As the obesity rate in America continues to rise, the levels of physical activity have persistently declined at a rapid pace across all age groups. This trend is demonstrated most significantly in individuals diagnosed with intellectual disabilities (ID). Due to the high obesity rate in individuals with ID, it is crucial to find an effective intervention to increase physical activity. The purpose of this study is to compare the effectiveness of token reinforcement and monetary reinforcement for increasing physical activity among adults with ID, to assess preference for token or monetary reinforcement, and to evaluate the effects of choice of reinforcement procedure on physical activity. An ABAB design with an alternating treatments design was used to compare the two conditions (token reinforcement and monetary reinforcement). In the second intervention phase, the participants chose between the two reinforcement conditions. Results showed that both reinforcement conditions increased physical activity.

Behavioral contracts were used to reduce the socially inappropriate and stigmatizing behaviors of adult men diagnosed with an intellectual disability. All three participants were residing in an intensive residential habilitation facility and receiving 24 hour supports due to the intensity of their problem behaviors. A multiple baseline across subjects with a series of reversals within the intervention phase was used to compare and evaluate the effectiveness of two types of behavioral contracts: one based on the function of the behavior and the other based on highly preferred items. Brief functional analyses were conducted to determine the function of the participants' problem behavior and multiple stimulus without replacement preference assessments were conducted to establish a hierarchy of highly preferred items. Based on the results of the brief functional analyses, all three participants' problem behaviors were likely to be maintained by attention. Results showed that the behavioral contracts resulted in a substantial decrease in maladaptive behaviors for all of the participants and, conversely, an increase in the use of functionally equivalent replacement behaviors; one of the participants showed differentiation between the treatment conditions, indicating that a functional approach might be more beneficial for some individuals.

The Support and Service Act (LSS) is a rights law that is intended to guarantee good living conditions for people with extensive and permanent disabilities. The law is intended to make it possible to receive support to be able to "live like others". The National Board of Health and Welfare describes participation as a "fundamental part of the law's values”. Participation is also one of the general principles in the UN Convention on the Rights of Persons with Disabilities. The purpose of this qualitative essay is to increase knowledge of support staff's perceptions of users' participation, and the purpose and questions have been answered through semi-structured interviews with five support staff at a group home. The theory is based om Shiers model for participation. The results showed how important support staff's attitude is in creating participation, but also how crucial augmentative and alternative communication (AAC) is, how support staff need to perceive and interpret the residents' behavior and other expressions and that the residents have different opportunities for participation depending on whether the decisions to be made are of a concrete or more abstract nature. / Lagen om stöd och service (LSS) är en rättighetslag som ska garantera personer medomfattande och varaktiga funktionsnedsättningar goda levnadsvillkor. Lagen ska göradet möjligt att få stöd för att kunna ”leva som andra”. Socialstyrelsen beskriverdelaktighet som en ”bärande del av lagens värdegrund”. Delaktighet hör också till deallmänna principerna i FN:s konvention om rättigheter för personer medfunktionsnedsättning. Syftet med denna kvalitativa uppsats är att öka kunskapen omstödpersonals uppfattningar om brukarnas delaktighet, och syfte och frågeställningar harbesvarats genom semistrukturerade intervjuer med fem stödpersonal vid engruppbostad. Teorin som används är Shiers modell för delaktighet. Resultatet visade påhur viktig stödpersonals attityd är i skapandet av delaktighet, men också hur avgörandealternativ och kompletterande kommunikation (AKK) är, hur stödpersonal behöveruppfatta och tolka de boendes beteende och andra uttryck samt att de boende har olikamöjligheter till delaktighet beroende på huruvida de beslut som ska fattas är av konkreteller mer abstrakt natur.

The purpose was to examine, from a staff perspective, the participation of people with intellectual disabilities who live in group homes and lack verbal communication skills. Six persons who worked at three different group homes were interviewed for a qualitative study. The theories of empowerment and salutogenesis were used to analyse the result. The results showed that the residents were involved in everyday decisions such as the choice of food, clothes and that they had the opportunity to influence activities and everyday routines. The staff proved to be a decisive factor for the resident’s participation in everyday life. Factors that constituted an opportunity for participation were the staff's ability to communicate with the residents through body language or alternative complementary communication, staff density and the staff's attitude and knowledge. Factors that constituted an obstacle to participation were collaboration with other departments and the staff's views on right and wrong. / Syftet var att utifrån ett personalperspektiv undersöka delaktighet hos personer med intellektuell funktionsnedsättning som bor på gruppbostad och saknar verbal kommunikationsförmåga. Sex anställda från tre olika gruppbostäder intervjuades i en kvalitativ intervjustudie. Resultatet analyserades med hjälp av teorierna empowerment och salutogenes. Resultatet visade att de boende med IF hade möjlighet att vara delaktiga i vardagliga beslut såsom val av mat, kläder samt att de hade möjlighet att påverka vardagsrutiner och val av aktiviteter de ville utföra. Personalen visade sig vara en avgörande faktor för de boendes möjlighet att vara delaktiga i vardagen. Faktorer som utgjorde en möjlighet för delaktighet var personalens förmåga att kommunicera med de boende genom kroppsspråk eller alternativ kompletterande kommunikation, personaltäthet samt personalens bemötande och kunskap gällande de boende. Faktorer som utgjorde hinder för delaktighet var samverkan med andra verksamheter och personalens synsätt gällande rätt och fel.

Because many individuals with developmental disabilities prefer to be as independent as possible, strategies need to be developed to teach them functional skills. Video prompting is a fairly new technology, in which a person learns to engage in a complex behavior by viewing steps of a task analysis on video. The steps are broken down so that the task is more manageable for the individual. The present study evaluated how many steps needed to be presented in the video model for the learner to acquire a functional skill. Three individuals between the ages of 17 and 29 and diagnosed with mental retardation were selected as participants. The target behaviors were to complete a 10 component laundry skill in a group home setting. Starting with viewing the entire task on video, the task was broken down into halves, then thirds, and so on until the individual performed all steps to criterion. A multiple baseline design was used to show the results of the video prompting procedure. The results showed that one individual learned the task with 5 steps in each video segment, another learned the task with the video broken into 4, 3, and 3 segments, and the final participant did not learn from video. For this participant, a least to most prompting procedure was effective.

Kommunala besparingar är ett återkommande, och högaktuellt, fenomen. I bespa-ringstider försätts lokala politiker i situationer där prioriteringar behöver göras, gällande resursfördelning. Historien visar att redan utsatta människor, som har be-gränsade möjligheter till att få sina röster hörda, i tillfällen som dessa kan hamna än mer i skymundan. Det är ofta verksamheter som vänder sig till att kunna stötta enskilda individer som lever med funktionsnedsättning som blir bortprioriterade. Dessa former av verksamheter kan exempelvis vara den som är i fokus för denna studie; särskilda bostäder inom LSS för individer inom pk1, som lever med intel-lektuella- eller neuropsykiatriska funktionsnedsättningar, såsom autism.I besparingstider kan det hävdas att både enskilda individerna, samt det yrkesverk-samma inom särskilda LSS-boenden för pk1 blir påverkade. Denna kandidatupp-sats syftar därför till att försöka redogöra för upplevelser som boendepersonal kan tänkas ha kring arbetssituationen, under dessa förhållanden. Både gällande deras arbetsmiljö, deras insatser till stödanvändare och gällande hanteringen av ett allt mer begränsat handlingsutrymme. Sammanfattningsvis visar resultaten att boen-depersonalen befinner sig i en så kallad “ond cirkel”, där arbetsmiljö och insatser till stödanvändare brister men kvalitetssäkring genom avvikelsehanteringen bort-prioriteras. Boendepersonalen åtar sig ansvaret för att de ej kan tillfredsställa de behov som stödanvändarna har, i den omfattning som behövs. Således blir vissa målformuleringar, enligt LSS (1993:387), emellanåt svåra att uppfylla, till följd av olika målkonflikter, som kan hävdas bli än mer aktuella i besparingstider. / The Swedish law called LSS can enable extensive support for people with special needs so they can live a life like any other. While the Swedish municipalities have the main responsibility to enable this support, economic savings are now current in many of the different municipalities. The aim of this study was therefore to ex-plore the staff's experiences from working in LSS-operations, like group homes for individuals with autism, cognitive- and developmental disabilities, during mu-nicipality savings. To explore this, semi-structured interviews were used as a base for a thematic analysis.The findings show that staff within LSS group homes sometimes feel that their re-sources are inadequate, that their work conditions are stressful and sometimes can result in an emotional tare regarding bad consciousness towards the individuals living there. The results also show a vicious circle, where lack of time often means that the staff priorities other assignments other than paperwork regarding quality improvements. The consequences of a municipality saving mode can nonetheless be the most noticeable for the individual in need of the support. It can harm an individual's living conditions and empowerment. The conclusion from this is that the conflicting objectives from politicians, organizations, and the law LSS, often results in consequences for staff and individuals during municipality savings.

Genom definitionen av sexualitet från Världshälsoorganisationen (WHO) tydliggörs sexualitetens centrala och grundläggande del av att vara människa. Rätten att oberoende av bland annat funktionsnedsättning själv bestämma över sin kropp och sexualitet står formulerad i de mänskliga rättigheterna, vilka förtydligas ytterligare i konventionen om rättigheter för personer med funktionsnedsättningar. För personer med intellektuella funktionsnedsättningar har omgivningen och framförallt yrkesverksammas attityder och föreställningar kring sexualitet visat sig påverka möjligheterna till dessa sexuella rättigheter. I detta tar denna studie sin utgångspunkt. Syftet för studien är att identifiera och belysa attityder och föreställningar kopplat till sexualitet, kön och intellektuella funktionsnedsättningar bland yrkesverksamma inom gruppbostäder enligt LSS. Vidare syftar studien också till att belysa yrkesverksammas syn på den egna rollen i relation till stödanvändares sexualitet. Genom semistrukturerade intervjuer, vilka kompletterades med vinjetter, har materialet till undersökningen samlats in och vidare analyserats. Resultatet tyder på överlag positiva och tillåtande attityder och föreställningar bland yrkesverksamma. Gällande kön uppvisades vissa skillnader bland de yrkesverksammas föreställningar, vilka främst berörde risker för sexuella övergrepp. Av resultatet framkom vidare en central upplevelse av ansvar. De yrkesverksamma uttryckte att det genom deras yrkesroll åligger dem ett ansvar att såväl stötta, främja, skydda och möjliggöra för stödanvändare att uttrycka och utveckla sin sexualitet. Vidare uttrycktes svårigheter att veta hur detta ansvar kan erbjudas i form av stöd och ett behov av vägledande riktlinjer som stöttar yrkesverksamma i situationer kring stödbehov kopplat till sexualitet blev tydligt. / From the definition of sexuality by the World Health Organization (WHO), sexuality stand as a central and fundamental part of being human. The right to independently, regardless of e.g. disabilities, decide over your own body and sexuality is written in the declaration of human rights, which is further clarified in the convention of the rights of people with disabilities. For individuals with intellectual disabilities, the surrounding community and foremost the professionals’ attitudes and perceptions about sexuality, has proven to influence the concession of these sexual rights. The aim of this study is to identify and elucidate attitudes and perceptions connected to sexuality, gender and intellectual disabilities among professionals working at group homes in accordance with LSS. Further, this study aims to illuminate the professionals’ view on their own role, relating to the user’s sexuality. Semi-structured interviews, supplemented with case-descriptions, formed the material which was then transcribed and further analysed. The results mainly indicates positive and allowing attitudes and perceptions among the professionals. Regarding gender, certain discrepancies among the professionals’ perceptions were shown, which mainly concerned the risks of sexual abuse. The personnel articulated that, embedded in their professional role, laid a responsibility to support, enable and protect the users’ opportunities to express and develop their sexuality. Further, difficulties knowing how this responsibility could be offered as support was expressed by the sample. A need for guidelines serving the professionals in situations connected to user-support and sexuality was identified as essential.

Direct-care staff working with individuals with developmental disabilities (DD) are frequently exposed to challenging behavior from residents and expected to respond correctly to challenging resident behavior, but often receive insufficient training due to lack of resources and high staff turnover (e.g., Collins, 2012; Collins, Higbee, & Salzberg, 2009; Haberlin, Beauchamp, Agnew, & O’Brien, 2009; Pelletier, McNamara, Braga-Kenyon, & Ahearn, 2010). Training methods such as Behavioral Skills Training (BST) are highly intrusive and require high amounts of resources (e.g., Parsens, Rollyson, & Reid, 2012). Research suggests technological based alternatives are more cost effective, decreases training time and response effort from management, and increases distance learning opportunities and dissemination capabilities. The purpose of this study was to evaluate the use of a hierarchical training model that incorporated video modeling, video modeling+assessment, and BST to train behavior management strategies for direct-care staff working with adults with developmental disabilities. Subjects were exposed to the most cost effective training approach first (i.e., video model) and sequentially moved to more intrusive methods (i.e., video model+assessment, & BST) as needed. All subjects implemented behavior management strategies with fidelity after exposure to technological based training alternatives (i.e., video model, video mdoel+assessment).

<p>The aim of our study was to investigate how much self-determination persons with intellectual disabilities living in group-homes have when it comes to recreational activities. We studied what the recreational activities looked like, if there was any self-determination concerning recreational activities and which factors influenced self-determination for persons with intellectual disabilities. We used qualitative interviews with persons with intellectual disabilities, next of kin and personnel at group-homes. The result has been analyzed from earlier research, central concepts as self-determination and recreational activities and the theory of empowerment. The most important results that emerged in our study were; that recreational activities for persons with intellectual disabilities varied substantially, that there is a large number of to recreational activities available and no one seemed directly displeased with their recreational activities. Organized recreational activities mostly took place in segregated environments. This circumstance led to discussions within the interview-groups. The interviewed persons were of the opinion that there existed self-determination concerning recreational activities, however, there were many factors influencing the degree of self-determination. These factors were; the level of intellectual disability, the personnel at group-homes, organisation and personnel-resources, economy and public communications.</p>

The aim of our study was to investigate how much self-determination persons with intellectual disabilities living in group-homes have when it comes to recreational activities. We studied what the recreational activities looked like, if there was any self-determination concerning recreational activities and which factors influenced self-determination for persons with intellectual disabilities. We used qualitative interviews with persons with intellectual disabilities, next of kin and personnel at group-homes. The result has been analyzed from earlier research, central concepts as self-determination and recreational activities and the theory of empowerment. The most important results that emerged in our study were; that recreational activities for persons with intellectual disabilities varied substantially, that there is a large number of to recreational activities available and no one seemed directly displeased with their recreational activities. Organized recreational activities mostly took place in segregated environments. This circumstance led to discussions within the interview-groups. The interviewed persons were of the opinion that there existed self-determination concerning recreational activities, however, there were many factors influencing the degree of self-determination. These factors were; the level of intellectual disability, the personnel at group-homes, organisation and personnel-resources, economy and public communications.