Using an accumulation of deficits approach to measure frailty in a population of home care users with intellectual and developmental disabilities: an analytical descriptive study

Potential deficits within-category correlation. Unadjusted odds ratio for 1-year admission to long-term care and the 42 FI items, sorted from strongest to weakest association. (DOCX 16 kb

Are we making a difference in primary care for adults with intellectual and developmental disabilities?

Objectives. To examine the impact of the dissemination of guidelines to physicians and of a population-level health communication intervention on the percentage of adults with intellectual and developmental disabilities (IDD) receiving preventive care through primary care. Methods. Noninstitutionalized adults with IDD in the province of Ontario, Canada, aged 40 to 64 years were matched to Ontarians without such disabilities each fiscal year (FY) from 2003 to 2016. Health administrative data were used to create a composite measure of receipt of recommended preventive primary care. Age-adjusted rates were used to assess trends, and average two-year rate ratios (RRs) and confidence intervals (CIs) were used to evaluate the effectiveness of the interventions. Results. The number of adults with IDD identified ranged from 20 030 in FY 2003 to 28 080 in FY 2016. The percentage of adults with IDD receiving recommended preventive primary care ranged from 43.4% in 2003 to 55.7% in 2015. Men with IDD had a 53.7% increase across the 13 years, while women with IDD only had a 30.9% increase. When evaluating the impact of the interventions, men with IDD were 4% more likely (RR: 1.04; 95% CI: 1.02–1.05) to receive recommended primary care in FY 2015 and FY 2016 as compared to FY 2009 and FY 2010; in contrast, women with IDD were 5% less likely (RR: 0.95; 95% CI: 0.93–0.98). A ­comparable drop was observed among women without IDD. Conclusions. Nearly 45% of adults with IDD in Ontario still do not receive recommended preventive care through primary care. Long-term impacts of the interventions introduced in the province may still occur over time, so ongoing monitoring is warranted. Special attention should be given to the preventive care needs of women with IDD

Shifting our conceptualization of social inclusion

Objective: Social inclusion is a right as well as a goal for community-based services and supports. Yet, there is a lack of consensus as to what constitutes social inclusion, which means that there is no real way to determine and measure services effectiveness. This paper identified current key components, definitions, and conceptual approaches to social inclusion, and determined gaps in the scope and clarity of existing conceptualizations. Method: We conducted a synthesis review on the social inclusion of persons with intellectual and developmental disabilities. We extracted data relevant to the definition of social inclusion, its key principles and elements, as well as its main challenges. We adopted a narrative approach to synthesize the findings. Results: The main challenges in understanding social inclusion are: social inclusion is at risk of being an ideology and may lead to ineffective and potentially harmful strategies; social inclusion is still mainly defined as the acceptance and achievement of the dominant societal values and lifestyle, which may lead to moralistic judgements; social inclusion is often narrowly defined and measured as productivity and independent living, which is inappropriate for people with more severe disabilities; and social inclusion is often limited to the measure of one’s participation in community-based activities. Conclusion and Implications: Shifting our understanding of social inclusion is essential. It means: adopting a proactive perspective that moves beyond theoretical discourse and leads to the identification of tools to improve social inclusion; abandoning the moralistic perspective that tends to impose the view of the dominant group and leaning toward an approach respectful of individuals’ expectations, choices and needs; defining social inclusion from a developmental perspective where one’s social inclusion improves with increased opportunities to interact with others and participate in activities; and including sense of belonging and well-being in our definition and measure of social inclusion

A comparison of the prevalence of chronic disease among people with and without intellectual disability

Some studies have reported the presence of health disparities in people with intellectual disability. This study compared the prevalence of chronic health conditions between people with and without intellectual disability (ID). Health-related data for 791 people with ID were collected through a province-wide mail survey in Quebec, Canada. The distribution of chronic health conditions reported was compared to the data on the health status of the general population. People with ID had higher reported rates of heart disease and thyroid disorder than the general population. We also found that people with ID were less likely to report suffering from arthritis, migraines, back or spinal pain, and food allergies. Significant health differences were found when the ID sample was stratified by etiology (i.e., Down syndrome) and severity of intellectual deficits. We discuss these results and the need for future research to understand the differences found in the health status of people with ID

Beyond an autism diagnosis: Children's functional independence and parents' unmet needs

High demand has resulted in gaps in autism service provision. Our objective was to explore the association between children's functioning and parents' perceived unmet needs. We conducted a cross-sectional study of 97 families of school-aged children with an autism spectrum disorder. Log binomial regression was used to examine the relative risk for unmet need. Families of children with high functional independence had lower unmet need than families of children with moderate functional independence (RR = 0.81, 95% CI = 0.67-0.99). Those who experienced greater impact of the child's disability had greater unmet need (RR = 1.22, 95% CI = 1.03-1.45). The child's functioning and its impact on the family provide insight into unmet need which may inform service planning