Berättelser om Downs Syndrom formuleras ofta utifrån, av andra än de som lever med diagnosen. Inom forskning är det vanligtvis genom anhöriga eller omsorgspersonal som vi försöker närma oss en förståelse av vad diagnosen innebär. Mitt syfte här var att, genom intervjuer med vuxna som har Downs Syndrom, studera hur identiteten konstrueras utifrån dessa villkor samt se om det handlar om en avvikaridentitet. För genomförandet använde jag narrativ teori och metod som jag låtit inspireras av den hermeneutiska tolkningsprocessen. Genom att analysera livsberättelser som ett uttryck för identitet som en en språklig process, ville jag fånga och förmedla de berättelser som personerna själva ger uttryck för. Jag fann berättelser om existentiell förlust i relation till det man inte har men "kunde ha haft". Jag fann upplevelser präglade av att vara kropp och av ensamhet samt berättelser om motstånd gentemot en identitet som avvikare. Ett motstånd som resulterar i att individen osynliggörs. Resultatet landar i att förmågan att skapa och upprätthålla en sammanhängande berättelse om sig själv och kunna förmedla den enligt det sociala livets normer, är grundläggande för huruvida en avvikaridentitet tar form eller kan bekämpas. För personer med Downs Syndrom kan detta ta sig uttryck i en mellanrumsidentitet och berättelsen tystnar.

Our study aims at investigating the unit manager’s, within LSS, perceiveddiscretion, when people with Down´s syndrome develop Alzheimer’s disease. We wanted to know what they perceive as limiting factors or facilitators in order to meet changing and/or emerging needs, as well as how they interpret their discretion in relation to this. We have conducted semi-structured qualitative interviews with five unit mangers within LSS.When analyzing the interview material, we have used a theoretical approach from a street-level bureaucracy and from the unit managers’ perceiveddiscretion point of view.Our study’s result demonstrate that the unit managers are experiencing a wide discretion and do not feel a need to widen their identifieddiscretion.

The aim of the present thesis was to examine possible cognitive consequences of acquired hearing loss and the possible impact of these cognitive consequences on the ability to process spoken language presented through visual speechreading or through a cochlear implant. The main findings of the present thesis can be summarised in the following conclusions: (a) The phonological processing capabilities of individuals who have acquired a severe hearing loss or deafness deteriorate progressively as a function of number of years with a complete or partial auditory deprivation. (b) The observed phonological deterioration is restricted to certain aspects of the phonological system. Specifically, the phonological representations of words in the mental lexicon are of less good quality, whereas the phonological system in verbal working memory is preserved. (c) The deterioration of the phonological representations has a negative effect on the individual's ability to process speech, either presented visually (i.e., speechreading) or through a cochlear implant, as it may impair word recognition processes which involve activation of and discrimination between the phonological representations in the lexicon. (d) Thus, the present research describes an acquired cognitive disability not previously documented in the literature, and contributes to the context of other populations with phonological disabilities by showing that a complete or partial deprivation of auditory speech stimulation in adulthood can give rise to a phonological disability. (e) From a clinical point of view, the results from the present thesis suggest that early cochlear implantation after the onset of an acquired severe hearing loss is an important objective in order to reach a high level of speech understanding with the implant.

This dissertation presents a discussion of life in the community for people experiencing psychiatric disabilities in the post-deinstitutional era, with the goal of developing knowledge that can suggest a focus for planning more relevant services and supports. While evaluations of deinsitutionalization have focused on possibilities for providing community, rather than hospital-based services for these individuals, the intention was to support a participatory life in the community, a life defined by much more than just care and treatment. The Mental Health Care Reform of 1995 in Sweden paved the way for this more community-based view of needs related to psychiatric disabilities, as local social services became responsible for supports to a participatory life, “like all others”.  The general aim of this dissertation was to explore and analyze the results of a series of surveys of psychiatric disability, in order to develop knowledge of the social context of the lives which individuals experiencing these disabilities live in the community. More specifically, the aim was to; • describe contacts/interactions between these individuals and the societal organisations with which they seek services or support. • describe characteristics and needs of the individuals identified in these studies as expressed by representatives of the helping system and users who participated in the studies. • develop knowledge of the mechanisms involved in these patterns of seeking support by exploring and analyzing the empirical results within the context of theoretical (social) approaches to understanding psychiatric disability. The findings of this research are based on an analysis of the quantitative and qualitative results of three studies involving seven municipalities in northern Sweden. Of the 2385 individuals who personnel identified as meeting the criteria for a serious psychiatric disability, approximately half did not have active contact with the formal mental health system. They did however seek services, supports and opportunities that they saw as relevant to their lives and needs as community members. These included health, housing and financial assistance as well as opportunities for education and employment. Various mechanisms operating in the community, including stigmatizing attitudes, exclusionary practices and organizational systems and rules, were seen by respondents as obstacles to these individuals developing meaningful and participatory roles. Social approaches, when utilized to explore and understand issues regarding psychiatric disability in the community, support a focus on the social landscape in which ndividuals experience disability-related needs, as well as the dynamics of the disability experience. While in the deinstitutional era, needs were assessed relative to the individual’s relationship to the psychiatric care system, in the post-deinstitutional era, they should be assessed from a participation-relative perspective, where their position as community member, rather than as patient or client, describes the social location of need. Specialized support to general community resources and services in addition to psychiatrically defined supports, would likely reach many, especially younger individuals who might otherwise become seriously disabled.

There has been much research on the physical barriers that those with disabilities experience. This research investigates the level of participation of disabled people in tourism and explores the perceptions of risks and barriers to participation in tourism for people with a disability. The barriers that were explored included information, economic, social, physical barriers and the perceptions of risks these barriers cause, within the concept of the 'Social Model‘ of disability (Shaw and Coles, 2004). Data was gathered from a sample group of 149 disabled people through an online survey and through face-to-face survey using paper questionnaires. Analysis of the questionnaire results showed that although the participation of disabled people in tourism has increased slightly, the estimated gap in participation in tourism between non-disabled tourists and the general population has actually increased in the previous eight years. Furthermore, the main barrier to participation in tourism was the lack of availability of sufficiently detailed information. This study found that other barriers to participation includes low level of income, increased price differentials and negative attitudes to disability in some cultures. This study discovered that a significant number of disabled people would prefer that existing tourist opportunities were made more accessible rather than specialised tours for tourists with a similar disability to theirs. All these barriers contribute to perceptions of risks. However, despite the feeling of not having a lot of control of risk, most respondents will sometimes overlook the risk involved in travel. This study has implications for travel agents and tour operators, who need to cater more for the heterogeneous needs of disabled customers and provide more information that is specific, personalised, easily accessible and readily available. To counteract social barriers, further training is required within the tourist industry focusing on the impact of 'cognitive dissonance‘ (discomfort in relating to the disabled results in avoiding getting into the position of the discomfort) on disabled tourists.

<p>AIM OF THE STUDY</p><p>The aim of this study was to explore if ICF-CY can support teachers in elementary schools in their work in promoting children’s health, development and learning. A further aim was to bring forward what teachers experience as benefits and disadvantages in using the classification.</p><p> </p><p>METHOD</p><p>After an introduction to ICF-CY, six elementary school teachers filled in questionnaires based on ICF-CY for 94 children. In conjunction with this, the teachers were interviewed about their experiences and perceptions of the work.</p><p> </p><p>RESULTS</p><p>The results show that through their work with the ICF-CY questionnaires the teachers experienced an active process of reflection and learning. They obtained new perspectives which gave them a more holistic picture of children’s situations than they had before. The teachers found the ICF-CY to be a useful instrument to support work within the school environment towards individualized education, based on the children’s possibilities. They also felt that the importance of cooperation between the persons around each child became clearer by using ICF-CY because no single individual is in possession of all the necessary information about the child’s situation, but by combining different perspectives it is possible to establish a common ground on which education and intervention can be based. At the same time, however, the teachers found the classification somewhat overly comprehensive and in some ways complicated. Therefore they felt that an introduction to the ICF-CY is essential before adopting it.</p><p> </p><p>CONCLUSIONS</p><p>The teachers’ experience of seeing each child’s situation more clearly after conducting a classification by using the ICF-CY questionnaires indicates that ICF-CY should be introduced to parents, teachers and other professionals working with education and intervention for children. The way in which assessment carried out with ICF-CY as an instrument affects the process of education and intervention remains to be examined.</p> / CHILD

<p>Studien behandlar bemötandet under det samordnade vårdplaneringsmötet, en vårdsituation där brukaren ofta har en utsatt position. Under dessa möten ska deltagarna gemensamt komma fram till lösningar för brukarens eftervård och situation efter utskrivning från psykiatrisk avdelning. Syftet med min studie är att beskriva och bidra med kunskap och förståelse om hur brukare med psykiska funktionshinder blir bemötta utav personal under samordnade vårdplaneringsmöten. Studien belyser frågan utifrån personalens synvinkel. Studiens empiriska data har samlats in genom kvalitativa intervjuer som utgår från olika samtalsområden, där respondenterna relativt fritt får själva berätta om sina upplevelser om bemötandet av brukare. Empirin är hämtad från en medelstor kommun i Mellansverige. Empirin har analyserats med hjälp av Habermas teori om kommunikativt handlande och teorin om samtidsdiagnosen (livsvärld och system) för djupare förståelse för de mekanismer som kan påverka bemötandet under vårdplaneringsmötet. Teorin bidrar till att förstå deltagarna under vårdplaneringsmöten har sina egna normer, värderingar och kulturer som formar och påverkar deras handlingar och bemötande, men även de lagar, regler och strategier som präglar kommun och landsting. Tidigare forskning om vårdplaneringsmöten inom en annan sektor visar att de föreskrifter i hälso- och sjukvårdslagar som tar upp vikten av delaktighet och inflytande inte efterföljs under vårdplaneringar. Resultatet visar att variationen av vårdplaneringsmötena och bemötandet beror på uppsättningen av människor som ska delta under mötena. Det finns vissa riktlinjer för vårdplaneringsmötets genomförande, men få känner till dessa, vilket gör att vårdplaneringsmötets genomförande hänger på deltagarna och personen som leder mötet. Ifall personen ifråga har en bra mötesteknik kommer brukaren till tals och blir delaktig i mötet.</p>

<p>The aim of this study is to illuminate images and discourses, in which media describe people with disabilities. The purpose of the study will be fulfilled, by answering the following questions: Is it possible to discern categories of how people with disabilities are described in the media and is it possible to find associations to handicap models? We have chosen to focus on how media describe people with physical impairments and have made a content analyses of articles, based on the theoretic aim of this study, social constructionism, handicap models and earlier research. Underlying the analyses, are six articles from two Swedish news papers. The results of our research are divided in three categories: assumptions which are taken for granted, hidden meanings and contradicted categories. To sum up the results, we have found several categories in Media’s description of people with disabilities, and in the articles we have also found associations to handicap models. One of the assumptions which are taken for granted is that the disability/impairment defines the person. Hidden meanings are found which indicates, that people with disabilities doesn’t share the same social position as other groups. The articles used in this study are characterised by contradicted categories, the most common is where deviations are compared with what is considered to be normal, by the prevailing discourses. The articles also show associations to the social and the individual model.</p><p> </p>

Avhandlingen handlar om prospektivt minne (PM) hos personer med utvecklingsstörning. PM syftar på att formulera intentioner och genomföra dessa någon gång i framtiden, antingen inom en definierad tidsram eller i samband med en specifik händelse. Frågeställningar: 1. Finns det en kvalitativ och kvantitativ skillnad mellan prospektivt minne hos personer med utvecklingsstörning och en kontrollgrupp? (Artikel I – II) 2. Hur ser sambandet mellan prospektivt minne, arbetsminne och episodiskt minne ut hos personer med utvecklingsstörning och, skiljer sig detta åt jämfört med kontrollgruppen? (Artikel II) 3. Vilka förutsättningar vid inkodning och hågkomst är kompatibla? (Artikel III) 4. På vilket sätt kan svag association mellan olika delar av information bidra till prospektiva minnesfel? (Artikel IV) 5. Går det att särskilja en hög- respektive lågpresterande grupp personer med utvecklingsstörning med avseende på prospektiv minnesprestation? (Artikel II) Personer med utvecklingsstörning begår fler prospektiva minnesfel än personer i kontrollgruppen. Motsvarande gruppskillnad finns inte för självskattat minne. Prospektiv minnesprestation är bättre med bilder jämfört med ord som prospektiva ledtrådar, mest tydligt för personer med utvecklingsstörning. Arbetsminneskapacitet visade ett samband med både prospektivt minne och antalet falska minnen i kognitivt krävande situationer, till exempel, situationer med flera parallella prospektiva minnesuppgifter. Falska minnen och prospektivt minne hade ett samband hos personer med utvecklingsstörning. Att felaktigt känna igen bilder med bara delvis bekanta delar och att känna igen prospektiva ledtrådar utan att komma ihåg själva intentionen hade ett samband hos personer med utvecklingsstörning. Personer med utvecklingsstörning var också sämre än kontrollgruppen på att upprepa tidsintervall. Detta kan till exempel bero på bristande episodiskt minne och begränsade strategier för att lösa den här typen av uppgifter. Resultaten diskuteras i relation till träning av prospektivt minne och val av hjälpmedel. / This thesis deals with prospective memory (PM) in individuals with intellectual disability. The term refers to planning and executing actions that cannot be performed immediately and have to be stored in memory and retrieved either within a specified timeframe or to be associated with a specific event. Following research questions were explored: 1. Does prospective memory performance in the intellectual disability group differ quantitatively and qualitatively compared to a control group of individuals without intellectual disability? (Paper I – II) 2. What are the relations between prospective memory, working memory and episodic memory in individuals with intellectual disability, and how are these relations different from the relations found in individuals without intellectual disability? (Paper II) 3. What conditions constitute compatibility between encoding and retrieval of prospective memory tasks? (Paper III) 4. In what way might weak binding contribute to PM failure? (Paper IV) 5. Is it possible to identify high and low PM-performing groups of individuals with intellectual disability? (Paper II) The results of the studies demonstrated that individuals with intellectual disability commit more PM errors than individuals in the control group, despite similarities in self-rated memory. Pictures as PM cues improved PM performance in comparison to words in both groups. This may be important primarily for recognition of the PM cue, particularly in the intellectual disability group. As to working memory capacity, it also shows a relation to both PM performance and binding performance in cognitively demanding situations (e.g., tasks with multiple parallel PM tasks). Furthermore, it was found that binding is related to PM performance in the intellectual disability group as there is a relationship between feature errors and recognition of cues, though not retrieving the correct intention. Finally, time reproduction was found to be weak in the intellectual disability group compared to the control group. This may be due to, for example, weak episodic memory and limited strategies for solving this type of task. These findings are discussed in relation to PM training and PM aids.

Computer usage today is predominantly based on graphical interaction, where the visual presentation of information is essential both for input (hand-eye coordination when using a computer mouse), and output (seeing the information on a computer screen). This can create difficulties for blind computer users, both at an individual level when interacting with a computer, and also when collaborating with other computer users. The work presented in this thesis has investigated interaction for blind computer users in three stages. First investigating access to information by making studies on an interactive audio-only game, drawing conclusions about auditory direct manipulation and auditory interface design. Second studying collaboration between blind and sighted computer users in two different contexts, leading to questioning of commonly expressed design principles regarding access to collaboration. Finally studying accessibility in a working environment, finding out how technology, the assistive device used by the blind person, communication with others and professional knowledge interplayed to create an accessible work environment. Based on these empirical studies, the main conclusion from this work is a proposal of a research perspective, Assistive interfaces as cooperative interfaces. Here, the context where the interface is going to be used is in focus, and cooperative and social dimensions of interaction are acknowledged and highlighted. The design and analysis of assistive devices should be highly sensitive to the socio-interactional environment, and not just focusing on the single individual using an assistive device. / QC 20100921