People with severe intellectual disabilities have a remarkably high risk of spending most of their lifetime without the possibility of engaging their surroundings. This study aimed to verify if it is possible to teach operant and choice behaviours for autonomus managment of leisure activity throught switches to people with severe intellectual disabilities. A two-switches training program was implemented following three subsequent steps: (1) switch pressure learning; (2) choice behavior learning (Level 1: choices between preferred and non-preferred stimuli; Level 2: choices between preferred and neutral stimuli); (3) subjective satisfaction. A single subject (N=1) multiple probe design, using intermittent probe sessions across behaviors, demonstrated experimental control. Results confirm the effectiveness of training in promoting both repertoires of switch pressure and choice behavior. The response rate and accuracy were statistically significant ( r range: .83–.99). The study shed light on the possibility of autonomous activity management through switches for persons with severe intellectual disabilities.
BackgroundThe United Nations has declared that people with disabilities should be enabled to live as independently as possible, since independence is correlated with a better quality of life. Consequently, services need to have common and validated measurement tools for the evaluation of the different levels of personal support needs in order to promote independent living skills. We aimed to create and validate the Adult Independence Living Measurement Scale (AILMS) to estimate personal skills considered tantamount for independent living in adult persons with intellectual and developmental disabilities. Methods AILMS is a short informant-rated assessment tool consisting of 19 items (goals) regarding the most important skills related to independent living. AILMS total score is directly proportional to the degree of independence, with scores ranging from 19 to 76. Our validation is a multicentre study attended by 243 subjects, 110 female and 123 males, with a median age of 37 years and with an interquartile range (IQR) of 18 (25th percentile [Q1] 29 years to 75th percentile [Q3] 47 years). All subjects had a diagnosis of intellectual disability associated with various neurodevelopmental disorders or syndromic conditions. ResultsThe AILMS shows a wide range of scores with a minimum score of 21 and a maximum of 72. We found no floor or ceiling effects for the total score on the AILMS. Cronbach's α coefficient (= 0.95), based on the 19 AILMS items, indicated high internal consistency. The tool demonstrates a very good agreement even when comparing the results submitted by two different interviewers. It also shows an excellent temporal stability of 1 week, with intraclass correlation coefficients both of 0.97. AILMS total scores do not differ by sex or age, while statistically significant differences are observed between people with different levels of severity of ID. Convergent validity of AILMS was analysed by correlating its total scores with the Italian validated versions of the Support Intensity Scale (SIS-I) and the Alzheimer's Functional Assessment Tool (AFAST-I) scores. Strong inverse Spearman correlations coefficients (r s ) were found both for the Support 560
The COVID-19 pandemic has had severe effects on social health services worldwide. Many people with neurodevelopmental disorders have lost their professional support. The interruption of supportive assistance has been devastating since it has negatively affected their continuity of care as well as their social inclusion and socialization. This paper aims to illustrate the impact of the COVID-19 on an Italian Public Social Health System Services for people with disability. It highlights and discusses the strategy that was adopted in order to ensure the continuity of care assistance provided to the service clients as the organization of emergency remote support and individual support services for independent living. An exploratory study was conducted involving the entire population of people with neurodevelopmental disorders (n=333) included in the Disability System Services of Udine (Friuli Venezia Giulia Region, North-East Italy) to analyze the main repercussions occurred on the organization of services during the pandemic period. A comparative analysis of the number of persons enrolled in the different types of support services and of individuals’ support needs, evaluated throught the Support intensity scale (SIS), pre- and post-pandemic crisis (January 2020 – January 2021) was conducted. The data shows that, despite the enormous difficulties, the adopted strategy has succeeded in limiting the risks of isolation and the negative impact on individual interventions, and opened the way to new alternative and innovative strategies for planning and implementing support.
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