BACKGROUND Goals and objectives as mentioned in Individual Support Plans (ISPs) were analysed to explore what domains of quality of life they are associated with, what support resources are referenced for achieving the goals, and how domains and resources are related to clients age, gender and intellectual disability (ID) level. METHOD A total of 209 ISPs for persons with ID from eight residential Dutch service provider organisations were analysed. Mixed linear regression analyses were conducted to examine the relations between client characteristics and the content of goals and support resources. RESULTS Results showed that ISPs of people with mild and moderate ID had significantly more goals related to independence and social participation as compared to the ISPs of people with severe and profound ID. ISPs of clients with profound ID addressed quality of life factors related to 'well-being' more than ISPs of all other clients. ISPs of people aged 20-34 years had significantly more goals on independence than the two other age groups. ISPs of people under the age of 50 had significantly fewer goals with respect to well-being than found in ISPs of older people. Regarding the use of resources, 42.6% of the ISP goals were associated with resources from specialised services, 31.5% associated with natural resources and 25.9% associated with a combination of both natural and specialised services. In ISPs of people with mild ID, natural resources are more often mentioned, and specialised service-based resources are less often mentioned than for other people. CONCLUSIONS This study offers empirical feedback on ISP practices in the field of ID in the Netherlands. In light of current ISP practices, results suggest that attention should be paid to: (1) distinguishing between a 'service contract' and an ISP; (2) keeping a focus on the whole person in all age groups and levels of functioning and (3) involving the service recipient in ISP development and implementation.

BACKGROUND:According to Dutch jurisdiction, individual support plans (ISP) should register the mutual agreements between a person with intellectual disabilities (ID) and a professional service organisation with respect to the support that will be provided. In planning for support, active involvement of both parties is necessary. The current study focuses on the perceptions and experiences of Dutch persons with ID with respect to their involvement in their ISP.METHOD:Data were gathered through semi-structured interviews with 61 people with mild to moderate ID. Participants were recruited in 23 Dutch service provider organisations. A systematic qualitative analysis was performed on the interview transcripts.RESULTS:Although persons with ID are present at their ISP meeting, active client involvement in developing, executing and evaluating the ISP is not common practice. Issues of accessibility and lack of control over the process and content of ISP hamper effective involvement of people with ID.CONCLUSIONS:The study raises questions concerning ISP practices in the Netherlands. The question needs to be addressed as to how to facilitate active involvement of people with ID in planning for support. The results further suggest that support organisations perceive an ISP rather as a formal document to comply with bureaucratic rules than as an instrument of empowerment to enhance control of persons with ID over their own lives.

Doel: Onderzoek naar de overeenstemming tussen gewichtsstatus classificaties (ondergewicht, normaal gewicht, overgewicht, ernstig overgewicht) op basis van vier antropometrische methoden: Body Mass Index (BMI), buikomvang, Vet Vrije Massa Index (VVMI) en huidplooimeting. Methoden: De onderzoeksgroep bestond uit 91 personen (27 mannen en 64 vrouwen) in de leeftijd van 18-63 jaar. Gewichtsstatus werd bepaald via BMI, buikomvang, VVMI en huidplooimeting afzonderlijk. Overeenstemming in classificatie op basis van de vier maten werd berekend door middel van Cohens kappa. Resultaten: De overeenstemmingen tussen de vier methoden ten aan zien van gewichtsstatus bleken laag. Dat gold ook ten aanzien van bijna alle overeenstemmingen in aparte analyses naar geslacht en leeftijd. Conclusie: Er is weinig overeenstemming tussen de vier methoden bij het classificeren van de onderzoekspersonen naar gewichtsstatus. Nader onderzoek naar de voordelen, nadelen en validiteit van de methoden is wenselijk.

STUDY DESIGN A systematic review of the literature. OBJECTIVES To describe which environmental factors have an impact on community participation of persons with an intellectual disability. METHODS A systematic literature search was conducted for the period of 1996-2006 in Pubmed, CINAHL and PSYCINFO. Search terms were derived from the International Classification of Functioning, Disability and Health. Three investigators assessed the relevance of the studies identified using predefined selection criteria. Aspects of community participation included were: domestic life; interpersonal interactions and relationships; major life areas; community, civic and social life. Environmental factors included were: products and technology; natural environment and human-made changes to environment; support and relationships; attitudes; services, systems and policies. RESULTS Out of 236 initial hits, 9 quantitative studies and 2 qualitative studies met the predefined selection criteria and were included in the study. Various research instruments were used in the studies and only one study used a conceptual framework. The review allowed the identification of a number of environmental factors positively affecting participation: opportunities to make choices; variety and stimulation of the environment of facilities; opportunities for resident involvement in policy making; small residential facilities; opportunities for autonomy; vocational services; social support; family involvement; assistive technology; and positive staff attitudes. A number of identified environmental factors negatively affecting participation are: lack of transport and not feeling accepted. DISCUSSION It can be concluded that little has been published about the impact of environmental factors on community participation. Many studies do not clearly define the concept of community participation. Research on the impact of environmental factors on community participation so far seems not to be based on a theoretical framework. Most studies focused on the impact of services on community participation in general.

STUDY DESIGN A systematic review of the literature. OBJECTIVES To investigate community participation of persons with an intellectual disability (ID) as reported in empirical research studies. METHOD A systematic literature search was conducted for the period of 1996-2006 on PubMed, CINAHL and PSYCINFO. Search terms were derived from the International Classification of Functioning, Disability and Health. Three investigators assessed the relevance of the initially identified studies using predefined content and methodological selection criteria. Included domains of community participation were: (1) domestic life; (2) interpersonal interactions and relationships; (3) major life areas; and (4) community, civic and social life. RESULTS Of 2936 initial hits, 23 quantitative studies eventually met the selection criteria and were included in the study. Only two studies are based on a theoretical framework. Research instruments were various and were most often ad hoc and not validated. The average number of persons in the social network of people with ID appears to be 3.1, one of them usually being a professional service staff member. People with ID are 3-4 times less employed than non-disabled peers; they are less likely to be employed competitively and are more likely to work in sheltered workshops or in segregated settings than those with other disabilities. People with ID are less likely to be involved in community groups, and leisure activities are mostly solitary and passive in nature. Most of the people with ID had been accompanied in an activity by training/therapeutic staff. CONCLUSION It can be concluded that on the basis of empirical evidence, within the time frame of this literature search, little is known about community participation of people with ID. Many researchers did not clearly define community participation and were concerned with limited areas of community participation; research is seldom based on a theoretical framework. Most studies focus on people with mild ID, and there are few reports of the subjects' sample. However, one conclusion can consistently be drawn from the review: people with ID living in community settings participate more than people living in a segregated setting, but their participation level is still much lower than non-disabled and other disability groups.

In response to the shift from a system-centred care model to a person-centred support model, the Supports Intensity Scale (SIS) has been developed as an instrument to assess the support needs of persons with intellectual disabilities. The instrument is used as a tool for constructing individual support plans, as well as a tool for resource allocation. The aim of the present study was to evaluate the usefulness of the SIS for persons with other than intellectual disabilities. Therefore, the psychometric properties of the SIS were investigated in a sample of 1303 persons with other than intellectual disabilities. Confirmatory factor analysis failed to support the originally proposed six-factor model within this sample. However, an explorative examination of the underlying structure resulted in a shortened version of the SIS, including four subscales and 22 items. Further analyses revealed satisfying results for reliability, construct validity, and criterion validity of the shortened assessment tool (SIS-NID).