Community Based Dietician Services for People with Intellectual and Developmental Disabilities

Background. People with intellectual and developmental disabilities (IDD) experience significantly poorer health outcomes and a shorter life expectancy when compared to the general population. People with IDD are also more likely to become over weight or develop obesity because of poor nutrition and lack of education. Due to the health disparities that people with IDD experience and the high prevalence of developing obesity it is important that preventive health measures, such as cost-effective nutrition interventions and services, are readily available.Specific Aims. The aim of this study is to explore how Medicaid Home and Community Based Services (HCBS) 1915(c) waivers – the largest providers of long term services and supports for people with IDD – across the United States provided dietician services for people with IDD.Method. This study analyzed fiscal year (FY) 2015 HCBS waivers for people with IDD from across the United States (n = 111) to determine how dietary services were provided, particularly focusing on service utilization and expenditures, including unduplicated participants, total projected spending, average spending per participant, reimbursement rates, and average annual service provision per participant. Services’ definitions were also analyzed for trends.Findings. We found that dietician services were not widely provided in HCBS waivers – less than 1% of the approximately 630,000 people with IDD supported by HCBS waivers in FY 2015 were projected to receive dietician services. Moreover, despite being useful for health promotion, .01% of FY 2015 funding ($26.5 billion) was projected for dietician services. There was also a lack of consistency across states and servicesDiscussion. People with IDD who do not receive support services are less likely to engage in health services or health promotion activities and more likely to develop secondary conditions;for this reason, it is imperative that states utilize HCBS waivers to provide dietician services

Getting Out There: Community Support Services for People With Intellectual and Developmental Disabilities in Medicaid HCBS Waivers

Despite an increased number of community-based services, people with intellectual and developmental disabilities (IDD) continue to struggle with meaningful community participation and often feel they are not valued community members. This study examined how community support services, which support physical placement and community integration, were allocated in Medicaid 1915(c) HCBS waivers, the largest provider of long-term services and supports for people with IDD in the United States. Community support services totaled $447.5 million of projected funding in fiscal year 2014. While community transition services funded expenses required to establish a basic household for the initial transition, community integration services promoted a successful community placement by utilizing natural supports and developing skills necessary to maintain community integration

Integrating Mental Skills into a Physical Activity Program for Children and Adolescents with Intellectual Disabilities Intégration des capacités intellectuelles à un programme d'activité physique pour les enfants et les adolescents ayant une déficience intellectuelle

Past studies have found physical activity (PA) programs can be effective in promoting mental skills; however, no research has examined a PA program that incorporates mental skills training for children and adolescents with intellectual disabilities (ID). The purpose of this study was to examine the potential benefits experienced by children and adolescents with ID as they engaged in a 6-week PA and mental skill routine-based program. Participants included four children and adolescents aged 8-15 with ID, and their mothers. Mental skills training was integrated into existing PA program activities to enhance young people " s confidence, focus, and anxiety management. Data were collected through parent interviews, parent questionnaires, and the researcher " s field notes, and examined through content analysis. Results highlight themes related to confidence, focus, and anxiety management, as well as participants " enjoyment of gym sessions and ongoing challenges. Findings suggest mental skills training in a PA setting should be further examined as an alternative therapy for young people with ID. Résumé Même si, dans le passé, des études avaient conclu que les programmes d'activité physique (AP) pouvaient enrichir les capacités intellectuelles (CI), aucune ne s'était penchée sur un programme d'AP intégrant la formation axée sur les capacités intellectuelles à l'intention des enfants et des adolescents ayant une déficience intellectuelle. La présente étude visait donc à examiner les bienfaits éventuels d'un programme routinier de six semaines axé sur l'activité physique et les capacités intellectuelles pour des enfants et des adolescents ayant une déficience intellectuelle. Le groupe de participants réunissait quatre enfants et adolescents de 8 à 15 ans ayant une déficience intellectuelle et leurs mères. Intégrée aux programmes d'éducation physique existants, la formation axée sur les CI avait pour objet d'accroître la confiance en soi des jeunes, d'améliorer leur concentration et de les aider à mieux gérer leur anxiété. Les données ont été recueillies à l'aide des entrevues menées avec les parents, des questionnaires Spassiani & Fraser-Thoma

Developing a mathematics module for students with intellectual disability in higher education

Individuals with intellectual disability (ID) have largely been excluded from accessing all levels of education and participating in college life. Fortunately, academic institutions around the world are slowly beginning to examine how they can support equal citizenship of individuals with ID within their community. In Ireland, one university has recently accredited an innovative higher education programme for college students with intellectual disabilities. One of the emergent modules focuses on mathematics and recognises the importance of developing students’ numeracy skills in order to confidently navigate today’s society. Despite the increased emphasis on general mathematics education, the authors found there to be a dearth of research regarding the development of such a module for students with ID. This paper describes the design and development of the mathematics module and also details its piloting and evaluation with a cohort of students with ID who were enrolled in a higher education course in an Irish university

Integrating Mental Skills into a Physical Activity Program for Children and Adolescents with Intellectual Disabilities Intégration des capacités intellectuelles à un programme d'activité physique pour les enfants et les adolescents ayant une déficience intellectuelle

Past studies have found physical activity (PA) programs can be effective in promoting mental skills; however, no research has examined a PA program that incorporates mental skills training for children and adolescents with intellectual disabilities (ID). The purpose of this study was to examine the potential benefits experienced by children and adolescents with ID as they engaged in a 6-week PA and mental skill routine-based program. Participants included four children and adolescents aged 8-15 with ID, and their mothers. Mental skills training was integrated into existing PA program activities to enhance young people " s confidence, focus, and anxiety management. Data were collected through parent interviews, parent questionnaires, and the researcher " s field notes, and examined through content analysis. Results highlight themes related to confidence, focus, and anxiety management, as well as participants " enjoyment of gym sessions and ongoing challenges. Findings suggest mental skills training in a PA setting should be further examined as an alternative therapy for young people with ID. Résumé Même si, dans le passé, des études avaient conclu que les programmes d'activité physique (AP) pouvaient enrichir les capacités intellectuelles (CI), aucune ne s'était penchée sur un programme d'AP intégrant la formation axée sur les capacités intellectuelles à l'intention des enfants et des adolescents ayant une déficience intellectuelle. La présente étude visait donc à examiner les bienfaits éventuels d'un programme routinier de six semaines axé sur l'activité physique et les capacités intellectuelles pour des enfants et des adolescents ayant une déficience intellectuelle. Le groupe de participants réunissait quatre enfants et adolescents de 8 à 15 ans ayant une déficience intellectuelle et leurs mères. Intégrée aux programmes d'éducation physique existants, la formation axée sur les CI avait pour objet d'accroître la confiance en soi des jeunes, d'améliorer leur concentration et de les aider à mieux gérer leur anxiété. Les données ont été recueillies à l'aide des entrevues menées avec les parents, des questionnaires Spassiani & Fraser-Thoma

Examining Chronic Disease, Pain-Related Impairment, and Physical Activity Among Middle-Aged and Older Adults in Canada: Implications for Current and Future Aging Populations

Purpose: With high levels of chronic disease (CD) and pain-related functional impairment (PFI), and low levels of physical activity (PA) among middle-aged and older adults, it is important to investigate ways to design age- and health condition-appropriate PA interventions.Methods: Using Canadian Community Health Survey data, relationships among CD, PFI, covariates, and PA were examined in mid- (40-59y; n=36,288) and later- (60y+, n=44,890) life.Results/Conclusions: PA levels varied between middle-aged and older groups according to CD and PFI status. Results are useful for developing targeted and tailored PA interventions to support the health of current and future populations

“Why Are You Here? Can’t You Cope at Home?” The Psychiatric Crisis of People With Intellectual Disabilities and the Community’s Response

Introduction: Individuals with intellectual disability (ID) are high users of emergency mental health services and can experience stigmatization in these circumstances. The purpose of the study was to examine the experiences of people with ID living in the community who interact with emergency services as a result of a psychiatric crisis, from the perspective of individuals with ID and their caregivers. Methods: In this qualitative study, we interviewed 12 individuals with ID, four family members and five direct support staff who visited emergency departments (EDs) during psychiatric crises. Thematic analyses were conducted on interview transcripts. Results: Four themes emerged: ID and mental health stigma, stigma preventing people from accessing services, lack of support, and concern regarding care planning. Participants reported feeling either dismissed or disrespected by emergency personnel, that staff are ill-prepared to support this population, and that they experience poor transitions between hospital and community.Conclusions: Work needs to be done to reduce stigma experienced by those with ID and mental health issues when using emergency services. Education and training should target individuals, caregivers, community providers, and emergency personnel

‘Now that I am connected this isn't social isolation, this is engaging with people’: Staying connected during the COVID‐19 pandemic

BackgroundThe COVID-19 global pandemic has put adults with intellectual/developmental disabilities at greater risk of being socially excluded due to physical distancing. Technology has been looked at as a tool for adults with intellectual/developmental disabilities to stay connected, however, little is known about this topic. The purpose of this study was to explore how a grassroots disability organisation used technology to help adults with intellectual/developmental disabilities feel socially connected during the pandemic.MethodsData were collected through questionnaires, attendance records, and field notes; and analysed through trend and thematic analysis.FindingsFour main themes emerged from the data: active leadership, mental wellbeing, technology/digital inclusion, and safety.ConclusionThese findings suggest that when participants overcome technological barriers they found it easy to socially connect online during lockdown

Evaluating the Implementation of Health Checks for Adults With Intellectual and Developmental Disabilities in Primary Care: The Importance of Organizational Context

Compared to other adults, those with intellectual and developmental disabilities have more health issues, yet are less likely to receive preventative care. One strategy that has shown success in increasing prevention activities and early detection of illness is the periodic comprehensive health assessment (the health check). Effectively moving evidence into practice is a complex process that often receives inadequate attention. This qualitative study evaluates the implementation of the health check at two primary-care clinics in Ontario, Canada, and the influence of the clinic context on implementation decisions. Each clinic implemented the same core components; however, due to contextual differences, some components were operationalized differently. Adapting to the setting context is important to ensuring successful and sustainable implementation