Interrater Reliability and Concurrent Validity of a New Rating Scale to Assess the Performance of Everyday Life Tasks in Dementia: The Core Elements Method

Adults with intellectual disabilities: Case studies using everyday technology to support daily living skills

Introduction

Adults with intellectual developmental disorders may have difficulties undertaking activities of daily living. This study aimed to identify changes in independence in activities of daily living following learning support using individualized everyday technologies.

Method

A double-baseline case study design explored the use of everyday technology applications and devices to support functional performance of three men aged 32, 33, and 55 years, with mild to moderate intellectual disabilities. Performance of selected tasks was video-recorded and analysed on four occasions for each participant. Baselines were recorded twice before intervention to ensure the participant’s performance of the selected task was consistent. The intervention video was recorded at the midpoint of the participant’s engagement in the study. Post-intervention video was recorded approximately 1 month after the intervention ended.

Results

All three participants’ functional performance of an activity of daily living task improved in accuracy and efficiency as cues from support workers were gradually faded. After the learning support ceased, technology continued to provide environmental support of participants’ ongoing independence and efficient performance of the activity.

Conclusion

Everyday technology applications and devices can be utilized together with a guided and structured client-centred approach and task-specific training with individuals with disability and learning difficulties.

Structured relearning of activities of daily living in dementia: the randomized controlled REDALI-DEM trial on errorless learning

Background

Errorless learning (EL) is a method for optimizing learning, which uses feed-forward instructions in order to prevent people from making mistakes during the learning process. The majority of previous studies on EL taught patients with dementia artificial tasks of little or no relevance for their daily lives. Furthermore, only a few controlled studies on EL have so far been performed and just a handful of studies have examined the long-term effects of EL. Tasks were not always trained in the patients’ natural or home environment, limiting the external validity of these studies. This multicenter parallel randomized controlled trial examines the effects of EL compared with trial and error learning (TEL) on the performance of activities of daily living in persons with Alzheimer’s or mixed-type dementia living at home.

Methods

Patients received nine 1-hour task training sessions over eight weeks using EL or TEL. Task performance was measured using video observations at week 16. Secondary outcome measures were task performance measured at week 26, satisfaction with treatment, need for assistance, challenging behavior, adverse events, resource utilization and treatment costs.

Results

A total of 161 participants were randomized, of whom 71 completed the EL and 74 the TEL arm at week 11. Sixty-nine EL patients and 71 TEL patients were assessed at the 16-week follow-up (the primary measurement endpoint). Intention-to-treat analysis showed a significantly improved task performance in both groups. No significant differences between the treatment groups were found for primary or secondary outcomes.

Conclusions

Structured relearning improved the performance of activities of daily living. Improvements were maintained for 6 months. EL had no additional effect over TEL.

Trial registration

German Register of Clinical Trials DRKS00003117. Registered 31 May 2011.

Electronic supplementary material

The online version of this article (doi:10.1186/s13195-017-0247-9) contains supplementary material, which is available to authorized users.