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Luckasson R, Schalock RL, Bradley VJ. Diffusion of the Shared Citizenship Paradigm: Strategies and Next Steps. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:362-376. [PMID: 39197847 DOI: 10.1352/1944-7558-129.5.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/27/2024] [Indexed: 09/01/2024]
Abstract
The field of disabilities is being challenged to adopt a paradigm that can be used to guide the transformation of services, supports, and research practices to ensure and enhance the personal autonomy, rights, and community inclusion of people with disabilities. This article describes strategies associated with the systematic diffusion and sustainability of an innovation such as the emerging Shared Citizenship Paradigm (SCP), which has the potential to guide the transformation. The systematic diffusion process incorporates five components: knowledge, persuasion, decision, implementation, and confirmation. The systematic process also addresses the risks of dissonance, backlash, unintended consequences, and backsliding that can emerge when the sustainability of a paradigm is not supported. Throughout the article, we stress that meaningful change in organizations and systems requires use of a paradigm such as the SCP and its principles and foundation pillars to guide the change, and a systematic process such as that described in this article to bring about and sustain the change.
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Affiliation(s)
- Ruth Luckasson
- Ruth Luckasson, University of New Mexico; Robert L. Schalock, Hastings College; Valerie J. Bradley, Human Services Research Institute
| | - Robert L Schalock
- Ruth Luckasson, University of New Mexico; Robert L. Schalock, Hastings College; Valerie J. Bradley, Human Services Research Institute
| | - Valerie J Bradley
- Ruth Luckasson, University of New Mexico; Robert L. Schalock, Hastings College; Valerie J. Bradley, Human Services Research Institute
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Nygren MA, Linscott R, Nagel M, Atkins M, Ward J, Alexander J. Developing and Evaluating the Fidelity and Understandability of Plain Language Summaries of Position Statements. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 62:74-81. [PMID: 38281510 DOI: 10.1352/1934-9556-62.1.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 08/08/2023] [Indexed: 01/30/2024]
Abstract
The American Association on Intellectual and Developmental Disabilities (AAIDD) and The Arc of the United States (The Arc) have a long history of taking jointly held positions on matters of public policy that affect people with intellectual and developmental disabilities (IDD). This article describes the methods used to develop and evaluate the understandability and fidelity of written plain language summaries of the organizations' joint position statements for an audience of people with IDD who read. Implications for adapting source material for nonreading audiences are discussed.
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Affiliation(s)
- Margaret A Nygren
- Margaret A. Nygren, American Association on Intellectual and Developmental Disabilities; and Robyn Linscott, Mike Nagel, Michael Atkins, Julie Ward, and Jenny Alexander, The Arc of the United States, Washington
| | - Robyn Linscott
- Margaret A. Nygren, American Association on Intellectual and Developmental Disabilities; and Robyn Linscott, Mike Nagel, Michael Atkins, Julie Ward, and Jenny Alexander, The Arc of the United States, Washington
| | - Mike Nagel
- Margaret A. Nygren, American Association on Intellectual and Developmental Disabilities; and Robyn Linscott, Mike Nagel, Michael Atkins, Julie Ward, and Jenny Alexander, The Arc of the United States, Washington
| | - Michael Atkins
- Margaret A. Nygren, American Association on Intellectual and Developmental Disabilities; and Robyn Linscott, Mike Nagel, Michael Atkins, Julie Ward, and Jenny Alexander, The Arc of the United States, Washington
| | - Julie Ward
- Margaret A. Nygren, American Association on Intellectual and Developmental Disabilities; and Robyn Linscott, Mike Nagel, Michael Atkins, Julie Ward, and Jenny Alexander, The Arc of the United States, Washington
| | - Jenny Alexander
- Margaret A. Nygren, American Association on Intellectual and Developmental Disabilities; and Robyn Linscott, Mike Nagel, Michael Atkins, Julie Ward, and Jenny Alexander, The Arc of the United States, Washington
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Schalock RL, Luckasson R, Tassé MJ, Shogren KA. The IDD Paradigm of Shared Citizenship: Its Operationalization, Application, Evaluation, and Shaping for the Future. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:426-443. [PMID: 36162049 DOI: 10.1352/1934-9556-60.5.426] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/06/2022] [Indexed: 06/16/2023]
Abstract
Changes in the field of intellectual and developmental disabilities (IDD) over the last 5 decades has resulted in the emergence of the shared citizenship paradigm. This paradigm is currently guiding the development of IDD-related policies and practices, and providing a framework for application, research-based inquiry, and evaluation. A shared citizenship paradigm is one that envisions, supports, and requires the engagement and full participation of people with IDD as equal, respected, valued, participatory, and contributing members of every aspect of society. The overall goals of the paradigm are to (a) further advance and focus on people with IDD as active agents in the change process, and (b) improve outcomes for people with IDD, including their access to and opportunity for shared citizenship. This article describes the paradigm's operationalization, application, evaluation, shaping for the future, and specific strategies to overcome implementation challenges.
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Thurm A, Srivastava S. On Terms: What's in a Name? Intellectual Disability and "Condition," "Disorder," "Syndrome," "Disease," and "Disability". AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:349-354. [PMID: 36018763 DOI: 10.1352/1944-7558-127.5.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/05/2022] [Indexed: 06/15/2023]
Abstract
Individuals living with intellectual disability can have multiple co-occurring medical conditions including associated genetic diagnoses. The number of genetic etiologies associated with ID is growing, with some quite new and rare, and others more common and associated with what is often considered a syndrome. In the context of genetic etiologies and associated medical comorbidities, appropriate use of descriptive terminology warrants clarification. Using accurate nomenclature is essential for descriptions, especially as terms are used across both research and clinical reports. Here we discuss several terms that may be confused with each other, including "condition," "disorder," "syndrome," "disease," and "disability." Our goal is to shed light on the meanings of the five descriptors and their appropriate use in the ID population, especially in relation to those who have a genetic diagnosis.
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Affiliation(s)
- Audrey Thurm
- Audrey Thurm, National Institute of Mental Health
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Impact of disability diagnosis on dental care use for adults in the United States. J Am Dent Assoc 2022; 153:797-804. [PMID: 35527037 PMCID: PMC9339456 DOI: 10.1016/j.adaj.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Approximately 25% of adults in the United States have a disability that limits function and independence. Oral health care represents the most unmet health care need. This population has been found to have decreased oral health outcomes compared with the general population. METHODS The authors used the 2018 adult National Health Interview Survey to assess the association between disability status and dental care use (dental visit within or > 2 years). Disability status was categorized as adults with an intellectual, acquired, or developmental disability (IADD) that limits function, other disability that limits function, or no disability, on the basis of diagnoses of birth defect, developmental diagnosis, intellectual disability, stroke, senility, depression, anxiety, or emotional problem, all causing problems with function. RESULTS Adults with an IADD with functional and independence-limiting disabilities experienced higher crude odds of going 2 years or more without a dental visit than adults without disabilities (odds ratio [OR], 2.29; 95% CI, 1.96 to 2.67). This association was part of a significant interaction and was stronger among those with IADDs who could afford oral health care (OR, 1.73; 95% CI, 1.47 to 2.14) than among those who could not afford oral health care (OR, 1.21; 95% CI, 0.88 to 1.67; P value of interaction <.01). CONCLUSIONS Adults with IADDs have decreased access to oral health care compared with adults with other disabilities or without disabilities. The inability to afford oral health care lessens the impact of disability status. PRACTICAL IMPLICATIONS Dentists can use this study to understand the implications of IADD diagnoses on dental care use and make efforts to facilitate care for these patients.
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Nishimura T, Kato T, Okumura A, Harada T, Iwabuchi T, Rahman MS, Hirota T, Takahashi M, Adachi M, Kuwabara H, Takagai S, Nomura Y, Takahashi N, Senju A, Tsuchiya KJ. Trajectories of Adaptive Behaviors During Childhood in Females and Males in the General Population. Front Psychiatry 2022; 13:817383. [PMID: 35401255 PMCID: PMC8983934 DOI: 10.3389/fpsyt.2022.817383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Little is known about the trajectory patterns and sex differences in adaptive behaviors in the general population. We examined the trajectory classes of adaptive behaviors using a representative sample and examined whether the class structure and trajectory patterns differed between females and males. We further explored sex differences in neurodevelopmental traits in each latent class. Participants (n = 994) were children in the Hamamatsu Birth Cohort for Mothers and Children (HBC Study)-a prospective birth cohort study. Adaptive behaviors in each domain of communication, daily living skills, and socialization were evaluated at five time points when participants were 2.7, 3.5, 4.5, 6, and 9 years old using the Vineland Adaptive Behavior Scales-Second Edition. Parallel process multigroup latent class growth analysis extracted sex-specific trajectory classes. Neurodevelopmental traits of children at age 9, autistic traits, attention deficit hyperactivity disorder (ADHD) traits, and cognitive ability were examined for females and males in each identified class. A 4-class model demonstrated the best fit. Moreover, a 4-class model that allowed for differences in class probabilities and means of growth parameters between females and males provided a better fit than a model assuming no sex differences. In the communication domain, females scored higher than their male counterparts in all four classes. In the daily living skills and socialization domains, the two higher adaptive classes (Class 1: females, 18.6%; males, 17.8%; Class 2: females, 48.8%; males, 49.8%) had similar trajectories for males and females, whereas in the two lower adaptive behavior classes (Class 3: females, 27.5%; males, 29.4%; Class 4: females, 5.1%; males, 3.0%), females had higher adaptive scores than their male counterparts. In Class 4, females were more likely to have autistic and ADHD traits exceeding the cutoffs, while males were more likely to have below-average IQ. Different trajectories in females and males suggest that adaptive skills may require adjustment based on the sex of the child, when standardizing scores, in order to achieve better early detection of skill impairment.
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Affiliation(s)
- Tomoko Nishimura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takeo Kato
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Akemi Okumura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taeko Harada
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Toshiki Iwabuchi
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Md Shafiur Rahman
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoya Hirota
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.,Department of Clinical Psychological Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Japan
| | - Michio Takahashi
- Department of Clinical Psychological Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Japan
| | - Masaki Adachi
- Department of Clinical Psychological Science, Graduate School of Health Sciences, Hirosaki University, Hirosaki, Japan
| | - Hitoshi Kuwabara
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Shu Takagai
- Department of Child and Adolescent Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoko Nomura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Queens College and Graduate Center, City University of New York, New York, NY, United States
| | - Nagahide Takahashi
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsushi Senju
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kenji J Tsuchiya
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.,United Graduate School of Child Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Gómez LE, Schalock RL, Verdugo MÁ. A quality of life supports model: Six research-focused steps to evaluate the model and enhance research practices in the field of IDD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104112. [PMID: 34655955 DOI: 10.1016/j.ridd.2021.104112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/03/2021] [Accepted: 10/08/2021] [Indexed: 06/13/2023]
Abstract
In the field of intellectual and developmental disabilities (IDD) the constructs of quality of life and supports have been combined into a Quality of Life Supports Model (QOLSM) that is currently used internationally for supports provision, organization transformation, and systems change. With the model's increasing and widespan use in research and practice, there is a need to evaluate the model's impact at the individual, organization, and systems levels. The purpose of this article is to outline six specific research-focused evaluation steps that allow researchers to evaluate the model and thereby enhance research practices is the field of IDD. These steps involve: (1) operationalizing components of the QOLSM; (2) relating QOLSM components to the type of research planned and intended outcome indicators; (3) gathering evidence and establishing its credibility; (4) interpreting and communicating the results; (5) implementing research outcomes at the level of the microsystem, mesosystem and macrosystem; and (6) judging the impact of the model. These steps delineate a research framework that is based on a systematic approach to evidence-based practices and enhanced research practices in the field of IDD.
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Affiliation(s)
- Laura E Gómez
- Departamento de Psicología. Universidad de Oviedo, Spain.
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Schalock RL, Luckasson R. Enhancing research practices in intellectual and developmental disabilities through person-centered outcome evaluation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104043. [PMID: 34325097 DOI: 10.1016/j.ridd.2021.104043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Research practices in IDD need to align current values towards people with IDD, the current understanding of IDD, and best practices regarding change strategies and valued outcomes. AIMS To describe the components to-and application of-a person-centered outcome evaluation model that meets the above criteria. METHODS AND PROCEDURES A person-centered evaluation logic model is used to identify and describe a conceptual framework (input), a change strategy (throughput), personal outcomes (outcome), and meaningful impacts (output). OUTCOMES AND RESULTS Specific person-centered outcomes and exemplary outcome indicators are presented for two outcome evaluation frameworks: human functioning dimensions, and the four theoretical perspectives on IDD: biomedical, psychoeducational, sociocultural, and justice. CONCLUSIONS AND IMPLICATIONS A person-centered approach to outcome evaluation enhances research practices in IDD by identifying and assessing valued personal outcomes that align current values, understanding, and best practices; increases transparency; facilitates accountability; and expands understanding.
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Affiliation(s)
| | - Ruth Luckasson
- Department of Special Education, University of New Mexico, United States.
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