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--- - |2+ Abstract Background To enhance social inclusion of people with intellectual disability, policy is aimed at increasing informal support networks. Nevertheless, staff continue to play a vital role in their support networks. Method Six individuals with mild intellectual disability, living in community‐based settings, were interviewed following a semi‐structured format. In‐depth accounts of participants’ support experiences were established using Interpretative Phenomenological Analysis. Results Three main themes were identified: relationships with staff placed within a personal history, relationships with staff within an organisational context, and staff support and interviewees’ place in the world. Conclusions Relationships with staff were often one of the closest and most significant social relationships participants had. As living in the community had not necessarily led to meaningful inclusion for participants, the findings point at the important role of staff in supporting and facilitating friendships and close relationships of people with intellectual disability. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Self‐determination involves autonomy, agency, choice and control. This study investigated how these aspects of self‐determination relate to engaging people with intellectual disability and complex support needs in setting goals and making plans. Method Body mapping was used to understand the planning experiences of 30 adults with intellectual disability and complex support needs. Each participant created two body maps using a guided group‐based process. Visual and text data were thematically analysed and a framework for planning engagement developed. Results The framework identifies the centrality of having a well‐developed sense of self which includes insight, motivation and agency, and which is shaped by contextual barriers and facilitators and influenced by helpful and unhelpful support. Conclusions A well‐developed sense of self and ability to harness resources and people is fundamental to the ability of individuals with intellectual disability and complex support needs articulating goals, identifying aspirations, and attaining valued outcomes. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background There is limited knowledge about how young people with intellectual disability can be facilitated in their process of deciding about parenthood. This study aimed to evaluate the feasibility of an upcoming trial to evaluate an intervention using the Toolkit “Children—what does it involve?” and the “Real‐Care‐Baby” (RCB) simulator among students with intellectual disability. Methods Six students with intellectual disability participated in an intervention with eight educational sessions and a 3‐day caring session with the RCB simulator. Data were collected with questionnaires and interviews. Results The study showed that it is possible to evaluate an intervention using these instruments among students with intellectual disability in order to provide them with further insights about parenthood. Conclusion It is feasible to evaluate the Toolkit and the RCB in a cluster‐randomized study and that such a study could add to our knowledge about possible intervention strategies regarding reproduction and parenting among students with intellectual disability. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background To help people with intellectual disabilities lead a more independent life, it is important to promote their self‐management. This study evaluated the effectiveness of a self‐management training for people with intellectual disabilities directed at independent functioning in daily life. Method In the training, 17 people with intellectual disabilities worked on personal self‐management goals covering a wide range of everyday affairs. Primary outcome measures focused on goal attainment, independence and support needs. Moreover, outcomes regarding psychopathological behaviour and quality of life were explored. Data were collected before and at the start of the training, and 3, 6, 9 and 12 months later. Results The training contributed to the attainment of self‐management goals and to the reduction in support needs (p < 0.01). There were no changes in independence, psychopathological behaviour and quality of life. Conclusions Results indicate that the training supports people with intellectual disabilities to self‐manage their daily affairs. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background This study investigated the psychocultural perspectives concerning family quality of life among Brazilian families with children who have severe or profound intellectual disability. Methods Individual in‐depth semi‐structured interviews conducted with 15 mothers, selected by convenience, were analysed using a categorical thematic analysis technique. The themes were examined to allow for an interpretative approach of the results. Results Mothers revealed that their children with disabilities had insufficient access to services and support related to health care, transportation and recreation. Family quality of life was negatively affected by financial restrictions and social interaction difficulties. Caring for a child with disabilities seemed to be centred on the mother and religious coping appeared as a common psychological adjustment strategy. Conclusions Improving emotional and psychological cares, as well as social and practical measures comprising income support and access to appropriate health care, were inferred to be the mothers’ priorities to improve their families’ quality of life. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background There is increasing evidence that cognitive behavioural therapy (CBT) can be effective for people with intellectual disabilities. The aim of this review was to report the nature and frequency of adaptations reported in studies of CBT for people with intellectual disabilities. Method This review updated and extended a previous review by (Whitehouse et al. 2006, J Appl Res Intellect Disabil, 19, 55), which used a framework of adaptations developed by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). Adaptations included simplification, language, activities, developmental level, use of directive style, flexible methods, involve caregivers, transference/countertransference and disability/rehabilitation approaches. A search identified peer‐reviewed papers that reported individual CBT informed psychological interventions for people with an Intellectual Disability. Results The search identified 23 studies which met the inclusion criteria for review. Studies reported the majority of the categories of adaptation described by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). Conclusions The results suggest that the framework of adaptations needs further development to increase sensitivity in identifying and categorizing adaptations of CBT. Increased, systematic reporting of adaptations to studies of CBT with people with intellectual disabilities is recommended. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Little is known about the health needs of people with intellectual disabilities who access out‐of‐hours primary care services, raising concerns about accessibility and quality of care for this group. This study aims to identify commonly presented health problems of people with intellectual disabilities in this specific setting compared with the general population. Method Cross‐sectional study with routine data at two out‐of‐hours cooperatives with a total of 41,166 persons aged 20–65 requesting outof‐hours primary care in 2014, of which 315 persons were identified as having an intellectual disability. Results Having an intellectual disability was associated with a higher probability of presenting with epilepsy (OR 45.65) and concerns about, and adverse effects of, medical treatment (OR 23.37, and 8.41, respectively). Conclusions Given the high rates of epilepsy and medication‐related concerns of people with intellectual disabilities, this study suggests that these issues require special attention to improve the accessibility and quality of out‐of‐hours primary care. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2 The Children's Test of Nonword Repetition (CNRep) is one of the most popular tests of nonword repetition. The test is composed of nonwords of different length, and normative data suggest that children experience more difficulties in repeating long nonwords. An analysis of the distribution of phonological clusters in the test shows that noninitial clusters are unequally distributed in the test: They only appear in long nonwords (four and five syllables). For this reason, we hypothesized that the difficulties children encounter with long nonwords may be influenced by the phonological complexity of the clusters and not just by the challenge for working memory associated with length. To test the hypothesis, we compared repetition performance in long nonwords with and without a noninitial cluster in 18 children with language impairment and 18 typically developing children. The analysis shows that long nonwords with noninitial clusters are repeated less accurately by both groups. In addition, there was an interaction between cluster and age: The effect of cluster is absent in younger children and gradually increases with age. These findings suggest that phonological complexity may be having an impact on the length effect normally observed in the CNRep, and this impact may be particularly evident in older children. - Dyslexia, EarlyView.

--- - |2+ Abstract Background People with intellectual disability experience higher rates of mental health disorders than the rest of the population, and expert opinion holds that multiple barriers prevent people with intellectual disability from accessing appropriate services. Methods A qualitative study was designed to explore the lived experience of barriers and enablers to access to mental health services among people with intellectual disability. Interviews and focus groups were conducted with people with intellectual disability, carers and service providers. Results Barriers and enablers were identified across four key dimensions of access: utilization of services; service availability; relevance, effectiveness and access; and equity and access. These factors operated at both systemic and personal levels. Conclusions The findings from this study provide empirical evidence of anecdotal experiences of access to mental health services and provide insight into the ways users, carers and service providers navigate an often hostile system and indicate further directions for research. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Background Balance alterations are one of the main problems in people with intellectual disabilities (ID), increasing their risk of falls and impacting their life. Aims To describe a vestibular rehabilitation programme (VRP) and evaluate its effects on the ability to maintain balance and risk of suffering a fall. Methods Forty‐seven adults with mild to moderate ID were randomly assigned to two groups: a control group (CG, N = 24), which performed a general physical exercise only, and an experimental group (EG, N = 23) which also completed a VRP. The variables, used pre‐ and post‐training and 1 month after the intervention, were as follows: Center of Pressure Displacement, Berg Scale, Timed Up and Go Test, and the Modified Clinical Test of Sensory Interaction and Balance. Results The EG improved significantly in each variable. The CG did not show changes for any of the parameters. Conclusions A programme based on VRP may improve balance and reduce the risk of falling. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2 This study examines the effect of demographic variables on the beliefs of teachers of English as a foreign language (EFL) about their preparedness to include dyslexic learners in mainstream classrooms in Greece, Cyprus, and Poland and identifies their professional development needs. Statistically significant multivariate analysis effects were obtained for country, training, teaching experience with dyslexic learners, and school type. Unlike overall teaching experience and completed level of education (degree), the type of teaching experience with dyslexic EFL learners (direct contact and personal involvement in teaching) seems to shape the perception of teacher preparedness to successfully include these learners. Other interesting tendencies were identified such as between‐country differences concerning sources of prior professional knowledge on EFL and dyslexia as well as preferences for particular modes of training. The paper highlights the demand for professional training on EFL and dyslexia as this was confirmed across the three countries. - Dyslexia, EarlyView.

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--- - |2 The analysis of spatial relations among components of a character is important in identifying visual word forms. We investigated such spatial configuration processing for Chinese characters in dyslexic children (aged 9–12 years) and two groups of typically developing children, matched according to chronological age or reading level. In this study, we used real characters and noncharacters to manipulate the spatial configuration between character components while preserving their local features. Both characters were displayed either in an upright or inverted position. Participants were asked to quickly determine whether the two presented stimuli were identical. A significant interaction between character type and character orientation showed children's matching performance was better in upright real characters than in the inverted version, but such effect was absent in noncharacters. This indicated that regardless of reading skills, children developed the ability to use local configuration information to visually identify words. Dyslexic children performed poorly in both real‐character and noncharacter conditions. Furthermore, compared with control groups, dyslexic children performed worse in real‐character conditions, which were close to the noncharacter performance of other groups. This reflected an impairment of global visual word‐form processing (i.e., spatial configuration between components) in dyslexia. - Dyslexia, EarlyView.

--- - |2+ Abstract Background Results of discontinuation of antipsychotics in people with intellectual disability are variable and may depend on staff factors. Method We attempted to taper off antipsychotics in 14 weeks after which participants were free to restart. We investigated the influence of support professionals’ feelings towards challenging behaviour, their knowledge of psychotropic drugs and clinicians’ judgements of participants’ behavioural functioning on whether or not antipsychotics were completely discontinued after 16, 28 and 40 weeks. Results Of the 129 participants, 61% achieved discontinuation at 16 weeks; at 28 and 40 weeks, 46% and 40% were completely discontinued. Staff's feelings of Depression/Anger towards their client's behaviour, less knowledge about psychotropic medication and clinicians’ judgements of behavioural worsening were negatively associated with achievement of discontinuation. Conclusions To enhance discontinuation off‐label drug use, staff's feelings should be explored, their knowledge of psychotropic drugs improved and reasons for clinicians’ judgements of participants’ behavioural worsening investigated. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Clinicians recommend including carers or others in a supporting role in the therapy as an important adaptation of psychological therapies for people with intellectual disabilities. This nested qualitative study from a larger trial explored supporters’ experiences of supporting people with intellectual disabilities receiving behavioural activation or guided self‐help therapies for depression. Method Twenty‐one purposively sampled supporters were interviewed. The semi‐structured interviews were subject to framework analysis, covering expectations of therapy, views of therapy sessions, relationships with therapist and participant, and perceived changes. Results Supporters were positive about both therapies and reported both therapy‐specific and nonspecific therapeutic factors that had significant positive impacts on people's lives. Most supporters reported their involvement contributed to the interventions’ effectiveness, and helped establish closer relationships to the people they were supporting. Conclusions The presence of supporters within psychological therapies for people with intellectual disabilities can be an effective adaptation to therapies for this population. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2 The present study explored the direct and indirect contribution of semantic abilities to the levels of phonological and orthographic abilities in children with dyslexia. The semantic abilities of fifty‐five 9‐year‐old Dutch children diagnosed with dyslexia were associated with their phonological abilities (phonological awareness, rapid naming, and verbal working memory) and their word decoding and pseudoword decoding efficiency scores. It was found that children's semantic abilities predicted both word decoding efficiency and pseudoword decoding efficiency indirectly via phonological awareness and rapid naming. These results can be explained in terms of a lexical restructuring account of early reading development; strong semantic abilities provide children with dyslexia with a boost to strengthen their phonological skills and naming skills, which indirectly facilitate their reading development. - Dyslexia, EarlyView.

--- - |2+ Abstract Background School experience is an important part of the life of children with developmental disabilities (DD) and their families. Research suggests that parents of children vary in their level of satisfaction with their child's school, but methodology and results have varied and no consistent reliable measure of school satisfaction exists. This paper presents a new brief measure of school satisfaction along with preliminary information on its psychometric properties. Method Parents (n = 185) of children with moderate to severe DD completed a longer questionnaire that included the 9‐item GO4KIDDS School Satisfaction Scale. Results The GO4KIDDS School Satisfaction Scale demonstrates high internal consistency reliability (α = 0.93), good item‐total correlations, and strong correlations with a single‐item rating of school satisfaction. Conclusions Results support reliability and validity, making the proposed scale valuable for survey research investigating school satisfaction among parents of children with DD. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Due to incompatibilities in communication, it is key that family members and support staff can take the perspective of people with moderate to profound intellectual disabilities (ID) whilst putting aside their own perspectives. Method Ten vignettes describing types of restraint interventions (RIs) were presented to 20 unique pairs of support staff and family members related to individuals with moderate to profound ID. Results In taking their own perspective, more than half of the support staff and family members perceived all RIs as involuntary and severe. In contrast, when asked to put themselves in the position of the client/family member, only three RIs were considered involuntary by a majority of support staff and family members. Conclusions These results indicate that support staff and family members can take into account the perspective of people with moderate to profound ID in the evaluation and consideration of involuntary care. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Research exploring nonpharmacological interventions for individuals with intellectual disability and personality disorder was reviewed. This should prove valuable to services and professionals contemplating how to offer interventions for these individuals. Method A systematic search of electronic databases was conducted. Articles were considered for inclusion according to criteria based on the PICOS model. The quality of the research was assessed utilizing the evaluative method for determining evidence‐based practice. Results Eleven studies were reviewed with quality assessment indicating that all provided weak research evidence. Consistent flaws included insufficient description of participants and lack of control groups. Conclusions The research base exploring nonpharmacological interventions for individuals with intellectual disabilities and personality disorder includes many methodological flaws but reveals some useful information regarding the characteristics of these individuals and components of interventions to support them. Further research is needed to identify the differential effectiveness of interventions over and above other confounding factors. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background People with intellectual disabilities are a high risk population for developing osteoporosis and fragility fractures, yet they experience barriers to accessing dual‐energy x‐ray absorptiometry (DXA) bone mineral density (BMD) screening and fracture assessment. Reasonable adjustments are a statutory requirement in the UK, but there is a paucity of evidence‐based examples to assist their identification, implementation and evaluation. Method Thirty adults with intellectual disabilities underwent DXA BMD screening and fracture risk assessment. Reasonable adjustments were identified and implemented. Results The presence of osteopenia or osteoporosis was detected in 23 out of 29 (79%) participants. Osteoporosis professionals report that 17 of 18 reasonable adjustments identified and implemented are both important and easy to implement. Conclusion Adults across all levels of intellectual disabilities can complete DXA BMD screening with reasonable adjustments. Widely implementing these reasonable adjustments would contribute to reducing inequalities in health care for adults with intellectual disabilities. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Although attention deficit hyperactivity disorder (ADHD) is considered a valid diagnosis for children with intellectual disability, no studies have evaluated the invariance of ADHD symptom ratings across children with and without intellectual disability. Method Parents completed ratings on the ADHD symptoms for 189 children with intellectual disability and for 474 children without intellectual disability. Differential item functioning analysis was used to determine the equivalence of the ADHD symptoms across the two groups. Results The symptoms loses things, talks too much, and blurts out answers showed significant bias against children with intellectual disability. The prevalence of ADHD in children with intellectual disability was 18% (according to the symptom criterion), and 7.4% when the academic and/or social impairment criterion was also considered. Conclusions Most of the ADHD symptoms can be valid for the assessment of ADHD in children with mild and moderate intellectual disability. ADHD symptoms may be used in further studies to establish base rates of the disorder in the intellectual disability population. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background An important mechanism that provides support and services for families with a child/youth with autism spectrum disorder is the home‐ and community‐based services (HCBS) Waiver authorized by Section 1915(c) of the Social Security Act or Medicaid. Methods This study used qualitative research methods to explore parent perspectives about the impact of HCBS Waiver services on the child/youth with autism and their family. In‐depth interviews focused on aspects of the programme they valued, identification of barriers and general issues they experienced. Results Results of the qualitative study indicated that improved outcomes could be explained by providers of services who were well‐trained, flexible and allowed parents’ opportunities for choice regarding provision of services to meet child/youth and family needs. Conclusion The findings of this study provide guideposts for further research about factors that contribute to satisfaction of families receiving waiver services for quality of life and child progress. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Advances in international studies on self‐determination point out the need for continuous efforts to deepen its understanding and implications. The aim of this study is to obtain a comprehensive pool of items to operationalize the self‐determination construct that serves as a starting point towards a valid instrument based on the reports of others. Method We conducted a Delphi study of three rounds involving three panels of experts: ten professionals, five people with intellectual disability and six relatives of people with intellectual disability. Data analysis required both qualitative and quantitative methods. Results The initial pool of 131 items was refined through the different rounds to a final set composed of 115—some were removed and new ones were added. Content‐based evidence is provided. In this study, the present authors generated a potential valid pool of items to develop a new measurement tool based on the latest advances on the self‐determination theoretical framework. Conclusions The implications for future research focus on strengthening the knowledge of self‐determination. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Adaptive skills measures tend to be lengthy. The GO4KIDDS (Great Outcomes for Kids Impacted by Severe Developmental Disabilities; (Journal of Applied Research in Intellectual Disabilities, 58, 2015 and 594)) Brief Adaptive Behaviour Scale was developed to provide a brief assessment of adaptive skills. Our study aimed to examine the psychometric properties of G04KIDDS Brief Adaptive Scale in a large sample of children in special education. Methods Teachers reported on 361 students with severe to profound intellectual disability. The scale's factor structure was examined through principal components analysis (PCA), while its convergent validity was examined in relation to the Vineland (VABS‐II; Vineland‐II adaptive behavior scales, Circle Pines, MN, AGS and 2005). Results The PCA indicated a single component measuring overall adaptive skills, which had excellent internal consistency (alpha = 0.93), and convergent validity (Pearson's r = 0.81). Conclusions Teacher‐reported scores on GO4KIDDS Brief Behaviour Scale can provide a reliable and valid composite of adaptive skills in children with severe to profound intellectual disability. The scale will be useful to researchers and teachers who need a brief descriptive assessment of adaptive functioning. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Carer mental health literacy and help seeking are areas that are not well researched in the intellectual disability field. This study aimed to explore the above including service utilization experiences of Australian parents with an offspring with an intellectual disability and a comorbid psychiatric disorder. Method Forty‐one parents took part in an online survey assessing satisfaction and helpfulness ratings of received services. Twenty‐six parents also completed items to assess mental health literacy and attitudinal barriers to help seeking. Results Parents showed good mental health literacy with depression and with challenging behaviour associated with autism and poorer literacy with mixed presentations. Few attitudinal barriers to help seeking were reported. Parents reported varied helpfulness and satisfaction ratings with disability and mental health services. Conclusions Parents are capable of recognizing the need to seek professional help for their offspring. Implications for service coordination, provision and carer involvement are discussed. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Parents often face many barriers when taking care of their offspring with disabilities. In childhood, support needs vary with families of children with Down syndrome often reporting less caregiving challenges. However, it is unclear whether support needs vary in adulthood. This study compared parents of adults with Down syndrome (DS), autism spectrum disorder (ASD) and cerebral palsy (CP) regarding support needs of their offspring with intellectual and developmental disabilities (IDD) and their families. Method Data were collected via a national survey in the United States with 189 parents of adults with IDD. Results Across the quantitative and qualitative analyses, parents of adults with DS (versus CP and ASD) reported significantly greater recreational, natural supports, more formal services and less future planning barriers. Conclusion The results indicate that the DS advantage may persist in adulthood regarding support needs. More research is needed to understand different types of support needs. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2 An association between learning disorders and coordination problems has been reported in several studies over the last few decades. In this study, we have investigated daily motor characteristics in children with a diagnosis of specific learning disorder (SLD) and compared them with those of children with developmental coordination disorder (DCD) and those of typically developing controls. Ninety‐six children aged 5 to 12 years were included: 29 with a diagnosis of SLD, 33 of DCD, and 34 controls. The Italian version of the Developmental Coordination Disorder Questionnaire 2007 (DCDQ‐Italian) was used to measure children's coordination in everyday functional activities. The mean DCDQ‐Italian total score was significantly lower in both SLD and DCD groups as compared with controls. Regarding subscores, both clinical groups scored significantly lower than controls on “Fine motor/handwriting” skills and on “General coordination.” The DCD group scored also significantly lower than controls on “Control during movement.” Moreover, clinical groups differed from each other, with SLD children scoring significantly higher on “Control during movement” and “General coordination” subscores. SLD children diverged from typically developing children in some motor skills during ordinary activities, and although this discrepancy was not as severe as in DCD children, it could have an impact on self‐esteem and sport inclusion. - Dyslexia, EarlyView.

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--- - - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 5, Page 948-948, September 2018.

--- - |2 No abstract is available for this article. - Dyslexia, Volume 24, Issue 3, Page 205-206, August 2018.

--- - |2 We examined the double‐deficit hypothesis in Arabic by investigating the reading and cognitive profiles of readers with selective deficits in naming speed, phonological awareness, or both. In a nationally representative sample of 486 children in the third and fourth grades, we identified 171 children with reading difficulties: 20 (12%) were classified as having a phonological deficit, 31 (18%) as having a naming speed deficit, and 41 (24%) as having a double deficit. Differences between the subgroups extended to reading, cognitive, and linguistic processes beyond phonological and naming abilities. Children with a double deficit performed worse than those with a naming speed deficit but similar to those with a phonological deficit. Numerous unconfirmed theories led to an in‐depth analysis of the nature of rapid automatized naming and its relation to orthographic processing. Surprisingly, our findings revealed that orthographic processing may be considered a novel and separate core deficit, suggesting a triple deficit in Arabic rather than a double deficit. The findings are discussed in light of the uniqueness and complexity of Arabic orthography and orthographic transparency in the Arabic language. - Dyslexia, Volume 24, Issue 3, Page 234-249, August 2018.

--- - |2+ Abstract Background Research suggests that having relevant contextual information can help increase the accuracy of emotion recognition in typically developing (TD) individuals and adults with an intellectual disability. The impact of context on the emotion recognition of children with intellectual disability is unknown. Method Emotion recognition tasks, which varied in terms of contextual information, were completed by 102 children (45 with and 57 without intellectual disability). Results There was a significant effect of age and group, with older and TD children performing better on average. There were significant group by condition interactions, whereby children with intellectual disability were more accurate at identifying emotions depicted by line drawings compared with photos with contextual information that was not directly related to the emotion being depicted. The opposite was found for TD children. Conclusions These results have implications for socio‐emotional interventions, such as universal school programmes. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2 Given that an estimated 5–10% of the worldwide population is said to have dyslexia, it is of great importance that teachers have an accurate understanding of what dyslexia is and how it effects their students. Using results from a large‐scale survey of teachers in England and in Wales (N ≈ 2,600), this paper demonstrates that teachers held a basic understanding of dyslexia, based on the behavioural issues that it is associated with. Teachers lacked the knowledge of the biological (i.e., neurological) and cognitive (i.e., processing) aspects of dyslexia. Moreover, a number of teachers mentioned visual factors in their description of dyslexia, despite there being inconclusive evidence to suggest a direct relationship between visual functioning and dyslexia. Further findings demonstrate the importance of good‐quality teacher training in increasing teachers' confidence working with those with dyslexia, while increasing their knowledge of the cognitive aspects of dyslexia. This paper argues that evidence‐based teacher training, which informs teachers of the up‐to‐date research on the biological, cognitive, and behavioural aspects of dyslexia, is essential to combat misconceptions and ensure that teachers have more nuanced and informed understandings of dyslexia. - Dyslexia, Volume 24, Issue 3, Page 207-219, August 2018.

--- - |2+ Abstract Background People with intellectual developmental disorders have significant health disparities and a lack of proper attention to their health needs. They have been underrepresented in scientific research, and very few studies have been carried out using a representative randomized sample. The aim of this study was to describe the methods used in the POMONA‐ESP project to recruit a representative and randomized sample of participants with intellectual developmental disorders. Methods The POMONA‐ESP project is an observational cross‐sectional study. It aims to explore the health status of people with intellectual developmental disorders across Spain and the use they make of health services. Results and conclusions The results of the POMONA‐ESP project may have a major impact on people with intellectual developmental disorders and society in general. It is the first study to obtain geographically representative epidemiological data from a large sample, information that is fundamental to improving care and healthcare planning for people with intellectual developmental disorders. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Informal supportive networks of individuals with intellectual disability have become increasingly important. The aim of this paper is to describe how the Family Network Method – Intellectual Disability (FNM‐ID) offers a way to gather the perspective of people with mild intellectual disability on their family support. Method The FNM is designed to explore how individuals define their family contexts, and more specifically how they perceive existing supportive relationships in these contexts. Results By carefully piloting ways of questioning people with mild intellectual disability, systematic adaptations were made to the original FNM. Data obtained by the FNM‐ID can be analysed using social network analysis. Thereby, the FNM‐ID provides rich, theoretically significant information on emotional support in the family networks of individuals with mild intellectual disability. Conclusions The FNM‐ID is a useful and successfully adapted tool for other researchers and professionals to systematically explore the family support experiences of individuals with mild intellectual disability. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Participation is a central aspect of quality of life, and it is indicative of high‐quality outcomes for people with intellectual disabilities. However, participation is difficult to achieve for adults with profound intellectual and multiple disabilities. Aim To describe staff members’ perceptions of what participation means for adults with profound intellectual and multiple disabilities. Method Using a phenomenographic approach, 27 interviews were analysed resulting in variations in the conditions for participation. Results The interviews revealed conditions for participation at individual, staff and organisational levels. Conclusion Participation appears to be an un‐reflected phenomenon, and several conditions must be met to achieve it. The conditions are experienced being fundamental for adults within the target group to achieve any kind of participation. The staff members and managers’ perceptions of participation as conditional can make it more difficult for adults within the target group to achieve the Swedish disability policy goal of participation. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Regular participation of children and adolescents with intellectual disabilites in physical activity is important to maintain good health and to acquire motor skills. The aim of this study was to investigate the habitual physical activity in these children. Methods Sixty‐eight children and adolescents (2–18 years) with a moderate‐to‐severe intellectual disability were included in the analyses. They wore an accelerometer on eight consecutive days. Data was analysed by use of descriptive statistics and multiple linear regression analyses. Results The participants took on average 6,677 ± 2,600 steps per day, with intensity of 1,040 ± 431 counts per minute. In total, 47% of the participants were meeting physical activity recommendations. Low motor development was associated with low physical activity. Conclusions As more than half of the participants were not meeting the recommendations, family and caregivers of these children should focus on supporting and motivating them to explore and expand their physical activities. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background The use of traditional/alternative medicine for health care in Africa has been examined for various conditions. However, there is limited research about traditional/alternative health care for intellectual disability. The present authors explored the explanatory models (EMs) of intellectual disability held by traditional/faith healers in Ghana. Methods Using a case vignette, the present authors conducted semi‐structured interviews with 36 traditional/faith healers in Accra, Ghana. Using the EMs of illness framework as a guide, participants were asked questions to examine their beliefs about the nature, causes, course and recommended treatment of intellectual disability. Results The healers' causal explanations included maternal negligence during pregnancy and spiritual factors. They also believed that intellectual disability was a congenital, lifelong condition which could not be cured. Conclusions Unlike other conditions which traditional healers claimed to cure, participants admitted that intellectual disability was not curable. The present authors suggest that the findings highlight opportunities that exist for collaboration between biomedicine and traditional medicine. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Following the global financial crisis in 2007/08, the UK implemented an austerity programme which may impact on services. Scotland comprises both densely populated urban conurbations and highly dispersed remote rural and island communities. Method Expenditure data were extracted from Scottish Government statistics. Per capita expenditure was calculated using adjusted Scotland's 2011 census data. Results There was a 3.41% decrease in real term expenditure on adult intellectual disabilities services between 2012/13 and 2014/15 (>£32 million). In 2014/15, per capita expenditure on adult intellectual disabilities health care ranged from £1,211 to £17,595; social care from £21,147 to £83,831; and combined health and social care expenditures from £37,703 to £85,929. Per capita expenditure on combined health and social care was greater in rural areas, with more on intellectual disabilities social care, though less on health care. Conclusions Scottish expenditure on adult intellectual disabilities services has not kept abreast of rising living costs. It varies considerably across the country: a postcode lottery. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background The hallmark of attachment is that contact, proximity and relief from stress are sought from specific individuals, laying important groundwork for healthy socioemotional functioning. This study investigated the extent to which differentiated attachment behaviour can be observed in young children with significant developmental delay (DD). Method Video‐taped observations of the parent–child and stranger–child interaction were conducted at home and complemented with questionnaires in 20 families with a child with significant DD (age 2–7 years with an average DD of 49 months). Results Children displayed more intense and persistent contact‐seeking, contact‐maintaining and resistant behaviour in the episodes with their parent compared to the episodes with the stranger. Parent‐reported secure attachment behaviour was slightly more characteristic towards mother compared to father. Conclusions Even children with significant DD develop differentiated attachment behaviour. Detailed observations may support parents in identifying the interactions that make the attachment relationship with their child special. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Little is known about the attitudes and practices of key personnel towards the domestic violence experienced by women with intellectual disabilities. Method An online survey was conducted of Police officers and health and social care professionals. A total of 717 Police and other professionals across a wide variety of UK sites responded. Research questions were focussed on direct experience, attitudes and responses. Results Approximately half of all respondents had direct experience of working with a woman with intellectual disabilities who had been through domestic violence. Professionals were more likely than the Police to see women with intellectual disabilities as being especially vulnerable. The majority of both professionals and Police believed women with intellectual disabilities were deliberately targeted by violent and abusive men. Conclusions More training is needed for both the Police and health and social care professionals specifically in domestic violence as it affects women with intellectual disabilities. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2 Abstract The study assessed the pragmatic skills of 19 well‐compensated Italian‐speaking young adults with dyslexia compared with controls. A comprehensive pragmatic assessment tool was employed, targeting production and comprehension (Assessment of Pragmatic Abilities and Cognitive Substrates [APACS]). Participants were also administered a series of standardized tests to assess verbal and non‐verbal cognitive abilities, including executive functions and social cognition tests. Data were analysed with the aim of understanding whether pragmatic abilities are compromised in dyslexia and of exploring associations between pragmatic performance and other cognitive domains. The performance of the dyslexia group was poorer than that of the control group in both expressive and receptive modalities. Data showed diffuse problems across several domains, with the greatest challenge posed by inferring nonliteral meanings, which indicates that pragmatic inefficiency is an important aspect of the linguistic and communicative profile of dyslexia in adulthood. Explorative correlations highlighted a relation between pragmatic performance and reading and vocabulary abilities, as well as between pragmatics and working memory. This suggests that pragmatic difficulties are strongly tied to the most distinctive aspects of dyslexia, namely, phonological awareness, verbal short‐term memory, pseudo‐word repetition, whereas the link with high‐level executive functions and Theory of Mind is negligible. - Dyslexia, Volume 24, Issue 3, Page 294-306, August 2018.

--- - |2+ Abstract Background Earlier studies show that to gain more understanding of the concept of social inclusion, the views and experiences of people with intellectual disabilities are needed. The aim of this study was to investigate their perspective on neighbourhood social inclusion from an ecological point of view. Method We carried out a photovoice study with 18 people with intellectual disabilities in three neighbourhoods in the Netherlands. Participants took photographs in their neighbourhood they considered relevant, and these photographs were discussed during an interview. Results Six themes emerged from qualitative analysis: attractiveness of the neighbourhood, social contacts in the neighbourhood, activities in the neighbourhood, social roles in the neighbourhood, independence and public familiarity. Conclusions As regards neighbourhood social inclusion, participants were often focused on small and informal activities and situations. Public familiarity proved very important. Framing the concept of neighbourhood social inclusion within an ecological approach may help to better understand processes of social inclusion. - Journal of Applied Research in Intellectual Disabilities, EarlyView.

--- - |2+ Abstract Background Little is known about the lives of parents with intellectual disabilities from minority ethnic communities. Previous research suggests that what it means to live with intellectual disabilities varies across cultural contexts. The current research aimed to explore how cultural values and practices impact upon the experiences of parents with intellectual disabilities within the Bangladeshi community in London, England. Method Six members of the Bangladeshi community, four Bangladeshi parents with intellectual disabilities and four of their family members were interviewed. Thematic analysis was used to identify key themes. Results Both parenting and intellectual disability are thought about in this community in ways that make parenting more accessible for people with learning disabilities, but also create tensions to be negotiated. Conclusions Bangladeshi family carers face dilemmas balancing the benefits and risks of promoting parenting for sons and daughters with intellectual disabilities, particularly in the context of service principles of autonomy and informed consent. - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 6, Page 1133-1143, November 2018.

--- - |2+ Abstract Background Past research suggests children with Down syndrome often lack awareness of their disability despite the visibility of their condition. Method This study used novel tasks to investigate their insight. Twenty‐eight young people with Down syndrome (aged 8–17 years) were recruited, along with control groups of 67 typically developing young people. Three tasks explored the children's awareness of Down syndrome: (a) choice of partner for social activities, (b) sorting photographs and (c) attributing positive or negative descriptors to photographs. Results All participants expressed a preference to engage in social activities with typically developing peers. Most participants with Down syndrome identified with the typically developing person. Even though all participants attributed more positive descriptors to the photographs of the typically developing individuals, they remained positive about themselves. Conclusion The early awareness of difference shown by young people with Down syndrome suggests this may play an important role in their developing identities. - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 6, Page 1197-1208, November 2018.

--- - |2+ Abstract Background Timely identifying people with intellectual disabilities in need of palliative care is important. Therefore, we developed PALLI: a screening tool for deteriorating health, indicative of a limited life expectancy. Here, we aimed to describe development of PALLI and to explore its applicability. Method We used a five‐stage mixed‐methods procedure to develop PALLI based on knowledge from practice. For exploring applicability, professionals caring for people with intellectual disabilities completed PALLI for 185 people with intellectual disabilities and provided information on applicability after 5–6 months. Results The final version of PALLI included 39 questions relevant for people with intellectual disabilities. Applicability was adequate: Most professionals found PALLI relevant and reported no ambiguous questions. Added value of PALLI was reflecting on and becoming aware of the process of decline in health. Conclusions PALLI shows promising applicability and has potential as a tool for timely identifying people with intellectual disabilities who may benefit from palliative care. - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 6, Page 1122-1132, November 2018.

--- - |2+ Abstract Background In the general population, the transition from adolescence to adulthood has been identified as a “high‐risk” period for weight gain. There has been no research examining health behaviours over this transition in adults with intellectual disabilities. Methods/design The feasibility of recruitment, retention and relevant health behaviours were measured in 31 adolescents with mild‐moderate intellectual disabilities. Anthropometric, objective physical activity, dietary and self‐determination measures were collected over a 12‐month transitional period from school to adulthood. Results Key results suggest weight and BMI increased significantly from month 6 to month 12 (p = 0.044 and p = 0.043). Waist circumference increased significantly from baseline to month 12 (p = 0.049), and from month 6 to month 12 (p = 0.03). Discussion Recruiting and retaining young adults with intellectual disabilities over a 12‐month health behaviour study is feasible. The data indicate the transition from school to adulthood may be the start of a high‐risk period for weight gain. - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 6, Page 1154-1163, November 2018.

--- - |2+ Abstract Background Supporting an adult with autism spectrum disorder (ASD) can be associated with family stress but also with personal growth and resilience. Research providing insight into how typically developing siblings make sense of their unique sibling relationships in adulthood remains limited. Method Using interpretative phenomenological analysis, this study explored subjective experiences of eight siblings of adults with ASD and co‐occurring intellectual disability. Results Analysis of interview transcripts revealed a complex lived experience explained by the overarching theme “engaging with and navigating limbo”, which was characterized by commitment to the sibling relationship, power tensions in the family, uncertainty about the future and negotiating the tension between relational closeness and distance. Conclusion Using family systems theory, overregulation and closed communication emerged as processes relevant to families living with ASD. Clinical opportunities to support family communication, change tolerance and belonging are discussed. - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 6, Page 1144-1153, November 2018.

--- - |2+ Abstract Background The issue of violence in secure services has long been recognized both in the UK and worldwide. However, there is currently scarce literature available about violence within learning disability (LD) secure settings. Methods Secondary data analysis was conducted on violent incidents, using information routinely collected by the staff over a 1‐year period. Results Physical assaults were the most frequent type of incident, and the distribution in terms of days or months was homogenous and incidents were concentrated in the corridors, lounges and dining rooms of secure facilities. Antipsychotic medication was not regularly prescribed. Generalized linear modelling analyses revealed significant predictors that increased the chances of seclusion and physical restraint, such as being female or directing the violence towards staff. Conclusions These findings can inform staff training on violence prevention and suggest that increased ward‐based supervision and enhanced use of psychological formulations may help in reducing violence within this service context. - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 6, Page 1164-1173, November 2018.

--- - |2+ Abstract Background Transforming Care is making mixed progress in supporting people with intellectual and developmental disabilities, and complex needs, move to more appropriate specialist accommodations closer to home. Community support staff often spend greatest amounts of time with service‐users, yet are some of the least heard voices about why placements succeed and fail to varying extents. Method Managers and support staff (n = 13), working in ostensibly “specialist” community placements, were interviewed about perceived barriers and facilitators to implementing Transforming Care. Transcripts were subjected to thematic analysis. Results Participants identified difficulties balancing people's rights, safety and quality of life needs, and felt the system's expectations of them are hard to deliver within the resources, legislation, values and support models provided them. Multidisciplinary expertise was highly valued for both emotional and practical support, but was least valued when perceived as overly blaming or inspectorial. Specialist health input was seen to withdraw prematurely for this particular client group. Conclusion Recommendations are provided for how staff perspectives should inform Transforming Care in interests of service‐users. - Journal of Applied Research in Intellectual Disabilities, Volume 31, Issue 6, Page 1209-1218, November 2018.