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Earixson DQ, Hall KC, Marraccini ME, Calhoun CD. Adapting suicide safety plans for youth with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13198. [PMID: 38361383 PMCID: PMC10913093 DOI: 10.1111/jar.13198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/27/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Although risk for suicide appears elevated in individuals with intellectual and developmental disorders (I/DD), few interventions or tools addressing suicide prevention have been adapted for this population. Among evidence-based interventions for preventing suicide, safety planning interventions are an effective and commonly employed intervention for reducing suicide-related risk. METHODS By drawing on Special Education praxis for supporting the learning needs of individuals with I/DD, we provide recommendations for adapting suicide safety planning interventions for youth with I/DD. RESULTS Specific visual, content, teaching, and communication components of the safety plan intervention can be adapted to better meet the needs of youth with I/DD. DISCUSSION Although future research is needed to evaluate these recommendations, these modifications may support clinicians serving youth with I/DD and suicide-related risk.
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Affiliation(s)
- Daniel Q Earixson
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Karen C Hall
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Casey D Calhoun
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Peabody Smith A, Feinsinger A. Extending patient-centred communication to non-speaking intellectually disabled persons. JOURNAL OF MEDICAL ETHICS 2024:jme-2023-109671. [PMID: 38373830 DOI: 10.1136/jme-2023-109671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
Patient-centred communication is widely regarded as a best practice in contemporary medical care, both in terms of maximising health outcomes and respecting persons. However, not all patients communicate in ways that are easily understood by clinicians and other healthcare professionals. This is especially so for patients with non-speaking intellectual disabilities. We argue that assumptions about intellectual disability-including those in diagnostic criteria, providers' implicit attitudes and master narratives of disability-negatively affect communicative approaches towards intellectually disabled patients. Non-speaking intellectually disabled patients may also be taken to lack decision-making capacity and resultingly, may be given very little role in determining their care. But, given evidence of the heterogeneous communicative practices available to non-speaking patients, efforts should be made to extend patient-centred communication to them. We offer four suggestions for doing so: (1) treating those with non-speaking intellectual disabilities as potential communicators; (2) lengthening appointment times to develop relationships necessary for communication; (3) disentangling capacity from communication in concept and in practice; and (4) recognising the bidirectional connection between supported decision-making and patient-centred communication.
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Affiliation(s)
- Ally Peabody Smith
- Department of Medicine, David Geffen School of Medicine, Los Angeles, California, USA
| | - Ashley Feinsinger
- Department of Medicine, David Geffen School of Medicine, Los Angeles, California, USA
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Scheffers F, Moonen X, van Vugt E. Photographic visualization of stories: documenting the experiences of people with intellectual disabilities with guided photovoice. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241229002. [PMID: 38261748 DOI: 10.1177/17446295241229002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
People with intellectual disabilities are often excluded from participation in research, whilst research has the potential to enhance positive change in their lives. In the current study, using a guided photovoice procedure, the experiences of people with intellectual disabilities regarding participation in research are evaluated. A total of 14 participants with intellectual disabilities were interviewed using guided photovoice. Through thematical analyses the experiences of people with intellectual disabilities regarding photovoice are discussed. Benefits were taking time, visual cues and the opportunity to speak out. Challenges were abstract concepts and aftercare. Guided photovoice helps to better understand the perspective of people with intellectual disabilities and thus can help to improve their quality of life. People with intellectual disabilities were interested in taking part in the current research project and experienced participating as a positive experience. However careful planning and expertise in communication with people with intellectual disabilities is necessary to include people with intellectual disabilities in research.
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Affiliation(s)
- Femke Scheffers
- Department of Behavioral Expertise, MEE ZHN, the Netherlands
- Forensic Child and Youth Care Sciences, University of Amsterdam, the Netherlands
| | - Xavier Moonen
- Forensic Child and Youth Care Sciences, University of Amsterdam, the Netherlands
| | - Eveline van Vugt
- Forensic Child and Youth Care Sciences, University of Amsterdam, the Netherlands
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Slater H, Yin Z, Walsh CG. Characterization of Adult Patients with Autism Spectrum Disorder that Use Patient Portal. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:1267-1276. [PMID: 38222351 PMCID: PMC10785869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Patients with autism spectrum disorder (ASD) access healthcare frequently, yet little is known about their interactions with patient portals. To describe adults with ASD using patient portal, we conducted regression analyses of visit history, demographics, co-occurring conditions and diagnoses, and patient portal use to determine factors most indicative of whether a patient 1) has sent at least one message (via patient or proxy) and 2) has at least one message sent on their behalf via a proxy account after they turned 18 years old. The 2,412-person cohort had 996 (41.3%) patients who had sent at least one message on their account with 129 (5.3%) of patients having at least one proxy message. This study found that adults with ASD are less likely to use messaging functionality and more likely to have a message sent via proxy than other patient populations. Comorbid mental illness was correlated with using messaging functionality.
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Affiliation(s)
- Hannah Slater
- Vanderbilt University Medical Center, Nashville, TN USA
| | - Zhijun Yin
- Vanderbilt University Medical Center, Nashville, TN USA
| | - Colin G Walsh
- Vanderbilt University Medical Center, Nashville, TN USA
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Nijhof K, Boot FH, Naaldenberg J, Leusink GL, Bevelander KE. Health support of people with intellectual disability and the crucial role of support workers. BMC Health Serv Res 2024; 24:4. [PMID: 38167137 PMCID: PMC10763292 DOI: 10.1186/s12913-023-10206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/24/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND People with intellectual disability have a poorer health status than the general population. In The Netherlands, support workers play a key role in meeting health support needs of people with intellectual disability. Research on how people with intellectual disability and their support workers experience the support worker's role in preventing, identifying, and following up health needs of people with intellectual disability is scarce. To enhance health support of people with intellectual disability it is crucial that we understand how health support is delivered in everyday practice. Therefore, this study investigated experiences of people with intellectual disability and support workers with the health support of people with intellectual disability. METHOD Data collection consisted of six focus group (FG) discussions with between four and six participants (N = 27). The FGs consisted of three groups with support workers (n = 15), two groups with participants with mild to moderate intellectual disability (n = 8), and one group with family members as proxy informants who represented their relative with severe to profound intellectual disability (n = 4). The data was analysed thematically on aspects relating to health support. RESULTS We identified three main themes relevant to the health support of people with intellectual disability: 1) dependence on health support, 2) communication practices in health support, and 3) organizational context of health support. Dependence on health support adresses the way in which support workers meet a need that people with intellectual disability cannot meet themselves, and communication practices and organizational context are identified as systems in which health support takes place. CONCLUSION This study investigated experiences with the health support of people with intellectual disability from the perspectives of people with intellectual disability and support workers. We discuss the dependence of people with intellectual disability and the complexity of health support in everyday practice. We provide practical implications that can strengthen support workers in the provision of health support for people with intellectual disability in everyday practice. The findings of this study emphasize the need for intellectual disability care-provider organizations to establish policies around consistency in support staff to make it easier to identify and follow up health needs, and an environment where support staff can develop their expertise concerning communication practices, lifestyle choices, and identifying and following up health needs.
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Affiliation(s)
- Kim Nijhof
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands.
| | - Fleur H Boot
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands.
| | - Jenneken Naaldenberg
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands
| | - Geraline L Leusink
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands
| | - Kirsten E Bevelander
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands
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Kolb RL, McComas JJ, Girtler SN, Simacek J, Dimian AF, Unholz-Bowden EK, Shipchandler AH. Teaching Requesting to Individuals with Rett Syndrome Using Alternative Augmentative Communication (AAC) Through Caregiver Coaching via Telehealth. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2023; 35:1063-1090. [PMID: 38053943 PMCID: PMC10697698 DOI: 10.1007/s10882-023-09894-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 12/07/2023]
Abstract
Rett syndrome is a severe neurodevelopmental disorder that results in both motor and language skill regression with a wide range of severity in symptom presentation. Communication intervention may be particularly challenging for this population due to the decline in speech, motor skills, and motor planning difficulties that characterize the disorder (Townend et al., 2020), often resulting in the need for augmentative and alternative communication (AAC) technology. Very limited research has evaluated communication interventions for individuals with Rett syndrome and even fewer have targeted expressive communication, an important skill required for improved autonomy and quality of life (Sigafoos et al., 2009; Townend et al., 2020). The current study sought to systematically replicate the Simacek et al. (2017) mand training procedures to teach three girls with Rett Syndrome to use AAC to make requests through caregiver coaching by researchers via telehealth. Results suggest that mand training was successful in increasing AAC use for all three participants. Barriers to intervention for this population and implications of results for future research and clinical practice are discussed.
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Affiliation(s)
- Rebecca L. Kolb
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Jennifer J. McComas
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Shawn N. Girtler
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Jessica Simacek
- Institute on Community Integration, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN 55414, USA
| | - Adele F. Dimian
- Institute on Community Integration, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN 55414, USA
| | - Emily K. Unholz-Bowden
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Alefyah H. Shipchandler
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
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Eisinger J, Dall M, Fogler J, Holzinger D, Fellinger J. Intellectual Disability Profiles, Quality of Life and Maladaptive Behavior in Deaf Adults: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9919. [PMID: 36011569 PMCID: PMC9407810 DOI: 10.3390/ijerph19169919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
Individuals who are prelingually deaf and have intellectual disabilities experience great challenges in their language, cognitive and social development, leading to heterogeneous profiles of intellectual and adaptive functioning. The present study describes these profiles, paying particular attention to domain discrepancies, and explores their associations with quality of life and maladaptive behavior. Twenty-nine adults with prelingual deafness (31% female) and mild intellectual functioning deficits (mean IQ = 67.3, SD = 6.5) were administered the Vineland Adaptive Behavior Scales-II (VABS-II) and an adapted sign language version of a quality of life scale (EUROHIS-QOL 8). Intellectual disability domain discrepancies were characterized as at least one standard deviation difference between the social domain and IQ and the practical domain and IQ, and a significant difference, according to the VABS-II manual, between the social and practical domains. Domain discrepancies were found between intellectual functioning and both the practical (58.6%) and social domain (65.5%). A discrepancy between intellectual and social functioning was significantly associated with a higher level of internalizing maladaptive behavior (T = 1.89, p < 0.05). The heterogeneous profiles highlight the importance of comprehensive assessments for adequate service provision.
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Affiliation(s)
- Johanna Eisinger
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
| | - Magdalena Dall
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
| | - Jason Fogler
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Leadership Education in Neurodevelopmental and Related Disabilities/Institute for Community Inclusion (LEND/ICI), Boston Children’s Hospital, Boston, MA 02115, USA
| | - Daniel Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Institute of Linguistics, University of Graz, 8010 Graz, Austria
| | - Johannes Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
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Shady K, Phillips S, Newman S. Barriers and Facilitators to Healthcare Access in Adults with Intellectual and Developmental Disorders and Communication Difficulties: an Integrative Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022; 11:1-13. [PMID: 35669718 PMCID: PMC9148936 DOI: 10.1007/s40489-022-00324-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
Abstract
This integrative review explores the barriers to and facilitators of healthcare access in adults with intellectual and developmental disorders (IDD) and communication difficulties (CD) using Levesque et al.'s conceptual framework of access to health. IDDs are a group of disorders that occur early in childhood and often involve language dysfunction. CDs are prevalent in adults with IDD. Several themes emerged as barriers to access for adults with IDDs and CDs including health literacy, understanding health information, and screening; fear and negative patient expectations; impaired autonomy; time; accommodation needs; insurance coverage and financial hardship; communication; coordination and continuity of care; and supporter presence and inclusion. Communication between providers, patients, and supporters is a significant barrier for adults with IDD and CD. Supplementary Information The online version contains supplementary material available at 10.1007/s40489-022-00324-8.
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Affiliation(s)
- Kathryn Shady
- Medical University of South Carolina, 99 Jonathan Lucas St, Charleston, SC 29425 USA
| | - Shannon Phillips
- Medical University of South Carolina, 99 Jonathan Lucas St, Charleston, SC 29425 USA
| | - Susan Newman
- Medical University of South Carolina, 99 Jonathan Lucas St, Charleston, SC 29425 USA
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Giachero A, Quadrini A, Pisano F, Calati M, Rugiero C, Ferrero L, Pia L, Marangolo P. Procedural Learning through Action Observation: Preliminary Evidence from Virtual Gardening Activity in Intellectual Disability. Brain Sci 2021; 11:766. [PMID: 34207553 PMCID: PMC8226894 DOI: 10.3390/brainsci11060766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 12/23/2022] Open
Abstract
Intellectual disability (ID) compromises intellectual and adaptive functioning. People with an ID show difficulty with procedural skills, with loss of autonomy in daily life. From an embodiment perspective, observation of action promotes motor skill learning. Among promising technologies, virtual reality (VR) offers the possibility of engaging the sensorimotor system, thus, improving cognitive functions and adaptive capacities. Indeed, VR can be used as sensorimotor feedback, which enhances procedural learning. In the present study, fourteen subjects with an ID underwent progressive steps training combined with VR aimed at learning gardening procedures. All participants were trained twice a week for fourteen weeks (total 28 sessions). Participants were first recorded while sowing zucchini, then they were asked to observe a virtual video which showed the correct procedure. Next, they were presented with their previous recordings, and they were asked to pay attention and to comment on the errors made. At the end of the treatment, the results showed that all participants were able to correctly garden in a real environment. Interestingly, action observation facilitated, not only procedural skills, but also specific cognitive abilities. This evidence emphasizes, for the first time, that action observation combined with VR improves procedural learning in ID.
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Affiliation(s)
- Alberto Giachero
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
- Dipartimento di Psicologia, University of Turin, 10124 Turin, Italy;
| | | | - Francesca Pisano
- Dipartimento di Studi Umanistici, University Federico II, 80133 Naples, Italy;
| | - Melanie Calati
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
| | - Cristian Rugiero
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
| | - Laura Ferrero
- Fondazione Agape dello Spirito Santo Onlus-Villa Lauro, 10132 Turin, Italy;
| | - Lorenzo Pia
- Dipartimento di Psicologia, University of Turin, 10124 Turin, Italy;
| | - Paola Marangolo
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Dipartimento di Studi Umanistici, University Federico II, 80133 Naples, Italy;
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