Adults with intellectual disability (ID) experience twice the rate of mental health disorders when compared to the general population. Despite increased prevalence of mental health disorders, caregivers supporting adults with ID rarely seek mental health counseling supports, but instead are referred to psychiatric services. There is limited understanding among researchers about the lack of counseling services for adults with ID. The purpose of this study was to explore the lived experiences of mental health counselors who have worked with adults with ID in a counseling relationship. Hermeneutic phenomenology was used to develop thick and rick experiential detail about counselor experiences providing services for adults with ID. The conceptual framework involved the social constructivist and hermeneutic phenomenological lenses. The 8 participants were recruited using a purposive snowball sampling method and provided data through semi-structured interviews. Data analysis involved coding for themes with the help of NVivo software. Findings indicated counselor perceptions of adults with ID as being stigmatized and marginalized within their communities, which aligned with literature. Adults with ID must be prepared for counseling and there must be appropriate adaptations to support meaningful participation and benefit from counseling interventions. Exposure to adults with ID was a factor in counselors being willing to engage with this population, and questions about counselor education and preparedness were a consistent theme. The social implications of exploring this gap will lead to a better understanding of counselor experiences and can inform the professional body about how to increase access to counseling services for adults with ID.

Unemployment is a problem for individuals with disabilities. Supported employment provides occupational supports for individuals with disabilities to get a job and keep that job once hired. The Performance Diagnostic Checklist-Human Services (PDC-HS) is used to address performance problems with employees in human services settings. This study evaluated using the PDC-HS with three adults with intellectual disabilities working in supported employment at a library cleaning shelves. The results of the PDC-HS identified insufficient training and prompting as barriers. The matched intervention package was effective in increasing performance of the shelf-cleaning task for all participants. Participant responses to a social validity questionnaire indicated that all participants thought the study was fair, they liked the way they were taught to clean the shelf, and felt that being in the study helped them improve at their job.

This study examined the attitudes held by police officers towards persons with mental retardation with regard to the domains of knowledge, social willingness, affect and contact. It also investigated relationships among group membership and perspectives towards mental retardation. An analysis of relationships between the four domains was also completed. A descriptive correlational design was employed to survey police officers, pairing the Social Distance Questionnaire with a researcher-designed instrument consisting of open-ended questions aligned with each domain. The sample included one hundred and eighty police officers from five different bureaus in one county in Central Florida. Results of the study indicate that police officers hold generally positive attitudes towards persons with mental retardation, are knowledgeable about persons with mental retardation, and are socially willing to interact with such persons. In the domains of contact and affect, a discrepancy was found between the open-ended responses and the questionnaire data. The latter showed scores were skewed slightly higher than the neutral point of the scale, but the open-ended responses reflected lower contact and less positive affect. This inconsistency was attributed to instrumentation as the level of contact and affect were measured differently between the two surveys. This study found that group membership by gender and race does in fact play a role in the shaping of police officer perceptions towards mental retardation, with females having more positive affect and Hispanic officers scoring lower in social willingness. Significance was not found for either chronological age or years of experience. The analysis of relationships among the domains showed that each domain has a significant relationship with the other, with the strongest relationship between affect and social willingness. According to the study results, the most significant influence on a police officer's attitudinal score is the officer's social willingness to interact with persons who have that disability. The level of knowledge between the study participants was variable, but the responses and level of social willingness demonstrated more consistency when compared with the overall score. Information gained from this study is useful for developing disability awareness curriculum for public service providers and higher education.

Bakgrund: Det råder en begränsad konsensus gällande en universell definition av begreppet självständig bland arbetsterapeuter, trots ett dagligt användande av begreppet. Forskningen visar på två beskrivningar av funktionsnedsättningar (medicinsk modellbeskrivning som utgår från fysisk kapacitet och social modellbeskrivning som betonar möjlighet till val, kontroll och självbestämmande) som i sin tur påverkar synen på självständighetsbegreppet. Ingen tidigare forskning är funnen som beskriver hur personer med lindrig intellektuell funktionsnedsättning uppfattar begreppet och deras upplevelser av att vara självständig respektive inte självständig/beroende. En betydelsefull kunskap för att kunna arbeta klientcentrerat. Syfte: Syftet är att beskriva hur personer med lindrig intellektuell funktionsnedsättning uppfattar begreppet självständig och vilka upplevelser de har av att vara självständiga respektive inte vara självständiga/beroende. Material och metod: Deltagarna i studien blev strategiskt valda utifrån ändamålsenligt urval. Individuella semi-strukturerade intervjuer gjordes med tio personer med lindrig intellektuell funktionsnedsättning (fem kvinnor, fem män i åldrarna 22-65 år) via Skype. Intervjuerna analyserandes utifrån kvalitativ innehållsanalys. Resultat: Personer med lindrig intellektuell funktionsnedsättning anser att självständig betyder; att klara saker själv, att man kan vara självständig trots hjälp, att bestämma över sitt eget liv samt att hjälpa andra – vara kompetent. Upplevelser av att vara självständig är en förutsättning för att känna frihet. De beror på faktorer som personens inre resurser och en möjliggörande omgivning. Att inte vara självständig, känna sig beroende upplevs då man inte klarar, behärskar saker/situationer och inte blir lyssnad på. Nedsatt hälsa leder också till upplevelse av beroende. Slutsats: Självständig i betydelsen att bestämma över sitt eget liv är avgörande för upplevelsen av att vara självständig. Ju större begränsningar i självbestämmandet desto lägre upplevelse av att vara självständig och vice versa. Självständig trots hjälp, förutsätter ett partnerskap (ömsesidigt beroende) mellan personen och hjälparen. När man hjälper andra är man kompetent och självständig. Betydelse: Arbetsterapeuter bör uppmärksammas på att identifiera och stödja aktiviteter där personer med lindrig intellektuell funktionsnedsättning ges möjlighet att hjälpa andra och betyda något för någon annan. / Background: There is a limited consensus regarding a universal definition of the concept independent among occupational therapists, despite the daily use of the concept. The research shows two descriptions of disabilities (medical model description based on physical capacity and social model description that emphasizes the possibility of choice, control and self-determination) which in turn affects the view of the concept of independence. No previous research has been found that describes how persons with mild intellectual disability perceive the concept and their experiences of being independent and not independent / dependent. An important knowledge to be able to work client-centered.   Aim: The aim is to describe how persons with mild intellectual disability perceive the meaning of independent and what experiences they have of being independent versus not independent/dependent. Material and methods: The participants in the study were strategically selected based on an appropriate selection. Individual semi-structured interviews were performed with ten persons with intellectual disabilities (five women, five men, aged 22-65), by Skype. The interviews were analyzed using qualitative content analysis. Results: Persons with mild intellectual disability believe that independent means; to handle things by yourself, that one can be independent despite recieving help, to make one’s own life decisions and to help others - be competent. Experiences of being independent is a qualification for feeling freedom. It depends on factors like the person's internal resources and an enabling environment. Not being independent, feeling dependent is perceived when you cannot cope, master things/situations and are not being listened to. Reduced health also entiles  experiencing dependence. Conclusions: To be independent, in the sense of making one’s own life decisions, is central for the experience of feeling independent. The more one’s self-determination is limited, the less one experiences being independent and vice versa. Independent despite help, presupposes a partnership (interdependence) between the person and the helper. When you help others - you are competent and independent. Significance: Occupational therapists should be alerted to identifying and supporting activities where persons with mild intellectual disabilities are given the opportunity to help others and mean something to someone else.

<p>The aim of this study is to describe and examine the characteristics of inclusion of children with disabilities in the kinder garden and primary school in Belarus. The data in this study were collected through interviews with special teachers and staff at the Developing and Rehabilitation center. The interviews were supported by child-observations and a literature study. Staying in boarding schools prevents handicap students from integrating with the society as well as getting social experience. Integrated education demands the combination of two regularities: education of children with normal development and special education of children with psycho-physiological problems. Many research works consider the interconnection between socio-cultural development of the society and the values in upbringing which are prioritized in the society. Socialisation is possible when the child is involved in the processes of the daily life as well as interacting with adults and friends. It is easier for a child to adapt to a social behaviour when he realises what happens around him, understanding the subjective processes which happen inside other people and when the child can use his knowledge and experience on practice. Therefore, socialization is both a process and a result of realisation and active implementation of a social experience by a child. Integration is a systematic stage in the development of special education caused by change in the attitude of the society and state towards individuals with disabilities, admitting their rights for the equal opportunities in different spheres of life including education. Successful implementation of integrative education depends a lot on the level of material, organisational, educational as well as methodological in educational institutions. Moreover, this process depends on socio-psychological factors and moral atmosphere in the society. Practical solution of the problems in integration attracts not only teaching staff in specific institutions, children with different development and their parents but also children and their parents, teachers in normal secondary schools.</p>

<p>The aim of this study was to investigate the emotions among the staff at the group housings when they observe the caretakers expressions of masturbation and how the staff handles these expressions in their daily and long-term work. The theoretical concepts that were used in this study are group housing as a public and private arena, occupational role, relation, humanistic effort, pedagogical effort, empowerment, care ethic and emotions. The concepts are related to each other and constitutes the foundation for the analysis of the empirical data used in this study. A qualitative study was carried out, in forms of half structured interviews with six informants, of which the majority was women. It came to light that the interviewees only had positive feelings for the caretaker’s expressions of masturbation. The interviewees had different procedures in their daily work, while there were more similarities in how the staff worked in a long-term perspective with the caretaker’s expressions of masturbation.</p>

<p>Syftet med denna uppsats är att undersöka hur socialsekreterare i några kommuner bedömer behovet av stöd för föräldrar med en lindrig utvecklingsstörning eller svagbegåvning. Vidare är syftet att undersöka vad socialsekreterarna upplever vara problematiskt vid dessa bedömningar, samt att inventera vad tidigare forskning säger på området. Forskningsöversikten kommer i uppsatsen att användas som analysverktyg. Som metod använder jag mig av en kvalitativ ansats i form av halvstrukturerade intervjuer. Resultatet visar att alla de tre intervjuade socialsekreterarna gör en vanlig utredning. Utöver det anlitar socialsekreteraren i den andra kommunen ett utredningshem, där familjen bor under en längre tid och där särskilda bedömningsinstrument används. I den tredje kommunen gör socialsekreteraren en utredning i en utredningslägenhet, där familjen vistas dagtid under en längre tid, men utan särskilda bedömningsinstrument. Svårigheter som upplevdes var bland annat beroende av själva utvecklingsstörningen eller svagbegåvningen i sig, att föräldrarna kan ha svårt att se sitt eget behov av stöd. Bemötandet och risken att föräldern ska känna sig kränkt och om föräldern ska räcka över tid var också svårigheter som togs upp. Överlag upplevdes detta vara ett svårt område med svåra bedömningar. Slutsatsen är bland annat att, antagligen, på grund av det relativt lilla antalet föräldrar med utvecklingsstörning och svagbegåvning så har inte alla kommuner utarbetat särskilda bedömningsmetoder just för den här gruppen. Men detta skulle behövas eftersom forskning visat att rätt bedömning är viktigt för att kunna utforma adekvat stöd.</p><p>Nyckelord: utvecklingsstörning, svagbegåvning, föräldraskap, bedömning, socialsekreterare.</p> / <p>Intellectual disability and parenthood</p><p>-social welfare secretaries assessment of the need of support for parents with an intellectual disability, and the difficulties around these assessments</p><p>The main purpose of this study is to examine how social welfare secretaries do their assessments of the need of support for parents with an intellectual disability, and what their experiences is about difficulties doing these assessments. The purpose is also to examine what earlier research says in the area. The research summary will be used for the analysis of the empirical data. The method used is a qualitative approach with semi structured interviews in three municipalities (A, B, C). The result shows that in all three examined municipalities (A, B, C) they do an ordinary investigation. In municipality B social welfare secretaries also use a special institutional flat where the family lives for a longer period of time and where special methods of assessment are used. In municipality C social welfare secretaries also use a special flat for purpose of investigation where the family stays day time for a longer period of time, but without using special methods of assessment. The result also shows that difficulties in doing these assessments depend for example on the intellectual disability in itself: parents not being able to understand their own need of support. It also shows difficulties in addressing the parents, without making them feel insulted. Generally the experiences of the interviewed social welfare secretaries is that it is a complicated area with complicated assessments. An important conclusion of this study is that, probably because of the relatively small numbers of parents with an intellectual disability, not all municipalities have developed special methods for this special group of people. But this will be needed, because as the research summary shows, a correct assessment by the social welfare secretary is necessary in order to be able to give adequate support.</p><p>Key words: intellectual disability, parenthood, assessment, social welfare secretary</p>

<p>It has been suggested that persons with intellectual disabilities (ID) manifest the full range of mental health problems. The main purpose of this thesis is to adapt and evaluate two clinical assessment instruments and to investigate the occurrence of mental health problems as well as psychiatric care utilisation in persons with ID. </p><p>The psychometric properties of a Swedish version of the two instruments [Reiss Screen for Maladaptive Behaviour (RSMB) and the Psychopathology Inventory for Mentally Retarded Adults (PIMRA)] were investigated in a random, institutional and clinical sample of administratively defined (ADDEF) adults with ID (n = 199). The analyses suggest that the RSMB could be used as intended by staff as a primary screening device for the identification of mental health problems in persons with ID, and that the PIMRA had a potential to identify individuals with a specific mental disorder. The psychometric evaluation reveals that the Swedish versions of the RSMB and PIMRA measure a construct related to the diagnostic categories in the DSM-III-R and DSM-IV. This construct could be conceptualised as mental health problems.</p><p>The RSMB and PIMRA results show that the overall occurrence of mental health problems in ADDEF samples of persons with ID (175 men and 148 women) ranged from 34 to 64%.</p><p>The preliminary level of ID was mild (23%), moderate (39%) and severe (38%). The most common mental health problems were aggressive and self-injurious behaviours, depression, anxiety and adjustment disorders. In registered patients receiving out- or in-patient psychiatric care the occurrence of adults with an ICD-10 diagnosis of ID was approximately 1% (70 to 90% had a mild level of ID). </p><p>In contrast to the high frequency of mental health problems reported, psychiatric care was used infrequently. This tendency is particularly evident in persons with moderate and severe ID.</p>

The main purpose was to study if children with intellectual disability interact or participate differently with preschool staff and peers compared to their non-disabled peers and how preschool teachers experience interaction and participation for children with intellectual disability and children with typical development. The results from study I show that there are more similarities than differences between the groups. There are no differences between the groups neither in engagement nor in what kind of material the children use or in what setting they play. The results indicated that children with intellectual disability interacted in the same contexts as their peers. Significant differences were found, indicating that the children with intellectual disabilities communicate less and especially less with peers. Children with intellectual disability are more often close to a teacher than children with typical development. Teacher’s communication indicates that teachers communicate and initiate more often to children with intellectual disabilities. Results from study II showed that the main difference between the target child and the control child expressed from the teachers was in the area communication. Participation differed in structured and unstructured situations even if it is not significant. The child with intellectual disability was less involved in his/her live situation in unstructured situations. The results from Individual Plans showed that goals and methods about communication were more common as a goal than interaction even if the teachers expressed that interaction is the child’s main problem.

It has been suggested that persons with intellectual disabilities (ID) manifest the full range of mental health problems. The main purpose of this thesis is to adapt and evaluate two clinical assessment instruments and to investigate the occurrence of mental health problems as well as psychiatric care utilisation in persons with ID. The psychometric properties of a Swedish version of the two instruments [Reiss Screen for Maladaptive Behaviour (RSMB) and the Psychopathology Inventory for Mentally Retarded Adults (PIMRA)] were investigated in a random, institutional and clinical sample of administratively defined (ADDEF) adults with ID (n = 199). The analyses suggest that the RSMB could be used as intended by staff as a primary screening device for the identification of mental health problems in persons with ID, and that the PIMRA had a potential to identify individuals with a specific mental disorder. The psychometric evaluation reveals that the Swedish versions of the RSMB and PIMRA measure a construct related to the diagnostic categories in the DSM-III-R and DSM-IV. This construct could be conceptualised as mental health problems. The RSMB and PIMRA results show that the overall occurrence of mental health problems in ADDEF samples of persons with ID (175 men and 148 women) ranged from 34 to 64%. The preliminary level of ID was mild (23%), moderate (39%) and severe (38%). The most common mental health problems were aggressive and self-injurious behaviours, depression, anxiety and adjustment disorders. In registered patients receiving out- or in-patient psychiatric care the occurrence of adults with an ICD-10 diagnosis of ID was approximately 1% (70 to 90% had a mild level of ID). In contrast to the high frequency of mental health problems reported, psychiatric care was used infrequently. This tendency is particularly evident in persons with moderate and severe ID.