Promoting Training and Employment Opportunities for People with Intellectual Disabilities: International Experience

The rights of people with disabilities have been given new attention with the entry into force of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in May 2008. The provisions of the CRPD contribute to other international standards concerning persons with disabilities, signalling a dramatic shift in international policy terms. In relation to training and employment, for example, states are called on to provide opportunities for disabled people alongside non-disabled people. Many countries have already declared their commitment to the goal of inclusion of persons with disabilities through ratification of the CRPD, while others have signed it with a view to ratification. Many have also ratified ILO conventions, committing themselves to the goals of equal opportunity and non-discrimination. People with intellectual disabilities are entitled to benefit from the provisions of the CRPD and ILO Convention concerning the Vocational Rehabilitation and Employment (Disabled Persons), 1983 (No. 159), as well as people with other kinds of disabilities. Yet, they are frequently not well placed to gain from this changed emphasis on inclusion. In many developing countries, in particular, they are often excluded from school and deprived of opportunities to acquire relevant vocational skills at all, presenting further disadvantages when it comes to seeking jobs. Yet, experience in many countries shows that, with the right training, support in the workplace as required, and the right opportunities, they can make valued contributions in the workplace and to a country’s economy. Measures to open employment opportunities for this group of persons with disabilities in line with the CRPD and ILO Convention No. 159 can build on extensive experience in recent decades in developing new approaches to training and employment. The review of international experience carried out for this working paper highlights good practice in supporting people with intellectual disabilities in integrated employment settings. Evidence clearly points to better outcomes for employees with intellectual disabilities, when they work in integrated settings, with appropriate supports. The aims of this paper are to: examine changes over time in the understanding of intellectual disability and the capacity of persons with disabilities to learn; provide an international overview of employment options for people with intellectual disabilities, with special emphasis on Supported Employment (SE) models; examine and critically analyse from a research perspective examples of SE across a range of low- and high-income countries; and make recommendations for the expansion and future development of inclusive employment options for this population. Section 1 provides a brief overview of the shift from classifying people with intellectual disabilities on the basis of IQ bands to a support needs 2 framework. It then explores the impact of research initiatives that demonstrated the learning capacity of people with intellectual disabilities in a work environment. Section 2 discusses the range of employment models currently accessed by people with intellectual disabilities in countries around the world. It highlights that, despite the emergence of a number of more inclusive practices, the predominant model continues to be sheltered employment in segregated settings, and that a high proportion of people with disabilities are unemployed. Section 3 reviews recent and emerging developments in promoting training and employment opportunities for people with intellectual disabilities, drawing from examples in both high- and low-income countries, with reference to factors facilitating and posing challenges to the spread of supported employment. The findings of research on these developments are summarized. Section 4 examines the policy implications of research findings and draws some conclusions about the way forward. The Working Paper has been informed by the report of the ILO/Irish Aid sub-regional conference People with Intellectual Disabilities – Opening Pathways to Training and Employment, held in Lusaka, Zambia 9-11 March 2010 (ILO, 2010a), and the accompanying Lusaka Declaration People with Intellectual Disabilities: Achieving Full Participation in Training and Employment (ILO, 2010b). The views of several individuals with intellectual disabilities on what work means to them are presented in different parts of the report, so that their voices are reflected, in line with the self-advocacy movement which is gaining momentum

Stepping out: information for families of young people with a disability moving from secondary school to adult life

Leaving secondary school means making the change from being a school student to becoming a young adult. It is a critical time and can have a significant impact on the lives of the young person and family members. This transition period involves many changes which can be both challenging and rewarding. It is a time of moving towards independence and may not always be an easy or smooth process. Choices about further study, training for work and moving out of home all need to be considered

Securing Personal Input from Individuals Aging with Intellectual Disability: Do Differing Methodologies Produce Equivalent information?

Research is limited on whether differing methodologies for facilitating personal contributions from individuals aging with intellectual disability produce equivalent knowledge outcomes. Two matched purpose-developed tools examined five quality-of-life domains. Results showed substantial variance between qualitative interview responses and Likert-scale data, and indicate validity concerns for using either methodology in isolation

The I-CAN : using e-Health to get people the support they need

Background: The I-CAN is a comprehensive, reliable and valid system of identifying and classifying support needs of people with disabilities based on the conceptual framework of the International Classification of Functioning, Disability and Health (ICF) [1] and the American Association on Intellectual and Developmental Disability (AAIDD) supports concept [2,3]. Originally developed for people with Developmental Disability, the I-CAN's application of internet technologies is currently being trialled in Mental Health, Rehabilitation Medicine and other disciplines. Conceptual underpinnings, research and implementation to date are summarized. Method: ICF based domains covering Health & Well Being and Activities & Participation have been refined over several versions. A total of 1012 individuals with disabilities across the eastern states of Australia were assessed using the first three versions, and 193 with the fourth versions. Studies investigated reliability, concurrent and predictive validity and user satisfaction. A fourth internet-based version has been implemented and is under continuing investigation and refinement. Results: The I-CAN instrument demonstrated good reliability and validity in studies to date. Domain scales effectively discriminated a range of intensities of support for people with various disabilities, with highest support needs generally recorded by individuals with multiple disabilities and ageing issues. Correlations between I-CAN and adaptive behaviour scales were mixed. The ICAN scales measure individual support needs. However, regression analysis suggests that staffing and other organizational factors play a significant role in resource allocation apart from individual support need. There was general satisfaction with the assessment process from stakeholders and participants groups. Several brief case examples shall be presented. Conclusions: The I-CAN provides a reliable and valid tool for assessing and reporting on the support needs of people with disabilities using a process that involves the person, their family, friends and staff as appropriate. Several possibilities exist for this unique tool and the application of the ICF framework to e-health

Making the move: information for families of children with a disability making the move from primary to secondary school

Making the move provides information to help families support their son or daughter with a disability in making the move from primary school to secondary school. The information has been developed from: research findings, focus group meetings held across NSW, input from parents and service providers to a website forum, advice from a Project Advisory Group established by Ageing, Disability and Home Care, Department of Human Services NSW (ADHC). This resource is not intended to be exhaustive. Children and young people with a disability and their families are diverse and have wide ranging needs, interests and talents. For this reason the booklet gives general information only. Readers are encouraged to use the links and contacts to seek more specific information that will be relevant to their own needs and interests. Contacts, including phone numbers and websites, are located in the Useful contacts section at the end of this booklet

Family quality of life and the building of social connections: practical suggestions for practice and policy

Copyright (c) 2018 Meaghan Edwards, Trevor Parmenter, Patricia O'Brien, Roy Brown This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.Family quality of life literature suggests that families with a member with an intellectual/developmental disability frequently face major difficulties in building social connections with others. They experience low levels of social support, face challenges in community inclusion, and are at risk of social isolation. These challenges may also be faced by other types of marginalized families. Families experiencing serious illness, families experiencing intrafamily violence, and migrant families or those seeking political asylum, for example, may also become isolated and find themselves without pathways to connections with others. We present practical suggestions intended for families and professionals interested in action and intervention at the personal, community, program, and policy levels to encourage the growth of social connections and prevent isolation of families experiencing social exclusion. The suggestions will come from families with a member with a disability and the findings of a study examining the social support of families as it relates to quality of life

Toward mid-infrared, subdiffraction, spectral-mapping of human cells and tissue: SNIM (scanning near-field infrared microscopy) tip fabrication

Scanning near-field infrared microscopy (SNIM) potentially enables subdiffraction, broadband mid-infrared (MIR:3–25-μm wavelength range) spectral-mapping of human cells and tissue for real-time molecular sensing, with prospective use in disease diagnosis. SNIM requires an MIR-transmitting tip of small aperture for photon collection. Here, chalcogenide-glass optical fibers are reproducibly tapered at one end to form a MIR transmitting tip for SNIM. A wet-etching method is used to form the tip. The tapering sides of the tip are Al-coated. These Al-coated tapered-tips exhibit near-field power-confinement when acting either as the launch-end or exit-end of the MIR optical fiber. We report first time optimal cleaving of the end of the tapered tip using focused ion beam milling. A flat aperture is produced at the end of the tip, which is orthogonal to the fiber-axis and of controlled diameter. A FIB-cleaved aperture is used to collect MIR spectra of cells mounted on a transflection plate, under illumination of a synchrotron- generated wideband MIR beam

Psychopathology in Young People With Intellectual Disability

Context Comorbid severe mental health problems complicating intellectual disability are a common and costly public health problem. Although these problems are known to begin in early childhood, little is known of how they evolve over time or whether they continue into adulthood. Objective To study the course of psychopathology in a representative population of children and adolescents with intellectual disability. Design, Setting, and Participants The participants of the Australian Child to Adult Development Study, an epidemiological cohort of 578 children and adolescents recruited in 1991 from health, education, and family agencies that provided services to children with intellectual disability aged 5 to 19.5 years in 6 rural and urban census regions in Australia, were followed up for 14 years with 4 time waves of data collection. Data were obtained from 507 participants, with 84% of wave 1 (1991-1992) participants being followed up at wave 4 (2002-2003). Main Outcome Measures The Developmental Behaviour Checklist (DBC), a validated measure of psychopathology in young people with intellectual disability, completed by parents or other caregivers. Changes over time in the Total Behaviour Problem Score and 5 subscale scores of the DBC scores were modeled using growth curve analysis. Results High initial levels of behavioral and emotional disturbance decreased only slowly over time, remaining high into young adulthood, declining by 1.05 per year on the DBC Total Behaviour Problem Score. Overall severity of psychopathology was similar across mild to severe ranges of intellectual disability (with mean Total Behavior Problem Scores of approximately 44). Psychopathology decreased more in boys than girls over time (boys starting with scores 2.61 points higher at baseline and ending with scores 2.57 points lower at wave 4), and more so in participants with mild intellectual disability compared with those with severe or profound intellectual disability who diverged from having scores 0.53 points lower at study commencement increasing to a difference of 6.98 points below severely affected children by wave 4. This trend was observed in each of the subscales, except the social-relating disturbance subscale, which increased over time. Prevalence of participants meeting criteria for major psychopathology or definite psychiatric disorder decreased from 41% at wave 1 to 31% at wave 4. Few of the participants (10%) with psychopathology received mental health interventions during the study period. Conclusion These results provide evidence that the problem of psychopathology comorbid with intellectual disability is both substantial and persistent and suggest the need for effective mental health interventions

Influence of the Environment on Participation in Social Roles for Young Adults with Down Syndrome

Background: The concept of disability is now understood as a result of the interaction between the individual, features related to impairment, and the physical and social environment. It is important to understand these environmental influences and how they affect social participation. The purpose of this study is to describe the social participation of young adults with Down syndrome and examine its relationship with the physical and social environment. Methods: Families ascertained from the Down syndrome ‘Needs Opinion Wishes’ database completed questionnaires during 2011. The questionnaires contained two parts, young person characteristics and family characteristics. Young adults’ social participation was measured using the Assessment of Life Habits (LIFE-H) and the influences of environmental factors were measured by the Measure of the Quality of the Environment (MQE). The analysis involved descriptive statistics and linear and logistic regression. Results: Overall, participation in daily activities was higher (mean 6.45) than in social roles (mean 5.17) (range 0 to 9). When the physical and/or social environment was reported as a facilitator, compared to being no influence or a barrier, participation in social roles was greater (coef 0.89, 95%CI 0.28, 1.52, coef 0.83, 95%CI 0.17, 1.49, respectively). The relationships between participation and both the physical (coef 0.60, 95% CI -0.40, 1.24) and social (coef 0.20, 95%CI -0.47, 0.87) environments were reduced when age, gender, behavior and functioning in ADL were taken into account. Conclusion: We found that young adults’ participation in social roles was influenced more by the physical environment than by the social environment, providing a potentially modifiable avenue for intervention

From the Field -- Implementation of Disability Studies within Post Secondary Education: An Australian Perspective

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