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Objective: People with intellectual disabilities (ID) are at higher risk of being sexually abused and developing psychiatric disorders in consequence. The effects of behavior prevention programs for children with ID have rarely been investigated. Previous studies suffer from methodical weaknesses, such as the lack of a control group, small sample size, or invalid outcome measures. This study aimed at demonstrating the efficacy of a prevention program by overcoming these flaws. Methods: A group prevention program was developed and evaluated. One hundred and six girls aged from 8 to 12 years with mild ID were enrolled in a randomized controlled study, comparing the training to a sham intervention. Effects were examined in a three-time follow-up design as individual changes in preventive knowledge (board game, verbal reports) and preventive behavior (role-play, in situ tests). Participants' behaviors were videotaped and rated by three blinded raters. Results: Girls from the intervention group (n = 64) showed significant improvements in preventive knowledge compared with the control group (n = 39) but showed non-significant improvements for preventive behavior. In situ tests with realistic seduction situations revealed no improvement. The intervention proved to be safe, but several risks need to be considered. Discussion: This is the first study that evaluates a behavioral prevention program on sexual abuse for children with ID on a high level of evidence. Group interventions empowering girls with ID to recognize abuse situations are suitable to enhance sexual preventive knowledge but are less suitable to enhance preventive behavior. Naturalistic settings are indispensable for providing evidence for preventive interventions in children with ID.
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INTRODUCTION: Falls cause major expenses in the healthcare sector. We investigate the ability of supporting a fall risk assessment by introducing algorithms for automated assessments of standardized fall risk-related tests via wearable devices. METHODS: In a study, 13 participants conducted the standardized 6-Minutes Walk Test, the Timed-Up-and-Go Test, the 30-Second Sit-to-Stand Test, and the 4-Stage Balance Test repeatedly, producing 226 tests in total. Automatedalgorithms computed by wearable devices, as well as a visual analysis of the recorded data streams, were compared to the observational results conducted by physiotherapists. RESULTS: There was a high congruence between automated assessments and the ground truth for all four test types (ranging from 78.15% to 96.55%), with deviations ranging all well within one standard deviation of the ground truth. Fall risk (assessed by questionnaire) correlated with the individual tests. CONCLUSIONS: The automated fall risk assessment using wearable devices and algorithms matches the validity of the ground truth, thus providing a resourceful alternative to the effortful observational assessment, while minimizing the risk of human error. No single test can predict overall fall risk; instead, a much more complex model with additional input parameters (e.g., fall history, medication etc.) is needed.
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The term inclusion (=admittance, involvement) is used almost synonymously for the concept of the joint schooling of children with and without intellectual disabilities, language disabilities, physical handicaps, or mental disorders. This article addresses the current state of inclusion in Germany as well as the international situation, such as the Salamanca Declaration of the UNESCO, the «Individuals with Disabilities Act¼ (IDEA) in the United States as well as European developments, particularly in Great Britain, Austria, and Russia. Even though, from a political perspective, the decision in favor of inclusion seems irreversible, there appears to be a lack an agreement on the modality and timeframe. Thus, the average percentage of students with special education needs in Germany amounts to only 28.2%. The reasons behind this situation are presently being analyzed and discussed. A question of key importance concerns the benefit for the persons concerned, since that should be the measure of the success of inclusion. This question will most likely be validly answered only for individual subgroups of disabilities. This field still requires extensive research.
Assuntos
Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/reabilitação , Comparação Transcultural , Crianças com Deficiência/psicologia , Crianças com Deficiência/reabilitação , Deficiência Intelectual/psicologia , Deficiência Intelectual/reabilitação , Internacionalidade , Inclusão Escolar , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Participação Social , Adolescente , Criança , Educação Inclusiva , Humanos , Nações UnidasRESUMO
The paper reviews international research on sexual abuse prevention for individuals with mental retardation and programs implemented in Germany. Using Pubmed, PsycINFO, and various search engines, 263 studies and 128,080 search results for programs were retrieved, of which twelve international studies and six national programs met several inclusion criteria. Studies provided evidence for the effectiveness of prevention programs. Clinical significance, however, is restricted by methodological limitations. None of the programs found throughout Germany has yet been evaluated. Implications for future research in the field of sexual abuse prevention for children and adolescents with mental retardation are discussed.