand, it is sometimes difficult for such patients to participate in MMG screening because of their inability to adapt to the examination. Therefore, some psychological method, for example operant conditioning, will be necessary for breast screening of patients with severe mental disability. (author)
Vinkler, Chana; Leshinsky-Silver, Esther; Michelson, Marina; Haas, Dorothea; Lerman-Sagie, Tally; Lev, Dorit
Genetic syndromes with proportionate severe short stature are rare. We describe two sisters born to nonconsanguineous parents with severe linear growth retardation, poor weight gain, microcephaly, characteristic facial features, cutaneous syndactyly of the toes, high myopia, and severe intellectual disability. During infancy and early childhood, the girls had transient hepatosplenomegaly and low blood cholesterol levels that normalized later. A thorough evaluation including metabolic studies, radiological, and genetic investigations were all normal. Cholesterol metabolism and transport were studied and no definitive abnormality was found. No clinical deterioration was observed and no metabolic crises were reported. After due consideration of other known hereditary causes of post-natal severe linear growth retardation, microcephaly, and intellectual disability, we propose that this condition represents a newly recognized autosomal recessive multiple congenital anomaly-intellectual disability syndrome. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Ditchman, Nicole; Sung, Connie; Easton, Amanda B; Johnson, Kristina S; Batchos, Elisabeth
Although the negative impact of symptom severity on subjective well-being outcomes has been established among individuals with brain injury, the mediating and protective role that positive human traits might have on this relationship has not been adequately explored. The purpose of this study was to examine the impact of social self-efficacy and disability acceptance on the relationship between symptom severity and life satisfaction among individuals with brain injury. Hierarchical regression analysis and correlation techniques were used to test a hypothesized dual-mediation model of life satisfaction in a sample of 105 adults with acquired brain injury. Results indicated that social self-efficacy and disability acceptance fully mediated the relationship between symptom severity and life satisfaction, lending support for a dual-mediation model with disability acceptance being the strongest contributor. These findings suggest there may be considerable value for rehabilitation providers to develop strengths-based service strategies and/or specialized intervention programs that focus on capitalizing these positive human traits to promote life satisfaction and well-being for clients with brain injury. Implications for clinical practice and future research direction are also discussed.
Louwerse, Ilse; Huysmans, Maaike A; van Rijssen, H Jolanda; van der Beek, Allard J; Anema, Johannes R
Today, work disability is one of the greatest social and labour market challenges for policy makers in most OECD countries, where on average, about 6% of the working-age population relies on disability benefits. Understanding of factors associated with long-term work disability may be helpful to identify groups of individuals at risk for disability benefit entitlement or continuing eligibility, and to develop effective interventions for these groups. The purpose of this study is to provide insight into the main diagnoses of workers who qualify for disability benefits and how these diagnoses differ in age, gender and education. Using a five-year follow-up, we examined the duration of disability benefits and how durations differ among individuals with various characteristics. We performed a cohort study of 31,733 individuals receiving disability benefits from the Dutch Social Security Institute (SSI) with a five-year follow-up. Data were collected from SSI databases. Information about disorders was assessed by an insurance physician upon benefit application. These data were used to test for significant relationships among socio-demographics, main diagnoses and comorbidity, and disability benefit entitlement and continuing eligibility. Mental disorders were the most frequent diagnosis for individuals claiming work disability. Diagnoses differed among age groups and education categories. Mental disorders were the main diagnosis for work disability for younger and more highly educated individuals, and physical disorders (generally musculoskeletal, cardiovascular and cancer) were the main diagnosis for older and less educated individuals. In 82% of the claims, the duration of disability benefit was five years or more after approval. Outflow was lowest for individuals with (multiple) mental disorders and those with comorbidity of mental and physical disorders, and highest for individuals with (multiple) physical disorders. The main diagnosis for persons entitled to
Robertson, Janet; Baines, Susannah; Emerson, Eric; Hatton, Chris
Background: Poor postural care can have severe and life-threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function. Method: Studies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and…
Hoedeman, Rob; Blankenstein, Annette H.; Krol, Boudien; Koopmans, Petra C.; Groothoff, Johan W.
Introduction: The primary objectives were to compare the duration of sickness absence in employees with high levels of somatic symptom severity (HLSSS) with employees with lower levels of somatic symptom severity, and to establish the long-term outcomes concerning return to work (RTW), disability
Walton, Catherine; Kerr, Mike
Background: The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and…
Participation in social networking sites has considerable potential to leverage the individual's social capital, including persons with intellectual disabilities, whose real-world social networks are fairly limited. This study aimed to understand how individuals with intellectual disabilities use Facebook to access social capital benefits, if at all. Qualitative interviews and observations were conducted with 20 adult Facebook users with intellectual disabilities. The online participation enhanced their bonding social capital as well as contributed to their psychological well-being through increasing their online visibility, popularity and sense of belonging. At the same time, they experienced stress and frustration due to usage difficulties, which prevented them from enhancing their bridging social capital. Participation in social networking sites may also leverage bridging social capital of persons with intellectual disabilities, but they need a more accessible platform and ongoing support to ensure safe and fruitful participation. © 2016 John Wiley & Sons Ltd.
Brandström, J; Vetander, M; Lilja, G; Johansson, S G O; Sundqvist, A-C; Kalm, F; Nilsson, C; Nopp, A
Treatment with omalizumab has shown a positive effect on food allergies, but no dosages are established. Basophil allergen threshold sensitivity (CD-sens) can be used to objectively measure omalizumab treatment efficacy and correlates with the outcome of double-blind placebo-controlled food challenge to peanut. To evaluate whether individualized omalizumab treatment monitored by CD-sens could be an effective intervention for suppression of allergic reactions to peanut. Severely peanut allergic adolescents (n = 23) were treated with omalizumab for 8 weeks, and CD-sens was analysed before and after. Based on whether CD-sens was suppressed after 8 weeks, the patients either were subject to a peanut challenge or received eight more weeks with increased dose of omalizumab, followed by peanut challenge or another 8-week cycle of omalizumab. IgE and IgE-antibodies to peanut and its components were analysed before treatment. After individualized omalizumab treatment (8-24 weeks), all patients continued with an open peanut challenge with no (n = 18) or mild (n = 5) objective allergic symptoms. Patients (n = 15) needing an elevated omalizumab dose (ED) to suppress CD-sens had significantly higher CD-sens values at baseline 1.49 (0.44-20.5) compared to those (n = 8) who managed with normal dose (ND) 0.32 (0.24-5.5) (P omalizumab, monitored by CD-sens, is an effective and safe treatment for severe peanut allergy. The ratio of IgE-ab to storage protein Ara h 2/IgE as well as CD-sens to peanut may predict the need of a higher omalizumab dose. Clinical trials numbers: EudraCT; 2012-005625-78, ClinicalTrials.gov; NCT02402231. © 2016 John Wiley & Sons Ltd.
Fesko, Sheila Lynch; Hall, Allison Cohen; Quinlan, Jerrilyn; Jockell, Catherine
As individuals with intellectual and developmental disabilities become more engaged in community employment, it will be critical to consider how their employment experience changes as they age. Similar to other seniors, individuals will need to consider whether they want to maintain their employment, reduce their work commitment, or retire…
Steinberg, Marc L.; Heimlich, Laura; Williams, Jill M.
Tobacco use is the leading preventable cause of death in the United States. Although few tobacco control efforts target individuals with intellectual and/or developmental disabilities, this population may be especially vulnerable to the deleterious effects of tobacco use and dependence. Individuals with intellectual and developmental disabilities…
Morash-Macneil, Virginia; Johnson, Friggita; Ryan, Joseph B.
Research has shown that assistive technology (AT) can help support employment skills for individuals with intellectual disabilities (IDs). The authors of this review examined the effectiveness of various types of AT support for individuals with ID in the workplace with a focus on the participant's independent ability to demonstrate a specific…
Roelofs, R. L.; Visser, E. M.; Berger, H. J. C.; Prins, J. B.; Van Schrojenstein Lantman-De Valk, H. M. J.; Teunisse, J. P.
Background: Executive functioning (EF) is important for adequate behavioural functioning and crucial for explaining symptoms of autism spectrum disorders (ASD) in individuals with normal intelligence, but is scarcely studied in individuals with ASD and intellectual disabilities (ID). We therefore study EF in an ID population by comparing…
Mendelsohn, Steven; Edyburn, Dave L; Rust, Kathy L; Schwanke, Todd D; Smith, Roger O
We know that work is recognized as a central component of life for individuals with and without disabilities. It yields many physical and psychological benefits to the individual while simultaneously contributing numerous benefits to society. Lawmakers have enacted a plethora of laws designed to prevent discrimination, provide incentives for employers to hire individuals with disabilities, and facilitate job training/career preparation. Assistive technology figures prominently in disability employment law as a critical strategy for gaining access and supporting employment and upward mobility in the workplace. However, little systematic effort has been devoted to examining assistive technology use and outcomes as they relate to the employment of individuals with disabilities. The purpose of this article is to articulate a series of issues that permeate assistive technology outcome measurement in employment settings and subsequently affect the use of research knowledge for federal and state policy makers. For each issue, the authors pose three questions for critical analysis: Does the law compel the provision of assistive technology? Does outcome data play any part in the operation of the law? When it does, what kind of data would be useful to collect and where could it be found? Finally, the authors provide a brief glimpse of the current and future research efforts concerning the RSA-911 database. The recent database summaries exemplify the importance of such a national data collection system for informing federal policy, particularly concerning the contributions of assistive technology device use and services on improving the employment of individuals with disabilities.
Griffiths, Colin; Smith, Martine
People with severe and profound intellectual disability typically demonstrate a limited ability to communicate effectively. Most of their communications are non-verbal, often idiosyncratic and ambiguous. This article aims to identify the process that regulates communications of this group of people with others and to describe the methodological approach that was used to achieve this. In this qualitative study, two dyads consisting of a person with severe or profound intellectual and multiple disability and a teacher or carer were filmed as they engaged in school-based activities. Two 1-hour videotapes were transcribed and analysed using grounded theory. Attuning was identified within the theory proposed here as a central process that calibrates and regulates communication. Attuning is conceptualized as a bidirectional, dyadic communication process. Understanding this process may support more effective communication between people with severe or profound intellectual and multiple disability and their interaction partners. © 2015 John Wiley & Sons Ltd.
This article evaluates three early intervention approaches--applied behavior analysis, TEAACH (Treatment and Education of Autistic and Related Communication Handicapped Children), a structured classroom-based program, and relationship therapy/"floor time"--to identify which aspects of each approach complement individual learning styles…
Horovitz, Max; Matson, Johnny L.; Sipes, Megan; Shoemaker, Mary; Belva, Brian; Bamburg, Jay W.
Individuals with intellectual disability (ID) have a high risk for developing comorbid psychopathology. While researchers have shown that symptoms of psychopathology remain relatively stable in children with ID over time, little research has been conducted to demonstrate symptom stability for adults with ID. Incidence of psychopathology symptoms…
Walker, J G; Anstey, K J; Lord, S R
To determine whether demographic, health status and psychological functioning measures, in addition to impaired visual acuity, are related to vision-related disability. Participants were 105 individuals (mean age=73.7 years) with cataracts requiring surgery and corrected visual acuity in the better eye of 6/24 to 6/36 were recruited from waiting lists at three public out-patient ophthalmology clinics. Visual disability was measured with the Visual Functioning-14 survey. Visual acuity was assessed using better and worse eye logMAR scores and the Melbourne Edge Test (MET) for edge contrast sensitivity. Data relating to demographic information, depression, anxiety and stress, health care and medication use and numbers of co-morbid conditions were obtained. Principal component analysis revealed four meaningful factors that accounted for 75% of the variance in visual disability: recreational activities, reading and fine work, activities of daily living and driving behaviour. Multiple regression analyses determined that visual acuity variables were the only significant predictors of overall vision-related functioning and difficulties with reading and fine work. For the remaining visual disability domains, non-visual factors were also significant predictors. Difficulties with recreational activities were predicted by stress, as well as worse eye visual acuity, and difficulties with activities of daily living were associated with self-reported health status, age and depression as well as MET contrast scores. Driving behaviour was associated with sex (with fewer women driving), depression, anxiety and stress scores, and MET contrast scores. Vision-related disability is common in older individuals with cataracts. In addition to visual acuity, demographic, psychological and health status factors influence the severity of vision-related disability, affecting recreational activities, activities of daily living and driving.
Panicker, Anuja S; Ramesh, Sonali
The psychological status of caregivers of individuals with intellectual disability and psychiatric illness (PI) is important for effective management. The aim of this study was to examine the psychological status and its relationship with coping styles among these caregivers. Caregivers (N = 80) of individuals with intellectual disability (n = 40) and PI (n = 40) were administered a socio-demographic questionnaire, depression, anxiety and stress scale and COPE Inventory. Caregivers experienced depression, anxiety and stress symptoms. These symptoms were found to be significantly higher among caregivers of individuals with intellectual disability than those with PI. The most common coping style used was religious coping. Use of positive reinterpretation and growth was associated with lower levels of depression and stress symptoms. Caregivers' mental health plays an important role in the quality of care delivery and outcome. Use of appropriate coping styles can reduce the impact of these symptoms. © 2018 John Wiley & Sons Ltd.
Exploring the life stories of leaders in the self-advocacy movement can expand our knowledge about leadership development of individuals with developmental disabilities. A better understanding of this process may assist with supporting the movement and leadership development of youth with disabilities. In-depth qualitative interviews were conducted with 13 leaders in the self-advocacy movement within the USA in order to explore their life stories. Purposeful sampling contributed to a diverse sample of leaders. A grounded theory approach led to the identification of major themes and factors associated with their leadership development. Four major themes emerged: (1) disability oppression and resistance; (2) environmental supports and relationships; (3) leadership skills; and (4) advanced leadership opportunities. Findings have conceptual and practical relevance for future interventions and research. © 2010 The Author. Journal of Intellectual Disability Research © 2010 Blackwell Publishing Ltd.
Kıvanç, Sertaç Argun; Akova-Budak, Berna; Olcaysü, Osman Okan; Çevik, Sadık Görkem
To identify the prevalence of ophthalmologic diseases in elderly patients who had been classified as severely disabled and to identify the ophthalmologic conditions leading to visual impairment and blindness. The medical records of 2806 patients who had applied to the Health Board of the Erzurum Region Training and Research Hospital between January 2011 and December 2012 were reviewed. One hundred ninety-nine patients aged >64 years who were classified as severely disabled with disability rates of over 50%, and who were unable to care for themselves or to move and/or communicate without help were included in the study. The most frequently seen disabilities were neurological (47.2%) and those resulting from eye diseases (17.1%). The most common ophthalmologic diseases were cataract, glaucoma, and age-related macular degeneration. The mean right and left eye visual acuities were 1.17 ± 1.10 logMAR and 1.13 ± 1.0 logMAR, respectively. Of the 60 patients with ophthalmologic diseases or conditions, 33 were blind (visual acuity worse than 20/400) and 10 were visually impaired (visual acuity worse than 20/70 but better than 20/400). Cataracts were the main cause of blindness. The mean age of the patients who were still being followed up at the time of application to the disability board was significantly lower than that of the others (p =0.015). Seventy-nine percent of the blind patients were from rural areas, and 88% of these had no regular follow-up. Among the blind and visually impaired, significantly more patients from urban areas had social security insurance (SSI) than those from rural areas (p =0.043). Nearly 64% of the blind patients were women. The follow-up rate was significantly lower in women (p =0.025). According to multinomial logistic regression analysis, the visually impaired and blind patients were more likely to have lower follow-up rates than the other types of severely disabled patients (OR: 0.231, 95% Cl: 0.077-0.688, p=0.009). Blindness gives rise
Sertaç Argun Kıvanç
Full Text Available ABSTRACT Purpose: To identify the prevalence of ophthalmologic diseases in elderly patients who had been classified as severely disabled and to identify the ophthalmologic conditions leading to visual impairment and blindness. Methods: The medical records of 2806 patients who had applied to the Health Board of the Erzurum Region Training and Research Hospital between January 2011 and December 2012 were reviewed. One hundred ninety-nine patients aged >64 years who were classified as severely disabled with disability rates of over 50%, and who were unable to care for themselves or to move and/or communicate without help were included in the study. Results: The most frequently seen disabilities were neurological (47.2% and those resulting from eye diseases (17.1%. The most common ophthalmologic diseases were cataract, glaucoma, and age-related macular degeneration. The mean right and left eye visual acuities were 1.17 ± 1.10 logMAR and 1.13 ± 1.0 logMAR, respectively. Of the 60 patients with ophthalmologic diseases or conditions, 33 were blind (visual acuity worse than 20/400 and 10 were visually impaired (visual acuity worse than 20/70 but better than 20/400. Cataracts were the main cause of blindness. The mean age of the patients who were still being followed up at the time of application to the disability board was significantly lower than that of the others (p =0.015. Seventy-nine percent of the blind patients were from rural areas, and 88% of these had no regular follow-up. Among the blind and visually impaired, significantly more patients from urban areas had social security insurance (SSI than those from rural areas (p =0.043. Nearly 64% of the blind patients were women. The follow-up rate was significantly lower in women (p =0.025. According to multinomial logistic regression analysis, the visually impaired and blind patients were more likely to have lower follow-up rates than the other types of severely disabled patients (OR: 0.231, 95
Cascella, Paul W.; Trief, Ellen; Bruce, Susan M.
Three trends emerged from independent parent and teacher ratings of receptive communication and expressive forms and functions among students with severe disabilities and visual impairment/blindness. Parents had higher ratings than teachers, receptive communication was rated the highest, and no skills occurred often. Implications are discussed for…
Spooner, Fred; Browder, Diane M.
This essay describes major advances in educating students with severe disabilities. The authors propose that applied behavior analysis, the focus on functional life skills, and the promotion of academic content have been the major advances in the "how" and "what" of learning for this population. An increased focus on literacy,…
Wells, Alice; And Others
The bibliography and resource guide summarizes relevant research and information on home care for children with disabilities and chronic illnesses, including those with such diagnoses as spina bifida, cerebral palsy, severe mental retardation, acquired immune deficiency syndrome (AIDS), hemophilia, sickle cell anemia, autism, or failure-to-thrive…
Bos, Isaac; Wynia, Klaske; Drost, Gea; Almansa, Josué; Kuks, Joannes
OBJECTIVE: To adapt and to combine the self-report Upper Extremity Functional Index and Lower Extremity Function Scale, for the assessment of disability severity in patients with a neuromuscular disease and to examine its psychometric properties in order to make it suitable for indicating disease
Neece, Cameron L.; Kraemer, Bonnie R.; Blacher, Jan
The transition from high school to adulthood is a critical life stage that entails many changes, especially for youth with severe intellectual disability. The transition period may be especially stressful for the families of these young adults, who often experience a sudden change, or decrease, in services. However, little research has examined…
Aherne, Cian; Coughlan, Barry
Background: Aquatics is an under-researched but possibly appropriate form of activity for people with severe to profound intellectual disabilities (SPIDs). Aim: The current pilot study investigates the suitability of an aquatics programme for service users with SPIDs. Method: Four service users with SPID completed an 8-12-session aquatics…
Most music educators have little experience or preparation in teaching students with severe intellectual disabilities. Increasing diversity in our schools will require music educators to teach students whose needs exceed those typically found in the music class or ensemble. Facilitating their inclusion in a music program can be immensely rewarding…
Nientimp, Edward G.; Cole, Christine L.
Evaluated effects of procedure to teach appropriate social responses to adolescents with severe disabilities by employing ABA withdrawal design, replicated twice with two students, and AB design with third student. Results showed increases in correct responding and decreases in echolalia following intervention. Generalization of appropriate…
Wang, Peishi; Michaels, Craig A.
This descriptive study gathered quantitative and qualitative data about 368 families in the People's Republic of China who had children with severe disabilities to better understand (a) the perceived needs that families have, (b) the supports available to them, (c) any differences in perceived needs and support between mothers and fathers, and (d)…
Rowsell, A. C.; Clare, I. C. H.; Murphy, G. H.
Background: In other populations, the psychological impact of abuse has been conceptualized as Post Traumatic Stress Disorder (PTSD, DSM-IV, American Psychiatric Association (APA), 1994), but little is known about whether this is appropriate for adults with severe intellectual disabilities and very limited communication skills. Methods: An…
De La Cruz, Carrie F.
Recently the National Reading Panel concluded that systematic and direct instruction in phonological awareness, phonics, fluency, vocabulary, and comprehension that is informed by ongoing assessments of student progress results in positive student achievement (NICHHD, 2002). For students with moderate to severe disabilities and students with…
Kreiner, Janice; Flexer, Robert
The purpose of this study was to develop and to evaluate the Preferences for Leisure Attributes (PLA) Assessment, a forced-choice computer software program for students with severe disabilities and communication difficulties. In order to determine content validity of the PLA Assessment, four experts in related fields assigned critical attributes…
Roberts, Carly A.; Ruppar, Andrea L.; Olson, Amy J.
School administrators play an important role in shaping teaching and learning. However, very little is known regarding how school administrators perceive instruction for students with severe disabilities and how those perceptions shape expectations and visions for instruction. Semistructured interviews were used to interview 12 administrators…
Moor, J.M.H. de; Didden, H.C.M.; Korzilius, H.P.L.M.
BACKGROUND: Young children with developmental disabilities are at risk of food refusal. In case of severe food refusal, children are being fed by nasal or gastrostomy tube. Behavioural treatment may be effective in establishing oral food intake. METHODS: A behavioural treatment package was
Moor, J.M.H. de; Didden, H.C.M.; Korzilius, H.P.L.M.
Background Young children with developmental disabilities are at risk of food refusal. In case of severe food refusal, children are being fed by nasal or gastrostomy tube. Behavioural treatment may be effective in establishing oral food intake. Methods A behavioural treatment package was
Moor, J.M.H. de; Didden, R.; Korzilius, H.P.L.M.
BACKGROUND: Young children with developmental disabilities are at risk of food refusal. In case of severe food refusal, children are being fed by nasal or gastrostomy tube. Behavioural treatment may be effective in establishing oral food intake. METHODS: A behavioural treatment package was
Waninge, Aly; Evenhuis, I.E.; Van Wijck, R.; van der Schans, Cees
Background The purpose of this study is to describe feasibility and test–retest reliability of the six-minute walking distance test (6MWD) and an adapted shuttle run test (aSRT) in persons with severe intellectual and sensory (multiple) disabilities. Materials and Methods Forty-seven persons with
Bruns, Deborah A.
This case study describes the 2-year process of moving a young child with severe disabilities and complex medical needs from a special school setting to a special class in a regular education setting. The child had Marshall-Smith Syndrome, characterized by respiratory, pulmonary, and skeletal abnormalities, and developmental delays due to the…
van den Broek, E.G.C.; Janssen, C.G.C.; van Ramshorst, T.; Deen, L.
Background: The prevalence of visual impairments in people with severe and profound multiple disabilities (SPMD) is the subject of considerable debate and is difficult to assess. Methods: In a typical Dutch care organization, all clients with SPMD (n = 76) participated in the study and specific
Pavlicevic, Mercédès; O'Neil, Nicky; Powell, Harriet; Jones, Oonagh; Sampathianaki, Ergina
This collaborative practitioner research study emerged from music therapists' concerns about the value of improvisational, music-centred music therapy for young adults with severe learning disabilities (SLDs), given the long-term nature of such work. Concerns included the relevance, in this context, of formulating, and reporting on, therapeutic…
Pence, Alicia R.; Dymond, Stacy K.
The purpose of this study was to investigate teachers' beliefs about the participation of students with severe disabilities (SD) in school clubs. Participants were special education teachers (N = 60) of middle and junior high school students with SD from one state. Data were collected using a survey. Results indicate that teachers value including…
Ballard, Sarah L.; Dymond, Stacy K.
This systematic literature review examined research on stakeholders' beliefs about addressing the general education curriculum in general education classrooms with students with severe disabilities (SD). The investigation was limited to studies published in peer-reviewed journals between 1997 and 2015. Ten articles were identified and then…
Ballard, Sarah L.; Dymond, Stacy K.
This case study examined one high school student's access to inclusive education and experiences in an inclusive English class after he acquired severe disabilities and complex health care needs from a nontraumatic brain injury. Multiple sources of data (i.e., interviews, field notes, and documents) were collected and analyzed to formulate…
Sebastián Aced López
Full Text Available Being able to play games in early years is very important for the development of children. Even though, children with physical disabilities encounter several obstacles that exclude them from engaging in many popular games. In particular, children with severe motor disabilities that rely on one-switch interfaces for accessing electronic devices find dynamic video games completely unplayable. In this paper we present the development and evaluation of GNomon: a framework, based on the NOMON interaction modality, that enables the creation of dynamic one-switch games for children with severe motor disabilities. The framework was designed following a series of guidelines elicited in close collaboration with a team of speech therapists, physiotherapists and psychologists from one of the Local Health Agencies in Turin, Italy. Likewise, three mini games were developed for testing the playability of GNomon-based games. Finally, we conducted a series of trials with 8 children with severe motor disabilities assisted by the health agency, in which we found that all of them enjoyed playing the GNomon- based mini games and that 7 of them were able to interact and play autonomously.
Beadle-Brown, J.; Leigh, J.; Whelton, B.; Richardson, L.; Beecham, J.; Baumker, T.; Bradshaw, J.
Background: People with severe and profound intellectual disabilities often spend substantial time isolated and disengaged. The nature and quality of the support appears to be important in determining quality of life. Methods: Structured observations and staff questionnaires were used to explore the quality of life and quality of support for 110…
Griffiths, Colin; Smith, Martine
Background: People with severe and profound intellectual disability typically demonstrate a limited ability to communicate effectively. Most of their communications are non-verbal, often idiosyncratic and ambiguous. This article aims to identify the process that regulates communications of this group of people with others and to describe the…
Full Text Available OBJECTIVE: to characterize the intensity of the support needs of individuals with severe mental illness. METHODS: quantitative and descriptive study that applied the Supports Intensity Scale to a sample comprising 182 individuals. RESULTS: the supports intensity profile identifies groups, individuals, and areas with different needs of support relative to the domains of home living, health, community living, learning, employment, and social living. As a whole, the intensity level of support needs found was low, and the domains with greater needs were employment and social. CONCLUSIONS: identification of the intensity of support needs is helpful in planning integral care and detecting professional training needs. The support provision-centered approach, associated with the person-related outcomes perspective, has been sparsely applied to individuals with mental illness, and this represents the main contribution of the present study. In addition, this study introduces novel approaches to assessment that are both concordant and an innovation in nursing because they might provide a tool for understanding other disabilities.
Waldman, H Barry; Perlman, Steven P
To emphasise the oral health needs of older individuals with intellectual and developmental disabilities, the impact on the individual's general health and the role that can be played by nurses. All too often an examination and consideration of the oral health condition of this patient population by nurses/physicians is cursory at best. The increasing retention of the dentition into later years of life provides both the favourable abilities for eating, speech and self esteem, but also the potential for local and general health concerns. Discursive paper. Based on the findings from dental examination of thousands of international athletes in the Special Olympic Games and clinical experiences in academic and private practice settings for care of individuals with intellectual and developmental disabilities, a discursive listing was developed for use in a preliminary examination of the oral cavity. A nurse can play a critical role in the examination, preventive services and referrals for dental care for older individuals with intellectual and developmental disabilities. The specific oral health needs of older individuals with intellectual and developmental disabilities should be an integral component of the preventive and general health care provided by nurses. © 2012 Blackwell Publishing Ltd.
Skjerbæk, Ag; Næsby, M; Lützen, Karin
This study tested whether upper-body endurance training (ET) is feasible and can be performed at sufficient intensity to induce cardiovascular adaptations in severely disabled patients with progressive multiple sclerosis (MS). Eleven progressive MS patients (6.5 ≤ EDSS ≤ 8.0) scheduled for a four......-week inpatient rehabilitation program were randomized to a control group (CON, n = 5) that received standard individualized MS rehabilitation or an intervention group (EXE, n = 6) that in addition received 10 sessions of predominantly upper-body ET. One patient dropped out of the EXE group (drop-out rate: 1....../6~17%) and no adverse events were recorded. The EXE group completed on average 9.3±0.8 sessions (~96.0±5%). During the ET sessions an average heart rate of 93.9±9.3beats*min(-1) were sustained corresponding to 91.6±6.8% of the maximal pre-intervention heart rate. In the EXE group a trend toward a time*group interaction...
Waldman, H Barry; Perlman, Steven P
The ADA Principles of Ethics and Code of Professional Conduct is an expression of the obligation occurring between the profession and society to meet the oral health needs of the public. At a time of economic concerns for the profession, suggestions are made to bring together the ethics of the profession and the need to expand services to underserved populations, including individuals with disabilities and the poor. The profession's effort to secure economic support for such an effort is possible with increased legislative awareness of the magnitude of the problem. To this end, the number of individuals with disabilities was developed for each Congressional district in New York State in an effort to challenge members of Congress to recognize the need in terms of their constituents, rather than in terms of the tens of millions with disabilities in the United States-which become "just numbers," not actual people.
von Bonsdorff, Mikaela B; Seitsamo, Jorma; Ilmarinen, Juhani; Nygård, Clas-Håkan; von Bonsdorff, Monika E; Rantanen, Taina
Lower occupational class correlates with a higher disability risk later in life. However, it is not clear whether the demands made by mental and physical work relative to individual resources in midlife predict well-being in old age. This study investigated prospectively whether work ability in midlife predicts disability severity in activities of everyday living in old age. Data come from the population-based 28-year follow-up called Finnish Longitudinal Study of Municipal Employees. A total of 2879 occupationally active persons aged 44-58 years answered a questionnaire on work ability at baseline in 1981 and activities of daily living in 2009. At baseline, perceived work ability relative to lifetime best was categorized into excellent, moderate, and poor work ability. At follow-up, disability scales were constructed based on the severity and frequency of difficulties reported in self-care activities of daily living (ADL) and instrumental activities of daily living (IADL). There was a graded prevalence of ADL and IADL disability severity, according to excellent, moderate and poor midlife work ability (pwork ability had an 11 to 20% higher mean ADL or IADL disability severity score, compared with those with excellent midlife work ability (reference), incidence rate ratios (IRR) ranging from 1.11 (95% CI 1.01-1.22) to 1.20 (95% CI 1.10-1.30). Those with poor midlife work ability had a mean ADL or IADL disability severity score 27 to 38% higher than the referent, IRRs ranging from 1.27 (95% CI 1.09-1.47) to 1.38 (95% CI 1.25-1.53). Adjusting for socio-economics, lifestyle factors and chronic diseases only slightly attenuated the associations. Work ability, an indicator of the de- mands made by mental and physical work relative to individuals' mental and physical resources, predicted disability severity 28 years later among middle-aged municipal employees.
Perrier, Marie-Josée; Shirazipour, Celina H; Latimer-Cheung, Amy E
Despite numerous physical, social, and mental health benefits of engaging in moderate and vigorous intensity physical activities (e.g., sport), few individuals with acquired physical disabilities currently participate in adapted sport. Theory-based sport promotion interventions are one possible way to increase the amount of individuals who engage in sport. The primary objective of this study was to examine the profiles of three different sport participation groups with respect to demographic, injury, and Health Action Process Approach (HAPA) constructs. ANOVAs and Chi-square tests were used to determine group differences on demographic and disability-related constructs. A MANCOVA was conducted to determine differences between three sport participation groups (non-intenders, intenders, and actors) with age, years post-injury, mode of mobility, and sex included as covariates. A cohort of 201 individuals was recruited; 56 (27.9%) were non-intenders, 21 (10.4%) were intenders, and 124 (61.7%) were actors. The MANCOVA revealed significant differences between groups on the HAPA constructs, F(22,370) = 9.02, p sport intentions. These results provide an important framework that adapted sport organizations can use to tailor their sport promotion programs. Copyright © 2015 Elsevier Inc. All rights reserved.
Smith, Stephen W
Arguments made by those in favour of the legalisation of physician-assisted suicide (PAS) and euthanasia often rely upon the idea of the quality of life. This idea states that an individual's life is not valuable as an intrinsic good, but is only good based upon the things which it allows us to do. It thus allows the argument that it is morally permissible to kill individuals whose lives have fallen below an acceptable 'quality of life.' However, this concept may require that one accept the killing of individuals who have not expressly request to be killed such as severely disabled newborns. This paper will examine the issue of whether those who utilise a quality of life approach to justify the legalisation of PAS and euthanasia must logically accept the policy of killing severely disabled newborn children. First, there will be an examination of the concept of quality of life and its importance in the arguments for the legalisation of PAS or euthanasia. This paper will then consider how notions of personhood interact with the concept of quality of life in order to create the problem faced by those who favour the legalisation of PAS or euthanasia. Finally, this paper will consider how the notion of autonomy may be used as a way to avoid this difficulty created by the quality of life approach.
Full Text Available Aim of this paper is to describe functioning of subjects with “severe disability” collected with a protocol based on the International Classification of Functioning, Disability, and Health. It included sections on body functions and structures (BF and BS, activities and participation (A&P, and environmental factors (EF. In A&P, performance without personal support (WPS was added to standard capacity and performance. Persons with severe disability were those reporting a number of very severe/complete problems in BF or in A&P-capacity superior to mean + 1SD. Correlations between BF and A&P and differences between capacity, performance-WPS, and performance were assessed with Spearman's coefficient. Out of 1051, 200 subjects were considered as severely disabled. Mild to moderate correlations between BF and A&P were reported (between 0.148 and 0.394 when the full range of impairments/limitations was taken into account; between 0.198 and 0.285 when only the severe impairments/limitations were taken into account; performance-WPS was less similar to performance than to capacity. Our approach enabled identifying subjects with “severe disability” and separating the effect of personal support from that of devices, policies, and service provision.
Kotani, Haruko; Hino, Hiroyuki; Takechi, Tomoki; Shiraishi, Taisuke; Ogura, Hideo
Some patient with severe motor and intellectual disabilities have a narrow mediastinum due to severe scoliosis or thoracic deformity. Complication of tracheostomy in these patients, such as granulation of the lower end of the cannula and tracheo-innominate artery fistulae, are difficult to treat. The causes of recurrent respiratory distress after tracheostomy in four patients with severe motor and intellectual disabilities were investigated, and its management was evaluated based on chest CT and bronchoscopy. In all patients, the lower end of the cannula was in contact with the site of tracheal stenosis, accompanied by granulation with arterial pulsation. In three patients, tracheomalacia as a complication of tracheostomy was also noted. In three patients, changing the cannula to fix its lower end proximally to the lesion, combined with stent placement in one patient with tracheomalacia, resulted in regression of the granulation and respiratory distress. However, one patient with severe tracheomalacia, who had been treated by stent placement alone, died of tracheo-innominate artery fistula. To prevent complications of tracheostomy in patients with severe motor and intellectual disabilities, it is important to select cannulas with a suitable length and angle. In the absence of severe tracheomalacia, use of custom-made short cannulas that can be fixed proximally to the site of stenosis and to the proximity of arteries are appropriate for this purpose.
Root, Jenny; Saunders, Alicia; Spooner, Fred; Brosh, Chelsi
The ability to solve mathematical problems related to purchasing and personal finance is important in promoting skill generalization and increasing independence for individuals with moderate intellectual disabilities (IDs). Using a multiple probe across participant design, this study investigated the effects of modified schema-based instruction…
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McMorris, Carly A.; Weiss, Jonathan A.; Cappelletti, Gabriella; Lunsky, Yona
Carers of individuals with an intellectual disability are often responsible for managing their children's psychiatric crises when they arise. The purpose of this study was to examine the experiences of families using crisis and short-term transitional supports from the perspectives of families and of crisis and transitional support staff. Three…
Aleman, Steven R.
This report provides a review of programs authorized under the Individuals with Disabilities Education Act (IDEA) and an overview of potential reauthorization issues, as the second session of the 103rd Congress considers revisions to these programs. The Infants and Toddlers Program (Part H of IDEA) provides formula grants to participating States…
Favazza, Paddy C.; Ostrosky, Michaelene M.; Meyer, Lori E.; Yu, SeonYeong; Mouzourou, Chryso
UNICEF's new Millennium Development Goals and Beyond (2015. http://www.un.org/millenniumgoals/) focus on the needs of the largest marginalised minority, individuals with disabilities, challenging us to examine issues related to exclusion and develop strategies for making an authentic sense of belonging and high-quality early childhood education a…
... DEPARTMENT OF EDUCATION Applications for New Awards; Technology and Media Services for Individuals With Disabilities--Stepping-Up Technology Implementation Correction In notice document 2012-12278 appearing on pages 29989 through 29995 in the issue of Monday, May 21, 2012 make the following correction...
Lang, Russell; White, Pamela J.; Machalicek, Wendy; Rispoli, Mandy; Kang, Soyeon; Aquilar, Jeannie; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio; Didden, Robert
We reviewed studies involving the treatment of bruxism (i.e., teeth clenching or teeth grinding) in individuals with developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 11 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) procedures…
Munde, V.S.; Vlaskamp, C.; Ruijssenaars, A.J.J.M.; Nakken, H.
In the support of individuals with profound intellectual and multiple disabilities (PIMD), assessing the level of alertness is a recurring issue for parents and other direct support persons. Although observations show clear advantages above and beyond other assessment methods, there are problems
Carlin, Michael; Toglia, Michael P.; Belmonte, Colleen; DiMeglio, Chiara
In the present study the effects of visual, auditory, and audio-visual presentation formats on memory for thematically constructed lists were assessed in individuals with intellectual disability and mental age-matched children. The auditory recognition test included target items, unrelated foils, and two types of semantic lures: critical related…
Hagopian, Louis P.; Rooker, Griffin W.; Rolider, Natalie U.
The purpose of the current study was to critically examine the existing literature on the treatment of pica displayed by individuals with intellectual disabilities. Criteria for empirically supported treatments as described by Divisions 12 and 16 of APA, and adapted for studies employing single-case designs were used to review this body of…
Vermeer, Adri; Lijnse, Margot; Lindhout, Marleen
The results of a study examining the psychometric quality of a pictorial scale to measure perceived physical competence, perceived cognitive competence and perceived social acceptance by peers and caregivers in individuals with intellectual disabilities are reported. The scale was administered twice to 100 subjects. The stability of the scale…
Colwell, Cynthia M.
The purpose of this study was to examine the impact of disability simulations on the attitudes of individuals who will be working with children with special needs in music settings and to compare these attitudes between student music therapists and pre-service music educators. Each participant completed a questionnaire on the first day of class…
Lustig, Daniel C.; Zanskas, Stephen
Although research supports a relationship between work and psychological factors, one area not studied is the relationship between preferred career value and psychological factors. This study investigated the relationship between preferred career values and psychological problems for individuals with disabilities. Career values have been shown to…
Sinclair, James; Unruh, Deanne; Lindstrom, Lauren; Scanlon, David
Individuals with intellectual and developmental disabilities (ID/DD) experience multiple barriers that may prevent them from understanding and exploring their own sexuality. These barriers prevent them from achieving the same autonomy and quality of life as their peers. This research synthesis focuses on 13 articles published between 2000 and 2013…
This manuscript provides a review of housing and independent living options for individuals with intellectual and developmental disabilities (I/DD). While there has certainly been an increased emphasis on community integration and inclusion for people with I/DD, barriers to delivering housing supports and services in natural, integrated settings…
Amado, Angela Novak; Stancliffe, Roger J.; McCarron, Mary; McCallion, Philip
As more individuals with intellectual/developmental disabilities are physically included in community life, in schools, neighborhoods, jobs, recreation, and congregations, the challenge of going beyond physical inclusion to true social inclusion becomes more apparent. This article summarizes the status of the research about community participation…
Cox, Alison D.; Dube, Charmayne; Temple, Beverley
Many individuals with intellectual disability engage in challenging behaviour. This can significantly limit quality of life and also negatively impact caregivers (e.g., direct care staff, family caregivers and teachers). Fortunately, efficacious staff training may alleviate some negative side effects of client challenging behaviour. Currently, a…
Shepherd, Terry L.
Weekly television series have more influence on American society than any other form of media, and with many of these series available on DVDs, television series are readily accessible to most consumers. Studying television series provides a unique perspective on society's view of individuals with disabilities and influences how teachers and peers…
Kim, Jemma; Kimm, Christina H.
This study employs a meta-analysis of single-subject design research to investigate the efficacy of mobile device-based interventions for individuals with intellectual disabilities (ID) and to further examine possible variables that may moderate the intervention outcomes. A total of 23 studies, 78 participants, and 140 observed cases that met the…
Cook, Erin E.; Nickerson, Amanda B.; Werth, Jilynn M.; Allen, Kathleen P.
A sample of 124 service providers (e.g. mental health professionals, educators, administrators) completed a survey about bullying of individuals with disabilities and the use and perceived effectiveness of resources and strategies to address bullying. Providing support and performing an action in response to bullying were reported to be used more…
Lin, E.; Balogh, R.; Cobigo, V.; Ouellette-Kuntz, H.; Wilton, A. S.; Lunsky, Y.
Background: Individuals with intellectual and developmental disabilities (IDD) experience high rates of physical and mental health problems; yet their health care is often inadequate. Information about their characteristics and health services needs is critical for planning efficient and equitable services. A logical source of such information is…
Bexkens, A.; Ruzzano, L.; Collot D'Escury-Koenigs, A.M.L.; van der Molen, M.W.; Huizenga, H.M.
Background: Individuals with intellectual disabilities (ID) are characterised by inhibition deficits; however, the magnitude of these deficits is still subject to debate. This meta-analytic study therefore has two aims: first to assess the magnitude of inhibition deficits in ID, and second to
D'Arrigo, Stefano; Gavazzi, Francesco; Alfei, Enrico; Zuffardi, Orsetta; Montomoli, Cristina; Corso, Barbara; Buzzi, Erika; Sciacca, Francesca L; Bulgheroni, Sara; Riva, Daria; Pantaleoni, Chiara
Microarray-based comparative genomic hybridization is a method of molecular analysis that identifies chromosomal anomalies (or copy number variants) that correlate with clinical phenotypes. The aim of the present study was to apply a clinical score previously designated by de Vries to 329 patients with intellectual disability/developmental disorder (intellectual disability/developmental delay) referred to our tertiary center and to see whether the clinical factors are associated with a positive outcome of aCGH analyses. Another goal was to test the association between a positive microarray-based comparative genomic hybridization result and the severity of intellectual disability/developmental delay. Microarray-based comparative genomic hybridization identified structural chromosomal alterations responsible for the intellectual disability/developmental delay phenotype in 16% of our sample. Our study showed that causative copy number variants are frequently found even in cases of mild intellectual disability (30.77%). We want to emphasize the need to conduct microarray-based comparative genomic hybridization on all individuals with intellectual disability/developmental delay, regardless of the severity, because the degree of intellectual disability/developmental delay does not predict the diagnostic yield of microarray-based comparative genomic hybridization. © The Author(s) 2015.
Investigating the Acquisition, Generalization, and Emergence of Untrained Verbal Operants for Mands Acquired Using the Picture Exchange Communication System in Adults with Severe Developmental Disabilities
Ziomek, M. M.; Rehfeldt, R. A.
This study compared the total amount of training time and total number of trial blocks for individuals with severe developmental disabilities to acquire mands under control of unconditioned establishing operations and mands under control of transitive conditioned establishing operations for manual sign and for the Picture Exchange Communication…
van den Heuvel, Renée; Lexis, Monique; de Witte, Luc
Play is important for a child's development. Children with severe physical disabilities experience difficulties engaging in play. With the progress of technology the possibilities to support play are increasing. The purpose of this review was to gain insight into the possibilities and availability of ICT based technology to support play in children with severe physical disabilities. A systematic literature search within the databases PubMed, CINAHL, IEEE and ERIC was carried out. Three reviewers assessed titles and abstracts independently. Additionally, Google Scholar, conference proceedings and reference lists were used. The included publications reported on 27 different technologies, which can be classified into three main groups; robots, virtual reality systems and computer systems. There are several options that may have great potential in supporting play for this target group.
McClinton, Shane; Weber, Carolyn F; Heiderscheit, Bryan
Lack of response to plantar heel pain (PHP) treatment may be related to unmanaged low back pain (LBP) and low back dysfunction, but a relationship between LBP and PHP has not been established. The purpose of this investigation was to compare the prevalence of LBP among individuals with and without PHP and to assess the association between low back disability and foot/ankle function. A cross-sectional study compared the prevalence and likelihood of LBP in individuals with (n=27) and without (n=27) PHP matched to age, sex, BMI, foot posture, and foot mobility. In individuals with PHP, correlations were examined between foot/ankle function using the foot and ankle ability measure (FAAM), low back disability using the Oswestry low back disability questionnaire (OSW), duration of PHP symptoms, body mass index (BMI), and age. A greater percentage of individuals with PHP had LBP (74% versus 37% of controls, odds ratio=5.2, P=0.009) and higher levels of low back disability (17% higher OSW score than controls, PPHP, FAAM scores were correlated with OSW scores (ρ=-0.463, P=0.015), but not with duration of PHP symptoms, BMI, or age (P>0.150). Individuals with PHP had a greater prevalence of LBP and higher low back disability that was correlated to reduced foot and ankle function. Treatment to address both local and proximal impairments, including impairments related to LBP, may be warranted to improve the management of PHP. Copyright © 2017 Elsevier Ltd. All rights reserved.
Padron, Jennifer M
There is a need for increased understanding and support of students with severe and persistent psychiatric disabilities in post-secondary education. Advancements in the pharmacological treatment of psychiatric disabilities are permitting a broader range of mental health consumers to reach a level of recovery allowing these consumers to begin or restart college careers (Eudaly, 2002). A post-secondary education is now considered a mandatory investment in the future ("Higher Education," 2003). There are a growing number of people pursuing higher education including those with serious mental illness. I am working on a Master's degree in a Rehabilitation Counselor Education program and face many obstacles due to my psychiatric disability, Bipolar Disorder.
Dai, Shenhao; Dieterich, Klaus; Jaeger, Marie; Wuyam, Bernard; Jouk, Pierre-Simon; Pérennou, Dominic
To understand the disability of adults with arthrogryposis multiplex congenita (AMC), a rare disease spectrum characterized by at least 2 joint contractures at birth in different body areas. This is a retrospective analysis of data for unselected persons with AMC referred to the French center for adults with AMC from 2010 to 2016. All underwent a pluriprofessional systematic and comprehensive investigation of deficits, activity limitation, and participation restriction according to the International Classification of Functioning, Disability and Health and genetic analysis when indicated. Participants were divided by amyoplasia and other AMC types. Mean (SD) age of the 43 participants (27 female) was 33.2 (13.4) years; 28 had amyoplasia and 15 other types of AMC. Beyond joint stiffness, deformities, and muscle weakness, the well-known core symptoms that we quantified and for which first-line treatment involved technical aids, other less visible disorders that could contribute to severe participation restriction were particularly pain and psychological problems including anxiety, fatigue, difficulty in sexual life, altered self-esteem, and feelings of solitude. Severe respiratory disorders were infrequent and were linked to PIEZO2 mutations. Gait disorders were not due to respiratory impairment but to skeletal problems and were always associated with amyoplasia when severe. Functional independence was worse but respiratory and swallowing capacities were better with amyoplasia than other AMC types. This study describes disability patterns of a cohort of adults with AMC by genotype. The disability of adults with AMC is influenced by genotype, with important invisible disability. © 2018 American Academy of Neurology.
López López, Carlos Omar; Lugo, Everardo Fuentes; Alvarez-Hernández, Everardo; Peláez-Ballestas, Ingris; Burgos-Vargas, Rubén; Vázquez-Mellado, Janitzia
Epidemiologic data from recent decades show a significant increase in the prevalence and incidence of gout worldwide, in addition to changes in its clinical expression. Our objective was to compare the frequency of the severity of gout and disability in two patient groups at our clinic during different periods. We included and compared data of two groups: group A (1995-2000), patients from previous report, and group B (2010-2014), the baseline data of current patients participating in a cohort (GRESGO). This evaluation included data of socioeconomic and educational levels, demographics, associated diseases, previous treatment, clinical and biochemical data, and disability evaluated using the Health Assessment Questionnaire (HAQ). We included data of 564 gout patients. Participants were 35.7 ± 12.7 years old at onset and had 12.0 ± 9.2-years disease duration at their first evaluation in our department. Group B patients were younger, had higher educational and socioeconomic levels, and had more severe disease. However, this group had less frequency of some associated diseases and significantly higher HAQ scores. With increased HAQ score, a higher number of acute flares and tender, limited-to-motion, and swollen joints were seen. The spectrum of gout has changed over the past decade. A higher percentage of our patients had a severe form of disease, were younger, had earlier disease onset, and had more disability reflected in higher HAQ scores. In our current patient group, the variable most associated with disability was limited-to-motion joints; however, the number of acute flares and tender and swollen joints was also higher in patients with greater disability.
van den Heuvel, Renée J F; Lexis, Monique A S; Gelderblom, Gert Jan; Jansens, Rianne M L; de Witte, Luc P
Play is an essential part of children's lives. Children with physical disabilities experience difficulties in play, especially those with severe physical disabilities. With the progress of innovative technology, the possibilities to support play are increasing. The purpose of this literature study is to gain insight into the aims, control options and commercial availability of information and communication technology (ICT) and robots to support play (especially play for the sake of play) in children with severe physical disabilities. A systematic literature search in the databases PubMed, CINAHL, IEEE and ERIC was carried out. Titles and abstracts were assessed independently by three reviewers. In addition, studies were selected using Google Scholar, conference proceedings and reference lists. Three main groups of technology for play could be distinguished: robots (n = 8), virtual reality systems (n = 15) and computer systems (n = 4). Besides, ICT and robots developed for specific therapy or educational goals using play-like activities, five of the in total 27 technologies in this study described the aim of "play for play's sake". Many ICT systems and robots to support play in children with physical disabilities were found. Numerous technologies use play-like activities to achieve therapeutic or educational goals. Robots especially are used for "play for play's sake". Implications for Rehabilitation This study gives insight into the aims, control options and commercial availability for application of robots and ICT to support play in children with severe physical disabilities. This overview can be used in both the fields of rehabilitation and special education to search for new innovative intervention options and it can stimulate them to use these innovative play materials. Especially robots may have great potential in supporting "play for play's sake".
Elberling, Jesper; Gulmann, Nils; Rasmussen, Alice
Multiple chemical sensitivity (MCS) is a chronic nonallergic, multisymptom disorder triggered by common environmental chemicals in concentrations considered nontoxic for most individuals. The condition may lead to loss of occupation and social isolation, and no effective treatment has been reported. Electroconvulsive therapy (ECT) is a safe and effective treatment of severe depression and medical conditions such as chronic pain disorders. We report a case of a 45-year-old man with a 5-year history of MCS who had to quit his job to live a solitary life without his wife and children because of the condition. The patient had no history of psychiatric illness and no signs of clinical depression at treatment start. Over a 3-week period, he underwent a course of 8 ECTs, giving a remarkable effect on symptom severity and social functional level. After a partial symptom relapse, maintenance treatment was started with 1 ECT every second week. No memory impairment or other complications of ECT were reported at the 4-month follow-up. In this case, a substantial, positive effect on symptom severity and social disability related to MCS was obtained by an initial ECT course and maintenance treatment. Electroconvulsive therapy should be considered an option in severe and socially disabling MCS, but more studies are needed to evaluate if ECT can be recommended as a treatment in MCS.
Hollingshead, Aleksandra K.
While a great deal has been written about the complexities of engagement for learners without severe disabilities, there is less for students with severe disabilities. Engagement as a complex construct, consisting of behavioral, cognitive, and emotional components (Finn & Zimmer, 2012; Fredricks, Blumenfeld, & Paris, 2004; Skinner &…
Waninge, Aly; van Wijck, R.; Steenbergen, B.; van der Schans, Cees
Background: The purpose of this study was to determine the feasibility and reliability of the modified Berg Balance Scale (mBBS) in persons with severe intellectual and visual disabilities (severe multiple disabilities, SMD) assigned Gross Motor Function Classification System (GMFCS) grades I and
Waninge, A.; van Wijck, R.; Steenbergen, B.; van der Schans, C. P.
Background The purpose of this study was to determine the feasibility and reliability of the modified Berg Balance Scale (mBBS) in persons with severe intellectual and visual disabilities (severe multiple disabilities, SMD) assigned Gross Motor Function Classification System (GMFCS) grades I and II.
Chen, Karen B.; Savage, Anne B.; Chourasia, Amrish O.; Wiegmann, Douglas A.; Sesto, Mary E.
Touch technology is becoming more prevalent as functionality improves and cost decreases. Therefore, it is important that this technology is accessible to users with diverse abilities. The objective of this study was to investigate the effects of button and gap size on performance by individuals with varied motor abilities. Participants with (n=38) and without (n=15) a motor control disability completed a digit entry task. Button size ranged from 10 to 30 mm and gap size was either 1 or 3 mm. Results indicated that as button size increased, there was a decrease in misses, errors, and time to complete tasks. Performance for the non-disabled group plateaued at button size 20mm, with minimal, if any gains observed with larger button sizes. In comparison, the disabled group’s performance continued to improve as button size increased. Gap size did not affect user performance. These results may help to improve accessibility of touch technology. PMID:23021630
Lipkin, Paul H; Okamoto, Jeffrey
The pediatric health care provider has a critical role in supporting the health and well-being of children and adolescents in all settings, including early intervention (EI), preschool, and school environments. It is estimated that 15% of children in the United States have a disability. The Individuals with Disabilities Education Act entitles every affected child in the United States from infancy to young adulthood to a free appropriate public education through EI and special education services. These services bolster development and learning of children with various disabilities. This clinical report provides the pediatric health care provider with a summary of key components of the most recent version of this law. Guidance is also provided to ensure that every child in need receives the EI and special education services to which he or she is entitled. Copyright © 2015 by the American Academy of Pediatrics.
MCDERMOTT, SUZANNE; BAO, WEICHAO; TONG, XIN; CAI, BO; LAWSON, ANDREW; AELION, CMARJORIE
AIM We explored the association of relatively low concentrations of metals in the soil proximal to maternal residence during pregnancy, with intellectual disability. We hypothesized different metals would be associated with mild versus severe intellectual disability. METHOD We used a mixed methods design, starting with a retrospective cohort from 1996–2002, of 10 051 pregnant mothers, soil sampling in the areas where these mothers resided during pregnancy, and follow-up of their children to determine if there was an intellectual disability outcome. We tested the soil and then predicted the soil concentration at the maternal homes, and modeled the association with the severity of the child’s intellectual disability. RESULTS We found a significant positive association between mild intellectual disability and soil mercury (p=0.007). For severe intellectual disability, there was a significant positive association with the soil arsenic and lead (p=0.025). INTERPRETATION This is the first report of the differential impact of metals in soil and severity of intellectual disability in children. Soil mercury concentration in the area the mother lived during pregnancy is associated with significantly increased odds of mild intellectual disability; a combination of arsenic and lead is associated with significantly increased odds of severe intellectual disability. These associations are present when controlling for maternal, child, and neighborhood characteristics. PMID:24750016
Increasing global population movement has resulted in a corresponding increase of children with severe and multiple disabilities and complex communication needs who at home are exposed to languages different from the language used at school. The aim of this study was to highlight facilitating as well as limiting factors for effective communication intervention for these children both in school and within the family. Based on observations, qualitative research interviews and analysis in the tradition of grounded theory the results indicate that the quality of parent-teacher-interaction is central to effective communication intervention and culturally sensitive use of communication aids. Challenges for teachers as well as parents to achieve a mutually satisfying interaction are addressed, and issues regarding the language use with children with severe disabilities and a multilingual and multicultural background and the inclusion of their parents in school based activities are discussed.
Cannell, M Brad; Bouldin, Erin D; Teigen, Kari; Akhtar, Wajiha Z; Andresen, Elena M
Research has demonstrated a clear association between cognitive decline and non-cognitive disability; however, all of these studies focus on disability as a correlate or result of some level of cognitive impairment or dysfunction. The relationship between disability and cognition is likely a complex one, that is currently incompletely described in the literature. Our objective was to estimate the prevalence of long-term, non-cognitive disability using a population-representative sample of adults aged 18 and older, and then estimate the association between long-term, non-cognitive disability and self-reported worsening memory. Using the 2009 Florida Behavioral Risk Factor Surveillance System (BRFSS), we measured the relationship between non-cognitive disability and worsening memory using multivariable logistic regression analysis weighted to account for the complex sampling design of the BRFSS. We also estimated the adjusted odds of worsening memory by disability severity, classified according to the types of assistance needed. Approximately 18% (95% confidence interval = (16%, 19%)) of Floridians were living with a long-term, non-cognitive disability in 2009. Among adults with no disability during or prior to the last year, only 5% reported worsening memory. The proportion of Floridians reporting worsening memory increases with increasing severity of disability-related limitations. In a multivariable logistic regression model, odds of worsening memory increased significantly with severity of disability-related limitations. These results highlight the association between non-cognitive disability and subsequent increased odds of worsening memory, independent of several other known risk factors, and a dose-response association with disability-related limitations. Copyright © 2016 Elsevier Inc. All rights reserved.
Pitkänen, A; Hätönen, H; Kuosmanen, L; Välimäki, M
People with mental disorders have been found to suffer from impaired quality of life (QoL). Therefore, the assessment of QoL has become important in psychiatric research. This explorative study was carried out in acute psychiatric wards. Thirty-five patients diagnosed with schizophrenia and related psychosis were interviewed. QoL was rated by the Schedule for Evaluation of Individual Quality of Life which is a respondent-generated QoL measure using semi-structured interview technique. Patients named five areas of life important to them and then rated their current status and placed relative weight on each QoL area. The data were analysed with qualitative content analysis and descriptive statistics. The most frequently named areas for QoL were health, family, leisure activities, work/study and social relationships, which represented 72% of all QoL areas named. Patients' average satisfaction with these QoL areas ranged 49.0-69.1 (scale 0-100). The mean global QoL score was 61.5 (standard deviation 17.4; range 24.6-89.6; scale 0-100). Awareness of patients' perceptions of their QoL areas can enhance our understanding of an individual patient's QoL and reveal unsatisfactory areas where QoL could be improved with individually tailored needs-based interventions.
Glick, N.R.; Fischer, M.H.; Heisey, D.M.; Leverson, G.E.; Mann, D.C.
Fractures are more prevalent among people with severe and profound developmental disabilities than in the general population. In order to characterize the tendency of these people to fracture, and to identify features that may guide the development of preventive strategies, we analyzed fracture epidemiology in people with severe and profound developmental disabilities who lived in a stable environment. Data from a 23-year longitudinal cohort registry of 1434 people with severe and profound developmental disabilities were analyzed to determine the effects of age, gender, mobility, bone fractured, month of fracture, and fracture history upon fracture rates. Eighty-five percent of all fractures involved the extremities. The overall fracture rate increased as mobility increased. In contrast, femoral shaft fracture risk was substantially higher in the least mobile [relative risk (RR), 10.36; 95% confidence interval (CI), 3.29-32.66] compared with the most mobile group. Although the overall fracture rate was not associated with age, the femoral shaft fractures decreased but hand/foot fractures increased with age. Overall fracture risk declined in August and September (RR, 0.70; 95% CI, 0.55-0.89), being especially prominent for tibial/fibular fractures (RR, 0.31; 95% CI, 0.13-0.70). Gender was not a factor in fracture risk. Two primary fracture mechanisms are apparent: one, largely associated with lack of weight-bearing in people with the least mobility, is exemplified by femoral fractures during non-traumatic events as simple as diapering or transfers; the other, probably due to movement- or fall-related trauma, is exemplified by hand/foot fractures in people who ambulate. The fracture experience of people with severe and profound developmental disabilities is unique and, because it differs qualitatively from postmenopausal osteoporosis, may require population-specific methods for assessing risk, for improving bone integrity, and for reduction of falls and accidents
Sterkenburg, P S; Janssen, C G C; Schuengel, C
Background: A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour., Method: Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were
Erdoğan; Bülent; Gökhan; Serkan Tevabil
It is considered that whether disabled individuals have low or high self- esteem Serkan T. AKA3 affects their interactions with the other individuals and how they cope with the challenges they come across in a society. Therefore, it is great significance to study the factors that are effective in boosting the self-esteem of such individuals. Bülent TATLISU2 The purpose of this study is to investigate the effects of sporting habits and different variables on the self-esteem level of ...
Kesler, Buford; Richmond, Bert O.
Investigated were the effects of sex, ability and training method on the musical instrument playing ability of 16 institutionalized severely and profoundly retarded persons ages 7 to 20 years. Ss were randomly assigned to one of four treatment groups, and the time required to reach criterion playing a familiar tune was recorded. Data indicated…
Jafari, Ali; Buswell, Nathanael; Ghovanloo, Maysam; Mohsenin, Tinoosh
This paper presents a low-power stand-alone tongue drive system (sTDS) used for individuals with severe disabilities to potentially control their environment such as computer, smartphone, and wheelchair using their voluntary tongue movements. A low-power local processor is proposed, which can perform signal processing to convert raw magnetic sensor signals to user-defined commands, on the sTDS wearable headset, rather than sending all raw data out to a PC or smartphone. The proposed sTDS significantly reduces the transmitter power consumption and subsequently increases the battery life. Assuming the sTDS user issues one command every 20 ms, the proposed local processor reduces the data volume that needs to be wirelessly transmitted by a factor of 64, from 9.6 to 0.15 kb/s. The proposed processor consists of three main blocks: serial peripheral interface bus for receiving raw data from magnetic sensors, external magnetic interference attenuation to attenuate external magnetic field from the raw magnetic signal, and a machine learning classifier for command detection. A proof-of-concept prototype sTDS has been implemented with a low-power IGLOO-nano field programmable gate array (FPGA), bluetooth low energy, battery and magnetic sensors on a headset, and tested. At clock frequency of 20 MHz, the processor takes 6.6 s and consumes 27 nJ for detecting a command with a detection accuracy of 96.9%. To further reduce power consumption, an application-specified integrated circuit processor for the sTDS is implemented at the postlayout level in 65-nm CMOS technology with 1-V power supply, and it consumes 0.43 mW, which is 10 lower than FPGA power consumption and occupies an area of only 0.016 mm.
Uliano, D; Falciglia, G; Del Viscio, C; Picelli, A; Gandolfi, M; Passarella, A
Augmentative and alternative communication devices proved to be effective in patients with severe intellectual disability to overcome their communication impairments. In order to give a contribution for design of augmentative and alternative communication systems that better meet the needs of beginning communicators we decided to report our clinical experience about using augmentative and alternative communication in adolescents with severe intellectual disability. Five patients who underwent a long time traditional speech rehabilitation program (at least 5 years) with scant improvements in linguistic function were recruited and evaluated by means of the Vineland Adaptive Behaviour Scale before and after a three years augmentative and alternative communication intervention carried out by a multidisciplinary team. After the rehabilitative intervention patients showed an improvement in communication, daily living skills and socialization as measured by the Vineland Adaptive Behaviour Scale. Augmentative and alternative communication is an effective rehabilitation approach to people with severe intellectual disability and impairments in linguistic expression. Moreover augmentative and alternative communication is a useful tool allowing these patients to increase their social participation also enhancing their self-esteem. Our clinical experience confirmed these topics also in adolescents who underwent a long time traditional speech rehabilitation program with scant improvements, providing practical information to clinicians.
Full Text Available The paper focuses on the issues of social support of individuals with disabilities and describes its role in the development and maintenance of subjective well-being of persons in situations of disability. A special external resource for overcoming unfavorable developmental conditions, social support is interlocked in a continuous relationship with psychological resources of personality. One of its distinctive features is that it implies the subject's activity aimed at overcoming difficult life situation on his/her own. When the person's bodily resources are insufficient (as it happens in situations of physical disabilities, the role of macro- and microsocial resources in supporting his/her well-being naturally increases. However, when both social and bodily resources are scarce, it is the individual's personality that stands in the gap. The research described in the paper explored the relationship between microsocial resources (support of family and friends, satisfaction with this support and psychological resources of resistance and self-regulation of personality. The sample consisted of 210 subjects (48 students with disabilities, 162 healthy subjects. The outcomes revealed certain differences between the subsamples with low and high rates of social support which suggest that the subjects' perceptions and evaluations of the support contribute to their psychological resources of coping and self-regulation, activating and/or reinforcing the existing potential of their personalities.
Vulto-van Silfhout, Anneke T; Rajamanickam, Shivakumar; Jensik, Philip J; Vergult, Sarah; de Rocker, Nina; Newhall, Kathryn J; Raghavan, Ramya; Reardon, Sara N; Jarrett, Kelsey; McIntyre, Tara; Bulinski, Joseph; Ownby, Stacy L; Huggenvik, Jodi I; McKnight, G Stanley; Rose, Gregory M; Cai, Xiang; Willaert, Andy; Zweier, Christiane; Endele, Sabine; de Ligt, Joep; van Bon, Bregje W M; Lugtenberg, Dorien; de Vries, Petra F; Veltman, Joris A; van Bokhoven, Hans; Brunner, Han G; Rauch, Anita; de Brouwer, Arjan P M; Carvill, Gemma L; Hoischen, Alexander; Mefford, Heather C; Eichler, Evan E; Vissers, Lisenka E L M; Menten, Björn; Collard, Michael W; de Vries, Bert B A
Recently, we identified in two individuals with intellectual disability (ID) different de novo mutations in DEAF1, which encodes a transcription factor with an important role in embryonic development. To ascertain whether these mutations in DEAF1 are causative for the ID phenotype, we performed targeted resequencing of DEAF1 in an additional cohort of over 2,300 individuals with unexplained ID and identified two additional individuals with de novo mutations in this gene. All four individuals had severe ID with severely affected speech development, and three showed severe behavioral problems. DEAF1 is highly expressed in the CNS, especially during early embryonic development. All four mutations were missense mutations affecting the SAND domain of DEAF1. Altered DEAF1 harboring any of the four amino acid changes showed impaired transcriptional regulation of the DEAF1 promoter. Moreover, behavioral studies in mice with a conditional knockout of Deaf1 in the brain showed memory deficits and increased anxiety-like behavior. Our results demonstrate that mutations in DEAF1 cause ID and behavioral problems, most likely as a result of impaired transcriptional regulation by DEAF1. Copyright © 2014 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.
Rao, Deepa; Horton, Randall A; Tsang, Hector W H; Shi, Kan; Corrigan, Patrick W
Stigmatizing attitudes toward people with disabilities can jeopardize such individuals' well-being and recovery through denial of employment and community isolation. By shaping social norms that define group membership, the construct of individualism may partially explain differences in stigmatizing attitudes across cultures. Further, widespread globalization has brought intensely individualistic social practices to certain segments of non-Western cultures. This paper examines whether the construct of individualism can help to explain cross-cultural differences in stigmatizing attitudes observed between American and Chinese employers. Employers (N = 879) from Beijing, Hong Kong, and Chicago provided information on their attitudes toward hiring people with disabilities, and path analyses were conducted to examine potential mediating relationships. Path analyses indicated that vertical individualism, along with perceived responsibility for acquiring a condition, partially mediated the relationship between culture and employers' negative attitudes about job candidates with disabilities. These results suggested that greater espousal of competitive and individualist values may drive stigmatizing attitudes across cultures. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Rao, Deepa; Horton, Randall A.; Tsang, Hector W.H.; Shi, Kan; Corrigan, Patrick W.
Purpose Stigmatizing attitudes toward people with disabilities can jeopardize such individuals' well-being and recovery through denial of employment and community isolation. By shaping social norms that define group membership, the construct of individualism may partially explain differences in stigmatizing attitudes across cultures. Further, widespread globalization has brought intensely individualistic social practices to certain segments of non-Western cultures. This paper examines whether the construct of individualism can help to explain cross-cultural differences in stigmatizing attitudes observed between American and Chinese employers. Design Employers (N = 879) from Beijing, Hong Kong, and Chicago provided information on their attitudes toward hiring people with disabilities, and Path Analyses were conducted to examine potential mediating relationships. Results Path analyses indicated that vertical individualism, along with perceived responsibility for acquiring a condition, partially mediated the relationship between culture and employers' negative attitudes about job candidates with disabilities. Conclusion These results suggested that greater espousal of competitive and individualist values may drive stigmatizing attitudes across cultures. PMID:21171794
Nemutandani, M S; Adedoja, D; Nevhuhlwi, D
To determine the prevalence of dental caries among disabled individuals attending special schools in Vhembe districts. A cross-sectional descriptive study was conducted from January to June 2012 among disabled individuals receiving special care in four specialised schools of Vhembe District. The research protocol had been approved by the Ethics Committee of the University of Limpopo, Polokwane Campus. Informed consent was obtained from the parents of the participants and from the respective school principals. Oral health examinations took place at the school under natural light, with participants seated on an ordinary chair/wheelchair. Dental caries examinations were carried out, using a mirror and wooden spatula in accordance with World Health Organisation (WHO) criteria and methods. Decayed, missing and filled primary and permanent teeth (dmft, DMFT) were recorded. All disabled individuals who were available during a screening period, were included. Those who were not available, as well as those whose health conditions could be compromised by dental examinations, were excluded. The number of decayed teeth ranged from 0-7 in children below 6 years, 0-12 in children below 11 years; and 0-17 among young adults. The mean decay scores and the numbers of missing teeth increased with age. Only 3 (0.04%) individuals had dental fillings. The mean dmft score of children under 6 years was 5.51 (+/- 2.1), ranging from zero to 8. The mean DMFT's of the 11-18 and 19 years and older groups were 7.38 (+/- 3.22) and 10.24 (+/- 2.97) respectively. Disabled individuals exhibited higher caries prevalence and unmet dental needs than the same age general population in Limpopo. Preventive measures and dental treatment should be considered urgent requirements at special needs schools in the Vhembe District.
Ishtiak-Ahmed, Kazi; Perski, Aleksander; Mittendorfer-Rutz, Ellenor
Stress-related mental disorders rank among the leading causes of sickness absence in several European countries. The aim of this study was to investigate predictors of all-cause and diagnosis-specific disability pension in sickness absentees with stress-related mental disorders. A cohort of 36304 non-retired individuals aged 16-64 years at 31.12.2004 with at-least one sickness absence spell due to stress-related mental disorders (SRMD) initiated in 2005 in Sweden was followed-up with regard to disability pension (2006-2010) by linkage of registers. Uni- and multivariate Hazard ratios (HR) with 95% Confidence Intervals, CI, were estimated using Cox regression for several risk markers. During the follow-up period, 2735 individuals (7.5%) were granted a disability pension, predominantly due to mental diagnoses (n = 2004, 73.3%). In the multivariate analyses, female sex, age exceeding 35 years, low educational level, being born in a country outside EU25 and Northern Europe, residing outside big cities, living alone, having had a long duration of the first spell due to SRMD (>90 days); mental disorders necessitating frequent specialised health care as well as comorbid somatic disorders were found to be predictive of granting disability pension. Some different patterns emerged for risk factors related to diagnosis-specific disability pension and for younger and older individuals. Several predictors could be identified as risk markers for disability pension. The variation in the effect of risk markers with regard to age and diagnosis of disability pension speaks in favour of the importance of a person-centered approach in treatment and rehabilitation.
Burke, Meghan M; Lee, Chung Eun; Arnold, Catherine K; Owen, Aleksa
Adult siblings of individuals with intellectual and developmental disabilities (IDD) report struggling to navigate the adult disability service delivery system and collaborate with professionals. To date, though, it is unclear how professionals encourage sibling involvement and, accordingly, the facilitators and challenges in working with siblings. For this study, 290 professionals participated in a national web-based survey; participants answered three open-ended questions about ways to involve siblings, positive experiences with siblings, and challenges in working with siblings. Professionals reported person-level and systems-level supports to encourage sibling involvement. Also, professionals reported enjoying working with cohesive families of individuals with IDD and witnessing the benefits that siblings bring to their brothers and sisters with IDD. Challenges in working with siblings included: lack of sibling involvement, systemic barriers, and caregiving burden. Implications for future research and practice are discussed.
Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks. Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice. Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed. Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap. Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities. PMID:22479290
Lodge, Keri-Michèle; Milnes, David; Gilbody, Simon M
Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks.Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice.Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed.Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap.Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities.
Kencana, Andy Prima; Heng, John
This paper introduces a novel passive tongue control and tracking device. The device is intended to be used by the severely disabled or quadriplegic person. The main focus of this device when compared to the other existing tongue tracking devices is that the sensor employed is passive which means it requires no powered electrical sensor to be inserted into the user's mouth and hence no trailing wires. This haptic interface device employs the use of inductive sensors to track the position of the user's tongue. The device is able perform two main PC functions that of the keyboard and mouse function. The results show that this device allows the severely disabled person to have some control in his environment, such as to turn on and off or control daily electrical devices or appliances; or to be used as a viable PC Human Computer Interface (HCI) by tongue control. The operating principle and set-up of such a novel passive tongue HCI has been established with successful laboratory trials and experiments. Further clinical trials will be required to test out the device on disabled persons before it is ready for future commercial development.
Leung, Willie; Siebert, Erin A; Yun, Joonkoo
Multiple studies have reported differing physical activity levels for individuals with intellectual disabilities when using accelerometers. One of the potential reasons for these differences may be due to how researchers measure physical activity. Currently there is a lack of understanding on measurement protocol of accelerometers. The purpose of this study was to synthesize the current practice of using accelerometers to measure physical activity levels among individuals with intellectual disabilities. A systematic search was conducted using multiple databases including Medline (1998-2015), Sport Discus (1992-2015), Web of Science (1965-2015), and Academic Research Premier (2004-2015). Seventeen articles were found that met the inclusion criteria. There is a lack of consistent research protocols for measuring physical activity levels with accelerometers. Issues with the amount of time participants wore the accelerometer was a challenge for multiple studies. Studies that employed external strategies to maximize wear time had higher compliance rates. There is a need to establish and standardize specific accelerometer protocols for measuring physical activity levels of individuals with intellectual disabilities for higher quality and more comparable data. Copyright © 2017 Elsevier Ltd. All rights reserved.
Mahta, Ali; Katz, Paul M; Kamel, Hooman; Azizi, S Ausim
This paper aimed to test the hypothesis that intraventricular extension of spontaneous intracerebral hemorrhage (ICH) in the absence of hydrocephalus is not associated with increased mortality or severe disability. We performed a retrospective consecutive cohort study of patients with primary spontaneous ICH who were admitted to a single institution. Multivariate logistic regression analysis was used to assess the association of each variable with functional outcome as measured by the modified Rankin Scale (mRS). A total of 164 patients met our inclusion criteria and were included in the study. Only hydrocephalus (p=0.002) and hematoma volume (p=0.006) were significantly associated with mortality or poor functional outcome (mRS of 3 to 6). In contrast, the presence of intraventricular hematoma was not independently associated with poor functional outcome. The presence of intraventricular extension of ICH in the absence of hydrocephalus may not increase mortality or disability. Copyright © 2016 Elsevier Ltd. All rights reserved.
Chang, Juhea; Lee, Jung-Hyun; Son, Ho-Hyun; Kim, Hae-Young
This study evaluated the caries risk profile of patients with severe intellectual disabilities (IDs) who received dental treatment under general anesthesia. One hundred and two patients with ID [ID group, mean age (SD); 23.8(9.3)] and 100 healthy patients without ID [NID group, mean age (SD); 23.19(3.3)] were included. Medication, disability type, oral hygiene maintenance, and cooperation of the patients were investigated. Dietary habits, plaque index, mutans streptococci counts, fluoride availability, and salivary buffering were scored and analyzed using the Cariogram. The mean chance of avoiding caries (SD) was 28.1(20.4) in the ID group and 54.7(18.4) in the NID group. The ID group had significantly higher numbers of decayed and missing teeth, but fewer filled teeth than the NID group (p oral hygiene maintenance (p oral hygiene maintenance and low fluoride availability most contributed to the high risk. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.
Full Text Available Abstract Background Several studies have shown a markedly higher mortality rate among disability pensioners than among non-retired. Since most disability pensions are granted because of non-fatal diseases the reason for the increased mortality therefore remains largely unknown. The aim of this study was to evaluate potential explanatory factors. Methods Data from five longitudinal cohort studies in Sweden, including 6,887 men and women less than 65 years old at baseline were linked to disability pension data, hospital admission data, and mortality data from 1971 until 2001. Mortality odds ratios were analyzed with Poisson regression and Cox's proportional hazards regression models. Results 1,683 (24.4% subjects had a disability pension at baseline or received one during follow up. 525 (7.6% subjects died during follow up. The subjects on disability pension had a higher mortality rate than the non-retired, the hazards ratio (HR being 2.78 (95%CI 2.08–3.71 among women and 3.43 (95%CI 2.61–4.51 among men. HR was highest among individuals granted a disability pension at young ages (HR >7, and declined parallel to age at which the disability pension was granted. The higher mortality rate among the retired subjects was not explained by disability pension cause or underlying disease or differences in age, marital status, educational level, smoking habits or drug abuse. There was no significant association between reason for disability pension and cause of death. Conclusion Subjects with a disability pension had increased mortality rates as compared with non-retired subjects, only modestly affected by adjustments for psycho-socio-economic factors, underlying disease, etcetera. It is unlikely that these factors were the causes of the unfavorable outcome. Other factors must be at work.
Kim, Junhyoung; Schilling, Mary Lou; Kim, May; Han, Areum
There is a dearth of literature that explores the relationships among leisure satisfaction, acceptance of disability, social relationships, and life satisfaction among adults with intellectual disability from Eastern countries. The purpose of this study was to examine how leisure satisfaction, disability acceptance, and social relationships are…
Marrocco, Anna; Krouse, Helene J
Individuals with disabilities have been identified as a population with a significantly lower usage of preventive services. Nurse practitioners (NPs) provide a key access point in the healthcare delivery system for preventive services for vulnerable populations such as those with disabilities. It is essential to understand existing barriers that prohibit access to effective preventive care for this vulnerable population. Systematic search and review of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Google Scholar, and government reports and World Health Organizations reports. Twenty-six articles were included in the review. This literature review confirmed previous notions that people with disabilities are receiving much fewer preventive services than the general population. The studies reviewed identified four major barriers that contributed to the lack of preventive care. These barriers included physical environment and system, transportation, provider knowledge and attitude, and financial. Recognition of the obstacles that this subpopulation faces in accessing preventive care services is the first step to effectively remedying this problem. Preventive services have been identified as one of the cornerstones to improving health and quality of life. By understanding the circumstances that restrict those with disabilities from accessing preventive services, NPs can provide meaningful and effective solutions. ©2017 American Association of Nurse Practitioners.
Bultmann, Ute; Christensen, Karl B.; Burr, Hermann; Lund, Thomas; Rugulies, Reiner
Are severe depressive symptoms prospectively associated with disability pension? To answer that question, we linked data from a representative sample of the Danish workforce with disability pension (DP) award data from the National Registry on Public Transfer Payments. Of the 5106 study
Nazarov, Zafar E.; Erickson, William A.; Bruyère, Susanne M.
Objective: It is useful to examine workplace factors influencing employment outcomes of individuals with disabilities and the interplay of disability, employment-related, and employer characteristics to inform rehabilitation practice. Design: A number of large national survey and administrative data sets provide information on employers and can…
Moore, Eric J; Schelling, Amy
Postsecondary education (PSE) programs for individuals with intellectual disabilities (IDs) have emerged exponentially in the United States over the last decade. Research regarding these postsecondary programs has largely been descriptive, and thus, there exists a need for qualitative, outcome-based research. In this comparative case report, graduates from two types of PSE programs for individuals with IDs are surveyed regarding employment outcomes and other personal developments. The results from each postsecondary program are compared with one another and also with a comparison group of individuals with IDs who did not attend a postsecondary program (utilizing the 2009 National Longitudinal Transition Study 2). This case demonstrates significant positive employment outcomes for individuals with IDs who attend postsecondary programs compared to those who do not attend such programs and highlights similarities and differences regarding outcomes of the two program types under consideration. © The Author(s) 2015.
Seng, Elizabeth K.; Buse, Dawn C.; Klepper, Jaclyn E.; Mayson, Sarah Jo; Grinberg, Amy S.; Grosberg, Brian M.; Pavlovic, Jelena M.; Robbins, Matthew S.; Vollbracht, Sarah E.; Lipton, Richard B.
Objective To evaluate relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score ≥ 21), and modifiable psychological factors [depressive symptoms (Patient Health Questionnaire-9), anxious symptoms (Generalized Anxiety Disorder-7), Pain Catastrophizing Scale and Headache Specific Locus of Control]. Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results Among 90 eligible participants the mean age was 45.0 (SD = 12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR = 1.99, 95% CI = 1,11, 3.55) and chance HSLC (OR = 1.85, 95% CI = 1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR = 3.54, 95%CI = 1.49, 8.41), anxiety symptoms (OR = 3.65, 95% CI = 1.65, 8.06), and pain catastrophizing (OR = 1.95, 95% CI = 1.14, 3.35), were associated with severe migraine-related disability. Conclusions Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate relationships among naturalistic
Full Text Available Introduction. This paper reports results of an investigation into the needs of persons with disabilities wanting to participate in the use of virtual communities. The aim was to investigate 'how virtual communities for persons with long-term, severe physical disabilities can best be facilitated'? Method. A Grounded Theory approach was adopted to inform the investigation. In- depth interviews were conducted with twelve persons with paraplegia, quadriplegia or other severe, long-term physical or mobility disabilities and six health care professionals, service providers, information personnel and policy advisers who were involved in their well-being. Analysis. Rich explanations were derived about the information and communication technology (ICT usage and the technologies' contributions towards restoration of sense of control over their lives. Results. The primary outcome of the investigation is a theory regarding the character of virtual communities for the disabled. The theory is represented as a Virtual Community Model. The model identifies: the need for 'a sense of control' as the foundation element of virtual communities for the disabled; the key domains in which disabled people participate in virtual communities; and the barriers and enablers to their participation. Conclusion. The model provides a framework which can be used by interest groups and other organizations to facilitate the development of virtual communities for persons with severe physical disabilities. The six key types of community need to be represented in such virtual communities if a full 'sense of control' is to be achieved by disabled persons.
Isrie, M.; Kalscheuer, V.; Holvoet, M.; Fieremans, N.; Van Esch, H.; Devriendt, K.
The advent of next-generation sequencing has proven to be a key force in the identification of new genes associated with intellectual disability. In this study, high-throughput sequencing of the coding regions of the X-chromosome led to the identification of a missense variant in the HUWE1 gene. The same variant has been reported before by Froyen et al. (2008). We compare the phenotypes and demonstrate that, in the present family, the HUWE1 mutation segregates with the more severe ID phenotyp...
Terrill, Alexandra L; Müller, Rachel; Jensen, Mark P; Molton, Ivan R; Ipsen, Catherine; Ravesloot, Craig
To determine how age and distress are associated in individuals with disabilities, and how happiness and its components (meaning, pleasure, and engagement) mediate or moderate this relationship. These were cross-sectional analyses of survey data from 508 community-dwelling adults with a variety of self-reported health conditions and functional disabilities. Measures included the Orientations to Happiness Questionnaire and items from the Behavior Risk Factor Surveillance System. Greater distress was associated with lower global happiness in both mediation and moderation models. The mediation model showed that middle-aged participants (age: 45-64) scored lowest in global happiness, and the effect of age on distress was partially mediated by happiness. None of the happiness components mediated the relationship of age on distress. The moderation model showed a significant interaction effect for age and global happiness on distress, where younger participants low on happiness were significantly more distressed. Of the three happiness components, only meaning was significantly associated with distress. There was a significant interaction between age and meaning, where participants who were younger and scored low on the meaning scale reported significantly higher distress. Findings from this study lay groundwork for the development of clinical interventions to address distress in individuals with functional disabilities. Middle-aged and younger people with disabilities may be particularly affected by lower levels of happiness and might benefit from psychological interventions that focus on increasing overall well-being and providing meaning and purpose in life. PsycINFO Database Record (c) 2015 APA, all rights reserved.
Quach, Emma D; O'Connor, Darlene Dee; McGaffigan, Erin
Nationwide people with disabilities are self-directing their long-term care supports through individual budgets. Because these individuals may rely on a "support broker" to assist them in making and executing decisions regarding their budgets, the interactions between the participant and the support broker can influence participant autonomy. Massachusetts piloted a program for 14 participants to receive individual budgets for home and community-based services. Central to this pilot were the participant-designated support brokers, including home care case managers and peer advocates. Analysis of data on participants and support brokers indicated that the support brokers struggled with when, how, and how much to assist participants to self-direct. Case managers or other providers assuming the support broker's role will need proper training if they are to respond skillfully to challenging situations self-direction may bring.
Salter, Erica K
Through an exploration of the experience of severe and profound intellectual disability, this essay will attempt to expose the predominant, yet usually obscured, medical anthropology of the child and examine its effects on pediatric bioethics. I will argue that both modern western society and modern western medicine do, actually, have a robust notion of the child, a notion which can find its roots in three influential thinkers: Aristotle, Immanuel Kant and Jean Piaget. Together, these philosophers offer us a compelling vision: the child is primarily a future rational, autonomous adult. While this tacit understanding has arguably widespread effects on such things as our concept of good parenting, of proper schooling, and so on, I will focus on the effect is has on the treatment of children with severe developmental disabilities. When examined in light of this population, the dominant medical anthropology of the child will be shown to be deficient. Instead, I argue for an expansion-indeed, a full reimagining-of our notions of childhood, not only to re-infuse dignity into the lives of children with SDD, but to better represent the goods of childhood, generally.
Cook, Albert M; Adams, Kim; Volden, Joanne; Harbottle, Norma; Harbottle, Cheryl
To determine whether low-cost robots provide a means by which children with severe disabilities can demonstrate understanding of cognitive concepts. Ten children, ages 4 to 10, diagnosed with cerebral palsy and related motor conditions, participated. Participants had widely variable motor, cognitive and receptive language skills, but all were non-speaking. A Lego Invention 'roverbot' was used to carry out a range of functional tasks from single-switch replay of pre-stored movements to total control of the movement in two dimensions. The level of sophistication achieved on hierarchically arranged play tasks was used to estimate cognitive skills. The 10 children performed at one of the six hierarchically arranged levels from 'no interaction' through 'simple cause and effect' to 'development and execution of a plan'. Teacher interviews revealed that children were interested in the robot, enjoyed interacting with it and demonstrated changes in behaviour and social and language skills following interaction. Children with severe physical disabilities can control a Lego robot to perform un-structured play tasks. In some cases, they were able to display more sophisticated cognitive skills through manipulating the robot than in traditional standardised tests. Success with the robot could be a proxy measure for children who have cognitive abilities but cannot demonstrate them in standard testing.
Full Text Available For adults with disabilities who are experiencing homelessness, chances of being approved for Social Security disability benefits are very low without assistance. Assisting with the SSI/SSDI application process can be challenging for case managers who lack capacity and expertise. Training caseworkers to document disability and submit complete, high-quality applications using the SSI/SSDI Outreach, Access and Recovery (SOAR model improves efficiency and outcomes. Nationally, 65% of applications using the SOAR model are approved, with decisions received in an average of 81 days in 2015. The SOAR Online Course was created to expand training opportunities for individuals to learn how to effectively assist with SSI/SSDI applications for individuals experiencing or at risk for homelessness. From October 1, 2014 to September 30, 2015, 1049 individuals from 49 states, Washington, D.C., and Puerto Rico successfully completed the SOAR online course. The course is a unique public health training model, in that it incorporates a realistic and multimodal practice SSI/SSDI application with comprehensive feedback provided by experts. Local SOAR leaders around the county are trained to facilitate and guide groups through the course. This study evaluated data on online course usage, user experience, and the translation from learning to practice for online course trainees. We found that successful course completions were most concentrated in areas that had local SOAR Leaders, trainees through the online course had higher data entry rates about case outcomes in the SOAR Online Application Tracking (OAT system, and that trainees reported a high satisfaction rate with the course and comprehensive feedback. The evaluation found that key success factors for online training models include the integration of a practice case component (or other generative learning activity, support from local facilitators, and feedback and technical assistance for trainees.
de Bildt, Annelies; Mulder, Erik J; Van Lang, Natasja D J; de With, S A Jytte; Minderaa, Ruud B; Stahl, Sherin S; Anderson, George M
The rooting reflex has long been studied by neurologists and developmentalists and is defined as an orientation toward tactile stimulation in the perioral region or visual stimulation near the face. Nearly, all previous reports of the visual rooting reflex (VRR) concern its presence in adults with neurological dysfunction. Previously, the VRR was reported to be present in a majority of individuals with autism and absent in control subjects. In the present larger study, we examined the presence of the VRR in 155 individuals with ASD and co-occurring Intellectual Disability (ASD + ID: autism, N = 60; Pervasive Developmental Disorder-Not Otherwise Specified (PDD_NOS), N = 95) and in a contrast group of 65 individuals with ID only. The VRR was present significantly more often in the ASD + ID (43.9%) group than in the ID-only group (24.6%; χ(1)(2)= 7.19; P = 0.007). Individuals with autism displayed a VRR more often (55.0%) than individuals with PDD-NOS (36.8%; χ(1)(2)= 4.92; P = 0.026) and individuals with ID only (24.6%; χ(1)(2)= 12.09; P = 0.001). A positive VRR was associated with lower IQ and adaptive functioning; in the ASD + ID group, ADI-R/ADOS domain scores were significantly higher in the VRR-positive subgroup. The results replicate and extend the finding of an increased occurrence of the VRR in autism. Although some association with IQ was observed, the VRR occurred substantially more often in the autism group compared with an intellectually disabled group, indicating some degree of specificity. Additional studies of infants and children with typical development, ASD and ID are needed to determine the utility of the VRR in ASD risk assessment and to elucidate possible specific behavioral associations. Copyright © 2011, International Society for Autism Research, Wiley-Liss, Inc.
Norlin, D; Broberg, M
Research on parents of children with intellectual disability (ID) has identified a range of risk and protective factors for parental well-being. In family research, the association between marital quality and depression is a vital field of investigation. Still little research has addressed how aspects of the couple relationship affect the adaptation of parents of children with ID. The present study examined predictive links between couple relationship factors (marital quality and coparenting quality) and individual well-being. Data were obtained through self-report questionnaires completed by parents of children with ID (mothers, n = 58; and fathers, n = 46) and control children (mothers, n = 178; and fathers, n = 141). To test the hypothesis that couple relationship factors predicted individual well-being, multiple regression analyses were performed controlling for the following risk factors identified by previous research: child self-injury/stereotypic behaviour, parenting stress, and economic risk. Marital quality predicted concurrent well-being, and coparenting quality predicted prospective well-being. Mothers of children with ID reported lower well-being than other parents. There is a continued need for investigation of the details of the links between couple relationship and individual well-being in parents of children with ID. Couple relationship factors should be given consideration in clinical interventions. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.
van den Berg-Emons, Rita J; L'Ortye, Annemiek A; Buffart, Laurien M; Nieuwenhuijsen, Channah; Nooijen, Carla F; Bergen, Michael P; Stam, Henk J; Bussmann, Johannes B
To determine the criterion validity of the Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) by means of daily physical activity levels measured by using a validated accelerometry-based activity monitor in a large group of persons with a physical disability. Cross-sectional. Participants' home environment. Ambulatory and nonambulatory persons with cerebral palsy, meningomyelocele, or spinal cord injury (N=124). Not applicable. Self-reported physical activity level measured by using the PASIPD, a 2-day recall questionnaire, was correlated to objectively measured physical activity level measured by using a validated accelerometry-based activity monitor. Significant Spearman correlation coefficients between the PASIPD and activity monitor outcome measures ranged from .22 to .37. The PASIPD overestimated the duration of physical activity measured by using the activity monitor (mean ± SD, 3.9±2.9 vs 1.5±0.9h/d; PPASIPD correlated poorly with objective measurements using an accelerometry-based activity monitor in people with a physical disability. However, similar low correlations between objective and subjective activity measurements have been found in the general population. Users of the PASIPD should be cautious about overestimating physical activity levels. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Hall, Sarah A; Rossetti, Zach
Siblings of people with intellectual and developmental disabilities (IDD) often assume key roles to support their brothers and sisters. For people with more significant support needs, siblings may undertake additional roles and responsibilities throughout their lives. The purpose of the present study was to identify and describe the roles of adult siblings who have a brother or sister with severe IDD. Seventy-nine adult siblings from 19 to 72 years of age completed an online survey with open-ended questions about the roles they play in their relationships with their brother or sister. Thematic analysis resulted in identification of several roles including caregiver, friend (social partner), advocate, legal representative, sibling (teacher/role model), leisure planner and informal service coordinator. Siblings assume key roles in the lives of people with IDD and need support from family and professionals to perform these roles. © 2017 John Wiley & Sons Ltd.
Kang, Da-Young; Choi, Sung-Hwan; Jung, Young-Soo; Hwang, Chung-Ju
This case report describes the beneficial effects of the interdisciplinary treatment of an adult patient with severe skeletal periodontal problems. A 30-year-old female patient presented with anterior open bite, gummy smile, and facial asymmetry. The patient had chronic generalized severe periodontitis with pathologic maxillary anterior teeth migration and mild intellectual disability. Treatment included 6 months of periodontal treatment, followed by presurgical orthodontic treatment, a Le Fort I osteotomy with anterior segmental osteotomy, a bilateral sagittal split ramus osteotomy, and postsurgical orthodontic treatment. After treatment completion, the patient exhibited functional and aesthetic improvements. Her periodontal condition improved and was maintained after the treatment. Here, we demonstrate a successful treatment outcome in a complicated case following a systematic interdisciplinary approach performed with the correct diagnosis and treatment planning.
“I love my sister, but sometimes I don’t”. This is one of the statements made in the study focused on the experiences of family members of people with (profound) intellectual (and multiple) disabilities (both of individuals living in a residential facility as persons living at home). In recent years, there has been greater recognition of the important position of parents and siblings of people with (profound) intellectual (and multiple) disabilities and the importance of the wellbeing of all ...
López-de-Uralde-Villanueva, Ibai; Sollano-Vallez, Ernesto; Del Corral, Tamara
To investigate whether patients with chronic nonspecific neck pain and having moderate to severe disability have a greater cervical motor function impairment and respiratory disturbances compared with patients with chronic nonspecific neck pain having mild disability and asymptomatic subjects; and the association between these outcomes in patients with chronic nonspecific neck pain and healthy controls. Cross-sectional study, 44 patients with chronic nonspecific neck pain and 31 healthy subjects participated. The neck disability index was used to divide the patients into 2 groups: 1) mild disability group (scores between 5 and 14 points); and 2) moderate to severe disability group (scores >14 points). Cervical motor function was measured by cervical range of motion, forward head posture, neck flexor, and extensor muscle strength. Respiratory function and maximum respiratory pressures were also measured. Statistically differences were found between the patients with chronic nonspecific neck pain having a moderate to severe disability and the asymptomatic subjects for cervical and respiratory muscle strength. Comparisons between chronic nonspecific neck pain and the asymptomatic groups showed differences for all the variables, except for forward head posture. The regression model determined that strength of cervical flexion explained 36.4 and 45.6% of the variance of maximum inspiratory pressures and maximum expiratory pressures, respectively. Only the chronic nonspecific neck pain group with moderate to severe disability showed differences compared with the healthy subjects. Neck muscle strength could be a good predictor of respiratory muscle function. Implications for rehabilitation Neck pain severity could be closely associated with decreased respiratory pressure in patients with chronic nonspecific neck pain. These findings suggest a new therapeutic approach for patients with moderate to severe disability, such as respiratory muscle training. The regression
Edwards, Thomas; Pilutti, Lara A
There is evidence for the benefits of exercise training in persons with multiple sclerosis (MS). However, these benefits have primarily been established in individuals with mild-to-moderate disability (i.e., Expanded Disability Status Scale [EDSS] scores 1.0-5.5), rather than among those with significant mobility impairment. Further, the approaches to exercise training that have been effective in persons with mild-to-moderate MS disability may not be physically accessible for individuals with mobility limitations. Therefore, there is a demand for an evidence-base on the benefits of physically accessible exercise training approaches for managing disability in people with MS with mobility impairment. To conduct a systematic review of the current literature pertaining to exercise training in individuals with multiple sclerosis (MS) with severe mobility disability. Four electronic databases (PubMed, EMBASE, OvidMEDLINE, and PsychINFO) were searched for relevant articles published up until October 2016. The review focused on English-language studies that examined the effect of exercise training in people with MS with severe mobility disability, characterized as the need for assistance in ambulation or EDSS score ≥ 6.0. The inclusion criteria involved full-text articles that: (i) included participants with a diagnosis of MS; (ii) included primarily participants with a reported EDSS score ≥ 6.0 and/or definitively described disability consistent with this level of neurological impairment; and (iii) implemented a prospective, structured exercise intervention. Data were analyzed using a descriptive approach and summarized by exercise training modality (conventional or adapted exercise training), and by outcome (disability, physical fitness, physical function, and symptoms and participation). Initially, 1164 articles were identified and after removal of duplicates, 530 articles remained. In total, 512 articles did not meet the inclusion criteria. 19 articles were
Kaplan, Katy; Salzer, Mark S; Solomon, Phyllis; Brusilovskiy, Eugene; Cousounis, Pamela
Despite the prevalence of Internet support groups for individuals with mental illnesses little is known about the potential benefits, or harm, of participating in such groups. Therefore, this randomized controlled trial sought to determine the impact of unmoderated, unstructured Internet peer support, similar to what is naturally occurring on the Internet, on the well-being of individuals with psychiatric disabilities. Three hundred individuals resident in the USA diagnosed with a Schizophrenia Spectrum or an Affective Disorder were randomized into one of three conditions: experimental Internet peer support via a listserv, experimental Internet peer support via a bulletin board, or a control condition. Three measurement time points, baseline, 4- and 12 months post-baseline, assessed well-being by examining measures of recovery, quality of life, empowerment, social support, and distress. Time × group interactions in the repeated measures ANOVA showed no differences between conditions on the main outcomes. Post-hoc repeated measures ANOVAs found that those individuals who participated more in Internet peer support reported higher levels of distress than those with less or no participation (p = 0.03). Those who reported more positive experiences with the Internet peer support group also reported higher levels of psychological distress than those reporting less positive experiences (p = 0.01). Study results therefore do not support the hypothesis that participation in an unmoderated, unstructured Internet listserv or bulletin board peer support group for individuals with psychiatric disabilities enhances well-being. Counterintuitive findings demonstrating those who report more positive experiences also experienced higher levels of distress are discussed but we also point to the need for additional research. Future research should explore the various structures, formats, and interventions of Internet support, as well as the content and quality of interactions
Davies, Daniel K; Stock, Steven E; King, Larry R; Wehmeyer, Michael L
Significant barriers exist for individuals with intellectual disability to independently access print-based content. It is regrettable that, while the amount of content now available electronically increases, tools to access these materials have not been developed with individuals with intellectual disability in mind. This article reports the results of research evaluating the use of a palmtop PC-based application designed to enable individuals with intellectual disability to access electronic books and documents. Participants with intellectual disability were randomly assigned to 1 of 3 groups, each group differing in the type of audio player used. Participants who used the specially designed reader made significantly fewer errors accessing electronic books and required significantly fewer prompts than did participants using either of 2 mainstream audiobook readers.
Laditka, Sarah B; Laditka, James N
Childhood adversity has been linked with adult health problems. We hypothesized that childhood adversity would also be associated with work limitations due to physical or nervous health problems, known as work disability. With data from the Panel Study of Income Dynamics (PSID) (1968-2013; n=6,045; 82,374 transitions; 129,107 person-years) and the 2014 PSID Childhood Retrospective Circumstances Study, we estimated work disability transition probabilities with multinomial logistic Markov models. Four or more adversities defined a high level. Microsimulations quantified adult work disability patterns for African American and non-Hispanic white women and men, accounting for age, education, race, sex, diabetes, heart disease, obesity, and sedentary behavior. Childhood adversity was significantly associated with work disability. Of African American women with high adversity, 10.2% had moderate work disability at age 30 versus 4.1% with no reported adversities; comparable results for severe work disability were 5.6% versus 1.9% (both pwork disability remained significant after adjusting for diabetes, heart disease, obesity, and sedentary behavior (pwork disability throughout adult life. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
Washburn, Richard A; Zhu, Weimo; McAuley, Edward; Frogley, Michael; Figoni, Stephen F
To evaluate the construct validity of a new 13-item physical activity survey designed to assess physical activity in individuals with physical disabilities. Mail survey requesting information on physical activity, basic demographic characteristics, self-rated health, and self-rated physical activity. In February 2000, surveys were sent to 1176 individuals who had used rehabilitative services at a major midwestern university between 1950 and 1999. Two hundred twenty-seven men and 145 women with disabilities responded to the mail survey (80%, spinal cord or other locomotor injuries; 13%, visual and auditory injuries; 7%, other; 92%, white; mean age +/- standard deviation, 49.8 +/- 12.9y; mean length of disability, 36.9 +/- 14.9y). Not applicable. Physical activity was assessed with the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD). The PASIPD requests the number of days a week and hours daily (categories) of participation in recreational, household, and occupational activities over the past 7 days. Total scores were calculated as the average hours daily times a metabolic equivalent value and summed over items. Pearson correlations between each survey item and the total PASIPD score were all statistically significant (P or= .20 (range, .20- .67). Factor analysis with principal component extraction and varimax orthogonal rotations revealed 5 latent factors (eigenvalues >or= 1, factor loadings >or= .40): home repair and lawn and garden, housework, vigorous sport and recreation, light sport and recreation, and occupation and transportation. These 5 factors accounted for 63% of the total variance. Cronbach alpha coefficients ranged from.37 to.65, indicating low-to-moderate internal consistency within factors. Those who reported being "active/highly active" had higher total and subcategory scores compared with those "not active at all." Those in "excellent" health had higher total, vigorous sport and recreation, and occupation and
Hicham A. Diab
Full Text Available Objectives: To assess the dental status of institutionalized intellectually disabled individuals in Lebanon and the role of background and behavioural determinants. Material and Methods: Oral health was recorded for 652 individuals (6, 12, 15 and 35 - 44 years old using the decayed, missing and filled teeth/decayed and filled teeth (DMFT/dft index. Data collected was statistically analysed with statistical significance set at P = 0.05. Results: Overall, mean DMFT index score was 5.86 (SD 6; composed of 3.64 (SD 4.05 decayed (D teeth; 1.71 (SD 4.38 missing (M teeth; 0.87 (SD 2.51 filled (F teeth. DMFT was highest in adults (12.71 [SD 7.43] and had a large component of missing (6.24 [SD 7.02] and filled (3.31 [SD 4.56] teeth. DMFT scores ranged between 3.5 (SD 4.44 at 6 years and 4.8 (SD 4.52 at 15 years and the decayed component was the main contributor. In multivariate analyses, governorate of residence was statistically significantly (P ≤ 0.040 and P ≤ 0.044 associated with D and DMFT, the degree of disability and caretaker educational level were statistically significantly (P = 0.009 and P = 0.008 associated with D, oral hygiene practices were statistically significantly (P ≤ 0.017; P < 0.001; P ≤ 0.017; P < 0.001 associated with D, M, F and DMFT and sugar consumption was statistically significantly (P ≤ 0.03 and P ≤ 0.019 associated with D and DMFT. Conclusions: In Lebanon, preventive and treatment programs to improve the oral health status of institutionalized intellectually disabled subjects are needed.
Tam, Cynthia; Schwellnus, Heidi; Eaton, Ceilidh; Hamdani, Yani; Lamont, Andrea; Chau, Tom
Children with severe physical disabilities often lack the physical skills to explore their environment independently, and to play with toys or musical instruments. The movement-to-music (MTM) system is an affordable computer system that allows children with limited movements to play and create music. The present study explored parents' experiences of using the MTM system with their children. A qualitative methodology employing in-depth interview techniques was used with six mothers and their children. The themes extracted from the data were organized under two main concepts of the International Classification of Functioning, Disability, and Health (ICF) (WHO, 2001) framework. The results showed that the MTM expanded horizons for the child along the ICF health dimensions and the MTM had a positive impact on ICF environmental determinants of health. The small sample size should be noted as a limitation of this study. Further research should be carried out with a larger sample of children with restricted mobility to obtain a better understanding of the impact of MTM technology on children's psychosocial development.
Full Text Available Objective. To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. Materials and methods. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. Results. While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4% and depression (1.5% daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. Conclusions. Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.
van Bakel, Marit; Einarsson, Ingolfur; Arnaud, Catherine
Our aim was to study the feasibility of creating a framework for monitoring and undertaking collaborative research on intellectual disability at the European level, based on existing databases of children with such disability.......Our aim was to study the feasibility of creating a framework for monitoring and undertaking collaborative research on intellectual disability at the European level, based on existing databases of children with such disability....
Borji, Rihab; Sahli, Sonia; Zarrouk, Nidhal; Zghal, Firas; Rebai, Haithem
This study examined neuromuscular fatigue after high-intensity intermittent exercise in 10 men with mild intellectual disability (ID) in comparison with 10 controls. Both groups performed three maximal voluntary contractions (MVC) of knee extension with 5 min in-between. The highest level achieved was selected as reference MVC. The fatiguing exercise consists of five sets with a maximal number of flexion-extension cycles at 80% of the one maximal repetition (1RM) for the right leg at 90° with 90 s rest interval between sets. The MVC was tested again after the last set. Peak force and electromyography (EMG) signals were measured during the MVC tests. Root Mean Square (RMS) and Median Frequency (MF) were calculated. Neuromuscular efficiency (NME) was calculated as the ratio of peak force to the RMS. Before exercise, individuals with ID had a lower MVC (psport train ID individuals, they should consider this nervous system weakness. Copyright © 2013 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background The new Musculoskeletal Services Framework outlines the importance of health care needs assessment. Our aim was to provide a model for this for knee pain and disability, describing felt need (individual assessment of a need for health care and expressed need (demand for health care. This intelligence is required by health care planners in order to implement the new Framework. Methods A multi-method approach was used. A population survey (n = 5784 was administered to adults aged 50+ registered with 3 general practices. The questionnaire contained a Knee Pain Screening Tool to identify the prevalence of knee pain and health care use in the population, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Survey responders who scored "severe" or "extreme" on at least one item on the pain or physical function scale on the WOMAC were categorised into "severe" groups. Qualitative interviews were undertaken with 22 survey responders to explore in detail the experience of living with knee pain and disability. A sample of interviewees (n = 10 completed an open format patient diary to explore the experience of knee pain in everyday life. Results The 12-month period prevalence of knee pain was 49.5%, of which half was severe. Severe difficulties were reported with domestic duties, bending, bathing, climbing stairs and getting in or out of a car. Some self-care is occurring. The majority (53% of responders with severe pain or disability had not consulted their GP in the last 12 months. The qualitative study revealed reasons for this including a perception that knee pain is part of normal ageing, little effective prevention and treatment is available and the use of medications causes side effects and dependency. Conclusion This study adds to previous work by highlighting a gap between felt and expressed need and the reasons for this mismatch. There is evidence of self-management, but also missed opportunities for
Benromano, Tali; Pick, Chaim G; Granovsky, Yelena; Defrin, Ruth
Previous studies on the sensitivity and reactivity to pain of individuals with intellectual disability (ID) are inconsistent. The inconsistency may result from the reliance on self-reports and facial expressions of pain that are subject to internal and external biases. The aim was therefore to evaluate the reactivity to pain of individuals with ID by recording pain-evoked potentials (EPs), here for the first time, and testing their association with behavioral pain indices. Forty-one healthy adults, 16 with mild-moderate ID and 25 controls. Subjects received series of phasic heat stimuli and rated their pain on self-report scales. Changes in facial expressions and in pain EPs were recorded and analyzed offline. Pain self-reports, facial expressions, and the N2P2 amplitudes of the EPs exhibited stimulus-response relationship with stimulation intensity in both groups. The facial expressions and N2P2 amplitudes of individuals with ID were increased and N2P2 latency prolonged compared with controls. N2P2 amplitudes correlated with self-reports only in controls. Individuals with ID are hypersensitive/reactive to pain, a finding bearing clinical implications. Although pain EPs may reflect a somewhat different aspect of pain than the behavioral indices do, there is evidence to support their use to record pain in noncommunicative individuals, pending further validation. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Mumford, Leslie; Lam, Rachel; Wright, Virginia; Chau, Tom
This study applied response efficiency theory to create the Access Technology Delivery Protocol (ATDP), a child and family-centred collaborative approach to the implementation of access technologies. We conducted a descriptive, mixed methods case study to demonstrate the ATDP method with a 12-year-old boy with no reliable means of access to an external device. Evaluations of response efficiency, satisfaction, goal attainment, technology use and participation were made after 8 and 16 weeks of training with a custom smile-based access technology. At the 16 week mark, the new access technology offered better response quality; teacher satisfaction was high; average technology usage was 3-4 times per week for up to 1 h each time; switch sensitivity and specificity reached 78% and 64%, respectively, and participation scores increased by 38%. This case supports further development and testing of the ATDP with additional children with multiple or severe disabilities.
Malone, Laurie A; Padalabalanarayanan, Sangeetha; McCroskey, Justin; Thirumalai, Mohanraj
Individuals with disabilities are typically more sedentary and less fit compared to their peers without disabilities. Furthermore, engaging in physical activity can be extremely challenging due to physical impairments associated with disability and fewer opportunities to participate. One option for increasing physical activity is playing active video games (AVG), a category of video games that requires much more body movement for successful play than conventional push-button or joystick actions. However, many current AVGs are inaccessible or offer limited play options for individuals who are unable to stand, have balance issues, poor motor control, or cannot use their lower body to perform game activities. Making AVGs accessible to people with disabilities offers an innovative approach to overcoming various barriers to participation in physical activity. Our aim was to compare the effect of off-the-shelf and adapted game controllers on quality of game play, enjoyment, and energy expenditure during active video gaming in persons with physical disabilities, specifically those with mobility impairments (ie, unable to stand, balance issues, poor motor control, unable to use lower extremity for gameplay). The gaming controllers to be evaluated include off-the-shelf and adapted versions of the Wii Fit balance board and gaming mat. Participants (10-60 years old) came to the laboratory a total of three times. During the first visit, participants completed a functional assessment and became familiar with the equipment and games to be played. For the functional assessment, participants performed 18 functional movement tasks from the International Classification of Functioning, Disability, and Health. They also answered a series of questions from the Patient Reported Outcomes Measurement Information System and Quality of Life in Neurological Conditions measurement tools, to provide a personal perspective regarding their own functional ability. For Visit 2, metabolic data were
Bosch-Bayard, Jorge; Galán-García, Lídice; Fernandez, Thalia; Lirio, Rolando B; Bringas-Vega, Maria L; Roca-Stappung, Milene; Ricardo-Garcell, Josefina; Harmony, Thalía; Valdes-Sosa, Pedro A
In this paper, we present a novel methodology to solve the classification problem, based on sparse (data-driven) regressions, combined with techniques for ensuring stability, especially useful for high-dimensional datasets and small samples number. The sensitivity and specificity of the classifiers are assessed by a stable ROC procedure, which uses a non-parametric algorithm for estimating the area under the ROC curve. This method allows assessing the performance of the classification by the ROC technique, when more than two groups are involved in the classification problem, i.e., when the gold standard is not binary. We apply this methodology to the EEG spectral signatures to find biomarkers that allow discriminating between (and predicting pertinence to) different subgroups of children diagnosed as Not Otherwise Specified Learning Disabilities (LD-NOS) disorder. Children with LD-NOS have notable learning difficulties, which affect education but are not able to be put into some specific category as reading (Dyslexia), Mathematics (Dyscalculia), or Writing (Dysgraphia). By using the EEG spectra, we aim to identify EEG patterns that may be related to specific learning disabilities in an individual case. This could be useful to develop subject-based methods of therapy, based on information provided by the EEG. Here we study 85 LD-NOS children, divided in three subgroups previously selected by a clustering technique over the scores of cognitive tests. The classification equation produced stable marginal areas under the ROC of 0.71 for discrimination between Group 1 vs. Group 2; 0.91 for Group 1 vs. Group 3; and 0.75 for Group 2 vs. Group1. A discussion of the EEG characteristics of each group related to the cognitive scores is also presented.
Full Text Available In this paper, we present a novel methodology to solve the classification problem, based on sparse (data-driven regressions, combined with techniques for ensuring stability, especially useful for high-dimensional datasets and small samples number. The sensitivity and specificity of the classifiers are assessed by a stable ROC procedure, which uses a non-parametric algorithm for estimating the area under the ROC curve. This method allows assessing the performance of the classification by the ROC technique, when more than two groups are involved in the classification problem, i.e., when the gold standard is not binary. We apply this methodology to the EEG spectral signatures to find biomarkers that allow discriminating between (and predicting pertinence to different subgroups of children diagnosed as Not Otherwise Specified Learning Disabilities (LD-NOS disorder. Children with LD-NOS have notable learning difficulties, which affect education but are not able to be put into some specific category as reading (Dyslexia, Mathematics (Dyscalculia, or Writing (Dysgraphia. By using the EEG spectra, we aim to identify EEG patterns that may be related to specific learning disabilities in an individual case. This could be useful to develop subject-based methods of therapy, based on information provided by the EEG. Here we study 85 LD-NOS children, divided in three subgroups previously selected by a clustering technique over the scores of cognitive tests. The classification equation produced stable marginal areas under the ROC of 0.71 for discrimination between Group 1 vs. Group 2; 0.91 for Group 1 vs. Group 3; and 0.75 for Group 2 vs. Group1. A discussion of the EEG characteristics of each group related to the cognitive scores is also presented.
Scoppetta, C; Scoppetta, M
We have recently designed a new type of walker for those severely disabled patients who cannot walk with commonly used medical walkers. A drawing and the description of this new walker is reported in order to permit the worldwide companies as well as artisans to develop and produce it for the people affected from severe motor problems. This walker supposes the patient wearing either a modified climbing harness or equipped clothes and being suspended to the walking frame. It consists in two series of bands suspending the patient from the frame; the upper one suspends him for the upper part of his trunk, the lower one by his pelvis. This walker is suggested for patients belonging to three principal groups: (1) Persons who have no trunk control (e.g.: patients affected by severe stroke or ataxias). (2) Persons whose walk is allowed only if they achieve a significant reduction (up to 30-40%) of the their body weight charging on trunk, spine, and lower limbs. (3) Persons who need a differentiated reduction of the body weight either among anterior and posterior side or among their right and left part of the body (hemiparesis, Parkinson disease, scoliosis, kyphosis). Creating this walker is easy; producing costs are low; there are no maintenance costs.
Sterkenburg, P. S.; Janssen, C. G. C.; Schuengel, C.
Background: A combination of an attachment-based therapy and behaviour modification was investigated for children with persistent challenging behaviour. Method: Six clients with visual and severe intellectual disabilities, severe challenging behaviour and with a background of pathogenic care were treated. Challenging behaviour was recorded…
Matson, Johnny L.; Terlonge, Cindy; Gonzalez, Melissa L.; Rivet, Tessa
The purpose of this study was to explore the interrelationship of social and adaptive skills in adults with bipolar disorder and severe or profound intellectual disability. A bipolar group (N=14), a severe psychopathology group without bipolar disorder (N=14), and a control group with no DSM-IV Axis I diagnosis (N=14) were compared on the…
Cornell Journal of Law and Public Policy: Vol. 26 : Iss. 1 , Article 2. The Americans with Disabilities Act (“ADA”) is recognized as one of the most significant pieces of civil rights legislation in American history and is aimed at protecting the rights of individuals with disabilities. Unfortunately, as the ADA has developed, some attorneys have exposed methods of exploiting the provisions of the ADA for personal, pecuniary benefits—fee-driven lawsuits for violations of plaintiff-friendly pr...
Eack, Shaun M.; Newhill, Christina E.
Racial disparities in mental health outcomes have been widely documented in noninstitutionalized community psychiatric samples, but few studies have specifically examined the effects of race among individuals with the most severe mental illnesses. A sample of 925 individuals hospitalized for severe mental illness was followed for a year after…
O'Neill, Linda P.; Murray, Lindsay E.
Adult siblings of individuals with developmental disabilities often experience higher levels of anxiety than individuals in the general population. The present study tested whether perceived parenting could mediate the relationship between attachment styles and anxiety in the sibling group compared to a control group. Little association was found…
van der Meer, Larah; Kagohara, Debora; Achmadi, Donna; Green, Vanessa A.; Herrington, Christina; Sigafoos, Jeff; O'Reilly, Mark F.; Lancioni, Giulio E.; Lang, Russell; Rispoli, Mandy
Anecdotal reports suggest that individuals with developmental disabilities who lack speech may be enabled to communicate through the use of a new iPod-based communication device. However, there appear to be limited empirical data demonstrating successful use of this new device by such individuals. This study was designed to provide empirical…
Burke, Meghan; Arnold, Catherine; Owen, Aleksa
Although individuals with intellectual and developmental disabilities (IDD) are living longer lives, fewer than half of parents of individuals with IDD conduct future planning. The correlates and barriers to future planning must be identified to develop targeted interventions to facilitate future planning. In this study, 388 parents of individuals…
Gül, Seray Olçay
There are many studies in the literature in which individuals with intellectual disabilities exhibit social skills deficits and which show the need for teaching these skills systematically. This study aims to investigate the effects of an intervention package of consisting computer-presented video modeling and Social Stories on individuals with…
Sleister, Heidi M.; Valdovinos, Maria Gabriela
Weight gain is an often-observed side effect of atypical antipsychotics (AAPs) and is particularly significant in individuals with intellectual disabilities (ID). The majority of individuals treated with AAPs will gain at least 10% of their initial body weight over the course of therapy (Umbricht & Kane, 1996). One's genetic constitution is an…
Brite, Roberta; Nunes, Francisco; Souza, Danielle
This study aims to analyze the managers' conceptions involved in the process of labor inclusion in 18 supermarkets with 5,000 employees, 300 of whom with disabilities. A group of 90 managers working with people with disability completed a Conceptions of Disability Inventory (CDI) about their conceptions of people with disabilities. Their responses were categorized as follows: (a) disability as a spiritual manifestation; b) disability as a deviation from normality; (c) disability based on assumptions of inclusion; (d) disability assessed from performance criteria; (e) disability assessed from the connection established with the work organization; (f) disability conceived by contracting benefits, and (g) disability based on the perception of the need for training. Based on the outcomes of the Pearson Correlation Matrix, significant linear correlations were found in seven managers' conceptions of disability. The results also indicate that the managers' conceptions contributed to differentiated inclusionist actions based on their perceptions related to people with disabilities. This study data contributes to identifying the best practices in labor inclusion. The outcomes of the present study could lead to development of a public policy aimed towards humanizing job alternatives for people with disability.
Tainio, Marko; Olkowicz, Dorota; Teresiński, Grzegorz; de Nazelle, Audrey; Nieuwenhuijsen, Mark J
Health impact assessment (HIA) studies are increasingly predicting the health effects of mode shifts in traffic. The challenge for such studies is to combine the health effects, caused by injuries, with the disease driven health effects, and to express the change in the health with a common health indicator. Disability-adjusted life year (DALY) combines years lived disabled or injured (YLD) and years of life lost (YLL) providing practical indicator to combine injuries with diseases. In this study, we estimate the average YLDs for one person injured in a transport crash to allow easy to use methods to predict health effects of transport injuries. We calculated YLDs and YLLs for transport fatalities and injuries based on the data from the Swedish Traffic Accident Data Acquisition (STRADA). In STRADA, all the fatalities and most of the injuries in Sweden for 2007-2011 were recorded. The type of injury was recorded with the Abbreviated Injury Scale (AIS) codes. In this study these AIS codes were aggregated to injury types, and YLDs were calculated for each victim by multiplying the type of injury with the disability weight and the average duration of that injury. YLLs were calculated by multiplying the age of the victim with life expectancy of that age and gender. YLDs and YLLs were estimated separately for different gender, mode of transport and location of the crash. The average YLDs for injured person was 14.7 for lifelong injuries and 0.012 for temporal injuries. The average YLDs per injured person for lifelong injuries for pedestrians, cyclists and car occupants were 9.4, 12.8 and 18.4, YLDs, respectively. Lifelong injuries sustained in rural areas were on average 31% more serious than injuries in urban areas. The results show that shifting modes of transport will not only change the likelihood of injuries but also the severity of injuries sustained, if injured. The results of this study can be used to predict DALY changes in HIA studies that take into account
Dauman, Nicolas; Erlandsson, Soly I.; Albarracin, Dolorès; Dauman, René
Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach. Methods: Twelve participants (six females, six males, aged 51–79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998). Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: “Losing body ownership,” “Lacking perspectives,” and “Persevering through difficulties.” Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model
Dauman, Nicolas; Erlandsson, Soly I; Albarracin, Dolorès; Dauman, René
Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach. Methods: Twelve participants (six females, six males, aged 51-79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data ( n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998). Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: "Losing body ownership," "Lacking perspectives," and "Persevering through difficulties." Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model identifies a
Full Text Available Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach.Methods: Twelve participants (six females, six males, aged 51–79 were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014, the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998.Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: “Losing body ownership,” “Lacking perspectives,” and “Persevering through difficulties.” Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance. It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore
Donna J. Cech
Full Text Available Individuals with disabilities experience inequities in access to health care, education, employment, and social inclusion. Causes for Change International (CCI, a non-governmental Organization (NGO, using a community-based rehabilitation approach has worked for 20 years to build self-sufficiency, improve health-care services, and education for women, children, and persons with disabilities in Ecuador. CCI initially addressed health; advocacy for individuals with disabilities; and promoted educational opportunities for children with disabilities, starting in one rural community. CCI’s outreach has expanded through Ecuador’s coastal provinces, Andean provinces, and Galapagos Islands. CCI also focused on local health-care workforce development, developing employment skills for individuals with disabilities and social inclusion for this population. CCI collaborated with local organizations, government, and universities to provide resources, managed by local leadership. Key program elements of the CCI approach include (1 develop trust between CCI, local communities, local agencies, and government; (2 empower local groups to assume leadership and sustain programs; (3 support communities and groups invested in developing self-sufficiency; and (4 strengthen collaborations and partnerships between local and international organizations, universities, and government agencies. Key lessons learned by CCI are to be supportive of cultural differences; understand that limited financial and material resources may limit the program development; recognize that it is difficult not to foster dependent relationships with communities and appreciate the importance of working with and within the host country’s governmental systems. CCI is expanding its service base to other regions of Ecuador and is focusing on development of the Ecuadorian health-care workforce and social inclusion opportunities for individuals with disability. The efforts of a small NGO have
Cech, Donna J; Alvarado, Zully J
Individuals with disabilities experience inequities in access to health care, education, employment, and social inclusion. Causes for Change International (CCI), a non-governmental Organization (NGO), using a community-based rehabilitation approach has worked for 20 years to build self-sufficiency, improve health-care services, and education for women, children, and persons with disabilities in Ecuador. CCI initially addressed health; advocacy for individuals with disabilities; and promoted educational opportunities for children with disabilities, starting in one rural community. CCI's outreach has expanded through Ecuador's coastal provinces, Andean provinces, and Galapagos Islands. CCI also focused on local health-care workforce development, developing employment skills for individuals with disabilities and social inclusion for this population. CCI collaborated with local organizations, government, and universities to provide resources, managed by local leadership. Key program elements of the CCI approach include (1) develop trust between CCI, local communities, local agencies, and government; (2) empower local groups to assume leadership and sustain programs; (3) support communities and groups invested in developing self-sufficiency; and (4) strengthen collaborations and partnerships between local and international organizations, universities, and government agencies. Key lessons learned by CCI are to be supportive of cultural differences; understand that limited financial and material resources may limit the program development; recognize that it is difficult not to foster dependent relationships with communities and appreciate the importance of working with and within the host country's governmental systems. CCI is expanding its service base to other regions of Ecuador and is focusing on development of the Ecuadorian health-care workforce and social inclusion opportunities for individuals with disability. The efforts of a small NGO have helped build
Full Text Available The paper is based on a research which tries to explore, explain and describe Islam - science integration approach to develop an Individualized Education Program (IEP for students with disabilities in chemistry lesson. As a qualitative case study, this paper is aimed at investigating how Islam - science integration approach can be underpinned for developing the IEP for Chemistry. Participants were recruited purposively and data were collected by interviews; documents’ analysis; and experts’ assessment (i.e. material experts, inclusive education experts, media experts, chemistry teachers and support teachers, then analyzed using content-analysis. The result shows Islam - science integration approach can be a foundation to develop the chemistry IEP by seeking support for the verses of the Qur'an and corresponding hadiths. Even although almost all the subject matter in chemistry can be integrated with Islamic values, this study only developed two contents, namely Periodic System of Elements and Reaction Rate.
Shnitzer-Meirovich, Shlomit; Lifshitz, Hefziba; Mashal, Nira
This study is the first to investigate the effectiveness of deep and shallow intervention programs in the acquisition of visual metaphor comprehension in individuals with non-specific intellectual disability (NSID; aged 15-59, N = 53) or Down syndrome (DS; aged 15-52, N = 50). The deep intervention program was based on dynamic assessment model for enhancing analogical thinking. The shallow intervention program involves memorizing a metaphorical relationship between pairs of pictures. Visual metaphor comprehension was measured by the construction of a metaphorical connection between pairs of pictures. The results indicated that both etiology groups exhibited poor understanding of visual metaphors before the intervention. A significant improvement was observed in both interventions and both etiology groups, with greater improvement among individuals who underwent the deep processing. Moreover, the latter procedure led to greater generalization ability. The results also indicated that vocabulary contributed significantly to understanding unstudied metaphors and that participants with poorer linguistic abilities exhibited greater improvement in their metaphorical thinking. Thus, individuals with ID with or without DS are able to recruit the higher-order cognitive abilities required for visual metaphor comprehension. Copyright © 2018 Elsevier Ltd. All rights reserved.
Full Text Available Work is important for one’s self-esteem, social standing and ability to participate in the community as well as for the material advantages it brings to individuals and their families. The evidence suggests that the benefits of employment outweigh the risks of work and are greater than the risks of long-term unemployment or sickness absence. Individuals may be born with physical or intellectual disadvantages (e.g., cerebral palsy, or they may be acquired during childhood or adult life. Some progressive conditions may present in childhood or adolescence (e.g., some muscular dystrophies and these need to be distinguished from those presenting later in life (e.g., trauma, stroke. Vocational rehabilitation (VR thus takes three forms: preparing those with a disability, health or mental health condition for the world of work, job retention for those in work and assisting those out of work into new work. Important components of VR consist of the attributes of the individual, the skills/knowledge of their health professionals, the knowledge and attitudes of actual or potential employers and the assistance that is provided by the state or other insurance facility. Charities are playing an increasing role.
Silfhout, A.T. van; Rajamanickam, S.; Jensik, P.J.; Vergult, S.; Rocker, N. de; Newhall, K.J.; Raghavan, R.; Reardon, S.N.; Jarrett, K.; McIntyre, T.; Bulinski, J.; Ownby, S.L.; Huggenvik, J.I.; McKnight, G.S.; Rose, G.M.; Cai, X; Willaert, A.; Zweier, C.; Endele, S.; Ligt, J. de; Bon, B.W.M. van; Lugtenberg, D.; Vries, P.F. de; Veltman, J.A.; Bokhoven, H. van; Brunner, H.G.; Rauch, A.; Brouwer, A.P.M. de; Carvill, G.L.; Hoischen, A.; Mefford, H.C.; Eichler, E.E.; Vissers, L.E.L.M.; Menten, B.; Collard, M.W.; Vries, L.B.A. de
Recently, we identified in two individuals with intellectual disability (ID) different de novo mutations in DEAF1, which encodes a transcription factor with an important role in embryonic development. To ascertain whether these mutations in DEAF1 are causative for the ID phenotype, we performed
“I love my sister, but sometimes I don’t”. This is one of the statements made in the study focused on the experiences of family members of people with (profound) intellectual (and multiple) disabilities (both of individuals living in a residential facility as persons living at home). In recent
Tomeny, Theodore S; Ellis, Brandi M; Rankin, James A; Barry, Tammy D
Research on adult typically-developing (TD) siblings of individuals with developmental disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual disability (ID) completed questionnaires about themselves and their affected sibling. Results of this study suggest that the attitudes possessed by adult TD siblings are important to consider when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of positive sibling relationship attitudes are related to TD siblings providing more aid/support to their sibling with a disability, along with having higher levels of general life satisfaction, and negatively related to levels of stress and depressive symptoms among TD siblings. Consistent with previous child research, siblings of individuals with ASD reported fewer positive sibling relationship attitudes compared to siblings of individuals with ID. Finally, group membership related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling relationship attitudes. Overall, results indicate that sibling relationship attitudes may be particularly important to consider when conceptualizing sibling relationships when one sibling has an intellectual or developmental disability. Copyright © 2017 Elsevier Ltd. All rights reserved.
Ritchie, Carrie; Hendrikz, Joan; Jull, Gwendolen; Elliott, James; Sterling, Michele
Retrospective secondary analysis of data. To investigate the external validity of the whiplash clinical prediction rule (CPR). We recently derived a whiplash CPR to consolidate previously established prognostic factors for poor recovery from a whiplash injury and predicted 2 recovery pathways. Prognostic factors for full recovery were being less than 35 years of age and having an initial Neck Disability Index (NDI) score of 32% or less. Prognostic factors for ongoing moderate/severe pain and disability were being 35 years of age or older, having an initial NDI score of 40% or more, and the presence of hyperarousal symptoms. Validation is required to confirm the reproducibility and accuracy of this CPR. Clinician feedback on the usefulness of the CPR is also important to gauge acceptability. A secondary analysis of data from 101 individuals with acute whiplash-associated disorder who had previously participated in either a randomized controlled clinical trial or prospective cohort study was performed using accuracy statistics. Full recovery was defined as NDI score at 6 months of 10% or less, and ongoing moderate/severe pain and disability were defined as an NDI score at 6 months of 30% or greater. In addition, a small sample of physical therapists completed an anonymous survey on the clinical acceptability and usability of the tool. Results The positive predictive value of ongoing moderate/severe pain and disability was 90.9% in the validation cohort, and the positive predictive value of full recovery was 80.0%. Surveyed physical therapists reported that the whiplash CPR was simple, understandable, would be easy to use, and was an acceptable prognostic tool. External validation of the whiplash CPR confirmed the reproducibility and accuracy of this dual-pathway tool for individuals with acute whiplash-associated disorder. Further research is needed to assess prospective validation, the impact of inclusion on practice, and to examine the efficacy of linking treatment
Ariel M Pani
Full Text Available Intellectual disability (ID affects 2-3% of the population and may occur with or without multiple congenital anomalies (MCA or other medical conditions. Established genetic syndromes and visible chromosome abnormalities account for a substantial percentage of ID diagnoses, although for approximately 50% the molecular etiology is unknown. Individuals with features suggestive of various syndromes but lacking their associated genetic anomalies pose a formidable clinical challenge. With the advent of microarray techniques, submicroscopic genome alterations not associated with known syndromes are emerging as a significant cause of ID and MCA.High-density SNP microarrays were used to determine genome wide copy number in 42 individuals: 7 with confirmed alterations in the WS region but atypical clinical phenotypes, 31 with ID and/or MCA, and 4 controls. One individual from the first group had the most telomeric gene in the WS critical region deleted along with 2 Mb of flanking sequence. A second person had the classic WS deletion and a rearrangement on chromosome 5p within the Cri du Chat syndrome (OMIM:123450 region. Six individuals from the ID/MCA group had large rearrangements (3 deletions, 3 duplications, one of whom had a large inversion associated with a deletion that was not detected by the SNP arrays.Combining SNP microarray analyses and qPCR allowed us to clone and sequence 21 deletion breakpoints in individuals with atypical deletions in the WS region and/or ID or MCA. Comparison of these breakpoints to databases of genomic variation revealed that 52% occurred in regions harboring structural variants in the general population. For two probands the genomic alterations were flanked by segmental duplications, which frequently mediate recurrent genome rearrangements; these may represent new genomic disorders. While SNP arrays and related technologies can identify potentially pathogenic deletions and duplications, obtaining sequence information
Keith, Jessica M; Bennetto, Loisa; Rogge, Ronald D
Increases in intellectual and developmental disability (IDD) diagnoses coupled with higher rates of inclusion in school and community settings, has created more opportunities for exposure and integration between those with IDD and the mainstream population. Previous research has found that increased contact can lead to more positive attitudes toward those with IDD. The current study further investigated this impact of contact on attitudes by examining the influence of the quality and quantity of contact on both explicit and implicit levels of prejudice, while also considering potential mediation via intergroup anxiety and implicit attitudes. Based on past research and theory, we predicted that contact (especially quality contact) would have a strong relationship with explicit and implicit positive attitudes toward individuals with IDD. In the present study, 550 people completed a survey and short task that measured their level of contact with individuals with IDD across their lifetime, their current attitudes toward these individuals, and other constructs that are thought to influence this relationship. Multiple regression analyses suggested consistent links between higher quality of contact and lower levels of prejudice toward individuals with IDD at both the explicit and implicit levels. After controlling for quality of contact, higher quantity of contact was either not significantly associated with our measures of prejudice or was, importantly, associated with higher levels of prejudice. Additional analyses support intergroup anxiety and implicit positive attitudes as significant mediators in the associations between quality of contact and the various dimensions of explicit prejudice. Thus, it would seem that it is the quality of interpersonal interactions that is most strongly related to positive attitudes toward individuals with IDD, making it crucial to take care when developing inclusion opportunities in community settings. Copyright © 2015 Elsevier Ltd
Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel
Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.
R.T.C. Yokota (Renata T. C.); J.H.A. van der Heyden; S. Demarest (Stefaan); J. Tafforeau (Jean); W.J. Nusselder (Wilma); P. Deboosere (Patrick); H. van Oyen (Herman)
textabstractBackground: Population aging accompanied by an increased longevity with disability has raised international concern, especially due to its costs to the health care systems. Chronic diseases are the main causes of physical disability and their simultaneous occurrence in the population can
Mizuno, Yuji; Ukaji, Koutarou
In 21 patients with severe motor and intellectual disabilities, bronchofiberoptic intubation was performed because of difficulty in tracheal intubation by direct laryngoscopy. The patients ranged from 3 to 35 years old (mean age: 20.2 years). Twenty patients (95.2%) were bedridden. Among the 21 patients, 15 had cerebral palsy and 20 had hypertonia. The reason for intubation were acute respiratory failure due to pneumonia in 17 cases, suffocation after aspiration of food in 2 cases, hypovolemic shock in 1 case, and laryngotracheomalacia in 1 case. Intubation was done pernasally in 15 patients and perorally in 10. It was successful in 20 cases without any significant complications. The Cormack score ranged from 3rd degree in 4 cases to 4th in 17 cases. The 20 cases of successful fiberoptic intubation were divided into 7 patients with and 13 without tracheostomy. The mortality rate was 14.3% in patients with tracheostomy and 30.8% in those without tracheostomy. When more than 4 intubation trials were needed, there was a significantly higher mortality rate. In neurologically handicapped patients with deformity or hypertonia of the oral, cervical, or airway structures, a bronchofiberoptic procedure may be recommended when there is difficulty with intubation.
Iiyama, Junichi; Matsushita, Kensuke; Tanaka, Nobuyuki; Kawahira, Kazumi
We have previously reported that thermal vasodilation following warm-water bathing and low-temperature sauna bathing (LTSB) at 60 degrees C for 15 min improves the cardiac function in patients with congestive heart failure. Through a comparative before-and-after study, we studied the hemodynamic and clinical effects of single exposure to LTSB in cerebral palsy (CP) patients who usually suffer from chilled extremities and low cardiac output. The study population comprised 16 patients ranging between 19 and 53 years with severe motor and intellectual disabilities. Noninvasive methods were used to estimate the systemic and peripheral circulatory changes before and after LTSB. Using blood flow velocity analysis, the pulsatile and resistive indexes of the peripheral arteries of the patients' lower limbs were calculated. Following LTSB, the patients' deep body temperature increased significantly by 1 degrees C. Their heart rates increased and blood pressure decreased slightly. The total peripheral resistance decreased by 11%, and the cardiac output increased by 14%. There was significant improvement in the parameters that are indicative of the peripheral circulatory status, including the skin blood flow, blood flow velocity, pulsatile index, and resistive index. Numbness and chronic myalgia of the extremities decreased. There were no adverse side effects. Thus, it can be concluded that LTSB improves the peripheral circulation in CP patients.
Darzi, Andrea J; Officer, Alana; Abualghaib, Ola; Akl, Elie A
The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes. We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale. Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively). The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their
McConachie, Douglas Alexander James; McKenzie, Karen; Morris, Paul Graham; Walley, Robert M
Support staff working with individuals with intellectual disability (ID) and challenging behaviour experience high levels of work-related stress. Preliminary theoretical and experimental research has highlighted the potential suitability of acceptance and mindfulness approaches for addressing support staff stress. This study examines the effectiveness of an acceptance and mindfulness-based stress management workshop on the levels of psychological distress and well-being of support staff working with individuals with ID and challenging behaviour. Support staff (n=120) were randomly assigned to a workshop intervention condition (n=66) or to a waiting list control condition (n=54). Measurements were completed at three time points (pre-, post and 6 week follow-up) for: psychological distress, well-being, perceived work stressors, thought suppression, and emotional avoidance/psychological inflexibility. The intervention led to significantly greater reductions in distress in the intervention group than in the control group. This was largely maintained at 6 week follow-up. This effect was more pronounced amongst a subsample that had shown higher levels of psychological distress at baseline. Thought suppression was found to reduce significantly in the intervention group between post intervention and follow-up, although no significant change was found in well-being or experiential avoidance/psychological inflexibility. Overall, results demonstrated support for the effectiveness of an acceptance and mindfulness-based intervention in reducing distress. Copyright © 2014 Elsevier Ltd. All rights reserved.
Blick, Rachel N; Litz, Katherine S; Thornhill, Monica G; Goreczny, Anthony J
More individuals with an intellectual disability now possess prerequisite skills and supports necessary for successful work force integration than did previous generations. The current study compared quality of life of community-integrated workers with those participating in sheltered vocational workshops and adult day care programs. We considered numerous indices of quality of life, including inclusion and community participation; satisfaction within professional services, home life, and day activities; dignity, rights, and respect received from others; fear; choice and control; and family satisfaction. Our data revealed several important differences in quality of life across daytime activities; participants involved in community-integrated employment tended to be younger, indicated a greater sense of community integration, and reported more financial autonomy than did those who participated in adult day care programs and sheltered workshops. However, individuals reported no differences in overall satisfaction across daytime activities. We discuss generational differences across employment status as well as possible explanations to account for high levels of satisfaction across daytime activities. Copyright © 2016 Elsevier Ltd. All rights reserved.
Waugh, Russell F.; Riddoch, Jane V.
There are few studies measuring the effects on painting quality of playing background classical music at special schools. Primary students with severe intellectual disabilities (N=24) were taught abstract painting in a two-part method. The first part involved a Pictorial Only method and the second, immediately following it, involved a Pictorial…
Lyons, Gregory L; Huber, Heartley B; Carter, Erik W; Chen, Rui; Asmus, Jennifer M
Although enhancing the social competence of students with severe disabilities has long remained a prominent focus of school-based intervention efforts, relatively little attention has focused on identifying the most critical social and behavioral needs of students during high school. We examined the social skills and problem behaviors of 137 adolescents with severe disabilities from the vantage point of both special educators and parents. We sought to identify areas of potential intervention need, explore factors associated with social skill and problem behavior ratings, and examine the extent to which teachers and parents converged in their assessments of these needs. Our findings indicate teachers and parents of high school students with severe disabilities rated social skills as considerably below average and problem behaviors as above average. In addition, lower social skills ratings were evident for students with greater support needs, lower levels of overall adaptive behavior, and a special education label of autism. We found moderate consistency in the degree to which teachers and parents aligned in their assessments of both social skills and problem behavior. We offer recommendations for assessment and intervention focused on strengthening the social competence of adolescents with severe disabilities within secondary school classrooms, as well as promising avenues for future research.
Jackson, Jeffrey B.; Roper, Susanne Olsen
Utilizing grounded theory qualitative research methods, a model was developed for describing parental adaptation after voluntary placement of a child with severe or profound developmental disabilities in out-of-home care. Interviews of parents from 20 families were analyzed. Parents' cognitive appraisals of placement outcomes were classified…
Dickerson, Elizabeth G.
Purpose: The purpose of this quantitative research was to examine what relationships, if any, exist between the independent variable of burnout and dependent variables of job satisfaction for special education teachers who work with students who have moderate to severe disabilities ages 5 to 22 in a Southern California school district.…
Carter, Erik W.; Asmus, Jennifer; Moss, Colleen K.; Biggs, Elizabeth E.; Bolt, Dan M.; Born, Tiffany L.; Brock, Matthew E.; Cattey, Gillian N.; Chen, Rui; Cooney, Molly; Fesperman, Ethan; Hochman, Julia M.; Huber, Heartley B.; Lequia, Jenna L.; Lyons, Gregory; Moyseenko, Kerrie A.; Riesch, Lindsay M.; Shalev, Rebecca A.; Vincent, Lori B.; Weir, Katie
Enhancing the social and learning experiences of students with severe disabilities in inclusive classrooms has been a long-standing focus of research, legislative, and advocacy efforts. The authors used a randomized controlled experimental design to examine the efficacy of peer support arrangements to improve academic and social outcomes for 51…
Hetzroni, Orit E.; Shalev, Maayan
The study examined the effects of the types of communication breakdowns of the communication partners on the repair strategies of students with severe intellectual disability during interaction within the natural school environment. Forty-eight staff members, divided into two groups based on daily vs. weekly contact with the student, and 12…
Mergler, Sandra; de Man, Stella A.; Boot, Annemieke M; Bindels-de Heus, Karen G. C. B.; Huijbers, Wim A. R.; van Rijn, Rick R.; Penning, Corine; Evenhuis, Heleen M.
Children with severe neurological impairment and intellectual disability are prone to low bone quality and fractures. We studied the feasibility of automated radiogrammetry in assessing bone quality in this specific group of children. We measured outcome of bone quality and, because these children
Lyons, Gregory L.; Huber, Heartley B.; Carter, Erik W.; Chen, Rui; Asmus, Jennifer M.
Although enhancing the social competence of students with severe disabilities has long remained a prominent focus of school-based intervention efforts, relatively little attention has focused on identifying the most critical social and behavioral needs of students during high school. We examined the social skills and problem behaviors of 137…
This research focused on whether a TEACCH-based approach could be effective in helping to develop the communication skills of older learners with Severe Intellectual Disabilities, to enhance their ability to communicate, to enhance their abilities to live independent lives, and to take part in discussions about their future. A TEACCH based…
Bernabe, Elaine A.; Block, Martin E.
Coaches and players were assisted in modifying select rules of a girls' fast-pitch softball league so as to accommodate the skill limitations of a player with moderate to severe disabilities. The girl's batting average and on-base average indicated that modifications were effective. The player was well received by her teammates and other teams.…
Blackstone, Sarah W.
This training module is part of a series that provides a basic introduction to using assistive technology with young children (ages 2 to 7) who have severe disabilities in more than one area of development. This module focuses on technology that gives children another way to communicate when speaking is difficult or impossible. The module presents…
Pyo, Geunyeong; Ala, Tom; Kyrouac, Gregory A.; Verhulst, Steven J.
Objective assessment of memory functioning is an important part of evaluation for Dementia of Alzheimer Type (DAT). The revised Picture Recognition Memory Test (r-PRMT) is a test for visual recognition memory to assess memory functioning of persons with intellectual disabilities (ID), specifically targeting moderate to severe ID. A pilot study was…
Alquraini, Turki A.
In Saudi Arabia, the majority of students with severe intellectual disabilities are still educated in special schools that do not meet their unique needs for interaction with their typically developing peers in public schools settings where they could improve social, communication and academic skills. One of the most significant obstacles to…
Conklin, Carl G.; Mayer, G. Roy
The purpose of this study is to evaluate the effects of "Picture Exchange Communication System" (PECS) training, using a multiple baseline design on the independent initiations of three adults with developmental disabilities and severe communication deficits. All participants increased their independent initiations, although at different…
Pennington, Robert C.
Developing high-quality programming for students with moderate to severe disability (MSD) and/or autism spectrum disorder (ASD) can be challenging for teachers across the range of experience and training including those in rural contexts. This article outlines a process for the iterative refinement of teaching programs comprised of an evaluation…
Peters-Scheffer, N.C.; Didden, H.C.M.; Mulders, M.; Korzilius, H.P.L.M.
This study evaluated the effectiveness of low intensity behavioral treatment (on average 6.5 h per week) supplementing preschool services in 3-6-year-old children with autism spectrum disorder and severe to mild intellectual disability. Treatment was implemented in preschools (i.e., daycare centers)
Kulkas, A; Leppänen, T; Tiihonen, P; Mervaala, E; Töyräs, J; Sahlman, J; Seppä, J; Kokkarinen, J; Randell, J; Tuomilehto, H
Weight loss is an effective treatment for obstructive sleep apnea (OSA). The mechanisms of how weight loss affects nocturnal breathing are not fully understood. The severity of OSA is currently estimated by the number of respiratory events per hour of sleep (i.e. apnea-hypopnea-index, AHI). AHI neglects duration and morphology of individual respiratory events, which describe the severity of individual events. In the current paper, we investigate the novel Adjusted-AHI parameter (incorporating individual event severity) and AHI after weight loss in relation to sleeping position. It was hypothesised that there are positional differences in individual event severity changes during weight loss. Altogether, 32 successful (> 5% of weight) and 34 unsuccessful weight loss patients at baseline and after 1 year follow-up were analysed. The results revealed that individual respiratory event severity was reduced differently in supine and non-supine positions during weight loss. During weight loss, AHI was reduced by 54% (p = 0.004) and 74% (p < 0.001), while Adjusted-AHI was reduced by 14% (p = 0.454) and 48% (p = 0.003) in supine and non-supine positions, respectively. In conclusion, the severity of individual respiratory events decreased more in the non-supine position. The novel Adjusted-AHI parameter takes these changes into account and might therefore contribute additional information to the planning of treatment of OSA patients. (paper)
Hull, Helia Garrido
This Article addresses the need to reform the ADA to prevent vexatious litigation and to promote the underlying goals of the Act. Part I of this Article introduces the topic of vexatious litigation and the importance of remedying the effects of exploitation of the ADA. Part II provides an overview of the ADA and its efforts to increase accessibility to individuals with disabilities, emphasizing the provisions of the Act that create incentives to engage in vexatious litigation. Part III examines and analyzes the judiciary's response to vexatious litigation under the ADA, and sanctions that have been issued to limit exploitation. Finally, Part IV provides recommendations to reform the ADA and state disability law counterparts, suggests corrective actions to address vexatious litigation, and identifies methods to promote equality for individuals with disabilities.
Lifshitz, Hefziba; Kilberg, Esther; Vakil, Eli
Integrative research review infers generalizations about a substantive subject, summarizes the accumulated knowledge that research has left unresolved and generates a new framework on these issues. Due to methodological issues emerging from working memory (WM) studies in the population with non-specific intellectual disability (NSID) (N=64) between 1990-2014, it is difficult to conclude on WM performance in this population. This integrative research review aimed to resolve literature conflicts on WM performance among individuals with NSID and to identify the conditions/moderators that govern their WM performance compared to controls with Typical development. We used the six stages of integrative research review: problem formulation, data collection, evaluation, data analysis, results, interpretation and discussion. The findings indicate two types of moderators that determine WM performance in the population with NSID: Participants' moderators (criteria for matching the ID and TD groups, CA and MA), and task moderators [the three WM components of Baddeley and Hitch's (1974) model and task load]. Only an interaction between the two moderators determines WM performance in this population. The findings indicate a hierarchy (from more to less preserved) in WM performance of individuals with NSID: The visuospatial tasks, then some of the executive functions tasks, and the phonological loop tasks being less preserved. Furthermore, at a low level of control, the performance of participants with NSID was preserved beyond the modality and vice versa. Modality and MA/intelligence determine WM performance of individuals with ID. Educators should prepare intervention programs take the impact of the two moderators into account. Copyright © 2016 Elsevier Ltd. All rights reserved.
Forsyth, Rob; McNally, Richard; James, Peter; Crossland, Kevin; Woolley, Mark; Colver, Allan
The aim of this study was to examine geographical variability in the support for families caring for children with severe disabilities as well as the relationships between this variability and local government social and educational performance indicators. Data were collected from a cross-sectional, self-completed postal survey of the families of 5862 children and young people (aged 0-24 y, mean 10 y 7 mo; 68% male) with severe disabilities resulting in a variety of impairments (21% with autism spectrum disorders, 16% with learning disabilities,* 13% with emotional and behavioural difficulties, and 13% with cerebral palsy [CP]). Data on the severity of intrinsic impairment were assessed using the Health Utilities Index, and the need for support was assessed from the results of a novel parent-completed questionnaire, the European Child Environment Questionnaire (ECEQ). These responses were related to data published by local authorities on educational and social policy. Higher levels of unmet need and lack of support, as reported by parents of children and young people with severe disabilities, are associated with greater impairment but not with socioeconomic deprivation. After controlling for impairment and diagnosis, variation at local government level is of the order of 1 to 1.5 ECEQ standard deviation scores. The best- and the worst-performing local authorities--in terms of the averages of the 'support' scores reported by their surveyed residents--cluster in urban areas. For children with CP, a positive correlation was found between the reported unmet educational support requirements in each local authority area and rates of mainstream school placement for children with special educational needs. This indicates that the placement of children with disabilities into mainstream schools is associated with reported unmet need (r=0.60; p=0.01). In the case of children with autism spectrum diagnoses, the provision of additional basic educational support in mainstream
Chen, Eunice Y.; Fettich, Karla C.; Tierney, Megan; Cummings, Hakeemah; Berona, Johnny; Weissman, Jessica; Ward, Amanda; Christensen, Kara; Southward, Matthew; Gordon, Kathryn H.; Mitchell, James; Coccaro, Emil
There are high rates of suicide ideation and/or behavior in severely obese individuals. The potential contributors to suicide ideation in a sample of 334 severely obese bariatric surgery candidates was explored. Lack of college education, a history of suicide ideation and/or behavior, psychological distress, hopelessness, loneliness, history of…
van der Ploeg, Hidde P; Streppel, Kitty R M; van der Beek, Allard J; van der Woude, Luc H V; Vollenbroek-Hutten, Miriam; van Mechelen, Willem; van der Woude, Lucas
BACKGROUND: The objective was to determine the test-retest reliability and criterion validity of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD). METHODS: Forty-five non-wheelchair dependent subjects were recruited from three Dutch rehabilitation centers. Subjects'
Luteijn, I.; Didden, H.C.M.; Nagel, J.E.L. van der
Knowledge regarding substance-related problems and offending behavior in individuals with mild intellectual disability or borderline intellectual functioning (MBID; IQ 50-85) has increased over the last years, but is still limited. The present study examined differences in prevalence and clinical
Fickert, Nancy A.; Ross, Diana
Caregivers who work in community living arrangements or intermediate care facilities are responsible for the oral hygiene of individuals with intellectual and developmental disabilities. Oral hygiene training programs do not exist in many organizations, despite concerns about the oral care of this population. The purpose of this study was to…
Introduction: Support staff working with individuals with intellectual disability (ID) and challenging behaviour experience high levels of work-related stress. Preliminary theoretical and experimental research has highlighted the potential suitability of acceptance and mindfulness approaches for addressing support staff stress. This study examines the effectiveness of an acceptance and mindfulness-based stress management workshop on the levels of psychological distress and well...
de Groot, S.; van der Woude, L. H. V.; Niezen, A.; Smit, C. A. J.; Post, M. W. M.
Study design: Cross-sectional study. Objectives: To evaluate the physical activity scale for individuals with physical disabilities (PASIPD) in people with spinal cord injury (SCI). Setting: Eight Dutch rehabilitation centers with a specialized SCI unit. Methods: The PASIPD was examined by comparing
Eglseder, Kate; Webb, Sheridan
Purpose: To investigate the need for sexuality education for individuals with adult onset physical disabilities as it relates to quality of life and to identify current trends in the provision of sexuality education by health care providers relating to quality of care. Data Sources: Literature review from January 1986 to December 2016. Study…
Shivers, Carolyn M.; Kozimor, Laura Michelle
Introduction: The presence of comorbid mental illness in individuals with intellectual and developmental disabilities (IDD) has been shown to have additional negative impact on parents and caregivers. However, the impact of such dual diagnoses on typically developing siblings has yet to be examined. Methods: Parents and typically developing…
Schepis, Maureen M.; Reid, Dennis H.
A young adult with multiple disabilities (profound mental retardation, spastic quadriplegia, and visual impairment) was provided with a voice output communication aid (VOCA) which allowed communication through synthesized speech. Both educational and residential staff members interacted with the individual more frequently when she had access to…
Munde, V. S.; Vlaskamp, C.; Maes, B.; Ruijssenaars, A. J. J. M.
BackgroundWhile optimally activities are provided at those moments when the individual with profound intellectual and multiple disabilities (PIMD) is focused on the environment' or alert', detailed information about the impact that the design and timing of the activity has on alertness is lacking.
Bouck, Emily C.
Is a functional curriculum aligned with the federal education policies of No Child Left Behind (2002) and the Individuals with Disabilities Education Act (IDEA, 2004)? This article analyzes the alignment, or lack thereof, between this approach to educating secondary students with mild mental impairment and the two main federal education laws…
Pert, C.; Jahoda, A.
Background: A few recent studies have adopted a social cognitive perspective to explore how individuals with intellectual disabilities (IDs), who present problems of aggression, view their social world. The focus has mainly been on participants' perceptions of others' behaviour within conflict situations. The present exploratory study aims to…
Duijvenbode, N. van; Didden, H.C.M.; Hazel, T. van den; Engels, R.C.M.E.
Objective: To investigate the reliability and validity of a Wechsler Abbreviated Scale of Intelligence-based Wechsler Adult Intelligence Scale - third edition (WAIS-III) short form (SF) in a sample of individuals with mild to borderline intellectual disability (MBID) (N=117; M-IQ=71.34; SDIQ=8.00,
Brenton, Beatrice White; Gilmore, Doug
An operational index of discrepancy between ability and achievement using the Wechsler Intelligence Scale for Children and the Peabody Individual Achievement Test (PIAT) was tested with 50 male and 10 female legally identified learning disabled (LD) children (mean age 9 years 2 months). Use of the index identified 74% of the males and 30% of the…
Nery-Hurwit, Mara; Kincl, Laurel; Driver, Simon; Heller, Brittany
Individuals with disabilities face increasing health and employment disparities, including increased risk of morbidity and mortality and decreased earnings, occupational roles, and greater risk of injury at work. Thus, there is a need to improve workplace safety and health promotion efforts for people with disability. The purpose of this study was to obtain stakeholder feedback about an online program, Be Active, Work Safe, which was developed to increase the physical activity and workplace safety practices of individuals with disability. Eight stakeholders (content experts and individuals with disability) evaluated the 8-week online program and provided feedback on accessibility, usability, and content using quantitative and qualitative approaches. Stakeholders suggested changes to the organization, layout and accessibility, and content. This included making a stronger connection between the physical activity and workplace safety components of the program, broadening content to apply to individuals in different vocational fields, and reducing the number of participant assessments. Engaging stakeholders in the development of health promotion programs is critical to ensure the unique issues of the population are addressed and facilitate engagement in the program. Feedback provided by stakeholders improved the program and provided insight on barriers for adoption of the program. Copyright © 2017 Elsevier Ltd. All rights reserved.
Heyn, Patricia C; Baumgardner, Chad A; McLachlan, Leslie; Bodine, Cathy
The purpose of this pilot study was to investigate the effectiveness of a mixed-reality (MR) exercise environment on engagement and enjoyment levels of individuals with spinal cord injury (SCI) and intellectual and developmental disabilities (IDD). Six people participated in this cross-sectional, observational pilot study involving one MR exercise trial. The augmented reality environment was based on a first-person perspective video of a scenic biking/walking trail in Colorado. Males and females (mean age, 43.3 ± 13.7 years) were recruited from a research database for their participation in previous clinical studies. Of the 6 participants, 2 had SCI, 2 had IDD, and 2 were without disability. The primary outcome measurement of this pilot study was the self-reported engagement and enjoyment level of each participant after the exercise trial. All participants reported increased levels of engagement, enjoyment, and immersion involving the MR exercise environment as well as positive feedback recommending this type of exercise approach to peers with similar disabilities. All the participants reported higher than normal levels of enjoyment and 66.7% reported higher than normal levels of being on a real trail. Participants' feedback suggested that the MR environment could be entertaining, motivating, and engaging for users with disabilities, resulting in a foundation for further development of this technology for use in individuals with cognitive and physical disabilities.
Fullerton, Brenna S; Hong, Charles R; Velazco, Cristine S; Mercier, Charles E; Morrow, Kate A; Edwards, Erika M; Ferrelli, Karla R; Soll, Roger F; Modi, Biren P; Horbar, Jeffrey D; Jaksic, Tom
This study characterizes neurodevelopmental outcomes and healthcare needs of extremely low birth weight (ELBW) survivors of necrotizing enterocolitis (NEC) compared to ELBW infants without NEC. Data were collected prospectively on neonates born 22-27weeks' gestation or 401-1000g at 47 Vermont Oxford Network member centers from 1999 to 2012. Detailed neurodevelopmental evaluations were conducted at 18-24months corrected age. Information regarding rehospitalizations, postdischarge surgeries, and feeding was also collected. "Severe neurodevelopmental disability" was defined as: bilateral blindness, hearing impairment requiring amplification, inability to walk 10 steps with support, cerebral palsy, and/or Bayley Mental or Psychomotor Developmental Index neurodevelopmental disability, nearly half underwent postdischarge operations, and a quarter required tube feeding at home. At 18-24months, extremely low birth weight survivors of necrotizing enterocolitis were at markedly increased risk (pneurodevelopmental disability, postdischarge surgery, and tube feeding. II (prospective cohort study with <80% follow-up rate). Copyright © 2017 Elsevier Inc. All rights reserved.
Kreisman, Brian M; John, Andrew B
In 1975, Congress passed the Education for All Handicapped Children Act (Public Law 94-142), and it has been revised and modified several times. At the time of this writing, this law was most recently amended by the Individuals with Disabilities Education Improvement Act (Pub. L. No. 108-446, 118 Stat. 2647, December 3, 2004), which took effect on July 1, 2005. Colloquially the law is still referred to as the Individuals with Disabilities Education Act (IDEA). Children with hearing loss or auditory processing disorder (APD) may qualify for services under IDEA. However, a review of the literature found no review of case law for such children. This article provides a comprehensive review of case law involving the IDEA and children with hearing loss or APD from the U.S. Supreme Court and U.S. courts of appeals. We conducted a systematic review of case law. A LexisNexis search for cases involving IDEA and children with hearing loss or APDs was conducted. For the purpose of the present case review, all appellate decisions (cases accepted by the U.S. courts of appeals or the U.S. Supreme Court) were included if they found that the child had hearing loss or APD, regardless of the reason for the appeal under IDEA. In the instance of multiple cases that involved the same two parties, these cases are summarized together to provide the legal context. Brief explanations of IDEA and the federal judicial process as it pertains to IDEA disputes are presented. Following these explanations, a chronological review of IDEA appellate cases concerning students with hearing loss or APD is provided. The IDEA cases reviewed focus on three main issues: placement of the child, methodology of teaching, and the provision of services. This case law review provides a helpful summary of higher court cases for educational audiologists and parents of children with hearing loss or APDs, as well as educators, individualized education program team members, school administrators, and legal
Havinga-Top, A M; Waninge, A; van der Schans, C P; Jager-Wittenaar, H
Body composition measurements provide important information about physical fitness and nutritional status. People with severe intellectual and visual disabilities (SIVD) have an increased risk for altered body composition. Bioelectrical impedance analysis (BIA) has been evidenced as a reliable and non-invasive method to asses body composition in healthy persons and various patient populations; however, currently, there is no feasible method available to determine body composition in people with SIVD. In this study, therefore, we aimed to assess the feasibility of BIA measurements in persons with SIVD. In 33 participants with SIVD and Gross Motor Functioning Classification System (GMFCS) Scale I, II, III, or IV, two BIA measurements were sequentially performed employing Resistance and Reactance in Ohm and fat-free mass (FFM) in kg as outcome variables, utilizing the Bodystat(®) QuadScan 4000. Feasibility was considered sufficient if ≥ 80% of the first measurement was performed successfully. Agreement between two repeated measurements was determined by using the paired t-test and Intraclass Correlation Coefficient (ICC; two way random, absolute agreement). Bland-Altman analyses were utilized to determine limits of agreement (LOAs) and systematic error. Agreement was considered acceptable if LOAs were feasible in persons with SIVD. Although these results require confirmation in a more extensive sample of persons with SIVD, the findings of this study are an important first step in the assessment of applicability of BIA measurements for non-invasive monitoring of physical fitness and nutritional status of persons with SIVD. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gosselink, R; Kovacs, L; Ketelaer, P; Carton, H; Decramer, M
To evaluate the contribution of respiratory muscle weakness (part 1) and respiratory muscle training (part 2) to pulmonary function, cough efficacy, and functional status in patients with advanced multiple sclerosis (MS). Survey (part 1) and randomized controlled trial (part 2). Rehabilitation center for MS. Twenty-eight bedridden or wheelchair-bound MS patients (part 1); 18 patients were randomly assigned to a training group (n = 9) or a control group (n = 9) (part 2). The training group (part 2) performed three series of 15 contractions against an expiratory resistance (60% maximum expiratory pressure [PEmax]) two times a day, whereas the control group performed breathing exercises to enhance maximal inspirations. Forced vital capacity (FVC), inspiratory, and expiratory muscle strength (PImax and PEmax), neck flexion force (NFF), cough efficacy by means of the Pulmonary Index (PI), and functional status by means of the Extended Disability Status Scale (EDSS). Part 1 revealed a significantly reduced FVC (43% +/- 26% predicted), PEmax (18% +/- 8% predicted), and PImax (27% +/- 11% predicted), whereas NFF was only mildly reduced (93% +/- 26% predicted). The PI (median score, 10) and EDSS (median score, 8.5) were severely reduced. PEmax was significantly correlated to FVC, EDSS, and PI (r = .77, -.79, and -.47, respectively). In stepwise multiple regression analysis. PEmax was the only factor contributing to the explained variance in FVC (R2 = .60), whereas body weight (R2 = .41) was the only factor for the PI. In part 2, changes in PImax and PEmax tended to be higher in the training group (p = .06 and p = .07, respectively). The PI was significantly improved after 3 months of training compared with the control group (p functional status. Expiratory muscle training tended to enhance inspiratory and expiratory muscle strength. In addition, subjectively and objectively rated cough efficacy improved significantly and lasted for 3 months after training cessation.
Luijkx, J; van der Putten, A A J; Vlaskamp, C
Raising children with severe or profound intellectual and multiple disabilities (PIMD) is expected to put extreme pressure on parental time use patterns. The aim of this study was to examine the total time use of mothers and fathers raising children with PIMD and compare it with the time use of parents of typically developing children. Twenty-seven fathers and 30 mothers raising children with PIMD completed a time use diary on a mobile phone or tablet app, as did 66 fathers and 109 mothers of typically developing children. Independent t-tests and Mann-Whitney tests were performed to compare mean time use. There are no differences in the time use of parents of children with PIMD on contracted time (paid work and educational activities) and necessary time (personal care, eating and drinking and sleeping) when compared with parents of typically developing children. There are significant differences between the parents of children with PIMD and the parents of typically developing children in terms of committed time (time for domestic work and the care and supervision of their children) and free time. The mothers of children with PIMD spend significantly less time on domestic work and more time on care and supervision than mothers of typically developing children. This study shows that the parents of children with PIMD have to spend a significant amount of time on care tasks and have on average 1.5 h less free time per day than parents of typically developing children. This is a striking difference, because leisure time can substantially contribute to well-being. Therefore, it is important not only to consider a child with PIMD's support needs but also to identify what parents need to continue their children's daily care and supervision. © 2017 John Wiley & Sons Ltd.
Cankaya, Serkan; Kuzu, Abdullah
Mobile skill teaching software has been developed for the parents of the children with intellectual disability to be used in teaching daily life skills. The purpose of this research is to investigate the effectiveness of the mobile skill teaching software developed for the use of the parents of the children with intellectual disability. In…
McGrail, Ewa; Rieger, Alicja
Research supports the inclusion of children with disabilities in general education classrooms as a way to boost academic and social development, not only for children with disabilities, but also for typically developing children. A wide variety of perspectives and abilities in the classroom builds empathy, understanding, and creativity--all…
Russell, Andrew T.; Hahn, Joan Earle; Hayward, Katharine
The purpose of this study was to describe the medication management and treatment provided in a specialty outpatient psychiatry clinic for 198 community-residing children and adults with intellectual disability and other developmental disabilities (IDD) referred to the clinic and discharged between 1999 and 2008. Using a descriptive design, data…
Müller, Rachel; Terrill, Alexandra L; Jensen, Mark P; Molton, Ivan R; Ravesloot, Craig; Ipsen, Catherine
The aim of this study was to examine how the construct of happiness is related to pain intensity, pain interference, and distress in individuals with physical disabilities. This study involves cross-sectional analyses of 471 individuals with a variety of health conditions reporting at least mild pain. The first hypothesis that happiness mediates the relationship between pain intensity and two outcomes, pain interference and distress, was not supported. The second hypothesis was supported by a good fitting model (χ2(10) = 12.83, P = 0.23, root-mean-square error of approximation = 0.025) and indicated that pain intensity significantly mediated the effect of happiness on pain interference (indirect effect: β = -0.13, P Happiness showed a significant direct effect on pain intensity (β = -0.20, P happiness components meaning, pleasure, and engagement fitted well (χ2(4) = 9.65, P = 0.05, root-mean-square error of approximation = 0.055). Pain intensity acted as a significant mediator but only mediated the effect of meaning on pain interference (indirect effect: β = -0.07, P = 0.05) and on distress (indirect effect via pain interference: β = -0.04, P = 0.05). Only meaning (β = -0.10, P = 0.05), but neither pleasure nor engagement, had a significant direct effect on pain intensity. Participants who reported greater happiness reported lower pain interference and distress through happiness' effects on pain intensity. Experiencing meaning and purpose in life seems to be most closely (and negatively) associated with pain intensity, pain interference, and distress. Findings from this study can lay the groundwork for intervention studies to better understand how to more effectively decrease pain intensity, pain interference, and distress.
Hashizume, Naoki; Fukahori, Suguru; Asagiri, Kimio; Ishii, Shinji; Saikusa, Nobuyuki; Higashidate, Naruki; Yoshida, Motomu; Masui, Daisuke; Sakamoto, Saki; Tanaka, Yoshiaki; Yagi, Minoru; Yamashita, Yushiro
The aim of the present study was to determine the utility of measuring the salivary pepsin level (SPL) as an objective assessment of gastroesophageal reflux disease (GERD) in severe motor and intellectual disabilities (SMID) patients. This prospective study included 26 SMID patients who underwent simultaneous 24-h multichannel intraluminal impedance pH measurement (pH/MII) and SPL evaluation. The enrolled patients were divided into GERD (+) or GERD (-) groups according to the pH/MII findings. The age, gender and pH/MII parameters were compared between the two groups. A correlation analysis was also conducted for the SPL following early-morning fasting and post-enteral feeding and the age, gender, presence of gastrostomy and tracheostomy and pH/MII parameters. The SPL was compared between the two sampling groups. Fifteen patients were classified as GERD (+), and 11 patients were classified as GERD (-). The mean SPL following early-morning fasting and post-enteral feeding among all patients were 104.3 (median: 38, 25th and 75th percentile: 12, 361) ng/ml and 222.2 (median: 152:0, 500) ng/ml, respectively. Regarding positivity, 76.9% and 73.1% of SPL values in early-morning fasting and post-enteral feeding SMID patients, respectively, were positive (≧16ng/ml). The SPL following early-morning fasting demonstrated a weak but significant positive correlation with age. In contrast, we noted no correlation between the pH/MII parameters and the SPL for either the early-morning fasting or post-enteral feeding patients, and no significant difference in the SPL was observed between the GERD (+) and (-) patients. The present study showed that a high proportion of SMID patients had a relatively high SPL, regardless of the presence of GERD. The SPL in SMID patients might be affected by several distinctive factors in addition to gastroesophageal reflux. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
Raver, Sharon A.; Michalek, Anne M.; Michalik, Jan; Valenta, Milan
Caregivers of individuals with disabilities in the United States have been reported to experience additional hardships than families with typical children as they attempt to balance family and work (Parish, Rose, Grinstein-Weiss, Richman, & Andrews, 2008). In this study, 31 caregivers of individuals with intellectual disabilities from the…
Jimenez-Pardo, J; Holmes, J D; Jenkins, M E; Johnson, A M
Physical activity is generally thought to be beneficial to individuals with Parkinson's disease (PD). There is, however, limited information regarding current rates of physical activity among individuals with PD, possibly due to a lack of well-validated measurement tools. In the current study we sampled 63 individuals (31 women) living with PD between the ages of 52 and 87 (M = 70.97 years, SD = 7.53), and evaluated the amount of physical activity in which they engaged over a 7-day period using a modified form of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD). The PASIPD was demonstrated to be a reliable measure within this population, with three theoretically defensible factors: (1) housework and home-based outdoor activities; (2) recreational and fitness activities; and (3) occupational activities. These results suggest that the PASIPD may be useful for monitoring physical activity involvement among individuals with PD, particularly within large-scale questionnaire-based studies.
Full Text Available Chimpanzee culture has generated intense recent interest, fueled by the technical complexity of chimpanzee tool-using traditions; yet it is seriously doubted whether chimpanzees are able to learn motor procedures by imitation under natural conditions. Here we take advantage of an unusual chimpanzee population as a 'natural experiment' to identify evidence for imitative learning of this kind in wild chimpanzees. The Sonso chimpanzee community has suffered from high levels of snare injury and now has several manually disabled members. Adult male Tinka, with near-total paralysis of both hands, compensates inability to scratch his back manually by employing a distinctive technique of holding a growing liana taut while making side-to-side body movements against it. We found that seven able-bodied young chimpanzees also used this 'liana-scratch' technique, although they had no need to. The distribution of the liana-scratch technique was statistically associated with individuals' range overlap with Tinka and the extent of time they spent in parties with him, confirming that the technique is acquired by social learning. The motivation for able-bodied chimpanzees copying his variant is unknown, but the fact that they do is evidence that the imitative learning of motor procedures from others is a natural trait of wild chimpanzees.
Hobaiter, Catherine; Byrne, Richard W
Chimpanzee culture has generated intense recent interest, fueled by the technical complexity of chimpanzee tool-using traditions; yet it is seriously doubted whether chimpanzees are able to learn motor procedures by imitation under natural conditions. Here we take advantage of an unusual chimpanzee population as a 'natural experiment' to identify evidence for imitative learning of this kind in wild chimpanzees. The Sonso chimpanzee community has suffered from high levels of snare injury and now has several manually disabled members. Adult male Tinka, with near-total paralysis of both hands, compensates inability to scratch his back manually by employing a distinctive technique of holding a growing liana taut while making side-to-side body movements against it. We found that seven able-bodied young chimpanzees also used this 'liana-scratch' technique, although they had no need to. The distribution of the liana-scratch technique was statistically associated with individuals' range overlap with Tinka and the extent of time they spent in parties with him, confirming that the technique is acquired by social learning. The motivation for able-bodied chimpanzees copying his variant is unknown, but the fact that they do is evidence that the imitative learning of motor procedures from others is a natural trait of wild chimpanzees.
Full Text Available The purpose of this paper is to provide a preliminary, qualitative review of an approach to training centre-based carers in supporting basic communication development and providing communication opportunities for the children with severe and profound disabilities in their care. In South Africa, these children are often the most neglected in terms of planning and providing appropriate interventions. For those with severe communication disabilities, an additional lack is in the area of the basic human right to meaningful interactions and communication. Sustainable strategies to provide opportunities for basic communication development of these children are urgently sought. Several effective international and local parent training programmes have been developed, but the urgent need remains to train centre-based carers who are taking care of groups of diversely disabled children in severely under-resourced settings. Non-profit organisations (NPOs have been exploring practical centre-based approaches to skills sharing in physical rehabilitation, activities for daily living, feeding and support for basic communication development. As a freelance speech therapist contracted by four NPOs to implement hands-on training in basic communication for centre-based carers of non-verbal children, the author describes a training approach that evolved over three years, in collaboration with the carers and centre managements. Implications for training (for speech therapists and for community-based rehabilitation workers and for further research are identified.
Peterson, Brennan D.; Sejbæk, Camilla Sandal; Prritano, Matthew
the individual and partner level. What is known already?: An infertility diagnosis, the stress of medical treatments and a prior history of depression are risk factors for future depression in those undergoing fertility treatments. Studies examining the impact of severe depressive symptoms on infertility-related......Study question: Are severe depressive symptoms in women and men associated with individual and dyadic infertility-related stress in couples undergoing infertility treatment? Summary answer: Severe depressive symptoms were significantly associated with increased infertility-related distress at both....../materials, setting, methods: Participants were consecutively referred patients undergoing a cycle of medically assisted reproduction treatment at five Danish public and private clinics specializing in treating fertility patients. Severe depressive symptoms were measured by the Mental Health Inventory 5 from...
Daatselaar, Rineke; Schaap, Mark; Mobach, Mark P.; Alexander, K.
Within Facility Management (FM) the connection between organisation and space is a well-established topic. This study was made in the context of discovery and explored to what extent changes in organisation and space can contribute to the quality of life of intellectually disabled residents with a
Tabacaru, Cristina Dumitru
The article aims to study ways of achieving human rights by offering everyone a voice, a communicational tool which will allow accessibility and access to quality education for all, regardless of the degree of disability. The main objective of the present study was to describe the profile of communication and study the use of verbal and nonverbal…
Casebolt, Kevin M.; Hodge, Samuel R.
The purpose of this study was to analyze high school physical education teachers' beliefs about teaching students with disabilities in inclusive physical education. The participants (3 men, 2 women) were certified physical education teachers at four suburban high schools. The research method was descriptive-qualitative using a case study approach…
Zaal-Schuller, I. H.; Willems, D. I.; Ewals, F.; van Goudoever, J. B.; de Vos, M. A.
In children with profound intellectual and multiple disabilities (PIMD), discussions about end-of-life decisions (EoLDs) are comparatively common. Nurses play a crucial role in the care for these children, yet their involvement in EoLD discussions is largely unknown. The objective of this research
Whinnery, Stacie B.; Whinnery, Keith W.
This study investigated the effects of a functional mobility program on the functional standing and walking skills of five adults with developmental disabilities. The Mobility Opportunities Via Education (MOVE) Curriculum was implemented using a multiple-baseline across subjects design. Repeated measures were taken during baseline, intervention…
Broersen, J.P.; Mulders, H.P.; Schellart, A.J.M.; van der Beek, A.J.
Background: Work disability is a major problem for both the worker and society. To explore the work opportunities in regular jobs of persons low in functional abilities, we tried to identify occupations low in task demands. Because of the variety of functional abilities and of the corresponding work
Longo-Mbenza, B; Muaka, M Mvitu; Yokobo, E Cibanda; Phemba, I Longo; Mokondjimobe, E; Gombet, T; Ndembe, D Kibokela; Mona, D Tulomba; Masamba, S Wayiza
Because of the demographic transition, lifestyle changes, urbanization, and nutrition transition, Central Africans are at higher risk of ocular diseases associated with oxidative stress and visual disability. This study aimed to estimate the normal values of oxidant status defined by oxidized low-density lipoprotein (Ox-LDL), 8-Isoprostane and 8-hydroxy-deoxyguanosine (8-OHdG) and to determine their pathogenic role in the prevalence and the severity of visual disability among these black Africans. This was a cross-sectional study, run in a case-control study randomly selected from Kinshasa province, DR Congo. The study included 150 type 2 diabetes mellitus (T2DM) patients (cases) matched for sex and age to 50 healthy non diabetic controls. Logistic regression models were used to identify independent determinants of visual disability. The presence rates were 8.5% for blindness, 20.5% for visual impairment and 29% for visual disability including blindness and visual impairment. After adjusted for taro leaves intake, red beans intake, T2DM, aging, waist circumference, and systolic blood pressure, we identified low education level (OR=3.3 95%CI 1.5-7.2; p=0.003), rural-urban migration (OR=2.6 95% CI 1.2-5.6; p=0.017), and high Ox-LDL (OR=2.3 95% CI 1.1-4.7; p=0.029) as the important independent determinants of visual disability. After adjusted for education, intake of red beans, intake of taro leaves, triglycerides, and T2DM, we identified no intake of safou fruit (OR=50.7 95% CI 15.2-168.5; pvisual disability. After adjusted for education level, no intake of red beans, no intake of Taro leaves, triglycerides, and T2DM, we identified no intake of Safou fruit (OR=43.1 95% CI 13.7-135.4; pvisual disability. Visual disability remains a public health problem in Central Africa. Antioxidant supplement, fruit intake, nutrition education, control of migration, and blocking of oxidative stress are crucial steps for delayed development of vision loss.
de Valenzuela, Julia Scherba; Bird, Elizabeth Kay-Raining; Parkington, Karisa; Mirenda, Pat; Cain, Kate; MacLeod, Andrea A N; Segers, Eliane
The purpose of this article is to describe the results of a thematic analysis of 79 semi-structured interviews collected at six research sites in four countries in relation to the inclusion and exclusion of students with developmental disabilities (DD) in and from special education and bilingual opportunities. The participants were individuals with expertise either in special needs and/or language education to support bilingualism (e.g., second language (L2) instruction), who served as key informants about service delivery and/or policy in these areas. Six themes emerged as salient during the analysis: we include all kids, special needs drives it, time/scheduling conflicts, IEP/IPP/statement drives it, it's up to the parents, and service availability. The results suggested that access to language programs and services is limited for children with DD, even though participants at all sites reported adherence to a philosophy of inclusion. A priority on special education services over language services was identified, as well as barriers to providing children with DD access to programs and services to support bilingual development. Some of these barriers included time and scheduling conflicts and limited service availability. Additionally, the role of parents in decision making was affirmed, although, in contrast to special education services, decision-making about participation or exemption from language programs was typically left up to the parents. Overall, the results suggest a need for greater attention to providing supports for both first (L1) and L2 language development for bilingual children with DD and greater access to available language programs. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available The aim of the study was to determine the status of SE in people with physical disabilities (PwPD and compare SE scores between active and inactive individuals. The sample of PwPD (n = 186 was divided into two groups of those who are regularly participating in sport (active; n = 88 and those who are not participating in any sport in their leisure (inactive; n = 98. The Rosenberg Self-Esteem Scale (RSES was used as a primary research method. 10-item scale measures global self-worth by measuring positive and negative feelings about the self. Higher scores (from 10 to 40 points indicate higher SE. The Pearson chi-square test was used to determine the differences of 10 RSES items and total scores between active and inactive PwPD. We found that the mean score of RSES in PwPD was 28.83 points; active PwPD observed total score of RSES 30.01 points and group of inactive PwPD showed the lowest SE by achieving 27.76 points. Mean scores comparison of each RSES item between active and inactive PwPD revealed higher SE in the group of active PwPD. Significantly higher SE was presented by 4 from 10 RSES items and by total score in the group of active PwPD. The results of our study confirmed that actively living PwPD have significantly higher SE comparing those PwPD who are living sedentary life style.
Communication symbols for students with severe intellectual disabilities often take the form of computer-generated line drawings. This study investigated the effects of the match between color and shape of line drawings and the objects they represented on drawing recognition and use. The match or non-match between color and shape of the objects and drawings did not have an effect on participants' ability to match drawings to objects, or to use drawings to make choices.
Full Text Available Objective: The aim of this study is to determine the oral health related quality of life and the effect of dental anxiety on the oral health related quality of life in young, mildly intellectually disabled individuals who are attending a special school. Materials and Methods: Eighty six mildly intellectually disabled students participated this cross-sectional study. Oral health-related quality of life-United Kingdom Scale and Oral Health Impact Profile-14 were used to evaluate the effects of oral health of the individuals on their quality of life. Modified Dental Anxiety Scale was used to determine the dental anxiety levels of the individuals. Data were analyzed statistically. Results: The mean age of the participants was 17.12±1.40 years and the mean decayed, missing, and filled teeth (DMFT score of the students was 3.10±2.76. According to the Modified Dental Anxiety Scale, 28.0% of the students had dental anxiety. A significant inverse relationship was detected between dental anxiety levels and oral health-related quality of life (r=-0.239; p=0.028. Conclusion: Nearly 30% of individuals with mild intellectual disabilities were determined to have dental anxiety. Considering that the oral health-related quality of life decreases with increasing dental anxiety, it may be beneficial for dentists to administer premedication before treatment to decrease the anxiety levels of these patients.
Chung, Peter J; Vanderbilt, Douglas L; Schrager, Sheree M; Nguyen, Eugene; Fowler, Eileen
Active videogaming (AVG) has potential to provide positive health outcomes for individuals with cerebral palsy (CP), but their use for individuals with severe motor impairments is limited. Our objective was to evaluate the accessibility and enjoyment of videogames using the Kinect™ (Microsoft, Redmond, WA) with the Flexible Action and Articulated Skeleton Toolkit (FAAST) system (University of Southern California Institute for Creative Technologies, Los Angeles, CA) for individuals with severely limiting CP. A videogaming system was installed in a community center serving adults with CP, and a staff member was instructed in its use. Participants completed a baseline survey assessing demographics, mobility, and prior videogame experience; they then used the FAAST system with Kinect and completed a 5-point Likert survey to assess their experience. Descriptive statistics assessed overall enjoyment of the system, and Mann-Whitney U tests were conducted to determine whether responses differed by demographic factors, mobility, or prior videogame experience. Twenty-two subjects were recruited. The enjoyment scale demonstrated high internal consistency (Cronbach's alpha=0.88). The mean total enjoyment score was 4.24 out of 5. Median scores did not significantly differ by ethnicity, gender, CP severity, or previous videogame exposure. The FAAST with Kinect is a low-cost system that engages individuals with severe movement disorders across a wide range of physical ability and videogame experience. Further research should be conducted on in-home use, therapeutic applications, and potential benefits for socialization.
Elsabbagh, M.; Cohen, H.; Cohen, M.; Rosen, S.; Karmiloff-Smith, A.
Background: Williams Syndrome (WS) is a neurodevelopmental disorder of genetic origin, characterised by relative proficiency in language in the face of serious impairment in several other domains. Individuals with WS display an unusual sensitivity to noise, known as hyperacusis. Methods: In this study, we examined the extent to which hyperacusis…
Huang, Kaiyong; Liang, Wenjie; Han, Shanshan; Abdullah, Abu S; Yang, Li
This study aimed to assess the relationships between road traffic injury severity and individual characteristics in Liuzhou, a city in southern China. Data for this study were collected from the Guangxi Public Security Bureau Traffic Police Corps. Multivariate ordinal logistic regression analysis was used. Of all 14,595 individuals involved in accidents, males, motor vehicle drivers, motorcyclists, and those aged 21-45 years accounted for the great proportion of all injuries. Children, the elderly, pedestrians, farmers and migrant workers, unemployed people, and novice drivers were at higher risk of serious injury in crashes. These findings suggest that individual characteristics (age, modes of transport, profession, driving experience) are strongly related to injury severity. To address road traffic related mortality and injuries, there is a need to develop policy strategies, strengthen road supervision, and improve public consciousness of road safety.
Full Text Available Background: We aimed to determine the status of strongyloidiasis in mentally disabled population in the institutional places in Rasht City, the capital of Guilan Province, northern Iran.Methods: This cross-sectional study was conducted in 8 institutions for mentally retarded population in Rasht in 2013. Before collecting the samples, a questionnaire was filled out for each participant by an expert person. A single stool sample was obtained from each of the 173 subjects and examined using direct wet mount, formalin-ether concentration technique and agar plate culture method. Results: A total of 173 mentally disabled individuals aged 2-57 (25.69±11.56 yr old were studied. Stool examination showed that 51 (29.5% cases were infected with at least one parasite. Of 173 studied cases only 10 (5.8% individuals were infected with pathogenic parasites, of which 2 (1.2% cases were infected with Strongyloides stercoralis and 8 (4.6% with Giardia lamblia. On the other hand, 42 (24.3% of the studied population were infected with non-pathogenic intestinal protozoa such as Blastocystis hominis (n=29, 16.8%, Entamoeba coli (n=16, 9.2% and Endolimax nana (n=4, 2.3%. Mixed protozoal infections were observed in 8 (4.6% individuals.Conclusion: The prevalence rate of S. stercoralis in mentally disabled individuals in Rasht was somewhat higher than those of normal population of the province. The same picture was seen when the prevalence of G. lamblia and non-pathogenic protozoa in normal and mentally disabled populations were compared.
Furrer, Angela; Michel, Gisela; Terrill, Alexandra L; Jensen, Mark P; Müller, Rachel
To investigate the associations between subjective well-being and pain intensity, pain interference, and depression in individuals with physical disabilities. We hypothesized that (1) pain control and (2) pain catastrophizing mediate the effects of subjective well-being on pain intensity, pain interference, and depression. Analyses of cross-sectional data from 96 individuals diagnosed with spinal cord injury, multiple sclerosis, neuromuscular disease, or post-polio syndrome, with average pain intensity of ≥4 (0-10) on at least half the days in the past month. Two models tested study hypotheses using structural equation. Both models showed acceptable model fit. Pain catastrophizing significantly mediated the effect of subjective well-being on pain intensity and pain interference, but not on depression. Pain control did not significantly mediate the effect of subjective well-being on pain intensity, pain interference, or depression. Path coefficients showed significant direct effects of subjective well-being on pain control (β = 0.39), pain catastrophizing (β = -0.61), pain interference (β = -0.48; -0.42), and depression (β = -0.75; -0.78). This study supports the potential of enhancing subjective well-being and lowering pain catastrophizing for reducing pain intensity, pain interference, and depressive symptoms in individuals with chronic pain and a physical disability. The findings indicate that true experiments to test for causal associations are warranted. Implications for rehabilitation The majority of individuals with physical disabilities report having persistent moderate-to-severe pain that may negatively limit daily activities and quality of life. The present cross-sectional study indicates that individuals who reported greater subjective well-being showed significantly lower pain intensity via the mediating effect of lower pain catastrophizing. Since sample size and respective power are low, these findings should be taken as first
Lauren J. Rice
Full Text Available In the present study we examined the nature and developmental trajectory of self-injurious behaviour in Prader Willi syndrome (PWS and autism spectrum disorder (ASD. The development of interventions is greatly aided by understanding gene to behaviour pathways, and this requires an accurate description of the behaviour phenotype, that is, which types and natural history of self-injurious behaviour are more common in PWS and ASD and which are shared with other forms of developmental disability. Self-injury displayed by individuals with PWS and individuals with ASD was compared with that reported in a group of individuals with intellectual disability due to mixed aetiology (ID group. Three self-injurious behaviours (head banging, skin-picking and hitting and/or biting self were measured on five occasions over 18 years using the Developmental Behaviour Checklist (DBC a well-validated caregiver report measure. Rates of skin picking were higher in individuals with PWS and hitting and/or biting self was higher in individuals with ASD compared to the ID group. Rates of head banging were similar across the three groups. Over time, skin-picking and head banging increased with age for individuals with ASD and hitting and/or biting self increased for the PWS group. In the PWS and mixed ID groups head banging decreased with age. These findings suggest that the typology and developmental trajectories of self-injurious behaviours differ between those with PWS and ASD.
Garbi, Márcia de Oliveira Sakamoto Silva; Hortense, Priscilla; Gomez, Rodrigo Ramon Falconi; da Silva, Talita de Cássia Raminelli; Castanho, Ana Carolina Ferreira; Sousa, Fátima Aparecida Emm Faleiros
OBJECTIVES: to measure the pain intensity, identify the disability and depression levels in people with chronic back pain and to correlate these variables. A cross-sectional, descriptive and exploratory study was undertaken at the Pain Treatment Clinic of the University of São Paulo at Ribeirão Preto Hospital das Clínicas, between February and June 2012, after receiving approval from the Ethics Committee at the University of São Paulo at Ribeirão Preto College of Nursing. METHOD: sixty subjects with chronic back pain participated. The instruments used were: the 11-point Numerical Category Scale, the Roland-Morris Disability Questionnaire and the Beck Depression Inventory. To analyze the data, the arithmetic means, standard deviations and Spearman's correlation coefficient were calculated. RESULTS: the findings show that the participants presented high pain, disability and depression levels. The correlation between pain intensity and disability and between pain intensity and depression was positive and weak and, between disability and depression, positive and moderate. CONCLUSION: the study variables showed moderate and weak indices and the mutual correlations were positive. PMID:25296139
Hemsley, Bronwyn; Balandin, Susan
Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.
Bunning, K; Smith, C; Kennedy, P; Greenham, C
Individuals with severe to profound and multiple intellectual disability (S-PMID) tend to function at the earlier stages of communication development. Variable and highly individual means of communicating may present challenges to the adults providing support in everyday life. The current study aimed to examine the communication interface between students with S-PMID and educational staff. An in-depth, observational study of dyadic interaction in a class within the secondary part of a special school was conducted. The designated educational level was Key Stage 3 under the National Curriculum of England, which is typically for children from age 11 to 14 years attending a state school. There were four student-teacher dyads in the class. The students had multiple impairments with severely limited communication skills. Video capture of dyadic interaction was conducted during five English lessons and sampled to 2.5 min per dyad per lesson. The video footage was transcribed into standard orthography, detailing the vocal and non-vocal aspects. A coding framework guided by the principles of structural-functional linguistics was used to determine the nature of dyadic interaction, comprising linguistic moves, functions and communicative modalities. The relative contributions of student and teacher to the interaction were examined. Significant differences were found between the students and educational staff on the majority of the measures. The teachers dominated the interaction, occupying significantly more turns than the students. Teacher turns contained significantly more initiations and follow-up moves than the students, who used more response moves. Teacher communication mainly served the functions of requesting and information giving. Feedback and scripted functions were also significantly greater among teacher turns, with only limited occurrence among the students. Self- or shared-expression was greatest among the students. The modalities of speech, touch, singing and
Cristina Batista Miamoto
Full Text Available The aim of the present study was to determine the prevalence of dental trauma and associated factors among a sample of patients with severe cerebral palsy. The sample was made up of 120 individuals equally divided into two groups. The group with cerebral palsy was made up of 60 patients diagnosed with the spastic form of the disease. The control group was made up of 60 individuals with no mental impairment. Questionnaires were used to collect information on individual, socioeconomic and behavioral characteristics. Dental trauma was assessed based on the clinical chart of each participant, on a questionnaire and on a clinical evaluation to determine past injuries. Mouth mirrors and millimeter periodontal probes (Community Periodontal Index probe were used to measure overjet. Lip seal and breathing type were determined during the clinical exams and interviews. Statistical analysis involved the chi-square test (p < 0.05 and multivariate logistic regression (forward stepwise procedure. The prevalence of dental trauma was greater among individuals with cerebral palsy (18% than in the control group (5%, with the difference achieving statistical significance (p = 0.023. Individuals with lip incompetence had a greater chance of exhibiting dental trauma (OR [CI 95%] = 3.81 [1.19-12.24]. The prevalence of dental trauma among individuals with cerebral palsy was high. A lack of lip seal was identified as a factor directly associated to this prevalence.
VanDerNagel, Joanneke E L; Kiewik, Marion; van Dijk, Marike; Didden, Robert; Korzilius, Hubert P L M; van der Palen, Job; Buitelaar, Jan K; Uges, Donald R A; Koster, Remco A; de Jong, Cor A J
Individuals with mild or borderline intellectual disability (MBID) are at risk of substance use (SU). At present, it is unclear which strategy is the best for assessing SU in individuals with MBID. This study compares three strategies, namely self-report, collateral-report, and biomarker analysis. In a sample of 112 participants with MBID from six Dutch facilities providing care to individuals with intellectual disabilities, willingness to participate, SU rates, and agreement between the three strategies were explored. The Substance use and misuse in Intellectual Disability - Questionnaire (SumID-Q; self-report) assesses lifetime use, use in the previous month, and recent use of tobacco, alcohol, cannabis, and stimulants. The Substance use and misuse in Intellectual Disability - Collateral-report questionnaire (SumID-CR; collateral-report) assesses staff members' report of participants' SU over the same reference periods as the SumID-Q. Biomarkers for SU, such as cotinine (metabolite of nicotine), ethanol, tetrahydrocannabinol (THC), and its metabolite THCCOOH, benzoylecgonine (metabolite of cocaine), and amphetamines were assessed in urine, hair, and sweat patches. Willingness to provide biomarker samples was significantly lower compared to willingness to complete the SumID-Q (p<0.001). Most participants reported smoking, drinking alcohol, and using cannabis at least once in their lives, and about a fifth had ever used stimulants. Collateralreported lifetime use was significantly lower. However, self-reported past month and recent SU rates did not differ significantly from the rates from collateral-reports or biomarkers, with the exception of lower alcohol use rates found in biomarker analysis. The agreement between self-report and biomarker analysis was substantial (kappas 0.60-0.89), except for alcohol use (kappa 0.06). Disagreement between SumID-Q and biomarkers concerned mainly over-reporting of the SumID-Q. The agreement between SumID-CR and biomarker
Watson, Joanne; Wilson, Erin; Hagiliassis, Nick
Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…
In a sample of 182 individuals with severe mental illness, the applicability of reflected appraisals and self-enhancement theories as explanations for global self-esteem was examined at two time points on components of stigma, mastery, overall functioning, education, and job prestige. Path analysis demonstrated that the two theories work independently; and that stigma, mastery, and overall functioning are significant, persist over time, and have an enduring effect on self-esteem.
Mergler, Sandra; Man, Stella A. de; Boot, Annemieke M.; Heus, Karen G.C.B.B.; Huijbers, Wim A.R.; Rijn, Rick R. van; Penning, Corine; Evenhuis, Heleen M.
Children with severe neurological impairment and intellectual disability are prone to low bone quality and fractures. We studied the feasibility of automated radiogrammetry in assessing bone quality in this specific group of children. We measured outcome of bone quality and, because these children tend to have altered skeletal maturation, we also studied bone age. We used hand radiographs obtained in 95 children (mean age 11.4 years) presenting at outpatient paediatric clinics. We used BoneXpert software to determine bone quality, expressed as paediatric bone index and bone age. Regarding feasibility, we successfully obtained a paediatric bone index in 60 children (63.2%). The results on bone quality showed a mean paediatric bone index standard deviation score of -1.85, significantly lower than that of healthy peers (P < 0.0001). Almost 50% of the children had severely diminished bone quality. In 64% of the children bone age diverged more than 1 year from chronological age. This mostly concerned delayed bone maturation. Automated radiogrammetry is feasible for evaluating bone quality in children who have disabilities but not severe contractures. Bone quality in these children is severely diminished. Because bone maturation frequently deviated from chronological age, we recommend comparison to bone-age-related reference values. (orig.)
Mergler, Sandra [Erasmus MC, Department of General Practice and Intellectual Disability Medicine, University Medical Centre, Rotterdam (Netherlands); Care and Service Centre for People with Intellectual Disabilities, Medical Department ASVZ, Sliedrecht (Netherlands); Man, Stella A. de [Amphia Hospital, Department of Paediatrics, Breda (Netherlands); Boot, Annemieke M. [University of Groningen, Department of Paediatric Endocrinology, University Medical Centre Groningen, Groningen (Netherlands); Heus, Karen G.C.B.B. [Erasmus MC, Department of General Paediatrics, Sophia Children' s Hospital, University Medical Centre, Rotterdam (Netherlands); Huijbers, Wim A.R. [Beatrix Hospital, Department of Paediatrics, Gorinchem (Netherlands); Rijn, Rick R. van [Emma Children' s Hospital/Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Penning, Corine; Evenhuis, Heleen M. [Erasmus MC, Department of General Practice and Intellectual Disability Medicine, University Medical Centre, Rotterdam (Netherlands)
Children with severe neurological impairment and intellectual disability are prone to low bone quality and fractures. We studied the feasibility of automated radiogrammetry in assessing bone quality in this specific group of children. We measured outcome of bone quality and, because these children tend to have altered skeletal maturation, we also studied bone age. We used hand radiographs obtained in 95 children (mean age 11.4 years) presenting at outpatient paediatric clinics. We used BoneXpert software to determine bone quality, expressed as paediatric bone index and bone age. Regarding feasibility, we successfully obtained a paediatric bone index in 60 children (63.2%). The results on bone quality showed a mean paediatric bone index standard deviation score of -1.85, significantly lower than that of healthy peers (P < 0.0001). Almost 50% of the children had severely diminished bone quality. In 64% of the children bone age diverged more than 1 year from chronological age. This mostly concerned delayed bone maturation. Automated radiogrammetry is feasible for evaluating bone quality in children who have disabilities but not severe contractures. Bone quality in these children is severely diminished. Because bone maturation frequently deviated from chronological age, we recommend comparison to bone-age-related reference values. (orig.)
... underserved populations; (4) identify research gaps; (5) identify mechanisms of integrating research and... translation grantees to advance or add to their work by-- (1) Conducting systematic reviews and developing... and Rehabilitative Services proposes a funding priority for the Disability and Rehabilitation Research...
Heller, Kathryn Wolff; Fredrick, Laura D.; Dykes, Mary Kay; Best, Sherwood; Cohen, Elisabeth Tucker
A national study involving 59 teachers instructing students with physical and health disabilities, 26 universities, 36 local school system directors, and 29 state departments of education, found over 40% of the teachers did not feel well trained in half of the competencies. Concerns regarding the effects of generic teacher certification are…
Scherba de Valenzuela, J.; Kay-Raining Bird, E.; Parkington, K.; Mirenda, P.; Cain, K.; MacLeod, A.A.N.; Segers, P.C.J.
The purpose of this article is to describe the results of a thematic analysis of 79 semi-structured interviews collected at six research sites in four countries in relation to the inclusion and exclusion of students with developmental disabilities (DD) in and from special education and bilingual
Brown, Ivan; Hatton, Chris; Emerson, Eric
Quality of life is a social construct that is measured by what are considered to be its most appropriate indicators. Quality of life measurement in intellectual disability reflects a variety of indicators, often grouped under life domains. Subjective and objective methods of measuring indicators each have strengths and drawbacks, but it is…
Sinclair, James; Kahn, Laurie G.; Rowe, Dawn A.; Mazzotti, Valerie L.; Hirano, Kara A.; Knowles, Christen
Sex education is not only a necessary component of public school curriculum, but it is also an important opportunity for students with and without disabilities to learn about their own development as emerging adults. Although comprehensive sex education is not federally mandated, many states and districts choose to offer some form of sex education…
Lifshitz, Hefziba; Shtein, Sarit; Weiss, Itzhak; Svisrsky, Naama
We previously reported a meta-analysis of explicit memory studies in populations with intellectual disability (ID). The current study discusses the educational implications of this meta-analysis. The main factors at the core of these implications can be divided into two categories: those related to task characteristics (e.g., depth of processing,…
Ellis, Roger; Hogard, Elaine; Sines, David
This article describes a risk audit carried out on the support provided for 36 people with profound learning disabilities who had been resettled from hospital care to supported housing. The risks were those factors identified in the literature as associated with deleterious effects on quality of life. The audit was carried out with a specially…
... affiliates need continued support to engage in meaningful dialogue, continual learning, and problem solving... dissemination strategies. The Partnership Project has developed and enhanced tools and strategies to improve the... disabilities within general education reform efforts. Engagement tools and strategies include: (1) Various...
Tan, Xi; Marshall, Vincent D.; Balkrishnan, Rajesh; Patel, Isha; Chang, Jongwha; Erickson, Steven R.
Psychotropic medications are a common treatment for mental illness in people with developmental disabilities. Medication adherence is a critical determinant of the effectiveness of psychotropic drugs, but psychotropic medication adherence research specific to this population remains limited. This retrospective study analyzed Marketscan®…
Van Laarhoven, Toni; Winiarski, Lauren; Blood, Erika; Chan, Jeffrey M.
A modified pre/posttest control group design was used to measure the effectiveness of video modeling on the maintenance of vocational tasks for six students with autism spectrum disorder and/or developmental disabilities. Each student was assigned two vocational tasks at their employment settings and their independence with each task was measured…
... the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person... income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the... include a full statement as to the veteran's service-connected disabilities, employment history...
Weis, Robert; Dean, Emily L.; Osborne, Karen J.
Clinicians uniformly recommend accommodations for college students with learning disabilities; however, we know very little about which accommodations they select and the validity of their recommendations. We examined the assessment documentation of a large sample of community college students receiving academic accommodations for learning…
Boehm, Thomas L.; Carter, Erik W.
Social relationships can shape the well-being of parents of children with intellectual and developmental disabilities (IDDs). Although much attention has focused on relationships with other family members or professionals, less is known about the place and contributions of informal relationships (i.e., non-family, unpaid others) in the lives of…
Sullivan, Michael J L; Simon, Gregory
The purpose of the present research was to examine the feasibility of a telephonic occupational rehabilitation program. A sample of 23 individuals with chronic musculoskeletal pain was enrolled in the telephonic version of the Progressive Goal Attainment Program (PGAP-Tel). The PGAP-Tel is a risk-targeted intervention designed to reduce pain-related disability consequent to musculoskeletal injury. Treatment outcomes of PGAP-Tel were compared to a group of individuals with chronic musculoskeletal pain, who participated in the face-to-face format of the PGAP. Results showed that PGAP-Tel was acceptable to the majority of participants (76%) to whom it was offered. There were indications that engagement and adherence issues were more problematic in PGAP-Tel than in the face-to-face intervention. Both groups showed comparable reductions in pain, depression, fear of symptom exacerbation, and self-reported disability. Participants in the face-to-face intervention showed greater reduction in catastrophic thinking than participants in PGAP-Tel. Finally, 26% of participants in PGAP-Tel had resumed some form of employment at treatment termination compared to 56% of the participants in the face-to-face intervention. Given the low cost of the PGAP-Tel intervention and the accessibility advantages of a telephonic delivery, this type of intervention might be an important resource for targeting occupational disability in rural or remote communities when face-to-face services are not available.
Smedema, Susan Miller; Kesselmayer, Rachel Friefeld; Peterson, Lauren
Purpose: To test a meditation model of the relationship between core self-evaluations (CSE) and job satisfaction in employed individuals with disabilities. Method: A quantitative descriptive design using Hayes's (2012) PROCESS macro for SPSS and multiple regression analysis. Two-hundred fifty-nine employed persons with disabilities were recruited…
Lee, Amy; Kiemle, Gundi
Background: This study examines the experiences of qualified nurses working with individuals diagnosed with both intellectual disability and personality disorder (PD) in a medium-secure forensic intellectual disability setting. Potential training needs are highlighted, as well as other ways in which services could better support staff to work…
Brown, Julie F.; Hamilton-Mason, Johnnie; Maramaldi, Peter; Barnhill, L. Jarrett
The perspectives of individuals with intellectual disabilities (ID) about family relationships are underrepresented in the literature. The topic of family relationships emerged in a grounded theory exploratory focus group study that involved thirty dually diagnosed participants with moderate or mild intellectual disabilities and histories of…
Cuskelly, Monica; Moni, Karen; Lloyd, Jan; Jobling, Anne
The study reported here was an examination of the reliability of a method for determining acquiescent responding and the capacity to respond to items using a Likert scale response format by adults with an intellectual disability. Reliability of the outcomes of these procedures was investigated using a test-retest design. Associations with receptive vocabulary were examined. The majority of the participants did not demonstrate acquiescent responding. Individuals' responses to the Likert-type discrimination tasks were consistent, although this varied somewhat depending upon the abstractness of the task. There was some association between receptive language age equivalence scores and respondent performance. It is recommended that the pretest protocol (a) be modified to improve its reliability, and (b) this modified version be used with study participants who have an intellectual disability to ascertain the appropriate level of choice to be used for items that use a Likert response format.
Smogavec, Mateja; Cleall, Alison; Hoyer, Juliane; Lederer, Damien; Nassogne, Marie-Cécile; Palmer, Elizabeth E; Deprez, Marie; Benoit, Valérie; Maystadt, Isabelle; Noakes, Charlotte; Leal, Alejandro; Shaw, Marie; Gecz, Jozef; Raymond, Lucy; Reis, André; Shears, Deborah; Brockmann, Knut; Zweier, Christiane
Heterozygous copy number variants (CNVs) or sequence variants in the contactin-associated protein 2 gene CNTNAP2 have been discussed as risk factors for a wide spectrum of neurodevelopmental and neuropsychiatric disorders. Bi-allelic aberrations in this gene are causative for an autosomal-recessive disorder with epilepsy, severe intellectual disability (ID) and cortical dysplasia (CDFES). As the number of reported individuals is still limited, we aimed at a further characterisation of the full mutational and clinical spectrum. Targeted sequencing, chromosomal microarray analysis or multigene panel sequencing was performed in individuals with severe ID and epilepsy. We identified homozygous mutations, compound heterozygous CNVs or CNVs and mutations in CNTNAP2 in eight individuals from six unrelated families. All aberrations were inherited from healthy, heterozygous parents and are predicted to be deleterious for protein function. Epilepsy occurred in all affected individuals with onset in the first 3.5 years of life. Further common aspects were ID (severe in 6/8), regression of speech development (5/8) and behavioural anomalies (7/8). Interestingly, cognitive impairment in one of two affected brothers was, in comparison, relatively mild with good speech and simple writing abilities. Cortical dysplasia that was previously reported in CDFES was not present in MRIs of six individuals and only suspected in one. By identifying novel homozygous or compound heterozygous, deleterious CNVs and mutations in eight individuals from six unrelated families with moderate-to-severe ID, early onset epilepsy and behavioural anomalies, we considerably broaden the mutational and clinical spectrum associated with bi-allelic aberrations in CNTNAP2. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Item response theory analysis to evaluate reliability and minimal clinically important change of the Roland-Morris Disability Questionnaire in patients with severe disability due to back pain from vertebral compression fractures.
Lee, Minji K; Yost, Kathleen J; McDonald, Jennifer S; Dougherty, Ryne W; Vine, Roanna L; Kallmes, David F
The majority of validation done on the Roland-Morris Disability Questionnaire (RMDQ) has been in patients with mild or moderate disability. There is paucity of research focusing on the psychometric quality of the RMDQ in patients with severe disability. To evaluate the psychometric quality of the RMDQ in patients with severe disability. Observational clinical study. The sample consisted of 214 patients with painful vertebral compression fractures who underwent vertebroplasty or kyphoplasty. The 23-item version of the RMDQ was completed at two time points: baseline and 30-day postintervention follow-up. With the two-parameter logistic unidimensional item response theory (IRT) analyses, we derived the range of scores that produced reliable measurement and investigated the minimal clinically important difference (MCID). Scores for 214 (100%) patients at baseline and 108 (50%) patients at follow-up did not meet the reliability criterion of 0.90 or higher, with the majority of patients having disability due to back pain that was too severe to be reliably measured by the RMDQ. Depending on methodology, MCID estimates ranged from 2 to 8 points and the proportion of patients classified as having experienced meaningful improvement ranged from 26% to 68%. A greater change in score was needed at the extreme ends of the score scale to be classified as having achieved MCID using IRT methods. Replacing items measuring moderate disability with items measuring severe disability could yield a version of the RMDQ that better targets patients with severe disability due to back pain. Improved precision in measuring disability would be valuable to clinicians who treat patients with greater functional impairments. Caution is needed when choosing criteria for interpreting meaningful change using the RMDQ. Copyright © 2017 Elsevier Inc. All rights reserved.
Yong, Yean K; Tan, Hong Y; Jen, Soe Hui; Shankar, Esaki M; Natkunam, Santha K; Sathar, Jameela; Manikam, Rishya; Sekaran, Shamala D
Currently, several assays can diagnose acute dengue infection. However, none of these assays can predict the severity of the disease. Biomarkers that predicts the likelihood that a dengue patient will develop a severe form of the disease could permit more efficient patient triage and allows better supportive care for the individual in need, especially during dengue outbreaks. We measured 20 plasma markers i.e. IFN-γ, IL-10, granzyme-B, CX3CL1, IP-10, RANTES, CXCL8, CXCL6, VCAM, ICAM, VEGF, HGF, sCD25, IL-18, LBP, sCD14, sCD163, MIF, MCP-1 and MIP-1β in 141 dengue patients in over 230 specimens and correlate the levels of these plasma markers with the development of dengue without warning signs (DWS-), dengue with warning signs (DWS+) and severe dengue (SD). Our results show that the elevation of plasma levels of IL-18 at both febrile and defervescence phase was significantly associated with DWS+ and SD; whilst increase of sCD14 and LBP at febrile phase were associated with severity of dengue disease. By using receiver operating characteristic (ROC) analysis, the IL-18, LBP and sCD14 were significantly predicted the development of more severe form of dengue disease (DWS+/SD) (AUC = 0.768, P dengue disease. Given that the elevation IL-18, LBP and sCD14 among patients with severe form of dengue disease, our findings suggest a pathogenic role for an aberrant inflammasome and monocyte activation in the development of severe form of dengue disease.
Heidi I Stanish
Full Text Available This paper provides an overview of strategies that have been used to promote physical activity in individuals with intellectual disability. Several different approaches are discussed and the strengths and limitations of each are presented. Some determinants of physical activity for individuals with intellectual disability are also reported in an effort to better understand the factors that influence participation that could be targeted in future interventions. Recommendations for programming are provided.Este artículo presenta un panorama de las estrategias que se han empleado para promover la actividad física en individuos con discapacidad intelectual. Se discuten varios enfoques distintos y se presentan las fortalezas y limitaciones de cada uno. Se informa asimismo acerca de algunos de los determinantes de la actividad física para los individuos con discapacidad intelectual para contribuir a un mayor entendimiento de los factores que influyen en la participación y que podrían ser el objetivo de futuras intervenciones. Se proporcionan recomendaciones para la programación.
Full Text Available The aim of the present study was to determine whether lung volume recruitment (LVR acutely increases respiratory system compliance (Crs in individuals with severe respiratory muscle weakness (RMW. Individuals with RMW resulting from neuromuscular disease or quadriplegia (n=12 and healthy controls (n=12 underwent pulmonary function testing and the measurement of Crs at baseline, immediately after, 1 h after and 2 h after a single standardised session of LVR. The LVR session involved 10 consecutive supramaximal lung inflations with a manual resuscitation bag to the highest tolerable mouth pressure or a maximum of 50 cmH2O. Each LVR inflation was followed by brief breath-hold and a maximal expiration to residual volume. At baseline, individuals with RMW had lower Crs than controls (37±5 cmH2O versus 109±10 mL·cmH2O−1, p0.05. LVR had no significant effect on measures of pulmonary function at any time point in either group (all p>0.05. During inflations, mean arterial pressure decreased significantly relative to baseline by 10.4±2.8 mmHg and 17.3±3.0 mmHg in individuals with RMW and controls, respectively (both p<0.05. LVR acutely increases Crs in individuals with RMW. However, the high airway pressures during inflations cause reductions in mean arterial pressure that should be considered when applying this technique.
Full Text Available Introduction: The objective of this study was to investigate with the help of a computerized simulation model whether the treatment of an acute asthma attack can be individualized based on the severity of the attack and the characteristics of the patient. Material and Method: A stochastic lung model was used to simulate the deposition of 1 nm - 10 μm particles during a mild and a moderate asthma attack. Breathing parameters were varied to maximize deposition, and simulation results were compared with those obtained in the case of a severe asthma attack. In order to investigate the effect of height on the deposition of inhaled particles, another series of simulations was carried out with identical breathing parameters, comparing patient heights of 155 cm, 175 cm and 195 cm. Results: The optimization process yielded an increase in the maximum deposition values of around 6-7% for each type of investigated asthma attack, and the difference between attacks of different degree of severity was around 5% for both the initial and the optimized values, a higher degree of obstruction increasing the amount of deposited particles. Conclusions: Our results suggest that the individualization of asthma attack treatment cannot be based on particles of different size, as the highest deposited fraction in all three types of attacks can be obtained using 0.01 μm particles. The use of a specific set of breathing parameters yields a difference between a mild and a moderate, as well as a moderate and a severe asthma attack of around 5%.
Full Text Available This study developed an assistive system for the severe physical disabilities, named “code-maker translator assistive input device” which utilizes a contest fuzzy recognition algorithm and Morse codes encoding to provide the keyboard and mouse functions for users to access a standard personal computer, smartphone, and tablet PC. This assistive input device has seven features that are small size, easy installing, modular design, simple maintenance, functionality, very flexible input interface selection, and scalability of system functions, when this device combined with the computer applications software or APP programs. The users with severe physical disabilities can use this device to operate the various functions of computer, smartphone, and tablet PCs, such as sending e-mail, Internet browsing, playing games, and controlling home appliances. A patient with a brain artery malformation participated in this study. The analysis result showed that the subject could make himself familiar with operating of the long/short tone of Morse code in one month. In the future, we hope this system can help more people in need.
Full Text Available Objective. To describe the prevalence and factors associated with severe child functioning difficulties and disability (CFD among two to four year old children in Mexico, and estimates the probability of presenting CFD based on specific population profiles. Materials and methods. The sample consists of 5 104 children who participated in the National Survey of Children and Women 2015 (ENIM. We used postestimation exploration by computing predicted values of CFD to interpret the logistic models for discrete combinations of the independent variables. Results. CFD prevalence is 2%,which means at least 130 000 two to four year-old children are at risk of experiencing severely limited participation in an unaccommodating environment. The probability of presenting CFD is dramatically higher in specific sub-groups of the population, in particular, male children of women with low education, who live in the poorest households. Conclusions. A significant proportion of Mexican children face important challenges due to functioning difficulties and disability. Public policies must be developed to accommodate the needs of these children and provide a proper environment for their development.
Full Text Available The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD was the first legally binding instrument explicitly focused on how human rights apply to people with disability. Amongst their obligations, consistent with the social model of disability, the Convention requires signatory nations to recognise that “…persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life” and mandates signatory nations to develop “…appropriate measures to provide access by persons with disability to the support they may require in exercising their legal capacity”. The Convention promotes supported decision-making as one such measure. Although Australia ratified the UNCRPD in 2008, it retains an interpretative declaration in relation to Article 12 (2, 3, 4, allowing for the use of substituted decision-making in situations where a person is assessed as having no or limited decision-making capacity. Such an outcome is common for people with severe or profound intellectual disability because the assessments they are subjected to are focused on their cognition and generally fail to take into account the interdependent nature of human decision-making. This paper argues that Australia’s interpretative declaration is not in the spirit of the Convention nor the social model of disability on which it is based. It starts from the premise that the intention of Article 12 is to be inclusive of all signatory nations’ citizens, including those with severe or profound cognitive disability. From this premise, arises a practical need to understand how supported decision-making can be used with this group. Drawing from evidence from an empirical study with five people with severe or profound intellectual disability, this paper provides a rare glimpse on what supported decision-making can look like for people with severe or profound intellectual disability. Additionally, it describes the importance of
Bouck, Emily C.; Satsangi, Rajiv
Students with mild intellectual disability generally garner less individual attention in research, as they are often aggregated with students with moderate and severe intellectual disability or students with other high incidence disabilities. This study used the National Longitudinal Transition Study-2 (NLTS2) to look at the personal…
Moneta, Maria Victoria; Garin, Noe; Olaya, Beatriz; Ayuso-Mateos, Jose Luis; Chatterji, Somnath; Leonardi, Matilde; Sainio, Päivi; Galas, Aleksander; Haro, Josep Maria
Objective The association between obesity and disability may differ between high-income and low-income/middle-income countries but there are no studies comparing this association between these settings. The aim of the study was to assess this association in nine countries using nationally-representative data from the Collaborative Research on Ageing in Europe (COURAGE) study and the WHO's Study on global AGEing and Adult Health (SAGE). Design Population-based cross-sectional study Setting The survey was conducted in China, Finland, Ghana, India, Mexico, Poland, Russia, South Africa and Spain between 2007 and 2012. Participants 42 116 individuals 50 years and older. The institutionalised and those with limited cognition were excluded. Primary outcome measure Disability was defined as severe or extreme difficulty in conducting at least one of six types of basic activities of daily living (ADL). Results The mean body mass index (BMI) ranged from 20.4 kg/m2 in India to 30.7 kg/m2 in South Africa. Compared to normal BMI (18.5–24.9 kg/m2), BMI≥35 kg/m2 was associated with significantly higher odds for ADL disability in Finland (OR 4.64), Poland (OR 2.77), South Africa (OR 2.19) and Spain (OR 2.42). Interaction analysis showed that obese individuals in high-income countries were more likely to have ADL limitations than those in low-income or middle-income countries. Conclusions The higher odds for disability among obese individuals in high-income countries may imply longer life lived with disability due to factors such as the decline in cardiovascular disease mortality. In South Africa, this may have been due to the exceptionally high prevalence of class III obesity. These findings underscore the importance of obesity prevention to reduce the disability burden among older adults. PMID:25838510
Areberg, Cecilia; Björkman, Tommy; Bejerholm, Ulrika
Across several research studies comparing the individual placement and support (IPS) approach to traditional vocational services, the approach has achieved employment outcomes superior to comparison conditions. However, to understand the efficacy of IPS, it is equally important to consider what is more or less effective as viewed by the IPS participants. To investigate participants' experiences of IPS participation and their experiences of receiving support from an employment specialist (ES). Interviews were conducted with 17 persons with severe mental illness. The interviews were subjected to qualitative content analysis. The principles of informed consent and the voluntary nature of participation were included as ethical considerations. Participation in IPS was associated with hope, meaning and an individualized support provided by the ES. The skills of the ES facilitated the relationship with the participant and the contact with the labour market. However, to make a change happen, everybody involved in IPS had to contribute. These findings have endorsed the guiding principles of IPS and emphasized the ES's role and skills during IPS as well as the participant's motivation. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.
Jenkins, Lisanne M; Skerrett, Kristy A; DelDonno, Sophie R; Patrón, Víctor G; Meyers, Kortni K; Peltier, Scott; Zubieta, Jon-Kar; Langenecker, Scott A; Starkman, Monica N
We investigated the ability of preferred classical music to activate the nucleus accumbens in patients with Major depressive disorder (MDD). Twelve males with MDD and 10 never mentally ill male healthy controls (HC) completed measures of anhedonia and depression severity, and listened to 90-second segments of preferred classical music during fMRI. Compared to HCs, individuals with MDD showed less activation of the left nucleus accumbens (NAcc). Individuals with MDD showed attenuation of the left NAcc response in later compared to earlier parts of the experiment, supporting theories that MDD involves an inability to sustain reward network activation. Counter intuitively, we found that NAcc activity during early music listening was associated with greater depression severity. In whole-brain analyses, anhedonia scores predicted activity in regions within the default mode network, supporting previous findings. Our results support theories that MDD involves an inability to sustain reward network activation. It also highlights that pleasant classical music can engage critical neural reward circuitry in MDD. Copyright © 2018 Elsevier B.V. All rights reserved.
Puanhvuan, Dilok; Khemmachotikun, Sarawin; Wechakarn, Pongsakorn; Wijarn, Boonyanuch; Wongsawat, Yodchanan
Currently, electric wheelchairs are commonly used to improve mobility in disabled people. In severe cases, the user is unable to control the wheelchair by themselves because his/her motor functions are disabled. To restore mobility function, a brain-controlled wheelchair (BCW) would be a promising system that would allow the patient to control the wheelchair by their thoughts. P300 is a reliable brain electrical signal, a component of visual event-related potentials (ERPs), that could be used for interpreting user commands. This research aimed to propose a prototype BCW to allowed severe motor disabled patients to practically control a wheelchair for use in their home environment. The users were able to select from 9 possible destination commands in the automatic mode and from 4 directional commands (forward, backward, turn left and right) in the shared-control mode. These commands were selected via the designed P300 processing system. The wheelchair was steered to the desired location by the implemented navigation system. Safety of the user was ensured during wheelchair navigation due to the included obstacle detection and avoidance features. A combination of P300 and EOG was used as a hybrid BCW system. The user could fully operate the system such as enabling P300 detection system, mode shifting and stop/cancelation command by performing a different consecutive blinks to generate eye blinking patterns. The results revealed that the prototype BCW could be operated in either of the proposed modes. With the new design of the LED-based P300 stimulator, the average accuracies of the P300 detection algorithm in the shared-control and automatic modes were 95.31 and 83.42% with 3.09 and 3.79 bits/min, respectively. The P300 classification error was acceptable, as the user could cancel an incorrect command by blinking 2 times. Moreover, the proposed navigation system had a flexible design that could be interfaced with other assistive technologies. This research developed
Sipowicz, Kasper; Żuraw, Hanna; Witusik, Andrzej; Mokros, Łukasz; Najbert, Edyta; Pietras, Tadeusz
People with severe and profound grade disabilities are the subject of interest in psychiatry, clinical psychology and special pedagogy. Unfortunately, the paradigmatic approach to special education based on postmodern philosophy is in contrast to the biomedical approach that is based on the positivist and Cartesian models. The paper is an attempt to systematize the similarities and differences between the humanistic approach and the modern biomedical model, which, despite the apparent differences, do not differ so much from each other. Work with a person disabled intellectually in the severe or profound degree is governed by the principles of methodical realism, taking into account to an equal extent the principal deficits, the concomitant diseases, limitations and the social context. The deeper the impairment and disability is, the smaller is the role of the humanistic paradigm in work with the client in the medical management and educational process. Changing the paradigms of special pedagogy has drawn attention to the social context of disability, separating, however, special pedagogy from modern medicine and psychology, cognitive-oriented and psychometry-based. The postmodern paradigm has become an ideology, which makes it difficult to work with deeply disabled people. Only the multidirectional approach including a variety of paradigms makes it possible to provide integrational aid to people with severe and profound grade intellectual disabilities. Working with such a disabled person should take into account equally the biomedical and humanistic aspects. © 2018 MEDPRESS.
Townley, Greg; Kloos, Bret
There is a disagreement in place-based research regarding whether objective indicators or individual perceptions of environments are better predictors of well-being. This study assessed environmental influences on well-being for 373 individuals with psychiatric disabilities living independently in 66 neighborhoods in the southeastern United States. Three questions were examined utilizing random effects models: (1) How much variance in personal and neighborhood well-being can be explained by neighborhood membership? (2) What is the relationship between participant perceptions of neighborhood quality and researcher ratings of neighborhood quality? and (3) What is the relative influence of individual perceptions, perceptions aggregated by neighborhood, and researcher ratings of neighborhood quality in predicting personal and neighborhood well-being? Results indicate that individual perceptions of neighborhood quality were more closely related to well-being than either aggregated perceptions or researcher ratings. Thus, participants' perceptions of their neighborhoods were more important indicators of their well-being than objective ratings made by researchers. Findings have implications for measurement approaches and intervention design in placed-based research.
Smith, Matthew J; Fleming, Michael F; Wright, Michael A; Jordan, Neil; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D
Individuals with severe mental illness have low employment rates, and the job interview presents a critical barrier for them to obtain competitive employment. Prior randomized controlled trials (RCTs) indicated that virtual reality job interview training (VR-JIT) improved job interviewing skills among trainees. This study assessed whether VR-JIT participation was associated with greater odds of receiving job offers in the six-months after completion of training. To assess the efficacy of VR-JIT, trainees (N=39) in the method and a comparison group (N=12) completed a brief survey approximately six months after participating in the RCTs. Primary vocational outcome measures included receiving a job offer and number of weeks searching for employment. A larger proportion of trainees than comparison participants received a job offer (51% versus 25%, respectively). Trainees were more likely to receive a job offer than comparison participants (odds ratio=9.64, p=.02) after analyses accounted for cognition, recency of last job, and diagnosis. Trainees had greater odds of receiving a job offer for each completed VR-JIT trial (odds ratio=1.41, p=.04), and a greater number of completed VR-JIT trials predicted fewer weeks of searching for employment (β=-.74, p=.02). Results provide preliminary support that VR-JIT is a promising intervention associated with enhanced vocational outcomes among individuals with severe mental illness. Given that participants had minimal access to standardized vocational services, future research could evaluate the effectiveness of VR-JIT among individuals with and without access to standardized vocational services as well as evaluate strategies to implement VR-JIT within a large community mental health service provider.
Ruiz, Sarah; Urdapilleta, Oswaldo; Clark-Shirley, Leanne J; Howard, Jennifer; Poey, Judith
This article explores how rebalancing efforts can support the needs of individuals aging with a lifelong disability. The National Balancing Indicator project examined the overall long-term supports and services system (LTSS) progress in five indicators within the Sustainability, Coordination and Transparency, and Prevention principles toward a balanced LTSS system for those aging with a lifelong disability. In assessing state efforts to create a balanced participant-directed LTSS system with the National Balancing Indicators, the findings suggest states are better equipping the system to handle a burgeoning population of individuals aging with a lifelong disability, but more progress is still needed. Overall, states need to continue to create a seamless system that allows individuals with lifelong disabilities to transition smoothly through the life course.
Full Text Available ABSTRACT CONTEXT: Bariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of individuals remain incompletely determined. CASE REPORT: A 25-year-old male with Prader-Willi syndrome, whose intelligence quotient (IQ was 54, was admitted with a body mass index (BMI of 55 kg/m2, associated with glucose intolerance. He underwent the Scopinaro procedure for biliopancreatic diversion, with uneventful postoperative evolution, and presented a 55% loss of excess weight one year after the surgery, with resolution of glucose intolerance, and without any manifestation of protein-calorie malnutrition. A 28-year-old male with Down syndrome, whose IQ was 68, was admitted with BMI of 41.5 kg/m2, associated with hypertension. He underwent Roux-en-Y gastric bypass, with uneventful postoperative evolution. He presented a 90% loss of excess weight one year after the surgery, with resolution of the hypertension. CONCLUSION: Bariatric surgery among individuals with intellectual impairment is a controversial topic. There is a tendency among these individuals to present significant weight loss and comorbidity control, but less than what is observed in the general obese population. The severity of the intellectual impairment may be taken into consideration in the decision-making process regarding the most appropriate surgical technique. Bariatric surgery is feasible and safe among these individuals, but further research is necessary to deepen these observations.
... entities because it affects only certain potential applicants and Federal employees. Executive Order 12866... particular work environment. For instance, the certification of readiness for an individual applying for a... performing work in an office environment.'' In the alternative, the current 213.3102(u)(3)(ii) allows...
Patricia NAVAS MACHO
Full Text Available People with intellectual (ID and developmental disabilities who have generalized or extensive support needs constitute a particularly vulnerable group that has traditionally experienced situations of exclusion. Despite this, their situation has not been a priority subject of study nor have there been specific developments in social policy to respond to their needs, which can be translated into an absence of interest in knowing the reality of these group, difficulties to guarantee the fulfillment of their rights, and lack of initiative aimed to achieve their full inclusion in society. Is therefore necessary to undertake different actions, translated into objectives of the present work: to explore and synthesize existing data on this group in our country; to detect their needs and their fulfillment; and to propose evidence-based guidelines to ensure their well-being and rights. For this purpose, the methodology used consisted of: (a a review of the most relevant scientific literature of the last ten years on ID and extensive support needs; and (b the analysis of the results yield by two national surveys carried out in Spain: the Disability, Independence, and Dependency Situations survey, EDAD (INE, 2008, and the System for Autonomy and Care for Dependency, SAAD (IMSERSO, 2016, among others. Considering the disparities observed within this group, urgent lines of action are highlighted, which are aimed to improve the knowledge about the living conditions of people with more significant ID and drive better practices in the provision of supports to this group.
Full Text Available In available studies of inclusive practice and IEP, emphasis was placed on the activities undertaken to reach the accessibility of teaching programs for students with special needs. Architectural accessibility of schools and its implementation for IEP has not been researched enough. The main aim of this research was to highlight the importance of architectural barriers for the process of creating IEP for pupils with physical disabilities, trough determining a current situation in regular elementary schools in Belgrade. An observation list, with 38 variables of architectural accessibility was used in this research. The sample consisted of 12 elementary schools in “Zvezdara” Municipality, Belgrade. The results show that there is complete architectural accessibility in nine out of 38 variables. All nine variables belong to “universal design”. In other variables, elements that measure specific components of architectural accessibility for pupils with physical disabilities mainly intermit. This must be taken into consideration when we discuss IEP, primarily from the aspect of planning additional help and support to professionals, providing additional time for pupils’ work and learning in class, and providing adequate place for learning.
Jahoda, Andrew; Selkirk, Mhairi; Trower, Peter; Pert, Carol; Stenfert Kroese, Biza; Dagnan, Dave; Burford, Bronwen
Establishing a collaborative relationship is a cornerstone of cognitive behavioural therapy (CBT). Increasingly CBT is being offered to people with intellectual disabilities who may have problems with receptive and expressive communication, and a history of disadvantage or discrimination in their relationships with those in positions of power. Consequently, they may have difficulty establishing a collaborative interaction with their therapist. This paper uses a novel method of interactional analysis to examine if collaboration increases as therapy progresses. Fifteen participants with borderline to mild intellectual disabilities and significant problems of depression, anxiety and anger were recruited from specialist clinical services to participate in this study. Verbatim transcripts of therapy sessions 4 and 9 were coded using an initiative-response method of analysing power distribution in dialogue, to investigate collaboration at the level of therapeutic interaction. The initiative-response scores indicated that power was relatively equally distributed between clients and therapists. On this measure there was no significant increase in collaboration as therapy progressed, as the dialogues were relatively equal from session 4. Analyses of the pattern of interaction showed that whilst the therapists asked most questions, the clients contributed to the flow of the analysis and played an active part in dialogues. The implications of these findings are discussed, along with the possible uses of such interactional analyses in identifying barriers to communication and ways of establishing effective therapeutic dialogue.
Vaitsman, Jeni; Lobato, Lenaura de Vasconcelos Costa
The 1988 Constitution approved the Continuous Cash Benefit (BCP) directed to elders and disabled persons with a household per capita income of 25% of the minimum wage, and around 4 million people received this benefit in 2015. The design of BPC for disabled persons involves organizations of social security, social welfare and health. This paper discusses how some intersectoral coordination mechanisms gaps between these areas produce access barriers to potential beneficiaries. Results stem from a qualitative study performed with physicians, administrative staff and social workers from the National Institute of Social Security (INSS) and of the Social Welfare Reference Center (CRAS) in three municipalities of different Brazilian regions. Intersectoral coordination and cooperation are more structured at the Federal level. At the local level, they rely on informal and horizontal initiatives, which produce immediate but discontinuous solutions. The role of the CRAS remains contingent on the implementation. The need to establish institutionalized mechanisms for coordination and cooperation between social welfare, health and social insurance to improve the implementation and reduce barriers to access to the BCP is apparent.
Araten-Bergman, T; Werner, S
The present study aimed to explore the applicability of the attribution model to social workers' attributions towards clients with dual diagnosis of intellectual disability and psychiatric illness. Specifically, the study examined the relations between social workers' attribution of responsibility, causality, stereotypes of dangerousness, their emotional reactions and behavioural reactions towards clients with dual diagnosis. Social workers (N = 279) completed questionnaires measuring attributions of responsibility, causation and dangerousness, and reported on their emotional and behavioural reactions to clients diagnosed with DD. Most social workers reported high levels of helping behaviours. The strongest predictor of discriminatory behaviours was the stereotype of dangerousness. Social workers who reported feeling less anger and more pity towards clients with DD tended to report higher levels of helping behaviour. But contrary to attribution theory, fear and anger did not predict discriminatory behaviours. The results are discussed in relation to the core values of social work and to professional identity. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Rodríguez Pulido, Francisco; Caballero Estebaranz, Nayra; Tallo Aldana, Elena; Méndez Abad, Manuel E; Hernández Álvarez-Sotomayor, M Carmen; López Reig, Susana; Vílchez de León, Patricia Inés; González-Dávila, Enrique
To assess the effectiveness of an individual placement and support (IPS) strategy in people with severe mental disorders in Tenerife Island (Spain). Patients of Community Mental Health Services with severe mental disorders were randomly assigned to two groups. One of them received IPS (n=124), and the control group (n=75) was advised in the usual job search. Patients were followed up for an average of 3.4 years and an analysis was made of how many patients worked at least one day, working hours, wages, the number of contracts and the number of hospital admissions. Non-parametric methods were used to compare the results (Mann-Whitney U test). The percentage of patients who worked at least one day was 99% in the IPS group compared with 75% in the control group; they worked on average 30.1 weeks per year vs 7.4; the monthly salary was € 777.9 vs € 599.9; the number of contracts per person was 3.89 vs 4.85, and hospital admissions were 0.19 vs 2.1. The IPS strategy is effective for the labour integration of people with severe mental illness getting them to work longer, have higher wages and fewer hospital admissions. Copyright © 2017 SESPAS. All rights reserved.
Lakhan, Ram; Kishore, M. Thomas
Background: Behaviour problems are most common in people with intellectual disabilities. Nature of behaviour problems can vary depending upon the age, sex and intellectual level (IQ). Objectives: This study examined the distribution of behaviour problems across intellectual disability categories and their association with IQ age and sex in…
Cullinan, John; Gannon, Brenda; Lyons, Seán
Addressing the extra economic costs of disability seems a logical step towards alleviating elements of social exclusion for people with disabilities. This paper estimates the economic cost of disability in Ireland in terms of the additional spending needs that arise due to disability. It defines and estimates models of the private costs borne by families with individuals who have a disability in Ireland when compared to the wider population, both in general and by severity of illness. Our mod...
Fickert, Nancy A; Ross, Diana
Caregivers who work in community living arrangements or intermediate care facilities are responsible for the oral hygiene of individuals with intellectual and developmental disabilities. Oral hygiene training programs do not exist in many organizations, despite concerns about the oral care of this population. The purpose of this study was to determine the effectiveness of a caregiver educational program. This study used a quasi-experimental one-group pretest/posttest design with repeated measures to describe the outcomes of an educational program. Program participants demonstrated oral hygiene skills on each other while being scored by a trained observer, after which they completed an oral hygiene compliance survey. After three months, a follow-up included the same posttest, demonstration of oral hygiene skills, and repeat of the compliance survey. Paired-sample t-tests of oral hygiene knowledge showed a statistically significant improvement from pretest to posttest and from pretest to three-month posttest. Oral hygiene skills and compliance improved. Results demonstrate evidence that caregiver education improves knowledge, skill, and compliance in oral hygiene. Further studies are required to demonstrate the value of providing oral hygiene education and training for caregivers of individuals with intellectual and developmental disabilities.
Tint, A; Thomson, K; Weiss, J A
Special Olympics (SO) is commonly cited to play an important role in the lives of individuals with intellectual disabilities (ID). The purpose of the current review was to (a) synthesise key findings regarding the physical, psychological/emotional, social and/or intellectual/cognitive correlates of SO participation for individuals with ID and (b) highlight limitations in the extant research as well as directions for future research. A systematic review of electronic databases was undertaken. A total of 46 articles were confirmed to meet study criteria. Quality assessments of included studies were conducted using checklists from the Scottish Intercollegiate Guidelines Network methodology checklists (SIGN 50; SIGN 2008). There was a larger amount of support for physical, psychological/emotional and social outcomes as compared with cognitive/intellectual outcomes; however, many studies were confounded by measurement difficulties, sampling procedures and a lack of replicable methods, which hinder generalisation of results. This review highlights the need for a continued critical focus on SO programme evaluation research with more rigorous and replicable methods. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
O'Neill, Linda P; Murray, Lindsay E
Adult siblings of individuals with developmental disabilities often experience higher levels of anxiety than individuals in the general population. The present study tested whether perceived parenting could mediate the relationship between attachment styles and anxiety in the sibling group compared to a control group. Little association was found between perceived parenting and attachment styles or anxiety for the siblings but there were robust and expected findings for the control. Adult attachment-related-anxiety was a significant unique predictor of anxiety in the sibling group but there was no mediational role for perceived parenting. Conversely, the majority of parenting styles significantly mediated the relationship between attachment and anxiety in the control. Implications for the atypical findings in the sibling group are discussed.
Peck, Kelly R; Smitherman, Todd A
Despite advances in headache medicine, there remains little research on process-related variables that mediate relations between headache and outcomes, as well as limited dissemination of optimal statistical methodology for conducting mediation analyses. The present paper thus aims to promote and demonstrate a contemporary approach to mediation analysis as applied to headache. An overview of a contemporary path-analytic approach to mediation analysis is presented, with an empirical exemplar for illustrative purposes. In the exemplar, headache management self-efficacy (HMSE) was proposed as a mediator between headache severity and disability. The sample included 907 young adults (M age = 19.03 [SD = 2.26]; 70.8% female) with primary headache. Direct and indirect effects of headache severity on headache disability through HMSE were assessed using the espoused methods. Pain severity was positively associated with headache disability (β = 2.91, 95% confidence interval [CI; 2.62, 3.19]) and negatively associated with HMSE (β = -3.50, 95% CI [-4.24, -2.76]); HMSE was negatively associated with headache disability (β = 0.07, 95% CI [-0.09, -0.04]). A positive indirect effect of pain severity on disability through HMSE was identified (point estimate = 0.24, 95% CI [0.14, 0.34]); thus, self-efficacy mediated the association between pain severity and disability. The proposed mediation model accounted for 38% of total variance in disability (P headache literature. In one exemplar application, self-efficacy partially accounted for the disability resulting from headache. We advocate for increased attention to intervening variables in headache via dissemination of contemporary mediation analyses. © 2015 American Headache Society.
Olaya, Beatriz; Moneta, Maria Victoria; Koyanagi, Ai; Lara, Elvira; Miret, Marta; Ayuso-Mateos, José Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Lobo, Antonio; Haro, Josep Maria
To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. Cross-sectional. Community-based. Population-based sample of 7987 non-institutionalized adults aged 50 and older. The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.
van den Bosch, Kirsten A.; Vlaskamp, Carla; Andringa, Tjeerd C.; Post, Wendy J.; Ruijssenaars, Wied A.J.J.M.
Background: People with profound intellectual disabilities experience a high prevalence of visual disabilities, making them more dependent on sound. However, research addressing the influence of the auditory environment is scarce. Method: Observations of the auditory environments (soundscapes) and
To study whether severity of traumatic brain injury and the intelligence quotient are related to executive dysfunction. Sixty-two adults with brain injury who were referred for a work capacity evaluation. Retrospective review of severity of traumatic brain injury, intelligence quotient from a previously-conducted neuropsychological evaluation, determination of executive function status from the neuropsychological evaluation, and both self-report and informant-report executive dysfunction scores from the Behavior Rating Inventory of Executive Function. Executive dysfunction and the intelligence quotient are related to severity of traumatic brain injury, but executive dysfunction and the intelligence quotient are not related to each other. Executive dysfunction as determined by a neuropsychological evaluation was not consistent with clients' self-reports but was consistent with informant-reported executive dysfunction. Five types of executive dysfunction were reported by knowledgeable informants, with significant elevations on the Shift, Plan/Organize, Task Monitor, Organization of Materials, and Working Memory BRIEF clinical scales. The intelligence quotient is not a useful indicator of executive dysfunction. Informant-report executive dysfunction is a reliable and potentially useful adjunct to a neuropsychological evaluation. Working memory is the most severe type of executive dysfunction and may not be adequately measured by current neuropsychological evaluation methods.
Zaal-Schuller, I. H.; de Vos, M. A.; Ewals, F. V. P. M.; van Goudoever, J. B.; Willems, D. L.
The objectives of this integrative review were to understand how parents of children with severe developmental disorders experience their involvement in end-of-life decision-making, how they prefer to be involved and what factors influence their decisions. We searched MEDLINE, EMBASE, CINAHL and
Manresa-Yee, Cristina; Morrison, Ann; Larsen, Jeppe Veirum
V-Sense is a vibrotactile interface that encourages children with severe or profound cognitive, sensory and physical impairments to move. The interface makes use of touch, in particular vibrations, as a supportive function to motivate users' actions. Specifically, we propose a vibrotactile...
Bertelli, M; Bianco, A; Rossi, M; Scuticchio, D; Brown, I
There is substantial literature investigating quality of life (QoL) of individuals with intellectual disability (ID). QoL of families of people with ID is emerging as an important field of research. Despite this, there is a lack of studies regarding their relationship. The present paper aimed to study the relationship between QoL scores of individuals with ID and members of their families. Twenty-seven parents or relatives of 27 adults with ID were recruited by four different research centres across Tuscany (Italy) to be interviewed through the Italian adaptation of the Family Quality of Life Survey - 2006 (FQoLS-2006), a tool developed for use in a multiple-country study on family QoL. The FQoLS-2006 was translated and adapted to Italian through three revisions. The last was submitted to the authors of the original version, who also maintain an electronic data file and data archive for statistical evaluations in various countries. QoL of persons with ID was assessed through the administration of the Quality of Life - Instrument Package. QoL scores were analysed to describe population characteristics and to examine the relationships among measures of individual and family QoL using correlations (Pearson and Spearman). Findings showed that family ratings of QoL were generally low. Families interviewed reported a low level of QoL in 'Support from Others' and 'Community Interaction', while 'Family Relationships' and 'Health of the Family' rated higher. For individual QoL, individuals had the lowest scores in the area of 'Spiritual being' and higher scores in the area of 'Physical being'. Correlations examining possible relationships among Importance, Satisfaction and Opportunities found some statistically significant correlation coefficients between some aspects of the three main areas of individual QoL (Being, Belonging and Becoming) and the nine family domains. Most of these correlations regarded family 'Financial Well-Being', 'Family Relationships, 'Support from
Full Text Available Objective: Renal function is often compromised in severe obesity. A true measurement of glomerular filtration rate (GFR is unusual, and how estimation formulae (EstForm perform in such individuals is unclear. We characterized renal function and hemodynamics in severely obese individuals, assessing the reliability of EstForm. Methods: We measured GFR (mGFR by iohexol plasma clearance, renal plasma flow (RPF by 123I-ortho-iodo-hippurate, basal and stimulated vascular renal indices, endothelium-dependent and -independent vasodilation using flow-mediated dilation (FMD as well as metabolic and hormonal profile in morbid, otherwise healthy, obese subjects. Results: Compared with mGFR, the better performing EstForm was CKD-EPI (5.3 ml/min/1.73 m2 bias by Bland-Altman analysis. mGFR was directly related with RPF, total and incremental glucose AUC, and inversely with PTH and h8 cortisol. Patients with mGFR below the median shown significantly higher PTH and lower vitamin D3. Basal or dynamic renal resistive index, FMD, pulse wave velocity were not related with mGFR. In an adjusted regression model, renal diameter and plasma flow remained related with mGFR (R2 = 0.67, accounting for 15% and 21% of mGFR variance, respectively. Conclusions: CKD-EPI formula should be preferred in morbid obesity; glucose increments during oral glucose tolerance test correlate with hyperfiltration; RPF and diameter are independent determinants of mGFR; slightly high PTH values, frequent in obesity, might influence mGFR.
Lundqvist, Lars-Olov; Andersson, Gunilla; Viding, Jane
Vibroacoustic music has been proposed to be an effective treatment for individuals with developmental disorders and challenging behaviors. The present study experimentally tested the effects of vibroacoustic music on self-injurious, stereotypical, and aggressive destructive behaviors in 20 individuals with autism spectrum disorders and…
Smith, Madison; Wilder, David A
The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to identify the variables responsible for performance problems. To date, the PDC-HS has not been examined with individuals with intellectual disabilities. In the current study, two supervisors with intellectual disabilities completed the PDC-HS to assess the productivity of two supervisees with disabilities who performed a pricing task in a thrift store. The PDC-HS suggested that performance deficits were due to a lack of training; a PDC-HS-indicated intervention was effective to increase accurate pricing. • The PDC-HS is an informant-based tool designed to identify the variables responsible for employee performance problems in human service settings. • The PDC-HS can be completed by some individuals with intellectual disabilities in a supervisory position to identify the variables responsible for problematic job performance among their supervisees. • A PDC-HS indicated intervention was demonstrated to be effective to improve the job performance of individuals with disabilities. • The PDC-HS may be a useful tool to support performance improvement and job maintenance among individuals with intellectual disabilities.
Wilkinson, Krista M; Light, Janice
Visual scene displays (VSDs) are a form of augmentative and alternative communication display in which language concepts are embedded into an image of a naturalistic event. VSDs are based on the theory that language learning occurs through interactions with other people, and recommendations for VSD design have emphasized using images of these events that include humans. However, many VSDs also include other items that could potentially be distracting. We examined gaze fixation in 18 school-aged participants with and without severe intellectual/developmental disabilities (i.e., individuals with typical development, autism, Down syndrome and other intellectual disabilities) while they viewed photographs with human figures of various sizes and locations in the image, appearing alongside other interesting, and potentially distracting items. In all groups, the human figures attracted attention rapidly (within 1.5 seconds). The proportions of each participant's own fixation time spent on the human figures were similar across all groups, as were the proportions of total fixations made to the human figures. Although the findings are preliminary, this initial evidence supports the inclusion of humans in VSD images.
Breuer, K; John, S M; Finkeldey, F; Boehm, D; Skudlik, C; Wulfhorst, B; Dwinger, C; Werfel, T; Diepgen, T L; Schmid-Ott, G
Occupational hand eczema (OHE) is associated with impaired health-related quality of life (QoL) and mental distress. Interdisciplinary inpatient rehabilitation measures in the framework of tertiary individual prevention (TIP) offered by the German employers' liability insurance associations include dermatological treatment, education and psychological interventions. To investigate the effects of interdisciplinary inpatient rehabilitation in the framework of TIP on mental health in patients with severe OHE and the relationships between recovery of OHE and improvement of mental health and QoL. A total of 122 patients participated in the study. A test battery consisting of the German versions of the Hospital Anxiety and Depression Scale (HADS-D), the Dermatology Life Quality Index (DLQI), the Short Form Health Survey-36 (SF-36) and the Trier Inventory for the Assessment of Chronic Stress (TICS) was applied at the time of admission (T1) and 3 weeks after dismissal (T2). Severity of hand eczema was assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). All parameters improved significantly from T1 to T2. A relationship was established between the improvement of QoL and recovery of OHE, while there was no such relationship between the improvement of mental distress and improvement of OHE. Nonresponders had significantly more cumulative days of sickness at T1. Our data underscore the importance of psychological interventions in addition to dermatological treatment in the framework of prevention measures for OHE. These measures should be applied at an early stage of OHE prior to the occurrence of sick leave. © 2015 European Academy of Dermatology and Venereology.
Zaal-Schuller, I H; de Vos, M A; Ewals, F V P M; van Goudoever, J B; Willems, D L
The objectives of this integrative review were to understand how parents of children with severe developmental disorders experience their involvement in end-of-life decision-making, how they prefer to be involved and what factors influence their decisions. We searched MEDLINE, EMBASE, CINAHL and PsycINFO. The search was limited to articles in English or Dutch published between January 2004 and August 2014. We included qualitative and quantitative original studies that directly investigated the experiences of parents of children aged 0-18 years with severe developmental disorders for whom an end-of-life decision had been considered or made. We identified nine studies that met all inclusion criteria. Reportedly, parental involvement in end-of-life decision-making varied widely, ranging from having no involvement to being the sole decision-maker. Most parents preferred to actively share in the decision-making process regardless of their child's specific diagnosis or comorbidity. The main factors that influenced parents in their decision-making were: their strong urge to advocate for their child's best interests and to make the best (possible) decision. In addition, parents felt influenced by their child's visible suffering, remaining quality of life and the will they perceived in their child to survive. Most parents of children with severe developmental disorders wish to actively share in the end-of-life decision-making process. An important emerging factor in this process is the parents' feeling that they have to stand up for their child's interests in conversations with the medical team. Copyright © 2015 Elsevier Ltd. All rights reserved.
Tatiana URIEN ORTIZ
Full Text Available This article analyzes the ethical implications of acknowledging disability as a human rights issue. The most common way to understand disability is inspired by a welfarist structure where collective needs trump the wishes of the individual. This new conceptualization, inspired by influential philosophers, such as Dworkin and Margalit, understands dignity as the individual’s right to have their life unfold in an inclusive context that creates self-respect.
Leeuw, N. de; Bulk, S.; Green, A.; Jaeckle-Santos, L.; Baker, L.A.; Zinn, A.R.; Kleefstra, T.; Smagt, J.J. van der; Vianne Morgante, A.M.; Vries, L.B.A. de; Bokhoven, J.H.L.M. van; Brouwer, A.P.M. de
We describe three patients with a comparable deletion encompassing SLC25A43, SLC25A5, CXorf56, UBE2A, NKRF, and two non-coding RNA genes, U1 and LOC100303728. Moderate to severe intellectual disability (ID), psychomotor retardation, severely impaired/absent speech, seizures, and urogenital anomalies
Dharmasaroja, Pornpatr A; Lolekha, Praween; Kulkantrakorn, Kongkiat; Charernboon, Thammanard; Watcharakorn, Arvemas; Piyabhan, Pritsana
More than half of patients with dementia lived in countries with low and middle incomes. However, there have been few studies on the natural course of disease in these countries. The purpose of this study was to study the natural course and the predictive factors of advanced stage and death in Thai patients with dementia. Patients with dementia who were treated in neurologic and psychiatric clinic from September 2004 to February 2016, were included. Data about natural course of diseases, behavioral and psychological symptoms in dementia (BPSD) and complications were studied. 207 patients were included. Mean age was 77years old. Mean Thai Mental State Examination (TMSE) was 17.5. Alzheimer's disease was the most common cause of dementia (55%). With the mean follow-up of 39months (range from 2 to 126months), 64% of the patients had BPSD. Sixty-two patients (30%) had complications required admission. Seven patients died. Fifty-four patients (29%) ended in the advanced stage of dementia. Mean duration from diagnosis to the advanced stage was 49months. Complications that required admission usually occurred in moderate to severe dementia and were strongly associated with the advanced stage or death (OR 6.1, 95%CI 2.57-14.49, p-valuedementia in the study. Most demented patients presented in moderate severity of dementia. Mean duration from diagnosis to the advanced stage of dementia was approximate 4-5years. Complications required admissions related to the progression to advanced stage or death. Copyright © 2017 Elsevier Ltd. All rights reserved.
Chambers, Mark; Rehfeldt, Ruth Anne
The purpose of this study was to determine whether manual sign or the Picture Exchange Communication System (P.E.C.S.) (Frost and Bondy, 1994) would be more effective in teaching mand skills to adults with mental retardation in the severe and profound range. Four participants were taught to mand for four reinforcing items using both communication modalities, in an alternating treatments design. Three of four participants demonstrated criterion performance across all four mands using P.E.C.S. first. Two of those three participants later demonstrated criterion performance for the mands using manual sign. The fourth participant was removed from the study during training due to illness, but her progress indicated greater acquisition with P.E.C.S. Generalization probes conducted at participants' respective residences showed that three participants demonstrated generalization across settings using P.E.C.S., and two participants demonstrated generalization across settings using manual sign. Participants were also more likely to mand for reinforcing items not present using P.E.C.S. than using manual sign.
Sousa, Kelienny de Meneses; Oliveira, Wagner Ivan Fonsêca de; Melo, Laiza Oliveira Mendes de; Alves, Emanuel Augusto; Piuvezam, Grasiela; Gama, Zenewton André da Silva
Purpose To identify access barriers to physical rehabilitation for traffic accident (TA) victims with severe disability and build a theoretical model to provide guidance towards the improvement of these services. Methods Qualitative research carried out in the city of Natal (Northeast Brazil), with semi-structured interviews with 120 subjects (19 key informer health professionals and 101 TA victims) identified in a database made available by the emergency hospital. The interviews were analyzed using Alceste software, version 4.9. Results The main barriers present in the interviews were: (1) related to services: bureaucratic administrative practises, low offer of rehabilitation services, insufficient information on rehabilitation, lack of guidelines that integrate hospital and ambulatory care and (2) related to patients: financial difficulties, functional limitations, geographic distance, little information on health, association with low education levels and disbelief in the system and in rehabilitation. Conclusion The numerous access barriers were presented in a theoretical model with causes related to organizational structure, processes of care, professionals and patients. This model must be tested by health policy-makers and managers to improve the quality of physical rehabilitation and avoid unnecessary prolongation of the suffering and disability experienced by TA survivors. Implications for rehabilitation Traffic accidents (TAs) are a global health dilemma that demands integrality of preventive actions, pre-hospital and hospital care and physical rehabilitation (PR). This study lays the foundation for improving access to PR for TA survivors, an issue of quality of care that results in preventable disabilities. The words of the patients interviewed reveal the suffering of victims, which is often invisible to society and given low priority by health policies that relegate PR to a second plan ahead of prevention and urgent care. A theoretical model of the
Galli, Manuela; Coghe, Giancarlo; Sanna, Paola; Cocco, Eleonora; Marrosu, Maria Giovanna; Pau, Massimiliano
This study analyzes how multiple sclerosis (MS) does affect one of the most common voluntary activities in life: the gait initiation (GI). The main aim of the work is to characterize the execution of this task by measuring and comparing relevant parameters based on center of pressure (COP) patterns and to study the relationship between these and the level of expanded disability status scale (EDSS). To this aim, 95 MS subjects with an average EDSS score of 2.4 and 35 healthy subjects were tested using a force platform during the transition from standing posture to gait. COP time-series were acquired and processed to extract a number of parameters related to the trajectory followed by the COP. The statistical analysis revealed that only a few measurements were statistically different between the two groups and only these were subsequently correlated with EDSS score. The correlation analysis underlined that a progressive alteration of the task execution can be directly related with the increase of EDSS score. These finding suggest that most of the impairment found in people with MS comes from the first part of the COP pattern, the anticipatory postural adjustments (APAs). The central nervous system performs APAs before every voluntary movement to minimize balance perturbation due to the movement itself. Gait Initiation's APAs consist in some ankle muscles contractions that induce a backward COP shift to the swing limb. The analysis here performed highlighted that MS affected patients have a reduced posterior COP shift that reveals that the anticipatory mechanism is impaired. Copyright © 2015 Elsevier B.V. All rights reserved.
Kamstra, Aafke; van der Putten, Annette Aj; Vlaskamp, Carla
Most people with profound intellectual and multiple disabilities (PIMD) have limited social contact and it is unclear what is done to maintain or increase these contacts. Individual support planning (ISP) can be used in the systematic enhancement of social contacts. This study analyses the content of ISPs with respect to the social contacts of people with PIMD. ISPs for 60 persons with PIMD in the Netherlands were inductively coded and illustrated with quotations. It turned out that every ISP contained information about social contacts. Of all the quotations extracted, 71.2% were about current conditions, 6.2% were about the future and less than 1% concerned actual goals. The social contacts of people with PIMD are mentioned in their ISPs, but this is rarely translated into goals. The results of the current study suggest that attention should be paid to ensuring that professionals understand the importance of social contacts and their application in practice.
van der Ploeg, Hidde P; Streppel, Kitty R M; van der Beek, Allard J; van der Woude, Luc H V; Vollenbroek-Hutten, Miriam; van Mechelen, Willem
The objective was to determine the test-retest reliability and criterion validity of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD). Forty-five non-wheelchair dependent subjects were recruited from three Dutch rehabilitation centers. Subjects' diagnoses were: stroke, spinal cord injury, whiplash, and neurological-, orthopedic- or back disorders. The PASIPD is a 7-d recall physical activity questionnaire that was completed twice, 1 wk apart. During this week, physical activity was also measured with an Actigraph accelerometer. The test-retest reliability Spearman correlation of the PASIPD was 0.77. The criterion validity Spearman correlation was 0.30 when compared to the accelerometer. The PASIPD had test-retest reliability and criterion validity that is comparable to well established self-report physical activity questionnaires from the general population.
Kurtz, Patricia F; Boelter, Eric W; Jarmolowicz, David P; Chin, Michelle D; Hagopian, Louis P
This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force, 1995) and adapted by Jennett and Hagopian (2008) for evaluation of single-case research studies were used to examine the support for FCT. Results indicated that FCT far exceeds criteria to be designated as a well-established treatment for problem behavior exhibited by children with ID and children with autism spectrum disorder, and can be characterized as probably efficacious with adults. Copyright © 2011 Elsevier Ltd. All rights reserved.
...) Information in reports prepared by individuals and entities performing certification or licensure reviews, or by professional accreditation organizations, as well as related assessments prepared for a facility... in the State when necessary to conduct a full investigation of an incident of abuse or neglect under...
Davis, Hope C; Troy Blackburn, J; Ryan, Eric D; Luc-Harkey, Brittney A; Harkey, Matthew S; Padua, Darin A; Pietrosimone, Brian
The purpose of this study was to determine associations between self-reported function (International Knee Documentation Committee Index), isometric quadriceps strength and rate of torque development in individuals with a unilateral anterior cruciate ligament reconstruction. Forty-one individuals [31% male, BMI mean 25 (SD 4) kg/m 2 , months post anterior cruciate ligament reconstruction mean 49 (SD 40)] completed the self-reported function and isometric quadriceps function testing. Rate of torque development was assessed at 0-100ms (early), 100-200ms (late) ms, and peak following the onset of contraction. Associations were examined between rate of torque development, strength, and self-reported function. Linear regression was used to determine the unique amount of variance explained by the combination of rate of torque development and strength. Higher rate of torque development 100-200ms is weakly associated with higher self-reported function in individuals with a unilateral anterior cruciate ligament reconstruction (r=0.274, p=0.091); however, rate of torque development 100-200ms does not predict a significant amount of variance in self-reported function after accounting for strength (ΔR 2 =0.003, P=0.721). Quadriceps strength has a greater influence on self-reported function compared to rate of torque development in individuals with an anterior cruciate ligament reconstruction with time from surgery. Copyright © 2017 Elsevier Ltd. All rights reserved.
Duijvenbode, N. van; Didden, H.C.M.; Voogd, H.F.J.M.; Korzilius, H.P.L.M.; Engels, R.C.M.E.
The primary aim of the present pilot study was to examine cognitive biases in individuals with mild to borderline ID and alcohol use-related problems. Participants (N = 57) performed the approach avoidance task, picture rating task and visual dot probe task, which was combined with eye-tracking
This study's purpose was to determine factors influencing treatment choices of individuals with severe mental illness (SMI). The sample was drawn from admissions to residential crisis programs in San Francisco. Inclusion criteria were an Axis I and Axis III disorder. This qualitative study utilized grounded theory method. Interviews and field notes were coded for recurring themes. Descriptive data were also collected. Participants revealed that the most important influences on treatment decisions were immediate need for care, the belief that their subacute complaints will not be taken seriously by providers, positive reinforcement for emergency service use, and enabling factors such as insurance coverage. Other remarkable findings included: numerous reports of substance induced medical crises, lack of support from family, and unawareness of client's medical conditions in psychiatric facilities. Health care seeking behaviors are learned and learning that will promote the use of outpatient services in SMI must include positive experiences in the delivery of care in the primary care setting. Participants were knowledgeable regarding their illnesses and able to articulate symptoms of illness well. Failure to communicate symptoms appeared to reflect the participant's perception of a lack of response to their reports.
Orita, Makiko; Hayashida, Naomi; Shinkawa, Tetsuko; Kudo, Takashi; Koga, Mikitoshi; Togo, Michita; Katayama, Sotetsu; Hiramatsu, Kozaburo; Mori, Shunsuke; Takamura, Noboru
Severely and multiply disabled children (SMDC) are frequently affected in more than one area of development, resulting in multiple disabilities. The aim of the study was to evaluate the efficacy of music therapy in SMDC using monitoring changes in the autonomic nervous system, by the frequency domain analysis of heart rate variability. We studied six patients with SMDC (3 patients with cerebral palsy, 1 patient with posttraumatic syndrome after head injury, 1 patient with herpes encephalitis sequelae, and 1 patient with Lennox-Gastaut syndrome characterized by frequent seizures, developmental delay and psychological and behavioral problems), aged 18-26 (mean 22.5 ± 3.5). By frequency domain method using electrocardiography, we measured the high frequency (HF; with a frequency ranging from 0.15 to 0.4 Hz), which represents parasympathetic activity, the low frequency/high frequency ratio, which represents sympathetic activity between the sympathetic and parasympathetic activities, and heart rate. A music therapist performed therapy to all patients through the piano playing for 50 min. We monitored each study participant for 150 min before therapy, 50 min during therapy, and 10 min after therapy. Interestingly, four of 6 patients showed significantly lower HF components during music therapy than before therapy, suggesting that these four patients might react to music therapy through the suppression of parasympathetic nervous activities. Thus, music therapy can suppress parasympathetic nervous activities in some patients with SMDC. The monitoring changes in the autonomic nervous activities could be a powerful tool for the objective evaluation of music therapy in patients with SMDC.
Deepika, Akhil; Devi, B Indira; Shukla, Dhaval
Most patients with severe traumatic brain injury (TBI) are discharged when they have still not recovered completely. Many such patients are not available for follow up. We conducted this study to determine whether the condition at discharge from acute care setting, as assessed with disability rating scale (DRS), correlates with functional outcome at follow up. This study was conducted at a Neurosurgical intensive care unit (ICU) of a tertiary care referral center. This was a prospective observational study. Patients admitted to ICU with a diagnosis of severe TBI were enrolled for the study. On the day of discharge, all patients underwent DRS assessment. A final assessment was performed using Glasgow outcome scale extended (GOSE) at 6 months after discharge from the hospital. The correlation between the DRS scores at the time of discharge with DRS scores and GOSE categories at 6 months after discharge was determined using Spearman's rho correlation coefficient. A total of 88 patients were recruited for the study. The correlation coefficient of DRS at discharge for DRS at 6 months was 0.536 and for GOSE was -0.553. The area under the curve of DRS score at discharge for predicting unfavorable outcome and mortality at 6 months was 0.770 and 0.820, respectively. The predictive validity of DRS is fair to good in determining GOSE at follow-up. Pending availability of a more accurate outcome assessment tool, DRS at discharge can be used as a surrogate outcome for GOSE at follow up.
Ishtiak-Ahmed, Kazi; Perski, Aleksander; Mittendorfer-Rutz, Ellenor
BACKGROUND: Stress-related mental disorders rank among the leading causes of sickness absence in several European countries. The aim of this study was to investigate predictors of all-cause and diagnosis-specific disability pension in sickness absentees with stress-related mental disorders. METHO....... The variation in the effect of risk markers with regard to age and diagnosis of disability pension speaks in favour of the importance of a person-centered approach in treatment and rehabilitation....
... types of services to passengers with a disability that are or are not available on the flight. ... NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Information for Passengers § 382.41 What flight-related... ability to accommodate passengers with a disability, including limitations on the availability of level...
Picture-book reading provides an effective intervention context for young children learning spoken language and may also be appropriate for teaching the use of augmentative and alternative communication to children with severe intellectual disabilities. This study reports on a group intervention using a semiscripted book reading routine implemented by a teacher in a classroom for students with severe intellectual disabilities. Student use of line drawings was observed over the course of the intervention. Students' abilities to match words, line drawings, book illustrations, and real objects were assessed weekly. There were differences between baseline and intervention performances for all students, and these differences were particularly noticeable for one student.
..., postsecondary education or training, braille literacy, inclusive corporate cultures, and some characteristics of... vision loss or who have multiple disabilities (National Longitudinal Transition Study-2, 2005; Shaw, Gold... (e.g., individuals with more severe vision loss or individuals with multiple disabilities). The RRTC...
Perrier, Marie-Josée; Smith, Brett M; Latimer-Cheung, Amy E
Few individuals with spinal cord injury (SCI) engage in the recommended amount of leisure time physical activity (LTPA). Yet little is known about how, and why, active individuals engage in specific types of LTPA. This study explored how a unique narrative environment and disability narratives motivated individuals with SCI to engage in LTPA. Fourteen individuals with SCI from a physical activity program participated in approximately hour-long interviews. Interviews were then subjected to a narrative analysis. Individuals who used a restitution narrative (n = 6) were motivated to engage in functional LTPA because of the desire to maintain the body and restore the past self. The individual who used the chaos narrative (n = 1) preferred solitary LTPA as exposure to others with SCI was a constant reminder of the lost, pre-injury self. Individuals who used a quest narrative (n = 7) explored LTPA options that fit with their interests; these individuals were open to new types of LTPA, such as sport and outdoor recreation. The plot of three disability narratives can all motivate the pursuit of LTPA; however, not all types of LTPA are seen as equal. LTPA interventions can be enhanced through the lessons learned from this unique type of environment. Despite individuals' views about their disability, they can still be motivated to engage in routine LTPA. Different theoretical determinants, such as health or social benefits, hold different relevance for LTPA among individuals with differing disability narratives. The environment provided by practitioners can therefore elicit some stories of SCI while stifling others. Open narrative environment will attract individuals to listen and maintain involvement in LTPA.
Eldrup, Nikolaj; Sillesen, Henrik; Prescott, Eva
We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease.......We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease....
Scherer, Reinhold; Faller, Josef; Friedrich, Elisabeth V C; Opisso, Eloy; Costa, Ursula; Kübler, Andrea; Müller-Putz, Gernot R
Brain-computer interfaces (BCIs) translate oscillatory electroencephalogram (EEG) patterns into action. Different mental activities modulate spontaneous EEG rhythms in various ways. Non-stationarity and inherent variability of EEG signals, however, make reliable recognition of modulated EEG patterns challenging. Able-bodied individuals who use a BCI for the first time achieve - on average - binary classification performance of about 75%. Performance in users with central nervous system (CNS) tissue damage is typically lower. User training generally enhances reliability of EEG pattern generation and thus also robustness of pattern recognition. In this study, we investigated the impact of mental tasks on binary classification performance in BCI users with central nervous system (CNS) tissue damage such as persons with stroke or spinal cord injury (SCI). Motor imagery (MI), that is the kinesthetic imagination of movement (e.g. squeezing a rubber ball with the right hand), is the "gold standard" and mainly used to modulate EEG patterns. Based on our recent results in able-bodied users, we hypothesized that pair-wise combination of "brain-teaser" (e.g. mental subtraction and mental word association) and "dynamic imagery" (e.g. hand and feet MI) tasks significantly increases classification performance of induced EEG patterns in the selected end-user group. Within-day (How stable is the classification within a day?) and between-day (How well does a model trained on day one perform on unseen data of day two?) analysis of variability of mental task pair classification in nine individuals confirmed the hypothesis. We found that the use of the classical MI task pair hand vs. feed leads to significantly lower classification accuracy - in average up to 15% less - in most users with stroke or SCI. User-specific selection of task pairs was again essential to enhance performance. We expect that the gained evidence will significantly contribute to make imagery-based BCI technology
Full Text Available Brain-computer interfaces (BCIs translate oscillatory electroencephalogram (EEG patterns into action. Different mental activities modulate spontaneous EEG rhythms in various ways. Non-stationarity and inherent variability of EEG signals, however, make reliable recognition of modulated EEG patterns challenging. Able-bodied individuals who use a BCI for the first time achieve - on average - binary classification performance of about 75%. Performance in users with central nervous system (CNS tissue damage is typically lower. User training generally enhances reliability of EEG pattern generation and thus also robustness of pattern recognition. In this study, we investigated the impact of mental tasks on binary classification performance in BCI users with central nervous system (CNS tissue damage such as persons with stroke or spinal cord injury (SCI. Motor imagery (MI, that is the kinesthetic imagination of movement (e.g. squeezing a rubber ball with the right hand, is the "gold standard" and mainly used to modulate EEG patterns. Based on our recent results in able-bodied users, we hypothesized that pair-wise combination of "brain-teaser" (e.g. mental subtraction and mental word association and "dynamic imagery" (e.g. hand and feet MI tasks significantly increases classification performance of induced EEG patterns in the selected end-user group. Within-day (How stable is the classification within a day? and between-day (How well does a model trained on day one perform on unseen data of day two? analysis of variability of mental task pair classification in nine individuals confirmed the hypothesis. We found that the use of the classical MI task pair hand vs. feed leads to significantly lower classification accuracy - in average up to 15% less - in most users with stroke or SCI. User-specific selection of task pairs was again essential to enhance performance. We expect that the gained evidence will significantly contribute to make imagery-based BCI
Poquérusse, J; Azhari, A; Setoh, P; Cainelli, S; Ripoli, C; Venuti, P; Esposito, G
Although the benefits of a range of disability-centric therapies have been well studied, little remains known about how they work, let alone how to monitor these benefits in a precise and reliable way. Here, in two independent studies, we examine how sessions consisting of occupational or music therapy, both widely recognised for their effectiveness, modulate levels of salivary α-amylase (sAA), a now time- and cost-efficient marker of stress, in individuals with intellectual disability and autism spectrum disorder. Pre-session and post-session levels of sAA were compared in both groups in response to therapy and control sessions. In comparison to control sessions, occupational therapy significantly dampened rises in sAA levels while music therapy significantly decreased baseline sAA levels, highlighting the ability of both types of therapy to reduce stress and by proxy contribute to enhancing overall well-being. Not only do these results confirm the stress-reducing nature of two types of multisensory therapy, but they support the use of sAA as a potential tool for evaluating stress levels in individuals with intellectual disability and autism spectrum disorder, providing an important physiological lens that may guide strategies in clinical and non-clinical care for individuals with disabilities. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.