The associations among executive planning, self-determination, and quality of life in adolescents with intellectual disability.

BACKGROUND: Skills such as planning and problem solving that are required in self-determination can be cognitively demanding. It has not yet been examined whether executive functions and intelligence are associated with levels of self-determination in individuals with intellectual disability (ID), and how that is related to quality of life (QoL). This study examined the associations among executive functions, intelligence, self-determination, and QoL in adolescents with ID. METHODS: Seventy-nine adolescents aged between 17 and 20 years with mild ID participated in the study. Executive functions were assessed by experimental tasks. Non-verbal IQ and survey data regarding QoL and self-determination capacity were collected from the participants. RESULTS: In a regression model with QoL as the dependent variable, only executive planning and self-determination capacity (but not working memory, inhibition and IQ) were significant predictors of QoL. Two mediation models were tested based on the hypotheses, literature and current findings. Model 1 revealed that executive planning had a negative direct effect on QoL when the mediator, self-determination capacity, was held constant. Model 2 indicated that the significant association between self-determination and QoL was not mediated by executive planning. CONCLUSIONS: The findings highlighted the crucial significance of self-determination, in comparison with executive functions and intelligence, for improving the QoL in adolescents with ID. Importantly, higher executive planning skill was even associated with lower QoL if self-determination was not concurrently strengthened. These findings carry implications for the design of education and intervention programmes aimed at improving QoL of adolescents with ID.

Psychometric properties of the AIR Self-Determination Scale: the Chinese version (AIR SDS-C) for Chinese people with intellectual disabilities.

BACKGROUND: The construct of self-determination has received considerable attention in the international field of intellectual disabilities (ID). Recently, there has been a rapid development of this construct in Chinese societies including Hong Kong. However, there is no locally validated instrument to measure self-determination in people with ID. This article explains the validation process of the AIR Self-Determination Scale - Chinese version (AIR SDS-C) adapted from the 24-item AIR Self-Determination Scale, developed by Wolman and his colleagues, which is used in school setting. METHODS: People with mild/moderate ID aged 15 years or above were recruited from special schools and social services units in different regions of Hong Kong. Factor analysis and reliability tests were conducted. RESULTS: Data for a total of 356 participants were used for the analysis. A confirmatory factor analysis was performed to test the factorial construct, and Mplus 7.0 was used for the analysis. The factor structure proposed in the original English version was supported by the data, and all factor loadings were between 0.42 and 0.76. The whole scale achieved good reliability (Cronbach's α = 0.88 and ω = 0.90). CONCLUSIONS: The AIR SDS-C appears to be a valid and reliable scale. This study examined adult groups as well as student groups. The application of the scale can thus be extended to a wider population. The implications for theory building and practice are discussed.

Initial validation of the Chinese Quality of Life Questionnaire-Intellectual Disabilities (CQOL-ID): a cultural perspective.

BACKGROUND: In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire - Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith. METHODS: People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity. RESULTS: A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40-item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self-determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P<0.000, P<0.01 and P<0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α=0.79). CONCLUSIONS: Initial validity tests indicated that the Chinese Quality of Life Questionnaire - Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made.

Enhancing staff attitudes, knowledge and skills in supporting the self-determination of adults with intellectual disability in residential settings in Hong Kong: a pretest-posttest comparison group design.

BACKGROUND: The ecological perspective recognizes the critical role that is played by rehabilitation personnel in helping people with intellectual disability (ID) to exercise self-determination, particularly in residential settings. In Hong Kong, the authors developed the first staff training programme of its kind to strengthen the competence of personnel in this area. The purpose of this study was to examine the effectiveness of staff training in enhancing residential staff's attitudes, knowledge and facilitation skills in assisting residents with ID to exercise self-determination. METHODS: A pretest-posttest comparison group design was adopted. Thirty-two participants in an experimental group attended a six-session staff training programme. A 34-item self-constructed scale was designed and used for measuring the effectiveness of the staff training. RESULTS: The results showed that the experimental group achieved statistically significant positive changes in all domains, whereas no significant changes were found in the comparison group. CONCLUSIONS: The findings provided initial evidence of the effectiveness of staff training that uses an interactional attitude-knowledge-skills model for Chinese rehabilitation personnel. The factors that contributed to its effectiveness were discussed and recommendations for future research were made.