scholarly journals Occupational therapy for adults with intellectual disabilities and sensory processing challenges: a Delphi study exploring practice within acute assessment and treatment units

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Helen Justice ◽  
David Haines ◽  
Jon Wright
Keyword(s):  
Intellectual Disabilities ◽  
Delphi Study ◽  
Sensory Integration ◽  
Occupational Therapists ◽  
The Body ◽  
Content Type ◽  
Assessment And Treatment ◽  
Importance Ratings ◽  
Adults With Intellectual Disabilities ◽  
Clinical Tools

Purpose Lack of research means guidance regarding the most effective sensory interventions for adults with intellectual disabilities is limited. Preliminary consensus evidence was created by gathering experienced occupational therapists’ views on practice. The purpose of this study was to establish important elements of practice when using sensory integration-informed approaches on assessment and treatment units. Design/methodology/approach A modified Delphi process was used to gather, explore and synthesise the views of 13 occupational therapists. Data was collected via online surveys and included quantitative importance ratings and qualitative comments. Findings An experienced panel was in strong agreement regarding many elements of practice they felt were important for use in this setting, and a list of important practice items was created. Two themes were identified: “Complexity” and “Pragmatism vs. Ideal World.” The themes highlight challenges to practice in this area and the complex clinical reasoning used to overcome these. Research limitations/implications Participants disagreed about the level of importance of a substantial number of items, therefore items that did not reach consensus may still be important. Practical implications This study indicates potentially helpful clinical tools, facilities and training and identifies support needed for occupational therapists working in these settings. Originality/value This study contributes to the body of knowledge regarding how occupational therapists do and could work with people with intellectual disabilities and sensory integration difficulties. Although this study takes a UK and Ireland perspective, similar agendas regarding care and support for those with intellectual disabilities internationally mean findings are relevant more widely.

scholarly journals Practices and roles of Irish occupational therapists’ with adults with intellectual disabilities who access supported employment services

2017 ◽  
Vol 45 (2) ◽  
pp. 78-91 ◽  
Author(s):  
Patrick Joseph Hynes ◽  
Alia Harb
Keyword(s):  
Occupational Therapy ◽  
Intellectual Disabilities ◽  
Social Inclusion ◽  
Supported Employment ◽  
Occupational Therapists ◽  
Well Being ◽  
Research Literature ◽  
Employment Services ◽  
Content Type ◽  
Adults With Intellectual Disabilities

Purpose Work is good for one’s health and well-being. Work for people with disabilities should be encouraged because it is therapeutic and improves participation in the society, leading to better health outcomes. It develops interpersonal relationships and enhances life quality. Work is an aspiration for many people with intellectual disability. Within research literature, there appears to be a lack of research into the experience of occupational therapists in Ireland who refer adults with intellectual disabilities to supported employment services. The purpose of this paper was to explore the experience of Irish occupational therapists who refer adults with intellectual disabilities to supported employment services. Design/methodology/approach Semi-structured, in-depth interviews were conducted with four occupational therapists recruited through the Association of Occupational Therapists of Ireland (AOTI). Data were analysed using thematic analysis. Findings Themes that emerged were as follows: occupational therapy participants did not directly refer adults to supported employment but received referrals; occupational therapy roles included assessments, task analysis and development of client’s skills are major components of current practice; pragmatics involved factors that facilitate and challenge; and future roles. Originality/value This paper contributes to occupational therapy practice knowledge by providing a perspective on supported employment in Ireland. Occupational therapists should continue to work in the area of supported employment to support social inclusion and enable participation. Further research with occupational therapists working in this field is required to inform practice.

Teaching playground behavioural expectations to secondary age students with intellectual disabilities attending a special school

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
David Simó-Pinatella ◽  
Marisa Carvalho
Keyword(s):  
Intellectual Disabilities ◽  
Secondary Students ◽  
School Setting ◽  
Special School ◽  
Content Type ◽  
Students With Intellectual Disabilities ◽  
Special Education School ◽  
Adults With Intellectual Disabilities ◽  
Materials Used

Purpose School-wide positive behaviour support (SWPBS) is a proactive behavioural support system that fosters behaviour change in individuals in a school setting. This article aims to present a case example of teaching and reinforcing behavioural expectations in a special school. Design/methodology/approach This case study reflects different steps and materials used before and during the intervention in a special education school with 61 secondary students with intellectual disabilities. An AB design (A – baseline; B – intervention) was used to collect and analyze data. Findings Results suggest that teaching behavioural expectations as a universal measure may be feasible and positively impact school climate. Suggestions and recommendations for implementing SWPBS within a school are provided. Originality/value This case study provides a step-by-step guide illustrating the process of teaching and reinforcing behavioural playground expectations to young adults with intellectual disabilities attending a special school.

Identification of PTSD in adults with intellectual disabilities in five patients in a specialised psychiatric inpatient unit

2014 ◽  
Vol 8 (2) ◽  
pp. 91-102 ◽  
Author(s):  
Trine Lise Bakken ◽  
Arvid Nikolai Kildahl ◽  
Vibeke Gjersøe ◽  
Espen Matre ◽  
Tone Kristiansen ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Practical Implication ◽  
Case Reports ◽  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Traumatic Experiences ◽  
Content Type ◽  
Psychiatric Inpatient Unit ◽  
Severe Intellectual Disabilities ◽  
Adults With Intellectual Disabilities

Purpose – The purpose of this paper is to describe and discuss assessment of post-traumatic stress disorder (PTSD) in adults with intellectual disabilities. Existing research in this area encompasses case studies, and includes, for the most part, persons with mild intellectual disabilities. Design/methodology/approach – The aim of this study is to investigate symptom presentation and subsequent identification of PTSD in persons with more severe intellectual disabilities; i.e. persons with moderate or severe intellectual disabilities. Five patients in a specialised psychiatric inpatient unit for patients with intellectual disabilities were included. Information about the patients was collected through case files and interviews with key informants: family, milieu therapists, and caregivers in community settings, and observations through inpatient admission. The authors of this paper followed a training programme for trauma therapists in addition to the inpatient treatment of the five patients. The five patients all met criteria for PTSD according to the Diagnostic Manual – Intellectual Disability. Findings – Previously, it was not suspected that the five patients suffered from PTSD, although they had experienced terrifying incidents. All patients displayed severe changes in behaviour, which may have overshadowed symptoms of PTSD. PTSD in persons with more severe intellectual disabilities may be interpreted as challenging behaviour, or other psychiatric disorders such as psychosis. Research limitations/implications – The limitation of the study is the small number of participants. Practical implications – Practical implication is linked to clinical practice related to identification of PTSD in persons with intellectual disabilities. Originality/value – The paper may encourage more research into how PTSD can be identified in persons with moderate and severe intellectual disabilities. The case reports may help clinicians to look for traumatic experiences in persons with intellectual disabilities who have experienced terrifying incidents.

Short communication: reliability and validity of the UKU Side Effect Rating Scale for adults with intellectual disabilities

2016 ◽  
Vol 10 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Anne Louise Tveter ◽  
Trine Lise Bakken ◽  
Jan Ivar Røssberg ◽  
Egon Bech-Pedersen ◽  
Jørgen G. Bramness
Keyword(s):  
Side Effects ◽  
Focus Group ◽  
Intellectual Disabilities ◽  
Side Effect ◽  
Rating Scale ◽  
Reliability And Validity ◽  
Medical Doctor ◽  
Face Validity ◽  
Content Type ◽  
Adults With Intellectual Disabilities

Purpose – The UKU side effect rating scale for adults with intellectual disabilities (UKU-SERS-ID) was developed to detect side effects among patients with intellectual disabilities (ID). The purpose of this paper is to examine the reliability and face validity of the UKU-SERS-ID. Design/methodology/approach – UKU-SERS-ID comprises 35 items. In total, 22 patients with ID were included from two specialized services for adults with ID and comorbid mental illness. All patients were rated on three different occasions by three clinicians; two nurses and one medical doctor. Reliability was estimated with Cohen’s κ. A focus group discussed the face validity of the items comprising the UKU-SERS-ID. Findings – Respectively ten (nurse-nurse scores) and eight (nurse-doctor scores) items were considered difficult to score due to low prevalence of the symptoms. For the other items the reliability was acceptable. Through discussion in a focus group, with the reliability scores in mind, only one of the items of the UKU-SERS-ID was discarded. Practical implications – The authors have developed a feasible side effect instrument for clinical practice. It is easy to score and relevant regarding important side effects. Originality/value – The UKU-SERS-ID seems to be a feasible tool. Further investigations are mandatory in order to gain knowledge about distribution and phenomenology of side effects from psychotropic medication for individuals with ID.

Community dialectical behaviour therapy for emotionally dysregulated adults with intellectual disabilities

2014 ◽  
Vol 8 (3) ◽  
pp. 165-173 ◽  
Author(s):  
Aubrey Baillie ◽  
Sean Slater
Keyword(s):  
Intellectual Disabilities ◽  
Detailed Examination ◽  
Outcome Data ◽  
Lessons Learned ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Client Group ◽  
Adults With Intellectual Disabilities

Purpose – The purpose of this paper is to reflexively examine the challenges of implementing a community dialectical behaviour therapy (DBT) service for adults with intellectual disabilities (ID) and describes the practical lessons learned about how to maximise the effectiveness of DBT with this client group. Design/methodology/approach – A brief overview of DBT is provided and reference is made to literature which highlights the potential benefits of providing a DBT service to clients with an ID. This is followed by a discussion of the clinical presentation of the clients receiving DBT in the service that is the focus of this case study. Using a reflexive approach, a detailed discussion follows of the challenges faced in implementing a community DBT service for the clients served. Findings – Solutions to a variety of challenges faced in four years of service delivery are described, key lessons learned are highlighted, together with issues meriting further research. Research limitations/implications – This case study and its implications are limited to community DBT services. Another limitation is that, although outcome data have been collected over the past two years, the dataset is not yet large enough to draw statistical conclusions. Practical implications – The paper describes adaptations to treatment structure and strategy which the authors believe are necessary to improve treatment outcomes in community DBT services for adults with ID. In particular, the practical experience suggests that a didactic approach to teaching DBT skills is not effective and should be replaced by the “community of learners” approach that involves the trainer contingently responding to client input. Pre-set lesson plans inhibit the trainers’ ability to respond contingently. Originality/value – The existing literature on providing a DBT service for people with an ID has principally focused on providing a rationale for providing this type of intervention, and on assessing outcomes. Given that this is still a relatively new type of provision for this client group, a detailed examination of process issues is called for.

The Adult Attachment Projective Picture System: a pilot study of inter-rater reliability and face validity with adults with intellectual disabilities

2018 ◽  
Vol 12 (2) ◽  
pp. 57-66 ◽  
Author(s):  
Deanna Gallichan ◽  
Carol George
Keyword(s):  
Intellectual Disabilities ◽  
Adult Attachment ◽  
Clinical Utility ◽  
Reliability And Validity ◽  
Clinical History ◽  
Face Validity ◽  
Rater Reliability ◽  
Content Type ◽  
Adult Attachment Projective ◽  
Adults With Intellectual Disabilities

Purpose The purpose of this paper is to assess whether the Adult Attachment Projective (AAP) Picture System is a reliable and face valid measure of internal working models of attachment in adults with intellectual disabilities (ID). Design/methodology/approach The AAPs of 20 adults with ID were coded blind by two reliable judges and classified into one of four groups: secure, dismissing, preoccupied, or unresolved. Inter-rater reliability was calculated using κ. Six participants repeated the assessment for test-retest reliability. Two independent experts rated ten cases on the links between the AAP analysis and the clinical history. Findings There was significant agreement between AAP judges, κ=0.677, p<0.001. Five out of six participants showed stability in their classifications over time. The majority of expert ratings were “good” or “excellent”. There was a significant inter-class correlation between raters suggesting good agreement between them r=0.51 (p<0.05). The raters’ feedback suggested that the AAP had good clinical utility. Research limitations/implications The inter-rater reliability, stability, face validity, and clinical utility of the AAP in this population is promising. Further examination of these findings with a larger sample of individuals with ID is needed. Originality/value This is the first study attempting to investigate the reliability and validity of the AAP in this population.

Direct care staff knowledge about medication for individuals with intellectual disabilities

2019 ◽  
Vol 13 (3/4) ◽  
pp. 144-151
Author(s):  
Amanda Sawyer ◽  
Johanna Lake ◽  
Yona Lunsky
Keyword(s):  
Intellectual Disabilities ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Medication Administration ◽  
Psychotropic Medications ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Content Type ◽  
Adults With Intellectual Disabilities

Purpose The majority of adults with intellectual disabilities (ID) are prescribed at least one, if not multiple medications, with psychotropic medications being the most commonly prescribed. Direct care staff play an important role in psychotropic medication administration and monitoring, yet little is known about their knowledge and comfort with medication. The paper aims to discuss this issue. Design/methodology/approach A 15-item survey, focusing on self-reported knowledge and comfort with psychotropic medication, was completed by 152 direct care staff employed at three agencies providing residential services for individuals with ID across Ontario. Findings In total, 62 per cent of staff respondents reported that psychotropic medications were among the top medications regularly taken by the individuals they support, with behaviour listed as the most commonly reported reason for taking this medication. The majority of staff reported monitoring medication, however, the frequency of monitoring varied considerably. Generally, staff reported feeling comfortable and knowledgeable about medication use, but, most reported a desire for additional medication training. Originality/value This is the first Canadian study to examine staff knowledge and comfort regarding medication use, and the first study to assess PRN (“as needed”) as well as regularly administered medications.

scholarly journals Commentary on “Dietitians’ challenges when consulting to adults with intellectual disabilities”

2019 ◽  
Vol 24 (4) ◽  
pp. 163-167
Author(s):  
Paraskevi Triantafyllopoulou
Keyword(s):  
Intellectual Disabilities ◽  
Intervention Studies ◽  
Overweight And Obesity ◽  
Future Research ◽  
Content Type ◽  
Prevalence Studies ◽  
Multiple Components ◽  
Obesity And Overweight ◽  
Randomised Control Trials ◽  
Adults With Intellectual Disabilities

Purpose The purpose of this paper is to consider issues around obesity and overweight for people with intellectual disabilities (IDs). Design/methodology/approach A review of the literature is provided looking at issues around overweight and obesity for adults with IDs. Both prevalence studies and intervention studies were considered. Findings The prevalence of overweight and obesity is considerably higher for adults with IDs when compared to the general population. Intervention studies focusing on multiple components seem to be the most effective. However, future research should focus on randomised control trials taking into consideration the views of people with IDs. Originality/value This paper synthesizes some of the available evidence on obesity and overweight for adults with IDs providing clear recommendations for the future.

scholarly journals Sensory-based interventions with adult and adolescent trauma survivors

2020 ◽  
Vol 48 (1) ◽  
pp. 31-54
Author(s):  
Suzie McGreevy ◽  
Pauline Boland
Keyword(s):  
Comparative Method ◽  
Continuing Professional Development ◽  
Occupational Therapists ◽  
Evidence Base ◽  
The Body ◽  
Trauma Survivors ◽  
Trauma Studies ◽  
Content Type ◽  
Adolescent Trauma ◽  
Constant Comparative Method

Purpose An emerging evidence base, and increased awareness of the effects of trauma on the body, advocates a sensory-based approach to treatment with posttraumatic stress and complex trauma survivors. This paper aims to identify, analyse and summarise the empirical evidence for the sensory-based interventions, which occupational therapists are using in the treatment of adult and adolescent trauma survivors. Design/methodology/approach An integrative review of the literature was undertaken. Both empirical and conceptual papers were included. An inductive approach and constant comparative method were used to understand and synthesise the research. Findings The literature search yielded 18 papers describing the types of sensory-based interventions used, sensory processing (SP) patterns and the context and evidence for sensory-based occupational therapy practice with trauma survivors. Nine of the studies were empirical and nine were conceptual and review papers. Themes identified included: atypical SP patterns; type of sensory-based intervention used with trauma survivors; and transdisciplinary treatment programmes can reduce the symptoms of trauma. Practical implications Sensory-based interventions with adult and adolescent trauma survivors are emerging as promising areas of practice and research in the literature. Although empirical data is limited, the sensory needs of the body in processing trauma experiences is becoming more recognised and are supported by the atypical SP patterns identified in survivors. A sensory-based, transdisciplinary approach to treatment has the potential to be effective in treating the trauma survivor. Originality/value With a skill base in sensory integration and occupational analysis, occupational therapists have much to offer the field of trauma studies. This review begins to address the gap in the literature, recommending more rigorous controlled outcome research with larger sample sizes, person-centred studies focussing on the trauma survivor’s perspective and continuing professional development and mentorship for occupational therapists working with this population.

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