Zoekresultaten

How architecture can improve the quality of life of individuals showing challenging behaviour

Challenging behaviour, such as aggression towards oneself, others, or objects, arises in interaction with the environment and may prevent individuals from participating in society and compromise their quality of life (QoL). Literature suggests that architects can contribute to prevention, by influencing challenging behaviour before rather than after its occurrence. By conducting a case study at a very-intensive-care facility, we explore how architecture can contribute to the QoL of intellectually impaired (and autistic) individuals showing challenging behaviour. The case study is based on interviews with residents and care providers, and direct observations of their daily life. Preliminary findings confirm the relevance of architecture in influencing challenging behaviour. They suggest that the residents are dependent on the (visual and auditory) connection with the care provider. Also, care providers confirm the importance of this connection for the quality of the care they provide. At the same time, residents may experience anxiety triggered by fellow residents and their challenging behaviour. Residents may also feel stress when faced with unexpected situations and this may lead to an onset of challenging behaviour. Sensory sensitivity, specifically to noise and heat is also relevant for their QoL.The findings will be further substantiated through multiple triangulation with available data (personal files, incident reports, photographs). Future research, specifically focused on intellectually impaired individuals showing challenging behaviour, is needed to better understand the similarities and differences between their needs and the needs of autistic people.

Dutch position statement children with listening difficulties

Inter)nationally there is discussion about whether auditory processing disorders (APD) should be seen as a unique clinical diagnosis and what is the most appropriate diagnosis and referral of children in this target group. In this context, the Dutch Audiological Centres (AC) have different care pathways for children with so-called unexplained listening difficulties. The purpose of the current document is to provide professionals with tools to identify, diagnose and treat children with listening difficulties. The Dutch Position Statement Children with Listening Difficulties has been developed based on current scientific evidence of listening difficulties, and based on meetings held with professionals. Professionals in the Dutch Audiological Centres have reached a consensus with the following 9 statements: Definition: (1) The target group 'Children with listening difficulties' is not a unique and demonstrable clinical entity. (2) The problems of children with listening difficulties are multimodal. (3) The symptoms of children with listening difficulties may also occur in children with other developmental disorders such as AD(H)D, DLD, dyslexia and learning disorders. Detection and referral: (4) After detection of listening difficulties, children can be referred to a multidisciplinary centre. Diagnostics: (5) When diagnosing a child with listening difficulties, an audiologist, a speech language therapist and a behavioral scientist must be involved. (6) Listening difficulties are initially mapped using patient history (with client-centred focus) and, if available, a validated questionnaire. (7) In the case of children with listening difficulties, a speech-in-noise test is always carried out in addition to the pure tone and speech audiometry (8) The diagnostic procedure for listening difficulties starts from a broad perspective on development. Therapy: (9) For children with listening difficulties, intervention is focused on the client’s needs and focuses on action-oriented practice. This document informs professionals in the Netherlands, who are working with children who are referred because of listening difficulties in the absence of hearing loss, about the current evidence available and about the consensus in the Netherlands.

Cluttering identified: differential diagnostics between cluttering, stuttering and speech impairment related to learning difficulties

parents' role in enabling the participation of their child with a physical disability

Parental involvement is a crucial force in children’s development, learning and success at school and in life [1]. Participation, defined by the World Health Organization as ‘a person’s involvement in life situations’ [2] for children means involvement in everyday activities, such as recreational, leisure, school and household activities [3]. Several authors use the term social participation emphasising the importance of engagement in social situations [4, 5]. Children’s participation in daily life is vital for healthy development, social and physical competencies, social-emotional well-being, sense of meaning and purpose in life [6]. Through participation in different social contexts, children gather the knowledge and skills needed to interact, play, work, and live with other people [4, 7, 8]. Unfortunately, research shows that children with a physical disability are at risk of lower participation in everyday activities [9]; they participate less frequently in almost all activities compared with children without physical disabilities [10, 11], have fewer friends and often feel socially isolated [12-14]. Parents, in particular, positively influence the participation of their children with a physical disability at school, at home and in the community [15]. They undertake many actions to improve their child’s participation in daily life [15, 16]. However, little information is available about what parents of children with a physical disability do to enable their child’s participation, what they come across and what kind of needs they have. The overall aim of this thesis was to investigate parents’ actions, challenges, and needs while enhancing the participation of their school-aged child with a physical disability. In order to achieve this aim, two steps have been made. In the first step, the literature has been examined to explore the topic of this thesis (actions, challenges and needs) and to clarify definitions for the concepts of participation and social participation. Second, for the purposes of giving breadth and depth of understanding of the topic of this thesis a mixed methods approach using three different empirical research methods [17-19], was applied to gather information from parents regarding their actions, challenges and needs.

Improving the quality of life with challenging behaviour through architecture

Background and aim – Challenging behaviour, such as aggression towards oneself, others, or objects, arises in interaction with the environment and may prevent individuals from participating in society and enjoying a high quality of life (QoL). Literature suggests that architects can contribute to prevention, by influencing challenging behaviour before rather than after its occurrence. The objective is to explore how architecture can contribute to the quality of life of intellectually impaired (and autistic) individuals showing challenging behaviour (CB). Methods – The case study is based on interviews with residents and care providers, and direct observations of their daily life. Results – Residents turn out to be dependent on the (visual) connection with the care provider and may experience stress from the behaviour of fellow residents. They also may experience stress when faced with unexpected situations and by sensory overload. Originality – The relevance of architecture for CB reduction is new to this particular field of healthcare. Practical or social implications – If these preliminary findings can be confirmed, they provide a basis for developing guidelines to design better environments for intellectually impaired individuals showing CB. Architecture might promote choice in interpersonal distance, by generous floorplans, a variety of spaces, and escape possibilities. Predictability might be enhanced by providing visual overview and previews into rooms. Finally, architecture that promotes sensory adjustment might improve the QoL of individuals showing CB by preventing sensory overload, and by doing so, mitigate related behaviours.Type of paper – Research paper.

Ready for handwriting? A reference data study on handwriting readiness assessments

IntroductionEarly evaluation of writing readiness is essential to predict and prevent handwriting difficulties and its negative influences on school occupations. An occupation-based measurement for kindergarten children has been previously developed: Writing Readiness Inventory Tool In Context (WRITIC). In addition, to assess fine motor coordination two tests are frequently used in children with handwriting difficulties: the modified Timed Test of In-Hand Manipulation (Timed TIHM) and the Nine-Hole Peg Test (9-HPT). However, no Dutch reference data are available.AimTo provide reference data for (1) WRITIC, (2) Timed-TIHM and (3) 9-HPT for handwriting readiness assessment in kindergarten children.MethodsThree hundred and seventy-four children from Dutch kindergartens in the age of 5 to 6.5 years (5.6±0.4 years, 190 boys/184 girls) participated in the study. Children were recruited at Dutch kindergartens. Full classes of the last year were tested, children were excluded if there was a medical diagnosis such as a visual, auditory, motor or intellectual impairment that hinder handwriting performance. Descriptive statistics and percentiles scores were calculated. The score of the WRITIC (possible score 0–48 points) and the performance time on the Timed-TIHM and 9-HPT are classified as percentile scores lower than the 15th percentile to distinguish low performance from adequate performance. The percentile scores can be used to identify children that are possibly at risk developing handwriting difficulties in first grade.ResultsWRITIC scores ranged from 23 to 48 (41±4.4), Timed-TIHM ranged from 17.9 to 64.5 seconds (31.4± 7.4 seconds) and 9-HPT ranged from 18.2 to 48.3 seconds (28.4± 5.4). A WRITIC score between 0–36, a performance time of more than 39.6 seconds on the Timed-TIHM and more than 33.8 seconds on the 9-HPT were classified as low performance.ConclusionThe reference data of the WRITIC allow to assess which children are possibly at risk developing handwriting difficulties.