Training In Intellectual Disabilities Research Articles

Psychometric properties of the Beliefs About Adults with ID Scale in American physicians: Application of classical test and Rasch measurement theories.

Physicians' erroneous assumptions about individuals with intellectual disability (ID) negatively impact the quality of care provided to this population. This study aimed to investigate the psychometric properties of the Beliefs About Adults with ID (BAID), an instrument we developed for measuring physicians' erroneous assumptions about adults with ID. Two hundred ninety-two American physicians participated. Classical test theory and Rasch measurement theory were used to refine the scale (through item analysis, exploratory factor analysis, infit and outfit mean-squares statistics, and differential item functioning) and investigate its psychometric properties (functioning of the response scale, reliability, and validity). The BAID provided a unidimensional, reliable, valid, and precise measure in assessing high levels of erroneous assumptions. It showed convergent and divergent validity with the different factors of a scale measuring attitudes towards ID. The BAID items were discriminant, non-redundant, unambiguous, and invariant across gender and previous ID training. The BAID response scale was found to be appropriate for measuring physicians' erroneous assumptions about adults with ID. BAID is a brief instrument with good psychometric properties to assess erroneous assumptions about adults with ID in physicians of different genders and who have/have not previously received ID training. Therefore, it might be helpful for research and medical education purposes.

Cultural beliefs versus professional health training: implications for healthcare delivery to persons living with intellectual disabilities in Ghana

ABSTRACT Background In most African countries, disability is explained by cultural beliefs. This has implications for healthcare delivery for persons with intellectual disabilities. Methods With the aid of a qualitative approach, we explore the interplay between cultural beliefs and the training of health professionals and their implications for the healthcare delivery to persons living with intellectual disabilities in the Asokwa and Oforikrom Municipalities. Findings Findings revealed that cultural beliefs about intellectually disabled people include the idea that their facilities are forbidden and that pregnant women who pass by them may have a child with a disability. Further, health professionals received little intellectual disability training. As a result, healthcare professionals lack knowledge of the needs and care of this group. Conclusion This study recommends that professionals should take comprehensive intellectual disability courses in training schools. Also, health professionals should attend periodic workshops on the range of intellectual disabilities to raise awareness of their needs and care.

17.3 DISSEMINATING MENTORSHIP AND ADVANCED TRAINING OPPORTUNITIES TO EARLY CAREER CHILD AND ADOLESCENT PSYCHIATRISTS

Although autism spectrum disorder (ASD) and intellectual disability (ID) are common, few child and adolescent psychiatrists specialize in working with patients who have these diagnoses. A recent initiative from AACAP's Autism and Intellectual Disability Committee has been to foster awareness of, and interest in, advanced training opportunities to work with this unique population among trainees and those early in their careers. This session will describe how this initiative developed and some of the lessons we learned about when and where opportunities exist to develop interest in advanced ASD and ID training. The presentation will discuss several approaches taken by the Early Career Working Group of AACAP’s Autism and Intellectual Disability Committee to disseminate mentorship and advanced training opportunities to trainees and early career child and adolescent psychiatrists. Our working group identified 8 programs across the country that provide advanced training to child and adolescent psychiatrists interested in working with the ASD and ID population. We distributed a flyer advertising these programs to child and adolescent psychiatry fellows at AACAP’s 66th Annual Meeting in 2019 but had limited engagement. However, we unexpectedly found that medical students and general psychiatry residents were interested in learning more about these programs. In light of this, at AACAP's 67th Annual Meeting in 2020 (virtual meeting), we prioritized ensuring that AACAP’s Autism and Intellectual Disability Committee would have a presence at medical student and trainee mentorship events. In 2021, we aim to maintain that presence, as well as to take advantage of the new ubiquity of videoconferencing to offer face-to-face mentorship opportunities beyond the annual AACAP meeting. By the time they are child and adolescent psychiatry fellows, many trainees may already have career plans. Engaging with and mentoring people earlier may be more effective in encouraging an interest in ASD and ID among trainees.

Child maltreatment investigations and substantiations in child protection services: Factors distinguishing children with intellectual disabilities

BackgroundChildren with intellectual disabilities (ID) are more vulnerable to maltreatment than children without ID. Few studies focused on understanding the experiences of maltreatment of children with ID, limiting our capacity to adequately care for them. ObjectiveThis study examined the types of maltreatment with which ID is associated among child protection investigations, and identified the individual, environmental, and service-related factors distinguishing children with ID from those without, among children with substantiated maltreatment. MethodsSecondary data from an incidence study on investigated child maltreatment including 2053 children aged 6–17 years old were analyzed through univariate and multivariate logistic regressions. ID was present for 5.7% (n = 117) of the children. ResultsID was associated with increased odds of being investigated for neglect and decreased odds of being investigated or substantiated for psychological maltreatment. The factors that most distinguished children with ID from other children were physical disabilities (8.45, p < 0.001) and autism spectrum disorder (11.33, p < 0.001) in the child and having at least one parent with ID (16.21, p < 0.001). Two other environmental factors, including having been reported by a professional (2.13, p = 0.047), distinguished children with ID from the other children. ConclusionsChildren with ID who experienced maltreatment present with greater adversity than children without ID. Professionals play a preponderant role in reporting situations of maltreatment for children with ID and need additional training to properly respond to maltreatment of children with ID.

Are we training psychiatrists to develop skills in intellectual disability psychiatry? Current European context and future directions.

The majority of people with intellectual disabilities (ID) and psychiatric disorders access mainstream mental health services across Europe. However, only 56% of countries provide postgraduate psychiatric training in ID according to a survey across 42 European countries. We explore the challenges of ID training and make recommendations for education and health policymakers.

Clinical competencies and training needs of psychologists working with adults with intellectual disability and comorbid mental ill health

ObjectivesPsychologists play a pivotal role in meeting the mental health needs of people with intellectual disabilities. The aim of this study was to investigate the perceptions of Australian psychologists who work with adults with intellectual disabilities and mental ill health regarding their clinical competencies, workplace supports and training needs.MethodOne hundred and nine psychologists in Australia completed a self‐report online survey exploring clinical attitudes and practices when working with adults with intellectual disabilities and mental ill health. Provisional, generalist and clinical psychologists from a range of disability and non‐disability work settings were recruited.ResultsFindings revealed that provisional, generalist and clinical psychologists reported no significant differences in levels of agreement on self‐perceived clinical competencies in conducting mental health assessments. Psychologists in private practice and in non‐government organisations reported more adequate workplace resources to support mental health assessments for people with intellectual disabilities than did psychologists in government settings. Psychologists across work settings expressed similar views in self‐perceived clinical competencies and workplace training supports. The majority of psychologists reported limited formal academic training in intellectual disabilities and expressed a need for continual and specialised training in mental health and intellectual disabilities.ConclusionsImplications for further training in mental health and intellectual disabilities highlight the need to cater to the specific needs of psychologists in the field.

Benefits of extending and adjusting the level of difficulty on computerized cognitive training for children with intellectual disabilities.

Training on working memory (WM) improves attention and WM in children with attention-deficit hyperactivity disorder and memory impairments. However, for children with intellectual disabilities (ID), the results have been less encouraging. In this preliminary study it was hypothesized that children with ID would benefit from an extended amount of training and that the level of difficulty during training would affect the outcome. We included 21 children with mild or moderate ID aged 8–13 years. They went through between 37 and 50 training sessions with an adaptive computerized program on WM and non-verbal reasoning (NVR). The children were divided into two subgroups with different difficulty levels during training. The transfer to untrained cognitive tests was compared to the results of 22 children with ID training only 25 sessions, and to a control group. We found that the training group with the extended training program improved significantly on a block design task measuring NVR and on a WM task compared to the control group. There was also a significantly larger improvement on block design relative to the training group with the shorter training time. The children that received easier training tasks also improved significantly more on a verbal WM task compared to children with more demanding tasks. In conclusion, these preliminary data suggest that children with ID might benefit from cognitive training with longer training periods and less demanding tasks, compared to children without disabilities.

Undergraduate intellectual disability teaching – a medical student's experience

Purpose – The purpose of this paper is to describe a medical student's experience of undergraduate teaching in intellectual disabilities. Design/methodology/approach – This paper presents the reflections of a medical student on the undergraduate intellectual disability teaching. It describes experiences of a placement in this field, and how it may influence future practice. Findings – It is apparent that exposure to intellectual disability training in the undergraduate curriculum can be limited. Much of the work in this area highlights the negative consequences of this when it comes to medical care for individuals with intellectual disabilities. This paper proposes that positive changes may be achieved, by providing medical students with more training in this area. Originality/value – By reflecting on an individual experience through medical school, this paper highlights the positive impact that teaching on intellectual disability can have on medical students, suggesting its value in the undergraduate curriculum.

Training on intellectual disability in health sciences: the European perspective

Background: Intellectual disability (ID) has consequences at all stages of life, requires high service provision and leads to high health and societal costs. However, ID is largely disregarded as a health issue by national and international organisations, as are training in ID and in the health aspects of ID at every level of the education system.Specific aim: This paper aims to (1) update the current information about availability of training and education in ID and related health issues in Europe with a particular focus in mental health; and (2) to identify opportunities arising from the initial process of educational harmonization in Europe to include ID contents in health sciences curricula and professional training.Method: We carried out a systematic search of scientific databases and websites, as well as policy and research reports from the European Commission, European Council and WHO. Furthermore, we contacted key international organisations related to health education and/or ID in Europe, as well as other regional institutions.Results: ID modules and contents are minimal in the revised health sciences curricula and publications on ID training in Europe are equally scarce. European countries report few undergraduate and graduate training modules in ID, even in key specialties such as paediatrics. Within the health sector, ID programmes focus mainly on psychiatry and psychology.Conclusion: The poor availability of ID training in health sciences is a matter of concern. However, the current European policy on training provides an opportunity to promote ID in the curricula of programmes at all levels. This strategy should address all professionals working in ID and it should increase the focus on ID relative to other developmental disorders at all stages of life.

Health professionals' attitudes and emotions towards working with adults with intellectual disability (ID) and mental ill health

Mainstream mental health services are providing more care for individuals with an intellectual disability (ID); this has implications for staff and service users. Attitudes of staff towards people with ID in mental health services may be negative and negative staff attitudes may have a detrimental impact on service provision. A cross-sectional design was used. A questionnaire designed to investigate the attitudes and emotions of staff towards delivering mental health care to adults with ID was completed by 84 staff from mainstream and specialist ID services. Staff in both services experienced more positive emotions when working with clients whom they are currently employed to work with. When the frequency of contact with adults with ID, the number of individuals worked with and the amount of formal ID training received were considered, there was no significant difference between the attitudes of staff in both services. Positive correlations were found between attitude scores and positive emotional experiences in both services. The research suggests that numerous factors, including the role of emotional experience and a number of environmental aspects, need to be considered in the context of providing mental health services to adults with ID to ensure the highest quality. Research limitations and clinical implications of the study are also considered.

Psychiatric Resident Education in Intellectual Disabilities: One Program's Ten Years of Experience

The authors evaluated the confidence and willingness of resident graduates to treat individuals with intellectual disability (ID), following a residency rotation in developmental disability. Thirty-two graduates of a single residency program were surveyed regarding their post-residency experience with patients with intellectual disability. All graduates had completed a 3 month, half-time residency rotation in intellectual disability. The anonymous 12-question survey sought feedback about satisfaction with the rotation, confidence in serving persons with ID, and actual post-residency work with ID patients. Twenty-three of 32 (72%) of graduates returned surveys. On a 6-point scale (1=strongly disagree; 6=strongly agree), residents most strongly endorsed that the rotation had built their capacity in ID (5.78), confidence (5.48), and satisfaction (5.37). Lowest ratings were given to professional contact in ID initiated by the graduate (2.74), identifying expertise to the community (3.22), and post-residency practice with patients with ID (3.30). Differences between respondents who identified post-residency contact with persons with ID (N=8), and respondents who did not (N=15), did not reach statistical significance. Psychiatric graduates appear to value specialized education and experience in working with ID patients during residency, and feel more confident as a result. In spite of this, the majority of resident graduates did not identify ID training or expertise to their practice community, or choose to work with ID patients following residency.

Attitudes of senior psychiatry residents toward persons with intellectual disabilities.

This study examined the attitudes of senior residents in psychiatry toward persons with intellectual disabilities. Examining residents' attitudes will highlight areas of training that could be enhanced to better prepare psychiatrists to work with individuals with intellectual disabilities. A questionnaire was distributed to senior psychiatry residents at a Canada-wide preparatory session for the Royal College of Physicians and Surgeons of Canada. Included in the questionnaire was the Community Living Attitudes Scale Mental Retardation--Short Form (CLAS) as well as demographic items (for example, age, sex, and marital status) and questions about training in intellectual disabilities. Scores on the 4 CLAS subscales (Empowerment, Similarity, Exclusion, and Sheltering) are reported, and analyses of variance were performed to identify factors associated with each subscale score. The residents' scores are compared with those obtained in surveys of other groups. Fifty-eight senior residents from across Canada completed the questionnaire. The residents' scores favored Empowerment and Similarity over Exclusion and Sheltering. Men and women responded differently. Training in intellectual disabilities during residency only appeared to influence the Similarity subscale scores. Senior psychiatry residents hold attitudes toward persons with intellectual disabilities that are not entirely consistent with the community living philosophic paradigm. More research is needed to uncover how attitudes of psychiatrists develop, as well as how training can influence attitudes.