Effect of AAC technology with dynamic text on the single-word recognition of adults with intellectual and developmental disabilities

Abstract

Purpose: Single-word recognition can support participation in life, including engagement in leisure activities, navigation through the community, and vocational opportunities. Given the limited reading skills of many adults with intellectual and developmental disabilities (IDD) and limited speech, the current study evaluated the effects of using an augmentative and alternative communication (AAC) app, featuring dynamic text and speech output embedded in visual scene displays, on the single-word recognition performance of six adults with IDD who demonstrated limited speech.

Method: A multiple baseline across participants single-subject design was used. Ten target sight words for each participant were selected on an individual basis, based on participant interest. Intervention consisted solely of interactions between investigators and individual participants using the app.

Result: In the absence of any formal instruction and solely through the use of the AAC app interaction, three of the six participants demonstrated increased accuracy in single-word recognition.

Conclusion: Results from the study were mixed, but suggest that AAC apps which provide the dynamic display of text in conjunction with voice output can assist some adults with IDD in achieving gains in single-word reading.     

Zero tolerance of abuse of people with intellectual disabilities: implications for nursing

Aims. This paper explores the concept of ‘zero tolerance’ to abuse in the context of the professional responsibilities of all nurses. The workability of zero tolerance will be considered in light of findings of a study into abuse. Background. Registered nurses are led to believe that zero tolerance of abuse of patients is the only philosophy consistent with protecting the public. However, the approach of zero tolerance is not without its difficulties. Staff, particularly registered nurses, who come into contact with people with intellectual disabilities have a professional responsibility to prevent and report all forms of abuse. Design. This study used a multiphase, multimethod approach (literature review, survey and focus groups). Methods. The results reported here relate to the focus group stage of the study. There were 70 participants in the focus group who worked either as direct care staff with people with intellectual disabilities or as investigators of abuse. Results. Analysis of recurrent themes indicated that both individual (e.g. a positive value base) and systemic factors (e.g. environment) seemed to have an impact on how staff will respond to abuse. Conclusions. This study found that a ‘hierarchy of abuse’ existed among staff who worked with people with intellectual disabilities. Individual staff members seemed to be ‘weighing up’ what they perceived as serious abuse before reporting areas of concern. This is in contrast to a philosophy of zero tolerance which registered nurses have to adhere to. Relevance to clinical practice. There needs to be a consistent approach to abuse and nurses need to have appropriate training in which to gain confidence in their role in preventing, identifying and responding to abuse of patients or clients.     

The perspectives of people with intellectual disabilities on their experience of voting in UK general elections

Background

People with intellectual disabilities' voting rate within the United Kingdom remains significantly below the population average despite government enacted voting promotion measures. No published academic literature directly involves people with intellectual disabilities when considering their UK general election experiences – this study aims to address this omission.

Methods

Semi-structured interviews were conducted with people with intellectual disabilities (N = 20) about their election experiences during the 2017 (n = 18) and 2019 (n = 8) general elections. Six participants were interviewed around both elections. Data was analysed with template analysis.

Results

Eight themes were produced – election information, political knowledge, political opinions, voting choice process, polling station experience, voting outcome, capacity and support. Theme interactions impacted on election experiences.

Conclusions

While acknowledging diverse experiences, voting outcomes and experiences were particularly impacted by factor interactions concerning election information and/or polling station accessibility, capacity and support. Voting promotion interventions and future research should consider these areas.     

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.

     

Obesity in people with intellectual disabilities: the impact of nurse-led health screenings and health promotion activities

BACKGROUND: Obesity appears to be more common among people with intellectual disabilities, with few studies focusing on achieving weight reduction. AIM: Firstly, to follow-up people identified as overweight and obese following special health screening clinics and to determine the actions taken. Secondly, to evaluate the impact of health promotion classes on participants' weight loss. METHODS: A clinic led by two learning disability nurses was held for all people aged 10 years and over (n = 464) who attended special services within the area of one Health and Social Services Trust in Northern Ireland. In a second study, the nurses organized health promotion classes for 20 people over a 6- or 8-week period. FINDINGS: The health screen identified 64% of adults and 26% of 10-19-year olds as being overweight or obese. Moreover, those aged 40-49 years who were obese had significantly higher levels of blood pressure. However, information obtained from a follow-up questionnaire sent after 3 months suggested that of the 122 people identified for weight reduction, action had been taken for only 34% of them and only three were reported to have lost weight. The health promotion classes, however, led to a significant reduction in weight and body mass index scores. CONCLUSIONS: Health screening per se has limited impact on reducing obesity levels in this client group. Rather, health personnel such as general practitioners, nurses and health promotion staff need to work in partnership with service staff, carers and people with intellectual disabilities to create more active lifestyles.     

The dream school: Mind‐changing perspectives of people with intellectual disabilities

In this study, we analyse the characteristics that define an ideal school, from the perspective of people with intellectual disabilities. we carried out an inclusive research qualitative study with 36 Spanish adults with intellectual disabilities. Information from individual interviews about educational inclusion was summarized on to notecards, allowing participants to place messages into categories on a poster board. Identified themes included facilities and resources; values and rules; intimidation; what students learn; how students learn best; exams; teachers; and classmates. Results highlight the importance of inclusive values and the need for a curriculum that meets the needs of all students.