Disabilities, Volume 4, Issue 2 (June 2024) – 8 articles

The purpose of this mixed-method study was to (1) examine the effect of an adapted physical activity program, Fitness Access McGill (FAM), on leisure-time physical activity (LTPA), autonomous and controlled motivation, and the basic psychological needs of self-determination theory among university students/staff with a physical disability and/or chronic conditions, and (2) explore participants’ experiences after completing FAM. Nineteen participants completed validated questionnaires for all study outcomes pre- and post-FAM. Nine participants partook in a 30–60 min semi-structured interview conducted within three months of completing FAM. Quantitative data were analyzed using repeated measures effect size calculations. Qualitative data were analyzed using directed content analysis. Participants reported an increase in total LTPA (dRMpooled = 0.58), with the greatest positive change on strenuous intensity (dRMpooled = 0.81). Large effects were found for changes in autonomous motivation (dRMpooled = 0.52), autonomy (dRMpooled = 0.79), competence (dRMpooled = 0.79), and relatedness (dRMpooled = 0.89). Participants reported FAM being supportive towards their psychological needs, the development of a LTPA routine, and enhanced overall well-being. Future research can be built upon this study to develop a robust understanding as to how need-supportive, adapted LTPA programs could be implemented within community settings or out-patient rehabilitation to support exercise engagement, physical health and overall well-being among adults with disabilities. Full article

Background: Understanding self-concept in individuals with intellectual disabilities is crucial for tailored support and interventions. The research question driving this study is: What factors influence the self-concept of individuals with intellectual disabilities, and how is it assessed? Methods: Employing a systematic review following PRISMA guidelines, studies from 1993 to 2024, which used diverse assessment tools such as the Pictorial Scale of Perceived Competence and Acceptance, Myself as a Learner Scale, and other self-report questionnaires, were analysed. Results: Factors influencing self-concept include diagnosis, age, gender, perception of control, school placement, and socioeconomic status. Internal factors like perception of control and external factors like societal attitudes interact to shape self-concept trajectories. Assessments reveal nuanced dimensions of self-perception, facilitating targeted interventions. Conclusions: Assessing self-concept among individuals with intellectual disabilities requires diverse evaluation methods. Insights gained inform tailored interventions to enhance well-being. Further research is needed to validate assessment tools across diverse populations. Recognizing the interplay of internal beliefs, external perceptions, and societal structures is crucial for empowering individuals to embrace their unique identities. Full article

Fetal Alcohol Spectrum Disorder (FASD) is considered a lifelong disability that has been framed with neurobiological descriptions focused on the brain. These are important features but fail to tell the story of living with FASD. By surveying those with FASD, this work expanded upon prior survey work which illustrated a multitude of early-onset physiological issues occurring at rates much higher than is typical of the general population. The current project, again using an anonymous survey methodology, sought to open up other direct experiences to better understand the complexity of living with FASD. An anonymous online survey was used to gather data on adversity in childhood, schooling, employment, housing and finances, and involvement with the criminal justice system, as well as relationships and parenting. Results indicate high levels of adversity throughout the life span; vulnerability to manipulation, which is connected to involvement in the criminal justice system; struggles with housing; economic instability; and struggles maintaining employment, as well as difficulties with social and familial relationships. Systemic stigma was also identified. Suggestions are offered to inform others on how support can be enhanced and targeted with a goal of improving quality of life, as well as dealing with self-imposed stigma. The survey was developed by adults living with FASD who have served as a long-standing advocacy and educational group influencing policy and practice in the field. Full article

There is an urgent need for valid and reliable measures of physical activity (PA) participation for use among people with physical and/or sensory disabilities. This study involved adapting the Leisure Time PA Questionnaire for People with Spinal Cord Injury for use in individuals with disabilities (i.e., the LTPAQ-D) and performing a preliminary evaluation of its content validity, construct validity, and same-day test–retest reliability in people with disabilities. User interviews assessed the content validity (n = 5). A cross-sectional study assessed the construct validity and same-day test–retest reliability (n = 27, 45 ± 21 years). Participants completed the LTPAQ-D, other self-report measures of aerobic and strength training PA, as well as tests of cardiorespiratory fitness (i.e., peak oxygen consumption ($\dot{\mathrm{V}}$O_2peak)) and muscular strength. LTPAQ-D measures of min/week of aerobic LTPA, aerobic moderate-to-vigorous PA (MVPA), and strength training shared medium-to-large correlations with other self-report measures of aerobic and strength training PA (r = 0.458–0.942, ps < 0.01). After controlling for age, aerobic LTPA and MVPA shared moderate partial correlations with $\dot{\mathrm{V}}$O_2peak (r = 0.341 and 0.356, respectively). Min/week of strength training, measured by the LTPAQ-D, was associated with predicted maximal strength on the chest press (r = 0.621, p = 0.009). All LTPAQ-D measures demonstrated good-to-excellent test–retest reliability (intraclass correlations = 0.709–0.948, ps < 0.01). This study provides preliminary evidence of the validity and reliability of the LTPAQ-D as a measure of LTPA among people with disabilities. Full article

The use of assistive technology (AT) devices enhances older adults’ function in daily activities. However, the lack of awareness of AT among potential AT users has been identified as a major barrier to its adoption. This study aimed to assess the quality of the Mi Guía de Asistencia Tecnológica (MGAT) web app, which provides information on AT, from the perspective of older Latinos with physical disabilities, and to explore their experience using the MGAT. We employed a convergent parallel mixed-method design involving 12 older Latinos living in Puerto Rico. In Phase I, the researchers trained the participants in the use of the MGAT. In Phase II, participants were encouraged to use it for 30 days. In Phase III, the participants completed the User Mobile Application Rating Scale (uMARS) and individual interviews, analyzed with descriptive statistics and a directed thematic content analysis. The quality of the MGAT was rated high in both the objective (uMARS mean = 3.99; SD = 0.68) and subjective (uMARS mean = 4.13; SD = 1.10) domains. Qualitative data revealed the MGAT was accessible, usable, desirable, credible, useful, and valuable to increasing older Latinos’ AT knowledge, function, and autonomy. The MGAT has the potential to increase AT awareness and adoption among older adults. Full article

Worldwide, the community transition process away from institutions has increased in the past 30–50 years among persons with severe intellectual and developmental disabilities. This process, also known as “deinstitutionalization”, could potentially impact problem behaviors and communication. This study examined the impacts of community transitions on behavioural and communication outcomes in Canadians with intellectual and developmental disabilities. Data were collected using the Comprehensive Health Assessment Program and medical chart reviews. Descriptive, aggregate-level, and individual-level analyses were conducted for 32 adults who transitioned to community living. Descriptive analyses and the McNemar Chi-Square Test were conducted. Following community transitions, the study group experienced a significant decrease in problem behaviours and changes in communication. The study findings suggest that deinstitutionalization could provide effective strategies for addressing problem behaviors and fostering improvements in communication, promoting the well-being and quality of life of persons with intellectual and developmental disabilities. Full article

(1) Background: Psychiatrists are increasingly required to treat minimally verbal (MV) individuals with autism spectrum disorder (ASD), intellectual disability (ID) and behavior problems without much published guidance. (2) Methods: We reviewed 80 charts of MV patients managed strategically for challenging behaviors, following IRB approval. Data extracted included demographics, ASD/ID level, diagnoses, epilepsy and medications. In this descriptive study, we examined the course of assessment and treatment and made recommendations for a strategic, person-centered approach. (3) Results: Of 53 males and 27 females, mean age 34 years (range 7–76), all had ID; 75 had ASD (94%). Diagnoses included seizures in 40/80 (50%), frequent aggression (89%), self-injury (80%), attention-deficit hyperactivity disorder (ADHD) (64%) and obsessive compulsive disorder (OCD) (34%). The commonest medication classes adjusted were antiseizure medications, antipsychotics, and non-stimulant ADHD medications. (4) Conclusions: Clinical impressions suggested that this strategic psychiatric approach was beneficial, notably a review of antiseizure and all other medications for polypharmacy, behavioral and other side effects, followed by a review of possible childhood/current ADHD and a trial of low-dose non-stimulant ADHD medications if warranted. Low-dose risperidone was often effective and tolerable for irritability and self-injury. Full article

Online child sexual exploitation and abuse (OCSEA) is a rising global problem affecting children and adolescents worldwide. Despite the escalating prevalence of OCSEA, there is limited research specifically focusing on children and adolescents with disabilities. To bridge this gap, this systematic review was conducted to identify the prevalence, nature and associated risk factors of OCSEA of children and adolescents with disabilities. Following the PRISMA Statement, this systematic review included scientific evidence from 12 academic databases and the gray literature published between 1993 and 2023. A total of 13 studies were extracted, and thematic analysis was conducted to analyze the data. The findings of this systematic review reveal the characteristics such as the gender, age and type of disabilities of OCSEA victims. Perpetrators use diverse techniques, including online grooming, manipulation, and cyber-threats, resulting in consequences such as mental health issues and social isolation of victims. The associated risk factors include lack of parental monitoring, social isolation, and low risk perception. The results of this research provide crucial insights into OCSEA of children and adolescents with disabilities, emphasizing the need for targeted interventions and further exploration in this understudied area. Full article