Journal on Developmental Disabilities

La recherche explore les facteurs qui facilitent ou qui nuisent à la mise en place et au maintien du partenariat entre les parents, les éducatrices à la petite enfance et les intervenantes dans un contexte d'intervention comportementale intensive (ICI) offerte en milieu de garde éducatif auprès d'enfants présentant un trouble du spectre de l'autisme (TSA). Pour ce faire, 17 parents, 10 éducatrices à la petite enfance et 20 intervenantes des centres de réadaptation ont rempli une fiche signalétique et ont été interrogés lors de groupes de discussion ou d'entretiens individuels. Bien que les participants soient assez satisfaits de leur expérience, les données recueillies indiquent que de nombreux obstacles sont tout de même rapportés par ceux-ci, comme des pratiques de communication peu efficaces, le manque de compréhension des rôles, des mandats et des activités de chaque membre de l'équipe d'intervention, des difficultés interpersonnelles et des modalités administratives. Par contre, les caractéristiques personnelles des individus, ainsi que la complémentarité, l'implication et le travail d'équipe sont des éléments qui facilitent le maintien du processus de partenariat. Enfin, des suggestions sont apportées par les participants pour améliorer sa mise en place et pour s'assurer que les changements dans les services se fassent de manière harmonieuse, positive et constructive.

Les différences individuelles entre les enfants qui présentent un trouble du spectre de l’autisme sont si importantes que leurs profils neurodéveloppementaux révèlent une profonde hétérogénéité. Cet article met en exergue les variations qui ont émergé des profils de cinq enfants autistes de 4-5 ans dans leurs réponses à des situations d’évaluation identiques faisant appel à l’attention, aux fonctions exécutives, au langage, à la coordination sensorimotrice, aux traitements visuospatiaux ainsi qu’à la mémoire et aux performances cognitives non verbales. L’article explore également les nombreuses similarités, les influences réciproques, ainsi que les énigmes qui demeurent, dans les performances des jeunes enfants autistes. Les résultats de cette étude indiquent notamment que des déficits sur le plan de l’autorégulation semblent jouer un rôle majeur dans la sévérité des problèmes qui se sont révélés lors des évaluations. En effet, les problèmes d’autorégulation permettent d’établir des corrélations entre, d’une part, les différences dans les manifestations comportementales et, d’autre part, les différences dans les performances aux différents tests et sous-tests. Ces constatations suggèrent fortement que des études plus approfondies devraient être menées concernant l’autorégulation chez les enfants autistes, dans le but de trouver notamment des pistes d’intervention dans les différents domaines développementaux.

Children with autism have demonstrated difficulty acquiring novel responses and often require repeated practice and high effort on the part of teachers to learn new language. The purpose of this study was to evaluate the effectiveness of different ways to teach. We carried out a program evaluation study using an applied behavior analytic approach to teaching participants to use new words. A single-case pre- and post-test research design was used to investigate the relationships between different early language skills in four 6-year-old boys with autism. Pictures of common items in two categories were identified for each of the participants: those items to which they could accurately point but couldn’t name and those items which they were unable to either point to or to name when asked. Participants were then taught to tact (name) all the pictures using an echoic-to-tact teaching procedure derived from verbal behaviour theory. This procedure required the participant to learn to echo the instructor’s word reliably before they had to use the word independently. Results indicate that all participants learned to tact pictures they could point to more quickly than those to which they could not point. The practical implications of these findings are that when children with autism are asked to learn to use new words, they will learn to say the ones they “understand” more quickly than the ones they don’t. When choosing targets to teach take into consideration the things that the child already knows and use that knowledge to build a bridge to new learning.

Persons with intellectual disabilities (ID) are at risk for challenging behaviour (e.g., self-injury, aggression, destruction) and several evidence-based interventions exist. Ontario recently mandated Quality Assurance Measures (QAMs) governing the design and implementation of Behaviour Support Plans (BSPs) for challenging behaviour in individuals with ID receiving government funded adult residential and day supports. This study evaluated the impact of QAM-compliant BSPs on challenging behaviour and staff use of intrusive procedures in 14 adults living in community group homes. Challenging behaviour, PRN (as needed) medication and restraint use decreased over a 12-month period. Staff viewed the new BSPs favourably. These preliminary findings support the value of legislated measures to improve interventions for adults with ID and challenging behaviour.

Health of Persons with Intellectual and Developmental Disabilities Transitioning into Community Homes from a Complex Care Residence in Canada Community living of persons with intellectual and developmental disabilities (IDD) has been encouraged to reduce health disparities experienced by this population. This study aims to assess health and access to healthcare of 45 persons with IDD prior to their transition into community homes. Data were collected retrospectively by reviewing individual medical charts of persons with IDD. Selected health measures were based on the Comprehensive Health Assessment Program and the recently updated Canadian consensus health guidelines to provide a description of the pre-transition health of the study group. The health and healthcare use of the study population mostly met the current healthcare recommendations. There were limited data for several areas that we recommend being collected as part of routine practice. We also recommend routine use of standard tools available. This was the pre-transition phase of a longitudinal study. Similar data will be collected post-transition to explore changes in health status.

Background: Although people with intellectual and developmental disabilities (IDD) are expected to access mainstream healthcare, doctors are ill-prepared to care for this population. Given the currently limited exposure to IDD in the medical curriculum and the healthcare challenges faced by the IDD population, the following study had two main objectives: (1) Assess preclinical students’ knowledge of IDD and attitudes toward IDD; and (2) Explore the experiences, learning outcomes, and attitudinal changes of medical students participating in a student led seminar series on IDD at the University of Toronto. Methods: The project consisted of two components: a needs assessment survey and focus groups. The survey explored 36 preclinical (Years 1-2) students’ prior experience with IDD, knowledge and attitudes toward IDD, and educational needs in this area. The second component of the study involved focus groups with 10 students who took part in a six-week “Developmental Disabilities Seminar Series.” Results: Survey respondents reported a wide range of previous experience, good knowledge and open attitudes toward people with IDD. Thematic analysis of the focus groups revealed three main themes: (1) The universality of person-centred communication skills; (2) The value of first-hand exposure to people with IDD; and (3) Appreciation for available community resources. Conclusion: This project helped identify some of the educational needs of first- and second-year medical students in the area of IDD and could guide future curricular efforts to better serve this population.