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Qualitative study of malnutrition in people with intellectual disabilities
- Authors:
- FRANSSEN Janine J. L., MAASKANT Marian A., SCHROJENSTEIN Henny M. J. van
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 8(4), December 2011, pp.239-246.
- Publisher:
- Wiley
People with intellectual disabilities (ID) are vulnerable to underweight status, often because of co-occurring eating disorders. However, it is unclear whether this results in malnutrition. This qualitative study investigated the awareness and knowledge of three physicians, three dieticians, and three direct care staff regarding malnutrition in people with ID from six different service providers in the Netherlands. Semi-structured interviews were held to explore participants’ experiences with problems and possible solutions. Findings revealed that the dieticians and physicians saw malnutrition prevalent in persons with ID that their clients, but they were uncertain about why this was the case. However, the direct care staff were certain that malnutrition was not present. The authors suggested screening of high-risk persons for the presence of malnutrition, and recommended education of direct care staff about healthy nutrition and weight. In ending, the authors called for the development of a screening instrument for malnutrition specifically for people with ID.
The prevalence of child sexual abuse in out-of-home care: increased risk for children with a mild intellectual disability
- Authors:
- EUSER Saskia, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 29(1), 2016, pp.83-92.
- Publisher:
- Wiley
Background: This study examined the year prevalence of child sexual abuse (CSA) in Dutch residential and foster care with a mild intellectual disability, and compared it with the prevalence in out-of-home care for non-disabled children and children in the general population. Materials and Methods: Professionals (N = 104) from out-of-home care facilities reported cases of CSA that occurred in 2010 for the children they worked with (N = 1650). Results: In out-of-home care for children with a mild intellectual disability, 9.8 per 1000 children were victims of CSA. This prevalence was significantly higher than in regular out-of-home care and in the general population. Conclusion: Children with a mild intellectual disability in out-of-home care have an increased risk of CSA. Adequate education and support for both children and caregivers is necessary to recognize and prevent further sexual abuse. (Edited publisher abstract)
Parents with intellectual disabilities seeking professional parenting support: the role of working alliance, stress and informal support
- Authors:
- MEPPELDER Marieke, et al
- Journal article citation:
- Child Abuse and Neglect, 38(9), 2014, pp.1478-1486.
- Publisher:
- Elsevier
Delaying or refraining from seeking advice and support in difficult parenting situations is identified as an important risk factor for child abuse and neglect. This study tested whether the extent of delays in support seeking is associated with working alliance for parents with mild intellectual disabilities (MID) and whether the importance of working alliance may depend on parenting stress and availability of informal support. Delays in support seeking were measured as parental latency (time waited) to approach the support worker. This latency was assessed in the intended response to hypothetical situations (vignettes) and in the reported behavioural response to real life difficult parenting situations from the preceding weeks. Multiple regression analyses were conducted for testing main and interaction effects of predictors on latency for support seeking. Better quality of the working alliance was associated with shorter intended latency to seek support for parents with MID, if parents had little access to informal support. Higher parenting stress predicted a shorter latency for intended support seeking. Parental support seeking intentions were positively associated with support seeking behaviour. A good quality of the working alliance might be important to connect needs of parents with MID to resources that professional support can offer, in particular for the most vulnerable parents. Parental reluctance to seek professional support may be the result of a combination of risk and protective factors and is not always a sign of poor working alliance. Implications for risk assessment and support practice are discussed. (Edited publisher abstract)
Contextual variables affecting aggressive behaviour in individuals with mild to borderline intellectual disabilities who live in a residential facility
- Author:
- EMBREGTS P. J. C. M.
- Journal article citation:
- Journal of Intellectual Disability Research, 53(3), March 2009, pp.255-264.
- Publisher:
- Wiley
Aggression is a common type of problem behaviour in clients with mild to borderline intellectual disability who live in a residential facility. This study explored contextual events that elicit aggressive behaviour and variables that were associated with such events. Respondents were 87 direct-care staff members of 87 clients with aggressive behaviour who lived in a residential facility. Staff members completed the Contextual Assessment Inventory (CAI) and a questionnaire on demographic information and types, frequency and severity of aggressive behaviour. Internal consistency of the total CAI was excellent. Both social and task-related events were reported to evoke aggressive behaviour of clients most often. Negative interactions, task characteristics and daily routines relatively often evoked aggressive behaviour while an uncomfortable environment, medication, illness and physiological states (i.e. physical and biological events) evoked aggressive behaviour least often. Mean CAI sub-scale scores were significantly related to gender, IQ and frequency of aggressive behaviour. The present study extends our knowledge regarding events that are associated with an increased probability of aggressive behaviour. Knowledge of these contextual variables may be helpful in designing programmes (e.g. applied behaviour analysis, social skills training and cognitive behavioural therapies) for the management and prevention of aggressive behaviour in clients with mild to borderline intellectual disability who live in a residential facility.
Falls and fractures: a major health risk for adults with intellectual disabilities in residential settings
- Authors:
- WAGEMANS A.M.A., CLUITMANS J. J. M.
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 3(2), June 2006, pp.136-138.
- Publisher:
- Wiley
Falls and fractures are a major health problem, especially among people with intellectual disabilities (ID). The authors report on an exploratory survey at one Dutch residential facility, aimed at determining the characteristics of people with ID who were prone to falling. Data on falls and fractures were compared with a number of characteristics of the institution's residents. Each week data about falls were sampled during the study period of 33 months. It was found that risk factors for falling included: previous fractures, increasing age, impaired vision, seizures, use of antiepileptic drugs, and impaired mobility. Some 57% of the population fell during the observation period, resulting in 26 fractures. The authors noted that as the expected incidence of falling was high, an important finding was that people capable only of walking inside the building have a high risk of falling. The risk factors found can help identify those persons who are prone to falling, and this information can be used in fall prevention programs.
Comprehension of pictograms for pain quality and pain affect in adults with Down syndrome
- Authors:
- DE KNEGT Nanda C., et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 41(3), 2016, pp.222-232.
- Publisher:
- Taylor and Francis
Background: Adults with Down syndrome (DS) are at risk for age-related painful physical conditions, but also for under-reporting pain. Pictograms may facilitate self-report of pain, because they seem suitable for the global visual processing in DS and for iconic representation of abstract concepts. Method: Participants (N = 39, M age = 41.2) assigned pain qualities to pictograms, rated pain affect levels in facial scales (pictograms vs. drawn faces), and performed cognitive tests. Results: Recognition of all intended pain qualities was above chance level. Pain affect levels of both facial scales were ordered equally well. Both facial scales were preferred equally well. Comprehension of the 3 scales was positively associated with mental age, receptive language ability, and verbal memory. Most participants (74%) had pictograms in their direct environment, mainly to communicate activities or objects. Conclusion: Using pictograms may optimise communication about pain for a subgroup of cognitively higher functioning adults with DS. (Edited publisher abstract)
Addressing challenging behavior in people with profound intellectual and multiple disabilities: analyzing the effects of daily practice
- Authors:
- POPPERS Petra, PUTTEN Annette A.J. van der, VLASKAMP Carla
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 11(2), 2014, pp.128-136.
- Publisher:
- Wiley
As some people with profound intellectual and multiple disabilities (PIMD) are at a high risk of developing a challenging behaviour, it is useful to look at measures taken to prevent or diminish this type of behaviour. The authors undertook a study of how self-injurious, stereotypical, destructive, or aggressive behaviours are addressed in daily practice in residential facilities. A stratified sample of 30 people with the most severe and frequently reported challenging behaviours was selected from a dataset of 181 children and adults with PIMD. Individual comprehensive service plans were used to determine whether challenging behaviours were present and how these problems were addressed. In total, only 51.8% of the challenging behaviours that occurred were described in the individual plans, and for 53.7% of the challenging behaviours, strategies or interventions were included in the individual service plans. Only 17.2% of the cases contained goals formulated to prevent or diminish such behaviour. A significant positive relationship was found between the severity of challenging behaviour and the extent to which it was described in the individual comprehensive service plans. The authors also noted that interventions that were aimed at diminishing or preventing challenging behavior were highly simplistic, and virtually no goals were formulated to document, diminish, or prevent challenging behaviour in people with PIMD. (Edited publisher abstract)