From mainstream employment to mainstream retirement: A randomised controlled trial of a transition to retirement intervention for adults with intellectual disability

Background

We evaluated a transition to retirement intervention that adapted strategies used to support employment of people with intellectual disability in mainstream workplaces. The intervention facilitated their independent participation in mainstream community groups and volunteering.

Methods

We randomised 29 older Australians who currently/previously worked in mainstream employment into an intervention group or wait-list control group. Hours of independent participation in target activities were collected before and after the 13-week initial intervention/waiting period, and at 52 weeks for intervention participants.

Results

Six of the 12 intervention participants selected an activity and increased hours of independent participation following 13 weeks in the Keeping Active (KA) program and eight were independently accessing their selected activity at 52-week follow-up. None of the 19 wait-list participants increased their independent participation after 13 weeks.

Conclusions

The intervention was effective and highlighted the need to account for factors such as participant choice in evaluation of individualised programs.     

Parents Plus parenting programme for parents of adolescents with intellectual disabilities: A cluster randomised controlled trial

Objective

This study evaluated the effectiveness of the Parents Plus Special Needs (PPSN) programme, a seven-week parenting group intervention for parents of adolescents with intellectual disabilities.

Method

In a cluster randomised controlled trial, 24 intellectual disability services supporting families of adolescents with an intellectual disability were assigned to PPSN (12 services; 141 parents) or waitlist control group (12 services; 136 parents). Primary outcomes were parent-reported parenting practices, family adjustment, problem behaviours, emotional problems, and prosocial behaviours. Secondary outcomes were parental satisfaction, parental self-efficacy, and goal attainment.

Results

Compared to the waitlist group, participants in the PPSN group reported improvements in parenting practices, problem behaviours, parental satisfaction, parental self-efficacy and goal attainment, which were retained at 3-month follow-up. There were additional gains for family adjustment at follow-up.

Conclusion

The PPSN is effective in improving parenting behaviour, family relationships, and problem behaviours in adolescents, but not in improving emotional difficulties.     

Prevention of falls for adults with intellectual disability (PROFAID): a feasibility study

Purpose: A novel physiotherapy intervention for people with intellectual disability (ID) to improve balance was developed and evaluated in a feasibility study which quantitatively assessed potential benefits on measures of balance, gait and activity participation, and qualitatively explored its acceptability, utility and feasibility. Methods: Participants were 27 adults with mild to profound ID (mean age 53 years SD 10.9). We used a mixed methods approach: an uncontrolled before–after study (data analysed with the related samples sign test) and a qualitative interview evaluation (data analysed with the general inductive approach). Balance, gait and participation were assessed at baseline and 6 months after introduction of the physiotherapy intervention with four standardised measures and two questionnaires. Results: Appropriate exercises and a physical activity could be found for all participants, irrespective of the level of ID, although for many this required a high level of assistance from support staff. Only the Balance Scale for ID changed significantly by a median score of 2 (95% CI?=?0.00–2.50, p?=?0.04). No other outcomes changed significantly. Four themes emerged: “Understanding the intervention”; “Routine and reality”; “Remembering what I have to do” and “What happens beyond the study itself”? Conclusions: The findings provide some evidence for the benefit, acceptability, utility and feasibility of the intervention justifying further evaluation.

• Implications for Rehabilitation

• Falling is a frequent and serious problem for many adults with intellectual disability.

• Two to three exercises targeted at increasing lower limb strength and challenging balance, performed each day as part of daily routine may help improve balance in adults with intellectual disability.

• The importance of exercising needs to be stressed to those who support adults with intellectual disability to encourage ongoing adherence.

     

Effects of the Attune & Stimulate-checklist for caregivers of people with severe and profound intellectual disabilities: A randomised controlled trial

Background

Sensitive responsiveness is an important aspect in affect-regulation of people with severe to profound intellectual disabilities.

Aim

This randomized controlled trial evaluated the Attune & Stimulate-checklist, a tool for detecting subtle and idiosyncratic communicative behaviours and responding adequately.

Methods

Effects on the sensitive responsiveness of professional caregivers and the arousal and valence of adults with severe to profound intellectual disabilities were investigated. Video recordings of 102 interactions were analysed with several observation instruments.

Results

Although no significant effect was found on the checklist-suggestions of responsive behaviours (d = 0.33, p = .052), the intervention increased caregivers’ sensitive responsive and affective behaviour (d = 0.94 – 1.10, p < .001) and clients’ optimal arousal (d = 0.48, p = .019) and interactive engagement (d = 0.40 – 0.48, p = .018 - .050).

Conclusion

This low-intensity intervention had a medium to large immediate effect on the interaction. Future research should investigate medium- and long-term effects.