In the State of Indiana, for students over the age of 14 who have been diagnosed with intellectual or developmental disabilities, the transition from special education to Medicaid waiver oversight should occur seamlessly, but gaps in integrated and aligned goal development strategies remain. As a consequence, students who need adult-based support may not be receiving the full scope of services to which they are entitled. Using common-pool resource theory as a foundation, the purpose of this explanatory case study of transitional services to Indiana Medicaid was to understand, from the perspective of disability support service staff, the barriers to effective quality of life outcomes and collaboration among government agencies involved in the transition process. In-depth interview data were collected from a total of 6 vocational rehabilitation specialists, directors, and transition coordinators. These interview data were inductively coded and thematically analyzed according to identified common pool action areas. Key research findings included: (a) the need for implementation of student self-determination principles, (b) a strengthening of sustainable goal development directed toward student employment, and (c) an overall enhanced collaboration between key disability service support staff roles to create sustainable structures. Positive social change opportunities include recommendations to the Indiana Division of Disability and Rehabilitation Services to improve the overarching student-to-adult transition process, reduce redundant funding streams, and streamline goal development to create a sustainable, collaborative experience for students over their lifespan of support.

Students with intellectual and other disabilities who age out of transition programs or graduate from high school may experience marginalization as young adults. There exists scant literature on the perceptions of parents about access to employment and services for their adult children with disabilities. The purpose of this qualitative study was to explore how parents perceived educational services, financial burdens, social isolation, and lack of access to employment for their children with intellectual and other disabilities. Critical disability theory and transformational theory constituted the study's conceptual framework. The research questions concerned how parents perceived access to services related to financial assistance, postsecondary education, employment, and vocational consultation. The design was a case study with a purposefully selected sample consisting of 5 parents from a Western U.S. state. Data sources included field notes, interviews, and artifacts. A field log, newspaper articles, and interview transcriptions were gathered, sorted, and categorized into themes. Results of the study revealed that employment gaps for adults with disabilities decreased with better knowledge about disability strengths, social capital, employer and employee diversity training, and competitive employment opportunities. A position paper was developed based on study findings, which was targeted to employers and included information on the reasons for a business to embrace diversity in the workplace. Business leaders' promotion of social enterprises that enable community inclusion and financial independence for people with disabilities may result in a positive paradigm shift towards equitable employment as a positive social change outcome.

Syftet med studien har varit att bidra med kunskap om hur professionella ser på faktorer som kan ha betydelse för social och politisk tillit hos föräldrar med intellektuell funktionsnedsättning. Det bakomliggande intresset grundar sig i det faktum att personer med intellektuell funktionsnedsättning många gånger har dåliga erfarenheter av kontakt med professionella som arbetar med att ge den typ av insatser som riktar sig till denna målgrupp. Tillit framstår som en viktig förutsättning för att insatserna och stödet ska ge effekt. Studiens frågeställningar har berört tre faktorer: socialt nätverk, anpassade stödinsatser samt attityder. Semi-strukturerade intervjuer har genomförts med professionella som är familjebehandlare eller kuratorer och bland annat arbetar med anpassade föräldrastödsprogram och gruppverksamheter, som sedan har analyserats med hjälp av tillit och socialt kapital som teoretisk analysram. Resultatet visar att förälderns delaktighet i sociala sammanhang kan vara ett sätt att vidga det sociala nätverket och öka den sociala tilliten. Det framkommer också att anpassat stöd och insatser ges i olika omfattning och att synsätten skiljer sig åt i olika verksamheter. Resultatet visar även att det finns utmaningar för de professionella på både individ- och samhällsnivå och att det är nödvändigt att förstå hur dessa kan påverka och motverka varandra. Den enskilde professionella har goda förutsättningar att öka tilliten på individnivå och stärka förälderns sociala och politiska tillit. Genom att ge föräldern möjlighet att vidga sitt sociala nätverk och öka sin sociala tillit finns förutsättningar att öka den politiska tilliten hos föräldern och att ge effektivt stöd för ökade föräldrafärdigheter. Samtidigt finns utmaningar för den enskilde professionella som behöver förhålla sig till värderingar och förhållningssätt på organisatorisk nivå. / The aim of this study has been to increase knowledge about social and political trust among parents with intellectual disabilities - ID - which can be understood as a consequence of, and a reason for, the challenges facing parents and professionals in creating a partnership. People with ID tend to be stigmatized and have a history of bad experiences with authorities and social services, which generally makes them “distrusters”. They are aware of this stigma when they become parents, and have a tendency of denying their need of support because of the fear of losing custody of their children.Nine social workers have been interviewed about their experience of working with parents with ID. The data was placed into three categories and analyzed through the framework of trust and social capital. These categories were: Support from the social network, Customized support from professionals and Knowledge and attitudes. This study shows that community participation such as parent groups gives the parents a chance to increase their social trust by expanding their social network. Their special needs require customized support for developing parenting skills, where the alliance with the social worker as a part of the social services can increase their overall political trust. This study also shows that the attitudes of the professional is an essential part of solving the problem with distrust. The stigmatization the parents are facing makes it challenging to change their status in society, as well as their deeply rooted lack of social and political trust.

Background: At the central administrative level in Sweden, care work is presented as a complex task for which personnel require special qualifications. In elderly care, questions of training and qualifications form the highly topical theme noticed by central actors. According to The National Board of Health and Welfare, the supply of manpower and the educational levels of the workers are the most important factors in ensuring high quality care for the elderly. The question of educational levels is, however, with the exception of personal assistants, not given as much attention in care for people with disabilities. Aim: The aim of this dissertation is firstly to compare elderly care and care for persons with disabilities with the focus to describe and analyse education and work environment in these sectors. Secondly, the aim is to analyse if, and if so how, questions of education interacts with personnel’s view of the social work environment. Methods: The thesis is comprised of four studies and paper 1, 2 and 3 are based on the results of a qualitative interview study, which was comprised of 48 persons who worked in elderly care and the care for persons with disabilities. Of the 48 persons who took part in the study, 11 of them worked as middle managers and 37 worked as care workers in the every day care. Paper 4 consists of a research summary on how education for care workers is being studied in a Swedish and an international context. The personnel who participated in the interview study work in different care settings; in elderly care the personnel work in both sheltered housing and public home care services. In the care for disabled persons, the personnel work in residential housing with special services, in public daily activities for people with intellectual disabilities and as personal assistants. Result: Both managers and personnel find it important for care workers to have a degree of educational background as a basis for the learning process at the work place. The results also show that educational levels and the work environment are themes that are discussed differently by different actors. In previous research on education for care workers in both elderly care and the care for People with disabilities, academic education or education at a ground level has been seen as problematic due to the distance it is said to create between the worker and the care recipient. My results show that the discussion about education for care workers has become rather biased, and that highly educated personnel tend to be more aware of the power they possesses and that the relation to the care receiver is important. In elderly care the issue of education seems to be more a question of a general educational level. In the care for people with disabilities, the question of education for personnel is on a more individual basis, where the care workers learn together with the care recipient. Educational levels, the work environment and relations with colleagues and care recipients are connected and support from the managers is important for understanding the work and the relational perspective.

This dissertation is an inductive, qualitative study of a theatre programme with persons with intellectual disabilities. The aims of the dissertation were: • to explore the experiences had by the actors as expressed through their descriptions, images and narratives, • to explore the context in which these descriptions, images and narratives take place and, • to conceptualise the experiences had by the actors. In the project, the following three qualitative methods were combined: qualitative interviews, participant observations and research circles. The theoretical framework is mainly built on three theoretical standpoints - social constructionism; the theoretical perspective that describes disability as a balance between deviance and normality; and cultural analysis. The analysis shows that the theatre and artistic programme are experienced as something new, interesting and qualitatively different from their earlier experiences. Their daily activities in the theatre are organized around and influenced by an artistic rationale. The work, the physical environment, and relations with the leaders of the theatre are different from the traditional social care setting (daily work places, group homes etc.) in which the actors are socialized. The analysis also shows a tension, in the theatre practice, between disability policy and artistic aims. On one hand, the programme has to consider the consequences of disability and disability ideology in their daily work. On the other hand, the focus of the theatre is on artistic aims and on the actors’ skills as producers of theatre and art. The social care setting, of which the theatre is a part, emphasises deviance (the problems and shortcomings of the actors) whereas the theatre emphasises normality (the artistic skills of the actors). Through their participation in the theatre company, the actors have gained a new role - the role of actors and producers of theatre and art, and not only the role of clients in the social service system. The actors also experience ambivalence from their social surroundings, such as in the theatre arena where the audience applauds their acting, whereas in other arenas they experience dissociating interaction. Both roles, being a client and being a theatre actor, are integrated in the self-understanding of the actors. In this way, the actors’ self-images can be described as a balance between deviance (intellectually disabled) and normality (theatre actor). Through their participation in the theatre, they also gained fellowship among other actors and between the actors and the leaders. This is analyzed in terms of affinity grouping. That is, the theatre can be understood as a community where the members share common interests and goals. Through the processes and acts in this community, the actors develop confidence and the strength to stand up for themselves. Against this background, parallels are discussed to disability culture and disability arts.

The general aim of this thesis is to describe mortality, health and living conditions in an administratively defined county population of people with intellectual disabilities born between 1959 and 1974 (N=213). The living conditions of persons with intellectual disabilities were compared with those of the general population. Moreover, the reports of relatives and staff were compared on the living conditions of people with intellectual disabilities. Information on the living conditions of persons with intellectual disabilities was provided by proxy (relative and staff) questionnaire reports and national welfare statistics conducted by Statistics Sweden (SCB). Medical examination and medical case records were used to obtain data on health and medical services. People with intellectual disabilities lived in the community and took part in numerous common recreational and cultural activities. However, the comparison with the general population indicated clear differences in living conditions, particularly regarding employment and social life. In contrast, surprisingly little variation in living conditions was found in people with intellectual disabilities, despite varying ages and a wide range of level of disabilities. In addition, gender related differences of persons with intellectual disabilities were few when compared with those found in the general population. A wide range of physical and mental health problems were identified in the group with intellectual disabilities. Although a majority of persons with intellectual disabilities had access to a family doctor and attended regular health checks, a number of needs of specialist examinations were identified indicating shortcomings in the quality of health care. Analyses indicated differences in the reports of relatives and staff on living conditions of most domains included in the questionnaire. In general, disagreement was higher on subjective than on objective items. Relative and staff responders contribute dissimilar information that is related to varying viewpoints and different types of information.

Denna studie har skrivits för att skapa en förståelse för vad deltagande i handikappidrott betyder för skapandet av identitet och självbild påverkas hos personer med intellektuellt funktionshinder. Att genom idrott lära sig vem jag är och vad jag kan. Ett ämne som är viktigt att belysa i en samhällsgrupp som ofta känner sig orättvist bedömda av andra. Det är även en samhällsgrupp som är eftersatt inom den kvalitativa forskningen och idrottspedagogiken. För att studera detta användes deltagande observationer och intervjuer. Likheter och olikheter jämfördes i empirin och utifrån det skapades olika teman på resultaten. Resultaten presenterar ett skapande av en gruppidentitet och en individuell identitet hos idrottarna. Ett skapande där olika villkor i idrottsmiljön har betydelse. Villkor som har betydelse för skapandet av en stark identitet och stark självbild men också tvärtom. Studien kan ge en bild av de villkor i idrottsmiljön som bidrar till en svagare identitet och självbild så att det problemet kan lösas inom laget. / This study has been written to create an understanding of what participation in disability sport means for the creating of identity and self-image among people with intellectual disabilities. Through sport learn who I am and what I can. A subject that is important to illustrate in a social group that often feels unfairly judged by others. It`s also a social group that is neglected in qualitative research and sports education. To study this we used participating observation and interviews. Similarities and differences were compared in our empirical data. Based on our findings we created different themes for the results. The results present an establishment of a group identity and individual identity among the athletes. An establishment where the different conditions in the sport environment are significant. Conditions that is important for the creation of a strong identity and a strong self-image, but also the opposite. The study can provide a picture of the conditions in the sport environment that contribute to a weaker identity and self-image so that the problem can be solved within the team.

Syftet var att undersöka hur chefer och medarbetare upplever att stödet är anpassat för att hjälpa unga vuxna med lindrig intellektuell funktionsnedsättning, samt om det behöver förbättras för framtiden. Det genomfördes med kvalitativ ansats där två chefer och två omsorgsassistenter intervjuades med stöd av en intervjuguide. Intervjuguiden täckte de fyra teman normalisering, identitet, utanförskap och socialt tillhörighet. Resultatet analyserades via en induktiv tematiserings metod och via teorierna KASAM och empowerment. Det mest framträdande resultatet var att informanterna är ense om att stödet har brister och inte är anpassat till den valda målgruppen, speciellt när det kommer till självbestämmande, familjebildning och arbetsmarknaden. / The purpose of this study was to examine how managers and employees experience the care for young adults with mild intellectual disabilities and if something needs to be done to make the support more adjusted to the these individuals. This was conducted with a qualitative study where two managers and two employees, who meets the target group of the study thought their profession, was interviewed. The interview guide covered the four main themes; normalization, individuality, alienation and social belonging. The results were analyzed through an inductive thematic analysis method through the theories SOC and empowerment. The most striking result was that the informants all agree that the support they have to offer isn’t adapted for the target group, especially when it comes to self-determination, building a family and labor market.

As students with disabilities age out of school-age resources, the need for self-evaluative skills in work tasks becomes more important. This study compared self-evaluation with reinforcement and self-evaluation with reinforcement plus external evaluation when completing room cleaning skills. The younger students did not demonstrate the ability to self-evaluate without external evaluation. Both conditions were effective when evaluating the older group of students. The author proposes additional research in looking at self-evaluative skills for specific age groups and conditions.

Syftet med denna studie är att undersöka hur några lärare på gymnasiesärskolans nationella program arbetar med bedömning av elevernas kunskapsutveckling samt hur dessa lärare arbetar för att eleverna ska kunna synliggöra sina kunskaper. Studien baseras på sju halvstrukturerade intervjuer med lärare som undervisar i svenska på gymnasiesärskolan.  Resultatet visar att lärarna använder sig av många olika metoder för att skaffa underlag för  kunskapsbedömning. Samtal, observationer och dokumentation är några exempel. Lärarna arbetar tätt ihop med eleverna och ger konkret, tät återkoppling för att synliggöra kunskapsutvecklingen både för eleven och sig själva. Eleverna behöver mycket stöttning och repetition för att utveckla kunskaper och självständighet i arbetet. Ett dilemma som framträder är att det är svårt att skapa förutsättningar för alla elever att kunna visa fram sina kunskaper. Det vanligaste är att man sitter bredvid och samtalar med eleven för att ta reda på vilka kunskaper eleven har tillägnat sig. Lärande som en social företeelse som sker i samspel med andra är ett synsätt som skiner igenom. Enligt min studie är det oftast eleven och läraren som samspelar med varandra. / The aim of this study is to explore how a few teachers in the upper secondary school’s national programmes for pupils with intellectual disabilities work with assessing the knowledge development in students and how these teachers work for the pupils to be able to make their own knowledge visible.   The study is based upon seven semi structured interviews with teachers teaching Swedish in upper secondary schools for pupils with intellectual disabilities.  The results show that the teachers use multiple methods to acquire ground for assessment of knowledge. Conversation, observation and documentation are some examples of methods. The teachers work closely together with the students and provide tangible, frequent feedback to make the knowledge development visible both to the student and themselves. The students need a lot of scaffolding and repetition to develop knowledge and independence in their work. An emerging dilemma is the difficulty to create opportunities for all students to communicate their knowledge. The most common strategy is to sit beside the student and have a conversation to find out what knowledge the student has acquired. Learning as a social experience which occurs in interaction with others is a line of approach that shines through. According to my study it is most commonly the student and the teacher who are interacting with each other.