Neurodevelopmental disorders and development of project of life in a lifespan perspective: between habilitation and quality of life

AbstractFor some years, the term “project of life” has become widely used in the field of neurodevelopmentaldisorders, and, at the same time, it has begun to make its way in many socialand health planning documents. However, beyond its relatively widespread use, this termdoes not yet possess an adequate and shared frame of the main underlying decision-makingprocesses. In particular, there is a need to identify the crucial questions for orientingthe choice of goals within the adolescent transition, which represents the complex hingebetween childhood and adulthood. Moreover, adulthood, which is often completely devoidof culturally and socially shared references, is still critical precisely because of thelack of future direction prompts usually represented by the stages of development. In thiscase, the themes of quality of life functioning as a guiding compass appear pertinent andmuch more relevant. The present contribution is, therefore, an attempt to present, in aunitary manner, the decision-making processes and questions at the basis of a constructof “project of life” shared within the scientific and associative communities

Paths and Technologies in the Life Project of People with Disabilities: International Perspectives and Educational Potential

The purpose of this paper was to analyse the core of the quality of life, intended as a complex construct with specific and transversal features. The approach to this issue, by linking it to the great emergency of disability in adulthood, pushes the analysis into deep conceptual pedagogical reflections, which lead the authors\u2019 initial reflections to focus on the theoretical framework related to the quality of life model and subsequently on the identification of some areas of intervention as a tangible application of the quality of life model. New perspectives and innovative potentials for the quality of life of adults with disability are investigated to reach new awareness, which can also be applied in different life contexts. The paper mentions meaningful trajectories, also from the international scene, aiming to guarantee significantly oriented life trajectories

Intellectual disability, exercise and aging: the IDEA study: study protocol for a randomized controlled trial

Background: People with intellectual disabilities (ID) have low levels of physical activity (PA) together with accelerated aging profiles. Adherence to PA interventions for persons with ID is low based on barriers such as motivation. The IDEA study aims to determine the effect of two types of exercise programs, continuous aerobic (CAEP) vs sprint interval training (SIT), designed for seniors with ID on health-related physical fitness, cardiovascular parameters, quality of life (QoL), and emotional and cognitive function. Methods: In this trial, ninety seniors with ID between the ages of 40 and 75 yrs. from occupational health centers from the Autonomous Region of Catalonia (Spain) will be recruited. Participants will be randomly allocated to the CAEP, SIT, and control group. Both intervention groups will train 3 days/week, 1.5 h/day over 6 months. Outcome variables will be assessed at baseline, 6 months and 12 months. The outcome variables include weight, height, body composition, cardiorespiratory fitness, muscle strength, balance, flexibility, cardiovascular parameters (blood pressure, pulse-wave velocity, pulse-wave analysis), QoL and cognitive function. The intervention effect will be determined with mixed models with repeated measures to assess changes in the outcome variables over time (baseline to month 12) and between study arms. Relationship between variables will be analyzed with appropriate regression analyses. Discussion: Various studies reported on CAEP and SIT as exercise interventions for persons with ID with beneficial outcomes on body composition, fitness and blood pressure. To our knowledge, this is the first trial designed to analyse the positive changes on fitness, PA levels, cardiovascular, QoL and cognitive function promoted by CAEP training and SIT in seniors with ID. The findings of this study will assist in the development of more effective exercise interventions to ensure better compliance and adherence to exercise in seniors with ID

Children with disrupted attachment histories: Interventions and psychophysiological indices of effects

Diagnosis and treatment of children affected by disruptions of attachment (out of home placement, multiple changes of primary caregiver) is an area of considerable controversy. The possible contribution of psychobiological theories is discussed in three parts. The first part relates the attachment theoretical perspective to major psychobiological theories on the developmental associations of parent-child relationships and emotional response. The second part reviews studies of autonomic reactivity and HPA-axis activity with foster children, showing that foster children show more reactivity within physiological systems facilitating fight or flight behaviours rather than social engagement, especially foster children with atypical attachment behaviour. The third part is focused on treatment of children suffering from the consequences of disrupted attachment, based on a psychotherapy study with psychophysiological outcome measures. Implications are discussed for theory, diagnosis, and intervention

Clinician Factors in Psychotherapy Disparities for People With Intellectual Disabilities and Co-Occurring Mental Illness

An estimated 4.5 million Americans with intellectual disabilities (ID) have lived in the community for over twenty years now, following the closing of institutions that once isolated them from the public (Scott, Lakin & Larson, 2008). It has since become evident that this group has the same and more vulnerabilities of developing mental illness than the general public but often lack access to therapeutic service (Whitaker & Read, 2005). Unfortunately society’s lack of interaction with and education about this population has contributed to a number of misconceptions and fears. The hypothesized variables for the behavioral health disparity included: level of exposure to people with ID, attitudes about people with ID and specialized education offered for providing therapy or other behavioral health services to people with ID. Psychiatric and psychology trained clinicians were asked to identify current practices, and experiences relative to people with ID, as well as thoughts about providing therapy and related services to people from this group when psychopathology is diagnosed. This study sought to identify 1) factors that influence clinicians to currently provide therapeutic services to the ID population and 2) factors that would influence clinicians’ willingness to provide services to this population. The research, conducted via a survey distributed to behavioral health clinicians throughout Pennsylvania, showed that clinicians are prone to bias, have limited exposure and receive little education or experience in working with people with ID. The benefit of this study comes from the report of those surveyed, indicating that if they received education and training; they would be more likely to add people with ID to their therapeutic caseloads. These finding help identify target areas for addressing the disparity experienced by people with intellectual disabilities, relative to finding clinical therapists, psychiatrists and therapeutic groups willing to meet this population’s behavioral health needs

Assessment of Anger in Persons with Cognitive Limitations : a Revision of the ADS-VII

Assessment of angry patients with mental retardation or borderline intellectual functioning is time consuming. Existing assessment tools may be inadequate for gathering data and for guiding treatment, thus presenting a challenge for practitioners. The Anger Disorders Scale (DiGiuseppe & Tafrate, 2001) samples the cognitive, affective, and behavioral components of anger. However, this scale is a self-report survey for adults of average or higher intellectual functioning. This investigation provided a feasibility test of the Anger Disorders Interview for persons diagnosed with Mental Retardation (ADIMR), a modified version of the Anger Disorders Scale designed as a clinical interview for cognitively limited patients who present with symptoms of anger. Comparisons between the ADIMR and existing assessment instruments for cognitively limited patients will be discussed

Conditionally Sexual: Constructing the sexual health needs of men and teenage boys with a moderate to profound intellectual disability

ABSTRACT This thesis reports on a study which explored the sexual health needs of men and teenage boys with a moderate to profound intellectual disability. Qualitative in design, this study was exploratory in nature as it sought to develop theoretical knowledge in male sexual health as a broad concept as opposed to testing a theory or hypothesis related to sexual health. Literature on sexuality and intellectual disability was reviewed in addition to male-specific literature on intellectual disability. In addition, mainstream literature on sexuality, sexual health, masculinity and men’s health was also reviewed. The literature review highlighted that the intellectual disability specific literature had largely ignored mainstream literature and had failed to acknowledge emerging work in men’s health and masculinities. Moreover, the literature identified a problematised focus toward sexual matters and males with an intellectual disability. The topic of enquiry was explored via an ethnomethodological design. Data consisted of interviews with 17 paid support staff, over 100 hours participant observation in community group homes, and triangulated with relevant artefacts from the field. The constant comparative method was used to analyse the data. Participants described the notion of men and teenage boys with a moderate to profound intellectual disability as being Conditionally Sexual. Conditionally Sexual was framed by three interconnected themes: 1) sexual development, 2) conditionally masculine, and 3) gendered service delivery. Through consideration of the implications to theory, practice, research, and policy, a propositional framework for a masculine health environment has been outlined. This framework is based on a salutogenic notion of male sexual health and the development of a healthy masculinity

Conditionally Sexual: Constructing the sexual health needs of men and teenage boys with a moderate to profound intellectual disability

ABSTRACT This thesis reports on a study which explored the sexual health needs of men and teenage boys with a moderate to profound intellectual disability. Qualitative in design, this study was exploratory in nature as it sought to develop theoretical knowledge in male sexual health as a broad concept as opposed to testing a theory or hypothesis related to sexual health. Literature on sexuality and intellectual disability was reviewed in addition to male-specific literature on intellectual disability. In addition, mainstream literature on sexuality, sexual health, masculinity and men’s health was also reviewed. The literature review highlighted that the intellectual disability specific literature had largely ignored mainstream literature and had failed to acknowledge emerging work in men’s health and masculinities. Moreover, the literature identified a problematised focus toward sexual matters and males with an intellectual disability. The topic of enquiry was explored via an ethnomethodological design. Data consisted of interviews with 17 paid support staff, over 100 hours participant observation in community group homes, and triangulated with relevant artefacts from the field. The constant comparative method was used to analyse the data. Participants described the notion of men and teenage boys with a moderate to profound intellectual disability as being Conditionally Sexual. Conditionally Sexual was framed by three interconnected themes: 1) sexual development, 2) conditionally masculine, and 3) gendered service delivery. Through consideration of the implications to theory, practice, research, and policy, a propositional framework for a masculine health environment has been outlined. This framework is based on a salutogenic notion of male sexual health and the development of a healthy masculinity