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Examining the Changes in Problem Behaviours and Communication of Persons with Intellectual and Developmental Disabilities after Transitioning from an Institutional Setting to the Community 研究智力和发育障碍人士从机构环境过渡到社区后在问题行为和沟通方面的变化
Pub Date : 2024-04-12 DOI: 10.3390/disabilities4020019
Kayla Kostal, Maria Baranowski, Hygiea Casiano, Margherita Cameranesi, L. McCombe, Shahin Shooshtari
Worldwide, the community transition process away from institutions has increased in the past 30–50 years among persons with severe intellectual and developmental disabilities. This process, also known as “deinstitutionalization”, could potentially impact problem behaviors and communication. This study examined the impacts of community transitions on behavioural and communication outcomes in Canadians with intellectual and developmental disabilities. Data were collected using the Comprehensive Health Assessment Program and medical chart reviews. Descriptive, aggregate-level, and individual-level analyses were conducted for 32 adults who transitioned to community living. Descriptive analyses and the McNemar Chi-Square Test were conducted. Following community transitions, the study group experienced a significant decrease in problem behaviours and changes in communication. The study findings suggest that deinstitutionalization could provide effective strategies for addressing problem behaviors and fostering improvements in communication, promoting the well-being and quality of life of persons with intellectual and developmental disabilities.
在世界范围内,过去 30-50 年间,重度智力和发育障碍人士从机构向社区过渡的情况越来越多。这一过程也被称为 "去机构化",可能会对问题行为和沟通产生潜在影响。本研究探讨了社区过渡对加拿大智力和发育障碍人士的行为和交流结果的影响。数据是通过综合健康评估计划和病历审查收集的。对 32 名过渡到社区生活的成年人进行了描述性分析、总体分析和个体分析。进行了描述性分析和 McNemar Chi-Square 检验。在过渡到社区生活后,研究小组的问题行为显著减少,沟通方式也发生了变化。研究结果表明,非机构化可以提供有效的策略来处理问题行为并促进沟通的改善,从而提高智力和发育障碍人士的福祉和生活质量。
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引用次数: 0
Minimally Verbal Individuals with Autism Spectrum Disorders/Intellectual Disability and Challenging Behaviors: Can Strategic Psychiatric Treatment Help? 患有自闭症谱系障碍/智力障碍和挑战行为的极少言语者:策略性精神病治疗能有所帮助吗?
Pub Date : 2024-04-10 DOI: 10.3390/disabilities4020018
Jessica A. Hellings, Saras Chen Singh, Sham Singh, An-Lin Cheng
(1) Background: Psychiatrists are increasingly required to treat minimally verbal (MV) individuals with autism spectrum disorder (ASD), intellectual disability (ID) and behavior problems without much published guidance. (2) Methods: We reviewed 80 charts of MV patients managed strategically for challenging behaviors, following IRB approval. Data extracted included demographics, ASD/ID level, diagnoses, epilepsy and medications. In this descriptive study, we examined the course of assessment and treatment and made recommendations for a strategic, person-centered approach. (3) Results: Of 53 males and 27 females, mean age 34 years (range 7–76), all had ID; 75 had ASD (94%). Diagnoses included seizures in 40/80 (50%), frequent aggression (89%), self-injury (80%), attention-deficit hyperactivity disorder (ADHD) (64%) and obsessive compulsive disorder (OCD) (34%). The commonest medication classes adjusted were antiseizure medications, antipsychotics, and non-stimulant ADHD medications. (4) Conclusions: Clinical impressions suggested that this strategic psychiatric approach was beneficial, notably a review of antiseizure and all other medications for polypharmacy, behavioral and other side effects, followed by a review of possible childhood/current ADHD and a trial of low-dose non-stimulant ADHD medications if warranted. Low-dose risperidone was often effective and tolerable for irritability and self-injury.
(1) 背景:精神科医生越来越多地需要治疗患有自闭症谱系障碍(ASD)、智力障碍(ID)和行为问题的最小言语能力(MV)患者,但却没有很多公开发表的指导意见。(2)方法:经 IRB 批准,我们审查了 80 名因挑战行为而接受策略性管理的 MV 患者的病历。提取的数据包括人口统计学、ASD/ID 水平、诊断、癫痫和药物。在这项描述性研究中,我们检查了评估和治疗的过程,并就以人为本的战略方法提出了建议。(3) 结果:53 名男性和 27 名女性,平均年龄 34 岁(7-76 岁不等),全部患有智障;75 名患有 ASD(94%)。诊断包括 40/80 例癫痫发作(50%)、频繁攻击行为(89%)、自伤(80%)、注意力缺陷多动障碍(ADHD)(64%)和强迫症(OCD)(34%)。最常见的调整药物类别是抗癫痫药物、抗精神病药物和非刺激性多动症药物。(4) 结论:临床印象表明,这种战略性的精神治疗方法是有益的,尤其是对抗癫痫药物和所有其他药物进行复查,以确定是否存在多重用药、行为和其他副作用,然后对可能的儿童/并发多动症进行复查,并在必要时试用低剂量非刺激性多动症药物。小剂量利培酮对烦躁和自伤通常有效且可以耐受。
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引用次数: 0
Online Child Sexual Exploitation and Abuse of Children and Adolescents with Disabilities: A Systematic Review 对残疾儿童和青少年的在线儿童性剥削和虐待:系统回顾
Pub Date : 2024-04-09 DOI: 10.3390/disabilities4020017
Garazi Álvarez-Guerrero, Deborah Fry, Mengyao Lu, Konstantinos Kosmas Gaitis
Online child sexual exploitation and abuse (OCSEA) is a rising global problem affecting children and adolescents worldwide. Despite the escalating prevalence of OCSEA, there is limited research specifically focusing on children and adolescents with disabilities. To bridge this gap, this systematic review was conducted to identify the prevalence, nature and associated risk factors of OCSEA of children and adolescents with disabilities. Following the PRISMA Statement, this systematic review included scientific evidence from 12 academic databases and the gray literature published between 1993 and 2023. A total of 13 studies were extracted, and thematic analysis was conducted to analyze the data. The findings of this systematic review reveal the characteristics such as the gender, age and type of disabilities of OCSEA victims. Perpetrators use diverse techniques, including online grooming, manipulation, and cyber-threats, resulting in consequences such as mental health issues and social isolation of victims. The associated risk factors include lack of parental monitoring, social isolation, and low risk perception. The results of this research provide crucial insights into OCSEA of children and adolescents with disabilities, emphasizing the need for targeted interventions and further exploration in this understudied area.
网上儿童性剥削和性虐待(OCSEA)是一个日益严重的全球性问题,影响着全世界的儿童和青少年。尽管 OCSEA 的发生率不断攀升,但专门针对残疾儿童和青少年的研究却十分有限。为了弥补这一空白,本系统性综述旨在确定残疾儿童和青少年 OCSEA 的发生率、性质和相关风险因素。根据 PRISMA 声明,本系统性综述纳入了 1993 年至 2023 年间发表的 12 个学术数据库和灰色文献中的科学证据。共提取了 13 项研究,并对数据进行了主题分析。本系统综述的研究结果显示了OCSEA受害者的性别、年龄和残疾类型等特征。施暴者使用多种手段,包括网上诱导、操纵和网络威胁,导致受害者出现心理健康问题和社会隔离等后果。相关的风险因素包括缺乏父母监督、社会隔离和低风险认知。本研究的结果为残疾儿童和青少年的 OCSEA 提供了重要的见解,强调了在这一研究不足的领域进行有针对性的干预和进一步探索的必要性。
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引用次数: 0
The Continued Evolution of Disabilities, an Inter- and Multi-Disciplinary Journal of Disability Research 残疾的持续发展》,跨学科和多学科残疾研究期刊
Pub Date : 2024-03-21 DOI: 10.3390/disabilities4010016
Reinie Cordier
Disabilities continues to grow in stature and attract quality submissions from scholars across the globe [...]
残疾问题》的地位不断提高,吸引了来自全球各地的学者提交高质量的论文 [...]
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引用次数: 0
Wheelchair Dance: Exploring a Novel Approach to Enhance Wheelchair Skills, Belongingness and Inclusion among Children with Mobility Limitations 轮椅舞蹈:探索一种新方法,增强行动不便儿童的轮椅技能、归属感和融入感
Pub Date : 2024-03-18 DOI: 10.3390/disabilities4010014
Jade Berthiaume, C. Cherriere, Béatrice Ouellet, Laurence Éthier, Paula W. Rushton, Martin Lemay, K. Best
Playful approaches are recommended to enhance wheelchair skills training with young people. Inclusive dance allows participants to discover motor skills and improve social participation. Integrating wheelchair skills training into dance has not been evaluated. This study aimed to explore participants’ experiences in dance while integrating wheelchair skills, and the influence of dance on wheelchair skills and wheelchair use confidence in young people. A convergent mixed-methods design was used during a one-week dance camp. Data collection combined observations, two focus groups (with young dancers who used manual wheelchairs and with professional dancers without disabilities), and evaluation of wheelchair skills and confidence. Data analyses included deductive thematic analysis guided by the Quality Parasport Participation Framework, merged with pre–post comparisons in wheelchair skills and confidence. Three young female dancers were 11, 12 and 15 years of age and three professional female dancers were 22, 27 and 27 years of age. Emergent themes included skill mastery, belongingness, and supportive environments. There were improvements in wheelchair skills and confidence (16.7%, 19.4%, 16.7%; 0.8%, 11.4%, 4.5%, respectively). Participants described overall positive experiences with the dance camp and perceived enhanced skills and confidence. This study advances knowledge about innovative approaches to integrate wheelchair skills training for young people. Future larger-scale controlled studies are needed to determine efficacy.
建议采用寓教于乐的方法来加强对年轻人的轮椅技能培训。全纳舞蹈可以让参与者发现运动技能并提高社会参与度。将轮椅技能训练融入舞蹈的做法尚未进行过评估。本研究旨在探讨参与者在舞蹈中融入轮椅技能的体验,以及舞蹈对轮椅技能和青少年使用轮椅的信心的影响。在为期一周的舞蹈夏令营活动中,我们采用了聚合混合方法设计。数据收集结合了观察、两个焦点小组(使用手动轮椅的年轻舞者和非残疾专业舞者)以及对轮椅技能和信心的评估。数据分析包括以 "优质残疾人体育运动参与框架 "为指导的演绎式主题分析,以及轮椅技能和信心的前后比较。三位年轻女性舞者的年龄分别为 11 岁、12 岁和 15 岁,三位专业女性舞者的年龄分别为 22 岁、27 岁和 27 岁。新出现的主题包括掌握技能、归属感和支持性环境。参与者在轮椅技能和自信心方面都有所提高(分别为 16.7%、19.4%、16.7%;0.8%、11.4%、4.5%)。参与者对舞蹈夏令营的总体评价是积极的,并认为他们的技能和信心得到了提高。这项研究增进了人们对整合青少年轮椅技能培训的创新方法的了解。今后还需要进行更大规模的对照研究,以确定其有效性。
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引用次数: 0
Public Transport in the Disabling City: A Narrative Ethnography of Dilemmas and Strategies of People with Mobility Disabilities 残疾城市的公共交通:行动不便者的困境与策略叙事民族志
Pub Date : 2024-03-18 DOI: 10.3390/disabilities4010015
Juan Camilo Mansilla, N. Boucher, F. Routhier
Access to transport is key to people’s movement in cities, their social participation, and personal development. People with mobility disabilities (PMDs) face additional barriers when using public transport. The objective of this study is to identify the dilemmas that PMDs face in their daily mobility practices and their coping strategies, in particular the ways in which these dilemmas and strategies are influenced by both personal and environmental characteristics. We conducted ethnographic research, utilizing narrative interviews, life stories, focus groups, and participant observations. Our aim was to analyse multiple experiences of mobility in situations of disability in Quebec City, Canada. This study engages the following research question: how do PMDs navigate their social environment, considering the impact of personal, social, and physical landscape factors on their mobility strategies? Depending on the accessibility of fixed-route public buses and the availability of public paratransit services, what are the dilemmas that PMDs face and how do they shape their mobility strategies? Using the three-dimensional model of narrative analysis, we present a narrative ethnography of participants’ dilemmas and strategies about their experiences on public transport. Five dilemmas are examined. Through this methodology, we propose to extend the study of “constellations of mobility” by including the notion of strategies as an experiential outcome between personal and physical landscape factors, practices, and meanings of mobility. This offers new research perspectives both in disability and mobility studies and in the understanding of urban accessibility experiences in situations of disability.
交通便利是人们在城市中行动、参与社会活动和个人发展的关键。行动不便者(PMDs)在使用公共交通时面临着更多的障碍。本研究旨在确定行动不便者在日常出行中面临的困境及其应对策略,特别是这些困境和策略是如何受到个人和环境特征的影响的。我们利用叙事访谈、生活故事、焦点小组和参与者观察等方法进行了人种学研究。我们的目的是分析加拿大魁北克市残疾人士的多重移动体验。本研究涉及以下研究问题:考虑到个人、社会和自然景观因素对其行动策略的影响,残疾人如何驾驭其社会环境?根据固定路线公共汽车的可达性和公共辅助交通服务的可用性,残疾人面临哪些困境,这些困境又是如何影响他们的行动策略的?我们利用叙事分析的三维模型,对参与者在乘坐公共交通时的困境和策略进行了叙事人种学研究。我们对五种困境进行了研究。通过这种方法,我们建议扩展对 "移动性组合 "的研究,将策略的概念纳入其中,将其作为个人和物理景观因素、实践和移动性意义之间的体验结果。这为残疾和移动性研究以及理解残疾情况下的城市无障碍体验提供了新的研究视角。
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引用次数: 0
Examining Model Similarity for Exercise Self-Efficacy among Adults Recovering from a Stroke: A Community-Based Exercise Program 研究中风康复者运动自我效能感的模型相似性:基于社区的锻炼计划
Pub Date : 2024-03-15 DOI: 10.3390/disabilities4010013
Olivia L. Pastore, François Jarry, Jammy Zou, J. Tomasone, Luc J. Martin, Véronique Pagé, Shane N. Sweet
We used a single-case experimental research design to examine the effect of modelling (peer versus non-peer) on exercise self-efficacy in stroke survivors who participated in a community-based exercise program. Data were obtained using an ABCA design: (A1) no model/baseline 1 (3 weeks); (B) peer model (6 weeks); (C) non-peer model (6 weeks); and (A2) no model/baseline 2 (3 weeks). Four participants completed self-efficacy questionnaires after each weekly session. Overall, participants reported higher exercise self-efficacy in the model conditions (Cohen’s d range from −0.37 to 4.22), with ratings appearing highest for the non-peer model. Modelling in general may help stroke survivors increase their exercise self-efficacy. Lastly, we provide our reflections on the pragmatics of completing a study within a community setting.
我们采用单例实验研究设计,考察了模拟(同伴与非同伴)对参加社区运动项目的中风幸存者运动自我效能感的影响。数据采用 ABCA 设计:(A1) 无模型/基线 1(3 周);(B) 同伴模型(6 周);(C) 非同伴模型(6 周);(A2) 无模型/基线 2(3 周)。每周课程结束后,四名参与者填写了自我效能问卷。总体而言,参与者在模型条件下的运动自我效能感较高(Cohen's d 范围从 -0.37 到 4.22),其中非同伴模型的评价最高。总体而言,建模可以帮助中风幸存者提高运动自我效能感。最后,我们对在社区环境中完成研究的实用性进行了反思。
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引用次数: 0
Accessibility, Functioning, and Activities of Daily Living with Visual Impairment amongst Adults from Minority Ethnic Communities in the UK 英国少数民族社区成人视力障碍的无障碍环境、功能和日常生活活动
Pub Date : 2024-02-29 DOI: 10.3390/disabilities4010011
Theofilos Kempapidis, Nikki Heinze, Asharee K. Green, Renata S. M. Gomes
Visual impairment (V.I.) has been associated with a negative impact on activities of daily living (ADL) and navigation outside the home. Adults from minority ethnic communities are projected to make up an increasing proportion of the V.I. population in the UK, yet the evidence relating to their experiences of living with V.I. is limited. This article uses data collected by the V.I. Lives Survey, between December 2019 and November 2020. Using secondary analysis of anonymised survey data, this article explores self-reported functioning relating to ADL, navigation outside of the home, and use of technology to access information in a matched control sample of adults from minority ethnic (MEC) and white communities (WC). The findings showed that most issues relating to self-efficacy, accessibility of public environments, and technology were significantly more important to MEC than WC participants. A significantly higher proportion of MEC participants required frequent help with cooking, received support for ADL from siblings and other family members, and had their shopping delivered. WC participants were significantly more likely to receive help with shopping from their spouse/partner and use public transport as much as they liked. Future research will need to confirm these findings in a larger sample and explore the reasons for them.
视力障碍(V.I.)对日常生活活动(ADL)和外出导航有负面影响。在英国,来自少数民族社区的成年人在视力障碍人群中所占的比例预计会越来越大,但与他们的视力障碍生活经历有关的证据却很有限。本文使用的数据来自 2019 年 12 月至 2020 年 11 月期间进行的 "V.I. 生活调查"。通过对匿名调查数据进行二次分析,本文探讨了来自少数族裔(MEC)和白人社区(WC)成年人的配对对照样本在日常活动、家庭外导航和使用技术获取信息方面的自我报告功能。研究结果表明,与自我效能、公共环境的可及性和技术有关的大多数问题,对少数民族社区参与者的重要性明显高于白人社区参与者。需要经常帮助做饭、在日常活动能力方面得到兄弟姐妹和其他家庭成员的支持以及购物有专人送货上门的男性和女性社区参与者的比例要高得多。而在购物方面得到配偶/伴侣帮助以及随心所欲地使用公共交通工具的比例要高得多。未来的研究需要在更大的样本中证实这些结果,并探讨其原因。
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引用次数: 0
Examining Parental Stress and Autism in the Early Days of the Pandemic: A Mixed-Methods Study 研究大流行初期父母的压力与自闭症:混合方法研究
Pub Date : 2024-02-23 DOI: 10.3390/disabilities4010010
B. Haidar, H. Meadan
In this convergent parallel mixed-methods study, we investigated the early impact of the COVID-19 stay-at-home mandate in Illinois on 16 caregivers of children with autism. Our goal was to understand contributors to caregivers’ stress by integrating qualitative and quantitative data. Through a joint display, we explored the intricate relationship between caregivers’ perceptions of their child’s needs, the loss of essential services, and stress levels. The caregivers’ reported needs, wishes, barriers, and coping strategies informed and corroborated final quantitative results on stress levels. Significant associations were found between stress levels and caregivers’ agreement with statements on child supervision, service loss, and perceived level of their child’s independence. These findings underscore the importance for robust support systems that enhance family resilience and validate prior research during exceptional circumstances. They offer insights for policymakers and service providers seeking to improve the well-being of families raising children with autism, particularly in times of crisis.
在这项趋同平行混合方法研究中,我们调查了伊利诺伊州 COVID-19 留家任务对 16 名自闭症儿童照顾者的早期影响。我们的目标是通过整合定性和定量数据,了解造成照顾者压力的因素。通过联合展示,我们探索了照顾者对孩子需求的看法、基本服务的丧失和压力水平之间错综复杂的关系。照顾者所报告的需求、愿望、障碍和应对策略为压力水平的最终定量结果提供了依据和佐证。研究发现,压力水平与照顾者对有关儿童监管、服务损失和儿童独立感知水平的陈述的同意程度之间存在显著关联。这些研究结果强调了建立健全的支持系统以增强家庭复原力的重要性,并验证了之前在特殊情况下进行的研究。它们为政策制定者和服务提供者提供了见解,帮助他们改善抚养自闭症儿童的家庭的福祉,尤其是在危机时刻。
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引用次数: 0
Empowering Physically Disabled People in Vietnam: A Successful Microenterprise Model 增强越南肢体残疾人的能力:成功的微型企业模式
Pub Date : 2024-02-16 DOI: 10.3390/disabilities4010009
June Alexander, C. Hutchinson, Greg Carey
Background: Disabled people in Vietnam are some of the most vulnerable to disadvantage. Employment involving microenterprises can provide economic empowerment and wealth generation. This qualitative study aims to address a gap in the literature regarding the establishment of microenterprises for physically disabled people in Vietnam. Method: Semi-structured interviews were undertaken with seven physically disabled individuals, including the founder and Director of ‘Company of Grace’ a non-governmental organisation with a mission to support physically disabled people in establishing their own microenterprises. Company of Grace (COG) supported six entrepreneurs in establishing microenterprises that provided English language instruction to school-aged children after regular school hours. Data were analysed utilising a framework that improves the probability of entrepreneurial success in developing countries. This framework aided in examining the approach of establishing microenterprises by the non-government organisation. Results: The physically disabled entrepreneurs reported earnings above average wages and feeling empowered by participating in the microenterprises. These feelings of empowerment were reportedly associated with greater independence, increased self-efficacy and confidence in planning for their futures. Conclusion: Microenterprises, exemplified by COG’s model, empowered disabled individuals to teach English, enhanced student engagement and fostered confidence and economic self-sufficiency among disabled entrepreneurs, thereby making a notable contribution to entrepreneurship for disability inclusion.
背景:越南的残疾人是最容易陷入困境的群体之一。通过微型企业就业可以增强经济能力,创造财富。本定性研究旨在填补有关越南肢体残疾人创办微型企业的文献空白。研究方法:对七名肢体残疾人进行了半结构式访谈,其中包括非政府组织 "Company of Grace "的创始人兼董事,该组织的使命是支持肢体残疾人创办自己的微型企业。恩典公司 (COG) 支持六位企业家创办微型企业,在正常上课时间之后为学龄儿童提供英语教学。数据分析采用了一个可提高发展中国家创业成功概率的框架。该框架有助于研究非政府组织创办微型企业的方法。结果:肢体残疾创业者报告说,他们的收入高于平均工资,并通过参与微型企业感到自己有能力。据报告,这些增强权能的感觉与更大的独立性、自我效能感的提高以及对规划未来的信心有关。结论:以 COG 的模式为例,微型企业增强了残疾人教授英语的能力,提高了学生的参与度,培养了残疾人创业者的自信心和经济自立能力,从而为残疾人融入创业做出了显著贡献。
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引用次数: 0
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