Journal of Policy and Practice in Intellectual Disabilities最新文献

Positive behaviour support is an evidence-based framework for people displaying behaviours that challenge, which is widely used within the United Kingdom. Few studies have investigated the experiences of people with intellectual disability, their family members, and paid staff members who receive positive behaviour support-based interventions from intensive support teams. Individual, semi-structured interviews were conducted with 10 adults with intellectual disability, 10 family members and 10 paid staff members who received an intervention based on a Positive Behaviour Support framework from an intensive support team in England. Participants were aged 18–74 years. Semi-structured interviews took place within 4 months of discharge from the service. They were recorded and transcribed. Data was analysed using an Inductive/Deductive Hybrid approach. Initially inductive data analysis was conducted using Thematic Analysis. Subsequent deductive analysis mapped themes onto an existing framework of Positive Behaviour Support. Four overarching themes were created from the data, ‘Developing a therapeutic working relationship’, ‘Access to resources’, ‘Building knowledge, skills and confidence in the present’, and ‘Instilling hope and resilience for the future’. Results were compared with the Positive Behaviour Support framework and areas of convergence and discrepancy were identified. Gathering multi-perspectival data was a strength of this study. Results from interviews largely mapped onto key components of a Positive Behaviour Support framework. Some additional relational factors were identified around developing therapeutic relationships across the system and the importance of instilling hope for change and the future. These factors may have implications for theoretical mechanisms of change and be helpful for clinicians to consider in their practise.

This study explores the positive and negative control beliefs of judo teachers toward the inclusion of participants with Intellectual Developmental Disorders (IDDs) in judo classes, employing a qualitative approach to examine the factors influencing these beliefs. Given the global push for inclusivity in sports and physical education as vehicles for inclusion and personal development, understanding these control beliefs is crucial for developing effective inclusive practices. This study engaged 21 judo teachers from Slovenia, Portugal, and France/French Polynesia through structured qualitative interviews focusing on behavioral, control and normative beliefs, based on the Theory of Planned Behavior. The results reveal that positive factors facilitating inclusion comprise additional human assistance, smaller group sizes, specific education and experience in handling disabilities, informed awareness about the participant's condition, and supportive group dynamics. The study also highlights the impact of these factors on teachers' perceived ability to effectively include participants with IDD. The findings suggest that successful inclusion in judo for participants with IDD requires not only physical adjustments and support but also significant attitudinal shifts and educational enhancements among instructors. These insights can contribute to the broader field of inclusive education within physical education and sports, encouraging more targeted training and policy frameworks to promote inclusivity.

Chronic conditions and multimorbidity are prevalent in older people with intellectual disability. International comparisons of disease prevalence may reflect the heterogeneity of healthcare policy internationally and the distinct social histories of different countries. This study sought to determine if differences in patterns of disease prevalence in Ireland and Australia could elucidate effective and deficient aspects of policy and practice in each country. Data from existing and independent national studies in Ireland and Australia were matched on demography and diagnoses. The prevalences of 9 chronic conditions and multimorbidity across and within both jurisdictions were compared. p values were corrected for multiple hypothesis testing. Thyroid disorder, epilepsy and hypertension were more prevalent in Ireland. Arthritis was more prevalent in Australia. In Australia, arthritis, asthma, and thyroid disorder were more common in females. In Ireland, diabetes prevalence was more prevalent in females (11.9 times more likely than in males). The Irish population was 2.7 times more likely to be multimorbid compared to their Australian counterparts. In both countries, females were 2.6 times more likely to be multimorbid than males. The findings of this study offer unique insights into identifying and tracking multimorbidity and serve as a foundation for developing strategies to improve healthcare outcomes for this population. Differences such as increased prevalence rates of hypertension, epilepsy, and thyroid conditions were observed in the Irish cohort. Differences in multimorbidity trends and sex-stratified disease burden, emphasize the need for further investigation into the environmental, diagnostic, and systemic factors that influence outcomes. These findings highlight the differences in disease prevalence and multimorbidity between Ireland and Australia. There is a critical need for improved data harmonization and targeted interventions to address inequalities particularly sex-stratified diseases which disproportionately affect women with intellectual disability.

Psychosocial support methods (PSMs) address social, health and psychological challenges faced by people with intellectual disabilities and their caregivers in long-term dementia care. However, care organisations struggle with choosing appropriate PSMs due to insufficient evidence, inconsistent findings, and a lack of a comprehensive overview of PSMs for people with intellectual disabilities and dementia. This study aimed to provide a detailed inventory of available PSMs in Dutch and compare their effectiveness in daily practice. The study explored two key questions: (1) Which PSMs are available for specialised residential facilities? and (2) What are the core elements and characteristics of these PSMs, particularly in terms of effectiveness and feasibility? A standardised definition of PSM was developed to ensure consistency in terminology and meaningful comparisons. Through a systematic search of academic databases (EBSCO, Scopus and PubMed) and Dutch grey literature, 28 PSMs were identified. For each PSM, a comprehensive literature study was conducted to gather all available references describing its content, feasibility, and scientific foundations. Three PSMs, that is dementia care mapping (DCM), integrated emotion-oriented care (IEOC) and Urlings–Van der Linden, specifically address people with intellectual disabilities and dementia. While all PSMs emphasise personalised care, long-term evidence for their effectiveness remains limited. So far, effectiveness has only been studied for DCM. This study provides a first and preliminary synthesis of the available knowledge on PSMs for individuals with intellectual disabilities and dementia. Among the three PSMs found, the most indications for effectiveness are currently reported for DCM. These results may aid care organisations in their choice for a promising PSM to enhance quality of care and, indirectly, quality of life of people with intellectual disabilities and dementia.

Positive behaviour support (PBS) is a widely adopted model in education and disability services for improving service provision and service user outcomes. However, there is a paucity of guidance to support the formulation and delivery of professional development in PBS across different contexts, including accredited programmes and in-service training. Thus, this study aimed to address this important gap by developing consensus for the core components of effective professional development and training in PBS, who it is that should receive what training, and how such training might be delivered. A modified Delphi methodology was employed, with an exploration phase (i.e., a narrative review of published literature and an audit of various training courses) and an evaluation phase (i.e., a two-round online Delphi). Delphi panellists identified core areas of capability with corresponding key competencies for PBS professional development and training. Specific areas in which various stakeholders would benefit most in training were identified. Panellists described a tiered approach to delivering training, from foundation knowledge to more complex skills. Combined, existing literature and course audits, established PBS practice frameworks and expert consensus provide evidence to inform curriculum to deliver professional development and training in PBS for governments and training providers as a step towards formal accreditation of PBS training.

The life expectancy of people with intellectual disabilities has increased over the past few decades; consequently, they are experiencing more chronic illnesses and life-limiting conditions. As a result, they require palliative and end-of-life care. Nonetheless, evidence highlights marked disparities in access to suitable care during this period, largely stemming from healthcare professionals' limited understanding of their specific needs. To synthesise the perspectives and experiences of people with intellectual disabilities regarding their palliative and end-of-life care needs. This meta-ethnographic review searched for relevant studies from four databases: PubMed, MEDLINE, PsycINFO and CINAHL. In addition, grey literature and citation searches were conducted to ensure a comprehensive search. The included studies underwent qualitative appraisal, and the data were analysed using a meta-ethnographic approach. The review included 14 qualitative studies published between 2002 and 2025 and 138 participants with intellectual disabilities from diverse countries. The synthesis identified four interconnected domains: communication, autonomy, relationships and environment (CARE). People with intellectual disabilities expect clear communication that is open, transparent and accessible. In addition, they want to make decisions about their care and maintain control of what is happening to them. They consider maintaining relationships with family members, friends and caregivers to be important sources of emotional support and connection. Finally, they want to be in their familiar environments, focused on dignity, comfort and maintenance of routines and activities, which are critical components of well-being. Professionals and caregivers require a system to understand the complex palliative care needs of people with intellectual disabilities, and the CARE framework provides a structured guide to address these challenges. It emphasises person-centred approaches that involve individuals with intellectual disabilities in care decisions, facilitating the delivery of fair and compassionate care through a collaborative ‘CARE’ model.

Little is known about knowledge and confidence to treat children with autism spectrum disorder (ASD) among physicians working in specific medical fields, such as orthopedics and ophthalmology. Understanding the perspectives and preparedness of professionals in these specialties is crucial for improving the quality of care provided to this population. The objective of this study was to compare the ASD knowledge level, perception of difficulties, and readiness to treat children with ASD between physicians in orthopedics and ophthalmology. A quantitative correlational survey methodology was employed. Participants included 202 physicians, with 94 from orthopedics and 108 from ophthalmology. Participants completed a questionnaire based on the “Knowledge about Childhood Autism among Health Workers” survey. Statistical analyses, including correlation and linear regression, were conducted to examine the relationships between variables. Orthopedic physicians exhibited lower ASD knowledge, reported more difficulties, and displayed lower readiness compared to their ophthalmologic counterparts. Handling aggression/destructive behaviors posed a greater challenge for orthopedic professionals, who also treated fewer children with ASD over the past year. Working in ophthalmology emerged as a strong predictor of readiness to treat ASD. Notably, a minority in both groups reported having received ASD-specific training. The study underscores the importance of ASD-specific training for physicians in orthopedics and ophthalmology, emphasizing the need for tailored training programs in distinct medical fields to optimize knowledge and skills for providing effective care to children with ASD.