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A critical comparison of welfare states and their relevance to people with an intellectual disability
- Authors:
- de CHENU Linda, DAEHLEN Dag, TAH Jude
- Journal article citation:
- Journal of Intellectual Disabilities, 20(4), 2016, pp.397-415.
- Publisher:
- Sage
- Place of publication:
- London
This article compares the welfare services for adults with an intellectual disability in three European countries: England, Norway and Sweden. The purpose of the comparison is to develop an understanding of the welfare state and institutional contexts of the country-specific policies and to develop a critical analysis through a comparative method based on selected secondary literature. Typological frameworks of European welfare states are applied as analytic frameworks to enable comparison between the countries. It is argued that there are international policy developments but these are shaped at a national level by different types of welfare states and histories. Through a comparison of similarities and differences, the article suggests that international policy ideas that impact on the lives of people with intellectual disabilities are mediated by different types of welfare states and institutions.
Project SEARCH UK: evaluating its employment outcomes
- Author:
- KAEHNE Axel
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(6), 2016, pp.519-530.
- Publisher:
- Wiley
Background: The study reports the findings of an evaluation of Project SEARCH UK. The programme develops internships for young people with intellectual disabilities who are about to leave school or college. The aim of the evaluation was to investigate at what rate Project SEARCH provided employment opportunities to participants. Methods: The evaluation obtained data from all sites operational in the UK at the time of evaluation (n = 17) and analysed employment outcomes. Results: Data were available for 315 young people (n = 315) in the programme and pay and other employment related data were available for a subsample. The results of the analysis suggest that Project SEARCH achieves on average employment rates of around 50 per cent. Conclusion: Project SEARCH UK represents a valuable addition to the supported employment provision in the UK. Its unique model should inform discussions around best practice in supported employment. Implications for other supported employment programmes are discussed. (Publisher abstract)
From framework to practice: person-directed planning in the real world
- Authors:
- MARTIN Lynn, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(6), 2016, pp.552-565.
- Publisher:
- Wiley
Background: Person-directed planning (PDP) is an approach to planning supports that aims to redistribute power from the service system to individuals with intellectual and developmental disabilities (IDD) and natural supports, improve relationships and build community. To do this, the right people with the right attitudes engaging in the right actions are needed. This paper examines how key elements in PDP contribute to successes in planning. Materials/Methods: Researchers worked with three planning teams from different community service agencies using participatory action research techniques (i.e. free list and pile sort, Socratic wheel, whys/hows exercise). Results: Most key elements of PDP were relevant to each team. Perceptions of which had most contributed to planning successes differed. Conclusions: The various elements of PDP are used by and useful to planning teams, although some may be more relevant to some successes than others because of specific goals, or the person's strengths and needs. (Edited publisher abstract)
Mapping the employability landscape for people with learning disabilities in Scotland
- Authors:
- McTIER Alex, et al
- Publisher:
- Scottish Commission for Learning Disability
- Publication year:
- 2016
- Pagination:
- 85
- Place of publication:
- Glasgow
This report maps the employability landscape for people with learning disabilities in Scotland and seeks to better understand the scale and effectiveness of employability support. The report finds that the current landscape is complex, fragmented and seemingly under-resourced given the very low employment rate of adults with a learning disability. The employment rate for working adults with a learning disability is in the range of 7% to 25%, and there could be as many as 125,000- 150,000 out-of-work adults with a learning disability. Very small numbers of people with a learning disability appear to be engaged in mainstream employability programmes while supported employment services are estimated to have supported up to 2,000 people in 2014/15. The number of people with a learning disability enrolled in Scotland’s colleges is unclear, but it is estimated they have a 16 hours/job outcome rate of 12%. Specialist employability organisations appear to have an overall 16 hours/week job outcome rate of 14% and a cost per 16 hours/week job outcome of £17,200. Project SEARCH programmes achieve higher employment outcome rates with a 16 hours/week job outcome rate of 61% but with current capacity in Scotland of only 100-150 people per annum. The report makes a series of specific recommendations for a variety of stakeholders. They include the need to: overcome the low expectations held by parents, schools, colleges and employers; gather data more effectively, investing funding where people with a learning disability in Scotland secure both employment and support to develop in that job, and; recruit and train job coaches that can support people with a learning disability into employment and throughout their careers. (Edited publisher abstract)
‘I don't feel trapped anymore…I feel like a bird’: people with learning disabilities' experience of psychological therapy
- Authors:
- LEWIS Nicola, LEWIS Karin, DAVIES Bronwen
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(5), 2016, pp.445-454.
- Publisher:
- Wiley
Background: This current research was developed in response to a clinical psychology service recognising the need to evaluate their psychological service for and, as part of this evaluation, the importance of consulting with service users about their experience of psychological therapies. Methods: Six service users with a learning disability were interviewed about their experience of individual psychological therapy. The interviews were analysed using interpretative phenomenological analysis. Results: Themes were generated from the interviews which highlighted both positive and negative feedback on the psychological therapy process. The feedback covered areas such as access to therapy, feelings about therapy, preparing for therapy, skill development and collaborative working, accessibility and making therapy fun, challenges to confidentiality, positive feelings towards the therapist, aspects of the therapeutic relationship, therapy being challenging but helpful, and positive outcomes. Conclusions: These results have contributed to the evidence base that people with a learning disability are able to meaningfully engage in research and provide essential feedback on the services that they receive. (Edited publisher abstract)
The utility of the Montreal Cognitive Assessment as a mental capacity assessment tool for patients with a learning disability
- Authors:
- EDGE Daniel, et al
- Journal article citation:
- British Journal of Learning Disabilities, 44(3), 2016, p.240–246.
- Publisher:
- Wiley
Objective: To determine the psychometric properties of the Montreal Cognitive Assessment (MoCA) in patients with a learning disability and examine it's utility for conducting mental capacity assessment. Method: This study was a cross-sectional, instrument validation study in an inpatient hospital setting, located in the East of England. The sample consisted of two groups: (i) 31 consecutively admitted hospital patients and (ii) 10 multidisciplinary team members who served as a comparison group. The MoCA, a 12-item screen for mild cognitive impairment and the Dysexecutive Questionnaire (DEX), were used in this study. Item analysis was conducted by comparing item endorsement for all participants that had a learning disability utilising Difficulty and Discrimination Indices for each item on the MoCA. The authors examined the internal consistency of a revised scale derived from item analysis and used a one-way ANOVA to determine concurrent validity by comparing scores between two patient subgroups and the comparison group. Results: A 7-item scale, ‘MoCA-LD’ (alpha coefficient = 0.82) emerged from item analysis. A statistically significant negative correlation was observed between MoCA-LD and DEX (Pearson correlation = −0.66, P < 0.01). As expected, participants in the borderline category scored higher on MoCA-LD than those with mild learning disability, as did those with no learning disability (P < 0.001). Conclusion: The MoCA-LD has the potential to be a useful tool for mental capacity assessment in patients with a learning disability. (Edited publisher abstract)
Examples of individual supported living for adults with intellectual disability
- Authors:
- COCKS Errol, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 20(2), 2016, pp.100-108.
- Publisher:
- Sage
- Place of publication:
- London
Background: This article provides a qualitative account of four models of support for adults with intellectual disability in individual supported living (ISL) arrangements. Materials and Methods: Completion of the first 50 evaluations of 150 arrangements for the third phase of the ISL project provided the examples. Results: Four approaches are described: living alone, co-residency, relationship and host family. Within each type, wide variations occur particularly based on security of tenure, formal and informal support and management variations. Conclusion: Fifty evaluations so far illustrated a wide range of approaches to ISL, providing evidence of the critical importance of the formal and informal support environment and reinforcing the contention that ISL is appropriate for people with high support needs. (Publisher abstract)
Effects of vocational training on a group of people with intellectual disabilities
- Authors:
- GOMES-MACHADO Maria Luiza, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 13(1), 2016, pp.33-40.
- Publisher:
- Wiley
Intellectual disability (ID) is the most restraining disability for professional inclusion, mainly due to the lack of adaptive skills focused on the work environment observed in people with ID. The aims of this study were (i) to describe and analyse the effects of a vocational training program on the adaptive behaviour of people with ID and (ii) to evaluate the social impact of employability on the life of the employees with ID. Participants were 43 people with mild or moderate ID, age between 18 and 28 years. The Supports Intensity Scale was applied at two stages: T1-Pretraining and T2-Posttraining, while the Social Impact Questionnaire was used at the third stage, after employment (T3 Postinclusion). The authors found that there were differences in total scores between stages T1 and T2 in relation to all the adaptive skills assessed, with a reduction of around 50% in the need for support. One year after inclusion in the labour market (T3), participants were still employed, with significant improvements in such aspects as learning, autonomy, affective and social development, as well as in family and community relations. The vocational training contributed to the global development of persons, favouring their professional inclusion, and as a result, sustenance, autonomy, and a decrease in the need for assistance and support. (Edited publisher abstract)
The close relationships of people with intellectual disabilities: a qualitative study
- Authors:
- SULLIVAN Faye, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(2), 2016, p.172–184.
- Publisher:
- Wiley
Background: Positive interpersonal relationships have been found to enhance an individual's quality of life. However, people with intellectual disabilities (PWID) often have restricted social networks, and little is known about their views on close social relationships. The study aimed to explore how this group perceives and experiences close relationships. Materials and Methods: Ten (6 = men 4 = women) PWID participated. Data were collected using semi-structured interviews, and analysed using interpretive phenomenological analysis. Results: The results report on three of five themes drawn from a larger qualitative study: ‘Relationships feeling safe and being useful’; ‘Who's in charge?’ and ‘Struggling for an ordinary life’. Conclusions: Close relationships are valued and desired by PWID, but a variety of barriers inhibit their development and maintenance. This includes the failure of others to value, accept and appropriately support the independence and relationships of PWID. Potential ways of addressing these issues are discussed. (Publisher abstract)
Geographical barriers to mental health service care among individuals with an intellectual disability in the Republic of Ireland
- Authors:
- RAMSAY Hugh, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 13(4), 2016, pp.261-268.
- Publisher:
- Wiley
People with an intellectual disability (ID) are more likely to experience mental health difficulties than others. The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) states that health services should be provided close to people's own communities. This article examines differences in access to psychiatry services for those with an ID according to geography, in the context of a small European country (Republic of Ireland). The sample consisted of 753 individuals aged 40 and over with ID in the Republic of Ireland, with data collected from the Intellectual Disability Supplement of the Irish Longitudinal Study on Aging (IDS-TILDA). The primary outcome of interest was attendance with any psychiatrist and the primary independent variables were area of residence (health service region and degree of county urbanicity). Logistic regression was used to analyse associations, unadjusted and then controlling for age group, gender and level of ID. Secondary analysis examined factors associated with anti-psychotic prescription without psychiatrist supervision. Treatment by a psychiatrist was associated with both health region (p = 0.029) and degree of urbanicity (p = 0.015) before controlling for group differences but only the health region was significantly associated after controlling for age, gender and level of ID. Antipsychotic use without a psychiatrist was associated with degree of urbanicity (p = 0.036) but not with health service region (p = 0.989). Geographic factors are associated with access to mental health services among those with ID in the Republic of Ireland. This may be partly due to movement of people with ID away from their area of origin, highlighting the need for locally tailored specialist ID mental health teams and for further research into barriers to treatment. Additional work in other countries will further understanding of similar roles of geographic factors in mediating mental health services access. (Edited publisher abstract)