Jun 6, 2021
A multiple baseline across settings was used to evaluate the effects of differential reinforcement of
alternative behavior, nonremoval of the fork (Hoch, Babbitt, Coe, Krell, & Hackbert, 1994),
and stimulus fading on consumption of food rejected previously. The study was conducted in
two separate settings, and caregivers were trained in the intervention technique to increase
generalization to natural settings. Food variety increased in both settings.
Jun 4, 2021
Despite change toward more individualized support, group homes are likely to remain for people with severe intellectual disability. As such, the search continues for ways to determine and maintain the quality of these settings. This article draws on in-depth qualitative analysis of participant observations conducted over 9-12 months in seven group homes for 21 people with a severe and profound level of intellectual disability. It explores the conceptualization of good outcomes and support for this group in terms of their quality of life and staff practices. The qualitative indicators of good outcomes for this group using quality of life domains can be used by auditors, community visitors, funders, advocates, or family members to guide observation and judgements about group homes.
Jun 4, 2021
Large-scale reviews of research in deinstitutionalization and community living were last conducted about 10 years ago. Here we surveyed research from 1997 to 2007. Articles were included if the researchers based the study on original research, provided information on the participants and methodology, compared residential arrangements for adults with intellectual disability, and were published in English-language peer-reviewed journals. Sixtyeight articles were found. In 7 of 10 domains, the majority of studies show that community-based services are superior to congregate arrangements. These studies provide more evidence of the benefits of deinstitutionalization and community living and continue to indicate variability in results, suggesting that factors other than the basic model of care are important in determining outcomes.
Jun 4, 2021
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 indica-
tors. 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.
Jun 4, 2021
Background
Past studies have found that people supported in more individualised housing options tend to have levels of community participation and wider social networks than those in other accommodation options. Yet, the contribution of support staff in facilitating social inclusion has received relatively scant attention.
Methods
In all 245 staff working in either supported living schemes, or shared residential and group homes, or in day centres completed a written questionnaire in which they rated in terms of priority to their job, 16 tasks that were supportive of social inclusion and a further 16 tasks that related to the care of the person they supported. In addition staff identified those tasks that they considered were not appropriate to their job.
Results
Across all three service settings, staff rated more care tasks as having higher priority than they did the social inclusion tasks. However, staff in supported living schemes rated more social inclusion tasks as having high priority than did staff in the other two service settings. Equally the staff who were most inclined to rate social inclusion tasks as not being applicable to their job were those working day centres; female rather than male staff, those in front-line staff rather than senior staff, and those in part-time or relief positions rather than full-time posts. However, within each service settings, there were wide variations in how staff rated the social inclusion tasks.
Conclusions
Staff working in more individualised support arrangements tend to give greater priority to promoting social inclusion although this can vary widely both across and within staff teams. Nonetheless, staff gave greater priority to care tasks especially in congregated service settings. Service managers may need to give more emphasis to social inclusion tasks and provide the leadership, training and resources to facilitate support staff to re-assess their priorities.
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