Information and training to assist staff in preventing, managing and remediating challenging behaviours exhibited by individuals with intellectual disabilities is readily available. However, knowledge gained via training is not integrated easily or transposed into work settings. Instead, management of issues is often haphazard and based on what works for a specific situation at the given moment. Although an abundance of research has been conducted on knowledge uptake, direct support staff that are integral to effective service delivery have often been neglected. As well, consideration of whether staff find the evidence relevant and applicable within their work environment has not been measured. The PARiHS Framework, Mindlines and Social Exchange theories assisted in addressing the question: what are staff experiences of applying training information into residential services for individuals with intellectual disabilities who present with challenging behaviours? Qualitative cross-case study methodology was employed and focused on two community residences governed by an agency offering supports to adults with intellectual disabilities. Unit A findings highlighted five key themes that emphasized personal confidence, elements of communication, consistency in approach, connection with individuals, teams and leaders, as well as continuing education strengths and barriers. Within Unit B, five main themes that accentuated personal traits such as caring and nurturing, in addition to communication factors, changes and challenges within the work context, connection to others and perceptions of continuing education were established.

Information and training to assist staff in preventing, managing and remediating challenging behaviours exhibited by individuals with intellectual disabilities is readily available. However, knowledge gained via training is not integrated easily or transposed into work settings. Instead, management of issues is often haphazard and based on what works for a specific situation at the given moment. Although an abundance of research has been conducted on knowledge uptake, direct support staff that are integral to effective service delivery have often been neglected. As well, consideration of whether staff find the evidence relevant and applicable within their work environment has not been measured. The PARiHS Framework, Mindlines and Social Exchange theories assisted in addressing the question: what are staff experiences of applying training information into residential services for individuals with intellectual disabilities who present with challenging behaviours? Qualitative cross-case study methodology was employed and focused on two community residences governed by an agency offering supports to adults with intellectual disabilities. Unit A findings highlighted five key themes that emphasized personal confidence, elements of communication, consistency in approach, connection with individuals, teams and leaders, as well as continuing education strengths and barriers. Within Unit B, five main themes that accentuated personal traits such as caring and nurturing, in addition to communication factors, changes and challenges within the work context, connection to others and perceptions of continuing education were established.

Two adults with intellectual disabilities were taught practical money skills within a stimulus equivalence training procedure taken from the PEAK equivalence relational training system. The participants were taught to accurately count and select combinations of money of five different values, in the presence of an object worth a specific value and combinations of coins worth the same value. The results of this study found that the PEAK program 12L: Monetary Exchange was successful in training two adults with intellectual disabilities and other co-occurring disorders how to accurately count five values as well as derive relations between two values and an object. The first participant mastered two complete levels of stimuli whereas the second participant mastered on complete level of stimuli before training was terminated due to behavioral variables.

Introduction: Research indicates that children with an intellectual disability [ID] are at an increased risk of developing attachment difficulties and subsequent affect regulation difficulties. Attachment theory may further understanding of the risk factors for individuals with an ID experiencing mental health problems, challenging behaviour and emotional difficulties. However, there is a paucity of research into attachment and adults with ID and there is a lack of valid and reliable measures for assessing attachment security for this group. The Manchester Attachment Scale-Third Party Observational Measure [MAST] was developed to assess degree of secure attachment behaviour for adults with ID and the current study examined the psychometric properties of the MAST. Method: Professional carers [N=40] supporting individuals with an ID completed the MAST and other measures related to the construct of attachment theory (subscales of the Edward Zigler-Yale Personality Questionnaire[EZPQ] and Emotional Rating Scale [ERS] as well as the Learning Disability Casemix Scale [LDCS) regarding individuals with an ID they were supporting [N=57]. Individuals with an ID [N=14] completed the Self-report Assessment of Attachment Security [SRAAS]. Results: The MAST was found to have good internal consistency and test-retest reliability. The convergent validity of the MAST was indicated by positive correlation with the EZPQ subscales (negative reaction tendency, obedience, positive reaction tendency and outerdirectedness) and scores on the SRAAS. The MAST was found to be correlated with both levels of ID and presence of challenging behaviour as measured by LDCS scores. Conclusion: These current results provide preliminary support for the reliability and validity of the MAST as a measure of secure attachment behaviour for adults with ID. The results provide support for previous research that indicates a relationship between attachment security and level of ID and challenging behaviour. The results of the study and the implications of attachment theory for adults with ID are discussed.

Research has documented that the dietary patterns of parents of typically developing (TD) children have an impact on their child's diets, including diet quality and intake of certain foods. This influence is thought to be a function of a combination of serving various foods to their child, modeling healthy eating behaviors, providing companionship during mealtime, and implementing various feeding styles and beliefs as their child develops. The extent to which parents of children with intellectual disabilities (ID) influence their children’s dietary intake is unknown. Children with ID experience aversions to certain sensory characteristics of food, food selectivity, and idiosyncratic mealtime behaviors, all of which may result in limited dietary variety. These factors may make children with ID less responsive to their parents’ dietary habits and patterns. Weak to moderate correlations have been found to exist between parents of TD children and their offspring in terms of dietary intake, however, studies examining the parent to child associations of fruit and vegetable intake in the ID population are lacking. We performed a secondary data analysis on a cohort of children and parents involved in the Children's Mealtime Study, a cross-sectional study conducted from 2013-2016 in order to examine factors associated with weight status in children with ID compared to TD children. The goal of our analysis was to determine whether correlations exist between fruit and vegetable variety and consumption frequency among children and mothers and whether these differ between children with ID and TD children. A modified food frequency questionnaire was used to assess variety and frequency of fruits and vegetables consumed by mothers and their children. Statistically significant positive correlations were observed for both fruit and vegetable variety score and consumption frequency among the entire sample. However, the strength of the correlations were weak overall. A significant positive relationship was shown to exist between child fruit consumption frequency for mothers of TD children and their children (p<0.01), but not between mothers and children with ID. The findings indicate that although children with ID may experience greater aversions to food during mealtime compared to TD children, they still appear to be responsive to dietary habits of their mothers for most measures of fruit and vegetable intake.

The parenting experience is as diverse as the children parented. Each child has diverse personality traits requiring flexibility and specificity in parenting strategy. This need for flexibility and specificity is more complex when one or more children within a family has an intellectual disability. Although research in this area is abundant, investigators have historically focused on mothers' attitudes, beliefs, and behaviors to represent the entire family (Essex, Seltzer, & Krauss, 2001; Greenberg, 2002) rather than focusing on fathers and their caregiving relationships with their children in need of malleable but consistent parenting. Using a qualitative descriptive design, this qualitative study explored expectations and subsequent experiences of men who have fathered children with and without intellectual disabilities. The investigator collected data through face-to-face semistructured interviews with 8 fathers in Tennessee. During these interviews fathers discussed each of their children, specifically their expectations of and experiences with their children prior to birth, reactions to the differences among their children, getting through the day, and their responsibilities in teaching each child. NVivo 9.0 data management software was used. Four main themes were inductively derived from the data: Learning to Dance in the Rain, Just Do What Needs Doing, The Power of Patience, and Nurturing Uniqueness. These themes contribute to nursing knowledge by delineating the perspectives of men as they father children of differing intelligences. The results from this study suggest strategies for educators and practicing healthcare professionals working with fathers in similar situations to increase mindfulness of this all-important relationship between fathers and their children with differing intellectual capacities; the investigator also proposes areas of continued research in this field.

Various findings indicate that children of parents with intellectual disabilities have a higher risk for various difficulties, but only few studies interview children for an account of their experiences. This study aimed at assessing how children of parents with intellectual disabilities reflected their upbringing and their everyday life regarding their parent’s disability. Eight studies were identified through a systematic literature review, with publication ranging from 1985 to 2017. Results show that the accounts contain both positive and negative experiences and reflect an ambivalent relationship towards the parents. The small population of the analyzed studies, as well as differences in the context and the method of the studies, allowed no general conclusions to be drawn. Further research is required to allow an evaluation of the experiences of children of parents with intellectual disabilities in a bigger context.

Texas houses the largest number of school-aged individuals with intellectual disabilities in state-administered institutions than any other state in the nation. Despite current conditions of legal and procedural constraints on such placements, the number of admissions of school-aged individuals has been increasing in recent years. Prior to conducting this study, a review of literature was completed, which provided an historical overview of the care for people with intellectual disabilities, the damaging effects of institutionalization in all areas of child development, and the reasons for placement of children with intellectual disabilities in institutions was completed. The purpose of the study was to gain an understanding of the decision-making processes involved in the placement of individuals under the age of 22 in Texas state supported living centers and the community services determined as necessary. Surveys were distributed to five groups of individuals who are typically involved in the decision-making process: parents of current residents under age 22 of state supported living centers, Local Authority interdisciplinary team members, local Community Resource Coordination Group interagency members, local County Judges, and the Directors of the state supported living centers. A sixth group surveyed included parents who sought placement for their child in the institution, but accepted Medicaid waiver-funded community-based services instead. Although the families expressed a strong commitment to keep their family member at home as long as possible, the results indicate that the Local Authority for intellectual disability services influences the majority of families' decisions to place their child in the institution as well as a severe lack of appropriate, adequate and accessible community-based services to meet the needs of families. Both parent groups rated improved public school and personal attendant services as the most necessary for the prevention of out-of-home placement. The availability of behavior supports and respite services were viewed by both the parents and the professionals as important in preventing out-of-home placement. / text

Introdução - A obesidade é uma doença crônica de origem multifatorial, considerada como um dos principais problemas de saúde pública nos países desenvolvidos, que constitui fator de risco para outras doenças graves. Sua prevalência vem aumentando mundialmente e em especial, em crianças e adolescentes. Acredita-se que as principais causas estão ligadas tanto a fatores genéticos como ambientais. Objetivo - Identificar por meio do relato de pais e de equipe interdisciplinar as facilidades e as dificuldades à adesão de adolescentes obesos com deficiência intelectual e de suas famílias para cumprir programa de orientação e prevenção das complicações da obesidade. Métodos - Trata-se de estudo de coorte histórica, descritiva e quali-quantitativa com um número de 47 adolescentes obesos com deficiência intelectual, seus responsáveis e equipe interdisciplinar, que no período de 2006 a 2008, participaram de um programa de orientação e prevenção de complicações da obesidade (POPO), oferecido pela Sociedade Pestalozzi de São Paulo. Os dados foram coletados dos prontuários, das fichas de acompanhamento do programa, dos questionários de estudo sócio-econômico e por meio de entrevistas utilizando um roteiro de questões específicas dirigidas às famílias e profissionais envolvidos no processo. Resultados - A caracterização dos adolescentes envolvidos no estudo mostrou uma prevalência da Síndrome de Down representada em 19 (40,4%) deles. Observou-se também, concentração de maior grau de obesidade com aumento da idade sendo, 63,2% estão na faixa etária de 17 a 20 anos e foram conceituados ao Grupo 3 (IMC>35). As famílias estudadas foram caracterizadas em sua grande maioria moradoras da Zona Norte SP, condições sócio-econômicas precárias com renda familiar de 1 a 2 salários mínimos e grau de escolaridade da mãe apresentando na sua grande maioria o ensino fundamental incompleto. Os profissionais que compõem a equipe interdisciplinar são na maioria absoluta do sexo feminino, atuam as áreas da medicina, psicologia e fisioterapia e apresentam experiência na área da deficiência intelectual que varia de um a 21 anos. Os resultados foram apresentados e descritos segundo dois eixos norteadores: Conclusão - A falta de locais especializados para pratica de atividades físicas, preço elevado dos alimentos sugeridos, não colaboração dos demais familiares, falta de autonomia e independência dos deficientes intelectuais e pouca freqüência às reuniões de orientações realizadas pela equipe, foram apontados como sendo os principais fatores que dificultam uma maior adesão ao programa. E quanto aos aspectos facilitadores destacou-se a comodidade do programa ser na própria instituição, a persistência da equipe e preocupação com a saúde dos filhos. / Introduction - There are many factors that contribute to the chronic disease of obesity. It is regarded as a major public health problem in developed countries. It is also a risk factor for other serious diseases. It\'s prevalence is increasing worldwide and especially in children and adolescents. It is believed that the main causes are linked to genetic and environmental factors. Objective - To identify through the report of parents and interdisciplinary teams, the facilities and the difficulties that obese adolescents with intellectual disabilities and their families have in accessing the ***Obesity Education and Prevention Program (POPO). Méthodos - It refers to a historical cohort study, that was descriptive, qualitative and quantitative. It included 47 obese adolescents with intellectual disabilities, their caregivers and the multidisciplinary team that from 2006 to 2008, participated in an ***Obesity Education and Prevention Program (POPO), offered by the Pestalozzi Society of Sao Paulo. Data was collected from medical records, the monitoring reports of the program, questionnaires from a socio-economic study and through interviews using a script of questions targeted at families and professionals involved in the process. Results - The results were presented and described according to five guiding principles: The characterization of adolescents involved in the study showed a prevalence of Down syndrome represented in 19 (40.4%) of them. The results was also indicated a greater degree of obesity with increasing age and 63.2% are between the ages of 17 and 20 years, which was representede in the Group 3 (BMI> 35). The families studied were characterized mostly living in the North Zone - SP, the socio-economic situations indicated family income between 1 to 2 minimum wages, the majority of the mothers had elementary school education and the majority of the professionals who comprise the interdisciplinary team are female. They include medical professionals, psychologists and physical therapists who have between 1-21 years of experience in the area of intellectual disabilities.Conclusion - It was determined that the main factors that render lower adherence to the program are: the lack of places to practice physical activities, the high price of food, the lack of cooperation from other family members, lack of autonomy and independence of the intellectually disabled and the infrequently meetings for feedback from the team. However, it was indicated as a facilitie, that the program was convieniently located within the institution and the team was persistent and concerned about the health of the children.

Background Offenders with Intellectual Disabilities (ID) represent a particularly vulnerable population within Criminal Justice System. Uncertainty remains in relation to the proportion of prisoners with intellectual disabilities within the UK. This presents challenges in service provision and development across both custodial and secure settings. Concurrent reforms in legislative practice and developments in models of offending behaviour have resulted in a development of community-based services for offenders with intellectual disability. Provision of good quality transitionary care for this population presents remains challenging and there is an increasing need to develop a more collaborative and person-centred measure of the ‘successfulness’ of these transitions. Methodology A systematic review was completed regarding the prevalence of ID in UK prisons and methodological quality was explored. This aimed to inform research, professional practice and service development. An empirical study employed the qualitative methodology of Interpretative Phenomenological Analysis to explore the transitionary experiences of offenders with ID across secure settings. This was aimed to address gaps in the existing literature and address over-dependence on traditional post-transition outcome measures. Results Systematic review findings demonstrated ID prevalence rates between 0% - 8.5% of the UK prison population. Studies were found to be of moderately low methodological quality and results must be interpreted with caution. Empirical study findings identified five master themes in relation to transitionary experience: Relationships with Staff, Lived Experience of Transition, Steps towards Freedom, Community Embeddedness and Different Concepts of Self. Conclusions Suggestions are provided for future research in relation to the need for more accurate estimates of ID prevalence in UK prisons with better adherence to standard diagnostic criteria for ID. The importance of screening for intellectual disabilities in prison populations is discussed and implications for professional practice are considered. In relation to the empirical study suggestions are provided for future research in relation to active participation of individuals with intellectual disabilities. The importance of employing newer models of offending behaviour in professional practice is considered.