Craving inclusion: a systematic review on the experiences and needs of people with disability eating out

PURPOSE

To systematically review the research relating to views and experiences of people with disability eating out in cafés, restaurants, and other settings; and identify factors that impede or enhance accessibility of eating out experiences, inform future inclusive research, and guide policy development.

MATERIALS AND METHODS

This study involved systematic search and review procedures with qualitative metasynthesis of the barriers to and facilitators for participation and inclusion in eating/dining-out activities. In total, 36 studies were included.

RESULTS

Most studies reviewed related to people with physical or sensory disability eating out, with few studies examining the dining experiences of adults with intellectual or developmental disability, swallowing disability, or communication disability. People with disability encountered negative attitudes and problems with physical and communicative access to the venue. Staff lacked knowledge of disability. Improvements in the design of dining spaces, consultation with the disability community, and staff training are needed.

CONCLUSION

People with disability may need support for inclusion in eating out activities, as they encounter a range of barriers to eating out. Further research within and across both a wide range of populations with disability and eating out settings could guide policy and practice and help develop training for hospitality staff.

"What ELSE about this job?" Teaching Job Decision-Making to College Students With Intellectual and Developmental Disabilities

Decision-making is the central element of self-determination, requiring targeted, systematic instruction to learn. In this study, researchers developed a multicomponent intervention, "What ELSE about this job?", to teach job decision-making skills to college students with intellectual and developmental disabilities. The intervention coupled remote audio coaching (RAC) with a mnemonic device, 'ELSE', to guide students to make decisions about whether certain jobs would be a good fit for them. The study aimed to investigate the effectiveness of the intervention and determine whether the skills would maintain once the intervention was removed. All students who received the intervention substantially increased their ability to make job decisions. Additionally, all participants maintained the skills upon removal of the intervention, and showed signs of generalizing their skills to novel job coaches and web-based job search apps. Implications and future research are discussed.

Guidelines for Conducting Socially Valid Systematic Preference Assessments

Systematic preference assessment is the process of presenting sampling trials and observing the person's response. The response to those items is then interpreted as an indicator of preference. The empirical research on systematic preference assessment has greatly advanced the field's understanding of how to identify the preferences of individuals with nonsymbolic and limited symbolic communication skills. The purpose of this paper is to translate this research into guidelines for planning systematic preference assessments that strive to reduce the risk of missing or misinterpreting the person's preferences, as well as increase the social validity of the process and outcomes. We present four guiding questions for practitioners to plan preference assessments: (a) What will be offered? (b) When and where will sampling opportunities take place? (c) Who will present the sampling options? and (d) How will sampling options be presented?

Increasing independence of adults with autism in community activities: a brief, embedded teaching strategy

We evaluated a brief, embedded teaching strategy for increasing the independence of adults with autism in performing community activities. Initially, community situations were observed to identify an activity that a support staff was performing for an individual. The staff person was then trained to implement SWAT Support (say, wait and watch, act out, touch to guide) involving least-to-most prompting and praise to teach the individual on the spot to complete the activity. SWAT Support was implemented by support staff with 3 adults during break activities at a community job (Study 1), with 1 adult in a grocery store (Study 2), and with another individual in a secretary's office (Study 3). All applications of embedded teaching were accompanied by increased participant independence, which generally maintained across follow-up periods of up to 33 weeks. Results are discussed regarding how practitioners could use the teaching strategy to reduce staff and caregiver completion of activities for adults with autism and increase active community participation.

Compatibility of person-centered planning and applied behavior analysis

In response to Osborne (1999), the aims and practices of person-centered planning (PCP) are compared to the basic principles of applied behavior analysis set forth by Baer, Wolf, and Risley (1968, 1987). The principal goal of PCP is social integration of people with disabilities; it qualifies as a socially important behavior, and its problems have been displayed sufficiently. However, social integration is a complex social problem whose solution requires access to system contingencies that influence lifestyles. Nearly all of the component goals of PCP proposed by O'Brien (1987b) have been reliably quantified, although concurrent measurement of outcomes such as friendship, autonomy, and respect presents a formidable challenge. Behavioral principles such as contingency and contextual control are operative within PCP, but problems in achieving reliable implementation appear to impede an experimental analysis.

Relationships Between Recreation and Levels of Self-Determination for Adolescents and Young Adults With Disabilities

Self-determination continues to be a focus for secondary students who have intellectual disabilities. This study examined the relationship between recreation and self-determination for adolescents and young adults with intellectual disabilities. Students from secondary and post—high school special education programs tracked their involvement in recreation for a 2-week period. Then students were given the Arc's Self-Determination Scale. The results establish a predictive relationship between recreation and self-determination indicating that increased amounts of time adolescents and young adults spend actively involved in recreation were found to be predictive of higher levels of self-determination. The findings support that recreation may be a useful strategy for enhancing self-determination skills and that self-determination can be increased through experiences, not just through teaching explicit skills.

Saying no to the staff: an analysis of refusals in a home for people with severe communication difficulties

People with severe communication difficulties may attempt to exercise control over their lives by verbally or non-verbally refusing an activity proposed by supporters. We detail examples in which such refusals are treated by care home staff as a temporary reluctance, warranting further attempts to persuade the individual to co-operate. We identify the following conversational (and bodily) practices by which staff achieve their institutional ends: appreciating a resident's behaviour as something other than refusal; formulating the invitation again in a no-blame format; minimising the task required; escalating the invitation to a request and an order; moving the person bodily; and positively glossing the proceedings. Dealing with refusals illustrates the dilemma faced by institutional personnel in health and care settings in accepting choices which might disrupt the efficient management of the service.