Supporting Families With Parents With Intellectual Disability: Views and Experiences of Professionals in the Field

'It wasn't the strategies on their own': Exploring caregivers' experiences of accessing services in the development of interventions for autistic people with intellectual disability

LAY ABSTRACT

Many autistic individuals with intellectual disability experience anxiety, and for those who use few or no words, anxiety may present as behaviour that challenges, such as self-injury and avoiding anxiety-provoking situations. Families report difficulty accessing support from services for autistic individuals experiencing anxiety. Moreover, once receiving support, effective interventions for autistic people with intellectual disability are limited. We completed individual and group discussions with 16 caregivers of autistic people with intellectual disability, to (a) explore their experiences of accessing services for anxiety and/or behaviour that challenges for their child; and (b) understand what matters to caregivers when developing interventions that have been designed for them and the autistic individual with intellectual disability that they support. Caregivers reported that services, in their experience, did not deliver the support that they expected, and that they often needed to 'fight' for support. Caregivers considered services and families working together, the inclusion of peer support, and families being offered interventions that are flexible to individual circumstances to be important. These considerations are valuable for clinicians and researchers developing interventions and aiming to improve outcomes for autistic people with intellectual disability and their families.

Support as described by fathers with intellectual disabilities

BACKGROUND

Many fathers with intellectual disabilities experience some difficulties in fulfilling their parenting role due external factors. The quality of their parenting depends on various factors, including the availability and adequacy of support. The aim of this study was to understand the lived experiences associated with social support of fathers with intellectual disabilities.

METHOD

The organisation of the research and data analysis were carried out in accordance with Interpretative Phenomenological Analysis. Semi-structured interviews were conducted with 20 fathers with intellectual disabilities.

RESULTS

In the analysis, three interrelated themes emerged: Discrepancies between needs and provision of support; Discriminatory practices and feeling (dis)empowered; and Recognition of support.

CONCLUSIONS

Fathers described negative aspects of their experiences that were not conducive to strengthening paternal competences and led to a sense of loneliness. Positive aspects also emerged, indicating that fathers were determined to fulfil their role despite the lack of adequate support for their needs.

Barriers and requirements for parenting supports and mental health care among mothers with intellectual disabilities: Health and social service-provider perspectives

BACKGROUND

Mothers with intellectual disability (ID) experience high rates of mental illness, but these needs are not adequately addressed.

AIMS

We examined health and social service-provider perceptions of barriers to parenting and mental health care among mothers with ID and strategies for building good practice capacity.

METHODS AND PROCEDURES

In this qualitative study in Ontario, Canada, we interviewed 13 service-providers working with mothers with ID about their experiences supporting parenting and mental health in mothers with ID, including barriers to services and strategies for building good practice capacity. Data were analyzed via inductive, semantic-level thematic analysis.

OUTCOMES AND RESULTS

Perceived barriers to care provision were the vulnerable social context of women with ID, distrust of "the system" by women with ID, and siloed services. Increased training of service-providers, making accommodations in existing services, and building a community of support for women with ID were offered as strategies for good practice capacity.

CONCLUSIONS AND IMPLICATIONS

Efforts to improve mental health among mothers with ID should focus on improving service-provider capacity and accommodations in existing services, and enhancing coordination of care. WHAT THIS PAPER ADDS?: Mothers with intellectual disability (ID) experience high rates of mental illness, but supports for mothers with ID typically focus on parenting skills, and women's mental health care services do not consider the unique needs of those with ID. Health and social service-providers have reported inadequate training, fragmented services, high caseloads, and lack of practical supports as barriers to providing quality care to mothers with ID. However, no studies have examined service-providers' perceptions of needs related specifically to parenting and mental health among mothers with ID. This study provides new information on barriers to parenting and mental health care among mothers with ID and strategies for good practice capacity, from the perspectives of service-providers. Perceived barriers to care provision include social determinants of health, a distrust of "the system" by women with ID, and siloed services. Providers recommended that providing better training, including accommodations in existing services, and building a community of support could be beneficial to improving practice capacity in the context of mental health care and parenting supports. These factors need to be addressed to improve mental health among mothers with ID.

Support needs of parents with intellectual disabilities: Systematic review on the perceptions of parents and professionals

This review aimed to examine the perceptions of parents, professionals and informal network members regarding support needs of parents with intellectual disabilities (ID). In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, five databases were systematically searched and 19 qualitative studies were reviewed using thematic analyses. No data were available on the perceptions of the informal social network. Data on parents and professionals were categorized in four themes (type of support, sources of support, conditions of successful support and characteristics of support members). Data from professionals did not refer to emotional support needs or to the potential support of volunteers, friends and neighbours. Data from parents indicated a preference to be treated as 'full' parents, whereas professionals tended to focus on disabilities of parents. Results and implications contribute to insights into support needs of parents with ID from different perspectives and may help identify new entry points to improve future interventions and working alliances.

Social worker attitudes toward parents with intellectual disabilities in Israel

Purpose: United Nations human rights treaties and domestic law require social workers to support the parenting rights of persons with intellectual disabilities. Social workers are also required to protect the health and well-being of those clients' children. This study explores the experiences, challenges, and complex attitudes of Israeli social workers regarding parenthood by their clients with intellectual disabilities.Methods: A qualitative method employed semi-structured interviews with twenty-one social workers. A thematic analysis identified major themes.Results: Social workers recognized the parental desires of clients with intellectual disabilities and acknowledged their role in supporting those individuals. Nevertheless, most of the social workers expressed negative perceptions regarding the right or capability of clients with intellectual disabilities to parent. Social workers thus felt the tension between their personal reservations and their professional duty to support these clients. Regardless of individual attitudes, social workers uniformly asserted that greater state and community support was needed to enable the parental capacity of their clients.Conclusions: In addition to increasing state and community support for parents with intellectual disabilities, additional training is needed for empowering social workers to act on behalf of these clients in Israel.Implications for RehabilitationSocial workers hold critical roles for parents with intellectual disabilities and are required to support their clients' parenting while ensuring the health and well-being of their children.Israeli social workers balance negative or ambivalent attitudes regarding the capability of parents with intellectual disabilities against a desire to honor their duty to support these clients.State and community support for parents with intellectual disabilities must be increased.Additional training is needed for empowering social workers to act on behalf of these clients in Israel.

Understanding support workers' competence development in working with parents with intellectual disability

Training for support workers who work with parents with intellectual disability can be aided by understanding how they perceive the training process and their competence development. This study explored the perceptions of competence development and the training process in Swedish support workers trained in the evidence-informed programme 'Parenting Young Children' (PYC). Training included a workshop, monthly peer support groups and access to a programme manual. Five focus groups discussed experiences of the PYC programme and the training they received. Twelve support workers completed a competency questionnaire. The findings of the current study suggest that perceived skill improved over time. Specifically, the findings suggest that peer support is a beneficial training follow-up mechanism for knowledge exchange and performance reflection. The main issues faced in skill development were transfer of learning and accessing parents to work with. These findings also highlight the importance of facilitative administration and technical support for managers and agencies.

Social Context of Disabled Parenting

The article discusses parenting of individuals with disability. It was based on the perspective of barriers, which (next to the perspective of risk and the functional perspective) marks the nature of discourse this theme takes in the literature on the subject and in practice. The perspective of barriers, related to the social model of disability, emphasizes the social factors important for the quality of parenting of individuals with disability. These factors were analyzed on the basis of available research results with mothers and fathers with disability, and able-bodied individuals who are part of their professional and non-professional environment. The article draws attention to the specificity of socialization of individuals with disability and its significance for preparations for family roles, social attitudes towards disabled individuals’ parenting, and their determinants. It also presents disabled parents’ experiences and the importance of realizing their role of a mother or father.

An interview study of young adults born to mothers with mild intellectual disability

A group of 10 young adults from a population-based series in Sweden, of originally 42 individuals, born to mothers with mild intellectual disability (ID), were interviewed with regard to their experiences during childhood, adolescence, and their current situation. The interview revealed that 6 of the 10 individuals had been removed from their biological parents during childhood, 6 reported clear child abuse and/or neglect, and 6 individuals had mild ID. The majority of the individuals reported difficulties in their relations with family and in school. The small number of participants (n = 10) who could be personally interviewed reflected the major problems that were encountered in the process of making contact with this group of young individuals. In conclusion, this study adds to other reports that children of mothers with ID constitute an extremely vulnerable group. Therefore, these families need full and continuous attention from the supportive systems in society.

Parenting with disabilities: experiences from implementing a parenting support programme in Sweden

This article reports on the initial stages of implementing an Australian-based education programme for parents with intellectual disabilities (IDs) in Sweden. The clinical utility of the programme, Parenting Young Children (PYC), in the new country context is explored through Swedish professionals' experiences in learning and using it. Study participants found PYC well suited for use in their working environment. Most of them reported the programme to have strengthened their work with parents. The programme was seen as benefiting both the study participants in their work with parents with IDs and these parents themselves, and its structure and content were found to be helpful in several ways. The checklists forming part of PYC were considered useful, but their purpose was sometimes misunderstood. The reported study helps to identify what is needed to improve the translation of the programme into the new country context, to promote appropriate and more effective use of programme materials.

The care burden of families with members having intellectual and developmental disorder: a review of the recent literature

PURPOSE OF REVIEW

The aim of this article is to review recent studies on the care burden of families with a member having intellectual and developmental disorder.

RECENT FINDINGS

The family is the core unit for providing care to people with intellectual and developmental disorder, regardless of where they live. Recent research on this issue has been focused on two areas: the lifelong burden itself and its impact on the family. The research has incorporated a range of different approaches and has yielded diverse findings.

SUMMARY

The longevity of people with intellectual and developmental disorder has made caring for older adults with intellectual developmental disorder developing dementia a new challenge. In addition, worldwide deinstitutionalization has made it possible for people with intellectual and developmental disorder to live within their communities and integrate with the general population. Because disabled individuals may become parents themselves, the requirements of family care for children born to persons with intellectual and developmental disorder may be different from previous generations of parents who raised children with IDD.