Increasingly, commissioners and providers of services for people with intellectual disabilities are turning to assistive technology and telecare as a potential solution to the problem of the increased demand for services, brought about by an expanding population of people with intellectual disabilities in the context of relatively static or diminishing resources. While there are numerous potential benefits of assistive technology and telecare, both for service providers and service users, there are also a number of ethical issues. The aim of this paper is to raise these issues and to set them within the ethical framework proposed by Beauchamp and Childress. There is a need for a wider debate as a first step in the development of strategies to address the issues raised in the paper.

A small-scale study of the inter-rater and staff:client reliability of the Schalock & Keith (1993) Quality of Life Questionnaire (QOL-Q) was conducted. Whilst the sample size was small and the QOL-Q achieved an acceptable overall level of reliability, the study replicated the pattern of low staff:client concordance and staff overestimation of the independence and autonomy of clients reported by Reiter & Bendov (1996). The results are briefly discussed in the context of the ongoing debate about the utility of proxy response in the literature.

Background Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for adults with intellectual disabilities in supported employment, employment enterprises and day services with non-disabled workers in community employment. Methods Comprehensive Quality of Life Scale, and Work Environment Scale were collected for people with intellectual disabilities: 17 supported employees; 10 employment enterprise workers; 10 day service attendees; and 17 non-disabled work colleagues of supported employees. Results Supported employees reported higher objective quality of life than employment enterprise workers and day service attendees. Non-disabled co-workers reported higher objective quality of life and autonomy at work than the three groups of people with intellectual disabilities. Supported employees reported higher subjective quality of life than non-disabled co-workers. Conclusions The findings support the utility of supported employment as a means to provide constructive occupation and enhanced quality of life to people with intellectual disabilities. However, closing the gap with respect to non-disabled co-workers on objective quality of life measures represents a challenge and will require improving the quality of job finding and workplace support and the training provided.

As more workers with disabilities are competitively employed, there are numerous opportunities to form social relationships with their co-workers. Close social relationships are associated with a number of positive outcomes (e.g., happiness, less stress) and should be actively pursued for those individuals desiring them. In this paper, we describe the types of social interactions displayed in work settings employing workers with and without disabilities. We also discuss some of the social problems experienced by some workers with disabilities. Finally, we describe two general categories of intervention strategies that have been used to impact social relationships: (a) strategies that involve changing the social behaviors of workers with disabilities, and (b) natural support strategies. The results from these strategies are discussed, and future areas of research are described. MRDD Research Reviews 7:128-133, 2001.

The findings suggest that person-centred planning can impact positively on some aspects of transition planning, while it may be too optimistic to expect radical improvement in other area. Key to further improvements is to complement person-centred planning with consistent involvement of all relevant stakeholders in planning for individuals.