In Israel today, with a total population of over 6 million persons, the Division for Mental Retardation (DMR) provides services to 23,000 persons with intellectual disability (ID). Of the 23,000, residential services are provided to more than 6,000 in close to 60 residential centers, another 2,000 are provided residential care in hostels or group homes in the community in about 50 locations, while the rest are served with day-care kindergarten, day-treatment centers, sheltered workshops, or integrated care in the community.The first Snoezelen room (controlled multisensory stimulation) in the DMR was established at the Bnei Zion residential care center in 1995. The Snoezelen method is now used in Israel in more than 30 residential care centers and 3 community settings. Since the year 2000, a physiotherapist has been employed in order to supervise the treatment and development of the method nationally. Professional staff meetings take place every 4 months. A certification course has been established on a national basis for individuals from different professions (occupational therapists, physiotherapists, teachers, music therapists, nurses, speech therapists, or caregivers). Snoezelen has proved to be an important instrument and a powerful therapeutic tool among the various treatment modules employed in Israel for persons with ID. This paper presents the concept illustrated with two case stories.
Snoezelen, or controlled multisensory stimulation, was first introduced in Israel in 1993. This paper presents a new concept of working with the whole family in the Snoezelen room with the participation of a social worker. The purpose was to facilitate family encounters with the child, to enable parents and siblings to become better acquainted with the resident through his/her strengths and special abilities, to encourage parental involvement in the care, to encourage increased visits, to improve quality of life (QOL) for the resident, and to reinforce a better relationship between resident, family, and home. Sessions were divided into two major parts. The first segment (duration 20-40 min) was free activity and the second was more structured (duration 15-30 min). Case stories are presented to illustrate the positive effects of this approach. Snoezelen can be used with the entire family with the participation of a social worker and can add new dimensions to communication.KEYWORDS: mental retardation, developmental disability, intellectual disability, human development, public health, Snoezelen, Israel DOMAINS: child health and human development, medical care, physical therapy, behavioral psychology, clinical psychology, psychiatry, nursing INTRODUCTIONThe concept of "Snoezelen", or controlled multisensory stimulation, was introduced by staff working at two Dutch centers for persons with intellectual disability (ID) in the 1970s [1,2]. The word "Snoezelen" is a combination of two Dutch words: snuffelen (the sniffing of a dog) and doezelen meaning to slumber, relax, or doze [1,2]. Snoezelen refers to a specially equipped room(s) where the nature, quantity, arrangement, and intensity of stimulation is controlled [2] with an environment designed to stimulate the senses by means of light, sound, touch, smell, and taste [3].*Corresponding author. ©2004 with author.500 Nasser et al.: Snoezelen in Israel TheScientificWorldJOURNAL (2004) 4, 500-506 The founders of the concept[1] used the method as a leisure or relaxation activity without therapeutic elements or supervision, and initially resisted any notion of research in the fear that it would become more therapeutic, objective, and product oriented [4]. Over time though, this has changed and a recent review [4] identified 21 research studies, where 14 studies involved persons with ID and 7 studies involved people with dementia. Of these studies, 14 reported positive effects within the Snoezelen room session, 4 showed positive postsession effects, and 2 had long-term effects and one was inconclusive.Snoezelen was first introduced in Israel within a day-treatment center for children with ID in 1993 [2,5] and the first Snoezelen room within the Division for Mental Retardation (DMR) was established at one of the residential care centers in 1995. Today in Israel, this method is used in more than 25 residential care centers and 3 community settings for persons with ID. Since the year 2000, a part-time physiotherapist has been employed to supervise the treatment and deve...
People with intellectual disability (ID) require special support in order to achieve independence in their daily life. Persons with ID are less exposed to assistive technology, although studies have shown that the availability of aids afford an opportunity to reach independence and cooperation. The aim of this study was to examine the nature of the relationship between involvement of the physiotherapy (PT) team and the degree to which assistive technology was used. A questionnaire was sent to all PTs employed at all 54 residential care centers for persons with ID of the Division for Mental Retardation at the Ministry of Social Affairs in Israel. A significantly positive correlation was found between the degree of involvement of the PT and the utilization of assistive technology. The study results may be summarized by stating that PTs demonstrated a great deal of involvement, particularly in relation to the extent of their work in the residential care centers. PT's awareness of the importance was indicated as the major reason to use assistive technology.
Background: In Israel, physical therapy (PT) services for clients with developmental disabilities (DD) and with intellectual developmental disabilities (IDD) are based on several laws. Similar to other health services, they are provided to children 0–3 years provided at ambulatory Child Developmental Centers, at ages 3–21 years provided at special-education settings, or at the residential centers in which they live. At ages 21 years and older, clients residing in supported living centers, are treated at their place of residence, and the rest are treated in their respective communities. This study aimed to describe PT services available to clients with DD and IDD throughout the lifespan and to assess the degree to which these services are provided as intended by the legislators. Methods: This is a qualitative study using data from the websites of the Ministries of Health, Education and Social Affairs, and from personal interviews with heads of PT services in Israel. Results: All over Israel, clients with DD and IDD are entitled to receive health services, including PT, throughout their lifespan. However, physical therapy services provided by Health Maintenance Organizations (HMOs), which act under the National Health Insurance Law, are limited after the age of 3 years. The Ministry of Education’s PT system mainly provides a response to clients with chronic conditions, whereas the Ministry of Social Affairs serves the entire population with IDD, in the absence of a suitable response by the HMOs. Supervision of PT services in both ministries is partial and performed within the system. Conclusions: PT services for clients with DD and IDD are provided throughout Israel and to all ages, as dictated by the law. However, the HMOs only provide services to very young clients.
Older people with intellectual disability (ID) often require assistive technology to promote independence in their daily lives. Objective'. To describe the degree of the use of assistive technology and walking aids by older people with ID. Study group: All permanent residents over the age of 50 years living in two different residential care centers in Israel. Methods·. Cross-sectional investigation generating data on: type of assistive devices (e.g., wheel-chair, walker, cane, orthopedic shoes, splint, brace, hearing aid, artificial teeth), mode and reason for use were inspected. Results: The majority of participants (>70%) used orthopedic shoes, and 53% used frame or cane for gait. The overall frequency of outdoor use was much greater than that for indoor use, and most participants (81%) used it more than 50% of all time. Of participants who used a gait aid (walker, cane) (n = 16) the majority (85%-90%) used it appropriately and satisfactory. The main reason for using the assistive device was to improve standing balance, gait stability, and enhancing daily activities and functions. The degree of fitting a hearing aid, eye glasses, and prosthetic/artificial teeth was quite disappointing and altogether, only 20%-35% of the subjects practically used them. Conclusions: Caregivers must not only provide for assistive device needs but also consider a mechanism to ensure that people with ID will be able to access and use the equipment they need to promote independence and quality of life in their daily lives appropriately.
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