Perceptual-motor coordination in persons with mild intellectual disability

Background. There is limited experimental evidence to support the view that individuals with intellectual disabilities (ID) have a deficit in motor control. This work is a first attempt to evaluate their motor coordination.

Purpose. The study assessed the relationship between cognitive ability and sensorimotor integration. The clinical hypothesis is that adults with ID fall below non-ID adults in motor skills that involve hand-eye coordination.

Method. A group of 42 adults with ID (ID group) was compared to 48 age-matched typical adults (TA) using a mixed experimental design ('Task' as the within-subjects factor and 'Group' as the between-subjects factor). Participants performed the following tests twice: Box-and-Blocks, 25-Grooved-Pegboard, Stick Catching and overhead Beanbag-Throw. Pearson correlations and ANOVAs were used to test the hypothesis (p ≤ 0.05).

Results. As expected, TA outperformed the ID group in all tests regardless of the hand used during for the assessment. However, TA individuals scored significantly better with one hand (i.e., the preferred and dominant hand) as opposed to persons with ID, who exhibited no hand preference. Test-retest correlations among the first and second assessment scores yielded moderate-strong coefficients, depending on the type of test (Box-and-Blocks = 0.92 and 0.96, 25-Grooved-Pegboard = 0.69 and 0.83, Stick-Catching = 0.88 and 0.94, Beanbag-Throw = 0.58 and 0.91 for ID and TA, respectively).

Discussion. Difficulties in the integration of perceptual information into motor action may result in inadequate solutions to daily motor problems. As it stems from our results, intellectual disability relates to inability to integrate visual inputs and hand movements. In people with mild ID such inability is observed using both hands (i.e., they show no hand preferences). Poor perceptual-motor coordination might have a functional significance in that it may lead to exclusion from vocational and recreational activities, and a decreasing competence of ADL. Assessing coordination in adults with ID may contribute to understanding the nature of the ID condition and may encourage an early rehabilitation.     

Family Nursing Network: Scottish initiative to support family care

This article describes the foundation in 1997 of a Family Nursing Network (FNN) in Edinburgh involving nurses from local trusts and Scottish universities. The purpose of the FNN is to support the use of family nursing in practice, research and education. Family nursing proposes that health care should focus on the needs of the family as a unit rather than as the context of care for a family member with health needs. Family nursing is not common practice in the UK but some nurses have found it highly relevant to their care. The World Health Organization (WHO) promotes the family health nurse as an important component of health care in the community for the future and family nursing could well provide the foundation for such practice. Definitions of the family and family nursing are offered, the conceptual background is analysed and the work achieved by the FNN is reviewed. The authors write on behalf of the FNN.     

The roles of adult siblings of individuals with a profound intellectual disability

Background

Adult siblings are important in the lives of individuals with profound intellectual disabilities, especially as parents age. However, little is known about the roles they assume.

Method

We examined these roles among 58 participants from the Netherlands, who completed an online questionnaire.

Results

Most participants (89.7%) assumed multiple roles, and the majority were content with their roles. Between 7% and 58% indicated that they were the only individuals providing a certain role. Shared roles primarily involved healthcare professionals, other siblings, and parents. Almost half the participants (48.2%) assigned higher scores for the amount of support provided than for the experienced burden.

Conclusions

Adult siblings often assume multiple roles. The shared roles emphasise the importance of collaboration.     

Important aspects of participation and participation restrictions in people with a mild intellectual disability

Abstract

Purpose: This study explored a possibility to assess the concepts of participation and participation restrictions in the International Classification of Functioning, Disability and Health (ICF) by combining self-ratings of the perceived importance with the actual performance of different everyday activities in people with a mild intellectual disability. Method: Structured interviews regarding 68 items from the ICF activity/participation domain were conducted (n?=?69). The items were ranked by perceived importance, performance and by combined measures. Furthermore, the measures were related to a single question about subjective general well-being. Results: Rankings of performance highlighted about the same items as “important participation”, while rankings of low performance addressed quite different items compared with “important participation restriction”. Significant correlations were found between subjective general well-being and high performance (r?=?0.56), high performance/high importance (important participation) (r?=?0.56), low performance (r?=?–0.56) and low performance/high importance (important participation restriction; r?=?–0.55). Conclusions: The results support the clinical relevance of the ICF and the studied selection of 68 items. Although performance only may sometimes be a relevant aspect, knowledge about the relationship between the perceived importance and the actual performance is essential for clinical interventions and for research aiming to understand specific needs regarding participation.

• Implications for Rehabilitation

• The concepts of participation and participation restriction are highly relevant in people with a mild intellectual disability.

• Self-rated performance might be sufficient to assess participation at a group level.

• In clinical practices, the relationship between the perceived importance and the actual performance of an activity is essential to assess.

     

Factors that affect GP referral of a child with intellectual disability for a mild illness: A discrete choice experiment

Background

General practitioners (GP) report multiple challenges when treating individuals with intellectual disabilities which may influence referral rates. The study aimed to establish factors that influence GP's decision-making when referring a child with intellectual disabilities to the emergency department.

Method

Discrete choice experiments (DCEs) are increasingly used in health research to further understand complex decision making. A DCE was designed to assess the relative importance of factors that may influence a GP's (N = 157) decision to refer.

Results

A random parameters model indicated that perceived limited parental capacity to manage an illness was the most important factor in the decision to refer a child to the ED, followed by a repeat visit, a referral request from the parent, and a Friday afternoon appointment.

Conclusion

Understanding the factors that influence referral is important for service improvement and to strengthen primary care provision for this population and their families.     

Social dancing: a way to support intellectual, emotional and motor functions in persons with dementia

Dementia causes serious impairments and the inability to perform those activities which give meaning to a person's life. Therefore, these persons are in need of professional nursing care interventions as well as a special supporting environment. In this study, social dancing has been regarded as a nursing intervention that supports persons with dementia in nursing home settings. The aim was to find out how persons with dementia functioned in social dance sessions, in order to understand the reasons behind the use of social dancing as a nursing intervention in a nursing home setting. Six persons with dementia were videotaped during four dance sessions in one nursing home. The qualitative content analyses were carried out deductively, using a guide developed from the variables in the Gottfries, Brâne and Steen rating scale (GBS scale). The findings show that, for persons with dementia, retained abilities were prominent in dancing. It was obvious that social dancing was supportive and seemed to have meaning to both patients and their carers. Social dancing seems to be a nursing intervention that supports patients' positive feelings, communication and behaviour. The carers' preunderstanding of the patients' levels of dementia and the wholeness of the situation was of importance.     

Graphic support resources for workers with intellectual disability engaged in office tasks: a comparison with verbal instructions from a work mate

Background: Research into workplace adjustments for people with disabilities is a fundamental challenge of supported employment. The aim of the present work is to investigate the effect of several graphic resources as natural support for workers with intellectual disability.

Methods: Two case studies were conducted to assess the performance of five workers engaged in office tasks, with three different support conditions.

Results: Results reveal a 20% increase in quality of performance of the tasks undertaken with graphic support as compared to support in which the participants received verbal instructions (VIs) from a work mate; and between 25 and 30% as compared to a control condition which included no help of any kind.

Conclusions: These findings are consistent with previous studies which support the possibility of generating, at low cost, iconic materials (with maps or simple graphics), which progressively facilitate workers’ autonomy, without dependence or help from the job trainer. We observed that the worst performance is in the support condition with VIs, this shows the limitations of this type of natural support, which is provided on demand by work mates without specialist knowledge of work support.

• Implications for Rehabilitation

• We studied the use of various types of natural support for people with intellectual disability in their workplace.

• The findings suggest that, with some brief training, the simple use in the workplace of graphic help on a card can increase between 20 and 30% the quality of performance of certain work tasks carried out by workers with intellectual disability.

• This advantage contrasts with the high cost or lower "manageability" of other material resources of natural support based on the use of technology.

     

Exploring the experiences of self-determination of individuals with mild intellectual disabilities and epilepsy

Background

While epilepsy can decrease quality of life and self-determination in individuals without intellectual disabilities, the impact of epilepsy on experienced self-determination in people with intellectual disabilities remains unclear.

Method

We conducted semi-structured interviews with six adults (four men, two women) aged 30–61 with mild intellectual disabilities and drug-resistant epilepsy to investigate their experiences of self-determination. The data were analysed using Interpretative Phenomenological Analysis.

Results

Three main themes were identified: (A) I am a competent person with epilepsy; (B) My social needs: being accepted as I am and stability in relationships; and (C) Being in control.

Conclusions

In this study, the impact of epilepsy on experienced self-determination of people with mild intellectual disabilities outweighs the influence of intellectual disabilities. Identity formation, friendships with peers, and autonomy support in risk management are identified as important topics in supporting this group.