Introduction: Interpersonal relationships are beneficial for people with a learning disability (PWLD), acting as a protective barrier against transition difficulties, social stigma and negative outcomes such as physical and mental health problems. The social networks of PWLD are, however, often more restricted than those of the general population. There has been very little research which has explored the views and experiences of PWLD about their social and sexual relationships. A systematic review of the qualitative research surrounding the sexual relationships of PWLD was conducted. Eleven studies were reviewed, which revealed five themes: ‘A lack of knowledge regarding sexual relationships’, ‘Sexual relationships as restricted and regulated’, ‘Sexual relationships perceived as wrong’, ‘Sexual relationships being desired’, and ‘Sex as a negative experience’. Positive developments in the attitudes of others and supports were described, but the impact and influence of stigma, assumption, ignorance and a lack of autonomy regarding sexual relationships were dominantly reported. However, the findings of the reviewed studies must be considered with caution due to methodological limitations. The current study aimed to build on the existing qualitative research by exploring the experiences and perceptions of both sexual and close relationships for PWLD. Method: Data were gathered from ten PWLD using one to one semi-structured interviews. Interviews were recorded, transcribed and analysed using Interpretive Phenomenological Analysis. Results: Five super-ordinate themes were identified; ‘Relationships feeling safe and being useful’, ‘Who’s in charge?’, ‘Struggling for an ordinary life’, ‘Touching people in relationships’ and ‘Hidden feelings’. The findings were shared with participants who confirmed their relevance in the lives of PWLD. ‘Touching people in relationships’ is presented separately within a journal article format. Discussion: The findings suggest that fundamental components of close relationships were feeling safe and receiving some form of positive gain. The lack of agency participants experienced limited the development of these aspects, whilst also preventing the ability to live an ‘ordinary existence’, which included physically intimate relationships for many individuals. Finally, participant’s feelings were generally unclear, which could be related to being interviewed by a relative stranger or emotional expression difficulties. Based upon these findings it is considered that those who support PWLD should focus their assistance on addressing negative attitudes and redressing the power imbalance to facilitate an ‘ordinary existence’ for these individuals, which may indirectly enable them to naturally develop safe and useful relationships. It is also possible that reducing the barriers and stigma surrounding close relationships would open up communication regarding this area, which could indirectly promote PWLD ability to express their emotions regarding relationships. Conclusions: The research provides a greater insight into the lived experience of close relationships for PWLD. Participants valued close relationships that were safe and useful, but their ability to develop and maintain these was described as being restricted by other people and service rules. It is proposed that those supporting PWLD need to balance protective action against the freedom and choice required to develop and maintain close relationships, as restricting the already limited social networks of this population will negatively impact upon their quality of life.

This thesis explored attachment in individuals with intellectual disability (ID). It investigated the role that attachment may have in presenting difficulties, including trauma symptoms, which has a growing body of literature, particularly in people without ID. Paper 1 describes a systematic review of the available literature relating to the psychological well-being of young people with ID in the UK who are 'looked after children' (LAC) or who live away from their birth families. Evidence suggests that both LAC and people with ID, may be vulnerable to developing mental health difficulties. However, there is a paucity of research investigating the psychological well-being of young people with ID who are LAC or who live away from birth families. 17 studies were reviewed, which ranged between 21% and 71% in quality as measured by the QATSDD (Sirriyeh, Lawton, Gardner, & Armitage, 2012). . Only one study was found that directly focused on the psychological well-being of LAC with an ID. The available studies offered some insights into the prevalence, characteristics of young people with ID who are LAC or who live away from their birth families and some of the psychological difficulties they encounter. However, given the methodological limitations of the included studies, no firm conclusions could be drawn. Paper 2 describes an empirical study that investigated the relationship between attachment security and trauma symptoms in adults with ID. 27 staff and service users participated in the research. Service user participants completed a self-report questionnaire regarding trauma symptoms with the researcher and staff participants provided demographic information and completed questionnaires that measured attachment security, trauma symptoms, depressive mood and traumatic events in relation to the service user. No relationship was found between attachment security and trauma symptoms. However, it provided tentative evidence with respect to the type of traumatic events experienced by people with ID and of the prevalence of mental health difficulties in people with ID. There were however several methodological limitations, including a small sample size. Implications for future research and clinical practice are outlined. Paper 3 provides a critical and personally reflective account of undertaking the systematic review and empirical study as outlined above. Strengths and limitations of the research are interwoven throughout. Recommendations for future research and implications for practice are also considered.

Students with learning disabilities (LDs) represent 9% of students attending college, and college administrators must comply with a large number of federal requirements outlining the provision of educational services for students with LDs, including offering support groups. Nurse-facilitated support groups, held within the university setting, could provide effective social support, increasing likelihood of college success among students with LDs. The purpose of this project was to develop a plan for implementing nurse-facilitated support groups for students with LDs within the student health services (SHS) department at a university designed to improve their coping skills on personal, social, and academic levels. Guided by the Logic Model, a plan for implementing nurse-facilitated support groups within the SHS department was developed and presented to university stakeholders. Components of the plan included a support group structure, curriculum, evaluation tools, steps for piloting the program, and a proposed timeline for implementing the program. The stakeholders acknowledged the potential benefits of initiating a program of nurse-facilitated support groups for students with LDs to assist in attaining their academic goals. However, additional analysis of the program and refining and other disabilities to assist in attaining their academic goals; however, additional analysis of the program and refining the proposed student self-evaluation tool were needed before implementing the program. Nurses in a SHS department staff are effective support group facilitators for students with LDs. This study holds the potential for positive social change by enhancing personal, social, and academic coping skills with nurse-facilitated support groups who may help students with LDs reduce their risk of experiencing burnout and enhance the likelihood of academic success.

The Response to Intervention (RtI) model is an identification model for Specific Learning Disability (SLD), one of the 13 disability categories identified under the Individual with Disabilities Education Act (IDEA) of 2004. The RtI model has been proposed as an alternative model to the discrepancy model (e.g., intelligence quotient-achievement discrepancy model). In the RtI model, students’ responsiveness (e.g., levels of performance and slopes of progress) yields their eligibility for special education. However, to date, research that examined the validity of the RtI model (e.g., examination of intervention responsiveness with students with academic deficits) has been limited in the area of mathematics. The purpose of this study was to examine the responsiveness of elementary-aged students, with and without SLD, to interventions for mathematics calculation. It was hypothesized that students with mathematics deficits would demonstrate progress after receiving an empirically-derived intervention, regardless of their placement in general or special education. It was also hypothesized that students with mathematics deficits would demonstrate satisfaction with intervention procedures and self-efficacy with their progress after receiving an empirically-derived intervention. Students with and without SLD were selected based on specific criteria for this study (e.g., a skill deficit). To examine these hypotheses, for each student, an intervention was selected using an experimental analysis. The effects of the intervention on mathematics calculation were examined using single subject design. Maintenance on instructional materials and generalization from instructional-level to grade-level materials were examined. Social validity (e.g., satisfaction) of interventions and self-efficacy of students were also assessed. The results of the study indicate that empirically-derived interventions were effective in enhancing the calculation skills of students with and without SLD and maintaining their skills during and after the intervention phase. However, the students with and without SLD did not generalize their calculation skills to grade-level materials. The students demonstrated high levels of satisfaction with the interventions at the end of the interventions and enhanced their self-efficacy across the study. The study partially supported the validity of the RtI model in the area of mathematics such that the RtI model may be reliable in identification of students with SLD in mathematics calculation.

No description available.

Research has typically addressed a specific emotional component of having a Learning Disability (LD), and thus has failed to capture the complete picture of what it is like to experience a LD. The current study asked university students to describe without any prompts or cues how it feels to have a LD, both retrospectively in high school and currently in university. We were interested in seeing how individuals with LDs describe their LD experience in their own words through free association. Information was collected from eight different cohorts throughout the past 11 years who were enrolled in a course on LDs for students diagnosed with LDs. All descriptors were coded into 17 different theme categories and further sorted by valence into positive, neutral, and negative categories. Participants reported more negative descriptors than positive ones, which interacted with the context in which they were reported. More negative descriptors were reported in high school compared to university and more positive descriptors were reported in university than high school. We failed to find any differences in emotional valence across the different cohorts. Latent class analyses revealed that reports of high school experiences consisted of two different LD profiles: extremely negative and negative. University experiences consisted of three different LD profiles: predominately positive, mixed emotional valence, and predominately negative. These results suggest that the experience of a LD can improve in university but that approximately 23% continue to find having LD a highly negative experience even though they are receiving support. / Social Sciences and Humanities Research Council: Joseph-Armand Bombardier CGS Master’s Scholarship

The awareness that people with Down syndrome are at risk of dementia at a younger age, even in their forties or fifties, brings to the fore a group previously excluded from research. Literature documents the experiences of people with Down syndrome and, separately, that of people with dementia. This includes knowledge of individual experiences through self-advocacy, inclusion in service development, policy and research, and the drive for a more person-centred way of providing support. We do not have the same knowledge about the experience of individuals who have both Down syndrome and dementia. Research literature suggests that people with Down syndrome are already marginalised before a diagnosis of dementia, due to society’s interpretation of their intellectual disability. The first quantitative stage of this longitudinal, mixed method study demonstrates the awareness of carers and actions taken post-diagnosis, highlighting the social exclusion experienced by people with Down syndrome. The second more substantive, qualitative stage considers factors that impact on the experience of individuals with Down syndrome and dementia. My observation identifies factors that highlight the process of further social and cultural marginalisation after a diagnosis of dementia. Findings are initially based on a thematic analysis of my transcribed data to develop case studies, followed by cross case analysis. Emerging issues from both stages of the research suggest commonality of experience in relation to the lack of a shared diagnosis, lack of recognition of sense of Self or identity, failure to recognise the importance of adapting communication to enable social interaction, a readiness to define a person by their situation rather than as an individual, and my observations of the impact of staff. I suggest that care and support for people with Down syndrome and dementia is at a crossroads, with an absence of shared learning between intellectual disability services and dementia services. I demonstrate how far I have been able to synthesise my approach to methodology and methods of data collection to enable the inclusion of a group previously excluded from research, incorporating both verbal and non-verbal exchanges as dementia progressed. Despite individuals with Down syndrome and dementia not being visible in service development and policy, it has been evidenced that their participation in research is not only possible, it is essential, as this group continues to enjoy a longer life expectancy that brings with it an associated risk of dementia.

This research addresses how socioeconomic status impacts the ways that students with learning disabilities and their families interact with the school system and the consequences of these interactions. This will inform policy on special education, and college level services and accommodations for students with learning disabilities. In addition to exploring general patterns of college attendance for students with learning disabilities, this research will include an analysis of what factors best predict college attendance and persistence for students with learning disabilities. Specifically, the forms of capital framework including economic, social, and cultural capital along with habitus are used to understand issues of access and success in college. The primary findings of this study include a) the intersection of socioeconomic status and disability create an extreme form of stratification in college attendance for students with learning disabilities, b) each form of capital is significantly related to college attendance, c) measures of habitus are some of the strongest predictors of college attendance, d) forms of capital best predict college attendance at four-year colleges and universities and are less predictive for other forms of post-secondary education, and e) current models of college persistence may not be accurate for this population of students.

Background: This study investigates whether the Theory of Planned Behaviour is a viable model to predict the intentions of care staff to support adults with a learning disability to take part in physical activity. Previous research has suggested that people with a learning disability take part in less physical activity than those without disabilities. Research also shows that people with a learning disability have additional health needs when compared to the general population. Some conditions affecting people with a learning disability may be prevented or alleviated by increased physical activity. People with learning disabilities are sometimes dependent on their care staff to support them to access activities, therefore it is important to include care staff in planning interventions. The principal hypothesis of this research was that the Theory of Planned Behaviour may be a useful model in predicting the intentions of staff to support service users to engage in physical activity. Method: Seventy-eight individuals who were keyworkers for adults with learning disabilities participated in this study. This study is based on the responses of these individuals as recorded on questionnaires at two distinct times. At time one, the respondents completed an adaptation of the International Physical Activity Questionnaire – Short Form (IPAQ-SF), and two questionnaires relating to the Theory of Planned Behaviour. At time two, the respondents completed a follow-up measure of physical activity using the IPAQ-SF. The questionnaires were distributed in a pencil-and-paper format, and were available online. Data were analysed using path analysis, an extension of multiple regression. Results: A number of significant relationships between variables were demonstrated by the data. Perceived behavioural control was a significant predictor both of care staff intention and of the behaviour of the service user. Attitude was also a significant predictor of care staff intention. The data did not support that intention would mediate the relationship between attitude, subjective norm and perceived behavioural control and behaviour. Perceived behavioural control was the most significant predictor of intention and of behaviour. Discussion: Results indicate that people with a learning disability take part in less physical activity than the recommendations for health. Perceived behavioural control was the most predictive variable in this population. The clinical and theoretical implications of this are discussed.

Objectives: There is body of evidence that suggests parents who have a child with a learning disability experience increased stress levels. In addition, research has found a bidirectional relationship between parental stress and child challenging behaviour. Other investigations in this area have found parental stress to be a significant predictor of intervention outcome, and it has been suggested that it should be targeted prior to any child focused intervention. The aim of the current study is to examine the effectiveness of an intervention that targets both parental stress and child challenging behaviour, in families who have a child with a learning disability Design & Method: The study employed a questionnaire based, quantitative, within and between groups methodology. The design included two groups, both parents of children with learning disabilities. Group one, attended three sessions targeting parental stress and three on child challenging behaviour and completed measures on parental stress, mood, coping and child behaviour. Group two, received ‘treatment as normal’ and completed the same measures. Results: Correlations were conducted to look at the relationship between parental stress, coping, mood and child behaviour. The results partially supported a relationship between parental stress, child challenging behaviour and coping. The ANOVA revealed a significant decrease in anxiety scores for the intervention group over time. The results provide some support the effectiveness of the sessions in reducing parental stress but not child challenging behaviour. Conclusions: The findings provide some support for the use of a brief intervention for parents who have a child with a learning disability. The results indicate high levels of stress and child challenging behaviour, which has been linked to increased risk of mental health problems in both child and parents. The current intervention may be appropriative for families with lower levels of stress and behaviour problems, and alternative approaches may be more suitable to families with chronic difficulties.