This article focuses on the Shared Citizenship Paradigm that incorporates a contemporary set of values and beliefs about people with intellectual and developmental disabilities and their right to participate fully in all aspects of life and society. The article provides an overview of the paradigm, describes the parameters of a shared citizenship measurement model, and discusses potential uses of shared citizenship measurement data. These uses involve guiding services and supports, providing formative feedback to individuals, organizations, and systems, and framing research opportunities and practices.

In this article we study the concept of 'belonging' within the context of inclusive education. We see inclusion and belonging as two entangled concepts and focus on inclusion as an ethical process. We do this by analyzing the Flemish documentary Inclusief [Inclusive] to investigate the idea of belonging as building and finding roots. As a method we carry out a close reading of two episodes of the documentary and plug in theory to gain a deeper sense about the meaning of belonging in two students' life stories. In our writing process these fragments become tangible. Through the stories, we see how belonging emerges. We come to understand belonging in inclusive education as connected to the dynamic interplay with the context; listening with care; and radical relationality. By combining these elements schools can invest in becoming inclusive communities of care, and contribute to every student having a feeling of belonging.

The purpose of this study was to explore the role of self-directed ageism in the relationship between frailty and quality of life in community-dwelling older adults. Secondary data-analysis on data from the Belgian Ageing Studies. A stratified sample of 1895 participants, based on census data by gender and age, was drawn between 2017 and 2019. Frailty, quality of life and self-directed ageism were assessed by the Comprehensive Frailty Assessment Instrument, a numeric rating scale and a newly developed self-directed ageism scale, respectively. The validity of this new scale was assessed by exploratory factor analysis, while mediation analysis was used to explore if self-directed ageism mediates the relationship between frailty and quality of life. The self-directed ageism scale proved highly reliable (Cronbach’s α = 0.898, Spearman-Brown = 0.906), explaining 58.86

The influence of context on the conceptualization, measurement, and application of the quality of life concept was acknowledged in the principles contained within the original Quality of Life Consensus Document published in 2002 and validated in 2004. Since that time, there has been a substantial increase in our understanding of both the QOL construct and the multidimensional properties of context. The purpose of this article is to report on a multi-step process conducted in 2019 by a group of international quality of life experts to review, critique, and update where necessary the QOL principles that were originally developed in 2002. Updated principles for conceptualization, measurement, and application are provided. An understanding of the role of context on the QOL concept allows for measurement guidelines to accompany the measurement principles, an understanding of the application conditions associated with a person- or family-centered approach to QOL, and implementing guidelines regarding both the development of QOL-related policies and practices and their monitoring and evaluation.

Transitioning to adulthood is a dynamic period in life, in which significant decisions are made in several domains. In this study, we investigate the transition into post-secondary life of young adults with an intellectual disability who have followed an inclusive school trajectory in Flanders (Belgium). We aim to clarify the significant elements of this transition when the known structures of school disappear. As a method, we ‘walk-with’ Gabria and connect three events of her life story with the concepts of desire and support. Gabria demonstrates the importance of starting from desire as an affirmative force, as she resists making disconnected choices and wants to be approached as a person with the aspiration to work, living alone and have a relationship. Furthermore, support in the current care systems seems too restricted to one specific policy domain into which these young adults need to fit. Interagency commitment and coordination are crucial for a holistic approach to young adults with an intellectual disability. To see Gabria fully implies starting from her needs and desires, and taking account of her difficulties and the support needs for her and her network by drawing on local knowledge.

Notions of citizenship and disability rights denote abstract, ambiguous, and contested principles, and realizing these ideas entails complexity in practice. This is particularly the case since the welfare state is no longer conceived as the principal provider of welfare services and resources in many European welfare states. In that vein, we critically analyze the underlying principles, rationales, values, and potential implications of the White Paper "Perspective 2020: a new support policy for disabled people" in Flanders (the Dutch speaking part of Belgium). We tease out which understanding of the disabled human subject is promoted by this so-called innovative social policy and excavate how policy makers and a diversity of actors involved in the policy implementation process consider the provision of care and support. Our main argument entails that the welfare state should acknowledge and vindicate differentiated manifestations of interdependency rather than reinforcing a dichotomy that is based on notions of in/dependent human subjects.

Background and objectives: Advanced age is often associated with frailty, which in turn is associated with low quality of life. This study explores to what extent multidimensional frailty is associated with multidimensional quality of life. Material and methods: A cross-sectional survey study was conducted in a sample of 336 Flemish older people aging in place. Data were collected between 2014 and 2016 using two multidimensional self-reporting instruments; the Comprehensive Frailty Assessment Instrument to assess frailty and the World Health Organization Quality of Life Instrument-Short Version to assess quality of life. Bivariate analyses were used to explore the relationship between quality of life, associated factors of quality of life and frailty. Results: The mean age of the respondents was 74.9 years and 71.7% were woman. An inverse correlation was found between frailty and quality of life (r = -.683) and the corresponding subdomains. Nevertheless, some respondents perceived their quality of life as high, although they were defined as mild to high frail. Further analysis indicated that neither socio-demographic factors nor being ill contributed to quality of life. Discussion and implications: Psychological frailty contributed the most to quality of life. However, the results indicate that frailty does not inevitably leads to a lower quality of life and that other factors, besides frailty, play an important role in determining quality of life. Knowledge about these factors and their mutual relationship can help policymakers and services in providing client-centered care to increase or maintain the quality of life of people aging in place.

Adolescents with Emotional and Behavioral Disorders (EBD) have complex needs and experience challenges in various developmental areas and life domains. The majority of current studies regarding Quality of Life (QOL) among adolescents often adopt a quantitative design to assess health-related aspects of QOL. While considerable progress has been made in acknowledging the rights of children and adolescents to express their views on life and well-being, there remains a lack of research regarding adolescents with EBD and their personal perspectives on QOL. This qualitative study aims to address this gap. Focus groups ( N = 6) were conducted with 25 adolescents aged 13 to 17 years living in a large-scale residential care organization. An expert panel, comprising six experts, was convened to classify the results from the focus groups (i.e., indicators) according to the QOL framework by Schalock and Verdugo ( 2002 ). An in-depth overview of the wide variety of aspects adolescents value with regard to their QOL was presented. The findings highlighted the importance of adopting a broad and holistic approach, instead of a traditional health-related and deficit-oriented one, when aiming to enhance the QOL of adolescents with EBD. Furthermore, several benefits for research and clinical practice relating to adolescents’ personal perspectives on QOL were discussed.

Societal views on the rights of persons with disabilities have changed over the last few decades. Evolutions are reflected in international conventions, as the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) developed to guide policies and practices. However, knowledge about the implementation of the Convention remains limited. In addition, another important construct, quality of life (QOL), has gained increasing prominence in the field of disability. This construct has evolved from a sensitizing notion to a measurable construct that provides a framework to assist organization and systems transformation. The present research focused on the implementation of the UNCRPD articles to assist organizations and systems in the support provision practice. The study is a preliminary step toward implementation, looking for consensus on cross-culturally referenced indicators of QOL outcomes. The methodology chosen to find cross-cultural consensus was an international modified Delphi study to determine the relation and alignment among UN Convention articles, QOL domains, and measurable indicators. A total of 153 experts (self-advocates, professionals, family members, academics, and experts in law) from 11 countries evaluated the indicators. The Delphi study resulted in finding at least one indicator per convention article/QOL domain pairing. Thus, an international pool of cross-cultural indicators was identified to assist the implementation of the Convention articles. The study provides a first exploration of using the QOL framework to implement the UNCRPD. Although international indicators have been found per convention article/QOL pairing, challenges exist in regard to the further translation process into practice between policy and research, and vice versa. Efforts should continue to determine not only the relations among convention articles and measurable indicators, but also associated strategies for realizing the aim of the Convention in local policies and practices.

Researchers in the medical and social sciences have shown a rapidly growing interest in the concept of Quality of Life (QoL) in the past few decades. Reasons include its potential as an outcome measure of service delivery, and the opportunity of using a shared language both within and between different disciplines. Despite the widespread use of QoL in research, practice and policy development, there is little agreement on the defining aspects, as well as on the operationalization of the concept. In an attempt to broaden the knowledge on QoL and to give an overview of interdisciplinary consensus- and discussion aspects, a review of peer-reviewed QoL-reviews, indexed in Web of Science, and published from 2000 to 2013 (n = 75) was carried out. Theoretical and measurement principles, derived from the QoL-framework of Schalock and Verdugo (Handbook on quality of life for human service practitioners, American Association on Mental Retardation, Washington, 2002) were systematically explored. Results indicate a growing interdisciplinary consensus on QoL as (1) a multidimensional construct, (2) composed of both objective and subjective dimensions, (3) with an emphasis on the subjective evaluation of one's life circumstances, (4) which is dynamic in nature and (5) which can be influenced and enhanced by a variety of factors, implying a positive view on social services. Contrary, debate is still going on (1) the ideal method to assess QoL, (2) the use of proxies in QoL-measurement and (3) the preference for a general or on the contrary disease- or target group specific QoL-instrument.

Although addiction is increasingly considered as a chronic problem, only a limited number of studies have addressed quality of life (QoL) in therapeutic communities (TCs) for addictions. This reflective conceptual article assesses the history, philosophy, and background of the TC movement as modern concept, with roots in existentialism and phenomenology, as well as the QoL approach as a "postmodern" concept, with a positive vision on wellbeing and happiness, grounded in Aristotelian rationalism. The exploration of the QoL concept situated in the context of TC values, facts, and subjects leads to the finding that both visions can go alternatively together and fertilize each other.

The purpose of this article is to move the field of intellectual and closely related developmental disabilities (IDD) towards a better understanding of evidence and evidence-based practices. To that end, we discuss (a) different perspectives on and levels of evidence, (b) commonly used evidence-gathering strategies, (c) standards to evaluate evidence, (d) the distinction between internal and external validity, and (e) guidelines for establishing evidence-based practices. We also describe how the conceptualization and use of evidence and evidence-based practices are changing to accommodate recent trends in the field.

Policy evaluation focuses on the assessment of policy-related personal, family, and societal changes or benefits that follow as a result of the interventions, services, and supports provided to those persons to whom the policy is directed. This article describes a systematic approach to policy evaluation based on an evaluation framework and an evaluation process that combine the use of logic models and systems thinking. The article also includes an example of how the framework and process have recently been used in policy development and evaluation in Flanders (Belgium), as well as four policy evaluation guidelines based on relevant published literature.

PURPOSE:In order to cope with the challenges that are the result of an aging population, policies and services promote keeping elders in the community and letting them age in place rather than sending them to specialized institutions. Aging in place refers to the option where people can stay in their homes as they age. This policy option, however, poses various challenges and may also threaten the quality of life of the aging. A literature review was performed on the quality of life of older people aging in place to determine whether the actual assessment of quality of life can be used within aging in place.METHODS:Web of Science, PubMed, CINAHL, Sociological Abstracts and Social Science Research Network were searched for publications on "Ag(e)ing in place" AND "Quality of life."RESULTS:Although assessment is crucial to a policy pursuing a good quality of life, literature reveals that it is seldom performed. Only a small part of the studies report on the assessment of quality of life, including the instruments used and the results. The findings also indicate that there is no consensus on the definition of quality of life or its domains structures.CONCLUSION:As no existing instrument assessing the quality of life of older people aging in place could be identified, such a tool should be developed, because any policy towards this growing group of people should be complemented by an evaluation.

Background: Over the past decades, there has been increased scientific and clinical interest in substance use among individuals with intellectual disabilities (ID). Despite raised interest and awareness in the topic, lack of supportive data on prevalence and risk factors highlights the need for ongoing research. The aims of this cross-sectional multicenter study were to examine the nature and extent of substance use in individuals with ID living independently, to investigate group differences in substance use and related problems, and to explore the role of substance-related knowledge and attitudes in substance use behaviors.Method: Participants were 123 individuals with mild to moderate ID receiving support from independent living services. Data were gathered by means of a structured interview strategy (i.e. the Substance Use and Misuse in Intellectual Disability-Questionnaire; SumID-Q).Results: Findings revealed that rates of lifetime use of licit and illicit substances were higher than those found in earlier studies among individuals with ID and the general population. While cannabis use was the only illicit substance reported, current tobacco and alcohol use were shown to be highly prevalent (48%-45.5%). Rates for the latter were similar to earlier studies among community samples of individuals with ID. In contrast to our hypotheses, few group differences in substance use behaviors were observed. Male gender was associated with age of onset of alcohol and tobacco use and tobacco use-related problems, while younger age was found to be associated with lifetime use of cannabis. No evidence was found regarding the role of knowledge; however, smokers and alcohol users rated tobacco and alcohol use more positively.Conclusion: This study demonstrated that individuals with ID living independently use a wide range of licit and illicit substances and present divergent levels and patterns of substance use. Notwithstanding the role of personal choice in substance use, more research is needed to better understand the nature and extent of substance use and related problems, as well as the role of substance-related knowledge and attitudes in individuals with ID. (C) 2016 Elsevier Ltd. All rights reserved.

Purpose This paper highlights the integrative character of orthopedagogics. Quality of Life (QoL), as guiding the normative framework in orthopedagogics is explicitly connected with the framework of human rights and the capability approach (CA) in the quest for social justice and human dignity. The purpose of this paper is to question that how these three specific frameworks can cross-fertilize each other and result in the development of an integrated normative foundation for supporting people living in socially vulnerable situations. Design/methodology/approach This paper reflects on the question on how the human rights framework, the CA and the framework of QoL can be integrated in the support of people who find themselves in a socially vulnerable situation. Findings The core features of each framework are described. Originality/value To conclude the paper, commonalities and the added value of integrating these three frameworks are explored. By integrating these three frameworks, they could function as a shared agenda that gives direction to the daily actions of professionals, with attention for aspects at the micro, meso and macro levels. Each framework and their interrelatedness urge for an integrative approach of orthopedagogics where the strengths of different frameworks are recognized and used in order to support people in socially vulnerable situations to achieve a life worth living.

Background This study describes the sociodemographic, clinical, and functional characteristics of a representative sample of service users in Italy. The supports provided by formal agencies, natural networks, and actual levels of quality of life (QOL) were assessed.Methods The participants were 1,285 individuals with intellectual and developmental disability served by 23 different services. The influence of availability of support strategies, environmental factors, client characteristics, personal desires and goals, and support needs on current QOL status was investigated using multiple regression.Results QOL outcomes were significantly explained by support needs, client characteristics, personal goals and desires, and marginally by the presence of support strategies and environmental factors. Further, only a minor effect was found from support activities for general QOL outcomes.Conclusions The results confirmed that the personal outcomes could be predicted providing support activities aligned to the specific personal needs and goals, confirming the importance of a person-centred planning process.