基于ICF构建智力残疾儿童适应性体育课程体系

目的 应用《国际功能、残疾和健康分类》(ICF)对智力残疾儿童的运动功能特点进行分析,并参照教育部《义务教育体育与健康课程标准(2022年版)》构建适用智力残疾儿童的功能定向和体育运动核心素养的适应性体育课程体系。方法 运用《国际疾病分类》(ICD-11)和ICF对智力残疾儿童运动功能、活动和参与功能进行系统分析。依据ICF“生物-心理-社会”的功能、残疾和健康模式以及教育部《义务教育体育与健康课程标准(2022 年版)》,参照美国《适应体育国家标准(第三版)》(APENS-3),构建适用于智力残疾儿童运动功能和运动能力发展要求的、功能定向的适应性体育课程体系。结果 智力残疾儿童可能表现出基本动作发展缓慢、体适能水平较差、运动能力弱、运动动机不足等问题。适应性体育课程目标主要是促进儿童核心素养,即运动能力、健康行为、体育品德的发展,并且掌握运动技能和发展运动能力,包括运动能力发展目标、动作发展目标、体育活动参与度目标、健康目标、适应与赋能目标。根据体育活动的类型,课程内容包括体适能类活动、运动技能训练类活动以及运动项目相关类活动。适应性体育课程实施过程涉及教材编写和教学建议。适应性体育课程实施效果评价可以从运动能力的发展、动作发展、体育活动的参与程度、健康行为的养成、对自然环境和社会环境的适应能力方面进行,运用整体、多维的评价方式全面评价智力残疾儿童的动作发展以及运动核心素养的养成。在开发适应性体育课程中,还应该确定无障碍环境与辅助技术的适用性。结论 运用ICD-11和ICF对智力残疾儿童的健康状况、主要功能和运动能力进行了系统分析。基于ICF的生物-心理-社会的健康模式,参照教育部《义务教育体育与健康课程标准(2022年版)》和APENS-3,构建了智力残疾儿童适应性体育课程开发的理论架构,并且建立了功能导向的适应性体育课程体系,该课程体系强调儿童体育运动核心素养的养成,即运动能力、健康行为、体育品德的发展。     

Cultural considerations for children with intellectual and developmental disabilities

The United States has been and continues to be a multicultural society. Many children are born into two cultures, sharing a different one with each parent. Children with intellectual and developmental disabilities (I/DD) may belong to a minority culture, the additional culture of disability, and the culture of poverty. After an introduction to culture and its characteristics, the focus of this article is on strategies pediatric nurses can use to assess and intervene with minority children with I/DD and their families in a culturally sensitive manner. Suggestions for future research are provided.     

Implementation of inclusive education for children with intellectual and developmental disabilities in African countries: a scoping review

Abstract

Purpose: To advance understanding of practices that support inclusion of children with intellectual and developmental disabilities in inclusive education classrooms in Africa by conducting a review of the extant literature.

Methods: Five academic databases were searched supplemented by a hand search of key journals and references of included studies. Two authors independently screened studies via a reference manager (Covidence) which allowed for blinding. A third author was consulted in cases of conflict.

Results: Thirty articles that provided empirical evidence of inclusive education implementation were included. Eight articles highlighted practices that support inclusion of children with intellectual and developmental disabilities. Using Bronfenbrenner’s bioecological framework, findings revealed that inclusive education implementation is influenced by factors on the bio level, micro level, meso level, and macro level. Recommendations for promoting inclusive education implementation are provided.

Conclusions: Inclusion goes beyond teachers and requires strong commitment of other stakeholders such as families and governments. To guarantee the smooth inclusion of children with special education needs and particularly with intellectual and developmental disabilities, a set of practices validated through rigorous research as supportive and unique and that can be universal to Africa is wise.

• Implications for rehabilitation

• A number of strategies were identified that can improve the classroom inclusion of children with intellectual and developmental disabilities. Development of policies that support such strategies could improve implementation.

• Inclusion goes beyond teachers. Rehabilitation professionals (i.e. occupational therapists) and educational professionals should partner to identify practical solutions to the challenges of creating inclusive environments for children with special education needs.

• Committing more resources and time towards the development and implementation of special education policies can advance the successful inclusion of children with special education needs.

     

Bridging the equity gap: health promotion for adults with intellectual and developmental disabilities

Health is influenced by political, economic, social, cultural, environmental, behavioral and biological conditions--either positively or negatively. Health promotion aims to make these factors more favorable through health advocacy. Advocating for physical, mental, and social health requires that individuals with I/DD have opportunities to identify and realize their aspirations, develop the capacity to satisfy their needs, and possess the ability to adapt and/or cope with the environment. Because health is both an individual and a social responsibility, effective health promotion strategies must incorporate linkages between health and development, particularly for vulnerable and disadvantaged groups where deprivation in health and economic resources exist simultaneously and reinforce each other [6]. Incorporating health and development at the core of health promotion activities addresses issues of poverty, poor health, and unemployment, while accounting for social, cultural and economic differences. Health promotion enables people with I/DD to achieve their health goals by ensuring equal opportunities and resources. This includes having supportive environments, access to information, and life skills and opportunities to make healthy choices. People cannot achieve their health goals unless they can control health determinants. Health promotion efforts require coordinated action from all interested groups (e.g., government entities, health and other social and economic sectors, nongovernmental and voluntary organizations, local authorities, industry and media), including individuals, families and communities. Community-based health promotion emphasizes community participation, along with empowerment of community members to address inequities and increase control over their health [3]. Individual satisfaction and participation are critical components in community coalitions that are providing health promotion programs. Moreover, community leadership, shared decision-making, linkages with other organizations, and organizational climate can predict satisfaction, participation, and planning. Health becomes a resource for everyday life when individuals with I/DD are empowered and can participate in health promotion activities that are based in their community.     

People with intellectual disabilities and their need for cancer information.

Many people with intellectual disabilities will be affected by cancer in their lifetime. There is a lack of available knowledge about people with intellectual disabilities' understanding and experience of cancer, and about their need for cancer information. The principal aim of the study was to explore the information needs of people with intellectual disabilities who are affected by cancer. This was a qualitative, hypothesis generating study. Nine people with intellectual disabilities who were affected by cancer were identified using a purposive sampling method; five of these participated in the study. Data collection included observation of the use of a pictorial cancer information book designed for people with intellectual disabilities, and semi-structured interviews. Data analysis revealed three themes: (1) "Nobody told me": the desperate need for cancer information; (2) "That reminds me": telling my own story; and (3) "I don't know much about cancer": the difficulties of the staff supporting people with intellectual disabilities to read the cancer information book. The people with intellectual disabilities in this study were not provided with information about cancer. They wanted this information, and appeared to be capable of comprehending it. Further development of accessible information materials around cancer and palliative care is needed.     

Alcohol education for patients: some nurses need persuading

Nurses form the largest group of health care workers and given their repeated contact with patients are in a good position to develop their health education role. Alcohol is the third major cause of morbidity and mortality and alcohol education is an important part of patient care. As part of a prospective study to assess the effects of early identification and education for those patients drinking to excess, we assessed nurses' attitudes towards screening patients for alcohol related problems, their knowledge of what constituted harmful drinking and their views on alcohol education for those at risk of harming their health. While nurses themselves were receptive to alcohol education a sizeable proportion remained unconvinced of the long term benefits of education for those who drink to excess. Alcohol researchers and health education still have some way to go in persuading health professionals of the benefits of incorporating health education into their everyday practices.     

Promoting sexuality across the life span for individuals with intellectual and developmental disabilities

Sexuality is a human right that is important to all individuals regardless of age, gender, orientation, or developmental level. Sexuality is closely related to a person's self-concept and self-esteem. Individuals with I/DD have a right to sexuality and sexual expression. Nevertheless, persons with I/DD have historically been denied this right, and many structural and attitudinal barriers exist to their healthy sexuality. Paradigms in sexuality education have shifted toward recognizing sexuality as a human right, a major life resource, and an integral part of one's makeup. To broadly address the development of healthy sexuality for individuals with I/DD, the issue needs to be normalized, not ignored or avoided; which means involving parents, staff, and professionals. Working with parents to overcome parental overprotection and social isolation is critical. Parents can provide opportunities for their sons and daughters to network and form meaningful personal relationships, with peers including encouraging association with peers outside of school or work hours.     

Health care transition planning for adolescents and emerging adults with intellectual disabilities and developmental disabilities: Distinctions and challenges

Purpose

The purpose of this article is to provide the reader with insight and enhanced understanding of the health care transition planning process for adolescents and emerging adults with intellectual disabilities and developmental disabilities. There are distinctly different programmatic considerations that need to be addressed in advancing their transfer of care to adult providers and promoting their transition to adulthood. These differences are due in part to the federal and state legislative initiatives that were established in the education, rehabilitation, employment, and developmental disabilities service systems. In contrast, no comparable federal and state mandates exist in the system of health care. The legislative mandates in education, rehabilitation, and employment are presented and discussed as well as the federal legislation on rights and protections for individuals with intellectual disabilities and developmental disabilities. Consequently, health care transition (HCT) planning involves application of a framework of care that is characteristically different than the planning efforts undertaken for adolescents and emerging adults (AEA) with special health care needs (SHCN)/disabilities and for typically developing AEA. The best practice HCT recommendations are discussed in the context of this intellectual disabilities and developmental disabilities framework of care.

Conclusions

Health care transition planning for adolescents and emerging adults with intellectual disabilities and developmental disabilities involves additional and distinctly clinical and programmatic models of care.

Practice Implications

Health care transition planning guidance for adolescents and emerging adults with intellectual disabilities and developmental disabilities are provided based upon best practice recommendations.     

The need for continuing professional education for nurses

This study was conducted among a total of 100 first level nurses, working within the St Helens & Knowsley Health Authority in the north of England. The aim was to discover the extent to which nurses were aware of the need to continue their education beyond the basic level of nursing, and to ascertain what steps were taken to ensure competence in practice.     

Nursing care resources for individuals with intellectual and developmental disabilities across the life span

This article provides resources that can be used by nurses working with individuals with intellectual and developmental disabilities (I/DD) across the life span and in a variety of settings. Resources include books, articles, videos, disability-related organizations, professional organizations, and agencies providing disability-related services. Additionally, resources are provided on a range of topics, including advocacy, issues across the lifespan for individuals with I/DD, health promotion, and legislation.     

Psychosocial theories of depression for individuals with intellectual and developmental disabilities: a historicist perspective

The mental health care system has historically marginalized individuals with intellectual and developmental disabilities (I/DD). Until the mid-1980s, many clinicians doubted that individuals with I/DD were capable of depression (Sovner & Pary, 1993). Although it is now generally accepted that individuals with I/DD do have depression, they may not be treated or may be inappropriately treated (Matson et al., 2000). A historicist perspective takes into account the effect of marginalization on science and practice. Depression has both biological and psychosocial aspects. Key groups of theories regarding the psychosocial aspects of depression include psychodynamic/psychoanalytic, behavioral, cognitive, and ecological/interpersonal theories (Clark, Beck, & Alford, 1999; Joiner, Coyne, & Blalock, 1999). The application of psychosocial theories of depression to individuals with I/DD continues to reflect their marginalization and oppression. Behavioral theories of depression are limited in their conceptions for research, identification, and treatment of depression but continue to be used widely with individuals with I/DD. Cognitive theories of depression are widely used in research and treatment of depression in the general population, but have limited usage among individuals with I/DD. Interpersonal theories of depression are used in the general population and have many benefits, but are only now being investigated for use with individuals with I/DD. In this article, theories of depression as applied to individuals with I/DD are discussed from a historicist perspective.     

Caring for adults with intellectual disabilities: perceived challenges for nurses in accident and emergency units

AIM: This paper reports a study exploring the experiences of nurses in accident and emergency units caring for people with intellectual disabilities. BACKGROUND: People with intellectual disabilities are increasingly in contact with healthcare professionals in accident and emergency units. Often this contact occurs within the accident and emergency service, an area in which staff care for a diverse range of people. The experiences of people with intellectual disabilities within acute general hospitals in the United Kingdom and internationally has largely been reported as quite negative. Conversely, little is known about the experiences of nurses working in acute general hospitals, nor the exact nature of any challenges they encounter, in providing care to people with intellectual disabilities. This lack of understanding weakens opportunities for nurses to reduce barriers to providing an equitable service for people with intellectual disabilities. METHOD: Five focus groups were conducted with 27 accident and emergency nurses from five hospitals in Northern Ireland in the spring of 2004. The data were then coded and recurring themes identified. FINDINGS: This paper focuses on two themes: lack of knowledge of the nature of intellectual disability and dependence on carers. Whilst these themes have been acknowledged in the existing literature, they have received limited attention and exploration. The experience of fear and vulnerability was considered by participants to be a consequence of their lack of knowledge. The experience of these emotions is viewed as a key factor in nurses' over-dependence on patients' informal carers. CONCLUSION: Increased awareness is needed among professionals in accident and emergency units of the abilities and needs of people with intellectual disabilities.     

In-home toxic chemical exposures and children with intellectual and developmental disabilities

Despite the focus on preventing toxic chemical exposures during pregnancy, the perinatal period, and childhood, health professionals have given little attention to the risks and effects of toxic chemical exposures on children with intellectual and developmental disabilities (DD). Children with DD may be at higher risk due to behaviors that persist past a developmentally appropriate age, communication skills, motor skills, nutrition issues, and health problems related to DD. This article examines exposure of children to lead, mercury, and environmental tobacco smoke, three toxicants known to affect children's health and development. The authors identify sources of these toxicants, examine research documenting their effects on children, consider strategies to prevent and manage exposure, identify characteristics and behaviors placing children with DD at increased risk of exposure, and discuss implications for health providers.