Nonemergency transportation drivers play a critical role in helping individuals with Intellectual Disabilities (ID) gain access to community integration opportunities. Challenging behaviors can limit access to enrichment opportunities and possibly increase the likelihood that individuals with ID will be isolated from community enrichment activities. The purpose of this study was to determine if positive behavior support training improved nonemergency transportation drivers' perceptions of challenging behaviors displayed by individuals with ID. For purposes of this study, perception was defined as staff (driver) beliefs about the causes of challenging behavior. A convenience sample of 52 nonemergency transportation drivers was chosen from a Logisticare provider list using local zip codes. Data were collected using the Challenging Behavior Attribution Scale (CHABA) before and after training using the Positive Behavior Support Curriculum 2nd Edition. A 2-way ANOVA revealed no statistically significant differences in perception before or after training. Analysis of the data indicated that training had no impact on driver perception of challenging behavior. The drivers who participated in this study appeared to have positive perceptions of challenging behavior, and, as a result, no statistically significant results were found. Perhaps the results of this study might lead community organizations that support individuals with ID to include transportation drivers in team meetings when there are concerns regarding challenging behavior. The drivers' positive perceptions regarding challenging behaviors may be an asset to support teams in developing positive behavior support strategies that improve the quantity of life for persons with ID.

Magister Curationis - MCur / Caring for people with intellectual disability is stressful as they have a reduced ability to cope independently. The stress may be exacerbated by the challenging behaviours intellectually disabled people display and by the lack of social support that care workers may experience. The aim of this study is to explore and describe care workers’ experience of stress and social support whilst caring for intellectually disabled residents with challenging behaviour. A qualitative, exploratory, descriptive phenomenology study was utilised to answer the research question: “What are the experiences of stress and social support of care workers caring for intellectually disabled residents with challenging behaviour at a residential facility in the Western Cape?” A purposive sampling technique was utilised to select ten care workers working at a residential facility for intellectually disabled residents with challenging behaviour in the Western Cape. Lazarus and Folkman’s transactional model of stress and coping has been used to guide the study. Data were collected by means of semi-structured interviews. Colaizzi’s method of data analysis was used to analyse the data. The four main themes that emerged are: (1) acceptance of abuse as a working condition, (2) interpersonal relationships with colleagues, residents and residents’ families, (3) the selfimpacted by an array of emotions and (4) social support and coping strategies used to deal with the stress experienced. The study concluded that care workers’ training does not prepare them to understand and manage residents with challenging behaviour adequately. Formalised training as well as interpersonal skills building is necessary for them to cope with the stress they experience while working with intellectually disabled residents.

As a result of the development and recognition of human rights and of the principle of normalisation, in recent decades sweeping changes have occurred in the living conditions of many people with intellectual disability. The United Nations Declaration on the Rights of Mentally Retarded Persons (1971)contains statements to the effect that, as far as possible, the lives of disabled persons should resemble those of their non-disabled peers, and this presumably extends to sexual expression. However, the words “as far as possible” imply that in some circumstances, limitations on a right may be justifiable. One such circumstance is where a competing right exists, for example, the right to sexual expression has to be balanced against a right to protection. Under some conditions, the provision of protective measures may fall to the criminal justice system, which may be used to afford protection to persons with intellectual disability. Australian jurisdictions have used three different approaches in current legislation: to set a minimum standard of sexual knowledge that must be present before the person is deemed capable of consent to sexual activities; to prohibit sexual relations with persons holding power or authority over the person; and to proscribe all sexual exploitation. This thesis contains proposals for reforms to each category of legislative provisions. First, it is suggested that the standard of knowledge required to support consent should more closely resemble the knowledge required for informed consent to medical procedures. Second, restrictions on sexual activity with persons with intellectual disability based on employment status should be relaxed where the role of the staff member does not confer power to coerce people with intellectual disability. Third, with regard to the prosecution of offences against incapable persons with mental impairment, it is proposed that the charge should be sex without consent. On the other hand, it is argued that prosecution under criminal law is inappropriate where a vulnerable but capable person is deemed to have been exploited. The thesis contains a number of further recommendations for the reform of anomalies which exist between the general law of sexual offences and those committed specifically against persons with mental impairment. It is suggested that marriage be abolished as a defence to sexual acts with an incapable person and that offences against persons with mental impairment carry equivalent penalties to general sexual offences. On the basis of literature reviewed in this thesis, two additional proposals have been made. First, that education in the sexual rights of persons with intellectual impairment should be given to carers so that they do not unduly inhibit the development of sexual relationships by that person. The second proposal is that reform should be accompanied by the provision of repeated, appropriate, detailed and specific sex education of all persons with intellectual impairment and that this education should be based on needs identified in the aforementioned research. The tentative outcome of proposals contained in this thesis is that persons capable of consent would enjoy enhanced freedom to exercise their right to sexual expression, and those incapable of consent would be afforded more certain protection.

This thesis reports the results of a comparison of the experiences of community participation between two groups of people - people with intellectual disability and non-disabled people. An interview schedule was developed, based on the social integration literature, government policy and a small empirical study. The common factors from these three bases were represented in the interview schedule which covered the areas of degree of social contact with family, friends and neighbours; involvement in the local community; and degree of satisfaction with the local community. Thirty people with intellectual disability and sixty non-disabled people were interviewed using the schedule. The non-disabled people lived in the same street (if possible) or within very close vicinity of the people with intellectual disability. The findings of community participation for people with intellectual disability reflected other research, indicating that this group had limited social contact, and reported few friendships in the community, but participated to a large extent in community activities and made use of community facilities. This group were also inclined to report satisfaction with living in, and feeling like part of the community. For non disabled people, the findings reflect a group that does not particularly feel like part of the community and makes limited use of community facilities. However, this group reported regular contact with family, friends and neighbours. The above findings are discussed with relevance to policy, theory, research and practice.

It is well understood that substantial health inequality exists for adults with an intellectual disability (AWID). In comparison to the general population AWID experience higher rates of morbidity and mortality associated with sedentary lifestyles, yet little is known about the role physical activity plays in preventing or mediating this outcome for this segment of society. Without appropriate instrumentation, it is not possible to address the inadequacies that currently exist in the area of physical activity and AWID. The primary aim of the series of studies in this thesis was to develop a psychometrically sound proxy-respondent measurement tool that could be used by researchers, epidemiologists and public health personnel to gather information on the physical activity behaviours of AWID. The International Physical Activity Questionnaire (IPAQ) is an internationally published tool with good psychometric properties when used as a self-report tool with adults without a disability (AWOID), but no evidence exists as to the validity or reliability of this tool when used by proxy respondents to report on the physical activity behaviour of AWID. Given little is known about the energy expenditure characteristics of AWID, nor the accuracy of tools developed for AWOID when applied to AWID, two secondary aims of this thesis were to measure the energy expended by AWID and AWOID during seven common activities of daily living (ADL) and to assess the accuracy of an objective physical activity measurement tool (Caltrac® accelerometer) for use with AWID. Evidence gathered through the studies in this thesis found that as the energy demand of ADL increased there was an increase in the difference between energy expended by AWID and AWOID. Results indicated that AWID achieved moderate-intensity physical activity when walking at a pace of 3.0 km/hr or more. The proxy-respondent telephone questionnaire (IPAQ-ID) described in this thesis allows for universal assessment of the physical activity behaviours of AWID. The IPAQ-ID was found to have measurement properties equivalent to measurement tools used among AWOID. The IPAQ-ID was found to be suitable for use as a surveillance tool by researchers to collect comparable data on health-enhancing physical activity behaviours of AWID.

Little research has been conducted focusing on parent training strategies aimed at teaching parents with an intellectual disability to implement strategies to decrease their child's problem behaviour and increase appropriate behaviours. This study aimed to do two things. First, to examine the effectiveness of an enhanced assessment-based BPT intervention that was implemented by parents with an intellectual disability with children with problem behaviour. Second, the current study also aimed to test the effectiveness of the parent training package used to teach parents to implement the intervention strategies. Importantly, in an attempt to identify the training condition, or combination of conditions, most needed to achieve behaviour change, individual conditions of a multi-condition parent training package were additively introduced during parent training based on the degree of intrusiveness in the target routine combined with the amount of structure required by the teaching strategy. Five parents were taught to implement a functional assessment driven intervention plan aimed at increasing their child's appropriate behaviour and decreasing their problem behaviour during a valued family routine. In order to establish the combination of parent training strategies that were sufficient to teach parents to effectively implement the intervention plan, a series of parent training strategies were introduced in a planned way. The strategies included role-play, verbal instruction, verbal instruction plus feedback, coaching and video-feedback. Results showed that for all parents skill acquisition did not occur until the final phase, video-feedback. Successful implementation of the intervention resulted in a corresponding increase in child appropriate behaviour and decrease in child problem behaviour. In addition to that, parents rated the social validity and contextual fit of the intervention highly.

<p>Levnadsvillkoren för individer med utvecklingsstörning har under de senaste decennierna förändrats till det bättre. Att känna sig delaktig i sitt liv och ha möjligheten att själv påverka livssituationen är viktigt för dessa människor. Uppsatsförfattaren ville med den här studien undersöka om skillnad finns i hur aspekter av delaktighet uppfattas av två grupper; individer med utvecklingsstörning och personer i deras omgivning. En enkätstudie genomfördes med en omarbetad version av ”The Arc’s Self-Determination Scale” (Wehmeyer, 1995).En rangkorrelation visade på samband mellan vissa frågeområden. Resultatet diskuteras i relation till tidigare forskning och till svårigheter att undersöka upplevelser hos personer med utvecklingsstörning.</p>

<p>The aim with this study was to illustrate communicative meetings between people that are visiting and working in two different associations for people with intellectual disabilities. The method we used was interviews. To find out the meaning of the associations for the members creating of identity, participation and self esteem we asked them if they felt stigmatized and if they thought that the associations reduced that feeling and how the pedagogy cooperation between them selves and the coaches were working. The results of the study showed that the members of the association experienced that it had a positive influence according to their creating of identity, participation and self esteem. The members felt that coaching and the pedagogy cooperation had both positive and negative aspects but mostly it worked well.</p>

The aim with this study was to illustrate communicative meetings between people that are visiting and working in two different associations for people with intellectual disabilities. The method we used was interviews. To find out the meaning of the associations for the members creating of identity, participation and self esteem we asked them if they felt stigmatized and if they thought that the associations reduced that feeling and how the pedagogy cooperation between them selves and the coaches were working. The results of the study showed that the members of the association experienced that it had a positive influence according to their creating of identity, participation and self esteem. The members felt that coaching and the pedagogy cooperation had both positive and negative aspects but mostly it worked well.

Levnadsvillkoren för individer med utvecklingsstörning har under de senaste decennierna förändrats till det bättre. Att känna sig delaktig i sitt liv och ha möjligheten att själv påverka livssituationen är viktigt för dessa människor. Uppsatsförfattaren ville med den här studien undersöka om skillnad finns i hur aspekter av delaktighet uppfattas av två grupper; individer med utvecklingsstörning och personer i deras omgivning. En enkätstudie genomfördes med en omarbetad version av ”The Arc’s Self-Determination Scale” (Wehmeyer, 1995).En rangkorrelation visade på samband mellan vissa frågeområden. Resultatet diskuteras i relation till tidigare forskning och till svårigheter att undersöka upplevelser hos personer med utvecklingsstörning.