For young adults with developmental disabilities, postsecondary experiences on a university campus with same-age peers can provide opportunities for learning and social integration. Through the collaborative support of university instructors, a preservice teacher, and her mother, a young woman with Down syndrome was successfully included in a speech communications course at a 4-year, private university. Our purpose here was to explore the impact of this experience on the student, her classmates, and preservice teacher who offered peer support. The experience provided opportunities for interaction with age-appropriate peers and was a positive learning experience for all participants. Challenges emerged related to assessment, expectations, and building relationships. Implications for potential inclusive transition opportunities at the university were discussed.
Osteoporosis is increasing due to the aging of the population. Women with cognitive impairment from childhood are at disproportionally high risk for osteoporosis and fractures. Suggested explanations for this increased risk include high use of anticonvulsant medications, lower peak bone densities, and higher rates of nonambulation. Down syndrome seems to be an independent risk factor for low bone density and fractures, presumably due to lower muscle tone. Here, the limited information available on the epidemiology of osteoporosis in the general population and in women with cognitive disabilities is briefly reviewed. Health care professionals should consider women with cognitive disabilities at high risk for osteoporosis and fractures. Studies are needed to determine screening regimens and prevention strategies appropriate for women in this population.
More and more persons with mental retardation and psychiatric disabilities are present in mainstream society, yet have little interaction and few relationships outside their own peer groups of devalued persons. Social integration remains a desirable yet elusive goal for most human service organizations, and there continues to be a certain amount of confusion about what constitutes social integration. Recent reviews in North America and Europe testify to the difficulty of achieving social integration, particularly for people with mental retardation and psychiatric disabilities. Social role valorization, with its use of the social role concept, provides useful insights and tools for analyzing the social integration conundrum. A social role conceptualization of social integration is proposed and an illustrative example is provided.
In clinical practice, we have come across people with intellectual disability who have gender dysphoria and cross-dress. Here, we review the literature on this subject and present an illustrative case example. We searched databases, followed-up references from relevant articles, and contacted colleagues in the field. We found nine papers with case examples and one survey. Gender identity problems certainly occur in people with intellectual disabilities, and developmental perspectives are important in assessing and treating them. In some cases autistic spectrum disorder was co-morbid, for individuals with and those without intellectual disability. Aggression was also common. Documented treatments were primarily psychological and social and did not include hormones and sex reassignment surgery. Capacity to consent is a factor that determines treatment.
People with developmental disabilities sleep less and experience higher incidence of clinical sleep disorders than the general population. Exploring the neurophysiology linking sleep with daytime performance in patients with developmental disabilities is now possible using minimally sufficient sleep and sleep-sensitive behavioral assays. Although frequent sampling represents the primary difficulty, it is required to untangle coincident effects of sleep quality amidst circadian variation. Recent evidence finds high quality sleep promotes brain plasticity, improves health measures, and enriches quality of life. Sleep treatments for apnea, insomnia, restless limbs, and conditioned sleep-aversion are available, although not readily provided, for people with developmental disabilities. This population would gain both clinical and behavioral benefits as improved sleep-monitoring, behavioral testing, and sleep-treatment technology is adapted to their needs.
Service-user groups whose goals include the promotion of self-advocacy for people with an intellectual disability aim, among other things, to encourage service users to identify problems and find solutions. However, service users' contributions to group sessions may not always be full and spontaneous. This presents a dilemma to the facilitator. In two case studies, we identify two ways in which the dilemma is managed. In one case, the facilitator takes an initiating role in each stage of a decision-making cycle. In the other, the facilitator short-circuits the decision-making cycle. The former seems to be closer to the philosophy of self-advocacy, but both nevertheless result in clients not taking the initiative and arguably disempowers them.
We reviewed a Mental Retardation article by Conroy et al. (2003) on consumer outcomes following the closure of the Hissom Center in Oklahoma. In this article the authors misconstrued their 254 subjects, implying they are representative of the Hissom Focus Class while failing to account for 128 subjects included in an earlier analysis. We found the research to be seriously compromised by data collection problems and discrepancies between reported findings and those obtained when the analyses were replicated. Problems ranged from those that seriously compromise the findings (such as the sample) to other problems in basic data management, transcription, and analysis that, when taken together, compromise the integrity of the findings, lead to inappropriate interpretations, and give rise to misleading conclusions that do not follow from the data.
A focus group study was conducted to develop an understanding of the experiences of mothers who are trying to balance employment with caring for an adolescent with developmental disabilities. Mothers reported facing considerable difficulties balancing work and caregiving responsibilities because support services rapidly declined when their child reached adolescence. Service cuts were related to the fact that adolescents are expected to be able to care for themselves, despite the fact that for many adolescents with disabilities, this is not possible. The mothers also reported that the preponderance of the responsibility for arranging care for their children was theirs and was not shouldered by their partners. Policy implications are discussed.
We examined the frequency and stability of family contact with long-term institutional residents during a major deinstitutionalization project. Movers relocated to community accommodation between Assessments 1 (baseline) and 2. Stayers remained institutionalized. We investigated family contact longitudinally over four annual assessments. There was no significant between-group difference in frequency of family contact at baseline, but, subsequently, movers had more frequent family contact than did stayers. There was a significant decline over time in the proportion of stayers with family contact and a significant increase in movers with family contact, with a marked resumption of contact by movers during the first year of community living. Carefully supporting family (re)involvement during the relocation process may be associated with stable, long-term family contact.
Our focus in this paper is on efforts to include persons with developmental disabilities in faith communities. We provide a review of the relevant literature on religious participation and faith communities for persons with disabilities and blend the limited data available on these topics with the perspectives of individuals whose efforts focus on these concerns. Topics explored are the implications of being part of the faith Community in terms of its impact on quality of life, the barriers to inclusion in Such Communities, strategies for overcoming these barriers, and special considerations for adults with mental retardation or other developmental disabilities. Discussion of the implications for enhancing inclusion in faith communities is provided.
The impact of a consumer-directed support program on family caregivers of adults with developmental disabilities was explored. Economic, health, and social outcomes were compared between families in the program and families on the waiting list for the program. Caregivers of adults in the program reported fewer out-of-pocket disability expenses, greater access to health care, engagement in more social activities, and greater leisure satisfaction. There also appeared to be greater impacts on lower income families; these caregivers reported better mental health and access to health care than did similar caregivers on the waiting list.
