Perceptions of a virtual reality sensory room for adults with neurodevelopmental disabilities.

PURPOSE: Mental ill health and sensory processing difficulties often limit participation in everyday life for adults with neurodevelopmental disabilities. Interventions using technology such as virtual reality (VR) are increasingly accessible and may mitigate these difficulties. Understanding what contributes to the successful implementation of novel interventions is important for future use and evaluation. This study aimed to explore the feasibility of implementing a VR sensory room for adults with neurodevelopmental disabilities, their carers and support staff and to explore future iterations of the product and process. MATERIALS AND METHODS: Thirteen stakeholders who participated in a pilot trial of a VR sensory room were interviewed. Interviews were recorded and transcribed verbatim for thematic analysis. RESULTS: Eleven themes were identified which indicated that adults with neurodevelopmental disabilities found the VR sensory room to be mostly acceptable and enjoyable with usage largely consistent. Individual variation and support requirements were highlighted for each user. Future use may require modifications to the headset, in-built customisation options as well as buy-in and training for support staff. CONCLUSIONS: The VR Sensory room is a promising tool to support adults with neurodevelopmental disabilities and results warrant further scaled research into the impact of this tool on outcomes for adults with disabilities.Implications for RehabilitationWhilst adults with neurodevelopmental disabilities may experience sensory processing difficulties which impact their everyday life, there is a paucity of interventions to address these difficulties.Implementation studies offer the opportunity to explore how evidence-based interventions may be implemented to facilitate the best outcomes.A Virtual Reality Sensory Room may offer an innovative alternative to a traditional sensory room for adults with neurodevelopmental disabilities where implementation is well supported.

Effectiveness of sensory adaptive dental environments to reduce psychophysiology responses of dental anxiety and support positive behaviours in children and young adults with intellectual and developmental disabilities: a systematic review and meta-analyses.

BACKGROUND: People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing difficulties, maladaptive behaviours and dental anxiety contribute to difficulties in receiving preventive and routine dental treatments. This study aimed to systematically review the evidence on the effectiveness of sensory adaptive dental environments (SADE) for children and young adults (up to the ages 24 years) with IDD to address cooperation and dental anxiety. METHODS: This review was reported according to The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE (Ovid), The Cochrane Library, Embase, Google Scholar, Web of Science and OT Seeker were searched using appropriate terms to identify Randomised Control Trails (RCTs) that matched inclusion criteria. Screening was conducted by two reviewers after de-duplication based on titles and abstracts followed by full text retrieval. Quality of the included studies was assessed using Cochrane Risk of Bias (ROB)-2 for crossover trials and data extracted by two reviewers. The details of the interventions and effectiveness were compared and discussed narratively, and comparable outcomes were included to meta-analyses using R software. RESULTS: A total of 622 articles were identified and five articles met eligibility for inclusion. Three studies used multi-sensory adaptations and one used single sensory adaptation of music. Narrative synthesis showed some evidence of SADE reducing magnitude and duration, although, questionable for reducing the number of maladaptive behaviours. Two studies demonstrated conflicting evidence of the effect of SADE on cooperation. Three studies demonstrated significant positive impact of SADE on psychophysiological outcomes. Despite an overall tendency to favour SADE, no statistically significant difference of maladaptive behaviours was found between SADE and regular dental environment (RDE) (Standardised mean change (SMC) = 0.51; 95% Confidence Interval (CI) -0.20 to 1.22; p = 0.161). SADE was superior to RDE (SMC -0.66; 95% CI -1.01 to -0.30; p = < 0.001) in reducing psychophysiological responses of dental anxiety. CONCLUSION: Current evidence suggests that adapting visual, tactile, and auditory aspects of the dental environment in a single or multi-sensory approach demonstrates small positive effects on psychophysiological responses and maladaptive behaviours of dental anxiety for people with IDD. TRIAL REGISTRATION: The title of this review was registered with PROSPERO (CRD42022322083).

School Experiences and Anxiety Trajectories Among Youth with Intellectual Disabilities.

This study investigated how the school experiences and personal characteristics of youth with Intellectual Disabilities (ID) contribute to their longitudinal trajectories of anxiety. To this end, we relied on a sample of 390 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged from 11 to 22 (M = 15.70), and recruited in Canada (n = 140) and Australia (n = 250). Across three yearly time points, all participants completed self-report measures of anxiety, school climate, and victimization. Our results revealed a slight normative decrease in anxiety over time and showed that experiences of school victimization were associated with higher levels of anxiety (initially and momentarily) and increases in victimization were accompanied by increases in anxiety over time. Perceptions of attending a school that fosters security and promotes learning also tended to be accompanied by lower levels of anxiety (initially and momentarily). Momentary increases in perceptions of attending a school that fosters positive peer interactions were associated with momentary decreases in anxiety, whereas momentary increases in perceptions of attending a school characterized by positive teacher-student relationships and an equitable treatment of all students both led to small momentary increases in anxiety once all other components of student school experiences were considered. The theoretical and practical implications of these results are discussed.

Evaluating a virtual reality sensory room for adults with disabilities.

Sensory processing difficulties can negatively impact wellbeing in adults with disabilities. A range of interventions to address sensory difficulties have been explored and virtual reality (VR) technology may offer a promising avenue for the provision of sensory interventions. In this study, preliminary evidence about the impact of Evenness, an immersive VR sensory room experience, for people with disabilities was investigated via a single intervention pre-post mixed methods design. Quantitative methodology included single intervention pre-post design (five month timeframe) with 31 adults with various developmental disabilities to determine the impact of use of aVR sensory room using a head mounted display (HMD) in relation to anxiety, depression, sensory processing, personal wellbeing and adaptive behaviour. Qualitative semi-structured interviews were also conducted with thirteen purposefully selected stakeholders following Evenness use. Results indicated significant improvements in anxiety, depression and sensory processing following Evenness use. Qualitative analysis corroborated the anxiety findings. No significant changes were observed in personal wellbeing or adaptive behaviour. Results are promising and indicate that a VR sensory room may have a positive impact on anxiety, depression and sensory processing for adults with disabilities. A longer study timeframe and a more rigorous experimental methodology is needed to confirm these findings.

Validation of an Adapted Version of the Glasgow Anxiety Scale for People with Intellectual Disabilities (GAS-ID).

The objective of the study was to validate adapted versions of the Glasgow Anxiety Scale for people with Intellectual Disabilities (GAS-ID) simultaneously developed in English and French. A sample of 361 youth with mild to moderate intellectual disability (ID) (M = 15.78 years) from Australia (English-speaking) and Canada (French-speaking) participated in this study. The results supported the factor validity and reliability, measurement invariance (between English and French versions), a lack of differential items functioning (as a function of youth's age and ID level, but not sex in the English-Australian sample), temporal stability (over one year interval), and convergent validity (with global self-esteem and school loneliness) of a bi-factor exploratory structural equation modeling representation of the GAS-ID. The present study supports the psychometric properties of the English-Australian and French-Canadian versions of the adapted GAS-ID.

Social Interaction Profiles Among Youth with Intellectual Disabilities: Associations with Indicators of Psychosocial Adjustment.

This study investigates the nature of the social interaction profiles observed among youth with intellectual disabilities (ID), defined while considering their relationships with their parents, peers, and teachers, as well as the implication of these profiles for self-esteem, aggressive behaviors, and prosocial behaviors. A sample of 393 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged between 11 and 22 (M = 15.70), was recruited in Canada (n = 141) and Australia (n = 253). Our results revealed four profiles, corresponding to Socially Isolated (23.24%), Socially Integrated (39.83%), Socially Rejected (28.37%) and Socially Connected (8.57%) youth with ID. The socially integrated and connected profiles both presented higher self-esteem, more prosocial behaviors, and less aggressive behaviors than the socially isolated and rejected profiles.

Longitudinal Associations Between Relationship Quality and Depression Among Youth with Intellectual Disabilities: A Latent Change Perspective.

This study investigates associations between initial levels and change in the quality of the relationships youth with intellectual disabilities (ID) share with their parents and teachers, and changes in their levels of depression over time. A sample of 395 youth with mild (48.3%) and moderate (51.7%) ID, aged between 11 and 22 (M = 15.69), were recruited in Canada (n = 142) and Australia (n = 253). Youth completed self-report measures of relationship quality and depression twice over a one-year period. Initial levels of warmth (ß = - .109) and conflict (ß = - .302) predicted decreases in depression. Increases in warmth predicted decreases in depression (ß = - .179), while increases in conflict predicted increases in depression (ß = .268). Discrepancies between youth relationships with their parents and teachers predicted decreases in depression (ßwarmth = - .732; ßconflict = - .608).

Validation of a Revised Version of the Center for Epidemiologic Depression Scale for Youth with Intellectual Disabilities (CESD-ID-R).

This study proposes a revision (R) of the Center for Epidemiologic Studies Depression Scale for youth with ID (CESD-ID) in English and French. 346 youth (36.02% girls) with mild (51.26%) and moderate (48.78%) ID (11-22 years; M = 15.69), enrolled in secondary schools in Canada (French-speaking; n = 115), and Australia (English-speaking; n = 231), as well as their parents and teachers, participated in this study. Results support the reliability, factor validity, equivalence (sex, ID level, comorbidities, and country), and convergent validity (with youth-, parent-, and teacher-rated measures of depression, anxiety, and loneliness/social isolation) of the CESD-ID-R. The CESD-ID-R allows youth with ID to provide a reliable and valid assessment of their depressive mood and happiness suitable for epidemiological studies.

Toward a Comprehensive Assessment of Relationships with Teachers and Parents for Youth with Intellectual Disabilities.

This study proposes a multi-informant (youth, teachers, and parents) measure of relationship quality with adults for youth with intellectual disabilities (ID). A sample of 395 youth with mild (49.15%) and moderate (50.85%) ID, aged 11-22 (M = 15.82) was recruited in Canada (French-speaking, N = 142), and Australia (English-speaking, N = 253). Results support the reliability, factor validity, discriminant validity (in relation to sex, ID level, country, and comorbidity), convergent validity (depression, anxiety, aggressiveness, and prosocial behaviors), and one-year longitudinal stability of the measure. Youth self-reports provide a complementary perspective on relationship quality with adults relative to teachers' or parents' reports, whereas teachers and parents seem unable to differentiate their own perspective from that of the target youth.

A psychometric validation of the motives for physical activity measure for youth with intellectual disabilities (MPAM-ID).

PURPOSE: To validate a version of the Motives for Physical Activity Measure (MPAM) adapted for youth with intellectual disabilities (ID). MATERIALS AND METHODS: A sample of 359 youth with mild to moderate ID from Australia and Canada respectively completed English and French versions of the MPAM-ID. RESULTS: Exploratory structural equation models supported the validity and reliability of the five-factor structure of the MPAM-ID, as well as the weak, latent variance-covariance, and latent mean invariance across linguistic versions. Additional results supported the partial strong and strict invariance of most MPAM-ID items across linguistic versions. The results also supported the complete measurement invariance of the MPAM-ID over time and revealed a lack of differential item functioning (DIF) as a function of youth's age, body-mass index (BMI), ID level, and frequency of sport involvement (FSI). However, partial DIF was found as a function of youth's sex. Additionally, latent mean differences in MPAM-ID's factors were found as a function of youth's ID level, sex, and FSI. Finally, results supported the convergent validity of the MPAM-ID factors with a measure of perceived physical abilities. CONCLUSION: The MPAM-ID can be used among English- and French-speaking youth with ID irrespective of their age, BMI, ID level, sex, and FSI.IMPLICATIONS FOR REHABILITATIONWe propose English and French adaptations of the Motives for Physical Activity Measure for Youth with Intellectual Disabilities (MPAM-ID).The MPAM-ID was able to identify the same motives as the original measure.The MPAM-ID will facilitate the assessment of motives for physical Activity in cross-sectional and longitudinal studies.The MPAM-ID will facilitate the assessment of motives for physical Activity among English- and French-speaking youth with ID.The MPAM-ID could be used to compare youth motives for physical Activity as a function of their age, body-mass index, ID level, and frequency of sport involvement.

Development and Validation of a Multi-informant Measure of Social Behaviors for Youth with Intellectual Disabilities.

Youth with intellectual disability (ID) are at an increased risk of displaying fewer prosocial behaviors and more numerous aggressive behaviors in various environments. This study proposes a new multi-informant (youth, teachers, and parents) measure of social behaviors for youth with ID. The sample includes 348 youth with mild (51.41%) and moderate (48.59%) levels of ID, aged 11-22 years old (M = 15.73, SD = 2.14; including 138 females), enrolled in secondary schools in Canada (French-speaking; N = 116; 33.33%) and Australia (English-speaking; N = 232; 66.67%). Measures were completed by the participants, their teachers, and their parents. Results support the reliability, factor validity, discriminant validity (in relation to sex, ID level, and country), concurrent validity (with measures of victimization, depression, hyperactivity-inattention), and one-year test-retest stability of the measure. Youth, teachers, and parents all provided a complementary perspective on youth social behaviors, consistent with youth adjusting their behaviors to the various environments in which they share social interactions.

A Systematic Review Protocol to Identify the Key Benefits and Associated Program Characteristics of Community Gardening for Vulnerable Populations.

Gardening has long been a popular pastime. There is a growing evidence base for the health and well-being benefits of gardening. Community gardening brings a social aspect to gardening, thereby increasing the potential benefits to include addressing social inclusion and poor community health through sharing of values, support of others, and building networks. This systematic review protocol aims to determine the characteristics of community gardening that could lead to beneficial outcomes such as connection with the community and development of new skills. Thirteen academic databases will be searched for studies looking at the benefits of community gardening, with a focus on vulnerable populations. Data will be extracted from all studies meeting the inclusion criteria and summarized to provide an overview of the current literature. This systematic review aims to provide a comprehensive investigation into community gardening, its benefits, and how they are achieved for the target population. By gathering and synthesizing this information, the review should allow policy makers and practitioners to work more effectively to address health and social inequities, by highlighting areas of need and enabling optimization of future interventions.

Mathematics Motivation in Students With Low Cognitive Ability: A Longitudinal Study of Motivation and Relations With Effort, Self-Regulation, and Grades.

Expectancy-value theory (EVT) is a popular framework to understand and improve students' motivation. Unfortunately, limited research has verified whether EVT predictions generalize to students with low levels of cognitive ability. This study relies on Grade 5 and 8 data from 177 students with low levels of cognitive ability and a matched sample of 177 students with average to high cognitive ability from the German "Project for the Analysis of Learning and Achievement in Mathematics." Results showed that students with low levels of cognitive ability were able to differentiate EVT components. Both groups demonstrated a similar downward developmental trend in motivation from early to middle adolescence, and similar relations between EVT components and levels of efforts, self-regulation, and mathematics class grades.

The moderating role of teacher-student relationships on the association between peer victimization and depression in students with intellectual disabilities.

BACKGROUND: Students with intellectual disabilities (ID) are at increased risk of peer victimization and depressive symptoms. Little is known about the protective and aggravating factors that influence the association between peer victimization and depressive symptoms among students with ID. AIMS: This study assesses the moderating role of two facets of teacher-student relationships (TSR)-warmth and conflict-on the association between peer victimization and depressive symptoms. METHODS: A sample of 395 students (aged 11-22) with mild and moderate ID was recruited in Canada and Australia. RESULTS: Hierarchical multiple regressions indicated that victimization and TSR conflict were both associated with higher levels of depressive symptoms, and that TSR conflict moderated the associations between both TSR warmth and victimization, and depressive symptoms. TSR warmth was related to lower levels of depression only for students who also reported a low level of TSR conflict. Similarly, associations between victimization and depression were weaker among students exposed to more conflictual TSR. CONCLUSIONS: Students with ID are at increased risk of developing depressive symptoms when exposed to negative social relationships (i.e., peer victimization or TSR conflict). For these students, the benefits of TSR warmth were far less important than the consequences of conflict.

A Systematic Review Protocol Investigating Community Gardening Impact Measures.

Existing community gardening research has tended to be exploratory and descriptive, utilising qualitative or mixed methodologies to explore and understand community garden participation. While research on community gardening attracts growing interest, the empirical rigour of measurement scales and embedded indicators has received comparatively less attention. Despite the extensive body of community gardening literature, a coherent narrative on valid, high quality approaches to the measurement of outcomes and impact across different cultural contexts is lacking and yet to be comprehensively examined. This is essential as cities are becoming hubs for cultural diversity. Systematic literature reviews that explore the multiple benefits of community gardening and other urban agriculture activities have been undertaken, however, a systematic review of the impact measures of community gardening is yet to be completed. This search protocol aims to address the following questions: (1) How are the health, wellbeing, social and environmental outcomes and impacts of community gardening measured? (2) What cultural diversity considerations have existing community garden measures taken into account? Demographic data will be collected along with clear domains/constructs of experiences, impacts and outcomes captured from previous literature to explore if evidence considers culturally heterogeneous and diverse populations. This will offer an understanding as to whether community gardening research is appropriately measuring this cross-cultural activity.

Do Exercise Interventions Improve Balance for Children and Adolescents With Down Syndrome? A Systematic Review.

BACKGROUND: Youths with Down syndrome are characterized by deficits in balance/postural stability. One way to palliate balance deficits among this population is through exercise interventions. However, to the authors' knowledge, the effects of exercise interventions designed to improve the balance of youths with Down syndrome have never been systematically reviewed. PURPOSE: The purpose of this review was to summarize the findings from studies examining the effects of exercise interventions designed to improve balance in youths with Down syndrome. DATA SOURCES: A systematic literature search was performed in 10 databases (Academic Search Complete, CINAHL Plus With Full-Text, Education Source, ERIC, Medline With Full-Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, Scopus, SocINDEX, and SPORTDiscus With Full-Text) on June 12, 2017. STUDY SELECTION: Randomized controlled trials and controlled trials examining the effects of exercise interventions designed to improve balance in youths with Down syndrome were included. DATA EXTRACTION: Two authors selected the studies and extracted their characteristics and results. Three authors assessed the risk of bias in the studies using the Cochrane Collaboration tool. DATA SYNTHESIS: Eleven studies, published between 2010 and 2017, met the inclusion criteria. The findings showed that exercise interventions were more effective than control conditions for improving the static balance of children with Down syndrome and the static-dynamic balance (ie, global balance score obtained with a scale measuring both static and dynamic balance) of children and adolescents with Down syndrome. Nevertheless, the findings on dynamic balance in children and static balance in adolescents were inconclusive. LIMITATIONS: With a small number of studies and their high risk of bias, the present findings must be interpreted with caution. CONCLUSIONS: The reviewed exercise interventions were successful in improving the static balance of children with Down syndrome and the static-dynamic balance of children and adolescents with Down syndrome.

Self-concept research with school-aged youth with intellectual disabilities: A systematic review.

BACKGROUND: Research on the self-concept of youth with intellectual disabilities has not been summarized in more than four decades. The present systematic review addresses this gap. METHOD: A systematic literature search was performed in nine databases and 21 studies, published between 1979 and 2017, met our inclusion criteria. RESULTS: Significant differences between the self-concepts of youth with intellectual disabilities and typically developing (TD) youth were found in: (a) cognitive-academic self-concept in disfavour of youth with intellectual disabilities; (b) global self-concept and cognitive-academic self-concept in disfavour of children with intellectual disabilities; and (c) global, behavioural, and cognitive-academic self-concept in disfavour of youth with intellectual disabilities schooled in a special class. Additionally, except for age, intellectual functioning and school placement, no significant relations were found between the self-concept dimensions and academic achievement and sex. CONCLUSION: Studies on self-concept research with school-aged youth with intellectual disabilities have several weaknesses that need to be advanced in future research.

Exercise interventions to improve balance for young people with intellectual disabilities: a systematic review and meta-analysis.

AIM: To conduct a systematic review and meta-analysis of the effects of exercise interventions designed to improve balance in young people with intellectual disabilities. METHOD: A systematic literature search was performed on 10 databases. Studies in press or published in English in a peer-reviewed journal were included if: (1) participants were young people with intellectual disabilities; (2) exercise interventions were designed to improve balance; and (3) they used quasi-experimental or experimental designs. Studies focusing only on a specific subpopulation of young people with intellectual disabilities or having a specific physical characteristic were excluded. Risk of bias was assessed for randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases. RESULTS: The search strategy identified 937 articles and 15 studies, published between 1991 and 2017, that met the inclusion criteria. Exercise intervention groups showed a significant and larger improvement in static (pooled effect size, Hedges' g=0.98) and dynamic (g=1.34) balance compared with the control groups. However, although the pooled improvement of static-dynamic balance was large (g=2.80), the result was non-significant. None of the subgroup analyses were significant, except for the improvement in: (1) static balance (higher in quasi-experimental than in experimental studies); and (2) dynamic balance (higher in young people with a mild vs a mild-moderate intellectual disability). INTERPRETATION: The reviewed exercise interventions seem to represent an effective means for improving the static and dynamic balance of young people with intellectual disabilities. However, the present findings should be considered as preliminary given the small number of studies and their limitations. WHAT THIS PAPER ADDS: Exercise intervention results in large and significant improvements in static and dynamic balance in young people with intellectual disabilities. Exercise intervention results in a large but non-significant improvement in static-dynamic balance. Static balance improvement was significantly higher in quasi-experimental versus experimental studies. Dynamic balance improvement was significantly higher in young people with mild versus mild-moderate intellectual disability. No significant differences related to age group, balance measures, and components of exercise intervention were found.

EJERCICIOS PARA MEJORAR EL EQUILIBRIO EN JÓVENES CON DISCAPACIDAD INTELECTUAL: UNA REVISIÓN SISTEMÁTICA Y UN METAANÁLISIS: OBJETIVO: Realizar una revisión sistemática y un metaanálisis sobre los efectos del ejercicio diseñado para mejorar el equilibrio en jóvenes con discapacidad intelectual. METODO: Se realizó una búsqueda sistemática en 10 bases de datos. Fueron incluidos estudios impresos o publicados en ingles en publicaciones revisadas por sus pares; que a su vez : (1) los participantes eran jóvenes con discapacidad intelectual, (2) las intervenciones a través del ejercicio fueron diseñados para mejorar el equilibrio, (3) fueron usados diseños experimentales o cuasi experimentales. Los estudios que se enfocaron únicamente a una subpoblación de jóvenes con discapacidad intelectual y los que tenían características físicas específicas fueros excluidos. El riesgo de sesgo fue evaluado para detectar randomización, ocultamiento de secuencia de alocación, estudios ciegos, datos de resultado incompletos, reporte de resultados seleccionados y otros sesgos RESULTADOS: La estrategia de búsqueda identificó 937 artículos y 15 estudios, publicados entre 1991 y 2017, que cumplieron los criterios de inclusión. El grupo con intervención de ejercicios mostró una mejora significativa en el balance estático (tamaño del efecto agrupado, g=0.98) y balance dinámico (g=1.34) comparado con el grupo control. Sin embargo, aunque la mejoría combinada del balance estático y dinámico fue grande (g=2.80), el resultado no es significativo. Ninguno de los subgrupos analizados fue significativo, excepto por la mejora en: (1) balance estático (mayor en los estudios cuasi-experimentales que en los experimentales) y (2) balance dinámico (mayor en gente joven con discapacidad intelectual leve que en gente con discapacidad intelectual leve -moderado). INTERPRETACION: La revisión de intervenciones con ejercicio parece representar un método eficaz para mejorar el equilibrio estático y dinámico en jóvenes con discapacidad intelectual. Sin embargo, los hallazgos deben ser considerados como preliminares por la pequeña cantidad de estudios y sus limitaciones.

INTERVENÇÕES COM EXERCÍCIOS PARA MELHORAR O EQUILÍBRIO PARA JOVENS COM DEFICIÊNCIA INTELECTUAL: UMA REVISÃO SISTEMÁTICA E METANÁLISE: OBJETIVO: Conduzir uma revisão sistemática e metanálise sobre os efeitos das intervenções com exercícios desenhadas para melhorar o equilíbrio em jovens com deficiência intelectual. MÉTODO Uma revisão sistemática da literature foi realizada em 10 bases de dados. Estudos in press ou publicados em inglês em revistas revisadas por pares foram incluídos se: 1) os participantes fossem jovens com deficiência intellectual; 2) intervenções com exercícios foram aplicadas visando melhorar o equilíbrio e 3) usaram desenhos experimentais ou quasi-experimentais. Estudos com enfoque em apenas uma sub-população específica de jovens com deficiência intelectual ou que tinham alguma característica física específica foram excluídos. O risco de viés foi avaliado para randomização, sequência de alocação selada, cegamento, resultados incompletes, relato seletivo de resultados, e outros vieses. RESULTADOS: A estratégia de busca identificou 937 artigos e 15 estudos, publicados entre 1991 e 2017, que atenderam aos critérios de inclusão Os grupos sob intervenção com exercícios mostraram significativa e maior melhora no equilíbrio estático (tamanho do efeito agrupado de Hedges g=0,98) and dinâmico (g=1,34) comparados com os grupos controle. Entretanto, embora a melhora agrupada no equilíbrio estático-dinâmico tenha sido grande (g=2,80), o resultado não foi significativo. Nenhuma das análises de subrupos foi significativa, exceto para a melhora em: (1) equilíbrio estático (maior nos estudos quasi-experimentais que nos experimentais) e (2) equilíbrio dinâmico (maior em jovens com deficiência intelectual leve versus leve-moderada). INTERPRETAÇÃO: As intervenções com exercícios revisadas parecem representar um meio efetivo de melhorar o equilíbrio estático e dinâmico de jovens com deficiência intelectual. No entanto, os achados presentes devem ser considerados preliminaries dado o pequeno número de estudos e suas limitações.

Combining Acceptance and Commitment Therapy With Adventure Therapy to Promote Psychological Wellbeing for Children At-Risk.

With high rates of psychological distress reported amongst children internationally, the development and evaluation of new program initiatives is critical in order to meet the challenge of this burgeoning issue. Both acceptance and commitment therapy and adventure therapy are emerging as popular strategies to elevate psychological wellbeing. This small-scale program evaluation focuses on nine upper primary school-aged children enrolled in a specialist school in Australia for children with challenging behavior and/or emotional needs. Participants completed a newly developed 8-week intervention entitled 'ACT in the Outdoors' which combined key principles of both acceptance and commitment therapy and adventure therapy. The program was evaluated via a combination of pre and post participant psychological measures, and post interviews with participants and teachers. The results of this small-scale preliminary evaluation suggest that a portion of the participating children reported improvements in psychological wellbeing and skill development. Improvements appear to be mitigated by attendance and level of psychological wellbeing upon program entry. Based on this premise, the results suggest that more research is warranted to further understand the potential benefit of this innovative interdisciplinary approach.

Prevalence of anxiety and depressive disorders among youth with intellectual disabilities: A systematic review and meta-analysis.

BACKGROUND: The purpose of this meta-analytic study was to determine the pooled prevalence estimates of anxiety and depressive disorders among children and adolescents with intellectual disabilities (ID) and to assess the extent to which these pooled prevalence rates differed according to studies' characteristics. METHOD: A systematic literature search was performed in nine databases and 21 studies, published between 1975 and 2015, met the inclusion criteria. RESULTS: The resulting pooled prevalence estimates of combined subtypes of anxiety and depressive disorders were respectively (a) 5.4% and 2.8% across samples; (b) 1.2% and 0.03% among children; and (c) 7.9% and 1.4% among adolescents. Pooled prevalence estimates for specific subtypes of anxiety disorders ranged from (a) 0.2% to 11.5% across samples; (b) 0.7% to 17.6% among children; and (c) 0.6% to 19.8% among adolescents. Pooled prevalence estimates of dysthymic disorder and major depressive disorder were respectively (a) 3.4% and 2.5% across samples; (b) 2.1% and 3.2% among children; and (c) 6.9% and 5.7% among adolescents. Finally, subgroup analyses showed significant variations in the pooled prevalence estimates of combined subtypes of anxiety disorders, obsessive-compulsive disorder, and generalized anxiety disorder; and combined subtypes of depressive disorders. LIMITATIONS: The present findings of this meta-analysis should be interpreted with caution given several limitations related to the characteristics of the populations, diagnostic method and sampling method. CONCLUSION: Findings provide recommendations for future studies investigating psychological disorders among youth with ID, as well as how clinicians and policy makers can improve diagnostic practices and support for youth with ID.