Journal on Developmental Disabilities

Early behavioural intervention (EBI) treatments are recognized as the most effective interventions to date for young children with autism spectrum disorders (ASD) and have a significant impact on the two domains implicated in the diagnosis of intellectual disability (ID). This study examined the role of concomitant ID features on young children with ASD’s outcomes in EBI. Participants were 88 children with ASD aged 51 months on average. Their intellectual quotient (IQ, WPPSI-III), adaptive behaviours (AB, ABAS-II), and the severity of their autism symptoms (CARS) were assessed before EBI and after 12 months of EBI. Among the 55 children who met the diagnostic criteria for ID, 15 displayed such improvements in IQ and AB that they no longer met these criteria after 12 months of EBI. These children also showed improvements on the CARS, whereas the remaining 40 children with ID only improved on the CARS. Children without ID features (n = 33) showed the greatest improvements in AB. Predictors of outcomes of EBI differed by ID status. Even at a relatively low intensity, interventions based on applied behavioural analysis may improve cognitive and adaptive functioning among young children with ASD. However, profiles that correspond to diagnoses of both ID and ASD may require further considerations in terms of intensity and duration in planning interventions.

It has been broadly acknowledged that supported, inclusive employment can promote independence, quality of life and social integration for people with intellectual and developmental disabilities (IDD). Despite the ongoing development of the individual placement and support model of supported employment, competitive employment rates for this population remain low. Social enterprise is a means of enhancing employment participation through the creation of jobs and job training in competitive community businesses in the “3rd sector.” This study used a case study methodology to examine practices of successful social enterprises for workers with IDD that led to both sustainable business ventures and promote desired social outcomes. Four Ontario and one Alberta work integration social enterprises (WISE) provided the primary data sources. Cross-case analysis revealed a number of tensions and challenges as agencies strive to meet provincial employment standards while running successful businesses and honouring worker need for choice and social inclusion. Results include identification of best practices and key outcome indicators for successful ventures at individual, business and community levels

Although a significant body of literature has focused on employment supports, knowledge of beneficial components of vocational services for adults with developmental disability (DD) from the perspective of employers is lacking. To our knowledge there is no synthesis review of grey literature focused on services, supports and strategies that foster employers’ capacity to support employment for adults with DD, including autism spectrum disorder (ASD). This review builds on our review of peer-reviewed literature in this area, and may reveal information and ideas not reported in academic materials. Accommodation in the workplace was a main theme that emerged in numerous documents included in this review. In addition, employment support and job coaching was identified as vital to supporting employment for people with ASD and DD. Education, awareness training and recruitment also emerged as main themes in the documents. The evidence from this synthesis review provides a strong platform to understand the literature focused on services, supports and strategies that foster employers’ capacity to support employment for adults with ASD and DD, including information broadly available outside of academic contexts.

Disclaimer: All inferences, opinions and conclusions drawn in this paper are those of the authors, and do not reflect the opinions or policies of the Data Steward. Administrative health data for 1986 to 2013 was used to identify the prevalence of child-hood developmental disability in British Columbia. A total of 26,320 children who have a developmental disability were found in the data set. Prevalence increased for all categories of developmental disability over the 27-year period. Following 2010, the rate of in-crease in prevalence for all categories of developmental disability slowed. The increase in prevalence was greatest for autism spectrum disorder. Prevalence data is important to have for planning programs and services for people who have a developmental disability.

Testicular cancer is the most common type of cancer affecting males between 15 and 34 years of age. Men with intellectual disabilities have an increased risk of testicular cancer, often presenting late. We compared educative teaching (Teaching group) with an educative pictorial leaflet (Leaflet group) using a multi-media questionnaire to assess participants’ knowledge, skills, and behaviour. Evaluation included demonstration of self-examination skills using an anatomically correct model. Adults with intellectual disabilities were involved as co-researchers at all stages from planning to writing-up the study. Both educational methods led to significant improvements in knowledge and skills, maintained 6 months after the intervention. At one-week, direct teaching had significantly greater effect on knowledge and skills than being given a leaflet. By six months improvements in knowledge, skills and behaviour were similar, without significant increase in health-related or general anxiety in either group. Young men with intellectual disabilities benefited from health education in group teaching sessions and through information provided pictorially in leaflets to read at home. This has wider implications for health promotion, where information is often withheld to avoid anxiety.

The prime objective of this qualitative study was to understand the health care experiences of people with developmental disability (DD) in order to inform initial and continuous training of health care professionals. Previous studies of health care experiences have not exclusively involved individuals with DD. Similar investigations involved caregivers’ perceptions and have focused on specific health care settings. This study highlights the benefits of including people with developmental disability in research and as health care advisors. The study involved 22 individuals, who participated in one of seven focus groups held between February and March, 2014. Focus group participants represented a diversity of ages, as well as physical and mental health conditions. Focus group participants provided examples of both good and not so good health care experiences. They described challenges, impacts on their health, and thoughts for improving interactions. Eight dominant themes were identified: Person-Centred Health Care, Barriers to Access, Attitudes, Communication, Professionalism, Outcomes, Continuity of Care, and Inter-Professional Care. Findings have been incorporated into health care education curriculum and ongoing training activities of health professionals.

This study explored whether Family Quality of Life (FQOL) differs in families with two or more children with developmental disability (DD) compared to families with only one child with DD and examined predictors of FQOL including child, family, and context variables. The current study used convenience sample information from a nationwide survey completed by 209 parents of children with severe DD across Canada. The two sub-groups were compared using independent t-tests and, contrary to our original hypothesis, families with more than one child with DD had significantly higher FQOL (t(177) = -2.35, p = .02) with a medium effect size. However, a hierarchical regression revealed that no additional variance was accounted for by whether there were one or multiple children with DD in the family after accounting for other child, family and parent, and context variables. These findings suggest that having two or more children with DD has no major negative impact on families’ QOL compared to having only one child with DD. In conclusion, these caregivers seem to be resilient despite the extra time and effort they devote to their multiple care giving roles. Furthermore, previous care giving experiences may have enhanced their resiliency to cope positively with their current circumstances.

Despite the high rate of criminality in adults with fetal alcohol spectrum disorder (FASD), little is known about the risk and protective factors associated with criminal behaviour in this population. Semi-structured interviews were conducted with eight families of adult children with prenatal alcohol exposure (PAE) to better understand the factors that increase or decrease criminality. Families identified four risk factors that contributed to their adult child`s trouble with the law, including difficulty with self-regulation, negative influences from the peer group, substance use, and multiple transitions from one living environment to another (e.g., living with different caregivers, residing in group homes, incarceration, or participating in inpatient treatment programs). Protective factors that were reported to help mitigate the effects of the legal issues were structure and supervision, educational and occupational success, access to clinical and financial support, and having a strong network of positive influences. The findings from this study emphasize the need for more family-centred interventions to improve the outcome for adults with PAE.

A Toronto emergency department (ED) implemented an initiative to improve emergency care for persons with developmental disabilities (DD). Feedback from ED staff was used to assess the process with respect to: (1) staff awareness of the initiative; (2) staff access to organizational support; (3) burden of the initiative on staff time; (4) fit of the initiative with current practices; and (5) what impact the initiative had on care provided to patients with DD. Overall, staff felt the initiative improved patient care through better awareness and a modified care approach, however some process gaps were identified.